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Work in social integration process of adults with intellectual disability.
SVITÁKOVÁ, Iveta
In my bachelor thesis, I dealt with the use of work activities in the process of social integration of adults with mental disabilities, the aim was to create, implement and evaluate regular work activities intended to a specific group of adults with mental disability and focused primarily on the development of social integration. The thesis is structured into six chapters. The first of them is focused on the definition of mental disability, characteristic of adulthood as an important developmental period in human life, and on adulthood of individuals with mental disabilities with a goal to find and identify the specifics that were needed to be taken into account when working with this target group of people. The following section is devoted to the social integration, its determinants and the environment in which it operates. I continued with the outputs in the third chapter, where I focused on key competencies, which them are the necessary basis for social integration, especially social and personal skills and communication skills, necessary basis. Targeted professional development can be realized through educational activities, but has to respect the specificities of the participants and voluntary participation. Both of these assumptions can be fulfilled within the leisure education using adequate pedagogical methods. For this reason, I decided to focus my attention on these areas at the end of the chapter. The fourth chapter is devoted to work and work activities, namely the definition of concepts, their characteristics and importance and role of work activities in human life, or a person with mental disability. Based on all acquired theoretical knowledge and using previous experience with the target group in the fifth chapter, I designed a specific training program based on the work and activities focused on the development of selected key competences. The educational program volunteered four participants, but I have decided to follow the development of competencies of three participants because one participant attended the program very irregularly. The program has been implemented three times a week, two and a half hours for seven months (from October 2015 to May 2016) in the premises of the training centre Mo-zai-ka. At the beginning of the realisation of the created educational program, the participants agreed that we will adhere and develop good habits necessary for good relations within the group and the results of the work. On a basis of the individual characteristics of the participants, I prepared the work, which should also contribute to the development of social and personal and interpersonal skills. I have continuously monitored and recorded them. During the implementation of the program, I put emphasis on repetition, patient negotiations with participants and creating a friendly atmosphere. After completing the training program, I evaluated the development of competencies in three selected participants. On that basis, I concluded that the biggest change was in the communicative competence. I also experienced a change in social and personal competencies, however, results varied widely among individual participants. Yet, I believe that the goal of the thesis was achieved. These results show that education in leisure time, based on work activities may lead to the development of social and personal and interpersonal skills that are for adults with mental disabilities necessary in the process of social integration. This thesis can be an interesting source of inspiration for the realisation of similar programs aimed at social integration of persons with mental disabilities.
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The reflection of František Bakule's work in a relation to a current special educational practice
BALÍKOVÁ, Tereza
František Bakule was a significant Czech teacher during the first half of the 20th century. He was known as the first director of the "Jedlicka Institute in Prague" as well as the founder of so-called "Bakule´s Institute" as well as one of the few representatives of the "Czech alternative approach towards education" which is very well recognized all around the world. His legacy and teachings, however, are currently not being developed on the systematic level and neither they are being put into practise by Czech professional mainstream educational community. We also need to mention that is not used by even the stream of special education, in contrast to many foreign alternative pedagogical trends, which are gaining popularity and are generally applied with success. The aim of this thesis is therefore to analyse the work of Frantisek Bakule through the prism of contemporary school educational environment with emphasis on the education of students with disabilities. The first chapter is devoted to outlining the life journey of Frantisek Bakule, particularly focusing on the major milestones that influenced the formation of his personality, his ideas, inspiration and motivation which was reflected in his teachings and then in his very own coherent concept of education. To be specific, we are introduced to his family background and a significant part is then devoted to description of Frantisek´s experience as a teacher, including stages of operating in Jedlicka´s Institute and in his own "Bakule´s institute". The second part is then focused solely on Bakule´s specific educational concept. First, the core principles of the concept are defined. Later parts then talk about Bakule´s original curriculum and a his proposal of an ideal classroom environment. The text also contains a detailed description of how Bakule approached several subjects, which were at the core of his teaching concept, namely "Work activities", "Music education" and "Arts". Original teaching practices are analysed by using current teaching methodology and terminology. Due to the identified aim and goals of the thesis, the third chapter analyses the current concept of education of the above, according to Bakule´s core areas and principles. The text is designed specifically to be subsequently reflecting the work of Frantisek Bakule from the perspective of today's teaching methods, namely the methods of special education. The idea is to define common points and possible differences and uncover hidden inspirational potential, which is then the main content of the fourth and final chapter. Based on the analysis and all its subsequent reflections, the final chapter tells us that although Bakule´s educational goals don´t differ too significantly from the current concept embedded in the relevant framework of educational programs, to achieve such goals we are currently using very different techniques and methods in comparison to Bakule´s ways. Even though Bakule himself tested and verified all of his concepts in practice, which can be very simply described as "do not teach students about life and work, but through life and work", and these concepts also have been proven correct by various subsequent results of psychological researches, the current system still doesn´t draw from them too much. From all the above it is quite obvious that the legacy of life´s work of Frantisek Bakule is currently not utilized nor it is being appreciated by our professional pedagogical community. On the other hand, we need to note that it may also be due to the level of fragmentation in which his concept and materials were preserved to the present days.
