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Ethical aspects of Nursing care in mechanical ventilated Patients
KŘIVKOVÁ, Jana
The diploma is focused on Ethical aspects of nursing care from the perspective of staff providing nursing care in the intensive care units and long-term intensive care units. We were also interested in respondent?s knowledge in the field of ethical principles in biomedicine and their legislation. The thesis is divided into two parts - theoretical and empirical. The theoretical part describes nursing care of the mechanically ventilated patients, short history of medical ethics and current status of the ethics in biomedicine. The investigative part was implemented by combination of a quantitative and a qualitative research. For the quantitative part of the investigation we used the method of questioning by a questionnaire. The questionnaire consisted of 20 questions, 10 closed questions, 8 half-opened questions and 2 open questions which offered to show a personal opinion. Questionnaires were anonymous. Respondents that were asked were workers providing nursing care in the intensive care units and long-term intensive care units. The first goal of the diploma was to find out respondents point of view on nursing care in patients on long term mechanical ventilation. The second goal was to find out the most important ethical problems in providing nursing care in this category of patients. The last goal of the diploma was to find out respondents knowledge of codes of ethics and legislation. For the quantitative research we had two hypotheses: 1. There are ethical problems related to providing nursing care in patients on long term mechanical ventilation. This hypothesis was verified, because statistically significant majority of respondents said, that there are ethical problems related to providing nursing care in this category of patients. 2. The nurses´ approach to patients on long term mechanical ventilation is different in the intensive care units and long term intensive care units. This hypothesis was verified, because there were statistically significant differences between answers of respondents providing nursing care in intensive care units and long term intensive care units. For the qualitative research we used the technique of half-structured interview offering open questions. Into the research file was involved 10 nurses, 5 from intensive care units and 5 from long term intensive care units. There were set three investigatory questions. 1. What opinion has respondents about nursing care in patients on long term mechanical ventilation? The investigation showed that nurses have the same attitude to long term ventilated paitents as in the case of patients on acute short term mechanical ventilation. 2. What are the most serious ethical problems related to nursing long term mechanical ventilated patients? The research found out the most serious ethical problems related to long term mechanical ventilation from the point view of a nursing staff. These are preservation of human dignity and prolonging medically futile treatment. 3. What awareness of basic ethical principles and their legislation the respondents have? The investigation showed that nurses have poor knowledge of the issue. The results confirm the current situation of this issue. Based on the results of our research, we prepared educational brochure draft, which could help to facilitate orientation in this field.
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Stress-strain analysis of arterial aneurysms
Tesařová, Petra ; Skácel, Pavel (referee) ; Burša, Jiří (advisor)
The diploma thesis is focused on the creation of the aneurysm finite element model and the making of the aneurysm wall stess-strain analysis using ANSYS software. The model of abdominal aortic aneurysm geometry starts from the CT scan of the particular patient. In the thesis there are compared two chosen constitutive models, each of them appears from different mechanical tests done on human arterial fibre samples. Furthermore, a limiting condition for aneurysm wall structure damage is expressed. On the basis of the results of stress calculation in the aneurysm wall and the limiting condition, the safety coefficient and rupture factors risk are worked out.
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Tick-borne encephalitis - from pathogenesis to therapy
PALUS, Martin
The proposed thesis contributes to the knowledge about tick-borne encephalitis and its pathogenesis. The thesis describes pathogenesis and immunopathogenesis of tick-borne encephalitis, impact of host's genotype in clinical course determination, immune response of patients with acute tick-borne encephalitis, the mechanism of tick-borne encephalitis virus migration into central nervous system and virus interaction with cells of neurovascular unit as well as potential medical interventions.
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Místní tlakové ztráty při proudění vody s přísadou micelárních aditiv
Mík, Václav ; Šesták, J. ; Kořenář, Josef ; Myška, Jiří
We have studied the influence of three cationic surfactants Arquad S50, CTAB and CTAC on three different types of local pressure drops. Experiments were done on a closed hydraulic loop with the range of Reynolds numbers from 1.600 to 23.000. Four different solution concentrations were investigated. Even though all three tested additives show similar drag reduction in the straight tube, there is a substantial difference in effectiveness at local loses.
