The article focuses on the standards of health care and their mutual relationship. Firstly, the article deals with different types of standards, i.e. with the medical standard, civil law (liability) standard and with the standard for the purposes of public health insurance law. The second part of the paper is aimed at their mutual relationship, primarily with an emphasis on the relationship between the civil law standard and standard for the purposes of public health insurance law, where there could evidently exist tension between them. and Článek je zaměřen na problematiku standardů při poskytování zdravotních služeb a jejich interakci. Nejprve se v článku pojednává o jednotlivých druzích standardů, tedy o standardu medicínském, civilněprávním (deliktním) a standardu zdravotních služeb pro účely práva veřejného zdravotního pojištění. Druhá část článku se věnuje jejich vzájemnému vztahu, a to s důrazem na vztah standardu civilněprávního a standardu práva veřejného zdravotního pojištění, kde může docházet k jejich vzájemné kolizi.
A historical and instrumental earthquake catalogue is prepared for the Northwest Himalayan Fold and Thrust Belt and Makran Subduction Zone Pakistan from 1960 to 2019 with homogenized moment magnitude. The local and some international published sources were utilized for the preparation of catalogue. This earthquake catalogue contained numbers of duplicate, repeated, dependent and independent events. Declustering process was opted to remove the dependent events such as foreshock and aftershock from catalogue to separate the mainshock only in term of distance and time space window. The declustering found 2714 clusters of earthquakes with total of 19512 (57.19 %) events out of 34112. Only cluster events which contained the mainshock or independent events were drawn on seismicity map with color identification. Maximum likelihood method was used to compute the value of magnitude of completeness i.e., Mc = 3.8 with estimation of a and b-values. Years vise magnitude of completeness was also computed to check the time period variation. The completeness of magnitude for different intervals of time indicates the impartial approximation of previous recorded seismicity. Temporal and spatial maps were also drawn to investigate the slope “b” and rate of productivity “a” in the study region. It is noted that b-values varied from 0.2 to 2.0 due to stress and intensive tectonic setting whereas a value increases due to increase the seismicity rate with respect to region. Seismotectonic map was drawn to delineate the major faults, seismicity pattern and tectonic activities. This work further can be used for single value hazard assessment for any region and their response spectra to update buildings and bridges codes.
Sourozenectví je jedním z nejvýznamnějších vztahů v lidském životě. Tento vztah může být velmi specifický, má-li jeden ze sourozenců vývojové postižení. Zdraví sourozenci potom, stejně jako jejich rodiče, bývají konfrontováni s řadou stresových a náročných situací, které u nich vedou ke zvýšenému výskytu psychických obtíží. Za účelem podpory a naplnění potřeb této skupiny byl vytvořen program STEPS – Skupinový terapeuticko-edukační program pro sourozence dětí s postižením. Pilotním během intenzivní alternativy tohoto programu prošlo pět sourozenců dětí s Williamsovým syndromem. Cílem článku je podat základní informace o prvním běhu programu a poskytnout tak podnět pro další rozvoj podpory rizikové a v naší zemi doposud opomíjené skupiny – sourozenců dětí s postižením. and Sibship is one of the most important relationships in life. However, this relationship may be very specific if one of the siblings suffers from a developmental disorder. In such a case healthy siblings are confronted with a similar number of stressful and challenging situations as their parents. These stressors lead to an increased incidence of mental health problems in this population. In order to support and fulfil the needs of healthy siblings, STEPS program (Group Therapeutic Program for Siblings of Children with Disabilities) was developed. Five siblings of children with Williams syndrome have participated in piloting of an intensive alternative of this program. The aim of this article is to provide basic information on the pilot of this program and provide suggestions for further development of support for at-risk and in our country neglected population – siblings of children with disabilities.
In this study, the value of proxy data was explored for calibrating a conceptual hydrologic model for small ungauged basins, i.e. ungauged in terms of runoff. The study site was a 66 ha Austrian experimental catchment dominated by agricultural land use, the Hydrological Open Air Laboratory (HOAL). The three modules of a conceptual, lumped hydrologic model (snow, soil moisture accounting and runoff generation) were calibrated step-by-step using only proxy data, and no runoff observations. Using this stepwise approach, the relative runoff volume errors in the calibration and first and second validation periods were –0.04, 0.19 and 0.17, and the monthly Pearson correlation coefficients were 0.88, 0.71 and 0.64, respectively. By using proxy data, the simulation of state variables improved compared to model calibration in one step using only runoff data. Using snow and soil moisture information for model calibration, the runoff model performance was comparable to the scenario when the model was calibrated using only runoff data. While the runoff simulation performance using only proxy data did not considerably improve compared to a scenario when the model was calibrated on runoff data, the more accurately simulated state variables imply that the process consistency improved.
