Discharge - as one of modes of resolving insolvency The subject matter of this master thesis is the institute of discharge of debts, with an emphasis on its rehabilitative nature. A certain degree of indebtedness of the population is currently a social standard and many consumers are falling into the so-called debt trap. This is the reason why the institute of discharge of debts has become the forefront of interest. Discharge allows a debtor to solve impending or already existing bankruptcy and his/her return to normal economic life with a clean sheet. In its seven chapters, the thesis classifies discharge in the system of insolvency law and chronologically deals with insolvency proceedings from the petition to declare bankruptcy and the motion to permit the discharge until its termination from the point of view of debtors as well as creditors. Besides defining alternative ways of resolving insolvency, basic subjects of insolvency proceedings and their possible intervention in the process; the thesis focuses on the subjective and objective admissibility of discharge. Furthermore, the thesis examines the choice of the appropriate method of discharge, namely realisation of bankrupt's estate, fulfilment of the instalment plan or combination of these methods; and conditions for successful completion of...

The rights and duties of natural persons during proceedings on discharge of the debt Abstract The main aim of the thesis is to describe the institute discharge of the debt that is defined in the Act No. 182/2006 Coll., on Bankruptcy and its solution (Insolvency Act). The thesis analyses the discharge of the debt from the perspective of the debtor, natural person. The thesis presents a status of the debtor, his rights and duties during insolvency, respectively presents the discharge debtor of his debt. The purpose of the thesis is to describe valid legal regulation, the description of the court decisions in the use of the Insolvency Act, the expert's opinions and the problems with the imperfection of the Insolvency Act, in the part of the discharge of the debt. In the first part, the thesis characterizes the history of the insolvency act and discharge of the debt in the Czech countries since 18th century. Next chapter defined some terms for the thesis important. Specifically, there is defined the term of the debtor. With regard to the discharge of the debt as one of debt-eliminating modes of solving bankruptcy of the non-businessmen's person, the thesis analyzes the term of non-businessmen's person in one of the subchapter. There are defined next terms, guarantor, co-debtor, the term of husband or wife of...

Discharge instructions provided to patients discharged from the emergency department (ED) are often provided in a way that is neither clear nor concise. Patients are often discharged home without a clear understanding of their diagnosis, medications, reasons to return to the ED, follow-up instructions, or how to manage their care at home during their illness. Therefore, a guideline needed to be developed in order to help the ED staff provide clear and concise discharge instructions to patients discharged from the ED. The Ace Star Model of Knowledge Transformation was the foundation for the development of the evidence-based guideline. A formative group of 7 individuals was created to critique the initial draft of the guideline, and a final version of the guideline was then distributed to 10 medical professionals to aid in the approval and determination of the quality of the guideline. The data analysis from the formative group questionnaire, and the appraisal of guidelines for research and evaluation tool led to the recommendations for a guideline on the delivery of evidence-based discharge instructions. This project has implications for social change in practice by (a) increasing the awareness among medical professionals about the importance of their communication style on patient discharge and (b) allowing for more efficient communication to occur between them and their patients. The use of an evidence-based practice guideline for providing discharge instructions to patients discharged from the ED will allow improved quality of care to patients, efficient communication between the healthcare providers and patients, a positive impact for social change in practice, and a consistent and reliable method for patients to understand their discharge instructions in a way that is clear and concise.

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Communication between patients and health care providers at hospital discharge is a critical factor that determines whether a patient understands their treatment plan and self-care instructions. Lack of effective health management after hospital discharge can decrease the quality of life for a patient and increase the likelihood of costly hospital readmission. The purpose of this phenomenological study was to explore factors affecting the receptivity of patients using social media as a platform for post discharge, provider-client communication, and assessment. This was explored using social presence theory. Twenty patients between 45 to 65 years of age, who received care from hospitals in Northeast Ohio, were interviewed for the study. The data was transcribed and analyzed through open coding to create themes and clusters. The themes that emerged from this study were ease of use, privacy, and convenience as well as reasons why participants may access health-related social media being specifically linked to cohesive factors of ownership of their data. The personal relationship established between patient and provider influenced communication methods. Social connections were also deeply-rooted themes in the study as the influence of other people or the need to access data were among reasons for choosing to use social media. Ease of access, importance of confidentiality, quick response time from providers, and ability to see personal medical information was important to the participants in social media communications with providers. The positive social change implications of this study are that communication issues at discharge could be mitigated if patients would accept using social media for communication with their health care providers once they are at home.

