This thesis explores the roles that medicine, human rights discourse, and the arts play in the project to improve the lives of patients suffering from severe forms of mental illness in the context of the post-socialist transformation of the Czech Republic. It is a study of the ways in which social solidarity and social exclusion intersect in the spaces of mental illness in a particular historical setting, and how the responsibility for care is negotiated between families, communities, the medical profession, and the state. The first part of the thesis focuses on the proposed reform of care for patients with severe mental illness that was put forward in the two decades after 1989. I examine the origins and aims of the attempted institutional change – the ‘humanization of psychiatry’ – in the context of the influential Charter 77 movement which demanded respect for the rights of those who are unable to claim them for themselves. I also trace how the re-establishment of a civil society that owed much to the concept of ‘apolitical politics’ and the process of the reintegration of Czech Republic into the European community impacted the attempted reforms. More than twenty years after the revolution, Czech Psychiatry still does not comply with international standards of care and, as I show, despite the explicit disclaimer with the totalitarian past and great hopes for change, there is in fact a clear continuation of many of the practices, ideas, interactions, as well as forms of governance of the preceding decades. These historical legacies, in combination with other factors, such as ideological disagreements within the psychiatric profession, a lack of political interest in this area, and a strong focus on other economic priorities have all contributed to the failure to improve mental health care. The second part of the thesis offers a complementary perspective on these processes – a view from ‘inside’ of the institutions that provide psychiatric care. The origins of institutional care in Central Europe date back to late nineteenth century, when large hospitals were built within parks as self-sufficient complexes surrounded by walls, outside of large cities. My research took place in two contrasting institutions: one a highly specialised clinical and research center for treatment of acute conditions, and the other a hospital for treatment of chronic conditions originally devoted to those with ‘incurable’ conditions. I show how the notion of ‘curability’ is a crucial factor in both the experience of the patients and the social responses to their conditions. In this part I also explore some epistemological issues in psychiatry, including knowledge, practices, and ideology, in the context of a strong scientific materialism where – unlike in many parts of the world – the tradition of psychoanalysis has been absent. Specifically, I examine the role of neurobiological paradigm in various interpretations of psychotic experience, its affect on patient’s self-understanding, and its role in the externalization of agency and responsibility. Finally I address the phenomenon of using ‘unclaimed bodies’ of psychiatric patients for anatomical teaching and research, and interpret this practice through notions of liminality, impurity, and sacrifice. I conclude the thesis by examining the ethical dimension of psychiatric care in the light of the writings by Emmanuel Lévinas.

In this thesis I present a narrative that describes and analyses the contested and moving boundaries in adult social care through the lens of three enduring themes: the health and social care interface; hospital discharge and NHS continuing health care; and eligibility for adult social care. The thesis draws upon a range of my published work undertaken from 2002-2011, and this in turn reflects a wider body of work undertaken from the 1980s onwards. The thesis is developed from my work which comes from a distinctive model of independent research and analysis, combining original empirical fieldwork and evaluation with detailed policy analysis and commentary. The publications are principally derived from research studies and evaluations commissioned from me by the Department of Health; by the Commission for Social Care Inspection (CSCI), and by the Putting People First Consortium and the Social Care Institute for Excellence (SCIE). This thesis examines the problematic boundaries between adult social care (particularly in the care of older people), and the NHS which have been in evidence since the creation of the two systems, and the extent to which these boundaries are contested and fluid over time. I argue that the location of the boundary is of great significance because of the consequences not merely for respective organisational responsibilities and budgets, but also - importantly - for individual service users and their families. The thesis was written on the cusp of the introduction of major legislation in social care, with the Care Act 2014 due for phased implementation from April 2015. It is an opportune moment to consider how and to what extent the Act offers the prospect of stabilising the shifting sands of the landscape of adult social care.

As a result of urgent medicine acceleration and neurosurgery care improvement individuals that had minimum chance of life saving in the past survive brain insults. Increasing occurrence of people with apallic syndrome is a consequence of this progress. This thesis compares domestic and institutional care of apallic people. It examines whether the care quality and complexity are comparable. As the domestic care is more economical for the government it has to be supported in the times of insufficient funds for health care. Quantitative research technique of non-standardized interview was used for data collection. The research sample consisted of six healthcare workers and six family members caring for apallic patients. One respondent had a son in institutional care, however she took him temporarily to domestic care. Questions for healthcare staff and for caring family members were prepared separately. The results show that apallic patients in domestic care achieve substantially better results. The physical load is comparable, mental load is higher for family members. The basal stimulation, which is extremely important for apallic patients, is purposefully applied in institutional care only, as it is provided by trained staff there. The results of this work were presented at the 4th National Student Conference organized by the Faculty of Healthcare Studies of the Pardubice University. The data are published in the proceedings: SOUSEDÍKOVÁ, Zuzana. Comparison of nursing care about apallic patients in domestic and institutional care. In VI. National Student Scientific Conference of Bachelor and Master Programmes General Nurse, Midwife, Healthcare Rescuer, Nursing. Pardubice: Pardubice University, 2011. p. 18. ISBN 978-80-7395-391-1. The thesis will also be provided to the Cerebrum Association, which is going to publish it on its website and provide it to its clients, who are in touch with patients after brain injury. Distribution of this work among people having individuals with insulted brain around is the best way how to highlight the urgency of the problem.