The determination of steroid hormones and subsequent interpretation of results is accompanied by a range of difficulties. The amount of information that current technology can provide on the circulating concentrations of more than a hundred various steroid compounds can lead to problems with interpretation. The aim of this study is to help provide orientation in this maze of data on steroid hormones. First we focus on specific aspects arising from the pre-analytical phase of steroid determination that need to be considered when planning sampling, whether for diagnostics or research. Then, we provide a brief summary of the characteristics and diagnostic relevance of several steroid hormones and/or their metabolites: pregnenolone, 17α-hydroxypregnenolone, dehydroepiandrosterone, hydroxyderivatives of dehydroepiandrosterone, androstenedione, testosterone, estrone, estradiol, estriol, cortisol, cortisone, which in our institute are determined with validated LC-MS/MS methods. For these steroids, we also provide newly calculated reference values in fertile women according to the phase of their menstrual cycle and Obsahuje bibliografii
As gestational diabetes mellitus (GDM) is both a frequent and serious complication, steroid levels in pregnancy are extremely elevated and their role in pregnancy is crucial, this review focuses on the role of steroids and related substances in the GDM pathophysiology. Low SHBG levels are associated with insulin resistance and hyperinsulinemia, while also predicting a predisposition to GDM. Other relevant agents are placental hormones such as kisspeptin and CRH, playing also an important role beyond pregnancy, but which are synthesized here in smaller amounts in the hypothalamus. These hormones affect both the course of pregnancy as well as the synthesis of pregnancy steroids and may also be involved in the GDM pathophysiology. Steroids, whose biosynthesis is mainly provided by the fetal adrenal glands, placenta, maternal adrenal glands, and both maternal and fetal livers, are also synthesized in limited amounts directly in the pancreas and may influence the development of GDM. These substances involve the sulfated Δ5 steroids primarily acting via modulating different ion channels and influencing the development of GDM in different directions, mostly diabetogenic progesterone and predominantly anti-diabetic estradiol acting both in genomic and non-genomic way, androgens associated with IR and hyperinsulinemia, neuroactive steroids affecting the pituitary functioning, and cortisol whose production is stimulated by CRH but which suppresses its pro-inflammatory effects. Due to the complex actions of steroids, studies assessing their predominant effect and studies assessing their predictive values for estimating predisposition to GDM are needed.
Stomatocystis goerresi sp. n., a gregarine (phylum Apicomplexa, Monocystidae) parasite of an important invasive earthworm in North America, Amynthas tokioensis (Beddard), is described. This is the second species placed into the genus, and details of its morphology and life cycle support Stomatocystis Bandyopadhyay, Mitra et Göçmen, 2006 as a valid taxon. The new species is described using standard nomenclature, measurements, shape descriptors, and photographs of living cells. The parasite was found only in A. tokioensis, and absent in sympatric earthworm species, suggesting it arrived when the earthworms were introduced from their origin from Japan. The species is distinctive from the type species in the genus, S. indica Bandyopadhyay, Mitra et Göçmen, 2006, in being substantially larger in all stages, found in only the host's seminal vesicles, and found in a different host species from East Asia. The distinctive trophozoites/gamonts develop a large funnel structure ringed with a collar of pronounced ridges, and the funnel appears even in the smallest cells. This funnel varies greatly in relative size (to the cell body) and shape, sometimes forming a large fan. The life cycle of S. goerresi is described including distinctive syzygy in which the funnels fuse and then produce a large cell with local centres of isogamete production (thus sex without gender). Gametes are large ( ~5 μm) spheres with complex tips. Oocyst production is large, > 1,000 per mature gametocyst. The genus Stomatocystis is placed into the Monocystidae, but the life cycle of the new species differs from those of other monocystid taxa, which may mean the Monocystidae are not monophyletic or life cycles are variable within the family. Prevalence of S. goerresi at the type locality was high (~ 90%). The parasites destroy the earthworm's organ of sperm self-storage thus eliminating the male function in the hermaphroditic host which may influence the ability of the earthworm to invade and be successful at new sites
Spiders are generalist predators that contribute to the control of pests in agroecosystems. Land use management determines habitats including refuges for hibernation and aestivation. The availability of shelters on the ground can be crucial for maintaining populations of spider within crops. We studied the effect of the number of stones on the surface of the soil on the spider community in selected olive groves in Trás-os-Montes (northeastern Portugal). The number of stones significantly influenced the overall diversity of spiders, abundance of immature individuals and abundance of ground hunters. Agricultural management practices aimed at the conservation of soil microhabitats such as hedgerows, stonewalls and stones on the ground should be promoted in order to maintain or increase the number of shelters for potential natural enemies of pests., Jacinto Benhadi-Marín, José A. Pereira, José A. Barrientos, José P. Sousa, Sónia A.P. Santos., and Obsahuje bibliografii
The ongoing covid-19 epidemic has affected the entire world. Somewhat surprisingly, it is not the case that the most successful countries are the richest one, with the best health care. Nor is there a clear link between success and geographical location. Above all, much of the rich Western world has failed so far to protect public health effectively, and so it is appropriate to consider the question why. In this article, I focus mainly on the choice of the basic epidemiological strategy, which I consider to be one of the key factors of success or failure of many countries. I further criticize the view that the protection of human lives would harm the economy or other important values of societies. and Probíhající epidemie onemocnění covid-19 se dotkla celého světa. Poněkud překvapivě neplatí, že nejúspěšnější země jsou ty nejbohatší a s nejlepším zdravotnictvím. Stejně tak neplatí ani jasná souvislost mezi úspěchem a geografickou polohou. Především značná část bohatého západního světa v ochraně veřejného zdraví doposud selhávala a je proto vhodné položit si otázku, proč tomu tak je. V tomto článku se zaměřuji především na volbu základní epidemiologické strategie, kterou považuji za jeden z klíčových faktorů úspěchu či neúspěchu mnoha zemí. Kritickému rozboru dále podrobuji názor, že by ochrana lidských životů poškozovala ekonomiku či jiné důležité společenské hodnoty.