Submitted by Biblioteca da Faculdade de Farmácia (bff@ndc.uff.br) on 2017-03-24T17:22:23Z No. of bitstreams: 1 Deutsch, Gabriela [Dissertação, 2014].pdf: 1124546 bytes, checksum: 4c2efe5d127b5965bea25e458da2afc4 (MD5) / Made available in DSpace on 2017-03-24T17:22:23Z (GMT). No. of bitstreams: 1 Deutsch, Gabriela [Dissertação, 2014].pdf: 1124546 bytes, checksum: 4c2efe5d127b5965bea25e458da2afc4 (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / A balneoterapia é um importante procedimento realizado diariamente em pacientes queimados. Esta prática consiste na limpeza mecânica com fricção manual sobre as áreas lesionadas pela queimadura utilizando antisséptico. Poucas são as evidências de que sua prática seja efetiva na higienização das feridas e na prevenção de infecção cruzada entre pacientes que utilizam o mesmo tanque. Neste projeto, buscou-se estudar a influência da balneoterapia na descolonização da superfície corporal queimada (SCQ) de pacientes internados em um centro de tratamento de queimaduras (CTQ), quanto à presença de cepas de Staphylococcus aureus e Pseudomonas aeruginosa. Swabs foram coletados durante a realização da balneoterapia de 18 pacientes por 14 semanas. A água utilizada também foi avaliada. Testes fenotípicos e genotípicos foram utilizados para identificação de S. aureus e P. aeruginosa. A susceptibilidade a antimicrobianos e biocidas foi verificada segundo os critérios do Clinical and Laboratory Standards Institute (CLSI). Pulsed-field gel electrophoresis (PFGE) foi utilizado para avaliar a diversidade genômica. Análise exploratória das variáveis envolvidas no processo da balneoterapia foi determinado pela estatística descritiva e testes estatísticos não paramétricos foram utilizados na análise dos fatores de risco. Trezentos e cinquenta e dois swabs foram coletados dos quais 214 (61%) da SCQ, 60 (17%) da cavidade nasal e 78 (22%) da mesa onde ocorreu a balneoterapia. Detectou-se 13 cepas de S. aureus e 39 de P. aeruginosa. A concentração mínima inibitória (CMI) para sulfadiazina de prata foi ≥32μg/mL para as cepas de S. aureus enquanto que para a P. aeruginosa a maioria das cepas apresentou CMI de 128μg/mL. Com relação a clorexidina, as cepas de S.aureus apresentaram um CMI variando de 2 a 8g/mL enquanto para P. aeruginosa a variação foi de 16 a 64μg/mL. Cinco amostras foram identificadas como S. aureus resistentes a meticilina (MRSA) e nove como P. aeruginosa resistentes a carbapenêmicos. A análise do perfil de fragmentação do DNA total (PFGE) nas cepas de P. aeruginosa demonstrou a existência de 10 clones entre 35 cepas analisadas. O tipo A foi o mais prevalente, com 23 cepas distribuídas em 8 subtipos. Estes estavam presentes na SCQ coletada antes e após o banho e nas superfícies da mesa de banho, sugerindo que há contaminação cruzada de um indivíduo para o outro, de uma área queimada para outra no mesmo indivíduo, da mesa da balneoterapia para indivíduos e finalmente do indivíduo para mesa. Os resultados não se mostraram estatisticamente significativos, no entanto, quatro pacientes que não apresentaram contaminação antes do banho se tornaram positivos após este procedimento, e 10 pacientes que