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Uvod: Pri prikazu anatomskih struktur ledvene hrbtenice je najbolj dostopna diagnostična metoda rentgensko slikanje. Standardni radiografski pregled za oceno ledvenega dela hrbtenice vključuje anteroposteriorno in stransko projekcijo. Po potrebi se lahko izvede slikanje hrbtenice pod različnimi koti. Pomembno je, da prikažemo vse kar protokol slikanja ledvene hrbtenice zahteva. Namen: Namen diplomskega dela je prikazati in oceniti po kriterijih za kakovost rentgenograma anatomske strukture ledvene hrbtenice pri rentgenskem slikanju v AP in PA legi ter pri spremembi kota med hrbtom in podlago do 45 stopinj. Metode dela: Prva metoda je bila deskriptivna. Vključevala je pregled domače in tuje strokovne literature pridobljene v knjižnici Zdravstvene fakultete Univerze v Ljubljani, Osrednji knjižnici Mozirje ter na spletu. Druga metoda je bila raziskovalno delo, pri katerem smo s pomočjo fantoma primerjali prikaze anatomskih struktur pri ledveni hrbtenici, ko je le ta pod različnimi koti. Rezultati: Medvretenčni prostori so na PA sliki bolj odprti. Na PA sliki vidimo pri L1 in L2 bolj enojne strukture telesa kot na AP sliki. Z večanjem kota pride do vse večje povečave leve strani, ki je v vsakem naslednjem rentgenogramu bolj dvignjena od podlage. Širina vretenca se spreminja z vsakim posnetkom, največje odstopanje se pojavi pri 10° in 30° kotu. Razberemo, da je v osnovnem položaju desen odrastek daljši od levega, najmanjša razlika med njima je pri 5° podlogi. Sakroiliakalna sklepa se začneta rotirati. Rotacija je vidna tudi po križničnih linah, ki se vse bolj odmikajo k podloženi levi strani. Desni SIS se na vseh rentgenogramih prekriva in je zaprt, medtem ko se levi do 20° kota odpira, nato pa pride do prekrivanja in je zaprt. Trni ledvenih vretenc se s podlaganjem pomikajo proti levi strani, do 30° kota so še vidni na telesu vretenca, pod večjim kotom pa jih že vidimo iz polstranskega prikaza. Razprava in zaključek: Anatomske strukture se pri majhnih spremembah položaja fantoma ali kota prikažejo drugače. Z večanjem kota med podlago in fantomom prihaja do vse večje distorzije velikosti in oblike, rentgenogrami pa niso več simetrični. Pomembna je natančna nastavitev pacienta, s tem mu prihranimo dozo in omogočimo, da so rentgenogrami ocenjeni in odčitani kakovostno. Introduction: The most available diagnostic method when presenting the anatomic structures of the lumbar spine is radiography. The standard radiographic examination used for the evaluation of the lumbar spinal region includes anteroposterior and lateral projection. If needed, the spinal imaging can be performed at different angles. It is essential that everything the lumbar spine protocol requires is presented. Purpose: The aim of the thesis is to demonstrate and assess the anatomic structures of the lumbar spine in AP and PA position, and the difference at the angle between the back and the grounding up to 45°, according to the radiography quality criterium. Methods: The first method used was descriptive, including an overview of Slovenian and foreign professional literature, obtained from the library of the Zdravstvena fakulteta in Ljubljana, and the Osrednja knjižnica Mozirje library, as well as sources online. The second method used was research work where we compared the demonstrations of anatomic structures of the lumbar spine when positioned at different angles with the help of the phantom. Results: The intervertebral space in the PA view is more open. The PA view shows more unified structures of the body at L1 and L2 compared to the AP view. With the extension of the angle comes an extended magnification of the left side, which is lifted more from the support in every following radiograph. The width of the vertebra changes with every imaging, the biggest deviation being at 10° and 30°. We discern that in the basic position the right spinous process is longer than the left one, the smallest difference between them being at 5° support. The sacroiliac joints begin to rotate. The rotation is also visible in cruciate ligaments which tend to move to the supported left side. The right SIS is overlapped in all radiographs and it is closed, while the left one opens up to 20°, then it overlaps and closes. The spinous process of the lumbar vertebrae, when supported, tends to move to the left side. Up to 30°, the spinous process is visible on the body of the vertebra at a bigger angle, however, it is visible from the oblique view. Discussion and conclusion: The anatomic structures are shown differently even when dealing a small change in the position of the phantom or the angle. The increase of the angle between the support and the phantom causes bigger and bigger distortion of size and shape, the radiographs are not symmetrical anymore. The precise setting of the patient is important by doing so, we reduce the radiation dose and enable the radiographs to be evaluated and read qualitatively.

