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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.
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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.
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Analysis of sheep utility attributes in ecological and conventional flocks in the Czech Republic
Linhartová, Iveta ; Ptáček, Martin (advisor) ; Jan, Jan (referee)
The goal of this diploma thesis was to perform an analysis of sheep breeding of Suffolk breed in basic reproductive performance and meat production traits aspects. The information for rating these aspects was used from two farms. The first of them used conventional way of breeding (ZVOZD Horácko, družstvo) and the second one used ecological way (EkofarmaKosařůvmlýn, s.r.o.).
Fertilization, fertility, intensity and rearing belong among monitored reproductive indicators. These reproductive indicators are expressed in percentages. Regarding meat production traits rating in this thesis we compared influences of year of lambing, farming method, birth month, sex, litter size and age of dam. All these influences were judge according to birth weight (kg), weight at the age of 100 days (kg), average growth (g), depth of the longest dorsal muscle (mm) and according to depth of subcutaneous fat (mm). Reproductive performance and meat production were monitored in years 2011, 2012, 2013, 2014 and 2015.
In terms of reproductive performance with a few exceptions it was true that ZVOZD Horácko, družstvo reached the best values, and in most cases better than the national average. For example in terms of intensity values in 2012 ZVOZD Horácko, družstvo had 35,9% better results compared to national average. In the same year this farm reached 48,1% higher values of percentage rearing compared to national average. Ekofarma Kosařův mlýn, s.r.o. showed worse performances, however it was in most cases better than national average. In terms of intensity in 2011 Ekofarma Kosařův mlýn, s.r.o. had the same results as the ZVOZD Horácko, družstvo. Meat production properties were supported by statistical calculations and all of them were conclusive at least at the level of significance P < 0,05 in all cases except month of birth effect on birth weight. The best results of meat production in terms of effect of lambing had the year 2012, when the birth weight was one of the highest and the other properties (weight at the age of 100 days, average growth, depth of the longest dorsal muscle, depth of subcutaneous fat) were by far the highest in the period of 2011-2015. Next we found out that the ecological way of breeding (in this case Ekofarma Kosařůvmlýn, s.r.o.) has better results than the conventional way (ZVOZD Horácko, družstvo).
The effect of birthmonth has the significant influence on the indicators of meat production and the lambs born in April had the best results. In the case of sex rams are better. Litter size has very important influence on meat production the more lambs per one mother, the lower
birth weights, the lower weights until the period of weaning, the lower weights at the age of 100 days. It is affected by milkiness of the mother. Moreover, the age of mothers also play a significant role. In our research the highest birth weights had lambs of one year old mothers and all other indicators were the highest in the case of three year old dams.
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Verification of project „Park za sv. Jakubem v Klatovech“
Malá, Kateřina ; Vacek, Oldřich (advisor) ; Jiří, Jiří (referee)
City council of Klatovy town in the Czech Republic submitted a contract for a new town park project on the place called "Za sv. Jakubem" in 2005. Studio SILVEX represented by Ing. Pavel Borusík won this contract and created a feasibility study as the first step of the project documentation. Till now the study has not been realized because of problematic ownership issues within the concerned area.
This diploma thesis strives to solve the question of the up-to-dateness of that project which has been suspended for ten years by now. The main subjects of this thesis have been the project content evaluation, verification of up-to-dateness and to design a new solution respecting current and future needs of the city inhabitants and park users.
Literary overview of the current state of the problem deals with public space areas characteristics, city park characteristics, graveyard characteristics including types of graveyards, burials, graves, burial history in the Czech Republic and Jewish cemeteries. The thesis addresses with the impact of the death on survivors and greenery effects as a green place useful for meditation. The graveyard topic is elaborated because of the geographical distance of Klatovy's town's graveyard to the intended park area.
Evaluation of detailed data provides the fundamental information about Klatovy and the park place, brief contents and main thoughts of feasibility study "Za sv. Jakubem", own verification of the available documentation including changes in the property relations.
All together it had served as a basis for designing new park concept proposal, which responds adequately to demands of park users. The project by Studio SILVEX proposes park place with purely town meaning, containing children playground, in-line skating track and other sport activities. The diploma thesis's park concept transforms the project with focus on scenery locations and relax place for visitors of the nearby town graveyard.
