93 research outputs found
Art therapy: nurses' attitudes and experiences
Get PDFName and surname of the author: Elizaveta Filimonova Institution: Charles University, Faculty od Medicine in Hradec Králové, Department of Non-medical Studies Title: Art Therapy: Nurses' Attitudes and Experiences Supervisor: doc. PhDr. Jana Marie Havigerová, Ph.D. Number of pages: 79 Number of attachments: 7 Year of defense: 2025 Keywords: Art therapy, Therapy, Nursing care, psychic stav This study focuses on researching the effectiveness and possibilities of integrating art therapy into the daily practice of nurses in caring for the mental state of patients in a hospital environment.The theoretical part summarizes key findings about art therapy, its nature, histori- cal development and therapeutic role in the care of mentally ill patients. The empirical part is based on a combined research approach with the aim of providing a comprehensive view of the application of art therapy in practice and evaluating its benefits and limits. The research was carried out in the form of semi-structured interviews with nurses working at a psychiatric clinic. The quantitative part of the research was carried out through a questionnaire survey. The results of the research show that nurses are well aware that art therapy has a positive effect on the emotional state of patients, contributes to the alleviation of...Autor: Elizaveta Filimonova Instituce: Karlova Univerzita, Lékařská fakulta v Hradci Králové, Ústav nelékařských studií Název práce: Arteterapie: postoje a zkušenosti sester Vedoucí práce: doc. PhDr. Jana Marie Havigerová, Ph.D. Počet stran: 79 Počet příloh: 7 Rok obhajoby: 2025 Klíčová slova: Arteterapie, léčba, péče, psychický stav Práce se zaměřuje na výzkum účinnosti a možností začlenění arteterapie do každodenní praxe sester při péči o psychický stav pacientů v nemocničním prostředí. V teoretické části jsou shrnuty klíčové poznatky o arteterapii, její podstatě, historickém vývoji a terapeutické roli v péči o psychicky nemocné pacienty. Empirická část vychází z kombinovaného výzkumného přístupu s cílem poskytnout ucelený pohled na aplikaci arteterapie v praxi a zhodnotit její přínosy i limity. Výzkum byl realizován formou polostrukturovaných rozhovorů se sestrami pracujícími na psychiatrické klinice. Kvantitativní část výzkumu byla provedena prostřednictvím dotazníkového šetření. Výsledky výzkumu ukazují, že sestry mají dobré povědomí o tom, že arteterapie má pozitivní vliv na emocionální stav pacientů, přispívá ke zmírnění úzkosti a napětí a podporuje celkovou psychickou pohodu, ale většina z nich přesto arteterapii nevyužívá, jako hlavní bariéry identifikují nedostatek vzdělání (nemají kurz)...Department of Non - Medical StudiesÚstav nelékařských studiíLékařská fakulta v Hradci KrálovéFaculty of Medicine in Hradec Králov
Befallsmuster von pelvinen und paraaortalen Lymphknoten-Metastasen bei Prostatakarzinompatienten
Get PDFObjectives
To investigate patterns of nodal involvement in a consecutive cohort of patients presenting for local ablative radiotherapy of pelvic and/or paraaortic lymph node metastases from prostate cancer.
Design & Methods
From 01/2009-09/2018, 75 patients received local ablative radiotherapy to pelvic and/or paraaortic lymph node metastases. Pelvic lymph node metastases were mapped to a common template with non-rigid-registration to create an atlas for visualization. As independent approach to mapping, the pattern of pelvic and paraaortic lymph node involvement was analyzed for each patient and RTOG-GU- and non-RTOG-GU-levels were evaluated for frequency of involvement. Patterns were compared for patients with and without primary resection. To identify candidate levels for dose-escalation, the relative proportion of lymph node metastases observed for each level was calculated and normalized by level volume.
Observations & Results
76.8 % of patients had strict unilateral pelvic involvement. The median maximum intra-patient distance of lymph node metastases was 7.8 cm (75th%ile: 11.0 cm and 95th%ile: 17.0 cm). Locations of lymph node metastases were significantly closer in individual patients than on a cohort-level (mean distance, 6.6 cm vs. 8.7 cm, p < 0.001). The external iliac level was most frequently involved (37.3 %), followed by paraaortic (32.0 %) and internal iliac (25.3 %). 42.7 % of patients had involved pelvic levels outside RTOG-GU-consensus, of which perirectal was most common (25.3 % of all patients) followed by common iliac nodes above L5/S1 (18.7 %). The mean proportion of involved lymph nodes was highest for external iliac and obturator levels (2.10 ‰/cm³ each), followed by perirectal (1.49 ‰/cm³) but was lowest for presacral (0.69 ‰/cm³, significantly lower than expected by a homogeneous spatial distribution of lymph node metastases, p = 0.016). Right external iliac involvement was significantly reduced after upfront resection (10.9 % vs. 45.0 %, p=0.002).