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Ego mechanism of defense in alcohol-dependent patients
Červená, Helena ; Niederlová, Markéta (referee) ; Šípek, Jiří (advisor)
The objective of this dissertation was to examine the Ego defense mechanisms and defense styles in alcohol-dependent patients. First, we introduced the phenomenon of Ego mechanisms of defense, presented the brief history resumption, outlined the major topics of clinical research interest and described the possibilities of use of defense mechanisms analysis in a clinical practice, particularly in diagnostics and psychotherapy. The Oefense Style Questionnaire (OSQ 40) was used to examine a sample of subjects (n=60) with an alcohol-dependence diagnosis. Bivariate correlation analyses yielded these results: the alcohol-dependence in women was correlated with mechanisms Idealization, Projection, Oevaluation and Isolation of affect, whereas in men with mechanisms Suppression and Isolation of affect. There was no relation between this syndrome and certain defense style approved. These results confirmed the psychogonical etiology of the above problem in women and suggest the connections with neurotic, depressive disorder, borderline and narcissistic personality disorder. In men, the possible connection between the mechanisms Isolation of affect and antisocial personality disorder is expected.
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Comparison of noradrenalin medication during cardio surgeries using extracorporeal circulation
Samková, Markéta ; Špunda, Miloslav (advisor) ; Mašín, Jaroslav (referee)
The theme of this thesis is a comparison of two methods of medication a noradrenalin hormone during surgeries using extracorporeal circulation. Both of these methods - continuous and bolus medication are common used in praxis to regulate blood pressure, but it is not uniquely determined which one is more convenient. The thesis has two parts - theoretical and practical research. The theoretical part is concerned with the brief description of extracorporeal circulation technique, including its connection, conduct, anatomical and physiological description of affection of blood pressure and influence of extracorporeal circulation over natural regulation mechanisms. The practical part is concerned with methodical description of the research, description of used tools and statistic evaluation of two groups of patients (each group was medicated via different method - continuous and bolus). The goal of this thesis is to discover, if any of these two methods of controlling the blood pressure is not more convenient regarding the after surgery keeping vasomotoric tonus and the length of convalescence.
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Care of the patient with acute respiratory insufficiency
Lochmanová, Alena ; Spálený, Antonín (advisor) ; Bláha, Jan (referee)
The thesis entitled Care for a Patient with Acute Respiratory Insufficiency was written at an anaesthesiology and resuscitation ward. It is divided into a theoretical and a practical part. The theoretical part provides a fundamental overview of the anatomy and physiology of the respiratory system, as well as patophysiological mechanisms involved and certain nosological units causing respiratory insufficiency. The practical part maps in detail the course of a difficult hospitalisation of a female patient with severe respiratory insufficiency. The treatment process is developed into nursing diagnoses serving as an overview of the aspects that must remain in the centre of focus when caring for patients with such severe conditions. The aim of this thesis is to provide a comprehensive overview of treatment, complications and nursing activities for a patient with acute respiratory insufficiency.
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Airtightness estimation of wood based residential houses using Blower-door test
Srba, Jaromír ; Böhm, Martin (advisor) ; Trgala, Kamil (referee)
This dissertation analyses airtightness of residential buildings which in many ways influences their energy performance and therefore also their costs of use. Properly conducted airtightening layer can significantly extend the lifespan of the construction. The main objective of the dissertation is to evaluate the construction of newly built buildings in the Czech Republic and to assess the most important parameters which affect airtightness.
The Blower-door test was used to assess air leakage. This method belongs among the most widely used and conclusive methods of analysis. Its advantage is mainly the fact that it can detect construction defects of the airtightening layer in important stages of construction (and possibly enable these defects to be corrected before completion). The core of this method is to create a pressure difference of deltap 50 Pa between the exterior and the interior of the building and at the same time discover the faulty places which are different for positive and negative pressure.
The air leakage was assessed in 345 residential buildings constructed between 2006 and 2016, especially in conventional wood frame buildings or with buildings made from wood panels such as cross-laminated timber. The development of values of air change rate through the building envelope was evaluated according to the Czech standard ČSN 73 0540-2 and the results were compared to previous outcomes of other authors. Analysis and photo documentation of the most frequently detected leakage points are also part of the dissertation. A significant decrease in values of the air change rate was discovered, on average by 40.49% in 2016 compared to 2006, while for passive houses the air change rate values were almost steady. For buildings with wood frame construction, it was the way of ventilation which was determined as the most significant parameter affecting air leakage. For wooden buildings with natural or combined ventilation, the average value of air change rate at the pressure difference of 50 Pa was 1,29 h-1, for buildings with mechanical ventilation and heat recovery it was 1,18 h-1 and for buildings with very low energy consumption for heating with mechanical ventilation and heat recovery it was 0,44 h-1. Other parameters affecting the values of air leakage include the construction company, the presence of a chimney, the place and method of construction of the wood frame construction.
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