apresentaram contaminação antes do banho, assim permaneceram. Conclui-se que o procedimento de descontaminação não está sendo eficaz uma vez que houve similaridade clonal entre as cepas de P. aeruginosa coletadas em vários pontos e momentos / Balneotherapy is an important procedure usually performed in burn patients. This practice consists on a mechanical cleaning with manual friction on the damaged areas using an antiseptic. There is little evidence that this practice is effective to clean the wounds and avoid cross infection between patients using the same table. In this project, we study the influence of hydrotherapy in the decolonization of burned body surface area (BSA) of patients admitted to a burn center (BC) for the presence of Staphylococcus aureus and Pseudomonas aeruginosa isolates. Thus, swabs were used to collect bacteria from 18 patients submitted to balneotherapy during 14 weeks. The material from bath table and the water used were also evaluated. Genotypic and phenotypic tests were used to identify S. aureus and P. aeruginosa. Susceptibility to antimicrobials and biocides has been verified according to the criteria of the Clinical and Laboratory Standards Institute (CLSI). Genomic diversity was assessed by pulsed-field gel electrophoresis (PFGE). Descriptive statistics were used in the exploratory analysis of the variables involved in the balneotherapy and non-parametric statistical tests were used in process analysis of risk factors. Three hundred fifty-two swabs were collected of which 214 (61%) were from BSA, 60 (17%) from nasal cavity and 78 (22%) from table where balneotherapy occurred. Thirteen isolates were identified as S. aureus and 39 as P. aeruginosa. Minimum inhibitory concentration (MIC) for silver sulfadiazine was ≥ 32μg/mL for S. aureus isolates and 128μg/mL for P. aeruginosa. It is possible that the increased MIC to silver sulfadiazine has occurred by the constant use of this antimicrobial in balneotherapy. However, MIC to chlorhexidine for S. aureus isolates range from 2 to 8mg/mL and for P. aeruginosa range from 16 to 64μg/mL. Furthermore, five S. aureus isolates were identified as methicillin-resistant Staphylococcus aureus (MRSA) and nine as P. aeruginosa resistant to carbapenems. A profile analysis of total P. aeruginosa DNA fragmentation showed 10 clones among 35 strains analyzed. Type A was the most prevalent, with 23 isolates distributed into eight subtypes. These subtypes were present in BSA collected before and after the bath and on the surfaces of the bath table, suggesting that there is cross-contamination from one individual to another, from a burned area to another in the same individual, from the balneotherapy table to an individual and finally from the individual to the table. The results were not statistically significant, however, four patients who were not contaminated before bathing became positive after this procedure, and 10 patients who were contaminated before bathing, remained so. Thus, it is possible to conclude that the procedure is not efficient for the decontamination because there was similarity between the clonal isolates of P. aeruginosa collected at various points and times