Conclusions
Inclusion of perirectal levels and raising of the cranial field boundary should be considered in pelvic radiotherapy for prostate cancer. External iliac and obturator levels are candidates for dose-escalation. Nodal metastases in individual patients were more spatially confined than on a cohort-level, which could be an important basis for future approaches towards individualized field designs. The impact of prior resection on distribution of lymph node metastases warrants further study.Hintergrund und Ziele
Das Ziel der Arbeit war es, das Muster des Lymphknotenbefalls in einem zusammenhängenden Kollektiv von Patienten, die sich zur lokal ablativen Radiotherapie von pelvinen und/oder paraaortalen Lymphknoten-Metastasen beim Prostatakarzinom vorgestellt haben, zu untersuchen.
Methoden (Patienten, Material und Untersuchungsmethoden)
Von Januar 2009 bis September 2018 erhielten 75 Patienten eine lokal ablative Radiotherapie von pelvinen und/oder paraaortalen Lymphknoten-Metastasen beim Prostatakarzinom in unserer Klinik. Zur Visualisierung wurde ein Atlas erstellt, in dem die Verteilung der Lymphknoten-Metastasen in einem gemeinsamen Computertomographie-Datensatz mittels nicht-rigider Registrierung abgebildet wurde. In einem hiervon unabhängigen Ansatz wurde das Muster des Lymphknoten-Befalls für jeden einzelnen Patienten analysiert. Zusätzlich wurde die Häufigkeit der Beteiligung von RTOG- und nicht-RTOG-Regionen evaluiert. Des Weiteren wurden die Befallsmuster von initial operierten und nicht operierten Patienten verglichen. Um Lymphknoten-Level für eine Dosis-Eskalation oder –Einsparung zu ermitteln, wurde zudem der relative Anteil der befallenen Lymphknoten für jede einzelne Region berechnet und auf das jeweilige Level-Volumen normiert.
Ergebnisse und Beobachtungen
76,8 % der Patienten hatten strikt unilateralen pelvinen Lymphknoten-Befall. In individuellen Patienten lag die maximale Distanz der Lymphknoten-Metastasen im Median bei 7,8 cm (75%-Perzentile: 11,0 cm und 95%-Perzentile: 17,0 cm). Die befallenen Lymphknoten lagen signifikant näher zueinander auf individueller Patienten-Ebene als auf der Ebene des Gesamtkollektivs (mittlere Distanz 6,6 cm vs. 8,7 cm, p < 0,001).
Die extern iliakale Region war mit 37,3 % am häufigsten befallen, gefolgt vom paraaortalen (32,0 %) und intern iliakalen Lymphknoten-Level (25,3 %). 42,7 % der Patienten hatten befallene pelvine Regionen, die außerhalb des im RTOG-GU-Konsens empfohlenen Zielvolumens lagen und von denen das perirektale Level am häufigsten (25,3% von allen Patienten) gefolgt von iliakal communen Lymphknoten oberhalb von L5/S1 (18,7%) betroffen waren.
Der mittlere Anteil der befallenen Lymphknoten normiert auf das Level-Volumen war am höchsten für die extern iliakale und obturatorische Regionen (jeweils 2,10 ‰/cm³), gefolgt vom perirektalen (1,49 ‰/cm³) und intern iliakalen Level (1,31 ‰/cm³). Der niedrigste Anteil zeigte sich hingegen für die präsakrale Region (0,69 ‰/cm³, signifikant niedriger als bei Annahme einer homogenen räumlichen Verteilung der Lymphknoten-Metastasen, p = 0,016).
Bei initial operierten Patienten war der Befall der extern iliakalen Lymphknoten auf der rechten Seite signifikant vermindert (10,9 % vs. 45,0 %, p = 0,002).
