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Palliative care is provided by patient's family at home
KUČEROVÁ, Tereza
The thesis, titled Palliative Care Provided by Patient's Family in Home Environment, discusses the specific care needs of a terminally ill patient in his/her own home. Caring for an ill person in a home environment is beginning to be a growing trend in home care, but also it is an increasingly common wish of the patients themselves. The family is therefore required to have enough theory and practical knowledge in order to deliver a highly demanding personal care for their close family members. The aim of the thesis is to summarize the current situation of delivering palliative care in home environment in Czech Republic whilst concentrating on the specific needs of the patient and the needs of their family. The objectives of the research were to determine whether family members were introduces to the specifics of palliative care of terminally ill patients; to map their skills in delivering palliative care in home environment and to reveal the most common issues that family members come across in that home environment. The final objective was to map out services in regions of Central Bohemia and Liberec that are accessible to family members whilst caring for a terminally ill patient. The research part of the thesis was completed employing a method of qualitative investigation using semi-structured interviews with patient's family members and nurses providing hospice care in home environment. It emerged from the analytical interviews that the family's knowledge level regarding support for palliative care in home environment is very limited and in hospitals families are only given minimal or no support or information. As a final document for the thesis an informative educational brochure was created based on the results of aforementioned research, primarily targeting patient's family; its core objective is to improve information and collate the specifics of care that would allow the patient a dignified end to their life.
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Gluten-free diet - reality in school facilities
JIRÁČKOVÁ, Marie
The topic of this bachelor thesis is gluten-free diet - reality in schools facilities. The goal of this work was to determine the number of school cafeterias in the Vysocina Region which provide gluten-free meals, to evaluate awareness of the canteen staff about preparation of the gluten-free diet and to describe the cooperation between the school cafeteria and family of the pupil with gluten-free diet. School meals are important to provide optimal intake of nutrition during the time the child spends in school, to establish proper eating habits and to better integrate the child into the group of its peers. Gluten-free diet is a necessary medical precaution especially for those with coeliac disease, in which case gluten can lead to villous atrophy, and for those with gluten allergy for whom gluten intake can cause anaphylactic shock. Adherence to the gluten-free diet is recommended also to those with non-coeliac gluten sensitivity diagnosis, although gluten causes only short-term complications, usually intestinal. The method of quantitative and qualitative research was used to make this thesis. The research sample consisted of 8 school cafeterias from the Vysocina Region which provide gluten-free meal to their pupils. Awareness about gluten-free diet principles of the managers of the cafeterias or of the cooks responsible for preparation of gluten-free meal was determined by means of semi-structured interviews. The calculation of the two-day menu of each cafeteria by means of the Nutriservis Profesional program was also part of this thesis. The results were compared with the recommended daily intake of energy, proteins, fat, and saccharides for pupils of elementary and secondary schools. The results of the quantitative research show that gluten-free diet is provided by only a small percentage of school cafeterias in the Vysocina Region. The qualitative research prove sufficient awareness of the cooks about gluten-free diet, with awareness of those cooks directly responsible for preparation of gluten free meals being at much higher level. It was also determined that the cooperation with parents of pupils with gluten-free diet is a usually one time occasion limited to an arrangement of nonperishable gluten free meal packages.
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Diets for food allergies
DOBRUSKÁ, Klára
I have chosen topic Diet with Food Allergy as a topic of my bachelor thesis. This illness is quite common these days. It affect infants mostly but allergy of cow´s milk protein of children under three years disappears itself mostly. There is increasing amount of causes when patient suffers more allergies. Number of people who have the most serious reaction the anaphylactic shock, icreeases. It can end with death. Doctors recommend to patients to strictly follow the elimination diet which is basic treatment of this illness. The most accurate diagnosis of illness (immunological or not) is another important factor for effective treatment. I have chosen three aims for this bachelor thesis. First to find out if patients are informed about their illness. Second to map eating habbits of people with food allergy. Third the evaluation of correctness of daily menus. I used approach of guality research. Research group consisted of six respondents with different food allergy. Those respondents wrote down their weeks menus. Menus were evaluated with program Nutriservis and it was assessed if it follows recommended dietary value. Suitable intake of energy and essential nutrients was calculated for every respondent. It was evaluated if respondents follows priciples of rational diet and if their diet contains sufficient amount of minerals and vitamins. Questionnaires were another key point of this research. Questionnaires were about illness know-how of patients and who has instructed them about it. It was found out the patients hasn´t got enough information about their illness and half of them has no idea which essential nutrients, minerals and vitamins could lack in their diet. It resulted from menus simultaneously that five of six respondents do not follow principles of rational diet and eat very monotonously. Only one respondent follows strictly elimination diet others violate diet exceptionally. Respondets would appreciate other research would focus on creation of special centres and training of doctors and nutritional therapist who would be focused on food allergies. Spreading the information about illness not only to patients but to public also is really important. Another important point is to increase amount of books about food allergies at the market.