Hrbtenica in trup sta pomembna člena kinetične verige človeškega telesa. Hrbtenica nudi osrednjo oporo skeletu in ščiti hrbtenjačo, medtem ko stabilen trup omogoča mobilnost okončin in skrbi za prenos energije preko telesa med gibanjem. Ključni dejavniki, ki določajo stabilnost trupa, so: anatomska zasnova telesa, lastnosti mišično-tetivnega sistema in delovanje upravljalnega sistema. Upad stabilnost trupa lahko negativno vpliva na športno zmogljivost in privede do nastanka poškodb. Med pomembnejše dejavnike, ki lahko zmanjšajo stabilnost, sodi upad mišične zmogljivosti po dolgotrajnem in visoko intenzivnem izvajanju gibalnih nalog. Slednje bi lahko v grobem delili na (i) gibalne naloge, pri katerih prihaja do izoliranega obremenjevanja predelov telesa, kot na primer med izoliranimi krepilnimi vajami, in (ii) gibalne naloge, pri katerih prihaja do povečane aktivnosti celotnega telesa in podpornih sistemov, kot je tek. Čeprav so v literaturi znani nekateri učinki lokalnega upada mišične zmogljivosti na aktivnost mišic trupa med stabilizacijskimi odzivi na pričakovano in nepričakovano motnjo drže, učinkov teka na slednje ne poznamo. Z vidika priprave varne in učinkovite športne vadbe bi bilo smiselno poznati učinke obeh tipov gibalnih nalog na stabilnost trupa. S tem namenom smo v naši študiji preverjali učinek lokalnih krepilnih vaj za mišice trupa in srednje do visoko intenzivnega teka na stabilizacijske odzive mišic trupa med predpripravljenimi prilagoditvami drže in refleksnimi odzivi. V študiji je sodeloval 101 preiskovanec. Razdeljeni so bili v dve skupini. V prvi skupini (TEK) (51 preiskovancev, 20 žensk in 31 moških, 1,78 ± 3,2 m 73,5 ± 6,8 kg 24,5 ± 2,2 let), smo preverjali učinke 12-minutnega srednje do visoko intenzivnega teka in v drugi skupini (MOČ) (50 preiskovancev, 29 žensk in 21 moških, 1,74 ± 2,9 m 71,5 ± 5,9 kg 24,7 ± 3,1 let) učinke lokalnih krepilnih vaj za upogib, izteg in oba stranska upogiba trupa. Preiskovanci so pred in po utrujajoči gibalni nalogi izvedli sklop naslednjih meritev meritve predpripravljenih prilagoditev in refleksnih odzivov mišic trupa na motnjo drže, meritve ravnotežja med sedenjem na nestabilni podlagi, aktivne repozicijske napake v smeri predklona trupa in meritve največjega zavestno proizvedenega navora v smeri iztega in upogiba trupa. Gibalni nalogi sta imeli statistično značilno različen vpliv na upad največjega navora v smeri iztega in upogiba trupa. V skupini MOČ se je ta znižal v smeri iztega in upogiba trupa, česar nismo zasledili v skupini TEK. Sprememb v največjem navoru v nobeni od skupin niso spremljale spremembe v vrednostih integriranega elektromiografskega signala. Ravno tako v nobeni od skupin ni prišlo do sprememb v aktivni repozicijski napaki trupa. Hitrejši pričetek mišične aktivnosti med refleksnim odzivom smo v skupini MOČ opazili za zunanjo poševno trebušno mišico. Med predpripravljenimi prilagoditvami drže je prišlo do skrajšanja latenc preme trebušne mišice v skupini TEK in zunanje poševne trebušne mišice v skupini MOČ. Spremembe vrednosti integriranega elektromiografskega signala med predpripravljenimi prilagoditvami drže in refleksnimi odzivi nismo zasledili. Ravno tako v teh dveh nalogah ni prišlo do značilnih sprememb v velikosti pomika skupne točke pritiska telesa na podlago. Med sedečo ravnotežno nalogo so se v skupini TEK zmanjšale vse hitrostne in amplitudne spremenljivke in v skupini MOČ vse frekvenčne spremenljivke. V skupini MOČ je po gibalni nalogi prišlo tudi so povečanja hitrosti in amplitude gibanja skupne točke pritiska v medialno-lateralni smeri. Povezanost med velikostjo sprememb posameznih spremenljivk se je razlikovala med obema skupinama, kar nakazuje na specifične odzive na gibalno nalogo. Rezultati študije nakazujejo, da uporabljeni gibalni nalogi povzročita značilne spremembe v stabilizacijskih strategijah mišic trupa, ki so odvisne od narave gibalne naloge. V skupini TEK smo zaznali specifične spremembe v mišicah, ki med tekom skrbijo za koordinirano gibanje medenice in prsnega koša, medtem ko smo v skupini MOČ zaznali predvsem strategijo hitrejše aktivacije mišic trebušne stene, ki pomagajo dodatno stabilizirati hrbtenico. V skupini TEK se je izboljšalo tudi ravnotežje med sedečo gibalno nalogo, medtem ko je v skupini moč prišlo do upada te sposobnosti. Pridobljeni podatki nakazujejo, da ima lahko izvajanje lokalnih krepilnih vaj za mišice trupa izvedene do odpovedi negativne učinke na stabilnost trupa, nasprotno je imel tek pozitivne učinki na stabilnost trupa. Izsledki naše študije omogočajo pomemben prenos izhodišč v športno prakso z namenom preventivnega delovanja in izboljšanja športne zmogljivosti. Spine and trunk are important parts of the human kinetic chain. The spine represent the central axis of the skeletal system and is responsible for protecting the spinal cord. Stabile trunk on the other hand enables mobility of the limbs and is responsible for transferring forces between the limbs during movement. Key elements defining trunk stability are passive, active and controlling systems. Decreased trunk stability can have detrimental effects on athletes performance and can lead to injury. One of such factors causing decreased stability is a decrease in muscle performance resulting from a strenuous physical activity. In general these could be divided into (i) isolated loading of individual body parts such as during resistance training and (ii) general, whole body activities such as running. There are some reports in the literature, how local decrease in the ability to produce force affects trunk muscle responses during anticipatory postural adjustments and reflex responses. However, no such reports can be found on the effects of running interventions. Coaches and athletes need to be familiar with the effects of such activities on trunk function in order to be able to prepare safer and more effective training regimes. The purpose of this study was to analyse the effects of local strengthening exercises performed to exhaustion and 12-min middle-to-high intensity running on trunk stabilizing functions. One hundred and one participants were divided in two groups. In the first group (51 participants, 20 women and 31 males, 1,78 ± 3,2 m 73,5 ± 6,8 kg 24,5 ± 2,2 years), the effects of 12-min middle-to-high intensity running were studied. In the second group (50 participants, 29 women and 21 males, 1,74 ± 2,9 m 71,5 ± 5,9 kg 24,7 ± 3,1 years), the effects of localized strengthening exercises on trunk stabilizing functions were studied. Before and after the intervention, following tests were performed measures of anticipatory postural adjustments and reflex responses, balance during sitting on an unstable surface, trunk repositioning error and maximal voluntary contraction during trunk flexion and extension. Local intervention has had an effect on the ability to develop maximal voluntary force in trunk extension and flexion, however no such changes were observed after running. No changes in integrated electromyogram during maximal voluntary contractions were observed. The trunk repositioning error also stayed unchanged following both interventions. Changes in the muscle activation latency during RR after running were observed in the obliquus externus, accompanied by changes in the latency average concurrent differences of trunk extensors. During anticipatory postural adjustments changes in latencies of the rectus abdominis were observed after running and of the obliquus externus after performing local strengthening exercises. No changes in the integrated electromyogram were observed after neither of the two interventions. No changes in the movement of the center of pressure during anticipatory postural adjustments and reflex responses were observed. However prominent changes were present for balance during sitting on unstable surface. Velocity and amplitude of the center of pressure movement in anterior-posterior and medial-lateral direction changed after performing a running protocol and all frequency parameters as well as medial-lateral velocity and amplitude after performing local strengthening exercises. Correlation analysis between the change-size for all parameters differed between the two groups. The results of this study show, that the two interventions used cause intervention specific changes in the selected trunk stability indicators. After running, specific adaptations were observed, that could be caused by demands for coordinating pelvic and upper-body movement during running. On the other hand, local trunk muscle strengthening exercises cause earlier activation of the abdominal muscles, possibly indicating their compensatory role following fatigue of trunk musculature. In addition, running improved balance during sitting balance tasks, and local trunk strengthening exercises had the opposite effect. Data from this study indicate, that strength training of the trunk muscles could have detrimental effects on trunk stability and spinal health. On the opposite, running proved to have some positive effects on trunk stability. These results land some important guidelines for preparing safer and more effective workouts.

