This diploma thesis deals with the desing documentation of a multifunctional house. The building is three-storeyed. The roof structure is designed as a single-layer, flat roof. This building is divided into three working parts. First part is used for medical clinic and pharmacy business. This section is wheelchair accessible. The second part of the building is designed as office space. In incudles office space, archive and hygiene facilitites for staff. The third part of building is for housing. Includes 2 apartments and associated storages. The building is designed from the structural systém POROTHERM and has rectangular plan shape with beveled edges.

L’être humain est de plus en plus souvent inscrit dans des contextes où lui est accessible un savoir nouveau sur sa vie biologique (e.g., gènes, épigénome, neurones, microbiote). À portées de mains ou de clics, des médiations toujours plus nombreuses (e.g. tests génétiques prédictifs en matière de santé ; « récréatifs », relatifs à l’« ancestralité biogéographique », microbiote intestinal ou à l’« âge épigénétique » ; applications dites de « self-tracking ») mettent l’usager en relation avec des formats d’information de plus en plus diversifiés (e.g., SNP’s, diagnostics, probabilités exprimées sous forme de pourcentages de développer des maladies ou d’autres conditions : réponses de l’organisme à certains pathogènes et molécules, résistance à certaines pathologie, et d’autres propriétés qui seraient influencées par la génétique, comme la longévité ou les facultés cognitives). La découverte de ces données biologiques éprouve la personne et la confronte à de nouvelles inquiétudes qu’elle doit traverser.Menée sur base de trois terrains situés dans le champ de la santé (consultation médicale, usage du web en matière de santé, et usage d’auto-tests tests génétiques), cette recherche contribue à la compréhension de ce phénomène de société. Elle s’applique en particulier à préciser la variété des façons dont la personne intègre ces données nouvelles qui s’accompagnent d’une prétention à un réalisme fort. Dans certains cas, ces technologies fournissent à l’individu une image objectivante de son « identité ». L’approche préconisée s’articule à un questionnement anthropologique singulier : Comment la personne s’arrange-t-elle de situations dans lesquelles elle est mise en relation non plus seulement avec d’autres humains mais au premier titre avec des données objectivantes relatives à son intériorité biologique ? Cette question anthropologique invite à porter au moins autant d’attention à ce qui nous relie à autrui et à notre environnement (deux questions classiquement situées au cœur du projet de la sociologie), qu’aux façons dont l’humain assure une continuité avec lui- même dans des situations où le vivant pose question. Cette recherche démontre que la conduite effectivement adoptée par les usagers des trois médiations examinées est irréductible à l’attente d’autonomie souvent promue comme prise en charge de sa santé relevant d’un plan d’action orienté vers un but à atteindre. Soutenue par des outils sociologiques qui sous-tendent une conception plurielle du sujet et de l’action, cette recherche attire l’attention sur des dynamiques peu traitées dans les sciences sociales de la santé. L’examen attentif du maintien du sujet mis à l’épreuve de ces nouveaux savoirs jette une lumière nouvelle sur l’habileté de l’humain à évoluer entre une pluralité de positions, de définitions de ce qu’il se passe et/ou de qui il est afin de s’arranger de ces découvertes qui insécurisent son état de sujet. Plutôt que de considérer le caractère ambivalent, équivoque et parfois carrément ambigu de la conduite de l’usager comme un échec de l’analyse, ce travail contribue à une approche de la composition dans le rapport à soi et à autrui. / More than ever before humans have access to new knowledge about their biological life (e.g., genes, biochemical marks influencing phenotypes, neurons, microbiota). This knowledge is progressively transfered out of laboratories and into commercial markets. Then, by means of an ever-increasing number of readily available mediations (e.g. direct-to-consumer (epi)genomic tests (DTC GT), health-related uses of the Internet, direct-to-consumer genomic tests, self-tracking applications on smartphones) layusers are connected to an increasingly diverse array of data (e.g., online diagnostics, genomic predispositions, probabilities, SNP’s). My doctoral thesis develops an investigation of the practices whereby individuals ensure continuity with others/themselves when confronted to new knowledge related to their biology. Knowing the so-called “real” or potential biological endowment of oneself but also of others has tremendous social, political and ethical consequences. These new reflexive technologies grant individuals with an objectifying image of their “identity”. These new objectifying data related to the biological self puts the subject to test. They confront them to inquietudes they have to cope with.Built on three fieldworks located in the field of health (the classic medical examination, health-related information on the Internet, health-related direct-to-consumer genomic tests), this research fosters a better understanding of this social phenomenon. My investigation specifically seeks to clarify the variety of ways that allow individuals to integrate these new data marked with a strong degree of realism. The approach set forth in this research revolves on a specific anthropological question: how human beings find arrangements with situations in which they are not only confronted to others but also with objectifying data related to their biological life? This anthropological problematic invites us to bring at least as much attention to what connects us with others than to the specific ways individuals ensure continuity with themselves in contexts where the “living” raises question. My research demonstrates that the conduct actually adopted by users of the three mediations studied is irreducible to the expected liberal autonomy often promoted in the literature as “management of one’s health”. A careful analysis of the subject’s consistence facing this new knowledge highlights social dynamics that have received little attention in the field of social sciences of health. The fieldworks carried out provide new insights on the human ability to bring together different positions or definitions of what is happening and/or who you are in order to arrange with these discoveries that challenge their subject consistency. Rather than considering the equivocal features and sometimes the outright ambiguity of the conducts as a failure of the analysis, this research effort contributes achieving a better understanding of the pervasiveness of composition in our relationship to our self and the others in social contexts related to biology