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Nutritional care about immobile patient on standard department of internal type
AMBLEROVÁ, Michaela
Nutritional care for immobile clients at a standard department of internal type becomes still more important, because nutritional care is important for maintaining good health and supporting quality of life. Nutritional status of immobile clients is very important to diagnose as early as possible in order to avoid all risks of potential complications. Adequate nutrition is also very important to maintain good mental health. The central objective of this work was to explore the specifics of nursing care in the field of nutritional care for immobile client at a standard department of internal type. Following this goal, three research questions were set up: How is the nutritional status of patients at a standard department of internal type assessed? What are the possibilities of application of nutrition for immobile client at a standard department of internal type? What are the specifics of nursing care in the fields of nutrition of immobile client at a standard department of internal type? The empirical part of the thesis was processed using qualitative research, which was realized through semi-structured interview technique. The interview contained 3134 questions, which focused on nutrition care for immobile clients on standard unit of internal type. The research sample consisted of nurses working in the standard department of internal type in the České Budějovice Hospital, a.s. Overall, this study leads to two findings, both positive and negative. Within the positive findings we can say that nurses provide adequate care in the application of nutrition per os. Negative findings relates to the fact that the interviewed nurses provide only basic care in case of the introduction of enteral and parenteral nutrition. They do not know more detailed specifics of enteral and parenteral nutrition. Based on this finding, we think it would be useful to organize regular seminars and trainings for nurses to expand their knowledge about this type of care, or at least remind it. This thesis can serve as an informational material for nurses in practice or students of other health professions. This work can serve also as a basis for further research.
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Specifics of nursing care in patients after transapical aortic valve implantation.
VOTRUBOVÁ, Nataliya
Transcatheter aortic valve implantation (TAVI) is a new and an attractive method in cardiology and as well as in cardiac surgery. It is constantly evolving method which has been developed as an alternative to standard open surgery, especially in patients with severe symptomatic aortic stenosis with unacceptably high perioperative risk or patients who are not suitable for conventional open heart surgery because of age and comorbidities.A teamwork is very importantfor this new method and approach. The choice for TAVI is discussed by the institutional multidisciplinary heart team, typically consisting of interventional cardiologists, imaging-specialists, cardiac surgeons and anaesthesiologists. The first implant in a human being was performed by Cribierin 2002. In Czech Republic this method was first used in 2008. Transcatheter aortic valve implantation (TAVI) was accepted as a minimally invasive alternative to open surgery. This method does not require the use of cardiopulmonary bypass, and cardiac arrest. Other several benefits includinglower risks of bleeding and stroke events, better wound healing, less pain, as well as more rapid early recovery due to preservation of continuity of the sternumthat result in shorter durations of stay in the hospital, earlier rehabilitation and faster returns to normal life. In the presented work was used a combination of qualitative-quantitative methods of investigation. The data was obtained by using the quantitative research. The main technique was using the questionnaires designed for nurses working at the Department of Cardiac Surgery, Hospital Czech Budejovice, a. s. These results were backed up by the implementation of qualitative research, which investigated the patients and physicians view on monitored issues. Questioning method using a semi structured interview technique was used for qualitative research. The results of the survey were processed using descriptive statistics charts in LibreOffice Calc and using diagrams created in LibreOffice Writer. Qualitative results of the research were transcribed from audio recordings and coded, and the base code was created nine categories of interviews with clients/patients and three categories of interviews with doctors. The aim of this work was to explore the specific problem of nursing care about the clients / patients after transapical aortic valve implantation. On the base of our obtained data it is evident, that the client/patient after TAVI may be positioned sideways, the use of surgical drains are less frequently, so the care about the surgical wounds is simpler, patients report less pain in the surgical wound and postoperative rehabilitation and recovery is shorter. H1 - The nurses take care about the clients/patients after transapical aortic valve implantation in the same way as about the clients/patients after open aortic valve replacement, without realizing the differences between the patients treated with different approaches, was not confirmed. The nurses'sees/reported major differences in invasiveness and extent of providing care, rehabilitation, convalescent, in the duration of the hospitalization and better cosmetic effect. The results of the research can serve as a basis for creating the standards of nursing care or educational material for clients/patients. It is also possible to present the results of this work at a specialized seminar for non medical healthcare workers and results can also increase the quality of nursing care about the clients/patients after transapical aortic valve implantation.