Uvod: Ena najpogostejših deformacij hrbtenice, s katero se srečujemo, je skolioza. Najlažje jo opišemo, če govorimo o dimenzionalni ukrivljenosti hrbtenice v vseh treh ravninah. Deformacijo glede na določene parametre lahko zdravimo operativno ali konzervativno z uporabo različnih spinalnih ortoz. Ravno elastična TriaC ortoza je tista, ki je v nekaterih primerih najbolj primerna oblika za konzervativno zdravljenje le-te. Njen prvoten cilj je zmanjšanje progresije deformacije in krivine poravnavati v normalen anatomski položaj. Namen: Namen diplomskega dela je predstaviti konstrukcijo elastične korekcijske spinalne ortoze TriaC, njeno učinkovitost pri zdravljenju skolioz skozi čas na podlagi predhodno opravljenih raziskav. Metode dela: Za izdelavo diplomskega dela smo uporabili opisno oziroma deskriptivno metodo zbiranja literature s pomočjo domačih in tujih virov. Izbrano literaturo smo pridobili preko mednarodnih baz podatkov z uporabo ključnih besed. Izbirali smo jo glede na časovni okvir 2008–2018, ker pa je ortoza TriaC bila nekoč bolj uporabljana in raziskovana, smo uporabili tudi starejše klinično pomembne študije. Rezultati: Na temo TriaC ortoze smo našli štiri uporabne članke, katere smo medsebojno primerjali in predstavili. Za boljšo primerjavo smo uporabili drugo različico elastičnih spinalnih ortoz – SpineCor ortozo. Razprava in sklep: TriaC ortoza je ena izmed fleksibilnih dinamičnih ortoz, ki je bila razvita z namenom udobja, kozmetike in možnostjo nadzora med samo uporabo. Njena prepoznavna lastnost je ustvarjanje neprekinjenih korekcijskih sil na hrbtenico v vseh položajih in s tem doseganje korekcije, ki ni le posledica delovanja zunanjih sil, ampak tudi notranjih sil, ki jih ustvarijo mišice. Je edina ortoza, ki se začne graditi od glavne zgornje krivine navzdol. Ortoza je najbolj primerna za korekcijo lumbalnih krivin, manj za torakalne in dvojne krivine. Večji pozitivni učinek kaže na področju kozmetike, prilagodljivosti in udobja v primerjavi z ostalimi rigidnimi ortozami. Introduction: One of the most common spinal deformations we encounter is scoliosis. It is easiest to describe it if we speak on the dimensional curvature of the spine in all three planes. We can treat deformation with regards to certain parameters operatively or conservatively with the use of various spinal orthoses. Especially TriaC brace is the one which is the most appropriate form in some cases to treat the spine conservatively. Its primary goal is to reduce the progression of deformation and to align the curvatures into a normal anatomic position. Purpose: The purpose of the bachelor’s thesis is to present the construction of the elastic correctional spinal orthosis TriaC, its efficiency in the treatment of scolioses through time on the basis of the previously performed research. Methods: In order to produce the bachelor’s thesis, we used the descriptive method of collecting literature by means of domestic and foreign sources. The selected literature was collected through the international databases by the use of keywords. We selected it with regards to the timeframe 2008-2018. Because the TriaC brace was more used and researched in past, however, we also used older clinically relevant studies. Results: We found four useful articles on the topic of the TriaC brace. We compared them and presented them. For a better comparison, we used the second version of the elastic spinal orthoses – the SpineCor orthosis. Discussion and conclusion: TriaC brace is one of the flexible dynamic orthoses which was developed with the purpose of the comfort, cosmetics, and the option of control between the uses. Its recognizable characteristic is creating continuous correctional forces on the spine in all the positions and thus achieving the correction which is not only a consequence of outer forces but also internal forces which are created by muscles. It is the sole orthosis which begins building from the main upper curvature downwards. The orthosis is the most appropriate for the correction of lumbar curvatures. It is less appropriate for thoracic and double curvatures. The larger positive effect is shown in the field of cosmetics, adjustability, and comfort in comparison to other rigid orthoses.

Uvod: Delo reševalcev vključuje tudi posredovanje pri prometnih nesrečah. Različni mehanizmi poškodb vozil privedejo do različnih oblik poškodb udeležencev v vozilu. Pomembno je, da po poškodbi pacientu zavarujemo vratno hrbtenico in celotno hrbtenico, da ne pride do dodatnih poškodb, ki lahko posamezniku povzročijo trajne posledice. Za varovanje hrbtenice je v reševalnih vozilih mnogo različnih pripomočkov za imobilizacijo. Ker gre v večini primerov za poškodovance v sedečem položaju, je za uporabo najprimernejši steznik za imobilizacijo hrbtenice v sedečem položaju. Namen: V diplomskem delu so predstavljene metode in uporaba pripomočkov za imobilizacijo hrbtenice v Sloveniji in vloga medicinske sestre pri uporabi pripomočka. Poudarek je na uporabi steznika za imobilizacijo poškodovanca v sedečem položaju. Metode dela: Uporabljena je deskriptivna metoda dela, ki zajema pregled domače in tuje literature. Pregled strokovne literature, zbornikov ter znanstvenih in strokovnih člankov je bil opravljen v obdobju od aprila do junija 2018. Z uporabo Kooperativnega bibliografskega sistema smo pridobili ustrezne domače znanstvene članke. Pregled tuje strokovne literature v angleškem jeziku je bil opravljen prek bibliografskih podatkovnih baz Science Direct, Cinahlin in Medline. Rezultati: Pomembno je, da se vsi imobilizacijski pripomočki nameščajo pravilno in na način, da se poškodovancu ne povzroči dodatne škode, bolečin ali trajnejših posledic. Glede na poškodbe vratne hrbtenice ali hrbtenice se lahko z nepravilnim pristopom ali nepravilnim nameščanjem imobilizacijskih pripomočkov povzroči več škode kot koristi. Obravnava poškodovana v sedečem položaju ni nič drugačna kot v drugih položajih. Kadar je poškodovanec kritično življenjsko ogrožen, je pomembno, da ne izgubljamo časa z nameščanjem imobilizacijskih pripomočkov, ampak se odločimo za hiter izvlek poškodovanca in nudenje nujne medicinske pomoči. Razprava in sklep: Nameščanje različnih vrst imobilizacijskih pripomočkov je postopek, ki pripomore, da se poškodovanca pri premikanju ne poškoduje dodatno. To je pomembno tudi pri poškodovancih, ki se po poškodbi nahajajo v sedečem položaju. Pravilna izbira, pravilno nameščanje in pravila uporaba so pomemben del oskrbe poškodovancev. Introduction: The work of paramedics consists of interventions to traffic accidents. Different types of accident mechanisms lead to different types of injuries. It is important that we immobilize the cervical as well as the whole spine in order to prevent permanent disability. We have different types of immobilization devices for this purpose. Most of the traffic accident victims are in a sitting position, so we often use the sitting position imobilization device. Purpose: The purpose of this paper is to present the methods and the use of spinal immobilisation devices in Slovenia. Methods: The thesis uses a descriptive method, an overview of domestic and foreign literature. The review of literature and articles in scientific publications was conducted from April to June 2018. We used the bilbliographical system to obtain relevant articles. The review of foreign literature was conducted using ScienceDirect, Cinahl, and Medline. Results: It is important for the immobilisation devices to be properly placed in order to not inflict further damage to the patients' health and to aviod causing pain. Every minute counts. In the case of spinal injury, improper immobilisation device placement can cause more harm than good. Even if the possibility of spinal injury is minor, proper immobilisation can prevent spinal damage. In the event of critically endangered patients it is important not to waste time, so we use a quick extrication of the patient and provide proper first aid. Discussion and conclusion: The application of different kinds of immobilisation devices is a procedure that prevents further health risks for injured patients. The correct choice, application and use of immobilisation devices is an important part of patient care.

Namen magistrskega dela je bil ugotoviti vpliv vadbe na telesno držo v osmih tednih. V raziskavi sta sodelovali dve merjenki, stari 24 in 49 let. Na začetku smo izvedli anketo, v kateri smo spraševali po njunih splošnih značilnostih, počutju doma in na delovnem mestu ter zadovoljstvu s samim seboj in načinom življenja. Izvedli smo klinično opazovanje drže in testiranje z metodo FMS, na podlagi katerih smo sestavili 8-tedenski program vaj. Vadba je potekala doma. Posamezna vadbena enota je bila sestavljena iz dinamičnega ogrevanja, gimnastičnih vaj, vaj za razvoj moči in gibljivosti ter vaj stabilizacije in ravnotežja. Merjenki sta vadili dvakrat tedensko 8 tednov. Na koncu vadbenega procesa smo spet opravili anketo in vsa testiranja ter jih primerjali z rezultati začetnega testiranja. Na podlagi dobljenih rezultatov smo sklepali o vplivu vadbe na telesno držo. Po celotnem vadbenem procesu je bilo ugotovljeno, da so se začela prva izboljšanja v telesni drži, kar je vidno iz kliničnega opazovanja telesne drže, vendar pa do velikih sprememb ni prišlo, saj je bilo obdobje vadbe relativno kratko. Je pa subjektivna ocena telesne drže, ki smo jo dobili s pomočjo ankete in samoocene merjenk, pokazatelj uspešnosti vadbe. Ugotovljeno je bilo izboljšanje gibalne učinkovitosti, ki smo jo izmerili s pomočjo testov FMS, katerih rezultati so bili več kot 100 % boljši kot na začetku. Na začetku testiranja sta dosegli 5 in 8 točk od 21, na koncu pa sta jih obe dosegli 20. Izboljšali so se tudi počutje, samopodoba, samozavest in energija obeh merjenk. Tako je 8-tedenski program vadbe pozitivno vplival na začetek izboljšanja telesne drže kot tudi na njun način življenja. Sklepamo lahko, da funkcionalna vadba pripomore k izboljšanju telesne drže, vendar je za to potrebno več kot 8 tednov. The purpose of the master’s thesis was to determine the impact of exercise on the body posture within eight weeks. Two testers, one 24 and the other 49 years old were included in the study. Initially we conducted a survey in which we asked about their general characteristics, feeling at home and at the workplace, the overall satisfaction with themselves and their way of life. We did clinical observation of body posture and FMS testing, on the basis of which we have drawn up an 8-week exercise program. The exercises were taking place at home. Each exercise unit consisted of dynamic warming, gymnastic exercises, exercise for the development of strength and flexibility, stabilization exercise and balance. The testers had practice twice a week for eight weeks. At the end of the training process, we performed the survey and all the tests again and compared them with the results of the initial testing. On the basis of the obtained results, we concluded the effect of exercise on the body posture. After the entire exercise process, the first improvements in body posture began, which was evident from the clinical observation of the body posture, but no major changes occurred since the training period was relatively short. However, a subjective assessment of the body posture, obtained through a survey and self-test is an indicator of performance of the exercise. An improvement in the movement efficiency was measured using FMS tests, and the results were more than 100 % better than in the beginning. At the beginning of the test, they reached 5 and 8 points out of 21, and at the end, they both reached 20. The feeling, self-esteem, self-confidence and energy of both testers also improved. Thus, the 8-week exercise program had a positive effect on the improvement of the body posture as well as in their lifestyle. We can conclude that functional exercise helps to improve the body posture, but the training process has to be longer than 8-weeks.

Uvod: Skolioza je strukturna deformacija hrbtenice, pri kateri so značilne tri spremembe: ukrivljenost dela hrbtenice ali cele hrbtenice vstran, torzija ali vrtenje posameznih vretenc in rotacija hrbtenice okoli vzdolžne osi. Rentgensko slikanje skolioze naj vključuje področje od baze lobanje do vrha črevnic, v postero-anteriorni (PA) projekciji, da lahko preprečimo preveliko radiacijo senzitivnih organov. Namen: Namen projektne naloge je primerjava protokolov med radiološkimi oddelki v Sloveniji pri slikanju skolioze. Metode dela: Za pridobitev rezultatov smo uporabili deskriptivno metodo: anketo in pregled literature. Literaturo smo nato primerjali z rezultati ankete in glede na priporočila skušali sestaviti najbolj optimalen protokol za slikanje skolioze. Rezultati: Med rezultati so predstavljeni rezultati ankete, ki smo jo poslali na vse radiološke oddelke slovenskih bolnišnic, kjer slikajo celotno hrbtenico po programu za skoliozo. Rezultati tako prikazujejo različne parametre, s katerimi radiološki inženirji na teh oddelkih slikajo celotno hrbtenico po programu za skoliozo. Razprava: Slikanje celotne hrbtenice se po radioloških oddelkih slovenskih bolnišnic glede na pregledano literaturo najbolj razlikuje pri uporabi projekcij, saj vsi anketirani slikajo preiskovance v antero-posteriorno (AP) projekciji, vendar je glede na literaturo in priporočila slikanje v projekciji PA boljše, saj s tem ščitimo radiosenzibilna tkiva. Anketiranci uporabljajo različne razdalje gorišče‒slikovni sprejemnik, vendar je razdalja odvisna od detektorskega sistema, ki je v uporabi, fokusa rešetke ter velikosti prostora, kje se izvaja diagnostika. Zaključek: Rezultati tokratne raziskave bodo omogočili optimizacijo radiološkega posega – rentgenskega slikanja hrbtenice po programu za slikanje skolioze, s čimer bodo preiskovanci v bodoče pri tej preiskavi prejeli nižjo dozo sevanja. Introduction: Scoliosis is a structural deformation of the spine, characterized by three changes: the curvature of a part of the spine or the entire spine sideways, the torsion or rotation of the individual vertebrae and the rotation of the spine along the longitudinal axis. X-ray imaging of scoliosis should include the area from the base of the skull to the tip of the ilia, in the posterior-anterior (PA) projection, in order to prevent excessive radiation of sensitive organs. Purpose: The purpose of this project is to compare protocols for imaging scoliosis between radiological departments in Slovenia. Methods: The descriptive method, a survey and literature review, was used to obtain the results. We then compared the literature with the results of our survey and according to recommendations we tried to draw up the most optimal protocol for imaging scoliosis. Results: In our results section we show the findings of our survey, which was sent to all the radiological departments in Slovenia, where the whole spine is imaged for scoliosis. The results thus illustrate the various parameters by which the departmental radiology engineers image the spine for scoliosis. Discussion: With regards to our literature review, imaging of the entire spine within radiological departments of Slovenian hospitals differs the most in the use of projections. Their responses indicated that most scoliosis imaging is in the anterior-posterior (AP) projection, whereas the literature and recommendations suggest the PA projection to be a better choice, since the radiosensitive tissues are protected. The respondents use different focal point-to-pixel distances, but the distance depends on the detector system in use, the focus of the grid and the size of the space where the diagnostics are performed. Conclusion: The results of this research will enable the optimization of radiological interventions – X-ray imaging of the spine for scoliosis diagnosis, which will allow the subject to receive a lower dose of radiation in the future.

Ljudje smo se prilagodili tehnološkim spremembam in se poenotili s sedečim načinom življenja. Vse več časa preživljamo na delovnem mestu in zanemarjamo zdravje s tem, ko večino dneva presedimo v nepravilnih položajih. Ti lahko imajo negativne učinke na mentalno in fizično zdravje, ki jih lahko odpravimo ali zmanjšamo z redno telesno dejavnostjo. Diplomska naloga je monografskega tipa, zato smo opravili pregled literature in raziskav na izbrano temo. Predmet in namen dela sta bila predstaviti problematiko delovnega mesta in negativne posledice, ki jih prinaša prekomerno sedenje. Opredelili smo tudi optimalni položaj sedenja med delom in načine razbremenitve telesa med delom. Prav tako je bil cilj diplomskega dela opisati vpliv promocije telovadbe in zdravega načina življenja in opredeliti pozitivne učinke telovadbe na delovnem mestu. Ugotovljeno je bilo, da pozitivni učinki telovadbe na delovnem mestu segajo na fizično in mentalno področje. Telovadba je zmanjšala bolečine mišično skeletnih struktur, predvsem v ledvenem delu hrbtenice, ramenih in vratu. Mnogi preiskovanci so prav tako zaradi vadbe med delom povečali telesno aktivnost v prostem času in izboljšali sestavo telesa. Raziskave opisujejo znižanje deleža maščobe in holesterola v telesu, mnoge pa poročajo o izgubljenih kilogramih in obsegu okoli pasu. Posledično se je znižalo tudi tveganje za sladkorno bolezen. Poleg fizičnega zdravja, raziskave poročajo o izboljšanem počutju, produktivnosti in manjšem deležu bolniške odsotnosti. People have adjusted to technological changes and accepted a sedentary way of life. Nowadays, we spend most of our time at work and neglect our health by sitting throughout most of the day. Many times, we do it in an incorrect position which is not optimal for our health. This causes many negative effects on our mental and physical health, which can be minimalised with a regular physical activity. The thesis is a monographic type. We reviewed literature and research focusing on the chosen subject. The purpose of the thesis is to present issues of a modern workplace and its negative effects. Moreover, we defined the optimal sitting position during work and ways to relieve tension in the body. Lastly, one of our main goals was to describe the promotion of worksite health and exercise and to define positive effects of workplace exercise. It was discovered that positive effects of exercise include improvement in both mental and physical health. Exercise decreases pain in musculoskeletal structures, mostly in lumbar spine, shoulders and neck. Many volunteers who did workplace exercise, increased the physical activity in their free time as well, thus there are findings of many pupils improving their body composition. Studies also show lower fat and cholesterol percentage and many people report losing weight and inches around waist. In addition, the weight drop reduces the risk of developing type 2 diabetes. Besides physical health benefits, studies show lower work absenteeism and improvements in productivity and overall well-being.

Uvod: Hrbtenica nam omogoča gibanje telesa in pokončno držo. Bolečino v hrbtenici je vsak izmed nas doživel najmanj enkrat v življenju. Torakolumbosakralne ortoze so vrsta spinalnih ortoz, ki se pri zdravljenju hrbtenice uporabljajo kot imobilizacija pri konzervativnem zdravljenju poškodb, degenerativnih bolezni in kot podpora po operativnih posegih. Degenerativne bolezni hrbtenice (predvsem hernija medvretenčne ploščice) so ena izmed najpogostejših težav v ledvenem delu hrbtenice, ki prizadene veliko ljudi. Spondiloliza in spondilolisteza se največkrat pojavita pri otrocih in mladostnikih, ki so športno preveč aktivni. Namen: Namen diplomskega dela je ugotoviti, kje in kdaj se uporabljajo torakolumbosakralne ortoze in kako so športne aktivnosti povezane z bolečinami v hrbtenici. Metode dela: V diplomskem delu je bila uporabljena deskriptivna metoda s pregledom literature. Vključene so bile tudi naslednje strokovne baze podatkov: MEDLINE, DiKuL, Google učenjak, PubMed, Cobiss in ScienceDirect. V diplomsko delo je bila vključena literatura izdana med letom 1990 in 2016, v angleškem, slovenskem in hrvaškem jeziku. Rezultati: Torakolumbosakralne ortoze se največkrat predpisujejo takrat, kadar so prisotne deformacije hrbtenice. K poškodbam hrbtenice pripomorejo tudi različne športne aktivnosti, pri katerih prihaja do prekomernih obremenitev hrbtenice. Največ poškodb terja gimnastika zaradi specifičnih gibov, ki so prisotni pri izvajanju. Razprava in zaključek: Najpogosteje je za zdravljenje deformacij hrbtenice predpisana rigidna (trda), po modelu narejena torakolumbosakralna ortoza. Pri poškodbah hrbtenice pa se predpisujejo tako rigidne, kot mehke TLSO. Večje in boljše učinke nudijo rigidne ortoze. Največ poškodb pri športnih aktivnosti se lahko opazi pri otrocih in mladostnikih. Ob pravilnem predpisu ortoze in upoštevanju navodil nošenja, so rezultati zdravljenja v velikih primerih pozitivni. Če konzervativno zdravljenje ni mogoče, so poškodbe ali deformacije prehude, je potrebna operacija. Pomembna je individualna obravnava vsakega pacienta, da je odločitev za predpis vrste ortoze pravilna. Izdelava torakolumbosakralnih ortoz se danes še vedno izvaja s pomočjo mavčnega odlitka pacienta. Ortotiki in protetiki se vse več poslužujejo tudi uporabe računalniško podprtega konstruiranja in računalniško podprte proizvodnje. Background: Spine allows movement of the body and upright body posture. Every one of us has experienced back pain at least once in a lifetime. Thoracolumbosacral orthoses are types of spinal braces used for immobilisation in conservative treatment of the spine in case of injury, degenerative diseases or as an addition to post-operative treatment. Degenerative diseases of the spine (especially spinal disc herniation) are one of the most common medical conditions in lumbar spine and it affects many people. Spondylosis and spondylolisthesis usually occurs with children and adolescents that are too active in sports. Objective: The purpose of the thesis was to determine the use of thoracolumbosacral orthoses and how sports injuries are related with back pain. Methods: The chosen descriptive method of work was systematic literature review. Literature was found on following web databases: MEDLINE, DiKuL, Google učenjak, PubMed, Cobiss and ScienceDirect and was published between 1990 and 2016 in English, Slovenian and Croatian language. Results: Thoracolumbosacral orthoses are usually prescribed when deformity of the spine is shown. Sports activities can cause injuries of the spine, because they put a lot of pressure on the spine. Most of the injuries in gymnastics occur because of the specific movement during the routine. Conclusions: Rigid, custom-made thoracolumbosacral orthosis is most commonly prescribed for spinal deformities. On the other hand both rigid and soft thoracolumbosacral orthoses are prescribed for spinal injuries. Results have shown that rigid orthoses have better effect. Incidence of sports injuries is bigger among children and adolescents. If the right orthosis is prescribed and the patient follows the instructions, the results of treatment are usually very good. If conservative treatment is not possible because the injury or deformity is to severe, surgery is required. Individual treatment is important for prescribing the correct and appropriate orthosis for the patient. Plaster cast are still used to make thoracolumbosacral orthoses. In addition orthotists and prosthetists use computer aided design and computer aided manufacturing system in the making of thoracolumbosacral orthoses.

Teoretična izhodišča: V diplomskem delu je predstavljena človekova telesna drža, ki je lahko nepravilna in pravilna. Na kratko smo opisali boleznsko ukrivljenost hrbtenice, kot so kifoza, lordoza, skoliotična drža, ploski in okrogel hrbet. Ustavili smo se tudi pri teži šolske torbe, poiskali vzroke in opisali pravilno sedenje. Ugotavljali smo vlogo medicinske sestre in zdravstveno vzgojno delo osnovnošolskih otrok in staršev. Metodologija raziskovanja: V empiričnem delu smo izvedli anonimno raziskavo med starši osnovnošolskih otrok v 3. in 5. razredu, ki je temeljila na kvantitativni metodologiji. Vprašalnik je zajemal 20 vprašanj zaprtega in odprtega tipa. Rezultate smo analizirali in sistematično uredili s pomočjo računalniških programov Microsoft Word in Microsoft Excel. Rezultati: Iz rezultatov raziskave smo ugotovili, da je večini staršev pomembna telesna drža otroka tako v 3. kot 5. razredu osnovne šole. Rezultati ankete so pokazali, da je teža šolske torbice absolutno pretežka glede na težo otroka tako v 3., kot v 5. razredu. Sklep: Starši so tisti, ki skrbijo in so odgovorni za zdravje svojih otrok. Žal je slovenski šolski sistem naravnan tako, da imajo šolarji dejansko pretežke šolske torbe, katere teža vpliva na njihovo ukrivljenost hrbtenice. Starši lahko vplivajo na zmanjšanje teže šolske torbe le s tem, da otroka opozorijo, da ne nosi v šolo stvari, ki jih tisti dan ne potrebuje in niso na urniku. Theoretical frame of reference: This diploma thesis deals with the human body posture, which can be either correct or incorrect. We briefly describe the different types of spine curvature disorders, such as kyphosis, lordosis, scoliosis, as well as the flat back and round back syndrome. An additional reference is made to the weight of the school bag, whereby we researched its causes and described the correct sitting position. We established the role of medical nurses as well as the importance of medical education of primary school children and their parents. Research methodology: In the empirical part an anonymous survey among parents of primary school children, attending the 3rd and 5th grade, was conducted, which was based on the quantitative methodology. The questionnaire consisted of 20 questions of open and closed type. The results were analysed and systematically categorised with the help of Microsoft Word in Microsoft Excel computer software programmes. Study results: The obtained results showed that most of the surveyed parents put great emphasis on their children’s posture (i.e. reference to 3rd and 5th grade). The results illustrate that the weight of the school bag is unquestionably too heavy for the weight of the children attending the 3rd and 5th grade. Conclusion: It is the responsibility of the parents to take full responsibility for the health of their children. Unfortunately, the school system is structured in a way which requires school children to carry schoolbags that are too heavy, which inevitably affects the curvedness of the spine. Parents can have a positive influence on reducing the weight of the school bag by reminding their children to only carry school requisites that they need that day in school

Gigabitno pasivno optično omrežje je optična omrežna tehnologija , ki se vedno bolj uveljavlja in uporablja po svetu. Na Kitajskem verjamejo, da je to tehnologija prihodnosti za optično dostopovno omrežje. Začelo se je z željo po uporabi enega vlakna za več uporabnikov, danes pa smo prišli do tega, da imamo običajno 64 uporabnikov z veliko pasovno širino, ki zadostuje še tako zahtevnim uporabnikom. Na drugi strani poteka evolucija mobilnih brezžičnih tehnologij in s tem tudi vedno večja potreba po nadgradnji hrbtenic oziroma dostopovnih omrežij baznim postajam. Poraja se možnost uporabe gigabitnega pasivnega optičnega omrežja kot dovod prometa LTE baznim postajam. V tem diplomskem delu je predstavljena tehnologija gigabitnega omrežja tehnologija LTE in njuna kombinacija. Na koncu diplomskega dela ugotovim, da tehničnih preprek ni in je samo še od operaterjev ter njihove politike odvisno kdaj se bodo tudi v Sloveniji začele spremembe v tej smeri. Gigabit-capable Optical Network (GPON) is becoming more and more common and used around the world. In China, they believe that this is the future technology for the optical network. It began with the desire to use one fibre for multiple users. Today we normally have 64 users with large bandwidth and it is sufficient even for the most demanding users. However, there is also the evolution of mobile wireless technologies and the growing need to upgrade backbones and access network's base station. It raises the possibility of using GPON as a supply LTE base station. In this work, I explain what is GPON and what is LTE separately and I examine options on how we could use these technologies in a combination. At the end of this work, I come to the conclusion that there are no technical barriers and that it depends only on the operators and their policy for a change in that direction to be made.

V diplomskem delu bomo predstavili hernijo diska, vzroke za nastanek, zdravljenje ter vlogo medicinske sestre. Bolečine v hrbtenici so v današnjih časih zelo pogost problem, celotne populacije. Način življenja in starost sta glavni vzrok za degenerativne spremembe hrbtenice, predvsem medvretenčne ploščice. Hernija diska pomeni zdrs medvretenčne ploščice iz vretenca in sicer kot posledica degenerativnih sprememb. Hernija najpogosteje nastane v ledvenem segmentu hrbtenice. Pojavijo se bolečine, ki predstavljajo veliko breme za pacienta in ga omejujejo pri vsakodnevnih aktivnostih. Pacienta je potrebno zdraviti. Medicinska sestra je tista, ki ima pomembno vlogo pri negovanju pacienta, saj sodeluje od začetka zdravljenja pa do popolne ozdravitve pacienta. Skrbi za pacientove aktivnosti, mu nudi podporo, sodeluje pri rehabilitaciji in deluje zdravstveno vzgojno. Uporabili bomo deskriptivno metodo dela. Podatke za izdelavo empiričnega dela bomo pridobili na osnovi študije primera pacienta po operaciji discus hernie. Podatke bomo zbirali s pomočjo intervjuja o pacientu, ki smo ga oblikovali po funkcionalnih vzorcih zdravega obnašanja Marjory Gordon, ter pacientove medicinske dokumentacije. In my thesis I will describe the herniated disc, reasons for its occurrence, treatment and the role of a nurse. Pain in the back is today a common issue of the population. The modern way of life and high age are the most often cause for degenerative changes of the spine, especially the intervertebral disc. Herniated disc is the slipping of the intervertebral disc from the vertebra as a result of degenerative changes. Usually, hernia occurs in the lumbar area of the spine. Pain arises, what is a heavy burden and limits the patients in carrying out their daily activities. A nurse has an important role in patient treatment, since he or she is involved in the process from the beginning of the treatment until the successful recovery. The nurse takes care for patient's activities, offers support, aids with rehabilitation and acts in a healthy and educational manner. We will use the descriptive method of work. Data for the empirical part will be gained on a role example of a patient after a herniated disc surgery. Data will be also acquired in form of an interview with the patient in line with the functional health patterns provided by Marjory Gordon and the patient's medical documentation.

Uvod: Bolečina v lumbalnem predelu predstavlja pogosto zdravstveno težavo med zdravstvenim osebjem. Z raziskavo smo želeli ugotoviti, kako pogosto se bolečine v križu pojavljajo pri zdravstvenem osebju, in sicer v povezavi z izbranimi dejavniki tveganja. Metode: Raziskava temelji na neeksperimentalni kvantitativni metodi empiričnega raziskovanja. Uporabili smo vprašalnik zaprtega tipa o bolečini v križu, ki ga je izpolnilo 89 zdravstvenih delavcev v Splošni bolnišnici Jesenice in domu upokojencev na področju Gorenjske. Za ugotavljanje statistično značilnih razlik med skupinami smo uporabili test χ2 in enofaktorsko analizo variance. Rezultati: Bolečina v križu se pri 40,4 % zdravstvenega osebja pojavlja večkrat na mesec, najpogosteje pri bolničarjih (p = 0,001) in zaposlenih na negovalnem oddelku (p = 0,006). Povprečno traja manj kot en teden (43,8 %). Dejavnik, ki je z njo najbolj povezan, je dvigovanje in prenašanje bremen (x = 4,5). Glede izobraževanj s področja bolečine v križu in pravilnega dvigovanja bremen obstajajo statistično značilne razlike med poklicnimi skupinami (p < 0,010). Diskusija in zaključek: Z bolečino so najbolj povezani dejavniki, ki nastanejo zaradi neposrednega fizičnega dela s pacientom. Potrebna so nadaljnja raziskovanja na reprezentativnih vzorcih, treba bi bilo izvesti tudi izobraževanja za zaposlene in uvesti nove pripomočke, ki bi jih zdravstveno osebje uporabljalo pri svojem delu s pacientom.

