The topic of this thesis is how the State Environmental Fund (SEF) of the Czech Republic contributes to the region's development through the financial support. Within thesis are chosen two regions. The Southwest Region with relatively balanced environment and the Moravia-Silesia Region with a damaged environment. The theoretical part is focused on the history of the Environment of the Czech Republic. There is also characterized by funding environmental resources of Czech Republic and EU resources. In this part is also characterized the quality of life and methods of measuring. The practical part deals with the analysis of financial support from the SEF to regions, as well as an analysis for what components to environmental flows the most investment and non investment expenses from all sources of the Regions of the Czech Republic. And the last part of the thesis deals with the quality of life in the selected two regions. Quality of life is evaluated by analyzing selected three components of the environment - air, water, forests. In another part of the quality of life is assessed by EPI index, which is modified for this thesis. This index assesses what was the environment in 2004 and in 2011, if has improved state of the environment or not.

A parada cardiorrespiratória (PCR) é a principal causa de morte em países desenvolvidos e em desenvolvimentos, ocorrendo principalmente em ambientes extra hospitalares. Frente a esse panorama mundial considerado um problema de saúde pública atual, a capacitação de leigos no Suporte Básico de Vida (SBV) com uso da simulação clínica tem papel relevante para a melhoria das taxas de sobrevivência das vítimas de PCR. Estudo com objetivo de avaliar o conhecimento (teórico) e das habilidades (práticas) de leigos antes e após a sua participação no curso de SBV para leigos submetidos a estratégias de ensino-aprendizagem, aula expositivo-dialogada e atividade prática em laboratório de habilidades ou aula simulada no atendimento a PCR/RCP com SBV para leigos. Estudo com delineamento quase experimental, abordagem quantitativa com delineamento tempo-série. A população consistiu dos estudantes do primeiro ao quarto semestre de graduação da Faculdade de Enfermagem da Universidade Federal do Mato Grosso e a amostra de 104 estudantes que participaram do curso em SBV para leigos em duas etapas. Na etapa I todos os estudantes foram submetidos ao pré teste teórico, à aula expositivo-dialogada seguida de atividade prática em laboratório de habilidades com manequim de média fidelidade e uso do Desfibrilador Externo Automático (DEA), simulação clínica em laboratório utilizando o mesmo manequim e DEA e pós teste teórico imediato. A Etapa II ocorreu de 15 a 20 dias após a primeira e todos os estudantes foram submetidos à simulação clínica em laboratório utilizando o mesmo manequim de média fidelidade e DEA seguido de pós teste teórico mediato. Elaboraram-se os instrumentos de avaliação teórica, cenário de simulação e OSCE - avaliação clínica objetiva e estruturada no cenário de simulação com (checklist), validados em aparência e conteúdo por comitê de juízes. A estratégia de coleta de dados foi o curso de SBV para leigos. Foram avaliados as avaliações teóricas e OSCE (Exame Clínico Objetivo Estruturado) - avaliação clínica estruturada em Laboratório de Simulação, este último empregando como ferramenta o manequim de média-fidelidade e DEA. A atividade foi filmada e analisada por três avaliadores. Analisaram-se os desfechos nas etapas I e II do curso de SBV para leigos: desempenho teórico nos testes teóricos e práticos no OSCE, tempo de execução total e de cada domínio do OSCE e a qualidade das compressões torácicas externas (CTE) quanto a frequencia e profundidade em 120 segundos de reanimação cardiopulmonar (RCP). Resultados: 86 estudantes eram do sexo feminino e 18 do sexo masculino, a idade média 23,32±6,66 anos. No pré-teste a nota média foi de 3,52±2,03, e a mediana 3,0. No pós-teste imediato (pós 1) a nota média foi 8,01±1,19 (mediana 8,0) e no pós teste mediato (pós 2) foi de 7,41±2,68 (mediana 8,5). Comparando-se as médias obtidas no pré-teste, pós 1 e pós 2 há diferença estatisticamente significante (p<0,001) com retenção do conhecimento. Comparando as notas do pós 1 e pós 2 teóricos evidenciou diferença estatisticamente significante (p=0,019) com perda do conhecimento no pós 2. A média no OSCE na