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Spatial development in city Čáslav before and after year 1989
Lejnarová, Tereza ; Šlemr, Jan (advisor) ; Macoun, Milan (referee)
In my bachelor thesis I investigate influence of the urban development planning before and after year 1989 through analysis of it in Čáslav. In my literature review I introduce signs of urban development planning in the Czech lands before year 1989 in the context of the communist centrally planned economy and consecutive transformation to the capitalistic market economy after year 1989. I describe changes apparent in Čáslav which are based on the differences in the urban development planning before and after year 1989. To precisely collect these changes, I used methods of qualitative research which I describe in detail in the thesis. I chose interviews as my main research method. I interviewed people who participated in the spatial development planning in Čáslav. In my thesis I compared literature on the planning before and after year 1989 and information about changes in the town with people who participated on them and whose perception of them may differ from official statement. The goal of my thesis is to describe the urban development planning in Čáslav before and after year 1989 and perception of differences in it by people who participated in it.
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Influence of term of winter rapeseed (Brassica napus) desiccation on yield and seed quality
Rajtmajer, Stanislav ; Bečka, David (advisor) ; Petr, Petr (referee)
Rapeseed is the world's third most important oil plant (the second seminal). It is the most cultivation and most important oil plant in Czech Republic. Winter rapeseed reaches about 85% of the harvest area of oilseeds in the country. The desiccation of oilseed crop is sphere of agricultural engineering, which is still worth discussing. The main problems are how to use the product, what dose and which dates to choose to desiccate. The results of this thesis could help to partially clarify this complex issue.
The aim of the thesis is to observe the effect of different terms oilseed rape desiccation by glyphosate on yield and seed quality.
Small-plot experiments to investigate the influence of the term desiccation of winter rapeseed were established in the years 2013/2014 and 2014/2015 on the lands of the experimental station of the Czech Agricultural University, Faculty of Agronomy Food and Natural Resources at the Červený Újezd.
In the first experimental year 2013/2014 was founded five variants in three replications (including undesiccated control). In the year 2014/2015 was founded seven variants in four replicates (including undesiccated controls). In the first experimental year was the first term desiccation 16. 6. 2014, the second year 8. 6. 2015. Subsequent periods of desiccation were a week apart.
The variety of winter rapeseed used for the experiments was a hybrid variety Rohan. The desiccating agent was used Dominator active substance glyphosate. The dose of
4 l / ha + 200 l H2O.
For all samples, both experimental, years yield was determined, the weight of a thousand seeds and oiliness. For desiccated variants were carried out pre-harvest analysis for the determination of solids in pods. Further, all harvested samples taken for laboratory germination test (Determination of germination) ISTA according to the methodology. The results of the experiment sprouting were statistically analyzed using ANOVA analysis of variance. Differences between mean values were evaluated by Tukey test, the computer program SAS at a significance level of p = 0.05.
Effect of desiccation term influences of winter oilseed rape seed quality in terms of weight and thousands of seeds in terms of oil content. Too early desiccation (46 to 39 days before harvest) HTS reduced by 7-17% and the oil content of 2-4% of the overall average. Oiliness of the observed characters minimum interference term desiccation. Desiccation in the optimum date (17 days before harvest) increased oiliness of 1-6%.
Influence term desiccation oilseed rape also greatly influences seed yield.
Too early desiccation (46 to 39 days before harvest) reduced the yield by 11-14%. Undesiccated control in both years achieved the highest yields, increase yield by 5-12%. Desiccation in the optimum date (17 days before harvest) increased the yield of attempts by 5-6%.
The term desiccation of winter rapeseed, also significantly affects the vitality of seeds, where very reduces energy germinating seedlings in the first days. The term desiccation, however, does not affect overall seed germination. Too early desiccation (46 to 39 days before harvest) EK2 decreased by 12-40%, EK3 decreased by 4-24%, 3-4% EK4 and extended MGT of 7-15%. In the first experimental year was the most vital option undesiccated control (EK2 = 50.4% = 91.3% EK3, EK4 = 97.9%). In the second experimental year was the most vital seeds of the optimal term desiccation, (Sixth term, 17 days before harvest) = 68.9% EK2, EK3 = 98.2%, EK4 = 100%. Seed samples of 2014/15 had a higher overall vitality of seeds, than samples from 2013/14, the overall vitality is probably worse given year old and transsilaged seed.
The results of the two-year experiment that term desiccation affects the quality of seeds, the yield of seeds and vitality of seeds. Pre-analysis was determined optimum solids content in siliques desiccated samples to values of 40-50%. Like most technology seems to desiccation in the optimum date (17 days before harvest) and agro technology without desiccated vegetation. As the least appropriate technology seems very early desiccation (46 to 30 days before harvest).
The first scientific hypothesis: Premature desiccation reduces seed yield, oil content and HTS. Yes, the hypothesis was confirmed.
The second scientific hypothesis: Desiccation made in the correct term do not affect the quality of the seeds (oiliness and HTS). Yes, the hypothesis was confirmed.