In elderly women, discharge after gynecologic surgery is often associated with increased morbidity. Little information exists about elderly women's discharge destination after gynecologic surgery and the outcome of early hospital readmission. The purpose of this study, conceptualized using the quality health outcomes model, was to examine whether post hysterectomy discharge destination is an independent predictor of 30-day hospital readmission in women age 65 and older. Examination of covariates included patient age, race, medical comorbidity and complications of care, as well as surgical anatomic approach and operative technique. This study involved use of a retrospective cohort design and data from 10,598 cases contained in the Healthcare Cost and Utilization Project 2010 and 2011 California State Inpatient Databases. Results of the bivariate analysis showed a statistically significant association between discharge destination after hysterectomy and 30-day hospital readmission. Additionally, the results of multivariate logistic regression revealed the odds of readmission after discharge with home care were 2.99, p < .001, 95% CI [2.29, 3.67] times greater when compared with discharge home for self-care and 5.99, p < .001, 95% CI [4.68, 7.43] times greater with discharge to continuing inpatient care versus home for self-care. This study may lead to positive social change for elderly women by informing health care providers about the odds of early hospital readmission associated with discharge destination after hysterectomy. Further, this information may stimulate development of interventions to improve health care practices for elderly women preparing for hospital discharge after hysterectomy.

The definition of a successful discharge is a discharge that results in patients successfully managing a chronic disease for at least 30 days without requiring an acute inpatient hospitalization. Many chronic disease readmissions are preventable. Successful discharge planning takes a multidisciplinary team that includes nurses who assess the discharge plan and provide additional education where needed. The purpose of this project was to determine staff nurses' understanding of their role in discharge education. Dorothea Orem's self-care deficit theory guided the project and root cause analysis was used in the development of the problem statements. Staff nurses (n=12) from evening and day shift of a rural hospital were interviewed using questions developed from the content from the literature review. Individual interviews were conducted with the volunteer participants and data from the interviews were examined using content analysis. Results included barriers to discharge education were related to inadequate nursing education, poor patient compliance, and inadequate discharge planning. Recommendations from the nurses' interviewed included the need for staff nurse education regarding their role in the educational needs of the patient and their family prior to discharge. The findings from this project may benefit nurses' practice by providing them with an understanding of the need for effective discharge education for patients. When patients are appropriately educated prior to discharge, their ability to self-manage their disease may improve, which can result in a decrease in health care costs and preventable readmissions. Educating nurses about their role in discharge planning promotes positive social change by improving the quality of the discharge education and patient outcomes.

Ratings curves are conventional means to continuously provide estimates of discharges in rivers. Among the most-often adopted assumptions in building these curves are the steady and uniform flow conditions for the open-channel flow that in turn provide a one-to-one relationships between the variables involved in discharge estimation. The steady flow assumption is not applicable during propagation of storm-generated waves hence the question on the validity of the steady rating curves during unsteady flow is of both scientific and practical interest. Scarce experimental evidence and analytical inferences substantiate that during unsteady flows the relationship between some of the variables is not unique leading to looped rating curves (also labeled hysteresis). Neglecting the unsteadiness of the flow when this is large can significantly affect the accuracy of the flow estimation. Currently, the literature does not offer criteria for a comprehensive evaluation of the methods for estimation of the departure of the looped rating curves from the steady ones nor for identifying the most appropriate means to dynamically capturing hysteresis for different possible river flow conditions. Therefore, the overarching goal of this study was to explore the uncertainty of the conventional approaches for constructing stage-discharge rating curves (hQRCs) and to evaluate methodologies for accurate and continuous discharge monitoring in unsteady open channel flows using analytical inference, index velocity rating curves (VQRCs), and continuous slope area method (CSA) with considerations on discharge measurement uncertainty. The study will demonstrate conceptual and experimental evidences to illustrate some of the unsteady flow impacts on rating curves and suggest the development of a uniform end-to-end methodology to enhance the accuracy of the current protocols for continuous stream flow estimation for both steady and unsteady river conditions. Moreover, hysteresis diagnostic method will be presented to provide the way to conveniently evaluate when and where the hysteresis becomes significant as a function of the site and storm event characteristics. The measurement techniques and analysis methodologies proposed herein will allow to dynamically tracking both the flood wave propagation and the associated uncertainty in the conventional RCs.

