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BackgroundSymptoms of anxiety and depression are common among family members of ICU patients and are culturally dependent. The aim of the study was to assess the prevalence of symptoms of anxiety and depression and associated factors in family members of ICU patients in two Central European countries.MethodsWe conducted a prospective multicenter study involving 22 ICUs (250 beds) in the Czech and Slovak Republics. The Hospital Anxiety and Depression Scale (HADS) was used to assess symptoms of anxiety and depression in family members of ICU patients. Family member understanding of the patient’s condition was assessed using a structured interview and a questionnaire was used to assess satisfaction with family member/ICU staff communication.ResultsTwenty two intensive care units (both adult and pediatric) in academic medical centers and community hospitals participated in the study. During a 6 month period, 405 family members of 293 patients were enrolled. We found a high prevalence of anxiety and depression symptoms – 78% and 54%, respectively. Information leaflets distributed to family members did not lower incidences of anxiety/depression. Family members with symptoms of depression reported higher levels of satisfaction according to the modified Critical Care Family Needs Inventory. Extended contact between staff and family members was the only related factor associated with anxiety reduction (p = 0.001).ConclusionFamily members of ICU patients in East European countries suffer from symptoms of anxiety and depression. We identified limited family member/ICU staff communication as an important health care professional-related factor associated with a higher incidence of symptoms of anxiety. This factor is potentially amenable to improvement and may serve as a target for proactive intervention proactive intervention.

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The article presents personality features of volunteers as relatively permanent psychological characteristics. It summarizes motives for volunteering discussed in the current concepts of volunteering and it introduces the Functional approach to volunteer motivation. Some results of the research supported by the Grant Agency of the Czech Republic No 407/11/0380, Prosocial behaviour and its personality aspects in the context of volunteering are presented. Research subjects were 240 volunteers, members of Czech Civic Associations of volunteers. Two questionnaires were used. Questionnaire NEO

The large-scale change of Czech society since 1989 has involved the democratic transformation of the health system. To empower the patient was one important goal of the healthcare reform launched immediately after the Velvet Revolution. The process has been enhanced by the accession of the Czech Republic to the European Union and the adoption of important European conventions regulating the area. The concept of informed consent and a culture of negotiation are being inserted into a traditionally paternalistic culture. Our article describes the current situation on the issue of the communication of information on state of health and treatment, and on the question of the participation of the patient in decisions on treatment. We present empirical results of a public opinion survey on this issue. The results show a still prevailing submissive attitude towards the physicians, despite the fact that the concept of informed consent has become more and more publicly familiar (42% of respondents gave the completely correct answer regarding informed consent). The impact of age, education and sex on answers to the questionnaire was analysed. Men, younger and more educated respondents were more likely to show the autonomous attitude, whereas women, older and less educated people tended to show the traditional submissive attitude. Further, our article raises the question of the cultural and historical background within which the current ethically and legally binding norms (products of western democracies, in fact) are interpreted. The question is how far cultural modifications are tolerable in the practical implementation of universal ethical constructs (informed consent).

This article focuses on rationing of expensive medical care in the Czech Republic. It distinguishes between political and clinical decision levels and reviews the debate in the Western literature on explicit and implicit rules. The contemporary situation of the Czech health care system is considered from this perspective. Rationing reoccurred in the mid 90s after the shift in health care financing from fee-for-service to prospective budgets. The lack of explicit rules is obvious. Implicit forms of rationing, done by physicians at the clinical level prevail, implying uncontrolled power of the medical profession and lacking transparency for ethical considerations of equity to access. It seems to be acceptable for physicians to play the role of allocators, probably because of their experience with rationing during the socialist period. Traditional rationing stereotypes from the previous regime seem to persist despite the health care system transformation during the 90s.

Aerodynamic bearings with elastically supported tilting pads have operational properties comparable with widely-used foil journal bearings. They combine the excellent stability of tilting pad bearings, as a result of very small cross-coupling stiffness terms, with the positive properties of foil bearings, namely their ability to adapt to changing operating conditions and presence of additional damping due to friction between elastic members and bearing casings. Air cycle machines (ACMs) are used in the environmental control systems of aircrafts to manage the pressurization of the cabin. An ACM with the abovementioned type of bearings and an operational speed of 60,000 rpm was designed and successfully tested, even under conditions of strong external excitation. Some problems with rotor stability in certain operation regimes were encountered. Rotor relative vibrations measured at both bearing locations increased substantially when excitation frequency was close to the lowest rotor eigenvalues. In spite of that and the 1000 start/stop cycles passed by the end of the test, any traces of wear on the bearing sliding surfaces were negligible. When the bearing distance had to be shortened in order to insert the machine into the defined space, the rotor quickly became unstable at relatively low speeds. Although rotor stability reserve was reduced only slightly, the rotor had to be redesigned in order to achieve stability. Operation characteristics of aerodynamic bearings with elastically supported tilting pads are presented together with rotor dynamic analysis and validated with measured results.

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