Методические основы оценки качества обслуживания в туристическом бизнесе

Проблема определения качества обслуживания в туристическом бизнесе является актуальной, т.к. туристическая деятельность является приоритетным направлением развития в АР Крым. Рассмотрена методика определения качества обслуживания туристов с учетом специфики функционирования туристской сферы.Проблема визначення якості обслуговування у туристичному бізнесі є актуальною, тому що туристична діяльність є пріоритетним напрямком розвитку в АР Крим. Розглянута методика визначення якості обслуговування туристів з умовою специфіки функціонування туристичної сфери.The problem of quality service in the tourist's business is very actuality, because the tourist's activity is the priority directions of development in the Crimea. Given the method of definition of the quality service in the tourist's business with registration of specific tourism sphere

Health–economic Benefits of Treating Trauma in Psychosis

Background: Co-occurrence of posttraumatic stress disorder (PTSD) in psychosis (estimated as 12%) raises personal suffering and societal costs. Health–economic studies on PTSD treatments in patients with a diagnosis of a psychotic disorder have not yet been conducted, but are needed for guideline development and implementation. This study aims to analyse the cost-effectiveness of guideline PTSD therapies in patients with a psychotic disorder. Methods: This health–economic evaluation alongside a randomized controlled trial included 155 patients with a psychotic disorder in care as usual (CAU), with comorbid PTSD. Participants received eye movement desensitization and reprocessing (EMDR) (n = 55), prolonged exposure (PE) (n = 53) or waiting list (WL) (n = 47) with masked assessments at baseline (T0) and at the two-month (post-treatment, T2) and six-month follow-up (T6). Costs were calculated using the TiC-P interview for assessing healthcare consumption and productivity losses. Incremental cost-effectiveness ratios and economic acceptability were calculated for quality-adjusted life years (EQ-5D-3L-based QALYs) and PTSD ‘Loss of diagnosis’ (LoD, CAPS). Results: Compared to WL, costs were lower in EMDR (-€1410) and PE (-€501) per patient per six months. In addition, EMDR (robust SE 0.024, t = 2.14, p = .035) and PE (robust SE 0.024, t = 2.14, p = .035) yielded a 0.052 and 0.051 incremental QALY gain, respectively, as well as 26% greater probability for LoD following EMDR (robust SE = 0.096, z = 2.66, p = .008) and 22% following PE (robust SE 0.098, z = 2.28, p = .023). Acceptability curves indicate high probabilities of PTSD treatments being the better economic choice. Sensitivity analyses corroborated these outcomes. Conclusion: Adding PTSD treatment to CAU for individuals with psychosis and PTSD seem to yield better health and less PTSD at lower costs, which argues for implementation

Effect of the unpolarized spin state in spin-correlation measurement of two protons produced in the 12C(d,2He) reaction

In this note we discuss the effect of the unpolarized state in the spin-correlation measurement of the $^1S_0$ two-proton state produced in 12C(d,2He) reaction at the KVI, Groningen. We show that in the presence of the unpolarized state the maximal violation of the CHSH-Bell inequality is lower than the classical limit if the purity of the state is less than $\sim \verb+70$. In particular, for the KVI experiment the violation of the CHSH-Bell inequality should be corrected by a factor $\sim\verb+10$ from the pure $^1S_0$ state.Comment: 6 pages, to appear in J. Phys.

Never injected, but hepatitis C virus-infected: a study among self-declared never-injecting drug users from the Amsterdam Cohort Studies

The aim of this study was to gain insight in transmission routes of hepatitis C virus (HCV) infection among never-injecting drug users (DU) by studying, incidence, prevalence, determinants and molecular epidemiology of HCV infection. From the Amsterdam Cohort Studies among DU, 352 never-injecting DU were longitudinally tested for HCV antibodies. Logistic regression was used to identify factors associated with antibody prevalence. Part of HCV NS5B was sequenced to determine HCV genotype and for phylogenetic analyses, in which sequences were compared with those from injecting DU. HCV antibody prevalence was 6.3% and HCV incidence was 0.49/1000 PY. HIV-positive status, female sex and starting injection drug use during follow-up (a putative marker of past injection drug use), were independently associated with HCV prevalence. The main genotypes found were genotype 3a (50%) and 1a (30%). Phylogenetic analysis revealed that HCV strains in never-injecting DU did not cluster together and did not differ from HCV strains circulating in injecting DU. We found a higher HCV prevalence in never-injecting DU than in the general population. Phylogenetic analysis shows a strong link with the injecting DU population. The increased risk could be related to underreporting of injecting drug use or to household or sexual transmission from injectors to noninjectors. Our findings stress the need for HCV testing of DU who report never injecting, especially given the potential to treat HCV infection effectively