For many years, great attention has been devoted to the care of the elderly due to global aging of population. Almost all people want to spend their old age at home in their environment. This idea is supported by many experts who deal with the issue of old age and point to the advantages that it entails for both the senior and for the society. Therefore, it is paradox that many old people are placed in various health and social care facilities despite a wide range of various external services that enable seniors to stay in their home environment. That is why this master thesis aims to compare the nursing care provided to elderly people in their home environment with the care provided in institutions, both from perspective of a nurse who provides the care and from perspective of the elderly person or members of their family. The thesis is divided into two main parts. The theoretical part focuses on explaining the old age and the changes that come along with the old age. It also points out how old age is perceived in contemporary society. Further, it deals with different types of senior care that is most frequently divided into family, health and social care. The practical part is focused directly on individual families of seniors who live at home supported with home care, and to families who have a member in the department for the chronically ill (DCI). In the practical part I also focused on nursing staff, particularly nurses who come into contact with the seniors every day. A qualitative research method was used for the research survey. The technique of in-depth interview was used for data collection. The first part of the research group consisted of nurses working in DCI and nurses working in home care. The second part of the group consisted of seniors who reside in DCI and their families and the elderly who use home care services and their families. Interviews with the nurses, seniors and their families are divided into individual categories: awareness, reason for placement to DCI, satisfaction with the care provided, the advantages and disadvantages of home care/DCI, differences in care in DCI and at home, in foods and drinks, positioning and incidence of pressure sores, hygiene, administering medicines, re-bandaging, in bowel habits, behavior of staff/family, facilities for a senior. The investigation shows that families consider hospital care and home care to be very good, but it can be seen that home care nurses enjoy greater trust of the family and have much closer relationship than those in a hospital. Both groups of nurses think that the care they provide is of high quality and professional, but point to the lack of funding that a hospital and a home care agency have. A very surprising fact emerged that families that have an elderly person in institutional care are eager for the placement since they believe that they would not be able to care of them properly themselves. The investigation cannot clearly assess which type of care is best because both methods have their positives and downsides for every party involved and there are different variables, such as the health condition of the elderly, their family or social background. Quantitative research over a longer period of time would be required for thorough mapping of the entire situation which could monitor the provided care in the long run and also take into account the above variables that may change over time.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / O presente estudo tem por objeto a promoção da saúde sexual de adolescentes em situação de acolhimento institucional. A saúde sexual de adolescentes institucionalizadas confere uma temática intrigante. Em um contexto particular, estas jovens recentemente iniciaram suas atividades sexuais e estão cercadas por disparidades sociais que aumentam os riscos de DST/Aids e gravidezes precoces. Esta situação desperta preocupações em relação aos seus comportamentos sexuais e às próprias estratégias desenvolvidas referentes a promoção da saúde sexual. Este trabalho teve como objetivo geral analisar a promoção da saúde sexual de adolescentes em situação de acolhimento institucional considerando a Teoria de Promoção da Saúde de Nola Pender e objetivos específicos, identificar e analisar os comportamentos e aspectos biológicos, psicológicos e socioculturais relacionados à saúde sexual de adolescentes acolhidas; identificar e analisar os sentimentos e fatores influenciadores das adolescentes acolhidas associados à promoção de sua saúde sexual; indicar possibilidades de cuidados auxiliadoras na autopromoção/autocuidado da saúde sexual das adolescentes em acolhimento. A pesquisa foi do tipo descritiva e exploratória, com abordagem qualitativa. O referencial teórico-metodológico utilizado foi A Teoria Modelo de Promoção da Saúde de Nola Pender, o qual, a partir da