Financial situation and challenges for management of SME hospitals: evidence from Poland

The hospital represents a specific organisation, operating in a turbulent environment and financed to a large extent by public funds. The health sector is exposed to constant political and social pressure. This causes significant problems with maintaining its financial stability, which particularly affects hospitals in the SME sector. The aim of this paper is to examine the relationship between selected financial indicators and some environmental phenomena that affect the financial situation and future financial stability of a selected group of hospitals from the SME group. The results will also be compared to the situation of other SME entities. The research is based on descriptive analysis, descriptive statistics, and correlation analysis of selected data. The results indicate that the financial situation of hospitals belonging to the SME group differs significantly from the overall SME sector, and does not bode positively for their future development. The current financial situation presents particular challenges for managers in balancing financial streams and ensuring economic sustainability. At the same time, this situation should encourage decision-makers to ensure an adequate level of revenues for these public service providers, as well as face other challenges related to operational management

Effect of lighting conditions on fine hand motor skills in sleep deprived soldiers

Title: Effect of lighting conditions on fine hand motor skills in sleep deprived soldiers Objectives: Determination of the effect of sleep deprivation performed during blue light exposure and during blue light blocking on fine motor skills of the hands. Methods: This theoretical-empirical work was conducted on a research cohort of 8 young men (n = 8) with an average age of 22,6 ± 1.6 years, height of 181,1 ± 3,7 cm and weight of 76,9 ± 4,9 kg. The participants were volunteers from the Military Physical Education Department at the Faculty of Physical Education and Sport (FPE) of Charles University (UK). The participants were induced into total sleep deprivation for 36 hours in two interventions. During this time, they followed established rules to avoid bias in the results and the course of the intervention was conducted according to standardized conditions. The first sleep deprivation intervention was performed in light and the second in darkness with blue light blocking. Disassembly and machine gun collection took place at fixed times and conditions, always at 7:30 am and 7:30 pm. Before each measurement, probands completed the Epworth Sleepiness Scale (ESS) questionnaire, which monitored the subjective level of sleepiness. In total, four measurements were taken with sleep deprivation and one...Název: Efekt světelných podmínek na jemnou motoriku rukou u spánkově deprivovaných vojáků Cíle: Zjištění vlivu spánkové deprivace provedené při působení modrého světla a při blokování modrého světla na jemnou motoriku rukou. Metody: Tato teoreticko-empirická práce byla provedena na výzkumném souboru 8 mladých mužů (n = 8) s průměrným věkem 22,6 ± 1,6 let, výškou 181,1 ± 3,7 cm a hmotností 76,9 ± 4,9 kg. Účastníci byli dobrovolníci z oboru Vojenské tělovýchovy při Fakultě tělesné výchovy a sportu (VO FTVS) Univerzity Karlovy (UK). Účastníkům byla navozena totální spánková deprivace v délce 36 hodin ve dvou intervencích. Po tuto dobu dodržovali stanovená pravidla, aby nedošlo ke zkreslení výsledků a průběh intervence probíhal dle standardizovaných podmínek. První intervence spánkovou deprivací proběhla za světla a druhá za tmy s blokováním modrého světla. Rozborka a sborka samopalu probíhala v stálých časech a podmínkách, vždy v 7:30 hodin ráno a 19:30 hodin večer. Před každým měřením vyplňovali probandi dotazník (ESS) Epworthská škála spavosti, která monitorovala subjektivní míru spavosti. Celkem byla provedena čtyři měření s odepřením spánku a jedno měření bylo provedeno po 8hodinovém ozdravném spánku. Celkem bylo provedeno pět měření v intervenci za světla a pět za tmy, pokaždé dle stejného...Vojenská tělovýchovaFaculty of Physical Education and SportFakulta tělesné výchovy a sport

Solvability of partial differential equations with generalized complex coefficients

