|
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.
|
|
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.
|
|
Nursing care in trauma centras in the Czech Republic
POLANOVÁ, Alena
Abstract The thesis deals with the issues of nursing care in trauma centres in the Czech Republic. Injuries requiring complex and multidisciplinary treatment apart from surgery therapy are still more frequent nowadays. This is why trauma centres have been established in the Czech Republic. Their establishment increases demands for caring staff of non-physician fields. These increasing demands are of mental and physical character and of course demands for further education. The aim of the thesis was to find what opportunities nurses of trauma centres have in the field of further education, what are their biggest problems and how they cope with mental and physical stress in their work. The following hypotheses were set upon qualitative research in the form of unstructured interviews with nurses of trauma centres. Hypothesis 1: Nurses working in trauma centres prefer specialization education to tertiary education. Hypothesis 2: Nurses working in trauma centres cooperate with nurses from other clinical branches on provision of nursing care. Hypothesis 3: Nurses working in trauma centres get education not only in traumatology, but also in further clinical fields. Hypothesis 4: Nurses working in trauma centres cope with mental stress. Hypothesis 5: Nurses working in trauma centres cope with physical stress. Quantitative research in the form of questionnaires was applied on confirmation or refutation of the hypotheses. The research sample consisted of nurses working in trauma centres in the Czech Republic. Upon evaluation of the results hypotheses 1, 2 and 5 were confirmed and hypotheses 3 and 4 were refuted. The research results confirm that the work of nurses in trauma centres is hard in terms of mental and physical stress. There are still some reserves in further education of nurses not only on the part of the top managements but also on the part of the health care staff themselves. The thesis result may help in recruiting new staff to departments where the expected psychical and physical intensity might be an incentive to the care about an employee in the field of mental hygiene and improvement of interdisciplinary cooperation in trauma centres in the Czech Republic.
|
|
Active employment policy in selected region
Čihák, Pavel ; Šrédl, Karel (advisor) ; Markéta, Markéta (referee)
The thesis considers unemployment and a possibility of increasing employment in the Central Bohemian Region using the active employment policy. The first part of the thesis is dedicated to theoretical basis gained from professional literature and internet resources about labor market, types of unemployment depending on the cause of its origin, risky groups of unemployed people, social and economic consequences of unemployment and about an analysis of actions of the active employment policy. Furthermore, there is described the Central Bohemian Region and its strong and weak aspects. We can look at the evaluation of employment and unemployment made by a study, status reports of the labor market and processing of statistical indicators in Central Bohemian Region. We can also peek at regional individual projects realized on the territory of Central Bohemian Region in 2015. The last part of this thesis is focused on some possibilities of more effective use of actions of the active employment policy in the region.
|
|
Changes in wetlands - change trajectories, causes
Brašna, Vlastimil ; Skaloš, Jan (advisor) ; Josef, Josef (referee)
This thesis analyzes the historical development of wetlands in corn production areas in Moravia, Czech Republic. Wetlands were analyzed changes in time and space for a period of 180 years.
The main objective is to analyze the development of wetland habitats in the landscape using old maps, aerial photographs and GIS. The bases were of the Imperial Imprints of the Stable cadastre from the first half of the 19th century and contemporary orthophoto. There were also used GIS layers of the current location of wetlands, farmland, forests, rivers and waterways. In historical documents were evaluated by two categories 1) wet meadows and 2) swamps and marshes. In the current surface are only evaluated wetlands.
The total area is 18054 ha. The area of wetlands dramatically decreased from 108 ha in the first half of the 19th century on 14 ha in 2015. Most of the wetlands have been converted to agricultural land - arable land (72 %), meadows and pastures (12 %). Wetlands succession was transformed to bushes (5,4 %). There was 5 % of the deaths of wetlands built and drained. Most wetlands have been transformed due to the pressure on the production function of the landscape in order to get more food. In the first half of the 19th century it was dominated by wet meadows, they had 684 ha. Despite the disappearance of a large part of the wetlands created new wetlands, which have 12.4 hectares. Most newly created wetlands are located in the cadastral area of Mutěnice. Only one wetland (1.68 ha) remained unchanged, located in cadastral Čejč. This wetland had a history of more land (25.15 hectares) and has been linked with Čejčské Lake.
