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Theoretical and methodological approaches to determining the macroeconomic contribution of primary prevention and health promotion
Voleman, Jakub ; Chytil, Zdeněk (advisor) ; Kovanda, Lukáš (referee)
Health is one of the most important things in human life and it also deeply affects its quality. Health prevention and promotion is fundamental both for individuals and the whole society. This thesis analyses the economic approaches to health prevention and promotion. The main aim of this thesis is the analysis of health promotion with respect to colorectal cancer. However, this is not a standard effectiveness analysis but the analysis of the future development in unique Czech environment. According to Czech demographic trends and based on incidence and mortality predictive ARIMA models for colorectal cancer, this work quantifies the increasing costs related to this disease treatment in 2024 and 2028. Also, it makes recommendations on possible spending on possible prevention related to this disease.
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Radiotherapy and its negative effects on patients with colorectal carcinoma
SYROVÁTKA, Radim
Colorectal cancer is one of the most common diseases in developed countries. There has been a persistent increase in the diagnosis not only in the Czech Republic, but also throughout the world. The awareness of it as well as primary and secondary prevention are of key importance regarding this disease. Primary prevention means a healthy lifestyle including a diet with plenty of fibre, physical activity and reducing or cutting out alcohol and cigarettes. Secondary prevention constitutes a medical examination of colon and rectum in high-risk patients and in individuals older than 55. Nowadays, two methods are available - a fecal occult blood test (FOBT) and a screening colonoscopy. Both methods are fully covered by health insurance. After the disease has been established by precise diagnostic methods, the patient is to undergo radiotherapy. Mostly this is neoadjuvant treatment; in the case of non-operable tumours it is only a question of individual curative radiotherapy. Brachytherapy is rarely used for treating colorectal cancer in the Czech Republic. If the disease is in an advanced stage and the patient is in an overall poor condition, we proceed to palliative care. The first objective of this thesis is to describe the pathology of the colon and rectum, radiotherapy and the negative effects of radiotherapy in patients with colorectal cancer. This objective is elaborated in the practical part of the Bachelor thesis. The second objective is to evaluate the doses of radiation in vital organs during radiotherapy for colorectal cancer between 2002 and 2013. In the Bachelor thesis, the following hypothesis is stated: "Owing to the improvement of planning systems, verification systems and the irradiation apparatus, the negative effects on vital organs during the radiotherapy for colorectal cancer were reduced." To evaluate the radiation doses and the hypothesis, data collection in České Budějovice Hospital, joint-stock company, had to be carried out. The group of assessed patients added up to 54 individuals who underwent curative radiotherapy and 7 patients who underwent palliative treatment in 2002, along with 69 individuals who were treated with a curative intent and 12 subjects who were treated with a palliative intent in 2013. The obtained data provided us with information that the dose of radiation in the bladder in patients who underwent curative treatment of colorectal cancer decreased between 2002 and 2013. As far as the palliative treatment is concerned there was no significant dose reduction in this vital organ.
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Nutrition and other factors, which have influence on the formation and prevention of colorectal cancer
BENEŠOVÁ, Lucie
The full title of my bachelor thesis is Nutrition and Other Factors Influencing the Development and Prevention of Colorectal Cancer. In the theory section of the paper I have concentrated on clarifying the term "colorectal cancer", its epidemiology, and furthermore, on diet and other risk factors concerning the development and prevention of this disease. In this theory section I have included information about screening tests for occult bleeding. I have addressed the key objectives in the practical section of the thesis. I had set two key objectives. The first was to research how well respondents were informed concerning diets beneficial in the prevention of colorectal cancer, and the second objective concentrated on assessing the respondents' behaviour in relation to the information they had acquired. The research questions were formulated thus: "How well are people informed about diets aimed at preventing colorectal cancer?" and "Do people behave according to information thus gained?" The qualitative research method a semi-structured interview was used for the research section. Ten male respondents over the age of 45 took part in the interview. Five of these males were Dr Ilona Paseková's outpatients all with a genetic disposition to colorectal cancer, with most experiencing problems related to this disease. The other five respondents were without any predispositions. After receiving answers to the questions posed to the respondents, I wanted to compare both groups in order to ascertain whether those with a genetic predisposition showed a greater interest in this disease. Furthermore, I wanted to find out whether those respondents were actively seeking information concerning the prevention or treatment of colorectal and anal cancer. All those interviewed were very open and willing to answer questions. Collection of data was carried out from January 2014 to March 2014. The conclusions of this thesis show that public awareness of colorectal cancer and its prevention is inadequate. Public awareness of diets beneficial in the prevention of colorectal cancer is markedly poor, even among high-risk respondents. Having observed this lack of awareness, I proceeded to question respondents as to their dietary and lifestyle habits. Furthermore, the respondents were asked if they were aware that colorectal cancer screening was available in the Czech Republic. The results showed that some respondents, however unaware of diets beneficial in the prevention of colorectal cancer, follow a healthy diet, thus fulfilling dieticians' recommendations concerning the prevention of this disease. When asked about preventive foods, respondents most often mentioned brassicas broccoli and cabbage, etc. Conversely, the most often mentioned foods said to increase the risk of disease were smoked meat and red meat. One respondent mentioned the preventive affects of shark cartilage. I was very surprised by this assertion and subsequently searched the internet for information relating to shark cartilage. To my surprise, I found that the respondent was indeed not mistaken, and that statements to that effect can be found on websites promoting dietary supplements containing shark cartilage extract. According to these sources sharks do not suffer from cancer and therefore, their cartilage is closely studied and dietary supplements containing its extracts are produced. Furthermore, I intended to compare two groups of respondents those with genetic dispositions and those without. After carrying out the respective interviews, their comparison appeared to be futile. In both groups I identified respondents who followed a healthy diet and lifestyle as well as those who did not. I found that there is no relation between high-risk habits and predisposition to colorectal cancer. Whether a respondent with such a predisposition decided to follow a healthy diet or change his dietary habits and lifestyle or not was purely a question of his personal preferences.
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The role of general practitioner nurse in the prevention of the colorectal cancer in surgery.
TETÍKOVÁ, Hana
Current situation: The Czech Republic belongs to countries with high prevalence of colorectal carcinoma (CC). The theoretical part of this thesis includes basic information on carcinoma of the colon and the rectum. It also deals with its causes, symptoms and treatments. Primary, secondary and ternary prevention of CC is described in detail. Also the role of the nurse in general practitioner´s (GP) office in such prevention in adults is thoroughly investigated. Aims: Main aim of this work was to find the level of patient knowledge about the prevention program on CC and to map the role the nurse in GP office for adults has in this prevention. Methodology: Both qualitative and quantitative methods were chosen for this research. Obtained data was transferred into data matrix, evaluated using contingency tables and for statistical evaluation the one-sample and the two-sided t tests as well as the chi square test were used. The second method used was qualitative research in the form of structured interview. The interviews were transcribed into text. Through open coding analysis four categories were identified: The primary prevention of CC, The secondary prevention of CC, The immunochemical test for occult blood and The tertiary prevention of CC. Research group: The first research group consisted of patients aged 50 and above. The second research group consisted of five nurses working in the GP offices. Results: The first aim was to establish the level of knowledge in patients about CC. Four hypotheses were stated in order to fulfil the first aim. First hypothesis was: "Patients are informed about the prevention of CC". The level of significance for this hypothesis was calculated to 48.1 % and the hypothesis was therefore confirmed. However, reserves were discovered regarding the information on the primary prevention and first information about the secondary prevention is seen to dominate. This means that the research showed that patients that seldom visit the GP office fall through the CC screening. It is therefore very beneficial that a project has started from January 2014 with addressed invitations to the targeted population to such CC screenings. Second hypothesis presumes that "The knowledge of prevention of CC is gender indifferent". However, the reached level of significance at 2.2 % declines this hypothesis which means that the knowledge does differ based on gender. In fact the results show that women possess deeper knowledge on this subject. For example more women believe that smoking influences the prevalence of CC. The third hypothesis was supposed to either confirm or disprove that people are equally well informed about CC prevention in urban and rural areas. The level of significance of 1.2 % shows that this knowledge is better in urban areas. The last, fourth hypothesis asked whether patients have acquired their knowledge of CC prevention in the GP office. The level of significance for this hypothesis is 88.6 % and confirms the question. The second aim of this research was to map the role of the nurse in the GP office regarding the prevention of CC. The research question asked was" What role does the nurse have in CC prevention?" The research shows that her role is both irreplaceable and very significant.
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Radiotherapy of colorectal cancer and compare information paramedical personnel and the general public.
VOCHYÁNOVÁ, Aneta
The theoretical part of this bachelor thesis contains general knowledge of colorectal carcinoma. Colorectal carcinoma is a civilizational disease and it is one of the most common cancer diagnoses in developed countries. The incidence of these tumours in the Czech Republic and other countries is growing. Difficulties appear only in the advanced stages of the disease; therefore, prevention is very important here. Prevention is divided into two parts: primary and secondary. Primary prevention involves healthy lifestyle. This includes regular exercise and a balanced fibre-rich diet. Secondary prevention involves screening of asymptomatic individuals. Patients? close relatives and high-risk individuals (people over 50 years of age) have been monitored regularly throughout the Czech Republic since 2000. Preventive examinations include hemoculture tests, colonoscopy, sigmoidoscopy, or virtual CT colonoscopy. CRC diagnostics includes a patient?s total medical history, clinical and laboratory examinations, radio-diagnostic imaging techniques, ultrasonography, and colonoscopy. The treatment depends on the TNM classification. The basic method is surgical treatment that is complemented by cancer treatments (chemotherapy, radiation therapy, biological therapy). This thesis deals mostly with radiation therapy (radiotherapy). The practical part of the thesis describes the therapy algorithm at the department of oncology in hospital Nemocnice České Budějovice a. s. Practical experience was used in this part. The therapy is a team work which involves a number of radiology assistants and physicians, radiology physicians, surgeons, gastroenterologists, psychologists and other specialists. In addition, data from this department was used to compare the most frequently used positions, techniques, and therapeutic modalities. 118 patients, who underwent radiation therapy in this hospital in 2012, were compared. Supine position is frequently used at the department due to its reproducibility. BOX technique is commonly used. T technique is used when the BOX technique treatment cannot be used. In 2012, the physicians often used a combination of therapeutic modalities of radiotherapy, surgery and chemotherapy. The thesis also included the compilation of a questionnaire focused on the awareness of paramedical staff and the general public. It was filled by 230 respondents: 119 medical professionals and 111 laymen. The knowledge of both the groups concerning colorectal carcinoma (CRC) is not at the expected level. The term colorectal carcinoma was known by 95 % of the medical professionals and 37.8 % of the laymen. Half of the laymen did not know the answer to the following question: ?What foods should you avoid as prevention of colorectal carcinoma?? 27.4 % of the medical professionals also did not know the answer. Most of the respondents mentioned the following food: red meat and smoked-meat products. Only a small percentage of the respondents (8 % of the medical professionals, 14.3 % of the laymen) stated that it was important to adopt a fibre-rich diet. In primary prevention, fibre plays an irreplaceable role. Therefore, better result was expected in this area. Many lay respondents did not know answers regarding preventive screening and CRC treatment. The medical professionals? answers were satisfactory, but better results were expected with regard to their education. The public should be more informed about this issue. Information should be provided to people through lectures, educational materials in general practitioners? waiting rooms, magazines, newspapers, or TV broadcasting. In this way, the existence of this disease should enter the public awareness and thus increase the interest in obtaining more information. The most important is the issue of prevention. If people get interested in this disease when it touches them themselves or their surroundings, it is usually too late.
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The Costs Analysis of Colorectal Cancer.
Bednářová, Martina ; Lešetický, Ondřej (advisor) ; Břehovský, Miroslav (referee)
The topic of this dissertation paper is the evaluation and comparison of costs related to the treatment of colorectal cancer in a sample of therapeutically significant groups of patients who were treated in the hospitals in Jindrichuv Hradec and Ceske Budejovice. Particular groups differ by the type of treatment used in this case and it is possible to distinguish patients with initial, advanced and most advanced stages of the illness.
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Radiotherapy of colorectal cancer
MAJERČÁKOVÁ, Iva
In agreement with WHO organisation is on record 940 000 new cases every year in the whole world, and one half of them die because of lateness. Consciousness of this disease is low, people think it{\crq}s insignificant and easily curable tumour. This diagnosis forms approximately 10 % of all registered malignant cancers and it is once of the most frequent causes death between tumours in the whole world. The Czech Republic rank among forefront in incidence and mortality in the Europe. Prevention this significant cancer is considerably deficient and uneconomical in the Czech Republic.
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Computed tomography of the intestinal tract, usage, advantages and disadvantages of this metod
SMOLÁKOVÁ, Eva
In presented essay author tries to offer comprehensive overview of possibilities of computer tomography (CT) in examination of the intestinal tract at her radiologic department. Introduction of Multidetector CT represents outstanding advance in spatial resolution in z - axis and accelerated data acquisition wihout increase of radiation dose. All these advantages of Multidetector CT project strongly onto examination of the intestines. At author´s department CT enterography and CT colonography replaced to the background classic methods as irrigoscopy and enteroclysis. The feasibility of assessment of the intestinal tract and other abdominal organs at the same time is the most significant contribution of this method. At our department we note progressive decrease of number of enteroclysis examinations since the year 2003. Limitations of this method are radiation exposure, intravenous application of iodine contrast medium and impossibility to obtain specimens for histologic examination. We expect, that future technologies will reduce some of these disadvantages.
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