identificação dos fatores biopsicossociais e comportamentais, busca incentivar atitudes saudáveis como proposta de promoção da saúde. As participantes foram oito adolescentes, institucionalizadas, do sexo feminino, e que vivenciaram vida sexualmente ativa. O cenário do estudo foi uma instituição de acolhimento localizada no município do Rio de Janeiro. Para a produção dos dados, utilizou-se a técnica de entrevista estruturada, utilizando um roteiro pré-elaborado, com base no modelo citado. A análise dos resultados foi baseada em Bardin (análise de conteúdo). A partir da análise dos dados, criou-se duas categorias: a) Contexto da saúde sexual de adolescentes acolhidas: características e experiências; b) Sentimentos e Conhecimentos das adolescentes acolhidas sobre a promoção da saúde sexual. As adolescentes apresentaram comportamentos sexuais lábeis, com uso de métodos contraceptivos descontínuos e uma dualidade nas práticas sexuais protegidas. Foram percebidas mudanças nos comportamentos sexuais através do aumento do uso de preservativos nas relações sexuais, redução do número de gravidez em comparação ao período antes e durante o acolhimento, uma maior percepção das vulnerabilidades sexuais e atitudes de autonomia e empoderamento nas estratégias de promoção da saúde sexual. Percebeu-se influência da família, amigos, mídia e instituição de acolhimento na promoção da saúde sexual das jovens. Observou-se ainda, comportamentos positivos resilientes e mecanismos pessoais de enfrentamento ao histórico de violência sexual. Ações educativas dialógicas, que valorizem a promoção da saúde sexual de adolescentes institucionalizadas, com base no Modelo de Promoção da Saúde de Nola Pender, constitui uma proposta viável e relevante na busca da cidadania dessas adolescentes, principalmente quanto a conquista dos direitos reprodutivos e sexuais sobre sua saúde. / The present study aims to the promotion of sexual health of adolescents in institutional care. The sexual health of institutionalized adolescents confer an intriguing theme. In a particular context, these young people have recently begun their sexual activities and are surrounded by social disparities that increase the risk of STD/ AIDS and early pregnancies. This situation raises concern regarding their own sexual behaviors and strategies developed relating to sexual health promotion. This study aimed as general propose to analyze the sexual health of adolescents ininstitucional care situation considering the Health Promotion Theory of Nola Pender and as specific objectives, identify and analyze the behavior and biological, psychological and sociocultural related to the sexual health of adolescents accepted; identify and analyze the feelings and factors that influence the immigrant adolescents associated with the promotion of sexual health; indicate possibilities of helper care in self-promotion / self-care of sexual health of adolescents in care. A descriptive and exploratory research with a qualitative approach. The theoretical and methodological framework used was the Health Promotion Model Theory of Nola Pender, which, from the identification of Psychosocial and behavioral factors, seeks to encourage healthy attitudes as a proposed health promotion. Participants were eight teenagers, institutionalized, female, and who had experienced sexually active. The study setting was a host institution located in the city of Rio de Janeiro. For the production of data, we used the semi-structured interview technique using a pre-designed questionnaire based on Nola Pender diagram. The analysis was based on Bardin (content analysis). From the analysis of the data, it was created two categories: a) Context of sexual health of adolescents received: characteristics and experiences; b) Feelings and knowledge of adolescents received about the promotion of sexual health. The adolescents had labile sexual behavior, using discontinuous contraception and a duality in protected sexual practices. Changes were perceived in sexual behavior by increasing the use of condoms during sexual intercourse, reducing the number of pregnancy compared to the period before and during the institutional care, a better sense of vulnerability and sexual attitudes of autonomy and empowerment strategies for health promotion sexual. Realized either, the influence of family, friends, media and host institution in promoting sexual health of young people. It was also observed, resilient positive behaviors and personal coping mechanisms to the history of sexual violence. The dialogic educational activities, that enhance the sexual health of institutionalized adolescents, based on Nola Pender's Health Promotion Model, are a viable and relevant proposal in search of citizenship of these adolescents, especially regarding the achievement of reproductive and sexual rights over their health.

