At present, the promotion of health in significant changes. In my work I try to find out how the financing of health care facilities, respectively. hospitals in the Czech Republic, especially in the Pardubice region. The work shows how to manage individual county hospital and the problems they face. To fulfill its objective, it is used the most recent literature, legislation and financial statements hospitals. The main contribution of this work is a complete analysis of five acute care hospitals in the Region, as yet arisen document, which would thus comprehensively evaluate the economic situation of hospital care in this region. Based on the findings is then in the final part of the thesis evaluates the real state management of five acute care hospitals. Outlines the major problems in hospitals and nejich possible solution.

Sammanfattning Bakgrund Det beskrivs att vissa akuta situationer känns bra och att teamarbetet fungerar väl men i andra situationer så kanske medlemmarna har ett sämre samarbete och det leder till en dålig känsla som påverkar deras prestation. En svårighet som finns är att identifiera vad som påverkar samarbetet. Specialistsjuksköterskornas upplevelser kan vara en viktig del i att identifiera detta. Syfte Syftet var att beskriva hur anestesisjuksköterskor och intensivvårdssjuksköterskor upplevde teamarbete och kommunikation i akuta situationer. Metod Studien genomfördes med beskrivande design och kvalitativ induktiv ansats. Semistrukturerade intervjuer med fem anestesisjuksköterskor och fem intensivvårdssjuksköterskor utgjorde datainsamlingen. Kvalitativ innehållsanalys användes. Huvudresultat Temat var hur tydlighetens betydelse i akuta situationer påverkar tryggheten och huvudkategorierna var; att samverka mellan professioner, att uppleva ledarskap i akuta situationer, att uppleva kommunikationens betydelse, att uppleva arbetsmiljön i samband med akuta situationer och att delta vid akuta situationer väcker känslor. Teamets utformning var beroende av dess teammedlemmar. Specialistsjuksköterskor upplevde det mer lättarbetat och tryggt när de kände personalen. Samt när deras yrkesroller och arbetsuppgifter var väl definierade. Teamets ledare hade stor betydelse i hur arbetet i teamet fungerade. Kommunikationsverktyg som ”closed-loop” ingav trygghet. Tydlighet framkom som en viktig del i teamarbetet. Slutsats Specialistsjuksköterskorna efterfrågade en lugn, tydligt och strukturerat omhändertagande av patienten. En tydlig teamledare som är informerande och uppmuntrande och tar till vara alla medlemmar i teamet och deras erfarenheter Kommunikationen ska helst vara ”closed-loop” samt att de önskade scenarioövningar, uppföljning och debriefing angående de akuta situationerna.

Given the proliferating aging population, increasing moderate-to-vigorous physical activity (MVPA) and exercise is critical because it enhances overall well-being and reduces the rates of many adverse age-related health conditions. However, intervention efforts to establish sustained changes in MVPA have yielded limited success due their sole focus on conscious factors (e.g., changing goals and intentions). Thus, older adults continue to represent the highest proportion of sedentary adults, despite their knowledge of the widespread health benefits associated with PA and exercise or even their intentions to engage in such behaviors. Consequently, the benefits of PA and exercise are not being fully realized and health problems perpetuate. Developing evidence-based interventions that establish sustained changes in MVPA and exercise behaviors in older adults is a major public health priority, but this requires going beyond social-cognitive constructs. The broad goal of my dissertation is to advance scientific understanding about the neural systems associated with changes in MVPA behaviors among sedentary older adults. Emerging evidence indicates that nonconscious processes also regulate exercise behaviors, stemming from accumulated affective responses from past exercise experiences (e.g., pleasant vs unpleasant). Grounded by current understanding about affect's role on decision-making, the present study hypothesized that physiological changes induced by single bouts of PA serve as somatic markers in the brain that guide future PA-related behaviors. Specifically, my dissertation extended previous research by testing whether acute exercise responses in affect-related brain systems predict PA behavior change following a 3-month exercise intervention. This hypothesis is supported by prior research indicating that self-reported changes in affect (i.e., pleasant/unpleasant feelings) during moderate-intensity exercise reliably predicts future MVPA behavior. The results of my dissertation advances previous findings by investigating how these affective responses to exercise are represented in the brain and how they relate to PA behavior change. I tested my central hypothesis through the following two specific aims: In Specific Aim 1, I investigated whether the acute physiological and neural responses to exercise were related to the subjective experience of exercise in older adults. Healthy, low-active, older participants (N = 34, Age = 67.2 years, 21 females) completed an acute exercise procedure consisting of two within-subjects exercise conditions occurring on separate counter-balanced sessions. During the active condition, participants cycled at a moderate intensity (65% of maximum heart rate), and during the passive condition, their legs were moved by motorized pedals on the same machine and at the same pedal rate as in the active condition. To investigate exercise-related changes in brain function, functional MRI scans were acquired before and after the acute exercise. Additionally, salivary samples were collected throughout the experiment to provide objective biomarkers that have been linked with psychological changes. Finally, participants provided self-reported changes in affect. I found that acute exercise was associated with increases in salivary markers of sympathetic activity and decreases in salivary cortisol levels with no significant differences between conditions. Acute exercise also resulted in observable increases in positive affect with no differences between conditions. Finally, no observable acute exercise-related changes in functional connectivity occurred. In Specific Aim 2, I identified predictors of exercise behavior change from objectively-measured biomarkers and neural systems that are acutely responsive to exercise. After completing the acute exercise sessions, participants began a 3-month supervised exercise intervention. To assess intervention-related changes in unsupervised PA behavior, participants wore a PA monitoring device for 7 days before and immediately after the intervention. Individuals who exhibited a stronger acute functional connectivity response between nucleus accumbens (NAcc) and medial prefrontal cortex (mPFC) before the intervention were more likely to increase their unsupervised levels of MVPA after the intervention. Given the role of NAcc-mPFC circuitry in affect-based decision making and self-referential processing, the present findings suggest that enhanced cognitive appraisal and awareness of affective changes are related to more sustained changes in long term behavior. This study is the first to demonstrate neurobiological evidence supporting the relationship between positive affective responses to acute exercise and long-term changes in exercise behavior. This research advocates the utility of affect-based measures in tailoring exercise interventions for sedentary older adults.

