Sous l’ancien régime du sursis à exécution, l’urbanisme avait cristallisé l’impuissance de la juridiction administrative à prévenir les conséquences difficilement réversibles de certaines décisions administratives. Il en résultait que la crédibilité et la légitimité de cette dernière étaient remise en cause. Cette thèse vise à démontrer comment le législateur et la jurisprudence du Conseil d’Etat, en redéfinissant l’office du juge des référés, ont donné les moyens juridiques au juge administratif de répondre aux attentes légitimes des justiciables en matière d’urbanisme. / Under the old regime of stay of execution the urbanism crystallised the incapacity of the administrative court to prevent consequences hardly reversible of few administrative decisions. This put directly into question the credibility and legitimacy of the latest. This thesis aims to demonstrate how the legislator and jurisprudence of the Conseil d'Etat, by redefining the role of the judge of chambers, have given the juridic means to the administrative judge to answer appropriately to the legitimate expectations from litigants in terms of urbanism.

Aim: The overall objective of the present thesis was to describe and assess the importance and impact of visits by the patients’ families in an ICU, from patient and family perspectives, and to develop, from a hermeneutic perspective, a research method to study the interplay between patient and family during the visit. Method: The comprehensive methodology of the thesis was hermeneutic. Qualitative as well as quantitative methods were applied to elucidate the issues at stake. In paper I, 198 patients were consecutively included, and data were statistically analysed to establish patient mortality and length of stay at the hospital, in relation to visits of families in the ICU. In paper II, ten patients and 24 visitors were observed during visits. In paper III, seven patients and five relatives were interviewed about their memories of the visits in the ICU. Field notes from the observations, and the interviews with patients and relatives, were interpreted and analysed inspired by Gadamer’s hermeneutic philosophy. Paper IV represents a theoretical discourse, and presents methodological aspects of the hermeneutic interpretation of data from the observations. Results: There were no significant differences between the patients having visitors and those who did not. The patient group with no visits comprised 25 %; they were older, and lived in single households, which contrasted to the patient group having visitors. Analyses of the three clinical studies revealed four themes. The themes relate to the meaning of visiting for patients and their relatives, and are as follows: the visit means to see and realize, to guard and watch, to meet, and to sacrifice. The caring entails that you witness and see with your own eyes, and that you feel a communion with the sick. From the patient perspective, the visit signifies that you are confirmed, empowering you to fight to get back to life. Communion and availability in conjunction enable an individual to achieve a thorough involvement with another being. The results of study IV disclosed that what you observe is depending on your theoretical view. If you see from your heart, you interpret from your heart. Conclusions: The conclusions drawn from the studies of the present thesis are that opportunities to create a presence in the community - a communion - between patients, relatives, and carers, are at want. The present fundamental view of caring in intensive care units is in need of change, in order to create optimal conditions for a communion. Visits need to be regarded as an essential part of caring, and relatives’ visits ought to be facilitated and encouraged. Furthermore, visits are important both for patients and their relatives, as sharing the event of critical illness, in the sense of sharing the suffering, the healing, and the restoration of health, is considered a precondition for their recovery. Care should be organized around the patients and their families. Families and patients bring their fellow stories of life, including values and beliefs, thereby increasing the probability of dignified individualized care. / <p>Akademisk avhandling som för avläggande av filosofie doktorsexamen vid Sahlgrenska akademin vid Göteborgs universitet kommer att offentligt försvaras i hörsal 2118, Institutionen för vårdvetenskap och hälsa, Arvid Wallgrens backe, Hus 2, Göteborg, fredagen den 19 oktober 2012 kl. 09.00</p>

The subject of this diploma thesis is to characterize the requirements on legal stay of foreign employees in the Czech Republic, their employment and recognition of their qualification. Topics found in the literature and associated to international migration of employees in medical facilities, topics associated to their legal stay in the Czech Republic, rules of employing them and rules of recognition of their qualification are described in theoretical part of my diploma thesis. The main goal of the practical part is to find out what is the state in 2 medical facilities which took part in my research. And to compare them from the perspective of their quality, according to the structure of all professions and work adjustment of foreign employees. Also to find out if and eventually why the legal regulations are contravened. Keywords: stay of foreigners, employment of foreigners, recognition of qualification, medical facilities, hospital staff.

