|
Communication of medics with the parents of a child patient.
ŽÁKOVÁ, Nikola
The theoretical part is divided into eleven chapters. The first chapter deals with the definition of communication. The second chapter describes the kinds of communication, including verbal and nonverbal. The third chapter discusses the communication skills of nurses. In the fourth chapter we expanded on the communication of the nurse with a child patient. The fifth chapter describes the basics of communication between nurses and parents of child patients. The sixth chapter discusses a situation where the nurse communicates with parents of a disabled and dying child. The seventh chapter describes the communication of nurses at the pediatric department. The eighth chapter contains the specifics of the children's department. In the ninth chapter is divided into childage. The tenth chapter discusses communication as a part of nursing care. A final chapter describes the process of hospitalization of children and their parents. The thesis is divided into theoretical and empirical parts. Much of the theory is described above whereas the empirical section describes the results of the research. Objectives and research questions The first objective of this thesis was to investigate how the nurse communicates with the parents of a child patient. The second objective was to determine whether a parent understands the information given by the sister and the final objective was to determine any errors that the nurse makes when they communicate with parents of child patients. Research questions: 1. How the nurse communicates with the parent of a child patient? 2. How does the nurse inform parents of a child patient? 3. How a parent of a child patient assesses the clarity of the information provided by the nurse? 4. What mistakes nurse makes in communication with the parents of a child patient? Methodics For the research a survey was chosen to provide qualitative information, which was obtained via interviews. The second methodology used in this work is called participant observation. Data for the first part of the survey was obtained through semi-structured interviews with the parents of hospitalized children. Interviews were conducted on the basis of questions prepared in advance. If necessary, the interview was supplemented with other issues. The interview was to determine how children were admitted to the children's department, what information reached parents about the examination of the child, and also the overall impression of the nurses on the ward. We asked parents about the verbal and nonverbal communication of sisters. They described the errors they found in the communication and behavior of nurses. The second part of the research was anonymous on the pediatric ward of the hospital where nurses evaluated verbal and nonverbal communication skills. The research group The research set for the first part of the survey consisted of seven mothers of children hospitalized in the pediatric ward. The mothers were in different hospitals in the Czech Republic. The research set for the second part of the investigation, which was carried out by observation technique, consists of six nurses employed at the pediatric ward of a state hospital. Nurses were selected randomly. They are of different ages and they have different length of practice and other training.
|
|
Oxygen therapy after cardiothoracic surgery from the point of view of nurses and patients
VRCHOTOVÁ, Klára
Cardiac surgeries are very serious surgical procedures with considerable specific features. This bachelor thesis focuses on oxygen therapy from the viewpoints of nurses and patients. Its theoretical part describes physiology of breathing and the oxygen therapy as such. It describes individual sources of oxygen and indications for oxygen administration. It also describes principles to be observed during oxygen administration. Specific aids are used for oxygen administration, particularly oxygen masks or oxygen goggles. Quality pulmonary rehabilitation is also necessary to make oxygen therapy more effective. Pulmonary rehabilitation is particularly important for patients after a cardiac surgery and it should be practiced even before the surgery. This approach is critical because in the post-surgery period the therapy makes it possible for the patient to breathe and to expectorate properly. Pulmonary rehabilitation is practiced with patients by general nurses at the cardio surgery ward, as well as by physiotherapists. There are various techniques available to determine efficiency of oxygen therapy and pulmonary rehabilitation. The techniques may be classified as invasive and non-invasive; the most frequently used non-invasive method is pulse oxymetry and the most frequently used invasive technique is blood collection for ABR. Two objectives were set for the thesis. The first objective was to map knowledge of nurses about how to provide care to patients treated with oxygen therapy. The second objective was to determine how the patients feel after a cardiac surgery. Two hypotheses and two research questions were formulated. The first hypotheses were: Nurses working at the resuscitation care station have more knowledge about oxygen therapy than nurses working at the intermediate care station. The second hypothesis was: Nurses working at the resuscitation care station have more knowledge about pulmonary rehabilitation than nurses working at the intermediate care station. The first research question was: How do the patients feel during oxygen therapy and pulmonary rehabilitation? The second research question was: How are the patients after a cardiac surgery informed about oxygen therapy