O presente estudo buscou compreender a dimensão política no trabalho do enfermeiro da atenção básica em um município paulista. Consideramos como dimensão política a relação que os trabalhadores estabelecem com a gestão pública em saúde e seus desdobramentos no trabalho na Atenção Básica nas distintas modalidades de organização da Atenção Básica (AB). Relação esta que não se limita aos espaços formais, como reuniões e normativas, mas que também se refletem nos modelos de atenção e organização do trabalho presentes nos serviços de saúde. Dessa forma, ao resgatar o caráter político da Reforma Sanitária Brasileira e o papel estratégico do SUS como política de Estado, este estudo pretende colaborar com o atual debate em torno da politização da saúde. O método utilizado para o desenvolvimento deste estudo foi o Estudo de Caso, alicerçado pela abordagem qualitativa, do tipo instrumental, a partir das seguintes fontes de dados: observação participante em cinco unidades de saúde de distintas modalidades de organização da AB, entrevista semiestruturada com oito enfermeiros, considerados informantes chaves e documentos oficiais de planejamento em saúde de instancia municipal de cinco quadriênios de gestão municipal. A coleta de dados foi realizada nos meses de outubro de 2013 a março de 2014. Foi realizada análise discursiva na perspectiva de Pêcheux com o material produzido nas entrevistas. Na análise documental, o que encontramos foi que, não obstante as dificuldades vividas pelos grandes municípios, mencionadas na literatura, é uma transição incompleta do modelo de AB, mais como mistura do que de transição, com uma implantação incipiente e incompleta da estratégia Saúde da Família, apesar dos documentos de planejamento, reiteradamente, colocarem essa estratégia como a opção municipal para a AB. Fica claro que a relação entre trabalhadores e gestão, por parte dos enfermeiros, não é de confiança, nem de corresponsabilidade. Não há a perspectiva de participação nos processos de decisão. Surgem críticas, responsabilizando a gestão, pela forma como são conduzidas determinadas políticas de saúde. É interessante observar que a crítica mais veemente surja justamente numa temática que envolve o interesse direto, poderíamos dizer até corporativo, dos trabalhadores. Por fim, parece ficar reforçada a ideia de Maria Cecília Puntel de Almeida, de que há entre as enfermeiras uma aceitação das limitações de poder, de forma relativamente passiva / This study sought to understand the political dimension of the work of the primary care nurse in a city in São Paulo. We consider the political dimension as the relationship that workers have with the public health management at work and its developments in Primary Care services in different modalities of Primary Care organization. A relationship that is not confined to formal settings, such as meetings and norms, but is also reflected in models of care and work organization present in health services. Thus, by returning to the political nature of the Brasilian Heath Reform and the strategic role of the SUS as a state policy, this research intends to collaborate with the current debate on the politicization of health. An instrumental case study was the method of choice for the development of this study, with a qualitative approach, using the following data sources: participant observation involving five health units of different modalities of organization, semi-structured interviews with eight nurses we considered to be key informants and official documents in health planning from the municipal management in five four-year periods. Data collection was conducted from October 2013 to March 2014. Pêcheux\'s discourse analysis was used for the interview data. In document analysis, what we found was, despite the difficulties experienced by large municipalities mentioned in the literature, an incomplete transition of the Primary Care model, more like a mixed system than a transition, with an incipient and incomplete implementation of the Family Heath strategy despite planning documents repeatedly putting this strategy as the municipal option for Primary Care. It is clear that the relationship between workers and management is not of trust. There is no prospect of participation in decision-making. Criticism does appear, blaming the management by the way they conducted certain health policies. It is interesting to note that the most vehement criticism arises precisely in a theme that involves direct interest of the workers. Finally, it seems the idea of Maria Cecilia Puntel de Almeida is reinforced, that between nurses there is an acceptance of the limitations of power, in a relatively passive way

The diploma thesis contains a comprehensive view of the health system in the Federal Republic of Germany in 1995-2015. The main aim of this work is to establish recommendations for improvement of the Czech health system based on the evaluation of the findings on the German health system. The partial aims of the diploma thesis are the characteristics of the health system and the analysis of income and expenditure in health care in Germany. The thesis is divided into six chapters. The first chapter is focused on the information obtained from professional literature. In particular, it describes the different concepts related to healthcare and its financing. The second chapter focuses on the economic concept and the issue of the health system. The third part contains a description of the country's health system. Here are also some selected data about Germany, organization or authority at federal, state and local levels. The fourth chapter deals with the insurance market in Germany. The fifth part summarizes the fundamental reforms of the health system of the Federal Republic. The last chapter is an analysis of income and expenditure of the health system. This section analyzes the data available from statistics from the German Statistical Office or from multinational organizations such as WHO, OECD or the World Bank.