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Poliomyelitis and contemporary issues of its eradication
PETRÁŇOVÁ, Monika
This diploma thesis deals with the issue of the eradication of infectious polio and its current problems. Polio is a highly infectious disease of viral origin. The most effective form of protection from the disease is vaccination. The main aim of this work was to determine the major issues in polio surveillance in the Pilsen region at present. Intermediate goals were determined in relation to the main aim: to ascertain the awareness of practicing paediatricians about the principles of poliomyelitis surveillance with an emphasis on diagnosing and reporting cases of acute palsy and further to ascertain the quality of the cooperation between the locally competent public health authority and practicing paediatricians in the field of poliomyelitis surveillance. The work is divided into two parts, theoretical and practical. The practical part was elaborated using a qualitative method based on semi-structured interviews with practicing paediatricians and with the locally competent public health authority. The research was participated in by 9 practicing paediatricians and one public health authority worker from the Pilsen region, with an average length of practice of 20 years. The resulting data was then evaluated by a coding method and divided into schemes according to Švaříček and Šeďová (2007). Three research questions were defined based on the set aims: RQ1: What do practising paediatricians see as the prime problems in polio surveillance? RQ2: How many cases of acute palsy do practising paediatricians record and subsequently report to the competent public health authority? RQ3: What is the quality of the cooperation between practising paediatricians and the locally competent public health authority? The research revealed that, according to the practising paediatricians, the problem in poliomyelitis surveillance is refusal of the vaccination and the associated decreasing immunisation coverage of the population. The next most commonly reported problem was population migration. Furthermore, it was found that not one practising paediatrician recorded or reported cases of acute palsy in their surgery. Only one respondent encountered acute palsy 10 years ago. The answer to the last research question is also apparent from the information obtained. More than half of the respondents agreed that so far there is no cooperation on this issue. Although four respondents stated that the cooperation is at a high level and is of very good quality.
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Stress situations and nursing personnel
MAREŠOVÁ, Lucie
This thesis deals with the stressful situations in the profession of the nursing staff. The occupation of the nurse belongs to the most demanding ones. In this occupation, the nurse is permanently affected by many stressors of different types. She faces death, the suffering, dying and incurably ill people very often. She is there in times of pain, agony and suffering. Personal encounters with these difficult situations require highly professional approach but most of all, they present immense work stress for the nurse. The theory section describes mainly the stressful situations that are the most common and most difficult in the work of the nursing staff. The next part of the theory section describes possible consequences of the stressful situations and methods of managing them including the support by the management. This thesis has two objectives. The first objective was to map the manners used by the nursing personnel to cope with the stressful situations brought by their profession. The second objective was to find out the difference in the coping with the stressful situations between the hospital staff and hospice staff. The research section of this thesis contains the quantitative research done using the technique of an anonymous questionnaire with 20 question prepared by ourselves. The questionnaire was distributed to the nursing staff of all categories in the hospital and hospice care. It was completed by 269 respondents in total. The data was statistically processed using systems Microsoft Excel 2010 and Software R, version 3.0.2 (Chi-squared test, Fisher´s exact test, and Wilcoxon test). We determined four hypotheses. H1: Manners of coping with the stressful situations depend on the qualification of the nursing staff reached; not confirmed. H2: Manners of coping with the stressful situations are influenced by the length of practice of the staff; not confirmed. H3: Manners of coping with the stressful situations differ between the hospital staff and hospice staff; confirmed. H4: The nursing staff views their own mental hygiene as more efficient than the support from the management concerning the coping with the stressful situations; confirmed. The research results show that the nursing staff faces the stressful situations very often. They see as the heaviest stress the care of the suffering and aggressive patient, conflicts with the patient´s family, conflicts at work and workload. The manners of coping with the work burden which proved as the best for them are relax, rest and sleep. There were no differences proved in the manners of coping with the stress among respective members of the nursing team. Nevertheless, the coping with the work burden of the nursing staff in the hospital and hospice care is different. A minimum of the respondents notices any support during the stressful situations from the employer. On the other hand, certain support by the management could be viewed in the form of trainings, supervision or contribution to a "recovery" which are granted to the respondents from the employer according to their answers. However, the respondents would prefer, as the support by the management, the increase in pay or more days off. The respondents view as insufficient the preparation of the graduates for the future stressful situations in their profession, as well. They would recommend mainly various trainings dealing with the stress and its management. A good solution to alleviate the work burden of the nursing staff and quality enhancement of the services provided could be investments into better work conditions, both in terms of sufficient human and material resources and the very organization of the work processes.