and pulmonary rehabilitation? In the research part of the bachelor thesis I have used both quantitative and qualitative research methods. Quantitative processing of data was used for questionnaires filled out by nurses working in the hospitals Nemocnice České Budějovice a.s., Nemocnice na Homolce in Prague and in the faculty hospital Královské Vinohrady in Prague. The method was used for evaluation and assessment of knowledge of nurses working at the resuscitation and intermediate care wards. Quantitative methods were used for processing of data obtained through semi-structured interviews with patients after a cardiac surgery. The data were transcribed and coded using a pencil and paper method. The data were categorized based on the identified codes. Two categories were created: oxygen therapy and pulmonary rehabilitation. Each of the categories was further divided into three sub-categories. Two categories were created for the research oxygen therapy and pulmonary therapy. Three sub-categories were subsequently created for the oxygen therapy and the pulmonary therapy. The quantitative research has shown that the knowledge of nurses about oxygen therapy is higher among the nurses working at the resuscitation care ward. However, the situation is different in case of their knowledge about pulmonary rehabilitation. In this case the knowledge of nurses working at the intermediate care ward was higher. The processed data from the qualitative research have shown that patients do have sufficient information about post-surgery oxygen therapy, as well as about pulmonary rehabilitation. For all patients in the post-surgery period after a cardiac surgery the frequency of pulmonary rehabilitation was higher than 1 per day.
|
|
A nursing issue: peripheral venous catheter
TOMÁNKOVÁ NOVÁKOVÁ, Monika
Peripheral venous catheter is used to access the venous system. It is one of the most commonly used invasive procedures in health care facilities. This procedure falls within the competence and daily tasks of nurses. Therefore this type of nursing care is susceptible to risk of proceeding routinely which might result in conscious or unconscious errors. Peripheral venous catheter needs to be introduced into the patient's vein in the following cases: planned parenteral nutrition, infusion or transfusion therapy, application of intravascular medication or contrast media, rehydration, blood sampling (which can be performed immediately after introducing the peripheral venous catheter and before administrating medication) and also during an emergency care for critically ill (such as cardiopulmonary resuscitation). Nurses should be as knowledgeable as possible about this issue so that the peripheral venous catheter can be introduced well and fulfil its purpose. It is important to ensure that nurses obtain all the necessary information about their patients before inserting the catheter and that they are able to properly inform the patients about the procedure and to communicate with them. Next, nurses should be familiar with the correct procedure for inserting catheters, they should be informed about possible contraindications and know how to choose the correct type of catheter as well as where to place it. Furthermore, nurses should care for this vascular access correctly and provide the patient with enough information about taking care of the catheter after the procedure. Finally, nurses should be aware of their own potential errors and also of possible complications. Therefore they should employ aseptic technique so that they can eliminate nosocomial infections. The thesis is divided into a theoretical and an empirical part. The theoretical part focuses on the history of peripheral venous catheters and their types, indications and contraindications, necessary equipment, nursing care, complications, etc. The empirical part consists of a research. The aim of the thesis was to map the use of peripheral venous catheters in hospitals as well as to identify factors that may lead to problems among the patients with peripheral venous catheters. Four research questions were assigned to these aims. 1. What is the procedure prior to inserting a peripheral venous catheter? 2. What are the standards of caring for patients with an inserted peripheral venous catheter? 3. In which steps of caring for peripheral venous catheters do the nurses lack knowledge? What equipment do the nurses prepare in order to insert a peripheral venous catheter? The Bachelor's thesis was conducted using a qualitative research survey. The methods of collecting data included semi-structured interviews and participant observations. The research was carried out only in one hospital ward and it was anonymous. First, the data were collected by means of a semi-structured interview. The nurses were asked 14 questions (see Appendix 8). During this interview, several more subquestions were added. The results of the interviews were then grouped into several categories for the sake of clarity. The second method of collecting data was participant observation. The observed facts were recorded into an observation sheet (see Appendix 9). The same nurses who were interviewed were also observed. This Bachelor's thesis has been written in order to provide a basic overview of the peripheral venous catheters. It could be used as an information source for more experienced as well as novice nurses. The practical output of this Bachelor's thesis is a nursing care standard concerning peripheral venous catheters. This standard was missing in the hospital ward and could help the nurses to take care of these vascular accesses, to proceed correctly and eliminate possible errors (see Appendix10).