Die vorliegende Arbeit befasst sich mit der Entwicklung und Umsetzung von Methoden und Werkzeugen zur Bereitstellung von Modellen und Randbedingungen für die Konstruktion individueller Langzeit-Knochenimplantate (Konstruktionsvorbereitung). Grundlage dabei ist, dass die Planung aus medizinischer Sicht z.B. durch einen Chirurgen und die Konstruktion unter technischen Aspekten z.B. durch einen Konstrukteur getrennt erfolgt. Hierfür wird ein erarbeitetes Planungskonzept vorgestellt, welches sowohl die geplanten geometrischen Merkmale, als auch weiterführende Metadaten beinhaltet (Randbedingungen). Die Übergabe dieser Planungsdaten an die Konstruktion erfolgt über eine dafür entworfene Formatbeschreibung im Kontext der Schnittstelle zwischen Mediziner und Ingenieur. Weiterführend wird die Notwendigkeit von speziellen Funktionen für die Konstruktion von individuellen Implantaten in der Arbeitsumgebung des Konstrukteurs (z.B. Modelliersystem – CAD) am Beispiel der konturlinienbasierten Modellrekonstruktion erörtert. Die gesamtheitliche Basis bildet eine durchgängig digitale Prozesskette zur Datenaufbereitung, Konstruktion und Fertigung. Die Anwendbarkeit der Methoden und zweier umgesetzter Demonstratoren wurde innerhalb eines interdisziplinär angelegten Projektes am realen Patientenfall bestätigt.

In my dissertation, I discuss the problematic of feedback in a leadership of medical non- doctor personnel and in directing its working performance. My aim was to comprehend and elucidate the process of feedback between superior and subordinate personnel, specifically between bedside nurses/assistive personnel and a charge nurse. As a secondary objective, I decided to investigate potential areas for improvement in leading management and to suggest possible advancements, which could contribute to more effective directing of work performance through the use of feedback. The dissertation is divided into two parts, theoretical and empirical. In the first theoretical part, I begin with defining the meaning of feedback. Following, I introduce topics that include: feedback in social communication, feedback in the process of directing work performance and work motivation. In the second empirical part, I present research conducted with the use of qualitative methodology, where the reader can view the discussed problematic from the perspective of subordinate (bedside nurses/assistive personnel) and superior (charge nurses) personnel. Key words: feedback, social communication, work performance, medical non-doctor personnel, bedside nurse, assistive personnel, healthcare, nursing, work motivation

The presented diploma thesis focuses on the identification of gender-based specifics in health care, specifically in the management of a health care institution as a caring institution. In the theoretical part, we defined feminism and feminist views, the concept of gender, medicine as a feminized environment, the legislative definition of work in health care in terms of management and, finally, stereotypes were defined. In the conducted qualitative research, we used unstructured interviews with health professionals (nurses and doctors) from the Czech and Slovak Republics, and we examined the gender-based specifics in health care. Research has shown that gender specificities in health care are emerging, in the areas of division of labor, impacts on job choices, equality and inequality, occupation of position and in provision of care. At the end of the thesis I presented recommendations for the use of management tools as a source of overcoming barriers to equality in the context of a caring institution. Key words Feminism, phenomenon of feminization, health care, woman, gender, caring institution, management, gender-based specifics, health care professional, nurse, doctor.

