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Objectives: Levodopa/carbidopa intrajejunal gel (LCIG) is an effective therapeutic strategy to overcome levodopa-induced motor complications in advanced Parkinson's disease (PD). However, it requires invasive percutaneous endoscopic gastrojejunostomy (PEG-J) and may be associated with serious adverse effects (AE). In this study, we aimed to evaluate long-term AEs related to LCIG treatment in a large homogenous cohort of advanced PD patients. Methods: One hundred three consecutive PD patients were regularly monitored for LCIG-related, PEG-J-related, and device-related AEs up to 14 years. Incidence of AEs was studied in time applying a time-to-event analysis and Cox proportional hazard model with age, disease duration, gender, and recurrent AE as covariates. Health-related quality of life (HRQoL) was estimated at each visit and compared to HRQoL before the LCIG treatment. Results: Among 296 AEs noted, 48.8% were LCIG-related, 32.4% PEG-J-related, and 19.6% device-related. While most of the studied AEs steadily accumulated throughout the follow-up period, 24.3% of the patients (95% CI 10.1%–36.3%) experienced PEG-J-related AE already within the first days after the PEG-J insertion. Cox model revealed that older patients had higher probability of psychosis, PEG-J- and device-related AEs (p < .05, p < .05, and p = .02) and suggested increased recurrence risk in those with early PEG-J and device-related AEs. Despite relatively high incidence of AEs, HRQoL significantly increased in the follow-up period (p < .0001). Conclusion: AEs related to LCIG treatment are common. Therefore, careful patient selection and monitoring throughout the treatment is recommended, especially in those with early side effects. Nevertheless, LCIG significantly improves HRQoL in advanced PD patients on a long term.

Uvod: Staranje prebivalstva po celotnem svetu predstavlja velik družbeni problem. Starejši lahko prispevajo k družbi na različne načine. Veliko študij navaja, da starejši ljudje, ki živijo bolj aktivno in vsakodnevno samostojno izvajajo različne aktivnosti, živijo dlje od svojih vrstnikov. Cilj delovne terapije je usmerjen na odkrivanje smisla v že obstoječih okupacijah ali pridobivanju novih. Namen: Preučiti najnovejšo literaturo na temo okupacij, ki spodbujajo zdravo staranje. Opisati vpliv samostojne izvedbe okupacij na zdravje in dobro počutje starejših ljudi ter opredeliti vlogo delovnega terapevta pri spodbujanju zdravega staranja in ohranjanju okupacij. Metode dela: Izveden je bil sistematični pregled literature. Iskanje je potekalo med januarjem in marcem 2022 v podatkovnih bazah Web of Science, PubMed, CINAHL, OTseeker in ProQuest. Pri iskanju smo uporabili kombinacijo različnih ključnih besed v angleščini: zdravje, okupacija in starejši ljudje. V analizo so bili vključeni članki dostopni s celim besedilom, objavljeni v slovenskem ali angleškem jeziku, med letom 2012 in 2022 iz področja okupacij in vpliva samostojne izvedbe okupacij na zdravo staranje ter opredelitev vloge delovnega terapevta. Rezultati: Rezultate smo pridobili s pomočjo vsebinske analize štirinajstih vključenih člankov. Oblikovali smo štiri glavne teme: pozitivni učinki okupacij, okupacije, ki podpirajo zdravo staranje (podteme: ožje dnevne aktivnosti, socialna vključenost, prostočasne aktivnosti), vloga delovnega terapevta (podtemi: promocija zdravja in učinkovitost delovno terapevtskih obravnav v procesu staranja) in okupacijsko prilagajanje. Razprava in zaključek: Ker zadovoljstvo z življenjem med starejšimi s časoma in poslabšanjem zdravja upada, jih moramo spodbujati, da se po zaključku aktivne poklicne poti še zmeraj ukvarjajo z različnimi okupacijami. Ugotovili smo, da ima izvedba okupacij na zdravje in dobro počutje starejših pozitivne učinke. Omogoča ohranjanje motoričnih, procesnih in socialno interakcijskih spretnosti, pozitivno vpliva na duševno zdravje osebe (zmanjšuje stres in anksioznost), pomaga pri ohranjanju identitete, ki se lahko zaradi opustitve okupacij podre in omogoča, da so starejši ljudje vključeni v družbo ter posledično bolj zadovoljni z življenjem. Izveden pregled literature ima uporabno vrednost, saj prikazuje poglobljen vpogled v izbrano temo. Ugotovitve lahko pripomorejo k nadaljnjemu razvoju delovne terapije v Sloveniji. Introduction: Population ageing presents an enormous problem for societies around the world. The older adults can contribute to society in many different ways. Several studies indicate that the older adults, who live actively and independently perform different every day activities, live longer than their peers. The role of occupational therapy is directed towards this goal, because it is focused on the discovery of meaning in existing as well as in new occupations. Purpose: To study the latest literature on the subject of occupations, which encourage healthy ageing. To describe the influence of independent performance of occupations to the health of individuals, well-being among the older adults and to define the role of an occupational therapist in encouraging healthy ageing and maintaining occupations. Methods: A systematic review of literature was conducted. The research was done between January and March 2022 in data bases Web of Science, PubMed, CINAHL, OTseeker and ProQuest. By our research we used a combination of different key words in English: health, occupation and older adults. The whole articles published in Slovene and English language between 2012 and 2022 in the fields of occupations, the influence of independent performance of occupations to healthy ageing and the definition of the occupational therapists role were included in the analysis. Results: We acquired the results with the help of content analysis of fourteen articles. We established four major topics: positive effects of occupations, occupations, which support healthy ageing, (subtopics: narrow every day activities, social inclusion, free time activities), occupational therapists role (subtopics: health promotion and effective work of an occupational therapist in the ageing process) and occupational adjustment. Discussion and conclusion: The satisfaction of life among older adults and along with the deterioration of health decreases in time, therefore we must encourage them, that they still engage in different occupations, after they have finished their active professional paths. We have discovered that occupations have a positive effect on the health and well-being of older adults. It enables the preservation of motor, process and social interactive skills, has a positive effect on the mental health of a person (it reduces stress and anxiety), it helps maintaining ones identity, which can be lost due to the omission of occupations and it enables the older adults to be included in the society, as a consequence they are more satisfied with their own life. The review of literature has a useful value, because it presents a thorough insight into the chosen topic. The findings can benefit further development of occupational therapy in Slovenia.

Uvod: Hemofilija je redka dedna bolezen, ki prizadene predvsem moške in je vezana na kromosom X. Posledica je pomanjkanje koagulacijskega faktorja VIII ali IX in nagnjenost h krvavitvam. Delimo jo na hemofilijo A in B, glede na resnost bolezni pa na blago, zmerno in hudo obliko hemofilije. Spremljajo jo spontane krvavitve v sklepe in mišice. Bolezen zdravimo profilaktično ali po potrebi z dodajanjem manjkajočega koagulacijskega faktorja. Najpogostejša posledica je hemofilna artropija, ki je posledica krvavitev v sklepe. Namen: Želeli smo ugotoviti adherenco na zdravljenje odraslih bolnikov s hemofilijo v Sloveniji in njihovo kvaliteto življenja. Poleg tega smo ugotavljali še značilnosti bolezni bolnikov s hemofilijo v Sloveniji in njihov življenjski slog. Metode dela: Teoretična izhodišča za diplomsko delo smo poiskali v literaturi iz zbirk Medline, Cinahl, UpToDate, Pub Med in z brskalnikom Google učenjak. Vključili smo 36 odraslih bolnikov z zmerno in hudo obliko hemofilije v Sloveniji, starih med 22 in 73 let. Pri raziskovalnem delu smo uporabili dva preverjena anketna vprašalnika, VERITAS-PRO in SF-36. Z VERITAS-PRO smo merili adherenco na zdravljenje v šestih dimenzijah in z SF-36 kvaliteto življenja s 36 trditvami. Pridobljene podatke smo prikazali z deskriptivno statistiko. Rezultati: Adherenca na zdravljenje bolnikov s hemofilijo je na vseh šestih dimenzijah dobra. Najboljša adherentnost se je izkazala pri odmerjanju in najslabša, vendar kljub temu še zmeraj dobra, pri komunikaciji. Le eden izmed anketiranih bolnikov je bil neadherenten, saj je imel število točk nad mejno vrednostjo (57). Bolniki ocenjujejo svojo kvaliteto življenja kot slabo. Mentalno zdravje v povprečju ocenjujejo bolje, kot pa fizično zdravje. Razprava in zaključek: Odrasli bolniki s hemofilijo imajo dobro adherenco na zdravljenje, kljub temu pa kvaliteto življenje v smislu zdravja ocenjujejo kot slabo. Rezultati odstopajo od rezultatov nekaterih drugih študij, kjer so ocene za kvaliteto življenja višje ali nižje. Vsem pa je skupno, da bolniki svojo kvaliteto življenja bolje ocenjujejo v smislu mentalnega zdravja v primerjavi z fizičnim zdravjem. Razlog za slabšo kvaliteto življenja v povezavi z zdravjem bi lahko bil, da v otroštvu niso prejemali ustreznega zdravljenja, saj ga takrat ni bilo. Introduction: Hemophilia is a rare hereditary disease that mainly affects men and is linked to the X chromosome. The result is a lack of coagulation factor VIII or IX and a tendency to bleed. It is divided into hemophilia A and B, and according to the severity of the disease, into mild, moderate and severe forms of hemophilia. It is accompanied by spontaneous bleeding into the joints and muscles. The disease is treated prophylactically or, if necessary, by adding the missing coagulation factor. The most common consequence is hemophilic arthrosis, which is the result of bleeding into the joints. Purpose: We wanted to determine the adherence to treatment of adult patients with hemophilia in Slovenia and their quality of life. In addition, we determined the disease characteristics of hemophilia patients in Slovenia and their lifestyle. Purpose: We wanted to determine the adherence to treatment of adult patients with hemophilia in Slovenia and their quality of life. In addition, we determined the disease characteristics of hemophilia patients in Slovenia and their lifestyle. Methods: The theoretical starting points for the diploma work were searched in the literature from the Medline, Cinahl, UpToDate, Pub Med collections and with the Google Scholar browser. We included 36 adult patients with moderate and severe hemophilia in Slovenia, aged between 22 and 73 years. In the research work, we used two verified questionnaires, VERITAS-PRO and SF-36. With VERITAS-PRO we measured adherence to treatment in six dimensions and with SF-36 quality of life with 36 statements. We presented the obtained data with descriptive statistics. Results: Adherence to the treatment of patients with hemophilia is good on all six dimensions. The best adherence was found in dosing and the worst, but still good, in communication. Only one of the surveyed patients was non-adherent, as he had a score above the threshold value (57). Patients rate their quality of life as poor. On average, mental health is rated better than physical health. Discussion and conclusion: Adult patients with hemophilia have good adherence to treatment, but despite this, they rate the quality of life in terms of health as poor. The results deviate from the results of some other studies, where the scores for the quality of life are higher or lower. What they all have in common is that patients rate their quality of life better in terms of mental health compared to physical health. The reason for the worse quality of life in relation to health could be that they did not receive adequate treatment in childhood, as it did not exist then.

