Abstract Objective: The research study is to characterize the nurses´ role in the prevention of chronic respiratory disease, focusing on smoking prevention. The next objective is to raise awareness among parents about the negative impacts of smoking on the health of their children. It was then established, how many informations have got parents smokers about adverse effect on the health of their children. In relation to these objectives was established six research questions. The way of achieving the objective: To achieve the objectives a method of qualitative research was chosen, which was implemented through in-depth interviews. On the basis of specified research questions were created individual categories for getting answers to the research questions. It was elected a methode of intentional choice. Survey research took place in outpatient offices in the districts Znojmo and Brno Venkov. 10 parents smokers and 10 nourses agreed to be interwieved through using a method of anonymous questioning. Scientific benefits: A research study presents an overview of the impact of smoking on the health of children, the possibilities for intervention in the prevention of chronic diseases of children and and helping their parents smokers in the treatment of tobacco dependence. It will find application in primarily preventive and inpatient care as well. The knowledges gained and their conclusions: Baby nurse has important and irreplaceable role in the healthy development of children and in the prevention of risks to their health. Risk behaviour of children and youth is currently a serious social problem. The educational efforts has to be directed to change lifestyle and its components and is connected with the support of health. The results of our investigation shows that parents smokers often underestimate the influence smoking on the health of their children and are not very willing to do something for children. Parents also underestimate the effect of passive smoking, even though most of them have sufficient information about the risks. Whereas, children usually can't decide on environment, where they live, health professionals would aim interventions to protect children including the unborn ones. Question of health education is included in the nurse´s competences and is ordered to the doctors and nurses by law. It is therefore desirable that paramedics, having used their authority, increase their efforts and interventions to promote non-smoking. Nurse can help the patient with motivation and treatment their addiction and intervene according to recommendations based on scientific evidences. To a short 10 minute intervention has nurse opportunity apply in every contact with the patient, during his visit at doctor´s office or at the hospital in the pacients admitted to hospital. At least ask about smoking and give the smokers clear recommandation how to stop smoking and offer clear advice to the treatment referred in the brochure, with information of the harmful effects of smoking on the health of children. Use for practice: The conclusions were accepted in the scientific magazine Pediatry for practice and magazine Florence.

My dissertation is aimed at the following questions: System of children care, organization of health-care policy in the Czech Republic, competencies and abilities to children care, document Health for Everybody in 21st Century, community nursing, nurse interventions in particular age categories, and my own research proceedings. The research section of the work contains both quantitative and qualitative research procedures. The data were collected of a questionnaire and semi-structured interview. The examined set of a qualitative research consisted of 9 respondents {--} 5 nurses and 4 medical practitioners for children and youth. The quantitative data were collected with an interview method. The questionnaires were designed for the unprofessional public {--} parents of children who are up to 18. The examined set of the questionnaire research consisted of 73 respondents (100%). The research proceeded from mid June 2008 to the end of July 2008 and its results have been processed into category tables and graphs in the program of Microsoft Office Excel 2007. I especially try to find the opinion of children nurses and children medical practitioners on introduction of a community children nurse in the Czech Republic and specify the functions that a community children nurse can perform in the Czech Republic when working with children community. I also try to find locations at which the community children nurse could work, and obstacles hampering to establish this new working position within the Czech Republic. Last but not least, I am interested in the public interest in the nurse{\crq}s affect to health protection and care for children. So far, there has not been a community nurse position established as an independent community professional in health protection and care for children within the Czech Republic. However, in other countries, community nurses work in the state interest and they form a part of the public health-care system. They are rewarded for their work, which is highly appreciated, from the public budget. Development of the community health-care is a WHO priority, and it has already established its firm position in the Czech health-care conception. As the main advantage of introduction of a community nurse I consider the fact, that both children and parents would have a better chance to use a wider variety of health-care services at school, in their household or at the doctor{\crq}s consulting room. Community nurse{\crq}s activities could help to inform families and to improve the health-care edification level. They could also assist the families that need highly intensive health and social care. Because of independent work of community nurses, nurse{\crq}s profession would become more attractive and nurse{\crq}s social position would improve.

La coagulopathie induite par la circulation extracorporelle (CEC) chez les enfants porteurs d’une cardiopathie congénitale et bénéficiant d’une chirurgie cardiaque est complexe et multifactorielle. La prise en charge de ces enfants est délicate et doit être spécifique aux caractéristiques de cette population. De plus, cette prise en charge doit être multimodale, basée sur la prévention et le traitement précoce et ciblé. <p>Dans la première partie de ce mémoire, nous avons étudié la place de l’acide tranexamique, agent antifibrinolytique, dans la prévention de la fibrinolyse chez les enfants bénéficiant d’une chirurgie cardiaque avec CEC. Nous avons évalué les propriétés pharmacocinétiques et pharmacodynamiques de la molécule dans cette population particulière. Notre hypothèse étant que l’utilisation de schémas adaptés pourrait permettre d’optimaliser la balance bénéfice/risque de l’utilisation prophylactique de l’acide tranexamique. <p>Nous avons également développé un modèle expérimental susceptible d’améliorer la sensibilité des tests viscoélastiques pour la détection de la fibrinolyse et qui pourrait être utilisé pour estimer la concentration minimale d’acide tranexamique nécessaire pour inhiber la fibrinolyse. <p>Dans la seconde partie de ce mémoire, nous avons étudié l’importance de l’implémentation d’une prise en charge adaptée de la coagulopathie, en utilisant un algorithme défini en tenant compte des caractéristiques de la population cible. Si le ROTEM® s’avère être un outil important, son utilisation doit être limitée aux enfants qui présentent un saignement anormal afin de guider l’administration de produits hémostatiques. L’ensemble de nos travaux contribue à l’amélioration de nos connaissances dans la prise en charge de l’enfant à risque de saignement en période péri-opératoire de chirurgie cardiaque. / Doctorat en Sciences médicales / info:eu-repo/semantics/nonPublished