Background. Breast cancer is the most common cancer in women. Menopausal symptoms, which can highly reduce quality of life in women of all ages, are frequent side-effects of systemic treatment of ...early breast cancer whether treated by hormonal or cytotoxic therapy. Methods. The article presents literature review of the causes, assessment and management of menopausal symptoms in breast cancer patients. Results. There are a number of non-hormonal drugs effective in treating vasomotor symptoms, and same alternative therapies, such as black cohosh, phytoestrogens, homeopathy, acupuncture, yoga and behaviour strategies. The decision, whether and which pharmacologic or non-pharmacologic treatment to choose, depends on symptoms and on patient wishes. The most effective drugs for reducing hot flashes are venlafaxine, paroxetine and gabapentin, unfortunately, the side effects are common. Vaginal estrogens are the most effective for treating atrophic vaginitis, but the safety in breast cancer patients is not established. Conclusions. Menopausal symptoms after breast cancer are severe and frequent and significantly reduce quality of life. Unfortunately, the possibility of treatment is limited.
Uvod: Napredovala stopnja demence je terminalna stopnja v kliničnem poteku demence, za katero sta poleg kognitivnih, telesnih, vedenjskih in psiholoških okvar značilna izguba samostojnosti pri ...izvajanju osnovnih dnevnih opravil ter visoko tveganje za podhranjenost. Namen raziskave je predstaviti pristope za zagotavljanje optimalne prehranjenosti pri osebah z napredovalo stopnjo demence v institucionalni oskrbi. Metode: Narejen je bil integrativni pregled literature, objavljene med letoma 2014 in 2019. Za identifikacijo relevantne literature smo uporabili iskalni niz dementia OR alzheimers OR cognitive impairment OR memory loss AND feeding OR eating OR nutrition, pregledani sta bili podatkovni bazi CINAHL in MEDLINE. V končno analizo je bilo vključenih 19 člankov. Rezultati: Izsledki pregleda literature so bili razporejeni v štiri kategorije: (1) spodbujanje samostojnosti pri hranjenju, (2) uporaba prilagojene prehrane, (3) obvladovanje motenj požiranja in (4) na posameznika usmerjena oskrba. Diskusija in zaključek: Pristopi pri zagotavljanju kakovosti življenja oseb z napredovalo stopnjo demence so usmerjeni k spodbujanju samostojnosti pri hranjenju. Slednje se lahko dosega z intervencijami na področju obvladovanja upada umskih in telesnih sposobnosti, motenj požiranja, z zagotavljanjem prehranskega vnosa per os ter izvajanjem oskrbe, usmerjene k posamezniku.
Quality of life of post-stroke patients Bártlová, Sylva; Šedová, Lenka; Havierniková, Lucie ...
Zdravstveno varstvo,
06/2022, Volume:
61, Issue:
2
Journal Article
Peer reviewed
Open access
Stroke is a disease whose consequences have a considerable impact on the quality of the patient's life. It is a widespread disease that has a disabling impact on life and, in addition to physical ...changes, brings about a number of psychological and cognitive processes.
The goal of the study was to identify and describe the quality of life of post-stroke patients.
The study design was quantitative. A questionnaire of the authors' own design and the SF-36 questionnaire were used to obtain the data.
Significant differences in patient quality of life were identified in relation to patient gender. Moreover, the quality of life in all individual SF-36 dimensions, except for mental health, deteriorated with age. With regard to occupational placement, employed respondents gave the highest evaluation of quality of life according to SF-36 and old-age pensioners the lowest. The analysis shows that quality of life in individual dimensions is positively influenced by respondents' higher education. The evaluation in individual dimensions improves with the time that has passed since the stroke.
The quality of life of post-stroke patients deteriorates with age. The deteriorating level of patient quality of life in older age requires programmes that include assessments and interventions that lead to the treatment of these patients.