Diplomsko delo z naslovom Vpliv nekaterih gibalnih sposobnosti na pravilni razvoj hrbtenice pri otroku je teoretično delo. V njem smo z deskriptivno in komparativno metodo predstavili in opisali dosedanja spoznanja ter jih primerjali med seboj. Namen diplomskega dela je bil opisati pomen razvijanja gibalnih sposobnosti, s katerimi omilimo deformacije hrbtenice pojasniti, kako z načrtovano gibalno aktivnostjo pripomoremo k pravilnemu razvoju hrbtenice in posledično k pravilni telesni drži otrok predstaviti gibalne aktivnosti, ki omogočajo optimalno funkcijo hrbtenice ugotoviti vlogo in pomen mišic, predvsem krepkih hrbtnih, za pravilno rast, razvoj in izoblikovanost hrbtenice. Ugotovili smo, da z razvijanjem gibalnih sposobnosti lahko omilimo nastanek deformacije hrbtenice da z načrtovano gibalno aktivnostjo lahko pripomoremo k pravilnemu razvoju hrbtenice in posledično k pravilni telesni drži otrok da gibalne aktivnosti omogočajo optimalno funkcijo hrbtenice ter da so krepke hrbtne mišice pomembne za pravilno rast, razvoj in izoblikovanost hrbtenice. The diploma thesis titled The influence of some physical abilities on the proper development of child's spinal column is a theoretical paper, which describes and compares existing knowledge using descriptive and comparative methods. The aim of the thesis was to describe the importance of the development of physical abilities that mitigate a deformation of spinal column to explain how planned physical activity contributes to the correct development of the spinal column and to the proper posture among children to present physical activities which enable optimal spinal column’s functioning to describe the role and the importance of the muscles – mainly strong back muscles – for proper growth, development and shaping of the spinal column. It has been established that development of physical activities can mitigate the formation of spinal column deformation. Planned physical activity can contribute to the correct development of the spinal column and to the proper posture among children. Moreover, physical activities enable optimal spinal column’s functioning, and strong back muscles are important for proper growth, development and shaping of the spinal column.

Namen diplomskega dela je opisati obravnavo pacienta s spondilolistezo pred in po operativnem posegu ter opisati vlogo medicinske sestre. Spondilolisteza je posledičen zdrs vretenca naprej ali nazaj, kjer lahko privede do močnih bolečin in omejitev pri vsakodnevnem gibanju. V teoretičnem delu je predstavljena spondilolisteza in vzroki za njen nastanek, vrste spondilolistez, klinični pregledi in diagnostične preiskave ter celostna obravnava pacienta pred operacijo in po njej. V raziskovalnem delu smo obravnavali pacienta s spondilolistezo pred in po operacijskem posegu. Obravnava je potekala po enajstih funkcionalnih vzorcih Marjory Gordon. Obravnavali smo pacienta v Ortopedski bolnišnici Valdoltra. Podatke smo zbrali s pomočjo intervjuja s pacientom, merjenjem vitalnih funkcij, opazovanjem in ocenjevanjem pacientovega stanja, s preučevanjem medicinske in negovalne dokumentacije pacienta in pogovorom s člani zdravstvenega in negovalnega tima. Z analizo pridobljenih podatkov smo oblikovali negovalne diagnoze, si postavili negovalne cilje in načrtovane aktivnosti zdravstvene nege ter vrednotili zdravstveno nego in počutje bolnika. Ugotovili smo, da so najpogostejše negovalne diagnoze pri pacientu s spondilolistezo: Nevarnost infekcije Mobilnost, nepopolna telesna mobilnost (I. stopnja) Samonega, zmanjšana zmožnost za samostojno osebno higieno (I. stopnja) Samonega, zmanjšana zmožnost samostojnega oblačenja in osebnega urejanja (I. stopnja) ter bolečina (v spodnjem delu hrbtenice). The purpose of this study is to describe the treatment of a patient with spondylolisthesis before and after the surgery as well as describe the role of a nurse in the treatment. Spondylolisthesis is a displacement of a vertebra either forward or backward, which can lead to severe pain and restraint at everyday movement. The theoretical part presents the causes of spondylolisthesis and its origin, types of spondylolisthesis, clinical examinations and diagnostic tests as well as a comprehensive care for the patient before and after the surgery. In our research work we treated a patient with spondylolisthesis before and after the surgery. The treatment was done in accordance with Gordon’s eleven functional health patterns. We treated a patient in the OB Valdoltra hospital. We gathered information through interviews with a patient, measuring vital functions, monitoring and evaluating patient’s condition, by examining medical and nursing documentation of the patient and by talking to members of the medical and nursing team. With the analysis of the acquired data we made a nursing diagnosis, we set nursing objectives and planned activities of nursing care. We also evaluated the nursing care and welfare of the patient. We found that the most frequent nursing diagnoses for a patient with spondylolisthesis is: Risk for infection Impaired physical mobility (Level I) Self-Bathing-Hygiene Deficit (Level I) Self-Dressing-Grooming Deficit (Level I) Pain (in low back).

Nasloni za roke pri zadnjih avtomobilskih sedežih predstavljajo način sprostitve mišic in hrbtenice pri sedenju v avtomobilu. Uporabniku nudijo oporo ter možnost spreminjanja položajev med vožnjo. V diplomski nalogi smo opisali ergonomske in biomehanske dejavnike, ki so ključnega pomena za optimalno oblikovanje naslona za roke. S pomočjo ankete smo raziskali mnenja uporabnikov naslonov, z metodo opazovanja smo ugotovili aktivnost določenih mišic pri opravljanju različnih del med vožnjo na zadnjih sedežih, preučili pa smo tudi že obstoječe rešitve naslonov. Rezultat diplomske naloge je inovativna zasnova naslona za roke, ki je ergonomsko in biomehansko dovršen ter tako prijazen širokemu spektru uporabnikov. Armrests in the back seats of a car are modality of muscle and backbone relaxation when sitting in a car. They offer support and possibility of changing positions during driving. Ergonomic and biomechanical factors, which are essential for optimal design of armrest, are described in this diploma paper. We examined the opinions of users of armrests by using a survey, determined the activity of certain muscles when executing different operations during driving in the back seats by using method of observation, and examined already existing solutions of armchairs. Result of diploma paper is an innovative design of an armchair, which is ergonomically and biomechanically perfected and to a large extent user friendly.

Predmet obravnave diplomskega dela z naslovom Posebni pristopi k ozaveščanju učencev k zdravemu načinu ţivljenja s poudarkom na predmetu spoznavanje okolja je predstavitev osveščenosti učencev o zdravem načinu ţivljenja na področju prehrane, tekočin, higiene in gibanja. V prvem delu diplomskega dela so predstavljena teoretična spoznanja, ki se oblikujejo v psihološkem, pedagoško-didaktičnem in preventivno-zdravstvenem področju. Podrobneje smo predstavili pojme druţina, ki je steber vsake druţbe, razvojno obdobje otroka, prehrano, gibanje in sedeč način ţivljenja, ki predstavlja vedno večje tveganje za okvaro hrbtenice ţe pri otrocih. V nadaljevanju smo predstavili sklope Nacionalnega učnega načrta za spoznavanje okolja s stališča zdravega načina ţivljenja ter povezanosti tem in ciljev, ki so povezani z obstoječim ţivljenjskim slogom učencev. V empiričnem delu diplomskega dela smo analizirali raziskovalne podatke, pridobljene na vzorcu učencev prvega triletja dveh osnovnih šol celjske regije o poznavanju zdrave prehrane, njihovi gibalni aktivnosti v šoli in v domačem okolju ter morebitno pojavljanje teţav s hrbtenico in opozarjanje učiteljic na pravilno drţo med sedenjem. Rezultati prikazujejo, da so učenci ţe od 1. razreda dalje o zdravi prehrani dobro osveščeni, kar je rezultat učnih vsebin pri predmetu spoznavanja okolja. Manj pa je storjeno na področju gibanja v šolah, saj so večino časa v gibanju le učenci 1. razredov, od 2. razreda dalje pa učenci večino časa v šoli presedijo. Podobno je doma, saj skoraj 30 % anketiranih učencev preţivi popoldneve pred televizorjem ali računalnikom. Še posebej je zaskrbljujoč podatek, da se ţe pri učencih 3. razreda začno pojavljati bolečine v hrbtenici, kar pomeni, da bodo učitelji morali v prihodnje v učne ure pri vseh predmetih (ne samo ŠV in SPO) integrirati več gibalne aktivnosti s strani učencev. The subject of discussion in this diploma titled Special approaches ... (sama napiši ker se ne spomnim dobesednega prevoda) is a presentation of pupil awareness about a healthy way of life in the fields of nutrition, liquids, hygiene and movement. In the first part of the diploma theoretical results are presented which are formed in psychological, pedagogic-didactic and preventive-medical fields. The concept of a family which is a pillar of every society, child development stages, nutrition, movement and sitting way of life that present increasingly bigger risks for spine defects were presented in detail. In continuation a compound of National curriculum for environmental studies from a standpoint of healthy way of life and connection of themes and goals that are connected to existing life style of pupils were presented. In the empirical part the data of pupils from first triad of two primary schools in Celje region were analyzed, regarding healthy nutrition, their movement activity during classes and in home environment and potential spine problems with warnings of the teachers for appropriate posture during sitting. The results show that pupils from first grade on are well aware of healthy nutrition. Less is done in the field of movement in schools since only first grade students are in movement, from second grade on pupils are mostly in sitting position, as well as at home since almost 30% of pupils in this survey spend their afternoons in front of television or computer. Pupils of third grade begin to have spine pain which is worrying information and in the future teachers will have to integrate more movement activities for pupils in all subjects (not only in physical education and environmental studies).

