Cíle. V oblasti psychopatologie jsme v posledních letech svědky nového trendu, který na duševní potíže nahlíží perspektivou síťových modelů. Tato perspektiva ve spojení s možností vzorkování zkušenosti pacientů v každodenním životě umožňuje vytvářet personalizované modely popisující dynamické vztahy mezi symptomy v čase. Cílem této studie bylo ověřit použitelnost těchto modelů pro porozumění dynamice medicínsky nevysvětlených tělesných symptomů (MUPS). Soubor a metoda. Dva pacienti trpící MUPS po dobu tří týdnů pětkrát denně vyplňovali s pomocí mobilní aplikace dotazník zjišťující intenzitu symptomů a vybrané psychologické a situační proměnné. Statistická analýza. Pomocí metody vektorové autoregrese byly modelovány dvě síťové struktury, temporální a simultánní. Výsledky. Temporální a simultánní síť je prezentována pro každého pacienta samostatně. Z modelů je následně vyvozováno možné zaměření psychoterapeutických intervencí. Limity studie. Relativně nízký počet měření neumožnil zahrnout do modelu všechny měřené proměnné. Malý vzorek pacientů omezuje zobecnitelnost výsledků na populaci pacientů s MUPS.

Objectives. The field of psychopathology has recently witnessed a new trend in which a network perspective is applied to understand mental health problems. This perspective, coupled with the sampling of patients' everyday experience, allows researchers to develop personalized models that describe the dynamic relationships between symptoms over time. The objective of this study was to test the applicability of network models to understand the dynamics of medically unexplained physical symptoms (MUPS). Sample and setting. Two patients suffering from MUPS answered a questionnaire for three weeks, five times a day, using a mobile application to determine the intensity of their symptoms and selected psychological and situational variables. Statistical analysis. Two types of networks, temporal and contemporaneous, were estimated using the vector autoregression method. Results. Temporal and contemporaneous networks are presented for each patient separately. Consequently, a possible focus of psychotherapeutic interventions is derived from the models. Study limitation. The relatively low number of measurements did not allow to include all measured variables in the models. A small sample of patients limits the generalizability of the results to the population of MUPS patients.

• MeSH
• lidé MeSH
• patologické stavy, příznaky a symptomy MeSH
• počítačové modelování podle konkrétního pacienta MeSH
• průzkumy a dotazníky MeSH
• psychosomatické poruchy * patofyziologie   psychologie   terapie   MeSH
• psychoterapeutické procesy MeSH
• sběr dat MeSH
• statistické modely MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• práce podpořená grantem MeSH

PURPOSE: The purpose of this study was the simulation of the implantation of intrastromal corneal-ring segments for patients with keratoconus. The aim of the study was the prediction of the corneal curvature recovery after this intervention. METHODS: Seven patients with keratoconus diagnosed and treated by implantation of intrastromal corneal-ring segments were enrolled in the study. The 3D geometry of the cornea of each patient was obtained from its specific topography and a hyperelastic model was assumed to characterize its mechanical behavior. To simulate the intervention, the intrastromal corneal-ring segments were modeled and placed at the same location at which they were placed in the surgery. The finite element method was then used to obtain a simulation of the deformation of the cornea after the ring segment insertion. Finally, the predicted curvature was compared with the real curvature after the intervention. RESULTS: The simulation of the ring segment insertion was validated comparing the curvature change with the data after the surgery. Results showed a flattening of the cornea which was in consonance with the real improvement of the corneal curvature. The mean difference obtained was of 0.74 mm using properties of healthy corneas. CONCLUSIONS: For the first time, a patient-specific model of the cornea has been used to predict the outcomes of the surgery after the intrastromal corneal-ring segments implantation in real patients.

• MeSH
• analýza metodou konečných prvků MeSH
• biomechanika MeSH
• keratokonus chirurgie   MeSH
• lidé MeSH
• mechanické jevy * MeSH
• počítačové modelování podle konkrétního pacienta * MeSH
• protézy a implantáty * MeSH
• rohovka chirurgie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

V 21. storočí výrazne narastá počet chronických ochorení. V roku 1999 Wagner a kolektív predstavili azda najvplyvnejší teoretický model starostlivosti chronicky chorých - Chronic Care Model - CCM. Cieľom tohto príspevku je popísať model starostlivosti o chronicky chorých, jeho špecifické využitie u pacientov s ochorením diabetes mellitus, keďže toto ochorenie bolo prototypom pre vznik tohto modelu. Chronic care model má potenciál na zlepšenie efektivity starostlivosti o pacientov s diabetes mellitus bez toho, aby negatívne ovplyvnil výsledky pacientov.