The thesis ``The impact of balneology treatment on Health Related Quality of Life (HRQoL) and drug consumption in young subjects under 35 years of age.{\crqq} The theoretical part deals with balneology treatment and quality of life in general, its assessment, with chronic diseases of musculoskeletal system and their impact on quality of life. The objective of the thesis is stated and hypothes is set in the practical part by means of which the research itself was started. The following chapter ``Methodology{\crqq} describes the research technique and methods used to confirm or disprove given objective and hypothes stated. The next chapter ``Results{\crqq} contains charts and graphs with final values and their verbal description. Information obtained from the research is confronted in the discussion.

The purpose of this dissertation is a formulation and analysis of a business plan for development of a new spa resort in Františkových Lázních and conduct feasibility study of proposed business case. The following work is divided into theoretical and practical part. While theoretical section of the dissertation outlines main terms and theoretical concepts, explains relevant legal and regulatory conditions and restrictions relating to offering spa services and details all factors necessary for appropriate formulation of presented business case. Practical part of the dissertation presents a real life business case together with a feasibility study of the proposal, competitor analysis, market research and planned marketing strategy, while analysing returns of invested capital in three alternative scenarios.

Chronic disorders of the locomotion organs belong to serious civilization diseases deteriorating the quality of human life. Medical literature generally accepts the opinion that the way of life is responsible for 50 % of our physical condition. Healthy lifestyle requires that we move regularly. Perceived as a kind of physical exercise, locomotion activities are expected to meet certain criteria - they should be attractive, easy to do, time unlimited, not expensive, and generally available. These criteria seem to be satisfied by what is known as Nordic Walking, an activity recently much promoted. This diploma paper uses a sample of 43 patients / clients suffering locomotion problems to evaluate the effect that Nordic Walking, as applied at the Rehabilitation Spa Sanatorium at Vráž, may have on the Health-Related Quality of Life (HRQoL), and it assesses the NW for its suitability of inclusion into the spa treatment as a part of group physical exercises. The sample of respondents comprised Czech patients having completed full spa treatment no shorter than 21 days, and German clients of the Spa, who paid for 3-week treatments between 1 July 2007 to 30 November 2007. The practical section of the paper relied on a quantitative method applied through the questionnaire technique, specifically the SF-36 HRQoL Questionnaire and the EDUTOOL Questionnaire. The SF-36 Questionnaire was used to investigate the health-related quality of life in eight principle areas, namely the physical functions; physical limitation of roles; emotional limitation of role; physical and emotional limitation of social functions; pain; mental health; vitality; and overall perception of the state of own health. The ninth area of investigation, employed primarily for internal supervision, rested in the changes of own health. The EDUTOOL Questionnaire (its balneology version designed to assess the basic nutritious, regimen and movement habits) was used to review the results of the educational interventions into the health & social sphere, and specify the period of their effectiveness after the balneology procedures were completed. The paper identified the procedure of Nordic Walking as an activity fit to be incorporated into the spa treatment, and proved it to be capable of improving the health-related quality of the patients' lives. Hypotheses formulated: a) Nordic Walking will enhance the health-related quality of life - confirmed b) The results will depend on proper observance of instructions and consistent application of stereotypes and habits instilled by the education - confirmed c) The German-speaking clients will be more consistent in the application of what they were taught than the Czech-speaking patients - confirmed The diploma paper can be a useful tool of social education suitable to enhance the awareness of this topic.

An importance of spa services is especially in the medical treatment, but their economic significance is also very substantial. It significantly affects investment activities and an employment and it contributes to a regional development. Aurora Spa in Třeboň specializes in treating of musculoskeletal disorders, rheumatic diseases, post-traumatic and post-operative conditions and overall recondition of the body. Spa services in Třeboň have been, since a long time ago, associated with a natural healing source, which is abundant in this locality ? a boggy soil. Aurora Spa is not determined only for ill clients, but it is frequently visited by healthy people who undergo reconditioning and relaxation stays. The current trend heads toward to the fact that in the future the spa care covered from the public health insurance, will be in some way limited and clients will have to pay either a part or the entire treatment from their own financial funds. For this reason it is necessary to concentrate with spa service operators on a great clients´ satisfaction with their spa stay, so that they would return to the spa facility. Since I have worked for five years in the area of providing of the treatment services, I followed my bachelor thesis ?Clients´ satisfaction with spa services? by this diploma thesis, in order to re-map the clients´ satisfaction with services provided in above mentioned spa. I wanted to find out whether clients´ attitudes to the provided services had significantly changed from the research in 2009 year in my bachelor thesis. I used for the research the same questionnaire as in the research in 2009 year. 220 respondents were chosen for the research in the period of September 2011; 110 respondents had their stay covered by some of health insurance companies, either in a form of a complex or a contributory spa care and 110 respondents paid their treatment stay from their own funds as private payers. I supposed that men would be more satisfied than women and clients to whom some of the health insurance companies paid the stay, would be more satisfied than clients paying the stay from their own funds. After processing the data, there were not found out any significant differences in the satisfaction between these groups of respondents and in comparison with the research in the bachelor thesis from 2009 year there were not apparent any significant variations in the clients´ satisfaction with the services provided, which confirms, that the spa services in Aurora Spa are still on a very high level. Results of this diploma thesis can be used by employees of Aurora Spa to enhance the quality of provided spa service in all areas and to improve staff access to their clients.