Diese Diplomarbeit diskutiert die Lösbarkeit von partiellen Differentialgleichungen mit \\verallgemeinerten komplexen Koeffizienten. Ähnlich wie im Fall von nicht verallgemeinerten konstanten Koeffizienten bedienen wir uns dabei dem Konzept der Fundamentallösungen. Da im Rahmen von Colombeau Algebren Dualräume den passenden theoretischen Hintergrund für dieses Vorgehen liefern, geben wir eine ausführliche Einführung in diese. Eine besondere Stellung nehmen dabei sogenannte Basisfunktionale ein, jene Funktionale die durch Netze von Distributionen bestimmt werden. Sie spielen im Weiteren eine wichtige Rolle für partielle Differentialgleichungen. \\\indent Die Hauptresultate der Arbeit sind eine verallgemeinerte Version des bekannten Malgrange-Ehrenpreis-Theorems und darauf aufbauend äquivalente Bedingungen zur Lösbarkeit von Gleichungen mit kompakt getragenen Inhomogenitäten. \\\indent Der letzte Teil der Arbeit ist anwendungsorientierter und beginnt mit einer Ausdehnung der Faltung, die unter bestimmten Bedingungen auch Inhomogenitäten mit nicht kompaktem Träger erlaubt. Im Folgenden werden dann einige Lösungen zu bekannten Differentialgleichungen, unter anderem die Cauchy-Riemann und eine Art der Schrödinger Gleichung, vorgestellt.The aim of this diploma thesis is to discuss the solvability of partial differential equations with generalized complex coefficients. Similar to the case of non generalized constant coefficients, we use the method of fundamental solutions. Since it turns out that in the Colombeau theoretic setting dual spaces provide an appropriate framework for them, we introduce these spaces in detail. A special focus is on basic functionals, which are determined by a net of distributions and play an important role in the context of partial differential operators. \\\indent As main results we obtain an adapted version of the Malgrange-Ehrenpreis-Theorem, which guarantees a fundamental solution, and based on this, equivalent assertions to the solvability for equations with compactly supported inhomogeneities. \\\indent The final part of the thesis begins with an extension of the convolution, which enlarges the class of possible inhomogeneities. In the following solutions for selected equations such as the Cauchy-Riemann and a generalized Schrödinger equation are presented

Differential geometry of space curves: Forgotten chapters

We study evolutes and involutes of space curves. Although much of the material presented is not new and can be found in classic treatises, we believe that a modern and unified treatment, complemented with several novel observations, may be useful. The results are illustrated with the help of computer graphics, a tool that was not not available to the classical geometers.Comment: 27 pages, 9 figure

Przewlekła choroba nerek u chorych na cukrzycę typu 2

In the whole world there is an increasing number of patients with diabetes mellitus. As a consequence chronic diabetic kidney disease, which develops in 15-40% of diabetics, becomes more prevalent. Currently diabetic kidney disease is the most frequent cause for the necessity of renal replacement therapy. Both diabetes and chronic kidney disease increase the risk of cardiovascular complications and death. Diabetic kidney disease is characterized by albuminuria (and proteinuria at later stages) and/or decreased glomerular filtration rate. Yearly screening (urinary albumin excretion and eGFR) is recommended to identify kidney disease in patients with diabetes. Prevention and treatment of diabetic kidney disease is based mainly on optimal serum glucose and blood pressure control. In type 2 diabetics with impaired kidney function oral drugs lowering serum glucose have limited use. Most of them are excreted in urine and the risk for hypoglycemia increases. In the recently introduced incretin drug linagliptin is an interesting alternative. This dipeptydilopeptidase-4 inhibitor is excreted in bile and its metabolism and effects are not changed in patients with impaired kidney function.Na całym świecie obserwuje się znaczny wzrost liczby chorych na cukrzycę i w konsekwencji osób z przewlekłą chorobą nerek w przebiegu cukrzycy. Cukrzycowa choroba nerek występuje u około15-40% chorych na cukrzycę. Obecnie w wielu krajach cukrzycowa choroba nerek wysuwa się na pierwsze miejsce, jako najczęstsza przyczyna leczenia nerkozastępczego. Jednocześnie zarówno cukrzyca jak i przewlekła choroba nerek znacznie zwiększają ryzyko wystąpienia powikłań sercowo-naczyniowych oraz zgonu. Choroba nerek w przebiegu cukrzycy przejawia się obecnością albuminurii (lub jawnego białkomoczu w dalszym przebiegu choroby) i/lub upośledzeniem czynności wydalniczej nerek. Zaleca się coroczne badania przesiewowe (albuminuria i eGFR) mające na celu wykrycie choroby nerek u chorych na cukrzycę. Zapobieganie jak i leczenie choroby nerek w przebiegu cukrzycy opiera się przede wszystkim na optymalnej kontroli glikemii i ciśnienia tętniczego. U chorych na cukrzycę typu 2 z upośledzoną czynnością wydalniczą nerek tradycyjne doustne leki przeciwcukrzycowe mają ograniczone zastosowanie ze względu na zwiększone ryzyko hipoglikemii. Wśród niedawno wprowadzonych leków inkretynowych wyróżnia się inhibitor dipeptydylopeptydazy-4 linagliptyna, która ulega wydalaniu wraz z żółcią i tym samym jej działanie i metabolizm nie są zmienione u chorych z uszkodzeniem nerek