Ozadje: Bolezenski proces pri multipli sklerozi (MS) sestavljata medsebojno tesno prepleteni vnetna in nevrodegenerativna komponenta, ki ju označujeta kopičenje vnetnih sprememb v beli možganovini in možganska atrofija. S sodobnimi zdravili uspešno zavremo vnetni proces, manj uspešni pa smo pri zaustavljanju procesa nevrodegeneracije in lajšanju simptomov, povezanih z MS. Poleg farmakoloških ukrepov zato iščemo tudi nefarmakološke, s katerimi bi lahko omilili težave, povezane z MS, ter dodatno zaustavili napredovanje bolezenskega procesa. Rezultati raziskav, osredotočenih na starejšo populacijo in bolnike z demenco, kažejo na možnost nevroprotektivnega učinka aerobne vadbe. Vpliv aerobne vadbe na vnetne in nevrodegenerativne procese pri bolnikih z MS še ni popolnoma pojasnjen. Prav tako ni znano, kakšen je dodani učinek aerobne vadbe v kombinaciji s farmakološkim zdravljenjem. Cilj: Namen naše raziskave je bil ugotoviti, kašen vpliv ima aerobna vadba v kombinaciji s farmakološkim zdravljenjem s fingolimodom na proces vnetne aktivnosti in nevrodegeneracije pri bolnikih z MS. Dokazi o ugodnem vplivu aerobne vadbe so pomembni kot osnova za nadaljnje raziskave v smeri iskanja strategij, ki bi omogočale boljši nadzor bolezenskega procesa MS in izboljšale kakovost življenja bolnikov. Dodatno bi lahko raziskava služila kot dokaz in podpora rehabilitacijskim programom, namenjenim bolnikom z MS. Bolniki in metode: Raziskava je bila zasnovana kot randomizirana kontrolirana študija v trajanju 12 tednov. Vanjo je bilo vključenih skupno 28 bolnikov, zdravljenih s fingolimodom od tega je bila polovica bolnikov (n = 14) vključena v program aerobne vadbe dvakrat tedensko v trajanju 60 min, polovica (n = 14) pa je v tem obdobju nadaljevala z običajnim življenjskim slogom. Primarni cilj raziskave so bili magnetnoresonančni biomarkerji vnetja (število in volumen T2 ter z gadolinijem obarvanih T1 lezij) in nevrodegeneracije (volumen celotne in sive možganovine, volumen posameznih možganskih struktur). Sekundarni cilji raziskave so bili ocena po razširjeni lestvici prizadetosti (angl. Expanded Disability Status Scale, EDSS), hitrosti hoje, serumske koncentracije citokinov (interlevkin-6, topni receptor za interlevkin-2 in BDNF (angl. brain-derived neurotrophic factor)), ocena kognitivnih funkcij, utrudljivosti, razpoloženja in kakovosti življenja bolnikov. Rezultati: V splošnem je bil vpliv aerobne vadbe na volumen celotne in sive možganovine ter na večino analiziranih posameznih možganskih struktur zanemarljiv. Ugotovili pa smo vpliv aerobne vadbe na volumen nekaterih posameznih možganskih struktur (amigdala, putamen, posteriorni cingulatni girus, parahipokampalni girus in talamus), pri čemer je bila smer vpliva heterogena. Aerobna vadba je bila tako povezana z zmanjšanjem volumna putamna in posteriornega cingulatnega girusa ter s povečanjem volumna parahipokampalnega girusa, hkrati pa smo ugotovili, da sta se volumen talamusa in amigdale ohranila. Pri bolnikih, vključenih v program aerobne vadbe, smo ugotovili tudi zmanjšanje števila in volumna z gadolinijem obarvanih T1 lezij. Analiza je pokazala še, da je aerobna vadba nekoliko izboljšala hitrost hoje in zvišala serumsko koncentracijo BDNF, medtem ko pomembnega vpliva na preostale sekundarne izide raziskave ni bilo. Zaključek: Naša raziskava nudi nove podatke o vplivu aerobne vadbe v kombinaciji s farmakološkim zdravljenjem s fingolimodom na bolezenski proces pri MS, saj gre za prvo tovrstno raziskavo na tem področju. Rezultati naše raziskave kažejo, da bi lahko aerobna vadba pozitivno vplivala na ohranjanje volumna nekaterih možganskih struktur, kot so parahipokampalni girus, talamus in amigdala, in s tem torej delovala nevroprotektivno. Raziskava je nakazala tudi možnost različnega učinka aerobne vadbe na posamezne možganske regije, saj smo zabeležili negativen učinek na volumen putamna in posteriornega cingulatnega girusa, klinični učinek tega pa za zdaj ostaja nepojasnjen. Možno je, da aerobna vadba deluje tudi protivnetno, saj smo zabeležili zmanjšanje števila in volumna z gadolinijem obarvanih T1 lezij, ob čemer je skupno število T2 lezij ostalo stabilno. Z izjemo blagega izboljšanja hitrosti hoje in povišanja serumske koncentracije BDNF, pomembnejšega vpliva aerobne vadbe na invalidnost, kognitivne funkcije, utrudljivost, razpoloženje ali kakovost življenja bolnikov z MS nismo zabeležili. Raziskava ima nekaj omejitev, ki otežujejo posploševanje na celotno skupino bolnikov z MS, med drugim zaznavanje pomembnejših sprememb onemogočata velikost študijskega vzorca in trajanje študije. Kljub temu pa naša raziskava daje pomemben temelj za nadaljnje raziskave daljšega trajanja, ki bi vključile večje število bolnikov in različne oblike zdravljenj ter s tem natančneje raziskale vpliv aerobne vadbe na bolezenski proces pri MS. Hkrati ta raziskava daje tudi prve spodbudne podatke o možnem pozitivnem vplivu aerobne vadbe predvsem na nevrodegenerativni, pa tudi vnetni proces pri MS, kar daje podporo rehabilitacijskim programom za bolnike z MS. Background: The inflammatory and neurodegenerative component of the disease process of multiple sclerosis (MS) are closely intertwined and characterized by the accumulation of white matter lesions in the central nerve system and accelerated brain atrophy. The inflammation can nowadays efficiently be targeted with the currently available disease modyfying drugs, but the neurodegenerative process and efficient symptom management are harder to tackle. Along with new pharmaceutical approaches, non-pharmaceutical approaches to alleviate MS symptoms and decelerate the disease progression are being sought. Studies on ageing in healthy subjects and subjects wih dementia suggest that aerobic exercise may have a neuroprotective effect. There is insufficient knowledge about how aerobic exercise impacts the disease process of MS and how aerobic exercise, combined with pharmaceutical treatment, might have a role in the management of MS. Objective: Our study objective was to examine the impact of aerobic exercise on neuroinflammation and neurodegeneration in persons with MS. Evidence of a favourable impact of aerobic exercise would serve as a base for further research, focused on finding strategies which would help alleviate and better control the disease process of multiple sclerosis and therefore improve their quality of life. Additionally, newly gained information could serve as proof and support for rehabilitation programs for persons with MS. Patients and methods: An exploratory 12-week randomized control trial including an intervention group (n=14, 12 weeks of aerobic exercise twice weekly in duration of 60 minutes) and a control group (n=14, continuation of usual lifestyle). Primary outcomes were magnetic resonance imaging measures of inflammation (T2 and T1-gadolinium enhancing lesion count and volume) and neurodegeneration (whole brain, gray matter and brain structure volume change), while secondary outcomes included disability measures (Expanded Disability Status Scale), Timed 25-foot Walk Test, blood cytokine levels (interleukin-6, soluble interleukin-2 receptor, brain-derived neurotrophic factor), cognitive tests and patient-reported outcomes (fatigue, mood, quality of life). Results: The effects od aerobic exercise on whole brain and grey matter atrophy were minor. The observed effect on volume (atrophy) in selected brain substructures was heterogeneous. Putaminal and posterior cingulate volumes decreased, parahippocampal gyrus volume increased, thalamuus and amygdala volume remained the same, and active lesion load and count decreased. However, apart from weak improvements in walking speed and brain-derived neurotrophic factor levels, there was no effect of aerobic exercise on other clinical, cognitive or patient-reported measures. Conclusion: The results of our study provide new information on the impact of aerobic exercise in combination with pharmaceutical treatment with fingolimod on thedisease process of MS. The results suggest that aerobic exercise in persons with MS has a positive effect on the volume of some of the substructures of the brain (parahippocampal gyrus, thalamus and amygdala), possibly indicating a slowing of the neurodegenerative process in these regions. However, the observed effect of aerobic exercise on the selected brain substructures seems to be heterogeneous so a negative impact on the volume of putamen and posterior cingulate gyrus was observed, with unclear implications. While the total T2 lesion load remained stable, a slight decrease in active lesion volume and count have been observed, which could imply to an antiinflammatory effect of aerobic exercise in persons with MS. Apart from weak improvements in walking speed and brain-derived neurotrophic factor levels we have observed no meaningful impact of aerobic exercise on disability, cognitive function, fatigue, mood or quality of life of persons with MS. Several limitations, especially the small sample size and study length, preclude the generalization of our study findings to all persons with MS. However, our study provides an important foundation for further studies of longer duration and larger sample size with inclusion of other disease-modifying drugs to either confirm of refute there findings and further elucidate the role of aerobic exercise as an adjunctive treatment option in the management of patients with MS. Furthermore, this study provides novel information on the probable positive effect of aerobic exercise on the neurodegenerative and inflammatory process of MS, additionally supporting rehabilitation strategies for people with MS.