etapa I (pós 1) foi 3,63±0,30 e na etapa II (pós 2) de 3,63±0,31; comparou-se tais notas verificando-se que não há diferença estatisticamente significante (p=0,966). O tempo médio de execução do OSCE no pós 1 foi de 156,96±8,16s e no pós 2 foi de 138,68±43,58s, havendo diferença estatisticamente significante (p<0,001). O domínio de intervenção do OSCE \"Chegada em Cena\" apresentou média 20,78±6,20s no pós 1 e 16,46±4,56s no pós 2, o domínio \"Checar a responsividade\" média de 6,38±3,48s no pós 1 e 5,13±2,36s no pós 2, o domínio \"Usar o DEA\" média de 77,30±14,45s no pós 1 e 66,80±11,44s no pós 2, todos com diferença estatisticamente significante (p<0,001). Avaliando a qualidade das CTE a profundidade média atingida em milímetros (mm) apresentou média de 36,26±9,62 (mediana 35,00) no pós 1 e 39,36±10,96 (mediana 40,00) no pós 2. O nº de CTE média por minuto apresentou média de 116,01±21,72 (mediana 116,00) no pós 1 e 98,94±19,52 (mediana 100,00) no pós 2, o nº total de compressões (CTE) em 120 segundos apresentou média de 227,88±41,81 (mediana 226,00) no pós 1 e 197,31±30,42 (mediana 195,50) no pós 2, o nº de CTE muito superficiais média de 132,20±89,94 (mediana 146,50) no pós 1 e 74,96±75,76 (mediana 53,00) no pós 2, todos com diferenças estatisticamente significante (p<0,001). Já o nº de CTE incompletas apresentou média de 25,09±56,95 (mediana 0,00) no pós 1 e 14,51±35,45 (mediana 0,00) no pós 2 com diferença estatisticamente significante (p=0,012). No presente estudo, apesar de diferentes estratégias de ensino abordarem o SBV para leigos, os resultados demonstram que as mesmas foram eficazes e os objetivos de aprendizagem foram alcançados, pois houve incremento nas notas obtidas nos pós-testes e no OSCE tanto na etapa I quanto na etapa II em relação ao conhecimento prévio e habilidades, porém houve perda da retenção de conhecimento e habilidade de 15 a 20 dias após o curso de SBV para leigos o que reforça a necessidade da capacitação permanente / Cardiac arrest is the leading cause of death in developed and developing countries, and mainly occurs in non-hospital environments. With this global scenario, which is considered a present public health problem, training laypeople in Basic Life Support (BLS) with clinical simulation has an important role in improving survival rate of the cardiac arrest victims. This present study aims to evaluate the knowledge (theoretical) and skills (practical) of laypeople before and after the BLS training underwent to teaching and learning strategies, expository and dialogue class and practical activities in skills lab or simulation class in CPR/CPA. This study has an almost experimental, quantitative and time-series approach. The population study is composed of students from the first to fourth semester of Nursing at Federal University of Mato Grosso (UFMT) and the sample of 104 participants in BLS for laypeople in two steps. In Step 1, all the students had to undergo to the theoretical pretest, expository and dialogue class followed by practical activity in the skills lab with a mid-fidelity manikin and using automated external defibrillator (AED), clinical simulation in the lab using the same manikin and AED and immediate theoretical posttest. Step 2 occurred from the 15th to 20th days after the first one and all the students had to undergo to clinical simulation in the lab using the same mid-fidelity manikin and AED followed by immediate theoretical posttest. It was elaborated theoretical evaluation tools, simulation scenario and OSCE - objective structured clinical examination in the clinical scenario with checklist, validated in aspect and content by a judges committee. The data collection strategy was the BLS for laypeople. It was evaluated the theoretical tests and OSCE (objective structured clinical examination) - clinical examination structured in Simulation Lab, using as tool the mid-fidelity manikin and AED. The activity was filmed and analysed by three evaluators. The outcomes of Step 1 and 2 of BLS for laypeople were analysed: theoretical performance on theoretical and practical tests in OSCE, total execution time, each OSCE realm and the quality of external chest compression (ECC) such as frequency and deepness in 120 seconds of cardiopulmonary resuscitation (CPR). Outcomes: 86 female and 18 male students, median age 23.32±6.66. Median score in pretest was 3.52±2.03 