|
|
Consumption of fiber in old age
ŠÁLEK, Jan
The theme of this bachelor thesis is the Consumption of fiber in the old age (seniors). Formerly, the dietary fiber was considered unnecessarily burdensome for human organism. Later, it was found that it has a relatively large impact on human health, especially by serving as a prebiotic for symbiotic bacteria inhabiting the gastrointestinal tract. There is still prevailing opinion that roughage divides into a soluble and insoluble, despite that some types of fiber cannot be definitely classified and placed into any of these groups because they have characteristics of both of them. The daily recommended dose is 30 g. The qualitative research was used for elaboration of the practical part. The first goal was to find out how much fiber seniors consume. The second aim was to compare the consumption of fiber among elderly people living alone and the elderly living in retirement homes built for them. The research group, at the first research question, consists of 20 seniors from the Southern Region aged over 65 years. The research group, at the second research question, consists of five retirement homes from the whole Czech Republic. All respondents were given a record sheet for one week, and instructions on how to fill it. Acquired menus were subsequently re-calculated through the program "Nutriservis Professional". The results show higher consumption of fiber than the average in the Czech Republic, but there is still almost a half missing to get the recommended daily dose. There was observed BMI and its impact on the consumption of fiber. No significant effect was found, because overweight had all interviewees except one respondent. The financial limit is visible for evaluated diet of homes for the elderly, therefore, there are no whole grain products, vegetables and almost no fruit. Despite these limitations, the average consumption of fiber is almost equal to elderly people living alone. In conclusion, there is a proposition how to, despite the low funds, increase the intake of roughage, and avoid or, at least, reduce the problems associated with its low consumption. Recommendations for respondents are individual and given under each evaluation.
|
|
Cystic fibrosis and Nutrition
PECHOVÁ, Jana
The name of bachelor's thesis is "Cystic fibrosis and nutrition". Cystic fibrosis is hereditary chronic disease. It is dysfunction ducts of chloride in a human organism. The manifestation of cystic fibrosis is large quantities of a mucus in the respiratory and digestive system of patient with this diagnostic. This disease we put in the group of very rare illnesses. The smaller percentage citizens in the Czech Republic have this disease. For the people with cystic fibrosis is priority follow recommended eating habits. Prognosis of this disease is getting better and patients can live full-value life. This thesis dealing with how observe the recommended eating habits and eating regimens. The thesis contains some objectives. First, there is finding out whether children who suffer from cystic fibrosis can all sorts of foodstuffs whether they have special requests for quality and preparation of foodstuffs. The second most important objective is appraisal of diets some sample of people with cystic fibrosis. For objectivity this thesis was chose four respondents in age bracket from three to eighteen years. On the basis of evaluation their week-long diet, questionnaires with their parents and with them and manoeuver a conversation will be to find out whether children observe all principle of recommended eating regimens. In the theoretic part of the thesis are use opinions of experts who are occupying with cystic fibrosis exhaustively. Their experience show how is important to choose right diet and observe correct eating principles and eating regimens. These opinions are use in the practical part. Conclusions from discussion can be used for practical work nutritive therapists who can meet with children with cystic fibrosis.
|
|
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.