Uvod: V raziskavi smo: 1) Analizirali vpliv intrinzičnih dejavnikov na predoperativno stanje bolnikov z osteohondralno lezijo talusa (OLT) 2) Primerjali predoperativno stanje bolnikov z OLT z bolniki pred drugimi pogostimi operativnimi posegi na gležnju 3) Primerjali uspešnost operativnega zdravljenja OLT z različnimi kirurškimi metodami, ter preučili vpliv intrinzičnih dejavnikov na stanje po operaciji. Metode: Preučili smo skupino 610 bolnikov po operaciji gležnja v obdobju med 2009-2018. Vsi bolniki so predoperativno izpolnili standardizirane vprašalnike FAOS (Foot and Ankle Outcome Score), EQ-5D (European Quality of Life in 5 Dimensions) in TAS (Tegner lestvico aktivnosti). 1) Iz primarne kohorte smo izbrali bolnike, ki so bili v opazovanem obdobju operativno zdravljeni zaradi kakršnekoli OLT. Z modelom linearne regresije smo analizirali vpliv značilnosti bolnika in karakteristike gleženjskega sklepa na predoperativno stanje. 2) Iz primarne kohorte smo izbrali samo bolnike, ki so bili operirani zaradi izolirane problematike gležnja: 19 primarna OLT (P-OLT), 18 revizijska OLT (R-OLT), 22 osteoartroza (OA), 15 lateralna nestabilnost gležnja (LN), 20 sprednji (S-US), 13 zadnji (Z-US) in 16 kombinirani utesnitveni sindrom (K-US). Med skupinami smo primerjali aktivno gibljivost, delovanja gležnja, kvaliteto življenja in telesno aktivnost pred operacijo. 3) Bolniki iz točke 1 so bili zdravljeni s 4 različnimi kirurškimi metodami. Po operaciji smo bolnikom ponovno razposlali standardizirane vprašalnike. S parnimi testi smo preverjali predoperativne in pooperativne vrednosti vprašalnikov. Z modeli logistične regresije smo analizirali uspešnost različnih kirurških metod glede na lastnosti bolnika in karakteristike gležnja. Za ovrednotenje preživetja presadkov je bil uporabljen Cox-ov regresijski model sorazmernih tveganj. Rezultati: 1) Model linearne regresije razkrije korelacijo med spolom, indeks telesne mase (ITM), Kellgren-Lawrence (KL) stopnjo artroze in predoperativno vrednostjo vprašalnikov FAOS in TAS. 2) Pri vseh analiziranih gleženjskih patologijah smo zaznali statistično pomembno slabše predoperativne vrednosti vseh vprašalnikov v primerjavi z zdravo populacijo. Najizrazitejše poslabšanje je bilo prisotno v skupinah R-OLT ter OA. 3) Vse pooperativne vrednosti FAOS in EQ-5D vprašalnikov so se statistično pomembno zvišale glede na predoperativne. Starost, spol, ITM, etiologija OLT, trajanje simptomov, lokacija lezije, spremljajoči posegi, KL stopna artroze in operativna metoda niso pomembno vplivali na pooperativne vrednosti vprašalnikov. Enoletno preživetje presadkov je bilo 100% ne glede na spol 5-letno preživetje je bilo 77% moški (M) oz. 47% ženske (Ž). Cox-ov regresijski model sorazmernih tveganj razkrije 1,6-krat večje tveganje za odpoved presadka pri ženskah. Zaključki: 1) Ženski spol, višji ITM in višja KL stopnja artroze so napovedni dejavniki za slabše predoperativno stanje bolnikov z OLT. 2) Bolniki z OLT pred operativim posegom imajo slabše funkcionalno stanje gležnja in znižano kvaliteto življenja glede na zdravo populacijo. V primerjavi z drugim pogostimi patologijami gležnja, primarne OLT zmanjšajo delovanje gležnja primerljivo kot lateralna nestabilnost in utesnitveni sindromi, medtem ko recidivi OLT znižajo delovanje gležnja podobno kot napredovala osteoartroza tega sklepa. 3) Različne operativne metode so pomembno izboljšale stanje bolnikov z OLT. Značilnosti bolnika in uporabljena kirurška metoda niso vplivale na izid operativnega zdravljenja. Preživetje presadkov se po 2 letih slabša, izrazitejše pri ženskah. Introduction: The aim of current study was to: 1) analyse the impact of intrinsic factors on preoperative status of patients with osteochondral lesion of talus (OLT) 2) compare preoperative status of patients scheduled for surgical treatment of seven common ankle disorders 3) evaluate the outcome after various operative interventions for OLT and identify predicting factors for the patients’ subjective outcome. Methods: Hospital records of 610 patients that were admitted for surgical intervention on the ankle joint between 2009 and 2018 were reviewed. Patients’ general and ankle-related subjective status, quality of life, and activity levels were recorded at the admission by standard questionnaires (PROMs): FAOS (Foot and Ankle Outcome Score), EQ-5D (European Quality of Life in 5 Dimensions) and TAS (Tegner activity scale). 1) First, all the patients who were admitted for OLT surgery of any kind were selected. Their demographics, medical history, and the index ankle joint status were tested as possible predictors for patients’ subjective status by a linear regression model. 2) Secondly, all the patients who were treated operatively for an isolated ankle pathology were identified: 19 primary OLT (P-OLT), 18 recurrent OLT (R-OLT), 22 osteoarthritis (OA), 15 lateral instability, 20 anterior, 13 posterior, and 16 combined ankle impingement. Across these seven groups, preoperative active range of motion, subjective ankle status, quality of life, and patients’ activity levels were compared. 3) The patients from the first cohort (OLT of any kind) were cross-sectionally re-evaluated after the operation by using the same PROMs. Preoperative to postoperative values of PROMs were compared with a paired Student t-test. Possible predicting factors (patients’ demographics, ankle characteristics, surgical technique) for the treatment improvement (postoperative to preoperative PROMs differences) were tested via a linear regression model. A Cox proportional hazard model was used fort the graft survival analysis. Results: 1) Linear regression model revealed that gender, body mass index (BMI), and Kellgren-Lawrence (KL) osteoarthritis score were correlated with the preoperative FAOS and TAS. 2) All evaluated ankle disorders induced significant preoperative subjective joint dysfunction, decreased quality of life, and activity level. The most profound impairments were reported by patients treated for OA and recurrent OLT. 3) All FAOS and EQ-5Q values increased from preoperative to the final follow-up values. There was no correlation between age, gender, BMI, aetiology, symptoms duration, lesion characteristics, additional procedures, OA toward the postoperative improvement of PROMs values. Graft survival rates were 100% at 1 year and 77% (males)/47% (females) at 5 years. A Cox proportional hazard model revealed 1,6-times higher risk of graft failure for females. Conclusions: Female gender, higher BMI, and higher grade of ankle OA were negative predictors for the preoperative status of patients with OLT. 2) Patients amenable for surgical treatment of the common ankle pathology reported considerable functional decline in comparison to the general population. The worst subjective ankle status was reported equally by OA and R-OLT patients, while patients with other five disorders reported comparable values. 3) Various operative interventions for OLT significantly improved patients’ ankle status, and quality of life. Patients’ characteristics and surgical technique had no influence on the treatment outcome. High graft survival rates were demonstrated over first two years, but notable decline was confirmed thereafter, especially in females.

Starši otrok z avtističnimi motnjami se srečujejo z različnimi ovirami in težavami, ki močno vplivajo na kvaliteto življenja vseh družinskih članov. Posebno veliko breme in skrb nosijo matere otrok z avtističnimi motnjami, ki v procesu vzgoje otroka doživljajo višjo stopnjo stresa. V magistrskem delu smo obravnavali kvaliteto življenja družine otroka z avtističnimi motnjami s perspektive matere in proučili dejavnike, ki v veliki meri vplivajo na slabšo kvaliteto življenja družine z otrokom z avtističnimi motnjami. V empiričnem delu smo uporabili raziskovalno metodo študije primera družine otroka z avtističnimi motnjami s perspektive matere. Sodelujoča je v prvem delu raziskave izpolnila lestvico kvalitete življenja. V drugem delu smo z materjo naredili intervju, v okviru katerega smo podrobneje raziskali najpogostejše dejavnike, ki vplivajo na kvaliteto življenja družine otroka z avtističnimi motnjami, in pridobili boljši vpogled v posledice, ki jih imajo dejavniki na življenje matere in celotne družine otroka z avtističnimi motnjami. Ugotovili smo, da so v preteklosti nižje prilagoditvene spretnosti in vedenjske težave otroka imele pomemben negativen vpliv na kvaliteto življenja matere. Dejavnik, ki je glede na naše ugotovitve najbolj negativno vplival na kvaliteto življenja matere in celotne družine, je bil pomanjkanje pomoči, ki jo je mati potrebovala v času, ko je otrok prejel diagnozo avtistične motnje. V preteklosti se je pomanjkanje nudenja pomoči odražalo tudi na duševnem zdravju matere, saj je bilo v času, ko je bil otrok mlajši, v njenem življenju prisotnega veliko stresa, stisk, tesnob in paničnih napadov. K prisotnosti teh dejavnikov je vplivalo tudi to, da je mati v tem obdobju veliko časa preživela sama z otrokom, saj je bil mož dosti časa službeno odsoten. Resnost otrokovih motenj je imelo na kvaliteto materinega življenja in na življenje celotne družine negativen vpliv predvsem z vidika nesamostojnosti otroka in posledično večje potrebe po pomoči. V želji po večji samostojnosti otroka in zmanjšanju potrebne pomoči je družina začela posegati po različnih izobraževanjih, terapijah in dodatnih aktivnostih za sina. Rezultati raziskave so pokazali, da ima financiranje dodatnih aktivnosti, dejavnosti in terapij za otroka z avtističnimi motnjami vpliv na kvaliteto življenja družine. Kljub temu da se družina zaradi financiranja ni nikoli znašla v finančnih stiskah, je bilo znotraj družine še vseeno potrebno veliko prilagajanja in odrekanja, da se je mati lahko udeležila izbranih izobraževanj. Novo pridobljena znanja so materi pomagala, da se je lažje soočala z vsakodnevnimi stresnimi situacijami ter boljše prilagajala okolje svojemu otroku in tako pozitivno vplivala na kvaliteto svojega življenja in celotne družine. Pozitivni vpliv na kvaliteto življenja matere in celotne družine imajo tudi dobri odnosi znotraj ožje in širše družine. Mati in njena družina je s strani sorodnikov prejela veliko podpore in pomoči, kar ima pomemben doprinos h kvalitetnemu življenju matere, njenega moža in otroka z avtističnimi motnjami. Parents of autistic children face different obstacles and problems that affect the quality of life of all the family members. In particular, mothers are the ones who experience higher levels of stress while carrying the burden and care for autistic children. In the Master’s Thesis, we discuss the quality of family life with an autistic child from the mother’s perspective. Moreover, we discuss the factors affecting the quality of life. In the empirical part, we use the research method of a case study of a family with an autistic child. We focus on the mother’s perspective. In the first part, the participant fulfilled the quality of life scale. In the second part, we interviewed the mother. In the interview, we talk about the most common factors affecting the quality of life of the family with an autistic child. Moreover, we get better insight into the consequences that those factors have on the life of the mother and the whole family. As shown in our findings, lower adaptive skills and behavioural problems of the child have a significant negative impact on the quality of life of the mother and the whole family. The lack of assistance the mother needed when faced with the diagnosis of autistic spectrum disorder, is one of the factors that most negatively affect the quality of life. In the past, when the child was younger, the lack of assistance affected the mental health of the mother, since she was stressed, distressed, and had anxiety and panic attacks. Moreover, the mother spent a lot of time alone with the child, since the husband was working. The child's disability harmed the quality of life of the mother and the whole family since the child was not independent and, consequently, he needed more help. To gain independence, the family attended different training, therapies, and additional activities. The findings show that the funding of activities and therapies for an autistic child affects the quality of life. Luckily, the family never endured difficulties due to the funding. But there were many adjustments and sacrifices for the mother to attend the training. Due to the acquired knowledge, the mother easier coped with everyday situations and helped adapt the environment for her child. The aforementioned had a positive impact on the quality of her life and the life of the whole family. Good relationships within the immediate and extended family have a positive effect on the quality of life of the mother and the family. The mother and her family have a lot of support from relatives, which improves the quality of her life, the life of her husband, and her autistic child.

The higher quality of life of people with spinal cord injury is closely related with their reintegration into the social environment. Social reintegration is a demanding and complex process, requiring individuals to become active again and acquire age-, gender-, and culture-appropriate roles and social status. It also involves independence and productive behavior as part of multiple interpersonal relationships with family, friends, and others. In order to establish whether individuals with spinal cord injury who are physically active subjectively rate their quality of life to be higher compared to those who are not, sixty-two respondents from Slovenia with spinal cord injury were interviewed. Thirty-one of them were physically active, and 31 were not. The level of injury of the responders was from Th6–Th12. The participants gave the highest assessments to their interpersonal relationships, and the lowest to their satisfaction with material prosperity. Data comparison showed that subjective estimates in all areas of quality of life are higher in respondents who were involved in physical activity after their injury. The results may encourage persons with spinal cord injury to participate more often in sports programs, and also encourage others to do so.