and the average 3.0. At immediate posttest (post 1) the median was 8.01±1.19 (average = 8.0) and at immediate posttest (post 2) 7.41±2.68 (average = 8.5). Comparing the pretest averages and posttests 1 and 2, there is a statistically significant difference (p<0.001) of knowledge retention. Comparing theoretical posttests 1 and 2 revealed the statistically significant difference (p=0.019) with knowledge loss at posttest 2. Step 1 OSCE average (posttest 1) was 3.63±0.30 and Step 2 (posttest 2) 3.63±0.31; when compared, these scores demonstrated that there is not a statistically significant difference (p=0.966). The OSCE execution time average at posttest 1 was 156,96±8,16 seconds and at posttest 2 138.68±43.58 seconds, which demonstrated statistically significant difference (p<0.001). OSCE intervention realm \"Arrival on the scene\" showed posttest 1 20,78±6,20s and posttest 2 16,46±4,56s averages, the realm \"Check Responsiveness\" had averages of 6,38±3,48s in posttest 1 and 5,13±2,36s in posttest 2, the realm \"Using DEA\" averages of 77,30±14,45s in posttest 1 and posttest 2 of 66,80±11,44s, all of them with statistically significant difference (p<0,001). Evaluating the quality of ECT the reached deepness average in millimeters (mm) resulted 36.26±9.62 (average 35.00) in posttest 1 and 39.36±10.96 (average 40.00) in posttest 2. The number of ECC per minute showed 116.01±21.72 (average 116.00) in posttest 1 and 98.94±19.52 (average 100.00) in posttest 2, the total of compressions (ECC) in 120 seconds showed 227.88±41.81 (average 226.00) and 197.31±30.42 (average 195,50) in posttest 2, the number of surface ECC 132.20±89.94 (average 146.50) and 74.96±75.76 (average 53,00) in posttest 2, all of them with statistically significant difference (p<0,001). In the incomplete ECC showed 25.09±56.95 (average 0,00) in posttest 1 and 14.51±35.45 (average 0,00) in posttest 2 with statistically significant difference (p=0,012). In this present study, besides the different teaching strategies approaches for laypeople, the outcomes demonstrate that they were effective and the learning goals reached, since the posttests had higher scores in previous knowledge and skills of steps 1 and 2 of OSCE. However it showed a loss of knowledge and skills retention in 15 to 20 days after the BLS training for laypeople, what demonstrates the need of permanent training

Cardiopulmonary resuscitation (CPR) and defibrillation are the interventions performed by health care professionals in order to preserve the life of a patient suffering cardiac arrest. These tasks are important to the role of nurses because they are the most common first responders to in-hospital cardiac arrest scenarios. The early initiation of CPR and defibrillation is essential in increasing the likelihood of a patient surviving cardiac arrest. Despite possessing the knowledge, skills, training, and professional obligation to deploy CPR and defibrillation independently, nurses may hesitate to perform the appropriate actions in a timely manner. This topic has been studied previously; however, there have been no studies directly examining this issue in the Ontario context. This thesis explored the factors that influence the behaviour of nurses in the first responder role by employing a mixed-methods research design. The quantitative portion of the study consisted of a series of scales on an online survey that examined teamwork factors and nurses’ experience with CPR events. The qualitative part of the study consisted of open-ended questions on the survey as well as individual interviews with nurses to understand the barriers and enablers to the role of nurses in the enactment of basic life support (BLS). The qualitative data were analyzed with a modified grounded theory approach. The qualitative data analysis followed the guidelines developed by Charmaz (2006) and employed the conceptual framework on optimizing scopes of practice developed by the Canadian Academy of Health Sciences (2014) to extrapolate findings on the influence of nurses’ scope of practice on their behaviour. This study revealed a number of contextual factors in Ontario influencing nurses’ deployment of CPR and defibrillation including variations in hospital unit types, geography, workload, the availability and quality of technology, legislation and regulation, accountability, as well as economic constraints.