Title: Effect of physiotherapy to reduce the length of hospital stay in patients with total hip arthroplasty: a literature review Objective: The purpose of this thesis is to research and compare available studies investigating the effect of extra physiotherapy in reducing the length of stay for patients with total hip arthroplasty. In addition, to make a compilation of available sources about issue of the hip, total hip arthroplasty in terms of anatomy, kinesiology and biomechanics and length of hospital stay. Methods: This diploma thesis has descriptively-analytical character and is structured in the form of literary review. Results: Physiotherapy decreases length of stay in patients with total hip arthroplasty. Future research could address a specific group of subjects and the issue of cost-effectiveness in reducing the length of hospital stay by physiotherapy. Key words: Hip joint, total joint replacement, THA, physiotherapy, length of stay

No description available.

Doctor of Philosophy / Department of Agronomy / Tesfaye Tesso / Fusarium stalk rot and charcoal rot caused by Fusarium thapsinum and Macrophomina phaseolina respectively are devastating global diseases in sorghum that lead to severe quality and yield loss each year. In this study, three sets of interrelated experiments were conducted that will potentially lead to the development of resistance based control option to these diseases. The first experiment was aimed at identifying sources of resistance to infection by M. phaseolina and F. thapsinum in a diverse panel of 300 sorghum genotypes. The genotypes were evaluated in three environments following artificial inoculation. Out of a total of 300 genotypes evaluated, 95 genotypes were found to have resistance to M. phaseolina and 77 to F. thapsinum of which 53 genotypes were resistant to both pathogens. In the second experiment, a set of 79,132 single nucleotide polymorphisms (SNPs) markers were used in an association study to identify genomic regions underlying stalk rot resistance using a multi-locus mixed model association mapping approach. We identified 14 loci associated with stalk rot and a set of candidate genes that appear to be involved in connected functions controlling plant defense response to stalk rot resistance. The associated SNPs accounted for 19-30% of phenotypic variation observed within and across environments. An analysis of associated allele frequencies within the major sorghum subpopulations revealed enrichment for resistant alleles in the durra and caudatum subpopulations compared with other subpopulations. The findings suggest a complicated molecular mechanism of resistance to stalk rots. The objective of the third experiment was to determine the functional relationship between stay-green trait, leaf dhurrin and soluble sugar levels and resistance to stalk rot diseases. Fourteen genotypic groups derived from a Tx642 × Tx7000 RIL population carrying combinations of stay-green quantitative trait loci were evaluated under three environments in four replications. The stg QTL had variable effects on stalk rot disease. Genotypes carrying stg1, stg3, stg1,3 and stg1,2,3,4 expressed good levels of resistance to M. phaseolina but the combination of stg1 and stg3 was required to express the same level of resistance to F. thapsinum. Other stg QTL blocks such as stg2 and stg4 did not have any impact on stalk rot resistance caused by both pathogens. There were no significant correlations between leaf dhurrin, soluble sugar concentration, and resistance to any of the pathogens.

The legal regulation of hiking and some selected free-time activities in Czech legal system The theme of this thesis is "The legal regulation of hiking and some selected free-time activities in Czech legal system". The aim of it is comprehensive synopsis of the issue of practising hiking and other selected free-time activities in Czech legal system. It familiarizes its readers with constitutional law basis of freedom of movement and freedom of stay, as well as with common grounds of legal regulation of given activities. Thesis is focused on a few laws, which are the most important from the perspective of this thesis. These laws allow basic overview of the most important institutes which regulate protection of water, protection of forest, general and particular protection of nature and land, restriction of admittance, restriction or prohibition of activity and other. Furthermore thesis talks about basis of legal regulation of offenses contained in given laws. In next part thesis describes selected activities and limits of its practising. Thesis is especially focused on hiking, and related activities as camping, overnight staying in nature, bivouacking, fire-making, which have sort of privilege position (according to a title of thesis). Moreover thesis describes water tourism, horse-riding,...