The aim of this diploma thesis is to point out European Union´s goals such as low carbon economy, mainly future increasing the use of renewable sources as a potential source of energy. Slovak republic has due to its position in central Europe, rich in natural healing sources of water, which are considered as the most perspective sources of renewable energy in this country. The problem was solved as energy, economic and environmental analysis of Balneotherapy at Slovak Heath Spa Piešťany a.s. This analyzation was provided by real experimental measurement of temperature and flow rate and computational simulation of technological devices in opened natural healing water system. Experimentally measured data were afterwards use for elaboration conceptual design of new technological devices in order to increase efficiency of collection energy from potential renewable source of energy. The research shows that with help of new design technological devices connected to existing ones will be possible to cool down temperature of hot natural healing water from 67 °C to 21 °C, which decrease operation costs of Balneotherapy for more than 1 414 € per day. By Slovak republic entering to European Union it was necessary to accept global goals of low carbon economy. This diploma thesis provides an attention on potential energy in natural healing sources of water as renewable source of energy and helps Slovak Health Spa Piešťany to decrease amount of green-house gases released to atmosphere by efficient increasing the use of energy potential in natural healing source of water.

This diploma work studies quality of life of patients suffering from Bechtěrev disease (Ankylosing Spondylitis), who had global four-weeks cure in Berta Health Spa in Třeboň from 1st January to 31st July 2006. Hypothesis says that six months after the end of balneotherapy the quality of life of these patients will be higher than before. For confirmation or confutation of this hypothesis there was used quantitative method of research, in form of adjusted questionnaire for detection of quality of Life by SEIQoL concept (Schedule for the Evaluation of Individual Quality of Life). By this measure respondents are allowed to nominate five areas of life (aims of life), which are most important, together with percentage rate of their satisfaction with each and the relative importance of each. Average life-quality index of the respondents before balneotharapy was 60,4 %, six months after the end of balneotharapy it was 62,7 %. Thus six months after the end of the cure the respondents have higher quality of life. Then there were mentioned and discussed differences in perception of quality of life of various age groups and of gender. There was also accomplished order of the most often mentioned aims of life, as well an analysis of ``health{\crqq} as alife aim was done. This diploma work could be used in cultural work and for improvement of informedness in problematic of life quality. But mainly, it could be perhaps taken as a little controversial report to the discussion about using of assorted exploratory concepts for evaluation of quality of life.

This thesis was prepared as an architectural study. In front of his graduate-seminar was a study on urban concept and the building Aquapark Brno - Zidenice hillside snakes. This thesis deals with the extension of the complex of Roman baths and sauna world. This is a two-storey building without a basement cubic shape. The proposal emphasizes the functionality of the service, interior design of the building and the overall expression

Architectural study offers solution of space of the Roman baths and sauna world in object next to the previously designed building of Aquacenter in Brno - Hády. Location of aquacenter is based on architectural search study Aquacenter - "The Water Temple" Brno (on development areas which are set by ÚPmB). Wellness facilities are today an important part of the water parks. The designed spaces of Roman baths and sauna world offers visitors the use of modifications of Roman baths and Finnish saunas, as well as other supporting treatments such as various massages, herbal baths, massage whirlpools, etc. It is not just a place to relax or to the curative stay, but there is also included a social function as a private spas (for business meetings), caldarium, possibly tepidarium, a rest rooms and relaxation bar. The form of a building, which is based on the form of the previously designed building of aquacentre, is a block with inclined SE, SW and NE wall (inclination of walls is 20 degrees from the vertical). In the center part of a layout is rest room and bar, along which sides are atriums. Around them are then arranged an individual operating units into single wings. The overall layout is also trying to build on the traditional content and linking space of Roman baths, abide the Finnish concept of the sauna and join both together in related wings. While the traffic of balneotherapy is as a "dirty" separated by hall, the wing with massages and less traditional saunas and spas (such as Sweden, Japan, etc.) together with the water baths wing are separated from the central area by corridor. Accommodation is dedicated the space of the second floor, which does not occupy the whole floor space as a first floor and is arranged in a T-shape. The basement which is partly sunk into the ground is located covered parking and service facilities.