869 resultados para military nurse


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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.

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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.

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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.

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The competence of graduating nursing students is an important issue in health care as it is related to professional standards, patient safety and the quality of nursing care. Many changes in health care lead to increased demand with respect to nurses’ competence as well the number of nurses. The purpose of this empirical study was to i) describe the nurse competence areas of nursing students in Europe, ii) evaluate the nurse competence of graduating nursing students, iii) identify factors related to the nurse competence, and to iv) assess the congruence between graduating nursing students’ self-assessments and their mentors’ assessments of students’ nurse competence. The study was carried out in two phases: descriptive phase and evaluation phase. The descriptive phase focused on describing the nurse competence areas of nursing students in Europe with the help of a literature review (n=10 empirical studies and n=4 additional documents). Thematic analysis was used as the analysis method. In the evaluation phase, the nurse competence with particular focus on nursing skills of graduating nursing students (n=154) was assessed. In addition, factors related to the nurse competence were examined. Also, the congruence between graduating nursing students’ self-assessments and their mentors’ assessments of students’ nurse competence was evaluated by comparing graduating nursing students’ self-assessments with the assessments by their mentors (n=42) in the final clinical placement in four university hospitals. Descriptive statistics and inferential statistics were used to analyse the data. Based on the results, the nurse competence of nursing students in Europe consists of nine main competence areas: (1) professional/ethical values and practice, (2) nursing skills and interventions, (3) communication and interpersonal skills, (4) knowledge and cognitive ability, (5) assessment and improving quality in nursing, (6) professional development, (7) leadership, management and teamwork, (8) teaching and supervision, and (9) research utilization. Graduating nursing students self-assessed their nurse competence as good. However, when graduating nursing students’ nurse competence was assessed by their mentors, the results were poorer. Readiness for practice based on nurse education, pedagogical atmosphere on the ward, supervisory relationship between student and mentor and being in paid work in health care at the moment of the study were the most significant factors related to the nurse competence. Conclusions: Nurse competence can be evaluated with a scale based on self-assessment, but other evaluation methods could be used alongside to ensure that nurse competence can be completed and evaluated critically. Practical implications are presented for nurse education and nursing practice. In future, longitudinal research is needed in order to understand the development of nurse competence during nurse education and the transition process from a nursing student to a professional nurse.

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This thesis in caring science didactics is based on a thinking, where the fundamental basis for the didactic is science-based, i.e. it does not emanate from the nursing profession but brings forward a didactic that grows out of caring science and its core substance and ethos. This view on didactics arises from the caritative theory developed by Eriksson. The overall aim of the study is to clarify the meaning and essence of understanding, as well as to explore and deepen the understanding of student nurses' processes of understanding and becoming with the intention of developing a theory model for caring didactics. The overarching research questions are: What is the essence of understanding (of caring science knowledge)? What are the possibilities and importance of understanding in the appropriation of caring science? What characterizes and impels the process of becoming? The thesis consists of four sub studies and a summary section. The overall methodological approach is hermeneutic involving quantitative as well as qualitative methods. The data for the study has been collected through a longitudinal research project that followed student nurses at three universities during their entire education. The empirical sub studies form the basis for the interpreted knowledge that is formulated in the new understanding. This new understanding have, through additional theory-charging with the theory fragments from Gadamer, generated the heuristic synthesis which is illustrated in the theory model. The findings shows that understanding can be described as something unlimited, as an endless movement, which can be illustrated as a lying eighth, a lemniscate. The lemiscate of understanding is characterized by seeing, knowing and becoming and consists of seven differently named phases; the acquired horizon of understanding, the encounter of horizons, the dialogue of horizons, the fusion of horizons, application, reflection and shaping a new horizon of understanding. Bildung (formation), is the ultimate imprint of the endless spiral movement of understanding. Ethos and arête constitute the hubs around which the lemniscate of understanding circles. These include the spirit and driving force that the student carries within. The caring culture encloses the lemniscate of understanding. The caring culture provides the life space of understanding and the prevailing basic values are evinced in the culture.

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The objective of the present study was to determine the impact of acute short-term exposure to air pollution on the cardiorespiratory performance of military fireman living and working in the city of Guarujá, São Paulo, Brazil. Twenty-five healthy non-smoking firemen aged 24 to 45 years had about 1 h of exposure to low and high levels of air pollution. The tests consisted of two phases: phase A, in Bertioga, a town with low levels of air pollution, and phase B, in Cubatão, a polluted town, with a 7-day interval between phases. The volunteers remained in the cities (Bertioga/Cubatão) only for the time required to perform the tests. Cumulative load 10 ± 2 min-long exertion tests were performed on a treadmill, consisting of a 2-min stage at a load of 7 km/h, followed by increasing exertion of 1 km h-1 min-1 until the maximum individual limit. There were statistically significant differences (P < 0.05) in anaerobic threshold (AT) between Cubatão (35.04 ± 4.91 mL kg-1 min-1) and Bertioga (36.98 ± 5.62 mL kg-1 min-1; P = 0.01), in the heart rate at AT (AT HR; Cubatão 152.08 ± 14.86 bpm, Bertioga 157.44 ± 13.64 bpm; P = 0.001), and in percent maximal oxygen consumption at AT (AT%VO2max; Cubatão 64.56 ± 6.55%, Bertioga 67.40 ± 5.35%; P = 0.03). However, there were no differences in VO2max, maximal heart rate or velocity at AT (ATvel) observed in firemen between towns. The acute exposure to pollutants in Cubatão, SP, caused a significant reduction in the performance at submaximal levels of physical exertion.

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Serologic data on diseases that are preventable by vaccines are necessary to evaluate the success of immunization programs and to identify susceptible subgroups. In the present study, we determined serum IgG levels against diphtheria toxin of military and civilian blood donors (N = 75; 69.3% males and 30.7% females) aged 18-64 years, from the Brazilian Army Biology Institute, Rio de Janeiro, using a commercial diphtheria kit (Diphtheria IgG ELISA; IBL, Germany). Most (63%) unprotected military donors were from the older age group of 41 to 64 years. In contrast, the majority (71%) of young military donors (18 to 30 years) were fully protected. About half of the military donors aged 31 to 40 years were protected against diphtheria. Among the civilians, about 50% of persons aged 18 to 30 years and 31 to 40 years had protective antibody levels against diphtheria as also did 64% of individuals aged 41 to 64 years. All civilians had a similar antibody response (geometric mean = 0.55 IU/mL) independent of age group. Military donors aged 18-30 years had higher IgG levels (geometric mean = 0.82 IU/mL) than military donors of 41-64 years (geometric mean = 0.51 IU/mL; P > 0.05). In conclusion, the existence of a considerable proportion of susceptible adults supports the position that reliable data on the immune status of the population should be maintained routinely and emphasizes the importance of adequate immunization during adulthood.

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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.