Komunitní zdravotní péče, zvláště ve vztahu k ošetřovatelským službám, je klíčem ke zlepšení zdraví a tělesné i duševní pohody všech lidí. Cílem výzkumu bylo zjistit, jaké jsou představy odborné a laické veřejnosti o možnostech působení sester v komunitní péči a podrobněji analyzovat jednotlivé oblasti této péče z hlediska uplatnění sester v nich. V rámci výzkumu byly předmětem zkoumání tři cílové skupiny – lékaři ČR, sestry ČR a občané ČR. Do výběrového souboru bylo zařazeno 1007 lékařů, 1005 všeobecných sester a 2022 občanů. Tito respondenti byli vybráni náhodným výběrem pomoci kvót. Následující článek je věnován interpretaci výsledků výzkumu všech cílových skupin – lékařů, sester i občanů z hlediska jejich názorů, týkajících se předpokladů a překážek, které vidí v začlenění sester do komunitní péči v České republice. Odborná i laická veřejnost vidí možnosti uplatnění sestry v komunitní péči v různých oblastech. Péče o seniory je nejvíce preferovanou oblastí ve všech skupinách. Nejdůležitějším předpokladem pro samostatnou práci sestry v komunitní péči je její předchozí klinická praxe, odpovídající zaměření komunitní péče. Hlavní překážky, které brání realizaci samostatné péče komunitních sester uvádí shodně odborná i laická veřejnost: nejasnost financování, finanční zátěž, obtížná spolupráce se zdravotními pojišťovnami, otázky legislativy – uzákonění a ustanovení kompetencí sester v ČR. Lékaři i sestry se shodují v tom, že činnost komunitních sester by měl financovat především stát, menší část respondentů si myslí, že financovat činnost těchto pracovníků by měla organizace, ve které pracují a třetím nejrozšířenějším názorem je financování krajem. Lékaři České republiky mají převážně zájem o případnou spolupráci se sestrami, působícími v oblasti komunitní péče a tuto spolupráci by přivítali. Ze strany sester však v současném období převládá v České republice nezájem o případnou práci v oblasti komunitního ošetřovatelství, který lze vysvětlit především nejasným financováním v této oblasti., The goal of the study was to ascertain the ideas of professional and lay public on the possibilities of work of nurses in community care and to analyze in more detail the individual areas of such care from the perspective of use of work of nurses in them. Three target groups consisted of 1007 physicians, 1005 general nurses and 2022 citizens. The respondents were selected by random selection with the help of quotas. Both professional and lay public sees the opportunities of use of work of the nurse in community care in different areas. Care for seniors is the mostly preferred area in all groups. The most important precondition for independent nurse’s work in community care is her preceding clinical practice corresponding to the focus of the community care. The main obstacles to implementation of independent care of community nurses are stated coincidently by professional and lay public: unclear funding, financial burden, difficult cooperation with health insurance funds, legislation questions – codification and establishment of nurse competences in the Czech Republic. Both the physicians and the nurses agree that the activity of community nurses should be funded mainly by the state; smaller part of respondents thinks that the activity of such workers should be funded by the organizations they work for, and the third most widespread opinion is funding by the region., Valérie Tóthová, Sylva Bártlová, Eva Prošková, and Lit.: 18
Cough is one of the most important defensive reflexes. However,
extensive non- productive cough is a harmful mechanism leading
to the damage of human airways. Cough is initiated by activation
of vagal afferents in the airways. The site of their convergence is
particularly the nucleus of the solitary tract (nTS). The secondorder neurons terminate in the pons, medulla and spinal cord and
there is also the cortical and subcortical control of coughing. Upper
airway cough syndrome (UACS) – previously postnasal drip
syndrome - is one of the most common causes of chronic cough
together with asthma and gastroesophageal reflux. The main
mechanisms leading to cough in patients with nasal and sinus
diseases are postnasal drip, direct irritation of nasal mucosa,
inflammation in the lower airways, upper airway inflammation and
the cough reflex sensitization. The cough demonstrated by UACS
patients is probably due to hypersensitivity of the upper airways
sensory nerve or lower airways sensory nerve, or a combination of
both. Further studies are needed to clarify this mechanism.