Odraslost je obdobje, ko posameznik konča s šolanjem, prične z iskanjem službe, se zaposli, prične skrbeti zase, skratka, se odseli od doma. Takrat prične opravljati različne pomembne družbene vloge. V tem obdobju so še posebej na udaru ženske, ki poleg skrbi zase, opravljanja gospodinjskih del in službe, skrbijo še za druge in se soočajo s številnimi težavami in stresnimi situacijami. Ženske namreč dvakrat pogosteje kot moški zbolevajo za depresijo, kar povezujejo s hormonskim ravnovesjem, bolj stresnim načinom življenja, soočenje z nasiljem in zlorabam ter nenehnim razmišljanjem. Živimo v času, kjer je doživljanje stresa nekaj čisto normalnega. Vsi ga kdaj občutimo. Je pa res, da posamezne stresorje dojemamo drugače. Nekomu nekaj povzroči stres, drugemu drugo. Problem nastane, ko je tega stresa preveč. Pretirano doživljanje negativnega stresa lahko vodi v doživljanje simptomov tesnobnosti in depresivnosti ali celo do različnih motenj in bolezni. Ljudje se zaradi pretiranega doživljanja stresa najpogosteje srečajo s tesnobo in depresijo. Pri tesnobi gre za nekajminutne neprijetne čustvene in vedenjske simptome, ki lahko sprožijo tudi napad panike, medtem ko gre pri depresiji za simptome, ki vztrajajo dlje časa ter je glavni simptom doživljanje neskončne žalosti. Stres, simptome tesnobnosti in depresivnosti lahko obvladujemo z različnimi strategijami. V našem delu se posvečamo sprostitvenim tehnikam. Sprostitvene tehnike izzovejo sprostitev, ki bistveno zniža učinke stresa na telo in um. Med drugim vadba le-teh upočasni srčni utrip, znižuje krvni tlak, upočasni dihanje in izboljšuje prebavo. Namen raziskave, izvedene med dvanajstimi aktivnimi ženskami, je bil preveriti, kako kratka, a redna uporaba sprostitvenih tehnik vpliva na razbremenitev stresa, doživljanja simptomov depresivnosti in tesnobnosti, na zmožnost osredotočenega zavedanja in sprejemanja sedanjega trenutka ter na zadovoljstvo z življenjem aktivnih žensk. V raziskavi smo uporabili kvazieksperimentalno metodo, in sicer enoskupinski predtest-posttest načrt kot pripomoček je bila izbrana mobilna aplikacija s sprostitvenimi tehnikami. Analiza rezultatov je pokazala, da ima redna vadba sprostitvenih tehnik pomemben vpliv na doživljanje stresa. Na podlagi ugotovitev v teoretičnem delu in kazalnikov v naši raziskavi lahko rečemo tudi, da imajo sprostitvene tehnike pozitiven vpliv na doživljanje simptomov depresivnosti in tesnobnosti, na zmožnost osredotočenega zavedanja in spoprijemanja sedanjega trenutka ter na zadovoljstvo z življenjem aktivnih žensk. Ugotovili smo tudi, da ni ene najboljše in najučinkovitejše sprostitvene tehnike, temveč lahko ob redni in vestni vadbi z vsako tehniko dosežemo sprostitveni odziv. Uporabnice so bile nad pozitivnimi vplivi redne vadbe sprostitvenih tehnik presenečene vse so čutile pozitivne spremembe in se strinjajo, da bodo z uporabo nadaljevale. Adulthood is the period when an individual finishes school, starts looking for a job, gets a job, starts taking care of himself, in short, moves away from home. It is then that he begins to perform various important social roles. During this period, women are particularly affected, who, in addition to taking care of themselves, doing housework, and working, also take care of others and face many problems and stressful situations. Women are twice as likely as men to suffer from depression, which they associate with hormonal balance, a more stressful lifestyle, coping with violence and abuse, and constant thinking. We live in a time where experiencing stress is something completely normal. We all feel it sometimes. However, it is true that we perceive individual stressors differently. To some, something causes stress, to others something else. The problem, however, arises when there is too much of this stress. Excessive experience of negative stress can lead to experiencing symptoms of anxiety and depression, or even to various disorders and illnesses. People are most likely to experience anxiety and depression due to excessive stress. Anxiety is a few minutes of unpleasant emotional and behavioural symptoms that can also trigger a panic attack, while depression consists of symptoms that persist for a long time and the main symptom is experiencing endless sadness. Stress, symptoms of anxiety and depression can be managed through a variety of strategies. In our work we focus on relaxation techniques. Relaxation techniques evoke relaxation, which significantly reduces the effects of stress on the body and mind. Among other things, exercise slows the heart rate, lowers blood pressure, slows breathing and improves digestion. The purpose of the study, conducted among twelve active women, was to examine how short but regular use of relaxation techniques affects stress relief, experiencing symptoms of depression and anxiety, the ability to focus on and accept the present moment, and life satisfaction of active women. In the research, we used a quasi-experimental method, namely one group with a pretest-posttest plan, and a mobile application with relaxation techniques was chosen as an aid. Analysis of the results showed that regular practice of relaxation techniques has a significant impact on experiencing stress. Based on the findings in the theoretical part and indicators in our study, we can also say that relaxation techniques have a positive impact on experiencing symptoms of depression and anxiety, on the ability to focus and cope with the present moment and on being satisfied with your life as an active woman. We also found that one single best and most effective relaxation technique does not exist, but we can achieve a relaxation response with each technique with regular and conscientious exercise. The users were surprised by the positive effects of regular practice of relaxation techniques, all felt positive changes and agreed to continue using them.

Frustracija in stiska med mladimi pred prvo zaposlitvijo sta veliki. Še posebno dandanes, v času, ki se tako hitro spreminja, trg pa se spreminja še hitreje. Zato ni čudno, da se nam naše veščine zdijo na trgu zelo zamenljive oz. nadomestljive. Prva zaposlitev za mlado osebo nima zgolj ekonomskega pomena, ampak tudi sociološkega in psihološkega. Posameznik je postavljen v novo odgovorno vlogo. Dotedanji način življenja se spremeni zaradi odgovornosti, ki jo pridobi s prvo zaposlitvijo. Ta postane njegova nova prioriteta za nadaljnje življenje. Tudi način življenja in rutine po končanem študiju se spremenijo. V diplomski nalogi želim predstaviti prav to stisko mladih, kako na tako tekmovalnem trgu sploh opozoriti nase, po drugi strani pa me bodo zanimale notranje stiske iskalcev zaposlitve. S pomočjo ankete, predvsem pa intervjujev, ki sem jih opravila z mladimi iskalci zaposlitve ? nekateri so jo že dobili, nekateri jo še iščejo ? bom poskusila prikazati vidik mladih ter njihovo stisko. Smotrno se je vprašati tudi, koliko ljudi sploh dela v stroki, za katero so se šolali, oz. ali delujejo na področju, kjer so koristni in zadovoljni. Disappointment, distress and frustration among young people before their first job are really high. Especially nowadays in a time that is changing so fast and the market is changing even faster. Therefore, it is not surprising that our skills seem very interchangeable in the market itself replaceable. For young people, first employment is not important just from the economic aspect, but also for sociological and psychological one. Individual is placed in a new responsible role. The current way of life changes due to the responsibility it acquires with the first job. It becomes his new priority for further life. Lifestyle and routines change after graduation. During my dissertation I want to present distress among young people. On the other hand, I want to research how to draw attention to ourselves in such a competitive market. With the help of a survey, especially interviews I conducted with young jobseekers - some have already gotten a job and some are still looking for one. I will try to show the aspect of young people and their difficult situation. It also makes sense to ask how many people work in the profession for which they were trained or even operate in an area where they are helpful and satisfied.

Hemodialysis (HD) patients have lower functional abilities compared to healthy people, and this is associated with lower physical activity in everyday life. This may affect their quality of life, but research on this topic is limited. Therefore, the present study aimed to determine the relationship between habitual physical activity and quality of life in HD patients and healthy controls. Ninety-three HD patients and 140 controls participated in the study. Quality of life was assessed using a 36-item medical outcomes study short-form health survey (SF-36). Human Activity Profile (HAP) was used to assess habitual physical activity. The adjusted activity score (AAS) from HAP, age, gender, fat tissue index (FTI), lean tissue index (LTI), and Davies comorbidity score were analyzed as possible predictors of the Physical Component Summary (PCS) of the SF-36. Three sequential linear models were used to model PCS. In Model 1, PCS was regressed by gender and age in Model 2 the LTI, FTI, and Davies comorbidity scores were added. Model 3 also included AAS. After controlling for age and gender (Model$_{HD}$ 1: p = 0.056), LTI, FTI, and Davies comorbidity score effects (Model$_{HD}$ 2: p = 0.181), the AAS accounted for 32% of the variation in PCS of HD patients (Model$_{HD}$ 3: p < 0.001). Consequently, the PCS of HD patients would increase by 0.431 points if the AAS increased by one point. However, in healthy controls, AAS had a lower impact than in the HD sample (B = 0.359 vs. 0.431), while the corresponding effects of age and gender (Model$_H$ 1: p < 0.001), LTI, FTI, and Davies comorbidity score (Model$_H$ 2: p < 0.001) were adjusted for. The proportion of variation in PCS attributed to AAS was 14.9% (Model$_H$ 3: p < 0.001). The current study results showed that physical activity in everyday life as measured by the HAP questionnaire is associated to a higher degree with the quality of life of HD patients than in healthy subjects. Routine physical activity programs are therefore highly justified, and the nephrology community should play a leading role in this effort.

Autorski prilog u okviru šire studije zasnovane na empirijskom istraživanju odnosi se na identifikaciju odrednica izbora sudbine stanovništva (iseljavanje ili lokalni socijalni i politički angažman). Pokazalo se da su oni koji imaju veće potencijale, potaknuti u većoj mjeri relativnom nego apsolutnom deprivacijom, skloniiji iseljavanju nego angažiranijem sudjelovanju u unapređenju lokalne kvalitete življenja.

Ruralna područja Europske unije u mnogočemu zaostaju za urbanim, kao što su dostupnost zdravstvenih usluga, prijevoz, kulturni sadržaji. U radu su utvrđene socioekonomske karakteristike života u ruralnim područjima EU te preporuke kreatorima politika. Korišteni su podaci Eurostata za ekvivalentnim raspoloživim dohotkom (€), troškove stanovanja, nezaposlenost te procjenu stanovništva o zdravstvenom stanju u razdoblju od 2014. do 2018. Zemlje članice EU-28 podijeljene su na sjever i jug. U svim navedenim kategorijama vidljive su razlike sjevera i juga, gdje su potonji puno više nezadovoljni, odnosno manji je neto dohodak, ali su troškovi stanovanja i nezaposlenost veći. Zadovoljstvo zdravstvenim uslugama puno je manje među južnim članicama, a Baltičke zemlje također izražavaju nezadovoljstvo. Kako bi se smanjio jaz među zemljama, navedeni su primjeri dobre prakse te dane preporuke za kreatore politika. The rural areas of the European Union lag far behind the urban ones in many ways, such as the availability of health services, transport and cultural facilities. This paper identifies the socio-economic characteristics of life in rural areas of the EU and makes recommendations to policy makers. Eurostat data were used for the median equivalised net income(€), housing costs, unemployment and population assessment of health status, in the period from 2014-2018, 28 member states of EU are divided into north and south. In all these categories, the differences between the north and the south are visible, where the latter are much more dissatisfied, i.e. they have lower net income and housing costs and unemployment are higher. Satisfaction with the health situation is much lower among the southern members, and the Baltic countries also express dissatisfaction. In order to reduce the gap between the countries, there are given examples of a good practice and recommendations to policy makers.

U izvješću su prikazani rezultati demografske analize sekundarnih podataka, rezultati kvantitativnog istraživanja na reprezentativnom uzorku punoljetne populacije županije i rezultati intervjua i fokus grupa među predstavnicima javnog života žuupanije.