Chronic diseases markedly increase in the 21st century. In 1999, Wagner and colleagues presented perhaps the most influential theoretical model for the care of chronically ill- Chronic Care Model - CCM. The aim of this thesis is to describe the model of care for the chronically ill, its specific use in patients with diabetes mellitus as this disease has been the prototype for the model development. We refer to the issue of care for the chronically ill and the role that a nurse plays in it. Chronic care model has the potential to improve efficiency of management of patients with diabetes mellitus without adversely affecting the results of the patients.

• MeSH
• chronická nemoc * epidemiologie   ošetřování   MeSH
• incidence MeSH
• lidé MeSH
• poskytování zdravotní péče MeSH
• výsledky a postupy - zhodnocení (zdravotní péče) * metody   MeSH
• Check Tag
• lidé MeSH

Modely a teorie jsou návody, které definují roli sestry v konkrétních situacích, pomáhají nalézt postupy, jak uspokojit potřeby pacientů. Jsou podkladem pro aplikovaný výzkum. Ida Jean Orlandová byla vědkyní v ošetřovatelství, její práce vedla k vytvoření koncepce ošetřovatelského procesu. Cílem této práce je vytvořit pro českou a slovenskou odbornou veřejnost popis Modelu dynamického interakčního procesu Idy Jean Orlandové a nastínit jeho využití v praxi. Na 11 platformách bylo provedeno vyhledávání článků, knih, elektronických knih a webových příspěvků o práci Orlandové s cílem vytvořit jednoduchý literární přehled (nikoliv systematický). Vyhledávání bylo provedeno od roku 1961 do roku 2019, v češtině a angličtině. Bylo nalezeno 13 zdrojů pojednávajících o díle Orlandové nebo o výzkumech zaměřených na využití její teorie. Orlandová i ostatní citovaní autoři se shodují v tom, že k tomu, aby byl pacient v psychické pohodě, přispívá uspokojování jeho potřeb a vytvoření pocitu jistoty a bezpečí. Aplikace modelu Orlandové může pomoci zlepšit poskytovanou péči a snížit pacientovu úzkost. Model je jednoduchým logickým rámcem aplikovatelným na ošetřovatelskou praxi a výzkum i v dnešní době.

Models and theories are guidelines, define the role of a nurse in specific situations, help to find the ways how meet patient needs. They are the basis for applied research. Ida Jean Orland was a nursing scientist. Aim of this work is create a description of the Orlando‘s model of dynamic interaction process for the Czech and Slovak professional and suggest its use in practise. A search for articles, books, e-books, and web-based articles on 11 platforms about Orlando's work was conducted in order to create a simple (not systematic) overview of literature. The year of publication ranging from 1961 to 2019, in both Czech and English language, was the only criterion for searching. 13 records describing the work of Ida Jean Orlando or researches, which applied her theory, have been found. Orlando and the other cited authors agreed that satisfying the patient ́s needs, creating a feel of confident and safety make patient mentally comfortable. Application of the Orlando’s model can help to improve care and reduce patient anxiety. The model is a simple logical framework applicable to nursing practice and research today.

• Klíčová slova
• Model Idy Jean Orlandové,
• MeSH
• odhad potřeb MeSH
• ošetřovatelská péče metody   trendy   MeSH
• ošetřovatelské modely MeSH
• pacienti psychologie   MeSH
• spokojenost pacientů MeSH

In vivo linear penetration in total hip arthroplasty (THA) exhibits similar values for 28mm and 32mm femoral head diameter with considerable variations between and within the studies. It indicates factors other than femoral head diameter influence polyethylene wear. This study is intended to test the effect of patient׳s individual geometry of musculoskeletal system, acetabular cup orientation, and radius of femoral head on wear. Variation in patient׳s musculoskeletal geometry and acetabular cup placement is evaluated in two groups of patients implanted with 28mm and 32mm THA heads. Linear wear rate estimated by mathematical model is 0.165-0.185mm/year and 0.157-0.205mm/year for 28 and 32mm THA heads, respectively. Simulations show little influence femoral head size has on the estimated annual wear rate. Predicted annual linear wear depends mostly on the abduction angle of the acetabular cup and individual geometry of the musculoskeletal system of the hip, with the latter having the greatest affect on variation in linear wear rate.