|
|
Iniciace pohybu byčíku, signalizace a regulace pohyblivosti spermií ryb: fyzikální a biochemické řízení
PROKOPCHUK, Galina
The current study attempted to shed light on the regulatory processes and response arrangements of fish spermatozoa during the course of maturation and motility initiation. The first intent of this study was to improve the understanding of the mechanism underlying the acquisition of potential for sperm motility in sturgeon. Up to present work, the physiological process underlying sperm maturation in this species has not been described at all. Our results showed that sperm maturation in sturgeon occurs outside the testes because of dilution of sperm by urine and involves the participation of high molecular weight substances as well as calcium ions present in seminal fluid and/or urine. The second aim of the present study was to investigate the coping mechanisms in fish spermatozoa with osmotic and ionic activating mode, as well as in spermatozoa of euryhaline fishes, to various environmental conditions. We showed that alteration of environmental osmolality might affect the fish sperm in different ways, depending on fish species and modes of spermatozoa motility activation either osmotic or ionic mode. In response to osmotic stress caused by hypotonicity, carp spermatozoa regulated the flow of water across their cell membrane and increased their cytoplasmic volume during their short motility period. In contrast, no indications of sperm volume changes were observed neither in sterlet nor in brook trout spermatozoa, both of which having an ionic mode of motility activation. We also examined the mechanism by which sperm motility triggering in euryhaline fishes can adapt to a broad range of environmental salinity. Our results demonstrated that spermatozoa of euryhaline tilapia, Sarotherodon melanotheron heudelotii, reared in fresh-, sea- or hypersaline water can be activated in hypotonic, isotonic or hypertonic conditions of swimming milieu, provided Ca2+ ions are present at various levels. It was established that the higher the fish rearing salinity or the more hypertonic ambient media at spermatozoa activation, the higher extracellular concentration of Ca2+ ions is required. The results obtained in the present study allow suggesting that osmolality is not the main factor inhibiting sperm motility inside the testis in the S. melanotheron heudelotii. A third aim of this study was investigation of the regulation of motility initiation process and description of flagellar beating initiation in chondrostean spermatozoa. We detected that K+ inhibition of sperm motility in sturgeon can be by-passed due to the pre-exposure of sperm cells to a high osmolality shock prior to its transfer to K+-rich swimming media. Thus, we hypothesized that sturgeon spermatozoa may be activated by use of an unexpected signaling pathway, independent from regular ionic stimulation. The successive activation steps in sturgeon spermatozoa were investigated by high-speed video microscopy, using specific experimental situation, where sperm motility initiation was delayed in time up to several seconds. At motility initiation, the first couple of bends formed at the basal region begins to propagate towards the flagellar tip, but gradually fades when reaching the mid-flagellum. This behavior repeats several times until a stage where the amplitudes of bends gradually reach similar value, what eventually leads to sperm progressive displacement. The total period needed for the flagellum to switch from immobility with rigid shape to full activity with regular propagating bends ranges from 0.4 to 1.2 seconds. In conclusion, the results of the current study bring valuable pieces of information into the general understanding of the processes of maturation of fish spermatozoa, their adaptability to different physical and biochemical circumstances, the extra- and intra-cellular signaling as well as the regulatory mechanisms of motility activation in fish spermatozoa.
|
|
Some Robust Distances for Multivariate Data
Kalina, Jan ; Peštová, Barbora
Numerous methods of multivariate statistics and data mining suffer from the presence of outlying measurements in the data. This paper presents new distance measures suitable for continuous data. First, we consider a Mahalanobis distance suitable for high-dimensional data with the number of variables (largely) exceeding the number of observations. We propose its doubly regularized version, which combines a regularization of the covariance matrix with replacing the means of multivariate data by their regularized counterparts. We formulate explicit expressions for some versions of the regularization of the means, which can be interpreted as a denoising (i.e. robust version) of standard means. Further, we propose a robust cosine similarity measure, which is based on implicit weighting of individual observations. We derive properties of the newly proposed robust cosine similarity, which includes a proof of the high robustness in terms of the breakdown point.
|
|
Ability of specially trained dogs to detect human scent which was exposed to different weather conditions over a long period
Machová, Lucie ; Vyplelová, Petra (advisor) ; Jaroslav, Jaroslav (referee)
Survivability of human scent was observed by many scientists mainly in artificial conditions (Hudson et al., 2009; Santariová et al. 2012; Preti et al., 2006). Against this exists a few researches about survivability of human scent in nature conditions (King et al., 1964; Santariová et al., 2016).