Nervous systems distinguish between self- and other-generated movements by monitoring discrepancies between planned and performed actions. To do so, when motor systems transmit motor commands to muscles, they simultaneously transmit motor copies, or corollary discharges, to sensory areas. There, corollary discharge signals are compared to sensory feedback arising from movements (reafference), which can result in gating of expected feedback. Curiously, in infant rats, twitches—which are self-generated movements produced exclusively and abundantly during active sleep (AS)—differ from wake-movements in that they trigger robust neural activity. Accordingly, we hypothesized that the gating actions of corollary discharge that predict wake reafference are suspended during twitching. In this dissertation, we first demonstrate that twitches, but not wake movements, robustly activate sensorimotor cortex as they do other brain areas. Next, we demonstrate that wake movements can activate the sensorimotor cortex under conditions involving presumed discrepancies between corollary discharge and reafference signals. Lastly, we reveal a neural mechanism in the brainstem that inhibits reafference, but only during wakefulness; this inhibitory mechanism is suppressed during active sleep. All together, our findings provide the first demonstration of a state-dependent neural comparator of planned and performed actions, one that permits the transmission of sensory feedback from self-generated twitches to the developing nervous system.

Acute decompensation of chronic heart failure is common and results in many patients being re-hospitalized every year (Jancin 2008). One of four voluntary core measures deployed by the Joint Commission for evaluation of quality of heart failure care in hospitals is heart failure discharge instructions, also called core measure HF1. Although the core measure is a widely disseminated standardized measure related to discharge education, there is little evidence about its impact on patient or readmission outcomes. The purpose of this study was to determine the relationship between the completion of heart failure discharge instructions as defined by the Joint Commission core measure HF1 in a single site, 500 bed tertiary hospital population in the Upper Midwest and the primary endpoint of subsequent readmission to the hospital 30, 90, 180 and 365 days following an index discharge for primary diagnosis of heart failure. Secondary endpoints included hospital readmission charges and total hospital readmission days per year. Patient characteristics, clinical characteristics, unit factors and index visit utilization variables were controlled. This study also described the relationship between nursing unit factors and completion of HF1. A retrospective, descriptive design, and analyses using primarily generalized linear models, were used to study the relationship of HF1 to utilization outcomes (readmission, hospital days and cost) and unit context (discharge unit and number of inter-unit transfers). Individual level retrospective demographic, clinical, administrative and performance improvement data were used (n = 1034). Results suggested a weak and non-significant association of completion of the core measure HF1 bundle and readmission within 30 days for all cause readmissions (p = .22; OR 1.32), and no association with HF to HF readmissions at 30 days. There was an inverse association 2 after 6 months for all cause readmission, and after 90 days for HF to HF readmission. There was a non-significant trend toward a relationship to total hospital days, but no relationship of HF1 to total annual charges. The study did find a significant relationship between type of discharge nursing unit and HF1 completion, and type of discharge unit and readmission. The discharge nursing unit was quite consistently and strongly related to all cause readmissions in binary (p = .029: OR 1.58) and counts analyses (p = .001; OR 1.52), but was not related to the subset of HF to HF readmissions. The study concludes that there is limited relationship between HF1 and 30 day all cause hospital readmission and total readmission days, but a stronger relationship between HF1 and discharge from a cardiology specialty unit. There was also a relationship between cardiology discharge unit and reduction in all cause readmissions.