• MeSH
• acetabulum anatomie a histologie   fyziologie   MeSH
• hlavice femuru anatomie a histologie   fyziologie   MeSH
• kosterní svaly anatomie a histologie   fyziologie   MeSH
• kyčelní protézy * MeSH
• lidé středního věku MeSH
• lidé MeSH
• náhrada kyčelního kloubu * MeSH
• počítačové modelování podle konkrétního pacienta MeSH
• polyethylen MeSH
• senioři MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

BACKGROUND: Variations observed in biomechanical studies might be attributed to errors made by operators during the construction of musculoskeletal models, rather than being solely attributed to patient-specific geometry. RESEARCH QUESTION: What is the impact of operator errors on the construction of musculoskeletal models, and how does it affect the estimation of muscle moment arms and hip joint reaction forces? METHODS: Thirteen independent operators participated in defining the muscle model, while a single operator performed 13 repetitions to define the muscle model based on 3D bone geometry. For each model, the muscle moment arms relative to the hip joint center of rotation was evaluated. Additionally, the hip joint reaction force during one-legged stance was assessed using static inverse optimization. RESULTS: The results indicated high levels of consistency, as evidenced by the intra- rater and inter-rater agreement measured by the Intraclass Correlation Coefficient (ICC), which yielded values of 0.95 and 0.99, respectively. However, the estimated muscle moment arms exhibited an error of up to 16 mm compared to the reference musculoskeletal model. It was found that muscles attached to prominent anatomical landmarks were specified with greater accuracy than those attached over larger areas. Furthermore, the variability in estimated moment arms contributed to variations of up to 12% in the hip joint reaction forces. SIGNIFICANCE: Both moment arm and muscle force demonstrated significantly lower variability when assessed by a single operator, suggesting the preference for employing a single operator in the creation of musculoskeletal models for clinical biomechanical studies.

• MeSH
• biologické modely MeSH
• biomechanika MeSH
• kosterní svaly * fyziologie   MeSH
• kyčelní kloub * fyziologie   MeSH
• lidé MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

In many biomechanical problems, the availability of a suitable model for the wrapping of muscles when undergoing movement is essential for the estimation of forces produced on and by the body during motion. This is an important factor in the Osteoporotic Virtual Physiological Human project which is investigating the likelihood of fracture for osteoporotic patients undertaking a variety of movements. The weakening of their skeletons makes them particularly vulnerable to bone fracture caused by excessive loading being placed on the bones, even in simple everyday tasks. This paper provides an overview of a novel volumetric model that describes muscle wrapping around bones and other muscles during movement, and which includes a consideration of how the orientations of the muscle fibres change during the motion. The method can calculate the form of wrapping of a muscle of medium size and visualize the outcome within tenths of seconds on commodity hardware, while conserving muscle volume. This makes the method suitable not only for educational biomedical software, but also for clinical applications used to identify weak muscles that should be strengthened during rehabilitation or to identify bone stresses in order to estimate the risk of fractures.

• Publikační typ
• časopisecké články MeSH

PURPOSE: Estimation of hip joint loading is fundamental for understanding joint function, injury and disease. To predict patientspecific hip loading, a musculoskeletal model must be adapted to the patient's unique geometry. By far the most common and cost effective clinical images are whole pelvis plain radiographs. This study compared the accuracy of anisotropic and isotropic scaling of musculoskeletal model to hip joint force prediction by taking patient-specific bone geometry from standard anteroposterior radiograms. METHODS: 356 hips from 250 radiograms of adult human pelvis were analyzed. A musculoskeletal model was constructed from sequential images of the Visible Human Male. The common body position of one-legged stance was substituted for the midstance phase of walking. Three scaling methods were applied: a) anisotropic scaling by interhip separation, ilium height, ilium width, and lateral and inferior position of the greater trochanter, b) isotropic scaling by pelvic width and c) isotropic scaling by interhip separation. Hip joint force in one-legged stance was estimated by inverse static model. RESULTS: Isotropic scaling affects all proportions equally, what results in small difference in hip joint reaction force among patients. Anisotropic hip scaling increases variation in hip joint force among patients considerably. The difference in hip joint force estimated by isotropic and anisotropic scaling may surpass patient's body weight. CONCLUSIONS: Hip joint force estimated by isotropic scaling depends mostly on reference musculoskeletal geometry. Individual's hip joint reaction force estimation could be improved by including additional bone geometrical parameters in the scaling method.