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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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The need for security and safety in connection with a planned surgery with the patient's perspective and nurses
BOHDALOVÁ, Jaroslava
A planned operation performance always affects patient´s needs for assurance and safety. It is important to provide necessary information connected with the planned operation performance itself so that the patient can feel assure and safe. The key role for the patient and her/his needs for assurance and safety is in general nurse´s hands because she is the closest person to the patient and can help to inspire her/his needs for assurance and safety with konfidence best through the aid of her knowledge and skills that she should have as well as through the aid of her attitudes. The target of the thesis was to find out how a planned operation performance affects patient´s needs for assurance and safety and how a general nurse inspires patient´s needs for assurance and safety connected with a planned operation performance with confidence. The following research questions were stated: How does a planned operation performance affect patient´s needs for assurance and safety? How does a general nurse affect patient´s needs for assurance and safety connected with a planned operation performance to inspire her/him with confidence? What is insufficient in filling patient´s needs for assurance and safety before a planned operation performance? How can a general nurse help a patient control her/his fear and state of anxiety related to a planned operation performance? The method qualitative research with the use of depth interview was used to figure out the investigation. The respondents were willing to record the interview which were verbally rewritten and then subjected to the contents analysis by the method paper and pencil. From the research it is clear that a planned operation performance affects patient´s needs for assurance and safety in a negative way disregarding to her/his previous experience. Patient´s worries and negative feelings can be eliminated by a general nurse who treats her/him as equal, taking up an individual approach, informing her/him about all performances and proceedings, having a calming and welcoming way of communication, using empathy and listening as well as trying to meet patient´s wishes according to her possibilities. The research reveals the advantage of patients´ readiness for planned operation performances. Patients can learn it in the framework of educational proceeding in the out-patients´ department at the same time when they learn that they are going to be operated. The research also shows that general nurses do not have enough knowledge in the sphere of therapeutical communication. The results indicate that it would be suitable to start educating patients as soon as it is known how their disease will be solved and treated in order to reduce the negative impact of surgical treatment to patients´ needs for assurance and safety. General nurses should complete their knowledge and skills to be able to help patients to cope with their difficult life-situation. On the basis of the research investigation and after the consultation with the senior nursing officer, the training course will be organized. The topic of the training course will concentrate on communication with patients before planned operation performances with a view to therapeutical communications and therapeutical interviews. Other discovered facts, for example, the lack of information provided to patients and possibilities regarding better patients´ readiness for planned operation performances will surely be solved by the hospital management.
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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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Pick´s disease and the specifics of the nursing care of a patient with this disease
KOPKAŠOVÁ, Lenka
Pick's disease is a degenerative-atrophic process that primarily affects the frontal and temporal lobes of the brain. Besides Alzheimer's disease, it is a lesser known form of dementia which affects people of younger age. Although the exact range of Pick's disease occurrence varies in the literature, the average reported age is between 50-60 years. The disease can change eating habits, cause emotional swings, inappropriate behaviour and sloppy appearance of the patients. The behaviour to others is often selfish, the patients are unable to listen to others and ignore their surroundings. Pick's disease is also characterized by inappropriate sexual behaviour. Globally, the number of dementia patients is still growing and according to expert guesses the increase will continue. Nursing care for patients with dementia is therefore becoming a very actual topic as dementia is called a quiet epidemic of our century. Nurses in their departments quite frequently encounter patients suffering from dementia of various origins at different stages of disability and the staff at healthcare facilities often regard these people as a burden. The aim of this thesis, which is called Pick's Disease and Specifics of Nursing Care for Patients with this Disease, is, based on the theoretical knowledge, to map definitions and diagnosis of Pick's disease, to define the needs of such a patient, and to list the most common problems in the nursing care. It focuses on people with dementia within medical facilities. For proper understanding of the problem, the thesis starts with the anatomy and physiology of the brain and the description of cognitive functions which are affected by the dementia syndrome and the definition of dementia. Based on the studied literature, dementia is divided according to various criteria. It has been found out that dividing dementia is not entirely uniform, but the essential facts and overall opinions of the authors do not diverge. Pick's disease belongs to a group of frontotemporal dementia and its position in this group has changed over time, as it is recorded in the literature. The thesis includes recommendations resulting from the studied literature in the approach to patients with dementia and emphasizes personal communication with the patients and empathetic and humane approach. Although medicine cannot prevent dementia, an early diagnosis of a specific type of dementia and correctly targeted treatment can increase the quality of life not only of the patients but also of their families. I have chosen this topic because I find it very current and interesting. During my nursing practice at the Surgery Department and Aftercare Department, I have met patients suffering from dementia and I did not know how to properly and efficiently communicate with them. For the theoretical part of my work, the methods of explanation, synthesis and induction on the basis of Czech and foreign information sources have been used. The most frequently quoted Czech authors in my thesis are doc. MD. Roman Jirák, PhD., the head of the center for diagnosis and therapy of Alzheimer's disease at the psychiatric clinic of the General University Hospital in Prague, the 1st Medical Faculty of Charles University. This thesis can serve as an informational and educational source both for nurses and the general public who may experience the disease within their families. It would be considered a great success if it helped nurses or family members to diagnose Pick's disease or other dementia at an early stage.