Bakgrund: Teknologi och behandlingsmöjligheter inom intensivvården är under ständig utveckling. Den växande möjligheten till livsuppehållande behandling är inte alltid gynnsam för alla patienter. Det är en utmaning att identifiera tidpunkten då behandlingen blivit medicinsk meningslös och därmed ska avslutas. Beslutsfattandet försvåras eftersom patienterna ofta inte kan tala för sig själva. Processen att komma fram till ett beslut kräver ett samarbete mellan läkare och sjuksköterskor för att tillgodose patientens bästa och anhörigas behov. Att ge alla inblandade en röst har visat sig vara en utmaning och kan leda till konflikt. Syfte: Att belysa intensivvårdssjuksköterskans upplevelse av samarbetet med läkare inför beslutsfattande kring avslutande av livsuppehållande behandling. Metod: En systematisk litteraturöversikt med kvalitativ ansats och induktivt förhållningssätt. Resultat: Sjuksköterskor upplever att deras involverade i beslutsfattandet är viktigt och åtar sig ett antal handlingar för att bidra till samarbetet, samtidigt som de känner sig exkluderade och att deras arbete är undervärderat. Beslutsfattandet upplevs komplext där tid, anhöriga och olika professionella perspektiv påverkar samarbetet. Hur samarbetet är utformad och vilka beslut som tas i enskilda situationer upplevs variera relaterat till hur den individuella beslutsfattaren är som människa och vilka erfarenheter de involverade har. Slutsats: Samarbetet mellan sjuksköterska och läkare vid beslutsfattande om avslut av livsuppehållande behandling är viktigt för att utforma vården efter den individuella patienten. Beslutsfattandet är komplicerat, där etiska och moraliska principer behöver tillgodoses. Genom att få bättre förståelse och reflektera över den professionella rollen kan samarbetet underlättas. Att ta beslut om människors livsöden förblir tungt, men rätt förutsättningar gynnar såväl yrkesprofessionella som patienter.

Planetary ball milling (PBM) is a well-known technique for efficient size reduction and homogenization of materials that has been used for many decades in various engineering and industrial processes. More recently, it has emerged as a unique top-down nanofabrication approach for nanomaterials based on nanoscale grinding. However, its potential application in nanostructured thin film fabrication has not been fully explored, as only a limited number of studies have been carried out. In this work, the effects of different grinding parameters (speed, time and solvents) were used to create previously unstudied nanoscale grinding conditions for nanostructured thin film materials via PBM with distinct and novel properties: Nanoparticles of silicon, titanium disilicide (TiSi2) and zinc oxide (ZnO) ground in different solvents (deionized (DI) water/ ethylene glycol (EG)/isopropyl alcohol) resulted in colloidal suspensions (or nanoinks) that could be used to coat various substrates (wafers, glass, flexible substrates, etc.) via drop casting, doctor blading or dip coating. Thin film properties such as wettability, electrical conductivity and gas sensing behavior are studied. The fabricated thin film coating properties could be tuned depending on the combination of starting powder materials, grinding parameters and resulting nanoparticle size/geometry: The influence of surface chemistry, solvent type, particle geometry, surface roughness and defects was shown to alter the conductivity and surface wettability of the resultant films. Thus, thin films formed using PBM nanoinks allow varied and tunable properties for advanced multi-functional coatings and devices. To demonstrate the feasibility of PBM nanoinks for thin film device applications, ZnO nanoinks were used to create chemiresistive gas sensors that operate at room temperature. By varying grinding parameters (speed, time and solvent) thin film sensors with differing particle sizes and porosity were produced and tested with air/oxygen against hydrogen, argon and methane target gas species, in addition to relative humidity. Grinding speeds of up to 1000 rpm produced particle sizes and RMS thin film roughness below 100 nm, as measured by atomic force microscopy and scanning electron microscopy. Raman spectroscopy, photoluminescence and x-ray analysis confirmed the purity and structure of resulting films. The peak gas sensor response was found for grinding parameters of 400 rpm (average particle size 275 nm) and 30 minutes (average particle size 225 nm) in EG and DI water, respectively, which could be correlated to an increased film porosity and an enhanced electron concentration resulting from adsorption/desorption of oxygen ions on the surface of ZnO nanoparticles. Similarly, gas response and dynamic behavior were found to improve as the operating temperature was increased between 100 and 150 °C. These results demonstrate the use of low-cost PBM nanoinks to optimize the active materials for solution-processed thin film gas/humidity sensors that can operate at room temperature for use in environmental, medical, food packaging, laboratory, and industrial applications. Overall, the nanogrinding technique can produce large amounts of nanoparticle suspension with variable particle sizes for creating thin films with tunable properties. By adjusting grinding parameters, the nanoparticle shape/size and properties can be varied resulting in nanoparticle inks for inexpensive coatings on various substrates and for use in different applications. / Graduate

