|
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.
|
|
Practical use of theatroterapy in the activation process of adults with intellectual disability
REJŠKOVÁ, Denisa
The aim of my bachelor thesis "A Practical Usage of Theatrotherapy During a Stimulation of Adult People with Mental Handicap" was to create, execute and evaluate a theatre performance focusing on a stimulation of mentally disabled adults. During leisure activities, it is possible to offer to mentally disabled people such activities that develop their personalities universally, lead towards their own activity and creativity. However, the mentally disabled people´s selection of activities is limited in comparison with the intact ones. Considering an offer of leisure activities for the target group, I decided to use theatrotherapy which has been created for them and then to implement a theatre performance. According to the specialised literature, by using it, it is possible to reach positive results in the field of communicative and locomotive skills as well as the memory and social relations. This thesis consists of three chapters. The target group will be defined in the first chapter in which I define the term of mental disability, characterise adult people with medium or severe mental disability and specify their social, mental and locomotive limitations in details. I define the theatrotherapy, describe its development, aims and methods in the second chapter. Simultaneously I mention it as a means of stimulation in the conclusion of this chapter. Theoretical part of the work is followed by in the third, practical chapter. I prepare a theatre performance based on specialised literature which I implement and evaluate here. The theatre performance was based on principles and rules of theatrotherapy. An original script adapted to the target group was used for its implementation. Classical teaching methods and drama teaching methods were used for rehearsing, namely methods verbal, graphically demonstrative, practical skills gaining, roleplaying, methods and techiques of training games and exercises, evaluation and reflection. During the evaluation and objective technique was used which aims for an analysis of actor´s activity, and a subjestive technique which aims for self-evaluation and actor´s feedback. The above mentioned activity was supported by IN Civic Society and ten people with medium and severe mental disability aged 25-45 participated. There was a process of involvement during a making of the performance and positive results in the field of communicative and locomotive skills were reached. The actors experienced new and unusual situation during the performance. They met new people too because some students of the University participated too. This resulted in social integration. The bachelor thesis is meant as an inspiration for the personnel of institutions providing social services.
|
|
Smoking in restaurants in the center of Pilsen
VIDRŠPERKOVÁ, Kristýna
The topic of this diploma thesis is ´Smoking in restaurant facilities in Pilsen city center´. Smoking in restaurant facilities harms not only their visitors but especially their employees. This group of citizens becomes passive smokers for the entire working time which may have negative health consequences. The main goal of this thesis was to map out the problem of smoking in restaurant facilities from their employee´s point of view. Three research questions have been determined towards fulfilling this goal. The research was implemented with the help of qualitative survey. Semi-structured in-depth interview was carried out with 13 respondents who had been chosen through the snowball sampling method. Information was evaluated through the open coding method and it has responded to the research questions. The first research question - What are the smoking habits of smoking restaurant facility employees? The research has proven that the amount of cigarettes smoked by the smoking restaurant facility employees has raised. The second research question - How do the employees of smoking restaurant facilities perceive the risk of passive smoking? Respondent´s answers have provn that they do not perceive passive smoking to be a risk factor which might harm their health. Only a minor part of respondents minds working in a smoking environment. The third research question was put this way: What is the attitude of employees in smoking restaurant facilities towards the new planned anti-smoking legislation? The research has proven that most respondents does not wish the acceptance of smoking prohibition in restaurant facilities. The reasons are concerns for their jobs, decrease in revenue, refusal of prohibition in general ort he fact that they themselves are smokers. Only a small number of respondent sis acutally concerned about their health and would welcome an amendment to the Act. A short intervention was carried out with the respondents within the research, which was supposed to inform the employees of restaurant facilities about the risks of passive smoking. The research has proven that employees of smoking restaurant facilities do not perceive the risk of passive smoking really. They are often exposed to tobacco smoke even in their leisure time. The most effective prevention may be ensured by politicians who would enforce a stricter legislation.
|
|
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.
|
|
Game as a Means of Teaching in Reading and Literature Lessons for the Second and Third Grades of Elementary Schools
NÁPRAVNÍKOVÁ, Veronika
The thesis deals with the application of creative methods and forms of work during reading and literature lessons in the 2nd and 3rd grades of elementary school. The main focus is on good orientation in contemporary professional literature, alternative textbooks and methodical guides. The thesis is divided into a theoretical and a practical part. The theoretical part presents teaching of reading from the pedagogical-psychological point of view, it focuses on didactical-methodical aspects, on the problem of intensification of teaching in reading and literature lessons possibilities of modernization, optimization, rationalization and efficiency. In the practical part I introduce interesting methods and forms of work, new unconventional model approaches and effective methodical management of the teaching process. The thesis is enriched with attractive techniques for practising and deepening one's knowledge. In this way, the practical part offers a collection of playful forms of work which can be used during reading and literature lessons. Some games are verified in practice.
