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"The Ambitious Women Illness" Gender Dimensions of Diagnostic Process of Multiple Sclerosis
Nejedlá, Adéla ; Sokolová, Věra (advisor) ; Kobová, Ĺubica (referee)
Diploma thesis analyses gendered dimensions pervading diagnostic process of multiple sclerosis based on semi structured interviews with women targeting their own lived experience and perspective. Theoretical part of this work introduces basic concepts and groundwork arising from previous research including the main and following topics. Starting with medical discourse and continuing with gender bias in medicine, which is amongst others represented by medicalisation of the female body. I also touched upon the topic of delayed diagnosis and introduced basic information about multiple sclerosis. Empirical part describes the goal of this work through qualitative research which was chosen with the vision of analysing specific female experience. Through interviews I had the opportunity to hear a real world stories about lives of women living with multiple sclerosis. Those stories lead me to possibly new findings about the diagnostic process. With this work I would like to bring some improvements to the complex diagnostic process. Key words Gender bias, medicine, diagnostic process, multiple sclerosis, gender stereotypes, semi structured interviews
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Working Ability of People with Multiple Sclerosis. ( Options of Occupational Therapy Counseling)
Vodová, Magdalena ; Novotná, Klára (advisor) ; Kuželková, Anna (referee)
DIPLOMA THESIS ABSTRACT Name: Bc. Magdalena Vodová Supervisor: Mgr. Klára Novotná, Ph.D. Title: Working Ability of People with Multiple Sclerosis (Options of Occupational Therapy Counseling) Abstract: Multiple sclerosis (MS) is a chronic autoimmune disease of the central nervous system affecting young people. Reduced ability to work is a serious consequence of MS. Academic literature addresses the negative factors leading to loss of employment. Occupational therapists can provide information and recommendations focusing on the work environment of people with MS through counseling. The aim of this thesis is to propose recommended strategies for people with MS in relation to work integration. The theoretical part of the thesis deals with factors impairing work ability, specific recommendations to influence them and important information stemming from legislation. The practical part verifies the findings based on the analysis of qualitative research among employed persons with MS, which is then further compared with information from the employer. The findings show that fatigue, mobility problems, cognitive impairment, urinary dysfunction and impaired thermoregulation in confrontation with barriers in the working environment affect the ability to work. Support and assistance from the employer, colleagues and...
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The Inter-rater Reliability of the Nine Hole Peg Test in Patients with Multiple Sclerosis
Rotbartová, Eliška ; Rybářová, Kateřina (advisor) ; Klimošová, Sylva (referee)
Author: Bc. Eliška Rotbartová Supervisor: Mgr. Kateřina Rybářová Title: The Inter-rater Reliability of the Nine Hole Peg Test in Patients with Multiple Sclerosis Abstract: Introduction: The Nine Hole Peg Test (NHPT) is used by occupational therapist as a standardized tool which evaluates fine motor skills and manual dexterity. The aim of this thesis was to establish the inter-rater reliability and variability of the results of the NHPT administered according to the Czech extended version of the manual in patients with multiple sclerosis (MS). Methods: 33 probands with MS (27 females, 6 males) were tested by NHPT. Video recordings taken during testing were analyzed by two independent raters. Pearson correlation coefficient was used for statistical data processing. Recording sheets from the testing were analyzed in order to determine invalidated trials for each subtest and reasons for the invalidation. Results: A very high positive correlation was established for inter-rater reliability (0,999902 to 0,999965) and variability of the results (0,999902 to 0,999965). The invalidation of trials was most frequent in the 2nd trial of the dominant hand (24.24% of 33 trials). The least frequent was in the 3rd trial of the non-dominant hand (6.06%). The most frequent reasons for invalidation of trials were:...
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Motivation for physical activity and exercise in people with Multiple Sclerosis
Tikovská, Iva ; Novotná, Klára (advisor) ; Větrovská, Renata (referee)
1 BACHELOR THESIS ABSTRACT Author: Iva Tikovská Supervisor: Mgr. et Mgr. Klára Novotná, Ph.D. Title: Motivation for physical activity and exercise in people with Multiple Sclerosis Abstract: Multiple sclerosis (MS) is chronic neurodegenerative disease, which affects young adults between the age of 20 and 40 and manifests with various neurological symptoms, depending on localization of the inflammatory damage in CNS. Concerning right management of the disease, in addition to regular pharmacotherapy it is important to observe rules of healthy lifestyle recommended for MS (so called MS Brain Health Initiative). In this study we were evaluating adherence to healthy lifestyle recommendations for MS (level of physical activity, sleep, stress, healthy diet) through questionnaire survey. The data were obtained by online form only. The questionnaires were distributed via Facebook and also with help of patient organisations and MS centre of General University Hospital in Prague and 1st medical faculty of the Charles University. The questionnaires included: General questionnaire of healthy lifestyle as well as Hospital Depression and Anxiety Scale, General Self Efficacy Scale, Social Support Scale, Physical Activity Enjoyment Scale and The Diet Questionnaire. There were 133 MS patients (112 women and 21 men) involved...