Die vorliegende Masterarbeit beschäftigt sich mit dem Thema der Auswirkungen der nachhaltigen Weiterentwicklung der Stadt Wien, wobei der Ausbau der bereits bestehenden und einer neuen U-Bahn Linie in den Vordergrund gerückt wird. Stützend auf den Ausbau wird die Lebensqualität der Bevölkerung analysiert, die in der Ausbauphase unter verschiedenen gesellschaftlich bedingten Aspekten geändert und entwickelt wird. Gleichzeitig wird die Masterarbeit auch die Mobilitätsproblematik im Alltag aufzeigen, welche sich durch die Ausführung des Ausbaus, die Anpassung des unterirdischen Verkehrs und die Beeinträchtigung des Straßenverkehrs in der Stadt reflektieren wird. Bezugnehmend auf das Thema, wird die Masterarbeit auch die Komplexität der nachhaltigen Planung und Stadtentwicklung hervorheben, die sich durch diverse Auswirkungen in der Stadt, sowie vor allem auf der Lebensqualität der Bewohner auswirkt. In dem empirischen Teil wurden, anhand einer Umfrage, die Auswirkungen des Ausbaus der U-Bahn-Linien geforscht. Die Befragten wurden nach der täglichen Anwendung der öffentlichen Verkehrsmittel befragt, wobei auch der Grund der persönlichen Auswahl zwischen den Transportmitteln hinterfragt worden ist. Zugleich wurde die Zufriedenheit mit dem Angebot der öffentlichen Verkehrsmittel hintefragt und vor allem die Stellungnahme des Einzelnen Befragten zu der Ausbauphase des Linienkreuzes U2/U5. Die Ergebnisse der Umfrage werden in der anschließenden Diskussion vorgestellt und kommentiert. V magistrskem delu bodo predstavljeni vplivi trajnostnega razvoja mesta Dunaj, kjer bo izgradnja obstoječe in nove linije podzemne železnice postavljena v ospredje. Na podlagi izgradnje omenjenih linij bo analizirana kakovost življenja prebivalstva, ki bo v času izgradnje zaznamovana skozi različne družbeno pogojene vzorce. Obenem bo magistrska naloga izpostavila vprašanja mobilnosti v času izgradje, ki se bodo odražali predvsem v okrnitvi cestnega prometa in prilagajanju podzemnega na le-tega.Posledično bo magistrska naloga izpostavila tudi kompleksnost trajnostnega načrtovanja in urbanega razvoja, ki se predvsem reflektira na kakovosti življenja v mestu. V empiričnem delu naloge je bila izvedena raziskava, kjer smo raziskovali vplive širitve linij podzemne železnice. Anketirance smo povprašali o vsakodnevni uporabi javnega prevoza in njihovih osebnih razlogih izbire javnega prevoznega sredstva. Hkrati raziskava prikazuje tudi mnenje prebivalstva o izgradnji novega podzemnega križa U2/U5, katero je predstavljeno v zaključni razpravi.

Izhodišča: Za področje psihiatrične zdravstvene nege je pomembno, da poznamo problematiko kajenja pri ljudeh z duševno motnjo in motnjo v duševnem razvoju. Namen diplomskega dela je raziskati področje kajenja pri ljudeh z duševno motnjo in motnjo v duševnem razvoju ter dejavnike, ki vplivajo na kajenje, kako to doživljajo posamezniki, ter kaj vpliva na odločitev o prenehanju kajenja. Raziskovalna metodologija in metode: Za predstavitev teoretičnih izhodišč smo uporabili deskriptivno metodo dela. Izvedli smo pregled in analizo slovenske in tuje literature iz področja, ki ga opisujemo. V empiričnem delu smo uporabili kvantitativno metodo dela, raziskovali smo s pomočjo anketnega vprašalnika. Podatke smo na koncu analizirali in jih predstavili s pomočjo računalniških programov Microsoft Word in Microsoft Excel. Rezultati: V raziskavi smo ugotovili, da je od 100 anketirancev, kar 79 trenutnih kadilcev, 11 bivših kadilcev in 10 nekadilcev. 42 % anketirancev ne razmišlja o prenehanju kajenja. O pomembnosti kajenja je kar 42 % anketirancev na lestvici od 1 do 10, izbralo 10. Večina anketirancev, 87 %, meni, da so odvisni od kajenja. Diskusija in zaključek: Raziskava je pokazala, da je med pacienti z duševno motnjo in motnjo v duševnem razvoju veliko trenutnih ali bivših kadilcev, ki kljub zavedanju, da kajenje škoduje zdravju, še vedno kadijo. Do prenehanja kajenja bi večino pripeljala želja po izboljšanju zdravstvenega stanja, bolezen njihovih bližnjih kot posledica kajenja ter prihranek oziroma pomanjkanje denarja. Introduction: In the field of health care, it is important that we know what affects on issues of smoking in people with mental illness and mental disorder. The purpose of the degree paper is to research the entire field of smoking in general and in people with mental illness and mental disorder as well as the factors which have and effect upon smoking, how individuals experience smoking and what effects on the decision of quitting smoking. Research methods: We used descriptive and qualitative work method. For the presentation of the theoretical starting point, we used descriptive work method. With that we used the overview and the analysis of Slovenian and foreign literature in the field that we are describing. In the empirical part we used the qualitative work method, we researched it with help of the survey questionnaire. We analysed the data and presented them with a help of computer programs such as Microsoft Word and Microsoft Excel. Results: In the research we found out that from 100 interviewees, as many as 79 current smokers, 11 ex-smokers and 10 non-smokers. On the scale from 1 to 10, for 42% interviewees smoking means 10. The most of the interviewees, 87%, thinks that they are addicted to smoking. Discussion and concclusion: The research showed that in between patients with mental illness and mental disorder is a lot of current smokers and ex-smokers. Despite the awareness, that smoking is harmful for your health, they continue to smoke. To most people, a desire to improve their health, illness of loved ones as consequences of smoking and saving or lack of money would drive this cessation of smoking.

Izhodišča: Za shizoafektivno motnjo so značilne epizodične motnje, pri katerih so vidni tako afektivni kot shizofreni simptomi, ki pa ne upravičujejo diagnoze bodisi shizofrenije ali depresivne ali manične epizode. Namen diplomskega dela je bil raziskati vpliv shizoafektivne motnje na kakovost življenja. Raziskovalne metode: Uporabili smo deskriptivno (opisno) metodo dela, v empiričnem delu pa kvalitativno metodologijo raziskovanja. Opravili smo intervju s pacientko, ki ima diagnosticirano shizoafektivno motnjo. Rezultati: Ugotovili smo, da ima pacientka težave s prekomerno telesno težo, z motenim vzorcem spanja in s tesnobo, kar lahko vpliva na kakovost življenja. Pacientka dobro pozna sebe, se posluša, se zna soočiti s stresnimi situacijami, ki bi lahko vplivale na kakovost življenja. Diskusija in zaključek: Kakovost življenja niso le posameznikove finančne zmožnosti, ampak je povezana tudi z občutkom zadovoljstva z lastnim življenjem. Pomembno je, da zna posameznik obvladovati stres, poslušati svoje telo, sebe. Prav tako je zelo pomembna vloga in podpora družine, skupnosti, ki v veliki meri pripomore k boljši kakovosti življenja pacienta. Basis: Schizoaffective disorder is characterized by episodic disorders, which include both affective and schizophrenic symptoms, but do not justify the diagnosis of either schizophrenia or depressive or manic episode. Purpose of the work is to investigate the impact of schizoaffective disorder on quality of life. Research methods: The diploma thesis includes descriptive method and in the empirical part we used qualitative methodology. We made an interview with a patient, who was diagnosed with schizoaffective disorder. Results: We found out that the patient has problems with excessive body weight, dysfunctional sleep pattern and anxiety, which can have an effect on quality of life. The patient knows herself well, listens to herself and she can confront stressful situations, that could affect her quality of life. Discussion and conclusion: Quality of life is not only financial abilities of an individual, but it is also associated with a feeling of satisfaction with their own life. It is important for an individual to know how to deal with stress and how to listen to their body, themselves. The roles of a family and a community are also very important. They are of enormous support and that is how they can contribute to better quality of life of the patient.

Izhodišča: Vstavitev perkutane endoskopske gastrostome je manjši kirurški poseg, opravljen v lokalni anesteziji, pri katerem se del želodca pričvrsti na trebušno steno, vstavi se gastrostomska cevka, s pomočjo katere se bolnik prehranjuje. Vstavitev je navadno izvedena zaradi nezmožnosti hranjenja per os ali zaradi rakavega obolenja, najpogosteje gre za rak glave ali vratu. Namen zaključnega dela je ugotoviti, kakšna je kakovost življenja bolnika z vstavljeno perkutano endoskopsko gastrostomo. Raziskovalne metode: Uporabljen je sistematičen pregled strokovne in znanstvene literature. Potek iskanja literature je predstavljen v PRISMA diagramu. Glede na zastavljeno raziskovalno vprašanje, je iskanje literature potekalo po vnaprej zastavljenih vključitvenih in izključitvenih kriterijih. V analizo je zajetih 15 raziskav. Rezultati: Z analizo literature smo ugotovili, da perkutana endoskopska gastrostoma ne vpliva na izboljšanje kakovosti življenja, pa tudi na zmanjšanje kakovosti življenja ne. Zaradi nezmožnosti hranjenja per os gre predvsem za olajšanje težav, saj perkutana endoskopska gastrostoma vzdržuje prehranjenost in telesno težo. V prvih mesecih po vstavitvi je prisotnih veliko težav. Največje težave povzroča spoprijemanje bolnika s perkutano endoskopsko gastrostomo, slabost, hiter občutek sitosti, okužba, krvavenje in zatekanje želodčnega soka ob vstopnem mestu gastrostomske cevke. Nekje po šestih mesecih pa bolniki začnejo perkutano endoskopsko gastrostomo doživljati tudi pozitivno. Diskusija in zaključek: Na posameznikovo življenje perkutana endoskopska gastrostoma najprej zaradi številnih sprememb in težav, do katerih pride po vstavitvi, vpliva negativno. Kasneje pa vpliva pozitivno, saj lajša posledice določene bolezni in s tem izboljša kakovost življenja bolnika. Background: Percutanous endoscopic gastrostomy is small and non invasive surgical procedure, carried out in local anesthesia. Part of a stomach is attached to the stomach wall. Then the gastrostomy tube is inserted. The patient can eat through the tube. Inability to eat orally or cancer, mostly head and neck cancer, are the reasons for insertion. The purpose of the final work is to determine the quality of life of patients with percutaneous endoscopic gastrostomy. Research methods: Systematic review of the professional and scientific literature was used. The course of literature search is presented in the PRISMA flow diagram. According to the research question, the search for literature was based on predetermined inclusion and exclusion criteria. In literatue analysis was used 15 researches. Results: With the analysis of professional literature, we found that percutaneous endoscopic gastrostomy does not increase the quality of life and also does not decrease the quality of life. Percutaneous endoscopic gastrostomy helps to maintain nutritional status and to gain weight. In first few months there are many difficulties. The biggest problem for patients represents handling with percutaneous endoscopic gastrostomy, nausea, feeling full quickly, infection, bleeding and leaking of gastric acid around the gastrostomy tube. After six months the patients are also experiencing the positive sides of percutaneous endoscopic gastrostomy. Discussion and conclusion: In first months percutaneous endoscopic gastrostomy has negative impact on patient life, because of many different cahanges in every day activities. Later by mantaining their nutritional stastus, percutaneous endoscopic gastrostomy impacts positive on patient life. Percutaneous endoscopic gastrostomy decreases consequences of ilness and with that increases the quality of life.