Emergence of a non trivial fluctuating phase in the XY model on regular networks

We study an XY-rotor model on regular one dimensional lattices by varying the number of neighbours. The parameter $2\ge\gamma\ge1$ is defined. $\gamma=2$ corresponds to mean field and $\gamma=1$ to nearest neighbours coupling. We find that for $\gamma<1.5$ the system does not exhibit a phase transition, while for $\gamma > 1.5$ the mean field second order transition is recovered. For the critical value $\gamma=\gamma_c=1.5$, the systems can be in a non trivial fluctuating phase for whichthe magnetisation shows important fluctuations in a given temperature range, implying an infinite susceptibility. For all values of $\gamma$ the magnetisation is computed analytically in the low temperatures range and the magnetised versus non-magnetised state which depends on the value of $\gamma$ is recovered, confirming the critical value $\gamma_{c}=1.5$

Trauma mechanism and patient reported outcome in tibial plateau fractures with posterior involvement

Introduction: Posterior tibial plateau fractures (PTPF) have a high impact on functional outcome and the optimal treatment strategy is not well established. The goal of this study was to assess the relationship between trauma mechanism, fracture morphology and functional outcome in a large multicenter cohort and define possible strategies to improve the outcome. Methods: An international retrospective cohort study was conducted in five level-1 trauma centers. All consecutive operatively treated PTPF were evaluated. Preoperative imaging was reviewed to determine the trauma mechanism. Patient reported outcome was scored using the Knee injury and Osteoarthritis Outcome Score (KOOS). Results: A total of 145 tibial plateau fractures with posterior involvement were selected with a median follow-up of 32.2 months (IQR 24.1-43.2). Nine patients (6%) sustained an isolated posterior fracture. Seventy-two patients (49%) sustained a two-column fracture and three-column fractures were diagnosed in 64 (44%) patients. Varus trauma was associated with poorer outcome on the 'symptoms' (p = 0.004) and 'pain' subscales (p = 0.039). Delayed-staged surgery was associated with worse outcome scores for all subscales except 'pain'. In total, 27 patients (18%) were treated with posterior plate osteosynthesis without any significant difference in outcome. Conclusions: Fracture morphology, varus trauma mechanism and delayed-staged surgery (i.e. extensive soft-tissue injury) were identified as important prognostic factors on postoperative outcome in PTPF. In order to assess possible improvement of outcome, future studies with routine preoperative MRI to assess associated ligamentous injury in tibial plateau fractures (especially for varus trauma) are needed. (c) 2021 Elsevier B.V. All rights reserved

Fluorescence kinetics of flavin adenine dinucleotide in different microenvironments

Fluorescence kinetics of flavin adenine dinucleotide was measured in a wide time and spectral range in different media, affecting its intra- end extramolecular interactions, and analyzed by a new method based on compressed sensing

High Fat Diet-Induced Changes in Mouse Muscle Mitochondrial Phospholipids Do Not Impair Mitochondrial Respiration Despite Insulin Resistance

BACKGROUND: Type 2 diabetes mellitus and muscle insulin resistance have been associated with reduced capacity of skeletal muscle mitochondria, possibly as a result of increased intake of dietary fat. Here, we examined the hypothesis that a prolonged high-fat diet consumption (HFD) increases the saturation of muscle mitochondrial membrane phospholipids causing impaired mitochondrial oxidative capacity and possibly insulin resistance. METHODOLOGY: C57BL/6J mice were fed an 8-week or 20-week low fat diet (10 kcal%; LFD) or HFD (45 kcal%). Skeletal muscle mitochondria were isolated and fatty acid (FA) composition of skeletal muscle mitochondrial phospholipids was analyzed by thin-layer chromatography followed by GC. High-resolution respirometry was used to assess oxidation of pyruvate and fatty acids by mitochondria. Insulin sensitivity was estimated by HOMA-IR. PRINCIPAL FINDINGS: At 8 weeks, mono-unsaturated FA (16∶1n7, 18∶1n7 and 18∶1n9) were decreased (-4.0%, p<0.001), whereas saturated FA (16∶0) were increased (+3.2%, p<0.001) in phospholipids of HFD vs. LFD mitochondria. Interestingly, 20 weeks of HFD descreased mono-unsaturated FA while n-6 poly-unsaturated FA (18∶2n6, 20∶4n6, 22∶5n6) showed a pronounced increase (+4.0%, p<0.001). Despite increased saturation of muscle mitochondrial phospholipids after the 8-week HFD, mitochondrial oxidation of both pyruvate and fatty acids were similar between LFD and HFD mice. After 20 weeks of HFD, the increase in n-6 poly-unsaturated FA was accompanied by enhanced maximal capacity of the electron transport chain (+49%, p = 0.002) and a tendency for increased ADP-stimulated respiration, but only when fuelled by a lipid-derived substrate. Insulin sensitivity in HFD mice was reduced at both 8 and 20 weeks. CONCLUSIONS/INTERPRETATION: Our findings do not support the concept that prolonged HF feeding leads to increased saturation of skeletal muscle mitochondrial phospholipids resulting in a decrease in mitochondrial fat oxidative capacity and (muscle) insulin resistance