Objetivo: Analisar relações entre testes referidos e observacionais. Métodos: Estudo transversal, idosos institucionalizados, de 60 anos ou mais, independentes e estado cognitivo íntegro. Aplicou-se questionário sócio-demográfico, questões referidas (subir escadas e abaixar/ajoelhar-se) e dois instrumentos observacionais (caminhar rápido e de habilidade para levantar/ sentar). Resultados: Convidados 92 idosos, oito recusaram e um desistiu durante o teste. Amostra com 83 idosos, predomínio do sexo feminino (58%), media e mediana de idade 78 anos, e desvio padrão de 8,4 anos. As limitações referidas são bastante próximas (71% e 65%) e nas observadas, detectamos um valor menor para caminhar rápido (54%). Convergência entre os instrumentos referidos e medida observada, habilidade para levantar de uma cadeira, foram encontradas. Identificou-se o mecanismo fisiológico ligado à predominância da força muscular dos membros inferiores. Diferenças entre os instrumentos referidos e a medida observada caminhar rápido foram observadas porque caminhar rápido exige também equilíbrio, além de força, que é de diferente intensidade daquela para subir escadas ou abaixar. Discutiu-se a possibilidade de complementariedade entre as abordagens referidas e observacionais. Conclusão: Na comparação de testes observacionais e referidos, a concordância favorece a interpretação, desde que se consiga identificar explicação fisiológica. A constatação de resultados divergentes requer uma análise mais complexa, pois incluiu a possibilidade de complementariedade entre testes / Objective: To analyse the relationships between the results of tests referred and observational. Methods: Study sectional, institutionalized elderly, of 60 years or older, who are independent and cognitive status intact. Applied to be a socio-demographic questionnaire, referred questions (to climb stairs and lower/kneeling up) and two observational instruments (to fast walk and ability to lift/sit down). Results: 92 elderly were invited, eight declined and one withdrew during the test. The sample was 83 elderly, and the predominance was female (58%). The ages ranged from 61 to 98 years with mean and median of 78 years. The referred limitations are very close (71% and 65%). Already in observed, there is a smaller value to fast walk (54%). Associations between referred instruments and observed measurement ability to lift and sit down were found. Identifying the physiological mechanism linked to the prevalence of muscular strength of the lower limbs. Differences between the referred instruments and the observed measurement to fast walk was observed, this because the fast walk also requires balance, and strength, which is different from that intensity to climb ladders or down. Conclusion: In comparison to observational tests and said, the agreement favors the interpretation provided they can identify physiological explanation. The finding of divergent results requires a more complex