Pojem fonetike in fonologije portugalskega jezika zaobjema široko in obsežno jezikoslovno področje preučevanja mnogih med seboj raznovrstnih fonoloških različic portugalščine, pri čemer kot ...poglavitni izstopata predvsem evropska ter brazilska različica portugalščine in njuna fonološka sistema. V prispevku je pozornost usmerjena k evropski različici jezika ter njenim posebnostim v primerjavi s slovenščino in slovenskimi fonološkimi značilnostmi. Namen prispevka je sprva opozoriti na glavne podobnosti in razlike med fonološkima sistemoma slovenščine in evropske portugalščine s poudarkom na samoglasniški in soglasniški klasifikaciji obeh jezikov. Nato pa v osrednjem delu preko predstavitve posameznih primerov predvideti najvidnejše diferenciacije ter ob tem morebitne težave, s katerimi bi se lahko soočili slovenski materni govorci in študentje portugalščine kot tujega jezika pri učenju in usvajanju portugalske fonologije, zlasti fonološkega sistema evropske portugalščine. Že raziskano vprašanje fonoloških težav portugalščine za slovenske govorce in študente na ravni usvajanja nosnih samoglasnikov in diftongov, kjer slovenski študentje ne morejo iskati analogije z maternim jezikom, je v tem prispevku nadgrajeno z drugimi fonološkimi posebnostmi, zlasti evropske portugalščine, za katere se predvideva, da bi lahko predstavljale problem slovenskim govorcem in študentom pri učenju, kot je na primer vprašanje soglasnikov in soglasniških sklopov, raznovrstnosti posameznih portugalskih fonemov ter izrazite tendence evropske portugalščine po vokalnih redukcijah.
Izhodišče: Orofacialni razcep je najpogostejša prirojena obrazna nepravilnost. Otroci z razcepi v orofacialnem področju imajo poleg težav z govorom tudi težave na področju hranjenja in požiranja. ...Raziskave kažejo, da so simptomi težav s hranjenjem precej raznoliki. V skrajnih primerih je potrebno uvesti nadomestne načine hranjenja. V Sloveniji še ni bila narejena raziskava o pojavljanju težav s hranjenjem pri otrocih z razcepi v orofacialnem področju.Metode: Ugotoviti smo želeli pogostost in vrsto težav s hranjenjem otrok z razcepi v orofacialnem področju, starih od pet mesecev do šest let. V ta namen smo izoblikovali anonimni vprašalnik za starše o vrsti orofacialnega razcepa, možnih otrokovih težavah pri hranjenju, požiranju in govoru ter pripomočkih za hranjenje. Vprašalnik je bil najprej pilotsko preizkušen pri starših otrok z orofacialnimi razcepi med kontrolnimi ambulantnimi pregledi, nato pa poslan 93 staršem otrok z orofacialnimi razcepi, rojenih v obdobju treh zaporednih let. Z opisno statistiko smo predstavili pogostnost pojavljanja težav ter analizirali dejavnike, ki so se pogosteje pojavljali pri otrocih s težavami pri hranjenju.Rezultati: Starši 58 otrok z orofacialnimi razcepi so izpolnili vprašalnik. Ugotovili smo, da je imelo skoraj tri četrtine otrok težave z vzpostavitvijo hranjenja takoj po rojstvu, kasneje so se težave s hranjenjem zmanjšale, vendar so bile v četrtini primerov še vedno prisotne do zaključenega kirurškega zdravljenja. Največ težav se je pojavljalo zaradi uhajanja hrane in pijače skozi nos, požiranja zraka pri hranjenju po steklenički in podaljšanega časa hranjenja. Otroci z razcepom neba z razcepom ustnice ali brez so imeli bistveno več težav s hranjenjem kot otroci samo z razcepom ustnice. Večina staršev je za hranjenje uporabljala prilagojeno stekleničko in je bila z uporabo zadovoljna. Več kot polovica staršev je izjavila, da so prejeli premalo informacij v zvezi s hranjenjem pred in takoj po rojstvu otroka.Zaključek: Kljub dobro organizirani multidisciplinarni skrbi za otroke z orofacialnimi razcepi v Sloveniji starši še vedno pogrešajo konkretna navodila o hranjenju otroka z orofacialnim razcepom, zaradi česar bo potrebno dodatno izobraziti predvsem medicinske sestre, ki delajo v porodnišnicah. Glede na visoke cene pripomočkov za hranjenje otrok z orofacialnimi razcepi bi bilo dobrodošlo, da bi kril stroške ZZZS.