On glass tubes were taken individual humant scent from 6 volunteers. Target scents were left outdoor during 2 different periods of year. Winter samples from 3 target people were outdoor from November to May and summer samples from other 3 people from May to December. Always after 3, 4, 5 a 6 months was taken scent from 1 glass tube of each target person. After last time period was taken scent from target people on cotton textile. Scent of other volunteer was taken at the same time for purpose scent deceptions.
Then was observed if dogs will be able to identify these samples corectly. Specially trained dogs on scent identification line-ups get sample from outdoor environment and they should choose the identical human scent from line of 6 samples (with 1 target and 5 deceptions).
The experiment showed, that dogs are able to identify winter samples in all time periods but are not able to identify summer samples in whatever time period. Time periods do not show any diference.
The biggest influence on quality change of individual human scent has intensity of sun radiation.
|
|
The use of (nano)oxides for metal and metalloid stabilization in contaminated soils
Michálková, Zuzana ; Komárek, Michael (advisor) ; Luke, Luke (referee)
The main objective of the thesis was to evaluate the potential of selected Mn and Fe (nano)oxides for the stabilization of metals and metalloids in contaminated soils. The research was focused basically on three materials - commercial nanomaghemite (Fe III), nanomagnetite (Fe II,III) and a synthetic amorphous Mn oxide (AMO). The main aim of the work was to provide a complex view on the chosen stabilizing amendments regarding not just their direct influence on contaminants mobility and stabilization mechanisms, but also their stability and alterations in soil conditions together with influence on soil microorganisms and higher plants. Firstly, adsorption properties of the tested materials towards Cd, Cu, Pb and As were investigated. In this context, the most effective material showed to be the AMO reaching one to two orders of magnitude higher adsorption capacities than Fe III and Fe II,III under given experimental conditions. Interestingly, the rate of As(V) adsorption onto AMO was increasing with increasing pH as a result of high pHzpc of the AMO (8.1) and significant dissolution of this phase at lower pH values. As a next step, the influence of (nano)oxides on metal(loid)s mobility and other physico-chemical soil characteristics after application to contaminated soil was examined. Again, the AMO proved to be the most efficient in reducing mobile pools of Cd, Cu, Pb, Zn and As. On the other hand, Fe III and Fe II,III addition had generally less significant effects on contaminants mobility. AMO application further resulted in an increase of soil pH connected with AMO dissolution and unwanted decomposition of soil organic matter. When (nano)oxides alterations in soil conditions were observed, MnCO3 coatings were identified on AMO surface while no significant changes were recorded for Fe III and Fe II,III. As the MnCO3 formation was connected with increased AMO stability, AMO particles synthetically covered with MnCO3 coating (denoted as SM AMO) were prepared. Although the SM-AMO had a lower mass loss in soil than pure AMO, the stabilizing efficiency was almost the same for both materials. The differences in surface composition of both materials were decreasing with time as MnCO3 naturally precipitated on the AMO surface in soils while the SM AMO coating was gradually dissolving. When investigating the effect on soil microbiota, AMO efficiently promoted soil microbial activity while no significant changes were observed in the case of Fe III and Fe II,III. The AMO was also able to reduce the uptake of Cd, Pb and Zn by sunflower (Helianthus annuus L.), eliminate Zn phytotoxicity symptoms and increase biomass yield. On the other hand, toxic levels of Mn released from the AMO in an acidic soil were found in sunflower tissues. AMO application is thus recommended for contaminated neutral or slightly alkaline pH with a higher cation exchange capacity in order to avoid unwanted release of Mn. Finally, various types of AMO-biochar composite sorbents were recently prepared and field experiment focused on stabilization of Cd, Pb, Zn and As using studied materials is currently under preparation. The combined results from the thesis highlight the importance of a complex experimental approach dealing with all parts of the contaminated soil environment in order to obtain complete information about the efficiency and usefulness of any newly developed stabilizing amendment.
|
guest ::