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Kinesiophobia, her predictors and consequences in selected chronic diseases - theoretical review
Schwarzová, Kristýna ; Mahrová, Andrea (advisor) ; Plevková, Lucia (referee)
Title: Kinesiophobia, her predictors and consequences in selected chronic diseases - theoretical review Objectives: To review the issue of the occurrence of kinesophobia in various chronic diseases and to identify its predictors. Methods: The diploma thesis was prepared in the form of a literature search using electronic resources of the National Medical Library, the Central Physical Education Library and professional databases Pubmed, EBSCO, SCORPUS, Medline, Web of Science. The first half of the work summarized all the theoretical background and knowledge of kinesophobia and selected chronic diseases. The second half was focused on the processing of the issue of kinesophobia in selected chronic diseases and on the mapping of their predictors. Results: Based on the processing of available resources dealing with the issue of kinesophobia in selected chronic diseases, a comprehensive overview was created. In patients with chronic low back pain, high levels of kinesophobia were most often associated with chronic pain, functional impairment associated with the disease, obesity, low levels of education, and emotional states (anxiety, depression). In coronary heart disease, high levels of kinesophobia were associated with a lack of understanding of the need for physical activity, social support,...
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Physiotherapy in people with multiple sclerosis with higher neurological disability
Knapová, Veronika ; Novotná, Klára (advisor) ; Suchá, Lucie (referee)
BACHELOR THESIS ABSTRACT Author: Veronika Knapová Supervizor: Mgr. Klára Novotná, Ph.D. Title: Physiotherapy in people with multiple sclerosis with higher neurological disability Abstract: The bachelor thesis deals with the possibilities of physiotherapy in patients with multiple sclerosis (MS) with severe disabilitiy focusing on postural and respiratory functions. The theoretical part gives a comprehensive overview of the problematics of this disease. Great emphasis is placed on the possibilities of rehabilitaion care in MS, especially in patients with severe neurological deficit and the importance of the interdisciplinary team. Furthermore, there is a chapter devoted to respiratory physiotherapy and basic terms in the postural system, on which procedures used in a practical part are focused. In the practical part I focus on the description of case reports of 4 patients with MS with severe neurological deficit according to the Expanded disability status scale 7.0 and more. Each patient underwent 6 individual home therapies. The therapies were focused mainly on influencing respiratory and postural functions. The results of these therapies were objectively evaluated using the following functional tests: Unsupported Sitting Endurance Test, Modified Functional Reach Test and Examination Of the Strenght Of...
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Multiple Sclerosis - Neuropsychological markers for monitoring disease activity
Friedová, Lucie ; Uher, Tomáš (advisor) ; Holštajn Zemánková, Petra (referee) ; Libertínová, Jana (referee)
Multiple sclerosis (MS) is a chronic autoimmune disease of the central nervous system that generates a wide range of clinical symptoms. These include cognitive impairment, a set of symptoms closely associated with the quality of life, which also serves as one of the most important predictors of limited ability to work. This doctoral thesis presents the output from four studies divided into three areas focusing on neuropsychological markers in connection to other manifestations and effects of MS. The first researched area is the link between speech characteristics and the information processing speed by patients with MS. Our study has proven a profound association between lower speed of articulation and below-average performance in terms of information processing speed. We have proven that acoustic quantitative speech analysis has the potential to identify patients with below-average cognitive performance. Another goal of this doctoral thesis was to ascertain the predictive value of serum neurofilament light chain levels in recently diagnosed patients with MS for the development of cognitive disorder within nine years of observation. During the period of observation, we uncovered only a loose link between high levels at the onset of the disease and the deterioration of cognitive functions in...
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Cognitive Deterioration in Otherwise Clinically Stable Patients with Multiple Sclerosis
Motýl, Jiří ; Uher, Tomáš (advisor) ; Světlák, Miroslav (referee) ; Hradílek, Pavel (referee)
Neuropsychological assessment of cognitive functions in multiple sclerosis (MS) is increasingly considered as an important paraclinical marker of disease stability or progression in MS. Recent recommendations pro-posed an annual screening of cognitive functions in all MS patients as a standard of neuropsychological monitoring in MS. There is a clear trend to diagnose possible disease progression as early as possible, to be able to respond quickly. The theoretical part of this thesis presents the current state of knowledge on cognitive impairment in MS, its correlates, predictors, and treatment possibilities. In addition, a comprehensive overview of the neuropsychological assessment and the diagnosis of cognitive deterioration in MS is presented. The highly relevant topics such as cutoff criteria of a meaningful change on individual neuropsychological examination, possibilities of treatment of cognitive deterioration, or the so-called isolated cognitive relapses, are discussed in a particular detail. The empirical part extends current knowledge in the field of MS. I present and discuss six original publications that follow these four main objectives: first, to describe the prevalence of isolated cognitive decline in MS and to put isolated cognitive decline in context with current knowledge on MS...
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Diagnostic potential of extracellular vesicles
Klementová, Helena ; Holada, Karel (advisor) ; Živný, Jan (referee)
Extracellular vesicles (EV) are membrane particles produced by cells. Many published papers describe changes in the level of EV in body fluids under various pathological conditions. In our study, we analyzed the numbers of EV in the peripheral blood of patients with multiple sclerosis (MS) and in the umbilical cord blood of preterm newborns with inflammation using flow cytometry. We extensively optimized the detection method and verified the presence of EV in the samples using electron microscopy. We found a reduced number of T-cell and phosphatidylserine-positive EV in patients with newly diagnosed MS compared to healthy blood donors. In MS patients requiring a change in the treatment, the number of B-cell EV was lower compared to neurological controls. Similarly, the level of endothelial EV was lower in MS patients receiving Natalizumab treatment. In the umbilical cord blood of preterm newborns with inflammation, we observed significantly increased numbers of placental, endothelial and platelet EV compared to preterm newborns without inflammation. Compared to the full-term controls, the changes in EV numbers were not significant. The number of endothelial EV in umbilical cord blood correlated with the concentration of IL-6 in the venous blood of newborns. Likewise, the number of platelet and...
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