The purpose of this study was to translate the low anterior resection syndrome (LARS) score into Slovenian and to test its validity on Slovenian patients who underwent low anterior rectal resection.
...The LARS score was translated from English into Slovenian and then back-translated following international recommendations. The Slovenian version of the LARS questionnaire was completed by patients who underwent low anterior rectal resection between 1 January 2006 and 31 December 2010 at the University Medical Centre Ljubljana. An anchor question assessing the impact of bowel function on lifestyle was included. To assess test-retest reliability, some of the patients answered the LARS score questionnaire twice.
A total of 100 patients (66.7%) of the 150 patients who were contacted for participation, were included in the final analysis. A total of 58 patients reported major LARS score. The LARS score was able to discriminate between patients who received radiotherapy and those who did not (p<0.001), and between total and partial mesorectal excision (p<0.001). Age was not associated with a greater LARS score (p=0.975). There was a perfect fit between the QoL category question and the LARS score in 66.0% of cases and a moderate fit was found in 24.0% of the cases, showing good convergent validity. Test-retest reliability of 51 patients showed a high intraclass correlation coefficient of 0.86.
The Slovenian translation of the LARS score is a valid tool for measuring LARS.
The aim of our systematic review was to analyse the published literature on the psychosocial dimension of care in family medicine and its relationship with quality of care. We wanted to find out ...whether there is any evidence on the psychosocial approach in (family) medicine. The recommended bio-psycho-social approach, besides the biomedical model of illness, takes into account several co-influencing psychological, sociological and existential factors. An online search of nine different databases used Boolean operators and the following selection criteria: the paper contained information on the holistic approach, quality indicators, family medicine, patient-centred care and/or the bio-psycho-social model of treatment. We retrieved 743 papers, of which 36 fulfilled our inclusion criteria. Including the psychosocial dimension in patient management has been found to be useful in the prevention and treatment of physical and psychiatric illness, resulting in improved social functioning and patient satisfaction, reduced health care disparities, and reduced annual medical care charges. The themes of patient-centred, behavioural or psychosocial medicine were quite well presented in several papers. We could not find any conclusive evidence of the impact of a holistic biopsycho-social-approach. Weak and variable definitions of psychosocial dimensions, a low number of welldesigned intervention studies, and low numbers of included patients limited our conclusions.
Izhodišča: V šoli otroci preživijo velik del dneva, zato ima šola pomembno vlogo pri zdravju otrok in mladostnikov pa tudi pri sodelovanju z zdravstvenimi službami.
Ugotoviti stališče ravnateljev o ...pomenu, smotrnosti in o možnosti umestitve šolske medicinske sestre v osnovne šole.
Podatki so zbrani s strukturiranim anketnim vprašalnikom. Vzorec zajema 55,6 % (n = 266) celotne populacije ravnateljev osnovnih šol. Uporabljena je deskriptivna statistika. Soodvisnost je analizirana z multiplo regresijsko in dimenzije odvisne spremenljivke s faktorsko analizo.
Na osnovnih šolah najpogosteje ukrepajo zaradi akutnega bolezenskega stanja (PV = 3,48), psihosomatskih (PV = 3,42) in kroničnih bolezni (PV = 3,22) (lestvica 1-6). Ravnatelji prepoznavajo potrebo po nalogah šolske medicinske sestre iz promocije zdravja in zdravstvenih storitev, saj je 11 od 13 predlogov dobilo v povprečju oceno nad 4 (lestvica 1-5). Najprimernejšo umestitev šolske medicinske sestre vidijo deloma v zdravstvenem domu, deloma v šoli (60,2 %); najprimernejši delodajalec je zdravstveni dom (59,4 %). Mnenja se ne razlikujejo glede na velikost šole in vključitev v mrežo Zdravih šol. Ravnatelji s šol, v katerih je telesnih poškodb učencev več, izražajo značilno večjo potrebo po šolski medicinski sestri (b = 0,208, p < 0,014), kar velja tudi za ravnatelje z mnenjem, da je usposabljanje učiteljev za prepoznavanje in ukrepanje ob zdravstvenih težavah v odgovornosti zdravstvenega doma (b = 0,270, p < 0,000).