This Master's thesis offers the insight into the problems of institutionalised upbringing of children in the Czech Republic. It consists of several parts. The theoretical part deals with family as a foundation in the child's life. Furthermore, it describes family dysfunction and possible upbringing options, either in a foster family environment or in an institution i.e. a children's home. The next chapter offers further particulars regarding institutionalised upbringing. We can find more detailed description of all professionals involved in the placement of children and decisions which type of upbringing is most suitable for them. In the theoretical part we can find further division of institutionalised upbringing options, depending on which ministerial departments are responsible. The practical part is based on a quality research with the help of half structured interview with children in family orientated children's home. The research was conducted in a real environment to achieve the most accurate result. The interviews were conducted between June and September 2017. Several questions were put to five children from five different family groups who were put into children's homes after the change of the Civil Code. The questions were geared mainly towards the biological family, reasons for placement into a children's home. The main aim was to ascertain the reasons for placement into a home with the changes of the law no 89/2012 being taken into consideration. My next objective was to determine if placements into children's homes are desirable and beneficial for their future upbringing. The interviews were copied word to word and analysed with the help of open coding and contrast technique. The conclusion of the research has determined that the Civil Code changes are not always beneficial for the child or the institution where the child is to be brought up. It was further determined that placements of children without their assessment in an appropriate institution is undesirable. The thesis could bring benefits to other professionals who actively participate in the placements of children into care. To achieve this quality research strategy has been chosen. The resource of the data received were half structured interviews with the children, their lawful guardians and the children's home director. Further details were obtained from the children's personal files. The conclusion of the thesis could be used as a tool when decisions regarding placements are made as this would benefit the child and be in his best interest. It could be used as a source for wider public and professionals alike.

Thesis (BTech (Surface Design))--Cape Peninsula University of Technology, 2010 / The purpose of this research is to generate a social outreach project by raising funds as well as getting sponsors to enhance the living environment at an institution for deaf girls. The focus is on Huis Soekie, a hostel which accommodates 17 deaf girls between the ages of 11 and 15. It is one of eight hostels situated at the De La Bat School for the Deaf in the rural town of Worcester. Frank Vodvarka and Joice Manice Malnar's work about Multi-Sensory design was used as inspiration to establish creative ways in which to enhance the living environment of institutionalized deaf girls. The living room of the hostel was chosen as focus area, since interaction among deaf people is important and the girls spend most of their time in it. To contribute to a more relaxing environment in this living room, secondary research was done on how nature together with the correct choice of colours can have a positive effect on humans' emotions. The living area of the hostel therefore has a central narrative and theme portraying nature as inspiration. All of the products that were designed for this space also incorporate elements of multi-sensory design. This type of design should be beneficial to the Deaf, because their other four senses are better developed than those of able people. This should also enhance their experience of the products.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / O presente estudo tem por objeto a promoção da saúde sexual de adolescentes em situação de acolhimento institucional. A saúde sexual de adolescentes institucionalizadas confere uma temática intrigante. Em um contexto particular, estas jovens recentemente iniciaram suas atividades sexuais e estão cercadas por disparidades sociais que aumentam os riscos de DST/Aids e gravidezes precoces. Esta situação desperta preocupações em relação aos seus comportamentos sexuais e às próprias estratégias desenvolvidas referentes a promoção da saúde sexual. Este trabalho teve como objetivo geral analisar a promoção da saúde sexual de adolescentes em situação de acolhimento institucional considerando a Teoria de Promoção da Saúde de Nola Pender e objetivos específicos, identificar e analisar os comportamentos e aspectos biológicos, psicológicos e socioculturais relacionados à saúde sexual de adolescentes acolhidas; identificar e analisar os sentimentos e fatores influenciadores das adolescentes acolhidas associados à promoção de sua saúde sexual; indicar possibilidades de cuidados auxiliadoras na autopromoção/autocuidado da saúde sexual das adolescentes em acolhimento. A pesquisa foi do tipo descritiva e exploratória, com abordagem qualitativa. O referencial teórico-metodológico utilizado foi A Teoria Modelo de Promoção da Saúde de Nola Pender, o qual, a partir da identificação dos fatores biopsicossociais e comportamentais, busca incentivar atitudes saudáveis como proposta de promoção da saúde. As participantes foram oito adolescentes, institucionalizadas, do sexo feminino, e que vivenciaram vida sexualmente ativa. O cenário do estudo foi uma instituição de acolhimento localizada no município do Rio de Janeiro. Para a produção dos dados, utilizou-se a técnica de entrevista estruturada, utilizando um roteiro pré-elaborado, com base no modelo citado. A análise dos resultados foi baseada em Bardin (análise de conteúdo). A partir da análise dos dados, criou-se duas categorias: a) Contexto da saúde sexual de adolescentes acolhidas: características e experiências; b) Sentimentos e Conhecimentos das adolescentes acolhidas sobre a promoção da saúde sexual. As adolescentes apresentaram comportamentos sexuais lábeis, com uso de métodos contraceptivos descontínuos e uma dualidade nas práticas sexuais protegidas. Foram percebidas mudanças nos comportamentos sexuais através