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Narcolepsy and other seizure disorders
TONDLOVÁ, Andrea
The thesis deals with the issue of seizure disorders from the perspective of special neurology. In terms of content, it is focuses on two major areas. The first part is theoretical in nature and has descriptions of the individual disorders, their clinical manifestations, diagnoses and current treatments. It is focused on the following seizure disorder group with regard to one of the objectives of the work: epilepsy, tetany, Meniere's syndrome, migraine and more specifically narcolepsy. These findings are supplemented with information on current knowledge regarding the treatment and diagnoses of these diseases, which make the lives of thus disables people very difficult and prevent them from leading their lives the way they could if they were in full health. The aim of the work is not just a theoretical description of the currently available knowledge of these diseases from literature, but also a practical confrontation thereof from experiences, which in this case result from the true stories of people suffering from seizure disorders. A specific seizure disorder has been selected for this second part of my thesis, which needs to be talked about more in order to become better known. It is a disorder that is interchangeable with regard to its symptoms, which are similar to other disorders, and it is difficult to diagnose or is only diagnosed after an inconveniently long time - i.e. Narcolepsy . The thesis therefore deals with the issue of narcolepsy in most detail, with regard to the practical focus in the next section, where in addition to aforementioned basic knowledge, the author describes the activities and the importance of sleep laboratories and centres as institutions involved in treatment. In order to penetrate into the issue of this disorder even more deeply, she adds the aforementioned anonymous stories of people affected in this way. This part is also complemented with illustrative images of the sleep laboratory and the stories of these people as a better visual complement of the thesis for the reader. A descriptive analysis (comparison) of each symptom was chosen as a comparative method of the aforementioned thesis objective (to compare the theoretically given symptoms of narcolepsy with the symptoms of individuals suffering from this disease), in which the goal was to choose the common symptoms these people which make their lives difficult and compare these data with information (symptoms of narcolepsy) found in contemporary literature. In conclusion, we visit the most important information from scientific literature, the views of the professional community on the current research and studies on narcolepsy, i.e. the specifically examined causal links of applying the Pandemrix vaccine (against swine flu) and narcolepsy and a summary of the results of other studies investigating the etiology of this disease. The aim of this section is to present the reader with, and identify, the current developments in narcolepsy research. An evaluation of the historical development of interest in sleep disorders and an evaluation of the conclusions drawn by comparing symptoms specified in professional literature on narcolepsy with actual symptoms of people suffering from this disease are also included. The aim is to provide the reader with a bio-psycho-social view of a person with this disease, which is not always emphatically discussed in every piece of professional literature. The result of the entire thesis is a summary of the current state of knowledge of these diseases and a reflection on the research of the current possible causes of narcolepsy. It continues to compare the theoretical background of the narcolepsy disorder with the experience of living with this disease, including stories of selectively chosen individuals suffering from narcolepsy.