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Participants and their activities in local development (Mikroregion CHOPOS)
Slivanská, Jana ; Kocmánková Menšíková, Lucie (advisor) ; Boukalová, Kateřina (referee)
This thesis deals with participants of local development. The aim of the thesis was to find out activities of micro-region CHOPOS. This micro-region is an actor in local development and the aim of this thesis is to monitor its activities. The thesis is focused on finding out how local actors contribute to the development of the site in accordance with the principle of an endogenous approach to development.
The theoretical part defines terms related to the issue of regional development. The findings of a secondary analysis of projects micro-region CHOPOS shows that the highest total costs of the projects for the period 2001-2008 were in 2003 (7,903 419 CZK). Most projects implemented by LEADER for the period 2007-2013 and implemented by the municipality Postupice and Teplýšovice, both municipalities made two projects (Postupice 1,529,961 CZK and Teplýšovice 1,033,657 CZK). Teplýšovice realized the most of the projects for the period 2001-2008, a total of 21 (with a value of 6,857,826 CZK).
Evaluated data from semi-structured interviews with mayors of micro-region CHOPOS shows that all the mayors see nothing but benefits in membership in the micro-region. And all other municipalities consider as rather active. Actors considered the most successful project of lookout of Špulka. These interviews were also found reason for the subsequent entry into the union one of the municipalities. The reason was indecision of council.
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Change trajectories of wetlands in the landscape of lowlands and uplands in the Czech Republic
Richter, Pavel ; Skaloš, Jan (advisor) ; Dagmar, Dagmar (referee)
Wetland habitats are of great multifunctional importance in landscape. In particular, they have the capacity to retain water during its surplus and then in the dry season to release the water. In this work the dynamics of change in wetlands coverage was analyzed, including the representation structure of different categories of wetlands over the past 180 years in the landscape of lowlands and uplands in the Czech Republic. The historical maps of Stable Cadastre, current orthophoto and current GIS layers of localization and classification of different types of land use/cover and landscape types were used as data sources. The area of wetlands has dramatically decreased from 5 762 hectares in the period 1825-1843 (more than 9.5 % of the area) to 54 hectares in 2014 (0.9 %). Based on the study of available documents three types of wetland habitats were classified: wet meadows, wet meadows with trees and swamps . Although, the most of the historic wetlands were constituted of wet meadows (89 %) these days the swamps (48 %) form the largest part of the wetlands. Half of the historic wetlands were transformed to arable land because of increasing production of agriculture. According to the evaluation of monitored changes by predictors it was found that more pressure on the degradation of wetlands was in the areas with more suitable climatic conditions for agriculture (e.g. The Danube basin, Moravia, soil types in the lowlands, Corn agricultural production area etc.). In these areas the swamps were formed as new wetlands in places of historical watercourses localization more significantly than elsewhere in monitored area. The aim of this work was also to describe the main driving forces and pressures that have influenced the changes in wetlands. The outcome of the paper can be used in landscape planning with regard to the protection and management of wetlands.
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Biotransfer of selected risk metals into plants and their accumulation and distribution in plant organs
Le Minh, Phuong ; Lachman, Jaromír (advisor)
Contamination of soils with heavy metals is one of the serious environmental problems threatening human being. Heavy metals are considered as the special hazard of soil pollutants because of the adverse effects on the plant growth, the amount, activity of useful microorganisms in soils and the quality of food. Regard to the persistent and toxicity, the heavy metals are toxic when we consider different kinds of pollutants in soils. In the soil, zinc (Zn), cadmium (Cd), lead (Pb) and mercury (Hg) toxicities frequently occur than the other metals because of their precipitation and sorption by the soil. It is a very dangerous situation because when these metals are taken up by plants, they can be transported to the food web and food chains.
In the present study, the accumulation of four heavy metals (mercury, zinc, lead and cadmium) in the whole grain of spring accessions of emmer, einkorn and common spring wheat cultivars and potato (Solanum tuberosum) is reported. Heavy and essential elements were monitored in potato cultivars in the exact field experiments and in hydroponically grown plants. The elements were determined by methods FAAS, ET AAS, and AMA (Advance Mercury Analysis). Statistical analyses were performed using SPSS 9.0 with the Tukey HSD (Honestly Significant Difference) test (alpha equal to 0.05).
In our study, the concentration of heavy metals decreased in the order zinc (Zn) > lead (Pb) > cadmium (Cd) > mercury (Hg) in the wheat grain. The comparison between three varieties of investigated wheat revealed that the emmer wheat was rich in zinc content (62.12 mg kg-1 dry matter), while the spring wheat had the lowest average concentration of zinc in the grain (40.99 mg kg-1 dry matter). Generally, the values of lead concentration in grain wheat varieties were low (ranging from 0.1268 mg kg-1 dry matter to 0.2950 mg kg-1 dry matter).