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The effect of pyrethroid based pesticides on fish
RICHTEROVÁ, Zuzana
Pyrethroids are ones of the most used pesticides worldwides. The widespread use and high stability of pyrethroids lead to the assumption of that their occurrence in the environment could be quite frequent. They can reach water ecosystem as pollutants. Residues of pyrethroids are not only detected in the water column, but also in sediments and in fish tissues. The first study was devoted to the product Nexide containing 60 g.l-1 of active substance gamma-cyhalothrin. Tested Nexide concentrations were 5, 25, 50, 100, and 250 µg.l-1. Early life stage test was used.Common carp (Cyprinus carpio) was tested. There were significant mortalities in all concentrations except the lowest concentration during the trial. The lowest concentration tested 5 µg.l-1 only caused a slightly increased mortality. This lowest concentration influenced the growth in length and weight negatively, decelerated ontogenetic development, and made the body surface of the individuals darker. Histopathology of individuals from this concentration revealed dystrophy in liver. Examination of kidney, intestine and gills did not show significant histopathological differences compared with control. The evaluation of selected parameters of oxidative stress demonstrated a significantly higher activity of detoxification enzyme glutathione-S.transferase (GST) and a significantly lower activity of defensive enzyme glutathione peroxidase (GPx) compared with the control group. The other examined parameters of oxidative stress such as catalase (CAT), glutation reductase (GR), and lipid peroxidation determined by using the thiobarbituric acid-reactive substances (TBARs) were comparable to the control group. Changes in oxidative stress parameters suggest that exposure of the organism to the product Nexide in the given concentration leads to dysbalance of defensive enzymes. The second study was devoted to the product Cyperkill 25 EC containing 250 g.l-1. Tested Cyperkill 25 EC concentrations were 7.2, 36, 72, 144, and 360 µg.l-1. The procedure of the trial was the same as the preceded one. There were 100% mortalities in all concentrations except the lowest concentration during the trial. The lowest tested concentration 7.2 µg.l-1 allowed 90% of individuals to stay alive till the end of experiment. The lowest concentration influenced the growth in length and weight negatively and decelerated ontogenetic development compared with the control. Any individual exposed to this concentration did not reach juvenile stage until the end of the trial. Dark pigmentation was visible in 68% of these exposed individuals on the last day. Similar darkening was visible in individuals from higher concentrations shortly before death too. Histological examination did not revealed significant changes in intestine, liver, kidney, and gills compared with the control group. Evaluation of selected parameters of oxidative stress demonstrated significantly lower activities of GST, GR, and GPx. Activities of CAT and TBARS were comparable with the control group. Changes in oxidative stress parameters suggest that exposure of the organism to the product Cyperkill 25 EC in the given concentration could induce oxidative stress and interfere with the activities of antioxidant enzymes. The presented thesis summarises actual data about pyrethroids and their influence on fish. The demonstrated effects confirm high susceptibility of early developmental stages of fish to tested pesticides. When interpreting the results, we have to take into account the fact that studies showed this risk even on single pyrethroid substances. But water organisms are exposed to many other more or less toxic products and substances in a real environment. These xenobiotics could react with each other and their mixture could even potentiate negative effects. The performed studies also clearly show the significant differences in the sensitivity of embryonic and embryolarval tests.
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Biomass as a base material for the production of fuels and energy
HUBAČ, Tomáš
Nowadays, with the dwindling fossil fuels there is need to find a new source of energy. One of interesting possibilities is to use biomass. The energy from biomass can be obtained in many ways. There are three main directions. Thermochemical conversion which involves incineration, gasification and pyrolysis. The biochemical conversion which comprises of anaerobic fermentation, aerobic fermentation and alcoholic fermentation. Last option is physical-chemical conversion comprising of esterification. Subsequently gained biofuel is divided into I, II, and III generation according to the method of production and resources. Alternatively derived biofuel equals, and sometimes surpasses the fossil ones. Biofuel has basic division into liquid (bioethanol, bio-oil, etc.), solid (wood pellets, briquettes, etc.) and gases (biogas, etc.). We should mention the need to improve the efficiency of existing technologies and to invent new economical and environment-friendly techniques.
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