Kakovost življenja in z njo sreča, ni pogojena samo s posameznikovim finančnim stanjem in imetjem, ampak predvsem s tem kako zadovoljen je s svojim življenjem. Kakovost življenja ima velik pomen tudi za paciente z duševno motnjo, saj so zaradi svojega stanja velikokrat prikrajšani pri osnovnih stvareh, ki vplivajo na zadovoljstvo v življenju. Pregled literature je pokazal, da na kakovost življenja pacienta z duševno motnjo vpliva veliko dejavnikov, tako pri pacientih pred hospitalizacijo kot pri pacientih v času hospitalizacije in ponovnemu vključevanju v družbo po hospitalizaciji. Najpomembnejši izmed teh dejavnikov so družina in njena podpora, stigma, razpoložljiva pomoč in možnosti zaposlitve, ki posamezniku omogočajo karseda normalno in neodvisno življenje. V diplomskem delu smo raziskali, kako posamezni dejavniki vplivajo na življenje pacienta z duševno motnjo in ugotovili, da kljub izobraževanju na tem področju in porastu v pojavu duševnih motenj, paciente še zmeraj spremlja močna stigma. Ta izvira iz nerazumevanja duševnih motenj, saj je vsaka drugačna in posebna tako kot tudi vsak posameznik, ki za to motnjo zboli. The quality of life, and with it happiness, is not conditioned solely on the individual's financial situation and property, but above all, how satisfied he is with his life. The quality of life is also important for patients with a mental disorder, because they are often deprived of their basic state of things because of their state of health. A review of literature has shown that the quality of life of a patient with a mental disorder is influenced by many factors, both in patients from hospitalization and in patients during hospitalization and reintegration into society after hospitalization. The most important of these factors are the family and its support, stigma, available help and employment opportunities that allow an individual to live a normal, independent life. In the diploma work, we investigated how individual factors influence the life of a patient with a mental disorder and found that, despite education in this field and an increase in the occurrence of mental disorders, patients are still accompanied by strong stigma. This originates from the misunderstanding of mental disorders, since each is different and special, just like any individual who falls ill with this disorder.

Koncept kvalitete življenja predstavlja osebam z motnjami v duševnem razvoju temelj za oblikovanje kvalitetne podpore, ki posamezniku omogoča optimalen razvoj in dobrobit. Duhovnost kot ena izmed bistvenih dimenzij kvalitete življenja tako osmišlja posameznikovo izpolnjeno in smiselno življenje v skupnosti. Zato je naloga vseh strokovnjakov, ki delamo z osebami z motnjami v duševnem razvoju, da jim omogočamo pogoje, možnosti za razvoj in doživljanje teh dveh področij življenja, ki vplivata na njihovo funkcioniranje, zadovoljstvo, ozaveščanje doživljanja in napredek, hkrati pa predstavljata del posameznikovega podpornega sistema. S kvalitativno fenomenološko raziskavo smo s pomočjo skupinskih intervjujev preučili, kako odrasle osebe z motnjami v duševnem razvoju doživljajo duhovno življenje ter kakšne vplive ima to na njihovo kvaliteto življenja. Z njo smo želeli predstaviti osebno doživljanje oseb z zmernimi motnjami v duševnem razvoju, kar je z vidika preučevanja kvalitete življenja najbolj smotrno in z vidika izboljševanja služb podpore in osebnega planiranja podpore najbolj pomembno. Izsledki so pokazali, da osebe z zmernimi motnjami v duševnem razvoju iščejo smisel življenja v odnosu, saj jim skupno delo, obroki, bivanje, obiski, druženja ob praznovanjih osebno veliko pomenijo. Želijo si imeti čas za umiritev in srečevanje z Bogom preko molitve, pogovorov, obiska svetih maš, romanj. Smisel življenja jim predstavljajo različne oblike srečevanj in pristna prisotnost v trenutnem času, ki jo doživljajo preko osebnih stikov z drugimi, umirjanja z glasbo ali duhovnega stika z Bogom in drugimi ljudmi preko molitve. Duhovnost tako pozitivno vpliva na doživljanje izboljšanja kvalitete življenja. Na podlagi individualnih doživljajskih zgodb smo podali konkretne smernice za strokovne delavce na področju oblikovanja duhovnega programa, obenem pa spodbudili razmislek o pomenu duhovnosti. The concept of quality of life represents to people with intelectual disabilities a foundation to shape quality support, which enables an optimal development and welfare for each individual. Spirituality as one of the essential dimensions to the quality of life gives meaning to the individual’s life in a community. Therefore, the job of all experts who work with people with intelectual disabilities is to create opportunities and conditions for development and experience these two parts of life, which affect their activity, satisfaction, informing their experience and progress. Simultaneously these parts of life represent a part of an individual’s support system. With a qualitative phenomenological research and the help of group interview we examined how adult people with intelectual disabilities incorporate spirituality into their lives and whether this affects their quality of life. With this research we wanted to present a personal experience of people with intelectual disabilities, which is most sensible to do with respect to examining the quality of life, improvement of expert support service, and the personal planning of support. The results have shown that people with intelectual disabilities search the meaning of life in relationships as working together, meals, residence, visits, and celebrations mean a tremendous amount to them. They want to have time to calm down and meet with God through prayer, conversations, going to Mass, and pilgrimages. They find the meaning of life in various social gatherings and authentic presence in the moment, which they experience through personal contacts with other people, calming down with music or spiritual connection with God and other people through prayer. In this sense, spirituality positively affects the experience of improving the quality of life. Based on individual experience we provided concrete guidelines for experts on how to structure a spiritual programme and encouraged them to give the meaning of spirituality serious consideration.

Izhodišča. Rak dojke je najpogostejša maligna bolezen žensk v razvitem svetu. Zdravi se s kombinacijo različnih metod, ki od obolele ženske zahtevajo velik fizični in psihični napor, na njej in njeni osebnosti pa pustijo velik pečat. Naš namen je predstaviti rak dojke, ter posledice, ki jih le-ta pušča na njenih socialnih stikih, psihološke težave, ki se pojavljajo kot posledica spremenjenega fizičnega izgleda, in kako se z njimi spopadati. Raziskovalne metode. Diplomsko delo vključuje deskriptivno metodo. V empiričnem delu smo uporabljali kvalitativno metodologijo. Metoda izbora je intervju, ki smo ga izvedli v ambulanti s pacientko po zaključenem zdravljenju raka dojke. Rezultati. Naše ugotovitve so, da sama diagnoza raka dojke zelo prizadene pacientko. Ob diagnozi se najprej pojavi stanje šoka, nato tekom zdravljenja preide v brezup, psihično in fizično izčrpanost. Pomembno je, da ima pacientka ob sebi nekoga, ki mu lahko zaupa, se nanj osloni. V našem primeru je to bil partner, pa tudi skupine za samopomoč, kjer so ženske z istimi težavami, ki skupaj premagujejo ovire. V našem primeru je pacientki pomagalo tudi izobraževanje o bolezni. Diskusija in zaključek. Rak dojke na ženski pusti velik pečat. Ne samo, da njen telesni izgled ne bo več isti, tudi njena osebnost bo za vedno spremenjena. Diagnoza in zdravljenje sta zelo obremenjujoča za psiho obolele ženske in za njene socialne stike. Spremeni se pacientkin odnos s partnerjem, družino, socialnim okoljem. Pomembno je, da se pacientka zna s težavami spopadati, pri tem ji lahko pomagajo njeni bližnji, učinkovite pa so tudi skupine za samopomoč. Introduction. Breast cancer is the most common malignant disease of women in the developed world. It is treated by a combination of various methods, that require a large physical and psychological effort from the woman, leaving a great mark on her and her personality. Our intention is to present breast cancer, the consequences it leaves on social contacts, the psychological problems that arise because of the changed physical appearance, and how to deal with them. Methodology. The diploma includes a descriptive method. In the empirical part, we used qualitative methodology. Our selected method is an interview, performed at the patient's clinic, after the conclusion of breast cancer treatment. Results. Our findings are, that the diagnosis of breast cancer greatly affects the patient. When diagnosed, a shock state occurs, then during treatment it leads to hopelessness, psychological and physical exhaustion. It is important, that the patient has a person to trust and rely on. In our case, it was her partner, as well as self-help groups, with women, having the same problems, that overcome obstacles together. Educating about the disease also helped. Discussion and conclusion. Breast cancer leaves a large impact on the patient. Not only her physical appearance is affected, also her personality is changed forever. Diagnosis and treatment are very burdensome for the patient and her social network. The patient's relationship with her partner, family and social environment changes. It is important, that the patient is able to cope with difficulties, with their help. Self-help groups are also effective.

Naše dosedanje izkušnje in izkušnje drugod jasno utemeljujejo potrebo dosmrtnega spremljanja bolnikov, ozdravelih od raka v otroštvu. Glede na to, da se enake težave in posledice zdravljenja raka verjetno pojavljajo tudi pri drugih bolnikih, ki imajo pred seboj še dolgo življenje, je potrebno dosmrtno spremljanje vseh nekdanjih bolnikov, ki so zboleli v mladosti.

The aim was to determine whether pregnant women conceiving through in vitro fertilization (IVF) differ from those conceiving spontaneously in terms of psychological well-being and the quality of life.In a prospective study we included 75 women conceived after IVF and 78 who conceived spontaneously in the same time period (control group). All the women were sent a self-report questionnaire about demographic and reproductive history, health, pregnancy concerns, containing Subjective Quality of Life Scale (QLS), Positive and Negative Affect Schedule (PANAS), the Psychological Well-Being Scale (PWB), Beck Depression Inventory (BDI), and Zung Self-Assessment Anxiety Scale (SAS); obstetric and newborn's data were obtained from medical records. Response rate was 66.6% in the IVF and 83.3% in control group.The mean women's age was 33.8 years in the IVF, and 32.5 years in the control group (NS). There were no significant differences between groups on the most of the outcome measures assessing psychological status. IVF mothers were just less satisfied in "friend/acquaintances" (P=0.03), a higher percentage had sexual problems prior to conception (P=0.03); the length of hospitalization during pregnancy was longer (P=0.02), and the preterm delivery rate was higher (P=0.01). Withingroup changes over gestation time indicated that IVF women, not controls, showed an increase in positive affect (P=0.04) and purpose in life (P=0.05).IVF women are inclined to social isolation. Despite more medical problems during pregnancy, they reported improved positive emotions and purpose in life as the pregnancy progressed.Namen študije je bil ugotoviti, ali se počutje in stopnja kvalitete življenja žensk, ki zanosijo s pomočjo postopkov oploditve z biomedicinsko pomočjo (in vitro fertilization - IVF), razlikuje od počutja in stopnje kvalitete življenja žensk, ki zanosijo spontano.V prospektivno študijo smo vključili 153 nosečnic; 75 žensk je zanosilo po IVF-metodi (IVF-skupina), 78 pa spontano v istem časovnem obdobju (kontrolna skupina). Odzvalo seje 66,6% žensk v IVF-skupini in 83,3% žensk v kontrolni skupini. Vsem je bil poslan anamnestični vprašalnik o biografskih in reproduktivnih podatkih, zdravstveni zgodovini in doživljanju nosečnosti, ki je vseboval tudi lestvico subjektivne kvalitete življenja (QLS), lestvico pozitivnih in negativnih čustev (PANAS), lestvico dobrega počutja (PWB), Beckov vprašalnik depresije (BDI) in Zinged vprašalnik anksioznosti (SAS). Podatke o porodu in novorojencu smo dobili iz porodnega zapisnika.Povprečna starost žensk v IVF-skupini je bila 33,8 leta in v kontrolni skupini 32,5 leta. Skupini se po psihičnem statusu žensk nista razlikovali v večini merjenih spremenljivk. Ženske v IVF-skupini so izražale le manjše zadovoljstvo s svojim socialnim življenjem (P=0,03), imele so več težav v spolnosti pred zanositvijo (P=0,03), odstotek hospitalizacij pri njih je bil višji (P=0,02) in tudi delež prezgodnjih porodov je bil višji (P=0,01). Testiranje sprememb znotraj skupin je pokazalo naraščanje pozitivnih čustev (P=0,04) in občutenja smisla življenja (P=0,05) z napredovanjem nosečnosti v IVF-skupini.Ženske v IVF-skupini težijo k socialni izolaciji. Kljub večjemu številu zdravstvenih težav pa se z napredovanjem nosečnosti krepijo njihova pozitivna čustva in občutenje smisla življenja.