do aumento do uso de preservativos nas relações sexuais, redução do número de gravidez em comparação ao período antes e durante o acolhimento, uma maior percepção das vulnerabilidades sexuais e atitudes de autonomia e empoderamento nas estratégias de promoção da saúde sexual. Percebeu-se influência da família, amigos, mídia e instituição de acolhimento na promoção da saúde sexual das jovens. Observou-se ainda, comportamentos positivos resilientes e mecanismos pessoais de enfrentamento ao histórico de violência sexual. Ações educativas dialógicas, que valorizem a promoção da saúde sexual de adolescentes institucionalizadas, com base no Modelo de Promoção da Saúde de Nola Pender, constitui uma proposta viável e relevante na busca da cidadania dessas adolescentes, principalmente quanto a conquista dos direitos reprodutivos e sexuais sobre sua saúde. / The present study aims to the promotion of sexual health of adolescents in institutional care. The sexual health of institutionalized adolescents confer an intriguing theme. In a particular context, these young people have recently begun their sexual activities and are surrounded by social disparities that increase the risk of STD/ AIDS and early pregnancies. This situation raises concern regarding their own sexual behaviors and strategies developed relating to sexual health promotion. This study aimed as general propose to analyze the sexual health of adolescents ininstitucional care situation considering the Health Promotion Theory of Nola Pender and as specific objectives, identify and analyze the behavior and biological, psychological and sociocultural related to the sexual health of adolescents accepted; identify and analyze the feelings and factors that influence the immigrant adolescents associated with the promotion of sexual health; indicate possibilities of helper care in self-promotion / self-care of sexual health of adolescents in care. A descriptive and exploratory research with a qualitative approach. The theoretical and methodological framework used was the Health Promotion Model Theory of Nola Pender, which, from the identification of Psychosocial and behavioral factors, seeks to encourage healthy attitudes as a proposed health promotion. Participants were eight teenagers, institutionalized, female, and who had experienced sexually active. The study setting was a host institution located in the city of Rio de Janeiro. For the production of data, we used the semi-structured interview technique using a pre-designed questionnaire based on Nola Pender diagram. The analysis was based on Bardin (content analysis). From the analysis of the data, it was created two categories: a) Context of sexual health of adolescents received: characteristics and experiences; b) Feelings and knowledge of adolescents received about the promotion of sexual health. The adolescents had labile sexual behavior, using discontinuous contraception and a duality in protected sexual practices. Changes were perceived in sexual behavior by increasing the use of condoms during sexual intercourse, reducing the number of pregnancy compared to the period before and during the institutional care, a better sense of vulnerability and sexual attitudes of autonomy and empowerment strategies for health promotion sexual. Realized either, the influence of family, friends, media and host institution in promoting sexual health of young people. It was also observed, resilient positive behaviors and personal coping mechanisms to the history of sexual violence. The dialogic educational activities, that enhance the sexual health of institutionalized adolescents, based on Nola Pender's Health Promotion Model, are a viable and relevant proposal in search of citizenship of these adolescents, especially regarding the achievement of reproductive and sexual rights over their health.

Reflections of an adolescent's own future may contribute to its future direction. The concept of one's own family occupies an important position in these reflections and, to a certain extent, determines their form. Individuals from institutional care have disrupted original family ties, which are supposed to negatively affect their own family concepts. The diploma thesis is based on a qualitative methodological approach. The family concepts of individuals both from institutional care and regular family environment are investigated under the light of individuals' future orientations. The semi-structured interview and projective graphical methods were assigned to six individuals from institutional care and six individuals from regular family environment. A qualitative analysis of the data gathered confirmed that the concepts of a planned family of adolescents from institutional care differ from those of teens from the regular family environment. Adolescents from institutional care lack the emotional aspect of the family, and the family is perceived primarily as an institution serving to protect its members. Moreover, gender aspects are more pronounced in their family concepts, especially in parental roles, than in adolescents from the control group. Differences between groups are also found in other...

The primary focus of these theses is issue of unwanted children and possible solution which is allowed by Czech law. Definition of the term unwanted child is not simple. The child can become unwanted even before his birth (for example in case of unwanted pregnancy) or during his childhood which is more common. For purpose of these theses child is considered a person who is under the age of eighteen. This is also supported by The European Constitution of the right of the child. Among the solutions of the issue of unwanted children I included the possibility of legal abandonment of the newborn after birth and issue of babyboxes. Both of the institutions focus on the newborn and their mothers. If the mother decides to postponement of the newborn after birth and the same time she wants to conceal her identity she can choose concealed birth or discrete birth. In the chapter describing the babyboxes I focused on legal issue of this institution and basic questions related to the problems of the babybox. This institute has many opponents and patrons from the professionals or general public. The following four chapters describe surrogate children care which is providing a solution for the unwanted child not only after birth but also during childhood. Legislation of institutional care when child is placed in...