Patient’s mobility throughout his lifetime leaves a trial of information scattered in laboratories, clinical institutes, primary care units, and other hospitals. Hence, the medical history of a patient is valuable when subjected to special healthcare units or undergoes home-care/personal-care in elderly stage cases. Despite the rhetoric about patient-centred care, few attempts were made to measure and improve in this arena. In this thesis, we will describe and implement a high-level view of a Patient Centric information management, deploying at a preliminary stage, the use of Agent Technologies and Grid Computing. Thus, developing and proposing an infrastructure that allows us to monitor and survey the patient, from the doctor’s point of view, and investigate a Persona, from the patients’ side, that functions and collaborates among different medical information structures. The Persona will attempt to interconnect all the major agents (human and software), and realize a distributed grid info-structure that directly affect the patient, therefore, revealing an adequate and cost-effective solution for most critical information needs. The results comprehended in the literature survey, consolidating Healthcare Information Management with emerged intelligent Multi-Agent System Technologies (MAS) and Grid Computing; intends to provide a solid basis for further advancements and assessments in this field, by bridging and proposing a framework between the home-care sector and the flexible agent architecture throughout the healthcare domain.

Economic reality of these days shows that pension, social, fiscal and educational system (we did not deal with flat politics friendly to young families) suffer from disputable till wrong decisions in last months and years. Many of such a decision seemed not to be effected based on scientific and expert analyses, results and recommendations but based on influence and obstinacy of the lobbyist parties and other groups. In the area of social politics we are missing the real social abstraction (i.e. long-term perspective of the social politics bearing) which could be acceptable by the residents. Pension savings and supplementary insurance act as barter -- we send to you contributions, you invest them into our bonds emitated to balance government debt (caused by this contributions as well) -- you have your profits, we have balance and meet liabilities. Fiscal system with its deductions, discounts and consolidations gives a favour to specific groups prior to the others. Social system with its substitutional durations, early pensions, excess indexation, parent leave duration and other advantages destroys natural development of the society, its revenues and expenditures. Early age educational system cannot ensure a sufficient pre-school education and changes parents into the bribees in bulk in order to find a place for their children (4-years and older). Than prolonged compulsory education causes prolonged entrance to the job market. High schools and universities throw up crowds of graduates without necessary practical skills which cause high amount of a young unemployment. We are the country of phenomenons. In the area of supplementary insurance support to the private pension companies we are the best. In the area of advanced women support for family and occupational life coordination (part-time jobs, flexible labour contracts, huge scale of pre-school day-care service) we are the worst and not only in domestic but also international comparison. We face absence of qualified work-force, human capital (necessary for healthy economic and social progress) in 50 or 60 years. This thesis has had for one's object to confirm or disconfirm the main hypothesis that with combination of defined important instruments and politics (aimed to non-financial benefits and huge flexible labour contracts supply) there is a possibility to achieve the long-term sustainability and balance of the pension account with not big shortage, no direction to destroy the whole economic development and with support to flexible job market. For children the thesis perhaps controversially looks as for human capital but from the economic point of view this is correct. In case of the Czech Republic the government approach does not work, the municipalities approach is absolutely unconceptual which restrains in many regions to achieve the co-operation of work and family life, to achieve the high standard of living of families, both due to unsupported pre-school day-care. We could accept one new solution -- no employers pension funds but employers pre-school day-care in co-operation with government and municipalities. This thesis established a hypothesis at the beginning which has been confirmed. PAYG in case of correct co-operation of important politics remains in long-term period stable (on condition 2 children for 1 mother), is just and effective. State income redistribution has moved to the service provider. Costs of such a day-care have been covered by revocation or reduction of the supplementary pension benefits, cancellation of the second pension pillar, shortening of the parent leave supplement, increasing of the employment and employees activity, increasing of efficiency and productivity and consequently profits of the companies and tradesmen. In combination with the high-quality fiscal politics without distortion and without one-side favouritism and senseless reliefs there has been secured stability of pension account, whole economy and public finance. Lower redistribution has been compensated by higher consumption and investment, government spending etc.