|
|
Nové postupy biomonitoringu cizorodých látek ve vodním prostředí
ČERVENÝ, Daniel
Within the presented work, several approaches of biomonitoring were studied. A well-established method for human health risk assessment was applied to evaluate the quality of fish from open waters in the Czech Republic. As this work is targeted on sport fishermen, who frequently consume their own catches, besides the publication in scientific journal, a brochure with results of this study was distributed via the Czech Fishing Union. Health risks for consumers related to the consumption of wild fish were found strongly species and locality dependent. As there is no risks related with the consumption of carp (Cyprinus carpio) at all investigated sites, frequent consumption of predatory fish should be avoided at some fishing grounds. The use of passive samplers has become more and more attractive in the last two decades. As these devices are able to mimic the biological uptake of chemicals, their potential for replacing fish as bioindicators in routine biomonitoring programmes is evident. In our study, the comparison between analysis of fish tissues and POCIS extracts from selected sampling sites confirms this idea about interchangeability of these indicators in the case of PFASs as target pollutants. Moreover, no metabolic transformation of contaminants present in water take place in passive samplers contrary to living organisms, thus these reflect the actual contamination at the locality more precisely. The use of passive samplers completely fulfils the internationally accepted principles of Replacement, Reduction, Refinement (the three R´s). Another promising approach using YOY fish as bioindicators was evaluated within the present study. Multispecies samples of YOY fish homogenate was found as a better indicator for wide range of pollutants than muscle tissue of adult fish within one species from the same locality. As all inner organs and tissues are presented in analysed samples, more target pollutants in higher concentrations are detected compared to the muscle of adults. Besides the higher sensitivity in pollutants detection and quantification, practical and economic benefits are of concern in the case of the YOY fish approach. The YOY fish approach also particularly fulfil the three R´s strategy, as sampling of this age group of fish has a smaller impact on the environment than the sampling of adults. In case of mercury, that was found as a limiting contaminant for the consumption of fish from open waters in the Czech Republic, a nonlethal method of finclips sampling can be used for the monitoring of this compound in aquatic environments. Besides the monitoring, our optimised method for the estimation of muscle tissue concentrations could be used for human health risk assessment as well. The difference between real muscle concentrations and concentrations estimated using our method differs less than 10% in most of the investigated localities. Benthic organisms are an important part of the food web in aquatic environments, but insufficient information about its contamination is available. In another study included in this thesis, first evidence about bioaccumulation of certain pharmaceuticals in benthic organisms was described. Although, pharmaceuticals are generally considered to be not accumulative in organisms, our study proved that certain pharmaceuticals have bioaccumulation potential. From this finding, it is evident that not only the concentrations of pharmaceutical dissolved in water but also the diet represents an important exposure pathway of contamination by these compounds for organisms (fish) inhabiting aquatic environments.
|
|
The Public Procurement for the Supplies
Holzäpfelová, Vlasta ; Civínová, Denisa (advisor)
The thesis deals with the theme of procurement of supplies in the Czech Republic from its beginnings to the present in the context of legal and economic developments. The current situation is analyzed on the basis of the Public Procurement Act, in connection with monitoring the preparation and adoption of new legislation. Legal issues will be extended by an overview of relevant laws and evaluate the problems in the formation of tender documents for the conclusion of framework agreements for the supply and reviewing compliance with the principles of the Act on financial control in public administration. Theme in the application of profiling on public procurement, focusing on a framework agreement designed to capture recurring delivery. The study is supplemented with practical experience in the field of public procurement for the conclusion of framework agreements, provides an analysis of the positive and negative aspects of this method of procurement, including proposed solutions. The practical part is elaborated on the basis of a comparison of the specific tender documents with the statutory legislation, qualitative research and secondary data analysis of tender documents for contracts to supply a valid framework contracts signed by the selected organization in the years 2012-2016.
|
|
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.
|
|
Business project
Hašková, Barbora ; Pilař, Ladislav (advisor)
The purpose of this work is to give guidance on creating a business project for starting companies. The work is divided into two parts. In the theoretical part defines terms related to legal forms of business, and also will explain possible sources of funding. The last chapter discusses the importance and structure of the business project, an emerging company. In the practical part I will present a business project and legal forms of business, which I chose for the business project and bring the advantages and disadvantages of selected legal form and the reason why I have this particular legal form chosen. The next step of my work will be acquainting the reader with an analysis of the company surroundings and marketing studies. The most important part of the practical part of this thesis is the financial project, which transformed with the previous section of the business project into numbers. In line with the findings in the theoretical part I create a business project that focuses its activities on photographic services.
|
|
Reproductive disorders in dogs
Szabová, Martina ; Rozinek, Jiří (advisor) ; Karlasová, Barbora (referee)
This labour is about reproductive disfunctions of dogs males and females. Prevention and early diagnostics can help to start with medical cure and finaly reinstate animal. Vaginal cytology is cheap, simple, considerate method, which helps define stage of females cycle or diagnose some patological conditions of organism. Bacterial cultivation of vagina or uterus shows natural microflora or pathogenical microorganism, who cause inflammation or sepsis. Sonography helps to find tumors,infections, mineralization or cysts.
The most common tumors are males prostate tumor or females tumor of mammary glands. New studies speculated about global genetic expresion of classification tumors depends on specific examples. Pyometra is one of the most common reproduction disease of females before they reaches ten years. It is an inflammation of uterus with cumulated septic fluid inside and mostly graduaded to ovariohisteroctomy. High concetration of chemokine helps to better diagnose inflammation of organism. Brucella cannis is serious disease, which seriously harms juveniles. In that case we talk about zoonosis which harms humans as well. Common tests who help us to diagnose problems are ELISA, PCR or serology. Canis herpes is expanded around whole world and its prevalency antibodies are very different. For detection of virus is mostly used VNT test, ELISA, PCR or hemaglutination. Abnormal sexual diferentiation is mostly disorder of females reprodaction system, abnormalties of chromosomes and defects on fenotype. Abnormal chromosomes we can categorize as syndrome XXY, syndrom XO, syndrom XXX or real hermaphrodites and chimers. Individuals with defects at gonades have chromosomes XX or XY, but their sexual glands are in contradiction with chromoses. Fenotype problems at individuals mostly have same chromoses as their sexual signs, but their fenotype does not fit to their sexual glands. For example pseudohermaphrodism.
|
guest ::