Between 2013 and 2016, 8.1% of U.S. adults 20 years and older suffered from depression, but only 29% of them sought help. This project addressed the low depression screening rate in a Federally Qualified Health Center (FQHC) that supported integrated care. The purpose of the project was to evaluate the integration of behavioral health into primary care in an FQHC through the rate of depression screenings. Two theoretical frameworks, the find-organize-clarify-understand-select/plan-do-study-act model and the Centers for Disease Control and Prevention's framework for program evaluation in public health were combined into a list of questions and data validity tests that were used to conduct the evaluation. This quality improvement (QI) project evaluated an existing QI initiative. Findings revealed that 75% of the patients seen, and not the initially reported 53%, received depression screenings, which indicated an improved outcome. Other findings were inadequate use of theoretical frameworks, poor data quality, and suboptimal effectiveness of QI team processes. The strategies and tools recommended in this project could be used by organizational leaders and QI teams to evaluate and improve QI initiatives. The project's contribution to awareness about depression through integrated care could increase patients' access to care, quality of life, and life expectancy, and positively impact social change.

Black Americans experience influenza vaccination rates that are lower than the rates of other ethnic groups. Low influenza vaccination rates among the Black community are associated with higher influenza infection rates, influenza-related hospitalizations, and higher influenza mortality rates. There is a belief within the Black American community that the medical establishment does not have the Black American patient in its best interest, leading to feelings of distrust. The purpose of this study was to determine if the distrust of the medical community is a relevant factor in the low influenza vaccination rates of Black Americans aged 18 and older in Baltimore, Maryland. The study also examined the belief that the influenza vaccine causes the flu and the effect this belief may have on influenza vaccination rates. The public health critical race theory served as the framework for the study. Previously validated survey instruments, the Health Care System Distrust Scale and the Adult Influenza Immunization Survey, were obtained with permission and used to collect data from the members of a Baltimore city church. The study used chi-square analysis, multivariable logistic regression, and narrative discussion to address the research questions and analyze the data of 105 completed surveys. Results of the study determined that distrust of the medical community was not a relevant factor in the influenza vaccination rates of study participants, and that participants' vaccination status was influenced by factors other than distrust. Implications for social change included improving the influenza vaccination rate among Black Americans and decreasing their influenza mortality rates.

Thesis "The health and social worker in cooperation with a multidisciplinary team in the care of chronically ill children "deals with the verification of the need and importance of multidisciplinary cooperation of the health and social worker with other professionals in the care of chronically ill children. The theoretical part deals with chronic ill children, its impact on the child and the family, describes the function of a health and social worker and other members of a multidisciplinary team with the aim of cooperation within a multidisciplinary team in the care of a chronically ill child. In the practical part, mutual cooperation is verified using the method of qualitative research, interview and case studies. The work is supplemented by a created relationship map of multidisciplinary cooperation in relation to a chronically ill child. Keywords Social worker in healthcare, multidisciplinary team, chronic ill child, hospital, social work, support, family, doctor, psychologist, therapist.