In this paper, we develop computational procedures to approximate the spectral abscissa of the switched linear system via square coordinate transformations. First, we design iterative algorithms to obtain a sequence of the least μ1 measure. Second, it is shown that this sequence is convergent and its limit can be used to estimate the spectral abscissa. Moreover, the stopping condition of Algorithm 1 is also presented. Finally, an example is carried out to illustrate the effectiveness of the proposed method.
We present a lower and an upper bound for the second smallest eigenvalue of Laplacian matrices in terms of the averaged minimal cut of weighted graphs. This is used to obtain an upper bound for the real parts of the non-maximal eigenvalues of irreducible nonnegative matrices. The result can be applied to Markov chains.
For a graph property $\mathcal {P}$ and a graph $G$, we define the domination subdivision number with respect to the property $\mathcal {P}$ to be the minimum number of edges that must be subdivided (where each edge in $G$ can be subdivided at most once) in order to change the domination number with respect to the property $\mathcal {P}$. In this paper we obtain upper bounds in terms of maximum degree and orientable/non-orientable genus for the domination subdivision number with respect to an induced-hereditary property, total domination subdivision number, bondage number with respect to an induced-hereditary property, and Roman bondage number of a graph on topological surfaces.
The paper deals with the existence of a quasi continuous selection of a multifunction for which upper inverse image of any open set with compact complement contains a set of the form $(G\setminus I)\cup J$, where $G$ is open and $I$, $J$ are from a given ideal. The methods are based on the properties of a minimal multifunction which is generated by a cluster process with respect to a system of subsets of the form $(G\setminus I)\cup J$.
Let $R$ be an integral domain with quotient field $K$ and $f(x)$ a polynomial of positive degree in $K[x]$. In this paper we develop a method for studying almost principal uppers to zero ideals. More precisely, we prove that uppers to zero divisorial ideals of the form $I = f(x)K[x] \cap R[x]$ are almost principal in the following two cases: – $J$, the ideal generated by the leading coefficients of $I$, satisfies $J^{-1} = R$. – $I^{-1}$ as the $R[x]$-submodule of $K(x)$ is of finite type. Furthermore we prove that for $I = f(x)K[x] \cap R[x]$ we have: – $I^{-1}\cap K[x]=(I:_{K(x)}I)$. – If there exists $p/q \in I^{-1}-K[x]$, then $(q,f)\neq 1$ in $K[x]$. If in addition $q$ is irreducible and $I$ is almost principal, then $I' = q(x)K[x] \cap R[x]$ is an almost principal upper to zero. Finally we show that a Schreier domain $R$ is a greatest common divisor domain if and only if every upper to zero in $R[x]$ contains a primitive polynomial.
Autor zdůvodňuje nutnost individuálního přístupu k edukaci o fyzické aktivitě. Individuální přístup se týká vhodné pohybové aktivity, intenzity a trvání pohybu, ale také úprav terapie. Autor ukazuje rámcová doporučení, týkající se úprav diety a také úprav dávek inzulinu tak, jak jsou v procesu edukace předkládány nemocným s diabetes mellitus na jeho pracovišti., Jindřich Olšovský, and Lit. 6
Disordered motility is one of the most important pathogenic characteristics of functional dyspepsia (FD), although the underlying mechanisms remain unclear. Since the sympathetic system is important to the regulation of gastrointestinal motility, the present study aimed to investigate the role of norepinephrine (NE) and adrenoceptors in disordered gastric motility in a rat model with FD. The effect of exogenous NE on gastric motility in control and FD rats was measured through an organ bath study. The expression and distribution of β-adrenoceptors were examined by real-time PCR, Western blotting and immunofluorescence. The results showed that endogenous gastric NE was elevated in FD rats, and hyperreactivity of gastric smooth muscle to NE and delayed gastric emptying were observed in the rat model of FD. The mRNA levels of β1-adrenoceptor and norepinephrine transporter (NET) and the protein levels of β2-adrenoceptor and NET were increased significantly in the gastric corpus of FD rats. All three subtypes of β-adrenoceptors were abundantly distributed in the gastric corpus of rats. In conclusion, the enhanced NE and β-adrenoceptors and NETs may be contributed to the disordered gastric motility in FD rats.