• MeSH
• anizotropie MeSH
• biologické modely * MeSH
• biomechanika MeSH
• dospělí MeSH
• kyčelní kloub fyziologie   MeSH
• lidé MeSH
• postura těla fyziologie   MeSH
• referenční hodnoty MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

The goal of the study was to simulate electrical activation of the heart ventricles and corresponding body surface potentials (BSPs) during premature ventricular contractions (PVC) using the patient specific realistic homogeneous model of cardiac ventricles and the torso. Real position of the initial ectopic activation during PVC was determined by intracardial measurement in the upper part of the right ventricle near the His bundle and confirmed by successful catheter ablation of the PVC origin. Simulated electrical activation in the ventricular model was started at the position of the initial ectopic activation as well as at several other sites at various distances from this position. The propagation of electrical activation in the ventricular model was modeled using bidomain reaction-diffusion (RD) equations with the ionic transmembrane current density defined by the modified FitzHugh-Nagumo (FHN) equations. The torso was modeled as a homogeneous passive volume conductor. The RD equations were numerically solved in the Comsol Multiphysics environment. Simulated ECG signals and BSPs were compared with those measured during PVC in a real patient. The polarity and shape of simulated and measured ECG leads as well as the BSP distribution during the PVC were in best agreement when the stimulated region was less than 10 mm from the position of the initial ectopic activation.

Vlivem globalizace žijeme ve světě se stále „menšujícími se hranicemi“, což mimo jiné znamená také život ve stále multikulturnější společnosti. Na tuto skutečnost reaguje také moderní pojetí ošetřovatelské péče, kdy sestra musí být důkladně připravená řešit specifické problémy různých komunit ve zdraví a nemoci. Výsledkem by měla být kulturně přiměřená péče, která respektuje kulturní specifika a je zaměřena na blaho zdravých i nemocných. Přestože slovo cizinec má stejný základ jako slovo „cizí“, nemělo by to znamenat, že lidé, kteří k nám přicházejí odjinud, mají zůstat nepoznaní, zcela odcizení. Naopak právě oni potřebují pochopení a případnou pomoc, zvláště pokud se dostávají do zdravotních nesnází a ocitají se v péči zdravotnického personálu (Adamczyk, 2002). Zdravotnická péče musí být poskytována všem, kteří jí na našem území nezbytně potřebují, tedy i všem cizincům. Technická dostupnost a rychlost dopravy, ekonomické faktory, turistický ruch, příbuzenské vazby a další vlivy vedou k tomu, že migrace, tranzit i krátkodobé pobyty obyvatelstva cizích národností a kultur jsou stále častější a co se týká národnostního, etnického či kulturního složení pestřejší. Kvalita ošetřovatelské péče je založena na uspokojování individuálních potřeb pacientů/klientů, což vyžaduje ošetřovatelský personál, který má odpovídající znalosti a dovednosti. Sestry by měly umět zhodnotit aktuální stav a reakce pacienta/klienta na neuspokojené potřeby, včetně potřeb souvisejících s odlišnou kulturou, a podle toho průběžně zajišťovat individuální péči. Zkušenosti z praxe však ukázaly, že je to právě oblast lidských potřeb (u pacientů s odlišnou kulturou), kde sestrám chybí potřebné vědomosti a vzdělání (Ivanová, 2005, s. 14).

Due to the globalization, we live in the world having ever “diminishing borders”, which, apart from other things, also means life in the evermore multicultural society. The modern concept of the nursing care also reacts to this fact, where a nurse must be thoroughly ready for the solution of specific problems of different communities in the health and disease. The result should be the culturally appropriate care respecting cultural specific features and aimed at the well being of healthy as well as diseased persons. The word foreigner has the same stem as the word “foreign”, but this does not mean that people coming from elsewhere should remain unrecognized and quite alienated. In contrast, these are just the people who need understanding and possible help, particularly if they fall into health problems and become subjects of taking care by health personnel (Adamczyk, 2002). The health care should be provided for anybody who is in need of it in our country, i.e. also for all the foreigners. The technical availability and velocity of the transportation, economical factors, tourism, associations between relatives and further effects lead to the fact that the migration, transit as well as short-term stays of citizens of foreign nationalities and cultures are evermore frequent and also more diverse as to the national, technical or cultural structure. The quality of the nursing care is based on satisfying individual needs of patients/clients, which calls for nursing personnel having appropriate knowledge and skill. The nurses should be able to assess the topical condition and reactions of the patient/client to unsatisfied needs, including those associated with different culture, and to continuously provide individual care in accordance with this. However, experience from the practice demonstrated that this is just the field of human needs (in patients with different culture), where the nurses lack the necessary knowledge and education (Ivanová, 2005, p. 14).

• MeSH
• finanční podpora výzkumu jako téma MeSH
• lidé MeSH
• ošetřovatelské modely MeSH
• transkulturní ošetřovatelství MeSH
• Check Tag
• lidé MeSH
• Geografické názvy
• Vietnam MeSH