Care for the homeless people in the city of Prague provided by some Christian institutions

Katedra pastorálních oborů a právních vědDepartment of Pastoral Theology and Law SciencesCatholic Theological FacultyKatolická teologická fakult

The process of specialized social counseling – key elements

The aim of the article is to indicate the general characteristics of the key elements of the social counseling process. To accomplish this task the authors used professional literature and one of the co-authors’ professional experience in his field of study. František Drozd has been practicing social counseling in Slovakia for several years. His experience has allowed him to competently determine the key factors in the counseling process. These are: (1) ambient conditions and taking into account the time factor; (2) properly conducted interview; (3) the relevant contract with the client and skillful completion of the counseling process, and (4) ethical principles in the counseling relation

Specialized social counseling – key elements

Celem artykułu jest wskazanie i ogólna charakterystyka kluczowych elementów procesu doradztwa społecznego. Przy realizacji tak postawionego zadania – oprócz fachowej literatury przedmiotu − wykorzystano doświadczenie zawodowe w tej dziedzinie jednego ze współautorów: František Drozd od kilkunastu lat prowadzi praktykę doradztwa społecznego na Słowacji. Zdobyta przez ten czas wiedza pozwoliła mu określić w sposób kompetentny zasadnicze czynniki procesu doradczego. Są to: (1) odpowiednie warunki zewnętrzne i uwzględnienie czynnika czasu; (2) właściwie przeprowadzona rozmowa doradcza; (3) zawarcie stosownego kontraktu z klientem i umiejętne zakończenie procesu doradczego, oraz (4) przestrzeganie zasad etycznych w relacji doradczej.The aim of the article is to indicate the general characteristics of the key elements of social counseling process. To accomplish this task authors used professional literature and professional experience in the field of one of the co-authors. František Drozd several years has been practicing of social counseling in Slovakia. His experience allowed him to competently determine the key factors in the counseling process. These are: (1) ambient conditions and taking into account the time factor; (2) properly conducted interview; (3) the relevant contract with the client and skillful completion of the counseling process, and (4) ethical principles in counseling work

Fatigue in an AZ31 Alloy Subjected to Rotary Swaging

The magnesium AZ31 alloy was swaged with rotary pressure with the aim of redefining the microstructure and improving mechanical and fatigue properties. The rotary swaging process and subsequent ageing improved the yield stress in tension and compression. In the present study, the investigation was focused on fatigue behaviour. The samples were cycled in a symmetric regime with a frequency of 35 Hz. A dependence of the stress amplitude on the number of cycles up to the fracture was estimated. The microstructure of the samples and fracture surfaces was analysed with a scanning electron microscope. The fatigue process was influenced by the pronounced texture formed in the swaging process. The fatigue properties of the swaged samples improved substantially—the endurance limit based on 107 cycles was approximately 120 MPa—compared to those of the cast alloy. The analysis of the fracture surfaces showed a transcrystalline fatigue fracture

Ticagrelor in patients with diabetes and stable coronary artery disease with a history of previous percutaneous coronary intervention (THEMIS-PCI) : a phase 3, placebo-controlled, randomised trial

Background: Patients with stable coronary artery disease and diabetes with previous percutaneous coronary intervention (PCI), particularly those with previous stenting, are at high risk of ischaemic events. These patients are generally treated with aspirin. In this trial, we aimed to investigate if these patients would benefit from treatment with aspirin plus ticagrelor. Methods: The Effect of Ticagrelor on Health Outcomes in diabEtes Mellitus patients Intervention Study (THEMIS) was a phase 3 randomised, double-blinded, placebo-controlled trial, done in 1315 sites in 42 countries. Patients were eligible if 50 years or older, with type 2 diabetes, receiving anti-hyperglycaemic drugs for at least 6 months, with stable coronary artery disease, and one of three other mutually non-exclusive criteria: a history of previous PCI or of coronary artery bypass grafting, or documentation of angiographic stenosis of 50% or more in at least one coronary artery. Eligible patients were randomly assigned (1:1) to either ticagrelor or placebo, by use of an interactive voice-response or web-response system. The THEMIS-PCI trial comprised a prespecified subgroup of patients with previous PCI. The primary efficacy outcome was a composite of cardiovascular death, myocardial infarction, or stroke (measured in the intention-to-treat population). Findings: Between Feb 17, 2014, and May 24, 2016, 11 154 patients (58% of the overall THEMIS trial) with a history of previous PCI were enrolled in the THEMIS-PCI trial. Median follow-up was 3·3 years (IQR 2·8–3·8). In the previous PCI group, fewer patients receiving ticagrelor had a primary efficacy outcome event than in the placebo group (404 [7·3%] of 5558 vs 480 [8·6%] of 5596; HR 0·85 [95% CI 0·74–0·97], p=0·013). The same effect was not observed in patients without PCI (p=0·76, p interaction=0·16). The proportion of patients with cardiovascular death was similar in both treatment groups (174 [3·1%] with ticagrelor vs 183 (3·3%) with placebo; HR 0·96 [95% CI 0·78–1·18], p=0·68), as well as all-cause death (282 [5·1%] vs 323 [5·8%]; 0·88 [0·75–1·03], p=0·11). TIMI major bleeding occurred in 111 (2·0%) of 5536 patients receiving ticagrelor and 62 (1·1%) of 5564 patients receiving placebo (HR 2·03 [95% CI 1·48–2·76], p<0·0001), and fatal bleeding in 6 (0·1%) of 5536 patients with ticagrelor and 6 (0·1%) of 5564 with placebo (1·13 [0·36–3·50], p=0·83). Intracranial haemorrhage occurred in 33 (0·6%) and 31 (0·6%) patients (1·21 [0·74–1·97], p=0·45). Ticagrelor improved net clinical benefit: 519/5558 (9·3%) versus 617/5596 (11·0%), HR=0·85, 95% CI 0·75–0·95, p=0·005, in contrast to patients without PCI where it did not, p interaction=0·012. Benefit was present irrespective of time from most recent PCI. Interpretation: In patients with diabetes, stable coronary artery disease, and previous PCI, ticagrelor added to aspirin reduced cardiovascular death, myocardial infarction, and stroke, although with increased major bleeding. In that large, easily identified population, ticagrelor provided a favourable net clinical benefit (more than in patients without history of PCI). This effect shows that long-term therapy with ticagrelor in addition to aspirin should be considered in patients with diabetes and a history of PCI who have tolerated antiplatelet therapy, have high ischaemic risk, and low bleeding risk