Introdução: Lesão por fricção é uma ferida traumática, que ocorre principalmente nas extremidades de idosos. Objetivo: O objetivo do estudo foi identificar e analisar a prevalência de lesão por fricção e os fatores demográficos e clínicos associados a essa ocorrência, em pessoas idosas residentes em Instituições de Longa Permanência para Idosos. Métodos: Trata-se de um estudo epidemiológico, transversal, analítico, exploratório, com abordagem quantitativa, realizado em três instituições do município de São Paulo que aceitaram participar do estudo, dentre 135 contactadas previamente. Os dados foram coletados mediante consulta ao prontuário, entrevista com o próprio residente e/ou responsável e exame físico do idoso. Os residentes foram entrevistados e avaliados quanto aos aspectos sócio-demográficos e clínicos, condições da pele e quanto às características das lesões encontradas. Para a coleta de dados, empregaram-se os seguintes instrumentos: instrumento de coleta de dados sócio-demográficos e clínicos, Teste Mini Exame do Estado Mental, Escala de Katz e Sistema de Classificação STAR Lesão por Fricção. Os dados foram analisados por meio de: teste exato de Fisher, teste de Wilcoxon-Mann-Whitney e modelo de regressão logística (backwardstepwise). Resultados: A amostra de 69 residentes foi composta predominantemente por mulheres (51/73,91%), da raça branca (50/72,46%), com média de 81 anos de idade (DP=9,30) e mediana 82 anos, com algum problema na marcha (58/84,06%), redução ou ausência na acuidade visual (56/81,16%), dependência para atividades básica de vida diária (52/75,36%), comprometimento cognitivo (51/73,91%), presença de incontinência (45/65,22%) e algum grau de desnutrição (magreza = 26/37,69%). Oito sujeitos apresentaram 13 lesões por fricção, implicando em prevalência global de 11,6% para essa amostra, sendo de 22,22% para homens, 7,84% para mulheres e 10,00% para a raça branca. Onze (84,6%) lesões localizaram-se nos membros inferiores, predominando aquelas de categoria 3 (6/46,1%). Embora os grupos com e sem lesões por fricção tenham diferido quanto à presença de: hipertensão arterial sistêmica, alterações na marcha (principalmente cadeirantes), rigidez, acuidade visual diminuída, edema de membros inferiores, equimoses, hematoma, pele seca e descamativa, púrpura senil, curativos/ adesivos, dependência para as atividades básicas de vida diária e magreza, somente as presenças de hematoma (RC: 9,159 / p: 0,017) e púrpura senil (RC: 6,265 / p: 0,033) permaneceram no modelo final de regressão logíastica. Conclusão: A prevalência de lesão por fricção entre idosos institucionalizados foi de 11,6%, comparável a escassos estudos internacionais realizados com pacientes hospitalizados. Os fatores associados à ocorrência de lesão por fricção, hematoma e púrpura senil, estão de acordo com a literatura sobre o tema. Ao tratar-se de estudo inédito em nosso meio, seus resultados contribuem para o diagnóstico situacional da ocorrência de lesão por fricção em idosos institucionalizados e para a necessidade de implantação de medidas preventivas em grupos vulneráveis como os idosos. / Introduction: Skin tear is a traumatic wound, which occurs mainly in the extremities of elderly. Objective: The study objective was to identify and analyze the prevalence of skin tears and demographic and clinical factors associated with its occurrence in institutionalized elderly. Methods: This is an epidemiological cross sectional analytical, exploratory study with a quantitative approach, performed in three nursing homes of São Paulo who agreed to participate in the study, among 135 ones previously contacted. Data were collected by records consultation, interview with the resident himself and /or care giver and physical examination of the elderly. Residents were interviewed and assessed for socio-demographic and clinical features, skin conditions and skin tears characteristics. The following tools were used for data collection: socio-demographic and clinical data, Mini Mental State Examination test, Katz index and STAR Classification System Skin Tear. Data were analyzed using Fisher\'s exact test, Wilcoxon-Mann-Whitney test and logistic regression (backward stepwise). Results: The sample of 69 residents was mostly composed by women (51 / 73.91%), Caucasians (50 / 72.46%), mean age 81 (SD = 9.30) and median 82 years old, some problem in mobility (gait) (58 / 84.06%), visual acuity problems (56 / 81.16%), dependence for activities of daily living (52 / 75.36%), cognitive impairment (51/73, 91%), presence of incontinence (45 / 65.22%) and some degree of malnutrition (underweight = 26 / 37.69%). Eight subjects had 13 skin tears, resulting in an overall prevalence of 11.6% for this sample, and 22.22% for men, 7.84% for women and 10.00% for the caucasians. Eleven (84.6%) skin tear were located in the lower limbs, predominantly category 3 skin tears (6 / 46.1%). Although there were statistically significant differences between groups with and without skinj tears related to: arterial hypertension, mobility problems (especially wheelchair users) , stiffness, decreased visual acuity, lower limb edema, ecchymosis, hematoma, dry and scaly skin, senile purpura, dressings / adhesives, dependence for activities of daily living and thinness, just the presence of hematoma (RC: 9,159 / p:0,017) and senile purpura ( RC: 6,265 / p: 0,033) remained after logistic regression analysis. Conclusion: The prevalence of skin tear among institutionalized elderly was 11.6%, comparable to few international studies with hospitalized patients. The factors associated with the occurrence of skin tear, hematoma and senile purpura, are consistent with the literature on the subject. When being unpublished study in our country, our results contribute to the situational analysis of the occurrence of skin tear in elderly nursing home residents and the need to implement preventive measures in vulnerable groups like the elderly.