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How to prevent the proliferation of Legionella pneumophylis in hot water in the hospital Czech Krumlov
TUREK, Jan
This diploma thesis deals with microbiological quality of hot water in a hospital in Cesky Krumlov as well as hot water piping condition with respect to Legionella. It also deals with arrangements for improving the quality of hot water in this hospital. The subject and target of this thesis are the findings of the mentioned parameters based on own observations, technical documentation and analysis of warm water performed by an accredited laboratory. The hospital in Cesky Krumlov, the construction of which began in 1909, was built in 1911 as the 'Nemocnice Císaře Františka Josefa I.' As the time went by, new buildings were built up. The hospital was renamed to 'Všeobecná veřejná nemocnice' in 1942. In the following years the hospital expanded until the current condition. Water quality and presence of Legionella is a world-wide issue, which we must fight against. The thesis is divided into two parts. First, theoretical part, which includes both general and specific knowledge about Legionella, its health risks, the environment in which it occurs, possibilities of eliminating, suitability of the material for hot water pipes, gained in professional literature and a part of the Czech legislation dealing with public health protection, the law 'No. 258/2004 Coll.' in actual version and quality of drinking water and hot water. In the second, empirical part, I focus on the situation of the hospital in Cesky Krumlov from 2009 till 2015, concerning newly built boiler room and the whole distribution system of hot water regarding Legionella. Particularly I focused on materials used for ecologisation of the gas boiler room and materials used for hot water pipes and actual state of water distribution in individual buildings of this health care facility. I mentioned the analysis of the water samples performed by an accredited laboratory with corresponding technical documentation, which concerns the water distribution system, provided by the medical facility. I used secondary data analysis to evaluate these documents. Regarding the results from 2009 to 2015 the microbiological quality of warm water doesn't meet the limits defined in the Attachment No. 3 of the above mentioned law Order 252/2004 Coll. Limit value for colony forming units of Legionella is set to maximum of 100 CFU. In most of the samples this limit was exceeded by series of units up to hundred thousands of units. The last results in 2015 prove improvement of the unfavorable situation. In that year the analysis was tested three times. First in February, where the CFU units were 'only' in hundreds, with the top value of 550 CFU in the Postacute Care ward. Second analysis was performed in June that same year. Results were acceptable. The highest value was 64 CFU. Last analysis in the hospital was performed in December. Increased concentration of Legionella was again in the Surgery building. There were established of 1400 colony forming units. There were 300 CFU in the Postacute Care ward and the limit value of 100 CFU was in the ward of Internal medicine. The answers to research questions 'How to prevent reproduction of Legionella peumophylis in the water distribution system of the hospital in Cesky Krumlov?' and 'How to ensure a sufficient amount of quality hot water in the medical facility?' are included at the end of the stated recommendations. A risk factor causing the fast reproduction of Legionella is the old water distribution system in most of the buildings and low water temperature of water leaving the boiler, which is 55°C. All mentioned results and evaluations are included in this thesis as well as attached pictures, which show the environment and situation within the Health Care Institutions.
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Strategie oplozování u ryb s vnějším oplozením
SIDDIQUE, Mohammad Abdul Momin
Morphological properties, species specific differences, development, and function of egg envelopes are of importance for a better understanding of fertilization strategies as well as for captive reproduction. We reviewed morphology and the developmental stages of egg envelopes, mechanism of polyspermy block, and also the role of micropyle and cortical granules in polyspermy block for acipenserid eggs. The structure of the egg envelope is similar among the acipenserids, comprising an external envelope (thecal cells, basal lamina, and follicular epithelium), a five-layered oocyte envelope (adhesive layer, alveolar layer, epilayer, and zona radiata externa and interna) and a layer of oocyte matrix and cortical granules. The development of acipenserid egg envelope within the ovary comprises five stages, with further changes following fertilization. Moreover, we standardized the terminology used to describe the egg membranes which can minimize the confusions and be helpful for future work on acipenserids eggs as well as for other fish species. The sperm to egg ratio (required to fertilize eggs) and effects of pre-incubation of eggs in freshwater before fertilization were studied to standardized fertilization protocols for sterlet Acipenser ruthenus. Pre-incubation time had no effect on fertilization success at 430,000:1 and 