Withdrawal of life support therapy involves controlled removal of life support modalities including artificial respiration and circulation with intent to provide a comfortable death. Withdrawal of life support therapy is necessary prior to procedures such as organ donation after cardio-circulatory death, but remains poorly explored in current literature. To enhance the current evidence, we conducted a thorough structured review, an observational study, and a qualitative comparison of components comprising withdrawal of life support therapy in both donor and non-donor patient groups. At all stages, we considered how results impacted donation after cardio-circulatory death. Withdrawal of life support therapy processes vary between countries, hospitals, practitioners, and patients. Variability in practice impacts care and outcomes for both donor and non-donor patients. Improved definitions and consensus about the process of withdrawal of life support therapy may improve patient care, success of organ donation after cardio-circulatory death, and uptake of donation protocols.

According to The Swedish act concerning Support and Service for Persons with Certain Functional Impairments (LSS), people with intellectual disability have certain rights. Even if the law does not specifically mention parents with intellectual disability or the right to start a family, it is clear that this law shall promote equality in living conditions and full participation in community life. The Swedish social board (Socialstyrelsen) describes daily life support as a help for people in their daily life. The support is often addressed to people with mental disability but in some Swedish municipalities people with an intellectual disability can receive this support as well. Daily supporters does not only help with practical needs but also with social and psychological needs. This qualitative study aims to capture the respondents perspectives and perceptions on support for parents with intellectual disabilities. Six respondents from three different municipalities in Skåne county has been interviewed. From these interviews four different themes has been selected. All of the respondents has in some way mentioned that alliance/trust/relationship is very important, and that it is necessary for their work to even be possible. They also talk about their work with practical support and their work with clients in supporting them in their self-esteem. Cooperation is according to the respondents necessary in their work with the clients but that cooperation with other professions does not work. When the respondents talk about their views on the target group they often mention that the parents can feel insufficient in their role as parents. They think it could be a result of how people with intellectual disability often is treated and viewed by society. The result of this study shows that daily life support, specifically for parents with intellectual disability, is inadequate. However, the result should be considered in relation to the extent of the study.

Beyond the protective confines of Earth's atmosphere and magnetosphere, spacecraft are subject to constant bombardment by high-energy charged particles originating from our Sun in the form of Solar Particle Events (SPEs), and from outside the solar system in the form of Galactic Cosmic Rays (GCRs). The harm these particles do can be reduced or mitigated outright through radiation shielding. Because protons and other charged particles comprise most of these radiation particles, strong magnetic fields could be generated around spacecraft to deflect incoming charged radiation particles. This thesis investigates the performance of specific configurations of toroidal superconducting solenoids to generate magnetic fields that deflect incoming energetic protons via the Lorentz force. Bulk material shielding configurations using various thicknesses of liquid water are similarly investigated, as are combination shielding configurations combining the best-performing toroidal shielding configurations with a small bulk material shield surrounding the spacecraft. The water shielding configurations tested included shields of uniform thicknesses from 1 cm to 10 cm surrounding an Apollo CSM-sized cylindrical candidate spacecraft. Water shielding was found to be very effective at reducing the SPE dose, from a 86\% reduction at 1 cm of water to a 94\% reduction at 10 cm. However water shielding was found to be minimally effective against the much higher energy Galactic Cosmic Ray protons, with no dose reduction at 1 cm and a paltry 1\% reduction at 10 cm. The toroidal shielding geometric configurations tested consisted of either 5 or 10 primary toroidal shields surrounding the candidate spacecraft, as was the addition of smaller nested toroidal shields inside the primary toroids and of toroids on the spacecraft's endcaps. The magnetic field strengths tested were 1.7 Tesla, 8.5 Tesla, and 17 Tesla. The best geometric configurations of electrodynamic shielding consisted of 5 primary toroidal shields, 5 total nested shields placed inside the primary toroids, and 2 total shields on the spacecraft's endcaps. The second best geometric configuration consisted of 10 primary toroidal shields plus two total endcap shields. These configurations at 1.7 Tesla reduced the SPE dose by 87\% and 87\%, and reduced the GCR dose by 11\% and 10\%. At 17 Tesla, these configurations both reduced the SPE dose by 90\%, and reduced the GCR dose by 76\% and 61\%. Combining these two configurations with a 1 cm-thick shield of water improved performance against SPE protons to 95\% and 93\% at 1.7 Tesla, and a 97\% and 96\% reduction at 17 Tesla. GCR dose reductions decreased slightly. Passive material shielding was found capable of providing substantial protection against SPE protons, but was minimally effective against GCR protons without very thick shielding. Electrodynamic shielding, at magnetic field strengths of 1.7 Tesla, was found to be similarly effective against SPE protons, and marginally more effective against GCR protons. Combining the best toroidal shielding configurations, at magnetic field strengths of 1.7 Tesla, with water shielding yielded high protection against SPE protons, but still marginal protection against GCR protons. Increasing the magnetic field strength to 17 Tesla was found to provide very high protection against SPE protons, and to significantly reduce the radiation dose from GCR protons. Of all shielding configurations tested, only those electrodynamic configurations with magnetic fields of 17 Tesla were able to reduce the GCR dose by more than half.

The gaseous plant hormone ethylene is a small molecule that regulates developmental change. Research was conducted in three areas: sensitivity, synthesis, and alterations to synthesis. Vegetative pea plants were more sensitive than radish plants to atmospheric ethylene. Light intensity did not affect ethylene sensitivity. Ethylene synthesis rates were measured for unstressed cotton, corn, soybean, and tomato plants. The per-plant ethylene synthesis rate ranged from 0.1-80 pmol plant-1 s-1. However, when normalized to net photosynthetic rate, this range was 1-4 µmol of ethylene synthesis per mol of CO2 uptake. Diurnal cycles in ethylene synthesis were present in all crops studied. These cycles were disrupted by drought stress and were attenuated when synthesis rates underwent large changes. Drought stress decreased synthesis in cotton. Flooded corn and soybean had increased synthesis. Blocked perception had no effect on ethylene synthesis or net photosynthetic rate in healthy unstressed plants.

The diploma thesis is focused on the topic of Living with patients with rare diseases - Epidermolysis bullosa in the Czech Republic is focused on identifying the role of individual actors involved in financing support for patients and evaluating the significance of their roles. Patients suffering from rare diseases have a very specific situation in terms of financial contributions from the public budget, as their situation is not common. The diploma thesis is focused on the role of public sector actors, the non-profit sector (the role of Debra) and patient families in financing treatment and necessary care. It examines and compares the share of funding support for these individual actors, especially focusing on the share of funding from the public sector and the non-profit sector, where the majority is occupied by Debra, which focuses on supporting patients with butterfly wing disease. The thesis examines whether the role of the public sector in financing is sufficient and how significantly its role is complemented by the non-profit sector. Subsequently, the quality of life and social construction of patients in the Czech Republic is evaluated, as well as the provision of care and financial assistance for their illness. The situation of patients will be compared with the situation in other European...

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The Water Recovery System (WRS) is one of the necessary subsystems in an Advanced Life Support program. It regenerates potable water by processing wastewater generated on a space shuttle or on a space station. The Biological Water Processor (BWP) is one of the complex subsections of WRS that involves processes described by continuous time as well as discrete event dynamics. Such systems can be modeled as hybrid dynamical systems in MATLAB/Stateflow. The following state variables of the BWP have been simulated in MATLAB: Pressure drop across Organic Carbon Oxidation Reactor (OCOR), Pressure drop across nitrification reactor, nitrifier flow rate, total flow to OCOR, Gas-liquid separator level, feed pump modes. The developed model of the BWP can be used for the simulation of the complete WRS and also for synthesis of a distributed control laws for the BWP subsection.