Teoretična izhodišča: Hernija diska pomeni zdrk medvretenčne ploščice, ki najpogosteje nastane v ledvenem delu hrbtenice, predvsem zaradi degenerativnih sprememb. Najpogosteje se kaže z bolečino v križu, ki je še vedno eden najpogostejših vzrokov za obisk zdravnika in predstavlja velik zdravstveni in ekonomski problem. Bolnike omejuje pri vsakodnevnih aktivnostih in s tem vpliva na kakovost življenja. Le ti morajo spremeniti način življenja omenjeni bolezni in svojo hrbtenico neprestano varovati. Namen: Predstaviti obravnavo bolnikov s hernijo diska v ledvenem delu hrbtenice. Z raziskavo smo želeli ugotoviti, ali bolniki s hernijo diska varujejo svojo hrbtenico, kako jo varujejo in s katerimi težavami se srečujejo ti bolniki. Metode: V diplomskem delu smo uporabili deskriptivno metodo dela. Teoretična izhodišča smo predstavili s pomočjo analize literature. Za zbiranje podatkov smo kot raziskovalni inštrument uporabili anketni vprašalnik. V raziskavi je sodelovalo 30 bolnikov s hernijo diska obravnavanih v Zdravilišču Laško. Rezultati in diskusije: Podatki, ki smo jih pridobili z raziskavo, kažejo, da vsi bolniki varujejo svojo hrbtenico, vendar večji del bolnikov le ob prisotni bolečini. Srečujejo se z različnimi težavami, med katerimi prevladuje bolečina v križu, kar nas ne preseneča, saj je le-ta ena glavnih znakov hernije diska. Theoretical bases: A Spinal Disc Herniation is a medical condition affecting the spine, in which a tear in the outer, fibrous ring of an intervertebral disc allows the soft, central portion to bulge out. This tear in the disc ring is mostly caused by degenerative modifications. The most common form is Lumbar Disc Herniation, causing lower back pain and it is the most frequent reason to visit a doctor. It represents profound medical and economic problem. Patients with Lumbar Dics Herniation are limited in daily activities and this affects their quality of life. They need to change their way of life due to the condition and protect their spines constantly. Aim: To introduce treatment of patients with herniated disc. In research we wanted to determine if Lumbar Dics Herniation patients are protecting their spine, how they are protecting it and what difficulties they are confronting. Methods: Descriptive work method was used. Theoretical bases were presented with literature analysis. Data was collected by personal interviews. 30 patients with Lumbar Disc Herniation from Laško Health Resort participated in the research. Results and discussions: Data gained show that all patients protect their spine but most of them only when the pain is present. They are facing many different difficulties, lower back pain is prevailing. Lower back pain is anticipated for it is one of the most common symptoms of Lumbar Disc Herniation.

V diplomskem delu smo prikazali anatomijo, fiziologijo, patologijo, diagnostične metode in načine zdravljenja s poudarkom na zdravstveni negi bolnika s poškodbo hrbtenjače v ledvenem delu hrbtenice. Bolnik, ki je utrpel takšno poškodbo, potrebuje ob sebi negovalni in zdravstveni tim, ki mu bo stal ob strani, ko se bo soočal s svojo spremenjeno telesno podobo. Negovalni problemi so na področju vseh življenjskih aktivnosti, vendar jih zaradi možnosti zgodnje mobilizacije, kjer ima rehabilitacija pomembno vlogo, sodobnega znanja in pripomočkov lažje obvladamo. Tukaj se zdravstvena nega in rehabilitacija močno prepletata. Predstavili smo tudi komunikacijo z bolniki in njihovimi svojci. Medicinska sestra potrebuje zelo razširjeno in poglobljeno strokovno znanje, izkušnje in osebnostne lastnosti, ki omogočajo dobro komunikacijo in empatijo. Zdravstveno vzgojno delo se prične že v bolnišnici in je eden najpomembnejših poslanstev medicinske sestre. Z njo želi bolnike usposobiti za sodelovanje pri zdravljenju njihove bolezni in nadaljnje življenje. V diplomskem delu smo s pomočjo anketnega vprašalnika, ki smo ga razdelili 40 medicinskim sestram in zdravstvenim tehnikom v Enoti intenzivne medicine operativnih strok in na Travmatološkem oddelku Splošne bolnišnice Celje, ugotavljali pomen vključevanja zdravstvene nege v rehabilitacijo, komunikacije z bolnikom in svojci ter zdravstvene vzgoje. Pokazati smo želeli tudi, ali delo z bolniki, ki so utrpeli poškodbo hrbtenjače v ledvenem delu hrbtenice, stresno in fizično vpliva na medicinske sestre in zdravstvene tehnike. The subsequent work comprehends anatomical, physiological, diagnostic and therapeutic aspects of spinal cord trauma with special emphasis on nursing care for patients after lumbar spinal cord injury. Patients suffering this trauma need health and nursing care teams that would help them to overcome the healing process and to face themselves with their altering physical image. Nursing problems with theses patients are numerous, concerning many of patients vital activities. Using modern rehabilitation approaches, skills, techniques and devices, therapeutic goals become more efficently achieved. Therefore nursing care and rehabilitation activities applied on spinal patients should be strongly interconnected. Another important issue is communication with patients and with their relatives. Nurses are expected to have knowledge, experience and personal characteristics that are required for appropriate communication and empathy with these patients. Health care education and preparation for their future life should be stared during in-hospital stay and is one of the most important tasks carried out by the nurses. A questionnaire was distributed among 40 nurses working in surgical ICU and traumatological department of Celje General Hospital in order to investigate their vision on importance of incorporation of their nursing care activities in rehabilitation processes, on communication with patients and their relatives, and on health care education as part of an integral treatment of patients after lumbar spinal cord injuries. Questions about physical and psychological stress that nurses are exposed to when nursing these patients were also included in the study.

V diplomskem delu smo predstavili pomen, kompleksnost in specifičnost zdravstveno-vzgojnega dela medicinske sestre pri bolniku s poškodbo hrbtenice ter pomebno vlogo tega v procesu zdravljenja in rehabilitacije. In the first part of a diploma we have presented significance, complexity and specification of a nurse health- education work, when patients with spine injuries are concerned, and the importance of that task in a process of rehabilitation and medical treatment.