The purpose of the study was to identify the effect of a single bout of moderately intense aerobic exercise on measures of executive function in young adults with ADHD. Thirty-two young adults between the ages of 18 and 25 years old were randomly assigned to either an acute exercise group or a control group. The exercise protocol was designed to address the methodological shortcomings in the exercise and executive function literature, and involved cycling on a stationary bike at moderate intensity for 30 minutes. Participants completed executive function tasks related to set shifting, working memory, and inhibition prior to and immediately following the treatment session. Results of the study reveal that acute exercise facilitated performance on the Stroop Color-Word task when compared to sedentary controls. However, unlike previous research on healthy adults, no improvements on the other measures of executive function were observed. These findings suggest that young adults with ADHD may specifically benefit from acute exercise on aspects of executive function related to the Stroop Color-Word measure. In conclusion, further research on this topic should continue to investigate this population, as well as consider the relationship between acute exercise and additional neuropsychological measures of inhibition, set shifting, and working memory in order to better determine the effects on each construct.

Childhood acute leukaemias are a heterogeneous group of malignant diseases. Based on cell origin, clinical manifestations, and molecular/chromosomal changes, we distinguish two main subtypes: acute myeloid leukaemia and acute lymphoblastic leukaemia. Acute lymphoblastic leukaemia (ALL) is the most frequent form of childhood leukaemia. Acute myeloid leukaemia (AML) is predominantly found in adults, being rarer in childhood. In the Czech Republic, the ALL is in childhood diagnosed approximately five times more often compared to AML. Despite the intensive research, aetiology of leukaemia has not been entirely clarified. So far, we only have knowledge of certain risk factors (ionising radiation, some chemicals and viruses) but in the vast majority of cases the aetiopathogenesis has not yet been made clear. Some of the answers may be provided by studies dealing with the presence of (pre)-leukaemic cells in a material archived prior to the clinical onset of the disease. Such are for example the so-called Guthrie cards, the dried blood samples collected immediately after birth and used in screening of the newborns for metabolic disorders. The better availability of material collected before the diagnosis of a secondary leukaemia (originally meant for the follow-up of the primary malignancy) might help us in better...

京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第22147号 / 医博第4538号 / 新制||医||1039(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 濵﨑 洋子, 教授 竹内 理, 教授 髙折 晃史 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

京都大学 / 0048 / 新制・課程博士 / 博士(社会健康医学) / 甲第22152号 / 社医博第100号 / 新制||社医||10(附属図書館) / 京都大学大学院医学研究科社会健康医学系専攻 / (主査)教授 川上 浩司, 教授 武藤 学, 教授 髙折 晃史 / 学位規則第4条第1項該当 / Doctor of Public Health / Kyoto University / DFAM

京都大学 / 0048 / 新制・論文博士 / 博士(医学) / 乙第13330号 / 論医博第2198号 / 新制||医||1044(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 長船 健二, 教授 羽賀 博典, 教授 山下 潤 / 学位規則第4条第2項該当 / Doctor of Medical Science / Kyoto University / DFAM

京都大学 / 0048 / 新制・課程博士 / 博士(社会健康医学) / 甲第22381号 / 社医博第103号 / 新制||社||医11(附属図書館) / 京都大学大学院医学研究科社会健康医学系専攻 / (主査)教授 中山 健夫, 教授 小池 薫, 教授 福原 俊一 / 学位規則第4条第1項該当 / Doctor of Public Health / Kyoto University / DFAM

京都大学 / 新制・課程博士 / 博士(医学) / 甲第23071号 / 医博第4698号 / 新制||医||1049(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 伊達 洋至, 教授 YOUSSEFIAN Shohab, 教授 平井 豊博 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM