Patienter med svårläkta bensår förekommer ofta i slutenvården och primärvården där sjuksköterskor och distriktssköterskor ansvarar för omvårdnaden. Svårläkta bensår orsakar stort lidande för patienten och innebär en stor kostnad. Syftet med denna studie var att beskriva och jämföra sjuksköterskors och distriktssköterskors kunskaper om rutiner, riktlinjer och omvårdnad av svårläkta bensår i slutenvården och primärvården. En enkät med frågor gällande kunskap om svårläkta bensår delades ut till 80 sjuksköterskor och distriktssköterskor och 55 enkäter besvarades. Resultatet visade att det fanns vissa brister i kunskapen om svårläkta bensår. Kompressionsbehandling användes profylaktiskt på enheterna för att undvika sårrecidiv, men färre än hälften visste vilken effekt kompressionsbehandlingen syftade till. Pumpstövel var något som sällan användes. Ankeltrycksmätning utfördes inte ofta preventivt eller för att utesluta arteriell insufficiens. Riktlinjer gällande dokumentation av sårbedömning och sårbehandling uppgavs av deltagarna fanns, men riktlinjer gällande själva bedömningen och behandlingen av svårläkta bensår var enligt resultatet inte lika vanligt förekommande. Många skattade att de inte hade tillräckliga kunskaper för att bedöma och behandla arteriella sår, venösa sår och blandsår. De testade kunskaperna visade att inom områdena omläggningsfrekvens, sårmiljö, venösa bensår, protein och zink var kunskaperna goda.  Jämförelsen mellan primärvården och slutenvården visade en signifikant skillnad där de som var verksamma i primärvården hade bättre kunskaper gällande sårmiljö, arteriella bensår, venösa bensår och ankeltrycksmätning. Slutsatsen som drogs av jämförelsen som gjordes mellan primärvården och slutenvården visade på en signifikant skillnad i testade och skattade kunskaper till fördel för sjuksköterskorna och distriktssköterskorna i primärvården som hade bättre kunskaper gällande sårmiljö, arteriella bensår, venösa bensår och ankeltrycksmätning.

This thesis presents a foundation for developing a business case for companies interested in the reconstructive and cosmetic procedure markets. The focus is on reviewing adipose tissue engineering research and proposing technology opportunities that could be applied to challenging soft tissue reconstruction cases and adjacently applied to cosmetic applications. To establish the foundation for this type of program, this thesis includes an evaluation of the reconstructive and cosmetic procedure markets, current practices in these markets and their constraints, as well as a literature review of research in adipose tissue engineering and its potential clinical applications. Additionally it captures the competitive landscape of major players in the reconstructive market as well as up-and-coming players in the adipose tissue engineering field. Technology development opportunities with associated customer and business value are discussed with a recommendation for the development of a detailed business case to evaluate specific product development opportunities in these markets. / text

American Water Resources Association Symposium Proceedings / Reprinted from Establishment of Water Quality Monitoring Programs / Edited By: Lorne G. Everett and Kenneth D. Schmidt / June 12-14, 1978 / San Francisco, California / Traditional techniques for monitoring the mass flux of pollutants in the vadose zone involve obtaining point samples of solute, either by core sampling of solids, followed by laboratory extraction, or by installation of suction probes. An alternative sampling technique, discussed in this paper, is to sample perched ground water within the vadose zone. Large amounts of water may be pumped for sampling purposes from wells drilled into productive, perched ground -water bodies. Alternatively, cascading water from perched regions may be sampled in wells with perforations above the water table. Analytical results of samples from such wells are more representative of regional conditions than small point samples. Case studies are presented on sampling from perched ground water underlying a point source (an oxidation pond), a line source (an ephemeral stream), and a diffuse source (irrigation return flow).

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Darbo tikslas: Ištirti darbuotojų požiūrį į darbo kokybę VšĮ Varėnos ligoninėje. Uždaviniai: 1. Ištirti darbuotojų požiūrį į paslaugų kokybę ligoninėje. 2. Įvertinti medicinos personalo požiūrį į kokybės sistemą ligoninėje. 3. Įvertinti darbuotojų požiūrį į kokybės sistemos dokumentus. Tyrimo metodika: 2007.11.05 – 2007.11.20 laikotarpiu VšĮ Varėnos ligoninėje bu¬vo atliekama anoniminė anketinė darbuotojų apklau¬sa. Buvo išdalinta 254 anketos, atsakė – 205 respondentai (atsakas – 80,7 proc.). Rezultatų statistinė analizė atlikta SPSS 13.0 versijos programiniu paketu ir MS Excel. Rezultatai: Kokybės sistemos diegime dalyvauja šiek tiek daugiau kaip pusė (57,7 proc.) darbuotojų; aktyviausi tyrimo dalyviai yra gydytojai (81,1 proc.) ir slaugytojos (71,9 proc.). Dauguma (85,1 proc.) darbuotojų mano, kad kokybės sistema didžiausią naudą duoda patiems darbuotojams. Darbuotojų nuomone darbo instrukcijos, metodikų supratimas ir naudojimasis jomis tiesioginiame darbe yra naudingi. 44,0 proc. respondentų mano, kad kokybės sistemos diegime dalyvauja gerai vykdydami jiems patikėtas dokumentuotas procedūras. Pagrindinė darbuotojų pasyvumo priežastis, diegiant jų skyriuje kokybės sistemą, yra motyvacijos (3,89 balo) ir paskatinimo iš vadovų (4,60 balo) (p<0,05) trūkumas. Išvados: Medicinos personalo nuomone ligoninėje kokybės vadybos sistema nėra įdiegta. Darbuotojų aktyvumas diegiant kokybės vadybos sistemą yra vidutinis. Paskatinimo iš vadovų trūkumas yra esminė darbuotojų... [toliau žr. visą tekstą] / Aim of the study: Examine the attitudes of the employees to work quality in the Varėna Hospital. Objectives: 1. Examine attitude of staff to the quality of services in the hospital. 2.Evaluate attitude medical staff’s of to wards the quality system in the hospital. 3. Evaluate attitude of staff of to wards the quality system’s documents. Methodics of the research: Anonymous questionnaire survey of employees was carried out in the Varėna Hospital during the period of 2007.11.05 – 2007.11.20. 254 questionnaires were distributed and 205 respondents have answered (response – 80,7 %). Statistic analysis of the results was performed using SPSS 13.0 version of programme pack and MS Excel. Results: Half of all employees (57.7 %) took part in the implementation of the quality system; the most active participants of the research are doctors (81.1 %) and tenders (71.9 %). The majority of respondents (85.1 %) believe that employees themselves benefit most from the quality system. Work instructions of the department, understanding of methodologies and their usage in direct work are very beneficial. 44 % of respondents believe that they participate in implementation of the quality system by performing to them assigned documented procedures well. The main reason of employees’ passiveness in implementing a quality system in their department was a lack of motivation (3.89 points) and encouragement (4.60 points) from the managers (p<0,05). Conclusions: Medical staff suggested that the... [to full text]

Atsižvelgiant į tai, kad realus visuomenės dalyvavimas Lietuvoje atliekamose poveikio aplinkai vertinimo (PAV) procedūrose iki šiol mažai nagrinėtas, buvo atlikta Kauno regione vykdytų poveikio aplinkai vertinimo procedūrų ir visuomenės dalyvavimo jose analizė. Tyrimo metu buvo išanalizuota visi Kauno regione 2005-2009 m. pateikti poveikio aplinkai vertinimo proceso dokumentai, nustatytas visuomenės dalyvavimas juose, taip pat buvo atlikta apklausa, kurios metu buvo siekiama išsiaiškinti, pasyvaus visuomenės dalyvavimo priežastis. Atlikus Lietuvos Respublikos Poveikio aplinkai vertinimo įstatymų ir poįstatyminių teisės aktų analizę nustatyta, jog Lietuvoje yra sudarytos ES reikalavimus atitinkančios visuomenės dalyvavimo PAV procese sąlygos. Visuomenės dalyvavimo PAV procedūrose aktyvumas yra labai mažas: 2005-2009 m. visuomenė pareiškė savo nuomonę tik dėl 1,9-3,1 % vykdytų projektų atrankų dėl PAV būtinumo procedūrų; PAV programos rengimo procese, kur visuomenė gali daryti didžiausią įtaką visam PAV procesui, motyvuotų pasiūlymų iš viso nebuvo sulaukta; Supažindinimo su PAV ataskaita metu visuomenė nebuvo aktyvi ir motyvuotų pasiūlymų buvo sulaukta tik vienai 2007 m. parengtai ataskaitai dėl žvyro ir smėlio telkinio eksploatacijos. Visuomenės ir kitų PAV proceso dalyvių informavimas apie PAV eigą tik formalus, kadangi skelbimai laikraščiuose dažniausiai yra labai mažo formato, įdėti mažiausiai skaitomuose laikraščio puslapiuose, pateikta informacija ne visuomet informatyvi... [toliau žr. visą tekstą] / In Kaunas region there has been made the analysis about the procedures of estimation of the effect on environment and society’s participation in it concerned with only a few cases of it having been analyzed. In this analysis there has been analyzed all the documents of the process of the effect on environment estimation that were received in 2005-2009 years in Kaunas. In the analysis there is defined the participation of society in this process, and also the testing has been made. It was tried to solve the reasons of passive participation of the society in the process of estimation of the effect on environment. The results of the analysis of Lithuania Republic Statute of Estimation of the effect on environment and the deeds of law have shown that in Lithuania there are all the conditions for the society to participate in this process, and all the conditions are defined by European Union requirements. The activity of the society’s participation in this process is very low: in 2005-2009 years the society expressed its opinion only about 1, 9- 3, 1 % of the selection of the projects that has been carried out in case to solve the necessity of the procedures. In the process of preparation of those procedures, in which the society can make the biggest influence to all the process, there has been received no motivate propositions. In the introduction of this process report to society, it was not active, there was only one motivate proposal to the report of the exploitation of sand... [to full text]

There is now widespread acceptance in the organisations that human resources are an important source of competitive advantage, or an important component of the value chain. In the public service sector, the delivery of services to the populace depends on the competence, motivation and discipline of the employees. All of this points to the importance of properly dealing with HR issues in organisations. This empirical study gathered the views of Ward Managers of the Kwa-Zulu Natal Department of Education. 40% of Ward Managers participated in this survey, and the responses were analysed utilising the Statistical Package for Social Sciences (SPSS). The results indicate that the majority of respondents perceived the department’s disciplinary process to be unfair both substantively and procedurally. The majority of respondents felt that there were inconsistencies in the decisions to discipline employees; that the sanctions were inconsistent and that the disciplinary hearings took too long to finalise. Finally, this study recommended further research on the subject, especially utilising different methodologies such as in depth case studies and unstructured interviews in order to gain insights into the reasons why Ward Managers hold the views that they hold or to refine some of the concepts in order to understand what exactly they understand by concepts such as ‘unfairness’. / Thesis (MBA)-University of KwaZulu-Natal, Westville, 2010.

Tyrimo objektas: sergančiųjų skolioze nuomonė apie gyvenseną, fizinį aktyvumą ir gydymą sanatorijos sąlygomis. Tyrimo subjektas: Šiaulių sanatorinės mokyklos mokiniai. Hipotezė: mokinių, sergančių įvairaus laipsnio skolioze, gydymo sanatorinėmis sąlygomis fizinė veikla ir gydymo procedūrų įvairovė, jų taikymo dažnis, nežiūrint kai kurių gyvensenos pokyčių, teigiamai veikia mokinių sveikatą. Tyrimo tikslas: ištirti, mokinių, sergančių skolioze gyvensenos įvairovę, nuomonę apie fizinę veiklą, gydymo procedūras ir pamokas. Tyrimo uždaviniai: 1. Sergančių skolioze mokinių demografinė charakteristika sanatorinėje mokykloje. 2. Priežastys, dėl ko mokiniai patiria gyvenimo sunkumus sanatorinėje mokykloje. 3. Sanatorinės mokyklos mokinių nuomonė apie gydymo procedūras ir pamokas. 4. Sanatorinės mokyklos mokinių fizino aktyvumo vertinimas. Išvados: 1. Sanatorijoje yra daugiau mergaičių nei berniukų. Daugiau vyresnio nei jaunesnio amžiaus mokinių. Mokiniai mokykloje mokosi tol, kol pasiekia teigiamų gydymo rezultatų, didžioji dalis mokosi pirmus arba antrus metus. Dauguma sanatorijos mokinių serga I ir II laipsnio skolioze. Jaunesniųjų sanatorijoje daugiausia su skolioze II°, o vyresniųjų skolioze I°. 2. Sanatorijos mokiniai susiduria su įvairiais sunkumais. Dažniausios patiriamų sunkumų priežastys - tėvų ir namų ilgesys, nuvargimas gulimoje padėtyje mokantis. 3. Daugumai mokinių visos procedūros patinka, bet malonumą kartais vertino prieštaringai, pavyzdžiui: gydomasis plaukimas... [toliau žr. visą tekstą] / Research object: students with scoliosis opinion about quality of life, physical activity and treatment of sanatorium conditions. Research subject: students in Siauliai sanatorium school. Hypothesis: students with differents degrees of scoliosis treatment in sanatorium conditions physical activity and treatments procedures applying, the frequency, some of the quality of life changes that positively affects students health. Research aim: students with scoliosis explore diversity to quality of life, opinion about physical activity, treatment procedures and lessons. Research tasks: 1. Students with scoliosis demographic characteristics in sanatorium school. 2. Students difficulties experiencing life in sanatorium school. 3. Students opinion about treatments procedures and lessons in sanatorium school. 4. Students physical activity evaluation in sanatorium school. Conclusions: 1. School studys and lives more girls than boys in sanatorium. Also, more older than younger age students. The students learns until they reach the positive treatment results most of them studys during the first or second year. Most students in sanatorium school sick I and II degree scoliosis. The youngest students in sanatorium school mostly with scoliosis II° and the oldest mostly with scoliosis I°. 2. Sanatorium school students comes up with differents of difficulties. The most rising difficulties among the students - yearning for parents and home, tiredness in learning lying position. 3. Most students... [to full text]

Spinal pain is one of the most frequent reasons of health disorder and consulting a doctor. 60-90% of adults complain of a spinal pain at least once in their lifetime. 50% of adults experience a spinal pain that makes them suspend their work and unbalance their everyday life. This is the main reason of adults’ disability till 45 years old ant the third most frequent reason of adults’ disability over 45 years old. 5-10 % of cases spinal pains are not acute. The aim of this research was to evaluate the efficiency of aquatic procedures and procedures done in the kinesytherapy hall in treating spinal pains. The goals of the research were: 1. To evaluate spinal pain of the examined ones before and after kinesytherapy. 2. To evaluate mobility of the spine of the examined ones before and after kinesytherapy. 3. To evaluate strength of lumbar muscles of the examined ones before and after kinesytherapy. 4. To estimate which aquatic procedure is more effective in treating spinal pains. The research was carried out in Kaunas Medicine University Clinics. There were examined three groups of patients. Each group consisted of 15 patients. Altogether 45 patients took part in the investigation. During the investigation there were evaluated such factors as pain, strength of muscles (abdominal, spinal, right and left sides) and mobility of the spine (forward, backward, left, right) of the patients. After kinesytherapy the intensity of pain of the examined ones decreased statistically... [to full text]

Bakgrund: Fasthållning av barn används vid ett flertal kliniska procedurer. Barns samt vårdnadshavares upplevelse av situationen är ofta negativ. Etiska principer samt lagar och riktlinjer utgör en teoretisk grund i en fasthållningssituation. Barnets autonomi samt sjuksköterskans omvårdnadsplikt är två utgångspunkter i fasthållning som fenomen. Syfte: Att beskriva sjuksköterskors erfarenhet av fasthållning av barn vid kliniska procedurer inom somatisk vård. Metod: Litteraturstudien är baserad på tio vetenskapliga artiklar med både kvalitativ och kvantitativ ansats. En textanalys, inspirerad av kvalitativ innehållsanalys, har gjorts i resultatet. Resultat: Fem kategorier framkom: Användandet skiljer sig åt, Fasthållning möjliggör kliniska procedurer, Optimera situationen för barnet, Kommunikation underlättar fasthållningen samt Fasthållning är en svårighet. Sjuksköterskornas syn på fasthållning skiljdes åt beroende på den specifika situationen samt på sjuksköterskornas egna kunskaper och förutsättningar. Sjuksköterskorna upplevde en känslomässig konflikt i användandet av fasthållning men ansåg också att fasthållning är en nödvändighet vid många kliniska procedurer på barn, särskilt i akuta sammanhang. Slutsats: Erfarenheten av fasthållning av barn vid kliniska procedurer är mångfacetterad. Sjuksköterskor bör ha god kunskap om barns rättigheter och om etiska principer för att kunna optimera de kliniska procedurerna. Klinisk betydelse: Studien kan ge ett ökat etiskt medvetande som stärker sjuksköterskans professionella roll samt ha betydelse för vårdrelationen. / Background: Restraint of children is used in multiple clinical procedures. The experience of the situation is usually negative on children and legal guardians. Ethical principles, laws and guide lines represents the theoretical foundation in a restraint situation. The autonomy of the child as well as the caring duty of the nurse make up two basis for the phenomena of restraint. Aim: To describe nurses' experiences of restraint of children during clinical procedures in somatic health care. Method: This literature review is based on ten scientific papers with both qualitative and quantitative approach. A textual analysis, inspired by qualitative content analysis, represents the result. Result: Five categories emerged in the result: The usage differs, Restraint enables clinical procedures, Optimizing the situation for the child, Communication facilitates the use of restraint and Restraint is a difficulty. The nurses' view on restraint differed depending on the specific situation as well as the skills and abilities of the nurse. The nurses experienced an emotional conflict in the use of restraint but considered it to be necessary in multiple clinical procedures, especially during emergency contexts. Conclusion: The experience of restricting children during clinical procedures is multifaceted. Nurses need to have good knowledge about children's rights and ethical principles to optimize the clinical procedures. Clinical significance: The study can provide a greater ethical awareness that strengthens the professional role of the nurse and also have significance for the nurse-patient relationship.