Sepse é causa comum de óbito, e vários fatores prognósticos têm sido identificados. Entretanto, é possível que a rota do paciente séptico no hospital também tenha efeito sobre o prognóstico. Nosso objetivo foi verificar se a rota do paciente séptico antes da admissão na UTI tem efeito sobre a letalidade hospitalar. Métodos Foi realizado um estudo de coorte retrospectiva com 489 pacientes com sepse grave ou choque séptico (idade >=18 anos), internados na Unidade de Terapia Intensiva. Analisamos se a rota está associada a mortalidade hospitalar usando modelo de regressão de Cox com variância robusta. Resultados Dos 489 pacientes, 207 (42,3%) foram diagnosticados com sepse na Unidade de Pronto Atendimento (UPA), 185 (37,8%) em unidade de internação clínica ou cirúrgica (Clínica Médica Cirúrgica - CMC), 56 (13,3%) em Unidade Semi-Intensiva (USI) e 32 (6,5%) em Unidade Terapia Intensiva.(UTI). A maioria (56,6%) dos pacientes era do sexo masculino, a idade média foi de 66,3 anos, 39,8% tinham APACHE II de 25 ou mais, e 77,5% tinham o diagnóstico de choque séptico. A letalidade foi 41,9%. Na análise multivariada com ajuste para diversos fatores prognósticos, incluindo tempo de internação hospitalar antes da admissão na UTI, não houve diferença estatisticamente significativa no risco de óbito entre pacientes com sepse grave diagnosticada na UPA ou CMC (risco relativo [RR] 1,36; intervalo de confiança [IC] 95% 1,00 a 1,83). Porém, o risco de óbito hospitalar foi maior nos pacientes em que a sepse grave foi diagnosticada na USI ou UTI (RR 1,64; IC 95% 1,20 a 2,25). Conclusão A mortalidade dos pacientes com sepse grave ou choque séptico atendidos na CMC é similar à de pacientes com sepse diagnosticada na UPA. Entretanto, o risco de óbito hospitalar foi maior nos pacientes que desenvolveram sepse na USI ou UTI / Sepsis is a common cause of death. Several predictors of hospital mortality have been identified. However, it is possible that the route the septic patient takes within the hospital may also affect endpoints. Thus, our main objective was to verify whether the routes of septic patients before being admitted to ICU affect their in-hospital mortality. Methods Retrospective cohort study of 489 patients with severe sepsis or septic shock (age >= 18 years) admitted to the Intensive Care Unit. We analyzed the impact of route on in-hospital mortality using Cox regression with robust variance. Results Of 489 patients, 207 (42.3%) presented with severe sepsis in the ED, 185 (37.8%) were diagnosed with severe sepsis in the ward, 56 (13.3%) in the step down unit and 32 (6.5%) in the ICU. The mortality rate was 41.9%. The mean age was 66.3 years, and 56.6% were men. APACHE II scores were >25 in 39.8% of patients, and 77.5% were diagnosed with septic shock. In the multivariate analysis, with adjustment for several prognostic factors including length of hospital stay before ICU admission, there was no statistically significant difference in the risk of death between patients who had severe sepsis diagnosed in the ED compared to CMC (relative risk [RR] 1,36; IC 95% 1,00 a 1,83). However, the risk of death was increased in patients who had severe sepsis diagnosed in the step-down unit or ICU (RR 1,64; IC 95% 1,20 a 2,25). Conclusion Patients who have severe sepsis or septic shock diagnosed in the CMC have in-hospital mortality similar to those who present with severe sepsis or septic shock in the ED. However, patients who develop severe sepsis in the step-down unit or ICU have higher mortality