Merkaptani (R-SH) i sumporovodik (H2S) spadaju u grupu spojeva neugodna i nadražujuća mirisa čija prisutnost u zraku u većim koncentracija značajno narušava kvalitetu življenja. Izvor R-SH i H2S uglavnom je raspad ugljikovodika u anaerobnim uvjetima. U zrak mogu dospjeti i kao jedni od nusprodukata tijekom eksploatacije i prerade prirodnog plina. Uredbom o razinama one- čišćujućih tvari u zraku (NN 117/2012, NN 84/17) propisane su granične vrijednosti (GV) koncen- tracija s obzirom na kvalitetu življenja (dodijavanje mirisom) na temelju 24-satnih prosjeka (GV (R-SH) = 3 μg/m3 , GV (H2S) = 5 μg/m3 ) kao i učestalost dozvoljenih prekoračenja tijekom kalendar- ske godine (prekoračenje GV ≤ 7 puta). Na lokalitetu plinskog polja Molve u Podravini od početka eksploatacije prirodnog plina osam- desetih godina prošlog stoljeća započelo se i sa sustavnim mjerenjima onečišćenja zraka, vode, tla, vegetacije i radioaktivnosti. Mjerenja se provode u okviru Programa utvrđivanja stanja okoliša u zoni utjecaja Centralne plinske stanice (CPS) Molve kao mogućeg izvora onečišćenja. Koncentra- cije R-SH i H2S u zraku praćene su na 5 mjernih postaja smještenih na CPS Molve i okolnim bušo- tinama. Prikazani su rezultati mjerenja R-SH i H2S u razdoblju od 2012. do 2016. godine. Mjerenja su se provodila 24-satnim uzorkovanjem tijekom trideset dana u toplijem i trideset dana u hladnijem dijelu godine. Uzorci R-SH i H2S prikupljani su prosisavanjem zraka kroz impregnirane filtar pa- pire, a masene koncentracije u zraku određene su spektrofotometrijski, pri čemu se koncentracija merkaptana odnosi na ukupne merkaptane, R-SH. Dobiveni rezultati obrađeni su statistički te inter- pretirani prema navedenoj Uredbi. Rezultati pokazuju da su se srednje mjesečne koncentracije merkaptana na plinskom polju Molve u toplijem dijelu godine kretale u rasponu od 0, 27 μg/m3 (2014.) do 1, 11 μg/m3 (2015.), dok su u hladnijem dijelu godine bile nešto veće, od 0, 34 μg/m3 (2013.) do 2, 93 μg/m3 (2015.). U proma- tranom razdoblju od pet godina, samo je tijekom zimskog razdoblja 2015. godine došlo do prekora- čenja GV više od 7 puta, koliko je dozvoljeno Uredbom, na dvije mjerne postaje (9 i 10 puta). Za H2 S se srednja mjesečna koncentracija u toplijem dijelu godine kretala od 0, 66 μg/m3 (2012.) do 3, 88 μg/ m3 (2014.), a u zimskom periodu vrijednosti su bile nešto niže i kretale su se u rasponu od 0, 28 do 2, 05 μg/m3 (2012.). U petogodišnjem razdoblju praćenja dolazilo je povremeno do prekoračenja GV za H2S no učestalost dozvoljenih prekoračenja tijekom kalendarske godine nikad nije bila veća od propisanih 7 puta.

Teoretična izhodišča: Totalna laringektomija je poseg pri katerem se bolniku, največkrat zaradi malignega obolenja, grlo v celoti odstrani. Bolniku se naredi traheostoma, s pomočjo katere diha, pot prehranjevanja pa se popolnoma loči od dihalne poti. Totalna laringektomija spremeni življenje bolnika in njegovo kakovost, saj bolnik ni več zmožen govora oz. verbalne komunikacije. Namen zaključnega dela je ugotoviti kakšna je komunikacija in kakovost življenja bolnikov po totalni laringektomiji. Raziskovalne metode: V zaključnem delu je uporabljen sistematični pregled strokovne in znanstvene literature. Potek iskanja literature je predstavljen v PRISMA diagramu poteka. Iskanje literature je potekalo po vnaprej zastavljenjih vključitvenih in izključitvenih kriterijih, glede na zastavljeno raziskovalno vprašanje. Rezultati: Z analizo strokovne literature smo ugotovili, da totalna laringektomija v veliki meri vpliva na kakovost življenja bolnikov, predvsem zaradi nezmožnosti verbalne komunikacije. V prvih letih življenja po totalni laringektomiji se bolniki še vedno navajajo na nov način življenja, nove načine komunikacije in interakcije z drugimi. Zmanjšana kakovost življenja pri bolnikih povzroči občutek manjvrednosti, pojav depresije, anksioznosti, zaprtosti v sebe. Bolniki so lahko izpostavljeni stigmatizaciji, imajo občutek nesprejetosti, zaradi izgube smisla življenja se pri nekaterih pojavljajo samomorilne misli. Diskusija in zaključek: Totalna laringektomija zelo vpliva na kakovost življenja bolnikov. Prizadeto je bolnikovo fizično, psihično in socialno življenje. Po posegu potrebujejo podporo in pomoč, tako zdravstvenega in negovalnega osebja, kot tudi družine in prijateljev. Theoretical background: Total laryngectomy is a surgery in which the throat is completely removed from the patient, mostly due to malignancy. Tracheostomy is performed on the patient by means of which he breathes, and the feeding path is completely separated from the airway. Total laryngectomy changes the patients life and the quality of it, since the patient is no longer able to speak, i.e. to verbally communicate. The purpose of the final work is to determine the communication and the quality of life of patients after total laryngectomy. Research methods: Systematic review of the professional and scientific literature was used. The course of literature search is presented in the PRISMA flow diagram. The search for literature was based on predetermined inclusion and exclusion criteria, according to the research question. Results: With the analysis of professional literature, we found that total laryngectomy affects the quality of life of patients, largely because of the impossibility of verbal communication. In the first years of life after the total laryngectomy, patients are still getting used to a new way of life, new ways of communicating and interacting with others. The reduced quality of life in patients causes a feeling of inferiority, the appearance of depression, anxiety and patients might become reserved. Patients may be exposed to stigmatization, have a feeling of rejection and because of the loss of the meaning in life some develop suicidal thoughts. Discussion and conclusion: Total laryngectomy greatly affects the quality of life of patients. The patients physical, psychological and social life is affected. After the surgery they need support and help by both medical and nursing staff, as well as family and friends.

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 (p0.001), and between total and partial mesorectal excision (p0.001). 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.Prevod in potrditev vprašalnika o sindromu nizke sprednje resekcije rektuma (vprašalnik LARS).Študija, ki je vključevala 100 slovenskih bolnikov, je potekala februarja in marca 2018. Vprašalnik LARS je bil preveden v slovenščino iz angleščine po mednarodnih priporočilih. Sodelovali so pacienti, ki so bili zaradi raka danke na Univerzitetnem kliničnem centru v Ljubljani operirani v obdobju od 1. januarja 2006 do 31. decembra 2010 in pri katerih je bila narejena sfinkter ohranjujoča nizka sprednja resekcija rektuma. Poleg vprašalnika LARS so pacienti odgovorili tudi na dodatno vprašanje o vplivu težav s črevesjem na kvaliteto svojega življenja.Vprašalnik z dodatnim vprašanjem smo poslali 150 pacientom, v raziskavo jih je bilo vključenih 100. Pri 58 bolnikih so rezultati potrdili prisotnost zelo izrazitega sindroma nizke sprednje resekcije. Vprašalnik LARS zanesljivo loči bolnike, ki so bili pred operacijo obsevani, od tistih, ki tovrstnega zdravljenja niso prejeli (p0,001). Prav tako zanesljivo razlikuje tudi med pacienti, pri katerih je bil narejen delni ali popolni izrez mezorektuma (p0,001). Starost ni povezana z rezultati vprašalnika LARS (p = 0,975). 51 naključno izbranim pacientom smo vprašalnik poslali dvakrat. Popolno skladnost med vprašanjem o kvaliteti življenja in izidom vprašalnika LARS smo ugotovili v 66,0 %, zmerno skladnost pa v 24,0 %, kar kaže dobro konvergenčno veljavnost testa. Testiranje in ponovno testiranje sta potrdili visoko zanesljivost slovenskega prevoda vprašalnika s korelacijskim koeficientom znotraj skupine, ki je znašal 0,86.Slovenski prevod vprašalnika LARS smo potrdili kot notranje skladno, zanesljivo in natančno orodje za oceno funkcionalnih težav s črevesjem pri pacientih po operaciji raka danke in tudi vpliv teh na kvaliteto njihovega življenja.