(Praktische) Schlussfolgerungen
Die Einbeziehung der perirektalen Region und die Anhebung der kranialen Feldgrenze sollten bei der pelvinen Bestrahlung bei Prostatakarzinom-Patienten in Betracht gezogen werden. Kandidaten für eine Dosis-Eskalation sind die extern iliakalen und obturatorischen Level. Die Lymphknoten-Metastasen in individuellen Patienten traten in engerer räumlicher Nachbarschaft auf als von der Verteilung auf Gesamtpatientenebene zu erwarten gewesen wäre, was eine wichtige Grundlage für zukünftige Ansätze in Richtung individualisierter Zielvolumen-Gestaltung darstellen könnte. Der Einfluss einer vorhergehenden Operation auf die Verteilung der Lymphknoten-Metastasen sollte in weiteren Studien untersucht werden
Childhood´s trauma in The Go - Between and Atonement. An analysis of children’s psychosexual development in the novels by L. P. Hartley and Ian McEwan
No full textThis essay will analyze the representation of children’s trauma and its impact on their future in the novel Atonement by Ian McEwan and in the The Go – Between by L. P. Hartley, using Sigmund Freud’s psychoanalytic theories. At first, Briony’s and Leo’s fantasy motifs will be examined, in which both children are looking for a wish fulfilment. Briony is an aspiring young writer, who lives in her imaginary world, and who confuses reality with fantasy, resulting in tragedy. Leo believes that he is a powerful magician; through magic he idealizes people and becomes involved in an adult’s love affair. Then the focus will shift to the children’s personality and psychosexual development. Using Freudian theories of three elements of personality, id, ego, superego, to analyze Leo’s and Briony’s psyche, the emphasis will be on unconsciousness and how it controls children’s behaviour. Later on, discussion of the theory of psychosexual development will focus on the importance of the parents, and fixations at the various stages. Briony and Leo do not resolve successfully the phallic stage and their fixation leads to the tragedy. Furthermore to cope with a sense of guilt, Briony uses a defence mechanism, sublimation: she sublimates her guilt into fiction and lives with a sense of guilt all her life. On the other hand Leo represses his memory and desires, as the trauma in childhood shaped his perceptions of sexuality
Evaluation of the influence of structural shifts in the subsoil use on the efficiency of the oil and gas complex of Russia
No full textKumis treatment in the steppe regions as a promising direction of tourist nature management
No full textRecently, much attention has been paid by scientists from different countries to the issues of tourist environmental management. The kumis therapy development, being a historically established direction of medical tourism, is promising in the steppe regions. When analyzing the history of the development of kumis therapy in the former USSR, it was revealed that after the collapse of the USSR, an organized network of kumis treatment centers ceased to exist. Original maps reflect historical aspects and modern geography of sanatorium with kumis treatment. Most of them are located in the forest-steppe and steppe zones. The paper considers the steppe region of Russia the Orenburg region promising for the development of kumis treatment in connection with a suitable dry steppe climate, the development of horse breeding and the possibilities of landscape therapy. The paper notes the appropriateness of the further development of kumis treatment and the modernization of kumis treatment centers in the Orenburg region
THE INTRASPECIES IDENTIFICATION OF THE MENINGOCOCCI BY THE CAPSULE ANTIGENES AND EXTRACELLULAR PROTEINS
No full textThe object of investigation: strains of meningococci, extracellular proteins of meningococci, meningococcus agglutinating serums, reference-reagents. The purpose of the work: standardization of the quality of the meningococcus agglutinating serums by creating the reference-reagents of serogroups A, B, C; the development of the new method of identification of the meningococcus cultures, being on the different levels of dissociation. For the first time, "The Method of Intraspecies Identification of Meningococci on the Base of the Extracellular Proteins" has been developed. First, the series of standard samples of agglutinating meningococcus serums of serogroups A, B, C have been obtained. the methods of selection of the strains, to be used for the commercial preparations quality control, have been justified. The materiald of the intraspecies grouping of the meningococci by the proteingrams of the extracellular proteins have been included in the methodical recommendations "Electrophoretic Methods of Differentiation of the Suppurative-Inflammation Diseases Pathogenes"; the Certifications and Instructions on application of the standard samples of the meningococcus agglutinating serums of serogroups A, B, C have been prepared and approved. The results of the work has been introduced in the Nizhnegorodsky Research Institute of Experimental Medicine and etc. The possibility of identification of the polyagglutinabel strains of meningococci has been shown, and the quality of control of the series of the meningococcus agglutinating serums to be madeAvailable from VNTIC / VNTIC - Scientific & Technical Information Centre of RussiaSIGLERURussian Federatio
Identification of factors affecting renewable energy consumption by country groups
No full textThe rapid development of renewable energy sources observed in recent years however has a number of limitations for different regions limited by non-price factors such as corruption and opacity of supporting institutions, lack the necessary technology to integrate renewable into the grid, lobbying and support of the interests of the owners of traditional energy sources and others. The article attempts to analyse the factors that affect the consumption of renewable energy sources in three groups of countries, pointing to the greater importance of such indicators as the share of R & d in GDP, the availability of traditional energy resources, oil prices, transparency of institutions for some countries and their lesser importance for others
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