Abstact The diploma thesis is focused on forms and dimensions of breast-feeding support regarding different levels of women and child care in the health care system of the Czech Republic from the perspective of a woman, a mother, who is the health care recipient in the context of the legal framework of Czech legislation and relevant international documents. The findings are based on empirical research results gained from ten semi-structured in-depth interviews. Ten individual research participants gave birth in the same medical institution with the title Baby Friendly Hospital during the last three years, which is the unifying element of the participants. The perspective of a woman, based on a thematic analysis of interviews , shows a lot of perceived dimensions of the provided health care. This work identifies the most obvious women themes: their perception of breastfeeding in pregnancy, importance of breastfeeding for woman, the mother's contact with the baby after the childbirth, medical staff attitude and quality of provided care, aspects of pediatric care and support of breast-feeding out of the health care system. These themes are part of an extensive, historically based conception of health care provided in the Czech Republic, which includes a model of the relationship between a physician (medical...

The diploma thesis focuses on impact of civic engagement on health care system. It studies to what level this participation helps health care system transformation and change of a relationship between patients and political and professional authorities. It's aim is to provide a critical sociological analysis and explain social processes accompanying patients' engagement by using examples. Patient organisations - an institutionalised form of civic society with a potential to evoke social change - get into scope here. The ambition of this thesis is to show the applicability of the reflexivity concept to the area of health care, to enrich this analytical framework by multilevel approach to the health care system and therefore add to the discourse around civic engagement phenomenon by a systemic and structured view of dynamic relationships between patient organisations and health care system. The findings of the author are based on an analysis of semi-structured interviews with patient organisations representatives and available documents. The author emphasises the ambivalent impact of civic engagement which on one side reinforces individual transformations of micro, meso, macro and meta levels of health care system and also acts as a catalyst of wider sociocultural changes. On the other hand, it is accompanied...

This paper deals with medical data extraction from electronic patient record (EPR) system. Most of the medical data are stored in patient record systems, and data that are much valuable for medical research. If a researcher wants to extract medical information today, it has to be done manually because the data are stored in unstructured textual format in a system created by hospital staff. There is no way of extracting data in structure way. This paper is going to introduce an information extraction application for EPR system that allows the researcher to set up a study with inclusion and parameters for extraction for retrospective surveys in a webuser-interface environment. Inclusion is what the researcher would like to study (a defined category or criteria) and parameters specify the characteristics of inclusion the criteria. Result of this application provides an extracted clinical data that is used for retrospective surveys, downloadable to an MS-Excel file.

(English) This diploma thesis deals with the issue of mental disorders and services provided to family members of people with mental disorder within a non-profit sector. The first part includes theoretical chapters which are processed by analysing available literature. The chapters inform about mental disorder, quality of life, and describe the care of people with mental disorders - particularly social skills and communication, housing, education, employment and leisure time. The theoretical part also focuses on social work with the mentally ill and includes a role of a social worker. In conclusion, the theoretical part describes the possibilities of supporting family members within the system of the care of persons with mental disorder, especially educational and psychoeducational programmes. The empirical part maps the current range of services for family members of people with mental disorder, and in connection with that, it determines what workers consider to be their benefit. Then, the views of family members on the psychoeducational programme and the current system of taking care of persons with mental illness were examined in a parent organization. To implement the research, I chose a qualitative approach. The method used was a questionnaire survey and group interviews. The results showed...

This thesis is based on a 10-month field work conducted in a retirement home. The empirical part is rooted in the fact that the author of this work actually became a part of the institution for a several months as its employee at the position of a certified nursing assistant. This perspective naturally enabled him to focus on a description of daily routines, taking place within the mentioned institution, from a perspective of a certified nursing assistant as well as on his interactions with the clients, which occur during these daily routines. Paying attention to the mutual interactions of both enables us to perceive how the dominant discourse in public health care works. It is particularly revealed through disciplinary techniques. The analysis of the disciplinary techniques follows the theory of power by Michel Foucault, which seems to prove that not only the clients but also the certified nursing assistants are being disciplined during the everyday practices of the given institution. Their position is at the lowest level of the hierarchy of health care system and this - in a way - dooms them to being disciplined since they are a part of the same routines as are the clients. Moreover, the analysis of the mutual power relationships between the certified nursing assistants and the clients shows that...

The thesis " Women after Mastectomy in the context of Social Work " deals with the topic of diagnosis of breast cancer, treatments and their side effects, itself, however focuses mainly on the psychological and social consequences that come along with such a serious illness. It aims to outline the possibilities that women with this diagnosis can use , and ultimately points out the great potential of social work within the health care system. Powered by TCPDF (www.tcpdf.org)