Ravnatelji menijo, da se v šolah srečujejo z zdravstvenimi težavami učencev, a učitelji za ukrepanje nimajo dovolj znanja niti kompetenc. Pozitivno prepoznavajo umestitev šolske medicinske sestre v šolo.
Background: Children spend most of their days in schools, therefore schools play an important role in children’s inter-institutional health care.
To identify views of school principals on the importance, relevance and possible placement of school nurses in Slovenian schools.
A structured questionnaire was used. The sample consisted of 55.6% (n=266) of the total population of elementary school principals; descriptive statistics was used. Interdependence was analysed with multiple regression, while dependent variable dimensions were obtained with factor analysis.
The most frequent interventions in schools are the result of acute medical conditions (M=3.48), psychosomatic disorders (M=3.42) and chronic diseases (M=3.22) (1-6 scale). Principals ranked the need for suggested services of school nurses highly, as 11 out of 13 suggestions received a mean value of over 4 (on a 1-5 scale), not only in health promotion/education but also in other medical services. The most appropriate work location of school nurses is partly in primary health centres and partly in schools (60.2%); the most appropriate employer is the primary health centre (59.4%). Opinions of principals do not differ according to the size of school or participation in the network ‘Schools for health’. Principals of schools with a higher number of interventions due to children’s injuries expressed a significantly higher need for school nurse services in the school (b=0.208, p<0.014); the same also goes for principals who feel that training teachers to recognise and act upon children’s health problems has to be organised by a primary health centre (b=0.270, p<0.000).
In school principals’ view, schools are faced with children’s health problems but teachers do not have enough knowledge or competences to take appropriate measures. They positively recognise the placement of school nurses in schools.
Disleksija (diskalkulija) je posebno nevrolosko stanje. Vcasih je povezano z levicarstvom osebe. Pri ljudeh z disleksijo se pojavijo izpadi dolocenih sposobnosti in nekateri nadpovpreeni talenti. ...Ostale sposobnosti so lahko zelo ozke, npr. sposobnost poslusanja in razumevanja tega, kar oseba slisi, sposobnost govornega izrazanja, sposobnosti vizualne percepcije, sposobnost branja, sposobnost pisnega izrazanja, obcutek za kvantitativna razmerja (numericnost), smisel za red, prostorska orientacija, obvladovanje zaporedij ( abeceda, postevanka, dnevi v tednu, meseci), posluh itd. Ob vstopu v solo se pokazejo ucne težave. Ucenec se dolgo privaja branju, here z okenckom, izpusca crke, obraca crke (s, z, b, d) in stevilke, predvsem pa grdo pise in dela veliko napak. Vidna znacilnost so niZji dosezki od intelektualnih sposobnosti osebe, dokler ne razvije svojih posebnih strategij za branje, pisanje in premagovanje drugih primankljajev. Potem gre njegova pot strmo navzgor. Postane usoden poslovnez, politik, umetnik, znanstvenik ali kaj drug ega. Zivljenjske poti ljudi z disleksijo so navadno skrajne: ali zelo uspdne (ce se dokopljejo do svojih talentov) ali pa povsem neuspešne, ce podlezejo ucnim tezavam ze na zacetku solanja.
This paper explores the problems caused by human impact with settlements and infrastructure in the surface water bodies, especially in potential flood plans. Moreover, the principles and obligations ...of the EU Flood Directive (2007/60/EC), which supplements the Water Frame Directive, are discussed. The principles and obligations of this directive have been introduced in Slovenia by local legislation: Decree on conditions and limitations for constructions and activities on flood risk areas (OG RS, No. 89/2008) and Rules on methodology to define flood risk areas and erosion areas connected to floods and classification of plots into risk classes (OG RS, No. 60/2007). Some features and obligations of state-ofthe-art hydraulic mathematical models for surface water dynamics simulation are described. Several problems encountered in developing the models and simulating problems are described; these involve using temporarily available geodetic data of the river beds and flood plans and some suggestions for improving of the modelling are made.
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