The concentrations of mercury in four typical growth stages of wheat (boot stage 10, heading stage 10.2 1/4 of head emerged, leaf-stage 10.2 and stage ripening 11 according to Feekes) were also determined. It has been shown that the concentrations of mercury in different wheat varieties were absorbed differently at different growth stages of plant. Stage 10.2 and leaf stage 10.2 showed the high mercury content (0.0152 mg kg-1 dry matter and 0.0214 mg kg-1 dry matter, respectively). Among individual varieties significant differences were determined.
Amounts of toxic and potentially toxic elements detected in investigated potato tubers are characterized by a large variability within investigated groups. Performing statistical analysis (one way ANOVA) showed that there were no significant differences between two investigated groups of samples (samples from Uhříněves and Valečov in the year 2013 and 2014) considering either one of investigated metals. Measurable levels of mercury were found in smallest amounts in all investigated potato samples comparing to other metals (Cd, Pb).
Plant cells compared to animal cells are characterized by the formation of cell walls. Plasma membrane or cell membrane is a biological active membrane separating the interior of cell from the outside environment. An adjusted method for isolation of protoplasts was developed and adapted for isolation of protoplasts from plant material (potatoes). In our experiment, the plants were grown hydroponically in the Research Institute of Plant Crops Prague-Ruzyně. If we examine the plant membrane, one option is to remove the cell wall by means of special mixture enzymes. Protoplasts were released in the dark at 25 degrees of Celsius for 18 hours. The 70 and 90 microns sieve was used to filter and then centrifugation for 5 minutes at 100 x g. All the steps were carefully carried out to prevent the damage or breakage of protoplasts.
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Effect of climatic and environmental variables on changes in numbers and migratory behaviour of wintering and migrating waterbirds.
Adam, Matyáš ; Musil, Petr (advisor) ; Bejček, Vladimír (referee)
Waterbirds with their specific habitat and food requirements varying during their annual cycle (Riffell et al. 2003; Taft and Haig 2006) are able to indicate the wetland diversity and quality due to their rapid responses on changes in environment (Delany 1999; Fernández et al. 2005; Amat and Green 2010). Remarkable land cover changes and climate warming led to significant shifts in distribution and abundance of many waterbird species across Europe in recent decades (Delany et al. 2006; Fox et al. 2010; Lehikoinen et al. 2013; Pavón-Jordán et al. 2015). To understand the dynamic of migratory birds in space and time and to assess effects of global conditions as well as local conditions of individual sites during their annual cycle there is need of international monitoring and research. Since the start of International Waterbird Census in 1967 both increasing and decreasing trends have been recorded in nearly fifty percent of waterbird species in Western Palearctic (Delany et al. 2006, Wetlands International 2016) and they consequently have affected trends in particular countries, including the Czech Republic. Wetland sites in the Czech Republic are generally situated on the edge of wintering range of most waterbird species (Gilissen et al. 2002), however the prevailing increase in abundance of waterbird species has been recorded here in recent decades (Musil et al. 2011). Though, the considerable growth of winter temperatures has not been noticed in the Czech Republic (Klein Tank et al. 2002; Musilová et al. 2009; Dušek et al. 2013), and the accessibility of the wetland sites, due to their freezing, varies year to year. Hence, we can assume that waterbirds have likely began using the alternative habitats with available food resources, i.e. cold-weather refuges, probably regardless of their conservation status (Musilová et al. 2015). Special protection areas were implemented to Czech legislation in 2004 to protect migratory birds (Birds Directive 2009/147/EC). So far there has not been tested the effectivity and impact of legislative protection on wintering waterbird species. Moreover, some previous studies indicated that SPA network do not match the species distribution pattern (López-López et al. 2007; Briggs et al. 2012; Albuquerque et al. 2013), so this issue urgently calls for scientific research.
The second part of the thesis focused on Greylag Geese, whose abundance has rapidly grown across the Europe in recent decades (Madsen et al. 1999; Fox et al. 2010), and that have become ideal model species to observe their responses to habitats and climate changes as well as their reactions to human disturbance (Fox and Madsen 1997; Ramo et al. 2015). This requires appropriate knowledge of geese distribution, abundance and their behaviour. Since 1930s, when the geese started to be ringed in the Czech Republic, the ringing intensity have markedly varied and have been reflected in numbers of recoveries. In last ten years the intensity have increased (Podhrazský 2010). However, complex of the historical data until 2002 (Cepák et al. 2008) and recent data have not been analysed so far. In the light of recent shifts in wintering ranges and migration phenology of many goose populations these analyses require increased attention. Furthermore, the satellite monitoring of geese is coming to detect more detailed information about behaviour of individuals.
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