Uvod: Osteoartroza kolena ima pomemben negativni vpliv na kvaliteto življenja povezano z zdravjem. Z odkrivanjem terapij, ki izboljšajo kvaliteto življenja pri pacientih z osteoartrozo kolena, bi lahko zmanjšali klinično, ekonomsko in socialno breme te bolezni. Namen: Glavni namen našega dela, je bil poročati o kvaliteti življenja in ortotični oskrbi pacienta z osteoartrozo kolena in ugotoviti, katera ortoza najbolj izboljša kvaliteto življenja po osmih dneh uporabe. Metode dela: V poročilo o primeru smo vključili 59-letnega pacienta z osteoartrozo in spremljajočo varusno deformacijo. Odločili smo se, da bomo preizkusili in primerjali tri različne ortoze. Izdelali smo ortozo za stopalo in ortozo za gleženj in stopalo, kolensko ortozo pa smo uporabili serijsko štiri točkovno (Medi-protect.4 evo). Primarni izid smo merili s pomočjo Knee injury and Osteoarthritis Outcome Score vprašalnika, sekundarnega pa s pomočjo Testa hoje na 10 m in z merjenjem lateralnih odklonov goleni v frontalni ravnini z merilno napravo MotionPod. Rezultati: Izid Knee injury and Osteoarthritis Outcome Score vprašalnika je bil najboljši pri ortozi za gleženj in stopalo, nato pri ortozi za stopalo in nazadnje pri kolenski ortozi, kjer so se rezultati celo nekoliko poslabšali v primerjavi z začetnim stanjem. Pri Testu hoje na 10 m se je statistično izboljšala hitrost sproščene hoje z uporabo ortoze za gleženj in stopalo. Pri hitri hoji nismo zaznali pomembnih razlik. Merjenje lateralnih odklonov je pokazalo največje zmanjšanje kotov z uporabo ortoze za gleženj in stopalo, sledila ji je ortoza za stopalo in nazadnje kolenska ortoza, vendar razlike niso statistično pomembne. Razprava in zaključek: Kvaliteto življenja našega pacienta je najbolj izboljšala ortoza za gleženj in stopalo, ki je tudi najbolj primerna za vsakodnevne aktivnosti, za športne aktivnosti pa ortoza za stopalo. Kolenska ortoza se je za našega pacienta izkazala kot neučinkovita, preveč okorna in neudobna. V prihodnje bi bilo dobro vključevati kvaliteto življenja v vse raziskave, ki temeljijo na pacientih z osteoartrozo kolenskega sklepa. Čeprav so nekatere ortoze mehansko učinkovite in zmanjšujejo bolečine, pa jih pacienti zaradi neudobja in okornosti zavračajo. Z vključevanjem tovrstnih vidikov bi morda lahko pripomogli k boljšim rezultatom ortotične oskrbe in kvaliteti življenja pacientov z osteoartrozo kolenskega sklepa. Introduction: Knee osteoarthritis has a significant adverse impact on health related quality of life. Recognizing therapies that improve health related quality of life in patients sufering from knee osteoarthritis may reduce the clinical, economic and social burden of this disease. Purpose: The primary aim of this study was to report on quality of life and orthotic care of a patient with knee related osteoarthritis and determining which orthotic is the most efficient at improving quality of life after eight days of use. Methods: A 59-year old male patient with knee osteoarthritis and varus deformity was included in this report. Three different types of orthoses were compared during the study. Foot orthosis and ankle foot orthosis used in this study were custom made and knee orthosis was of the shelf four point system brace (Medi-protect.4 evo). The primary outcome was assesed with Knee injury and Osteoarthritis Outcome Score questionnaire. Timed 10 m walk test was evaluated and angular measurements of thigh's lateral thrust during walking were made using MotioPod as a part of the secondary outcome. Results: Most of the Knee injury and Osteoarthritis Outcome Score subscales were improved by both ankle foot orthosis and foot orthosis but not the knee brace. Evaluation of relaxed timed 10 m walk test showed significant improvements in walking speed compared with initial measurements using ankle foot orthosis. On the other hand fast pace showed no differences between conditions whatsoever. The angles of lateral thrust were most reduced by ankle foot orthosis, following by foot orthosis and the knee brace, however no reduction was statistically significant. Discussion and conclusion: The custom made ankle foot orthosis improved quality of life of our patient and is the most suitable for activities of daily living. Foot orthosis would be recomended for sport activities in addition. Knee brace, however was found inapropriate due to the lack of improvement, bulkiness and discomfort alltogether. Future studies involving patients with knee osteoarthritis may want to consider including quality of life as a part of orthotic treatment outcome. In spite of mechanical effectiveness and success at reducing pain, some orthoses may have poor patient's compliance due to the lack of comfort and bulkiness thus reducing quality of life. Including this perspective in orthotic care may improve quality of life and treatment outcomes of patients with knee osteoarthritis.

Akt požiranja je kompleksen proces, pri katerem sodeluje veliko število organov, mišic in živcev. Na samo požiranje vpliva veliko različnih faktorjev, nujna je tudi usklajenost z dihanjem. Tipična populacija načeloma s požiranjem nima težav, lahko pa se začnejo pojavljati s starostjo ali ob raznih poškodbah in nevrodegenerativnih boleznih. O motnjah požiranja oziroma disfagiji govorimo takrat, ko ocenimo, da je motena vsaj ena izmed faz požiranja. Pri disfagiji se pogosto pojavlja aspiracija, ki lahko resno ogroža bolnikovo zdravje. Zato je pri motnjah požiranja nujna obravnava z multidisciplinarnim pristopom, saj vsak strokovnjak s svojim znanjem pripomore k rehabilitaciji. Slednjo načrtujemo glede na pridobljene diagnostične podatke, kot so vzrok težav in samo izražanje motnje. Pri rehabilitaciji in obravnavi motenj požiranja pa ne smemo pozabiti na kvaliteto življenja oseb z motnjami požiranja, saj ima hranjenje, poleg vseh ostalih, tudi socialno funkcijo ter vpliv na emocionalno stanje posameznika. Prvi in najbolj pogosto uporabljen merski instrument za ugotavljanje kvalitete življenja oseb z motnjami požiranja je SWAL-QOL, ki je preveden v 14 jezikov, sama pa sem ga prevedla še v slovenščino. V empiričnem delu sem tako preverjala merske karakteristike slovenskega prevoda vprašalnika »The SWAL-QOL« na tipični populaciji. V raziskavo je bilo vključenih 187 ljudi različnih starostnih skupin in obeh spolov, brez kakršnihkoli nevroloških težav. V povprečju so osebe v vzorcu na celotnem vprašalniku zbrale 88,22 točk (+/- 8,8), najnižje povprečje točk so dosegale pri ocenjevalnih lestvicah spanja in utrujenosti. Zanesljivost vprašalnika je bila preverjena s Cronbach alfa koeficientom, ki je za celotno vprašalnik znašal 0,947, kar kaže na visoko stopnjo zanesljivosti. Le dve ocenjevalni lestvici sta imeli vrednost Cronbach alfa koeficienta pod 0,7, to sta ocenjevalna lestvica spanja in trajanje hranjenja. Vsebinska veljavnost je bila potrjena s strani štirih ekspertov, konstruktno veljavnost pa sem potrdila z eksplorativno faktorsko analizo, ki je postavke smiselno razdelila v šest faktorjev. S koeficientom variacije in Ferguson delta koeficientom sem preverila diskriminativnost vprašalnika. Za celotni vprašalnik prvi znaša 9,975%, drugi pa 0,99. To pomeni, da je diskriminativnost vprašalnika SWAL-QOL-SI odlična. Nato sem preverila če korelacije med posameznimi ocenjevalnimi lestvicami ter razlike glede na spol in starost. Pokazalo se je, da so vse povezave med ocenjevalnimi lestvicami statistično pomembne, medtem ko se spol in starost nista izkazala za statistično pomembni spremenljivki. Zaključujem, da je vprašalnik SWAL-QOL-SI zanesljiv in veljaven merski pripomoček za uporabo v slovenskem prostoru. The act of swallowing is a complex process involving a large number of organs, muscles and nerves. There are many different factors affecting swallowing, while compliance with the process of breathing is also necessary. A typical population does mostly not have problems with swallowing, but difficulties may start with ageing, various injuries, and neurodegenerative illnesses. We note swallowing disorders or dysphagia when we estimate that at least one of the stages of swallowing has been interrupted. Dysphagia often causes aspiration, which can seriously compromise the patient's health. Therefore, it is necessary to deal with swallowing disorders with a multidisciplinary approach, since each expert shares his own knowledge and contributes to the rehabilitation process. The latter is planned according to the acquired diagnostic data, such as the cause of the problems and signs of the disorder itself. During the rehabilitation process and treatment of swallowing disorders, we must not forget the quality of life of people with swallowing disorders, since feeding, in addition to all others, also has a social function and influences the emotional state of the patient. The first and most widely used measuring instrument for determining the quality of life of people with swallowing disorders is SWAL-QOL, which has been translated into 14 languages, and I have translated it to the Slovene language. In the empirical part, I have tested measurement characteristics of the Slovene translation of the SWAL-QOL questionnaire on a typical population. The study included 187 people of different age groups and of both genders, with no neurological problems. The tested individuals collected a total of 88.22 points (+/- 8.8) on average, the lowest average score was seen at sleep and fatigue assessment scales. Reliability of the questionnaire was verified by the Cronbach alpha coefficient, which was 0.947 for the entire questionnaire, indicating a high level of reliability. Only two assessment scales had the Cronbach alpha coefficient value below 0.7, i.e. sleep and feeding duration assessment scale. Four experts confirmed the substantive validity, and I confirmed the constructive validity with an exploratory factor analysis, which meaningfully divided the items to six factors. With the variation coefficient and the Ferguson Delta coefficient, I examined the discriminatory nature of the questionnaire. The first coefficient is 9.975 % and the second 0.99 for the entire questionnaire. This means that the discrimination of the SWAL-QOL-SI questionnaire is excellent. I then tested correlations between the individual scales and differences in gender and age. It turned out that all the links between the assessment scales are statistically significant, while gender and age have not proved to be statistically significant variables. I conclude that the SWAL-QOL-SI questionnaire is a reliable and valid measuring device for use in the Slovenian area.

Pravica do zaposlitve in delovnih aktivnosti je ena pomembnejših človekovih pravic, kar velja tudi za osebe z motnjami v duševnem razvoju (v nadaljevanju MDR). Osebe z zmernimi, težjimi in težkimi MDR se največkrat vključijo v delovne aktivnosti, ki potekajo v varovanem okolju, v katerem imajo malo stika z lokalno skupnostjo in osebami brez MDR, medtem ko raziskave kažejo, da ima za te posameznike boljši učinek zaposlitev, ki omogoča vključenost v okolje in je čim bolj podobna običajnemu delu. Zaposlitev v običajnem okolju ima v primerjavi z zaposlitvijo v varovanem okolju tudi boljši vpliv na kvaliteto življenja oseb z MDR, predvsem na področjih socialnega vključevanja, razvoja socialnega kapitala ter materialne dobrobiti. V empiričnem delu magistrskega dela sem ugotavljala, kako posamezna od omenjenih dveh oblik zaposlitve vpliva na kvaliteto življenja ter kakšne so glavne razlike med njima v slovenskem prostoru. Uporabljen je bil kvalitativen raziskovalni pristop, zbiranje podatkov pa je potekalo na dva načina, in sicer preko opazovanja z udeležbo ter preko polstrukturiranih intervjujev z uporabniki. Vzorec je obsegal 11 intervjuvancev z zmernimi ali težjimi MDR, ki so vključeni v štiri različna delovna okolja (dve obliki zaposlitve v varovanem okolju ter dve v običajnem okolju), pridobljene podatke pa sem kodirala in interpretirala na podlagi teoretičnih izhodišč. Rezultati raziskave so pokazali, da med zaposlitvijo v varovanem okolju in zaposlitvijo v običajnem okolju obstaja nekaj razlik, še posebej v glavnih značilnostih delovnega mesta, zadovoljstvu uporabnikov, medosebnih odnosih ter plačilu. Nakazala se je tudi povezanost med obliko zaposlitve in kvaliteto življenja, pri čemer oblika zaposlitve na nekatere dejavnike kvalitete življenja vpliva bolj, na nekatere pa manj. Na podlagi rezultatov ugotavljam, da zaposlitev v običajnem okolju, v primerjavi z zaposlitvijo v varovanem okolju, pozitivneje vpliva na večino dejavnikov kvalitete življenja, predvsem na kategorijo socialne vključenosti ter materialne dobrobiti. The right to work is one of the more important human rights, which also holds true for people with intellectual disabilities. People with moderate, severe and profound intellectual disabilities are most often involved in work activities that take place in a sheltered environment (sheltered workshops) in which they have little contact with the local community and people without intellectual disabilities. Meanwhile, research shows that integrated employment, which enables them to be more involved in their local communities, has better impact on individuals with intellectual disabilities then sheltered workshops. Integrated employment also positively impacts their quality of life, especially aspects like social inclusion, social capital and material welfare. This research examines how each of the two forms of employment affects the quality of life for persons with intellectual disabilities, and also what the main differences between them are in Slovenia. A qualitative research approach was used, and data collection was carried out in two ways: by observation with participation and by semi-structured interviews with service users. The sample consisted of 11 interviewees with moderate or severe intellectual disabilities involved in four different working environments, two forms of employment in sheltered environment and two in integrated employment. Data was later codified and interpreted on the basis of theoretical starting points. Results of the research show that there are some differences between sheltered workshops and integrated employment, namely in areas of working environment, satisfaction with the employment, relationships and wage. Based on the results, I have found that integrated employment, compared to sheltered workshops, positively influences most of the quality of life aspects. This is true especially in the categories of social inclusion and material wellbeing of persons with intellectual disabilities.