The main result of this work is to determine the trajectories of development of wetland ecosystems in the lowlands of Moravia. Descriptions of these trajectories have contributed to understanding influences on the development of wetlands. Results wetlands contribute to the development of knowledge in the field of landscape ecology. The results can be used to restore extinct wetlands and creation of new wetlands in the historic wet meadows. The information obtained can be used in landscape planning with regard to the protection and management of wetlands.
|
|
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.
|
|
The renovation of historical parks near the small feudal residences on the example of the study of the renovation of the castle garden in Doudleby nad Orlici in Eastern Bohemia.
Faltysová, Lenka ; Buttry, Ivana (advisor) ; Jakub, Jakub (referee)
The aim of this work is the processing methodology and presentation process how to restore monuments of garden art. On the example of the revitalization of the castle garden immovable cultural monument Castle Doudleby nad Orlicí, based on the study of literature, similar interventions and the analysis and interpretation of various types of archival material the current quality of historic garden was evaluated. It is based on field survey, which consists of dendrological research, analyzing the authenticity of trees and appreciation of all the collected documents, historical sources and professional literature. Concept recovery of castle garden is based on the expert authority´s binding point of view of the state care of historical monuments.
Renaissance castle in Doudleby nad Orlici is located in the eastern part of the town on a slightly raised hill on the right bank of the River Divoká Orlice. There was a wooden medieval fortress with the farmyard on this place in the 13th century. Sr Mikuláš from Bubno started to build a hunting lodge in the Renaissance style as villa in 1588, which was finished in 1590. The significance of Renaissance residence, which complement the early Baroque elements from the late 17th century, is enhanced by the opulent and impressive sgraffito - carpet pattern covering all external and internal frontage, restored in 1886 by Kirchner. The tall chimneys are the part of decoration in the courtyard decorated with sgraffito as well. The chateau complex is formed along its circuit of farm buildings and residential buildings. Building of castle itself is separated by a park with old trees and newer lawns (Hieke, 1984).
Castle park in Doudleby nad Orlicí was founded in 1809 in compositional continuity of the Renaissance castle building. The park forms one organic complex with the castle. The promoter strived, like in the castle rooms, to demonstrate here his wealth, his sense of art and his botanical-dendrological knowledge. The park is designed as a narrow disposition in landscape style and it is composed as a long vista to the castle. The area of the landscape park is 3.76 hectares nowadays.
The literature search is especially dedicated to the Renaissance and its relationship to the garden art. The monument care in the Czech Republic and the activity of professional organization of the monument care of the National Heritage Institute in Josefov is introduced in this section.
The methodological guide describes the used bolsterings and resulting outputs on the basis of them are implemented of such measures, which will help to improve the health and vitality of existing promising trees and new plantings of trees, which are consistent with the original composition with emphasis on the rehabilitation and upgrading of historical value of the object. Treatment of trees and supplementary planting will be done within the frame of total revitalization of the castle park.
The practical unit describes the current status of vegetation monuments of garden art. The inventory trees is the essential tool for analyzing the current status of vegetation monuments of garden art. Inventory, which should provide quality base for a draft recovery, should also be addressed in certain parts with characteristics of individual species (Krejčiřík, 2015).
The results of field investigation were completely recorded in the graphical output.
|
|
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.
|
|
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.
|
|
Trend of beer trade
Kolář, Petr ; Šánová, Petra (advisor) ; Markéta, Markéta (referee)
Thesis The beer trade trends identifies variables which have an impact on the consumption of beer and predicts the trend of trade in beer in the Czech Republic in the globalization context. To achieve the results was used linear econometric model. Using the Method of least squares determined the size and direction of individual variables for beer consumption. Based on the verified model is a model applicated and based on software Gretl is predicted the beer consumption for a period of 3 years. The biggest influence on beer consumption has production, nominal wages (adjusted for inflation), and the impact of the economic crisis. The prediction is dependent on the lingering economic crisis, beceause the predicted values for 2015 are higher than beer consumption in the same year by 3 litres. The lingering economic crisis has an impact in 2015 on the consumption of beer and during 2016 this dependence should disappear. Trend beer consumption is rising to the level of 146 l per person per year.
|
guest ::