43,000:1 sperm to egg ratios, while it was significant at the 4300:1 and 430:1 ratios. The use of adequate experimental suboptimal sperm to egg ratio revealed a positive effect of pre-incubation time, such that at the 430:1 ratio, 0.5 min pre-incubation increased the fertilization rate than 10 min. Transmission electron microscopy showed that pre-incubation of eggs in water for <10 min did not trigger a cortical reaction, suggesting that a low sperm to egg ratio 0.5 to 1 min pre-incubation of eggs in freshwater prior to fertilization can enhance fertilization rate of sterlet (minimally do not change fertilization). The effects of pre-incubation in seawater and the duration of egg receptivity were determined for fresh and over-ripe sea bass eggs. Our results revealed a significant effect of pre-incubation time for both the fresh (P < 0.01) and over-ripe eggs (P < 0.01). The fresh eggs had a higher fertilization success than over-ripe eggs. Fertilization success of eggs significantly declined for both of these treatments after 3 min of pre-incubation clearly indicated that sea bass eggs are able to be fertilized by sperm for up to 3 min after release into seawater. Effects of pre-incubation of eggs and activation medium on the percentage of eyed embryos for Ide Leuciscus idus were examined. At the eyed-egg stage, pre-incubation time was significant for the freshwater activation medium (P < 0.001), such that the percentage of eyed embryos declined across the pre-incubation time gradient. Activating medium had a significant effect on the percentage of eyed embryos for each pre-incubation time (P < 0.05). More precisely, freshwater produced the lowest percentage of eyed embryos at all pre-incubation times, whereas saline water and Woynarovich solution produced the highest percentage of eyed embryos at 0 s and 30 s before incubation. Examination of sperm traits showed no impact of activating medium on computer assisted sperm analysis parameters. Our results suggested that saline water or Woynarovich solution improve fertilization rate in Ide during fertilization. In conclusion, this thesis provides basic knowledge on gamete biology, role of egg receptivity period, effects of pre-incubation of eggs and different activating medium which can be useful to understand the fertilization strategies of different externally fertilizing fishes as well as standardize their fertilization protocol for captive reproduction.
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Vliv teploty vody a intenzity světla na raný vývoj sumečka afrického v komerčním chovu
PROKEŠOVÁ, Markéta
The successful production of quality early fish stages is crucial for artificial rearing fish species. Nevertheless, it is quite a problematic process, because fish as poikilothermic organisms are highly sensitive to various environmental conditions. Moreover, both fish embryos and larvae are more affected by biotic and abiotic factors (such as predation, stocking density, temperature, light, pH, salinity, oxygen saturation, feeding availability, or their interactions) than older juveniles or adults. Most fish processes such as reproduction, metabolism, survival, development and growth can be considerably (positively, negatively or not) influenced by these conditions. Therefore, it is important to understand their impacts on fish stages during embryonic, larval, juvenile, adult, and eventually the senescent period. Then, following the application of new knowledge to the practise, especially species- and age-specific optimal conditions, should result in higher survival, better growth rate, well developed fish without deformities and lower cannibalism. The objectives of the present thesis were to assess the effect of water temperature and light intensity on the early development (embryonic and larval period) of African sharptooth catfish as a perspective fish species for freshwater intensive aquaculture. Due to its great characteristics (for instance fast growth, ability to breathe atmospheric air, rearing at high stocking density) this species can meaningfully contribute to the global aquaculture production which is expected to rise in the coming years. However, there are still some difficulties in the early rearing African sharptooth catfish regarding the cannibalism, feeding, survival and necessity of detailed information about the effects of some abiotic factors and their interactions.
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Supplier management in automotive industry
Holubcová, Romana ; Štůsek, Jaromír (advisor)
In my thesis I deal with the process of Supplier management in automotive industry. Supplier - customer relationship is very important for a success both company and for the global development of the economy too. These relationships must be partnership and support the development of the companies and their each other businesses are beneficial for both sides. In my thesis I analyze current process of the supplier management in the company, what directly supply to OEM. Original Equipment manufacturing (OEM), is the final producer of automobiles, it is mean this company do not produce components but assemble supplied modules. I propose improvements and up-date the directive Strategic purchasing according to results from the analysis.
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