Туризм и внешняя торговля АР Крым: географические аспекты современного развития

Целью данной статьи является оценка современного состояния внешней торговли АР Крым и ее составляющей – туристской деятельности

Axonal mapping of the motor cranial nerves

Basic behaviors, such as swallowing, speech, and emotional expressions are the result of a highly coordinated interplay between multiple muscles of the head. Control mechanisms of such highly tuned movements remain poorly understood. Here, we investigated the neural components responsible for motor control of the facial, masticatory, and tongue muscles in humans using specific molecular markers (ChAT, MBP, NF, TH). Our findings showed that a higher number of motor axonal population is responsible for facial expressions and tongue movements, compared to muscles in the upper extremity. Sensory axons appear to be responsible for neural feedback from cutaneous mechanoreceptors to control the movement of facial muscles and the tongue. The newly discovered sympathetic axonal population in the facial nerve is hypothesized to be responsible for involuntary control of the muscle tone. These findings shed light on the pivotal role of high efferent input and rich somatosensory feedback in neuromuscular control of finely adjusted cranial systems

Home videophones improve direct observation in Tuberculosis treatment: a mixed methods evaluation

BACKGROUND: The use of direct observation to monitor tuberculosis treatment is controversial: cost, practical difficulties, and lack of patient acceptability limit effectiveness. Telehealth is a promising alternative delivery method for improving implementation. This study aimed to evaluate the clinical and cost-effectiveness of a telehealth service delivering direct observation, compared to an in-person drive-around service. METHODOLOGY/PRINCIPAL FINDINGS: The study was conducted within a community nursing service in South Australia. Telehealth patients received daily video calls at home on a desktop videophone provided by the nursing call center. A retrospective cohort study assessed the effectiveness of the telehealth and traditional forms of observation, defined by the proportion of missed observations recorded in case notes. This data was inputted to a model, estimating the incremental cost-effectiveness ratio (ICER) of telehealth. Semi-structured interviews were conducted with current patients, community nursing and Chest Clinic staff, concerning service acceptability, usability and sustainability. The percentage of missed observations for the telehealth service was 12.1 (n = 58), compared to 31.1 for the in-person service (n = 70). Most of the difference of 18.9% (95% CI: 12.2 – 25.4) was due to fewer pre-arranged absences. The economic analysis calculated the ICER to be AUD$1.32 (95$0.51 – $2.26) per extra day of successful observation. The video service used less staff time, and became dominant if implemented on a larger scale and/or with decreased technology costs. Qualitative analysis found enabling factors of flexible timing, high patient acceptance, staff efficiency, and Chest Clinic support. Substantial technical problems were manageable, and improved liaison between the nursing service and Chest Clinic was an unexpected side-benefit. CONCLUSIONS/SIGNIFICANCE: Home video observation is a patient-centered, resource efficient way of delivering direct observation for TB, and is cost-effective when compared with a drive-around service. Future research is recommended to determine applicability and effectiveness in other settings.Victoria A. Wade, Jonathan Karnon, Jaklin A. Eliott and Janet E. Hille

Observations of a mass occurrene of Macoma balthica larvae in midsummer

In 1995 the seasonal development of concentrations of both phytoplankton and larvae of the bivalve Macoma balthica was studied in the coastal zone behind the back-barrier island of Spiekeroog (German Wadden Sea). In July=August larvaereached maximum concentrations of about 1000 to 4200 ind.

Stay off the lawn! Creating smooth paths based on region preferences.

Modern virtual environments can contain a variety of characters and traversable regions. Each character may have different preferences for the traversable region types. Pedestrians may prefer to walk on sidewalks, but they may occasionally need to traverse roads and dirt paths. By contrast, wild animals might try to stay in forest areas, but they are able to leave their protective environment when necessary. This paper presents a novel path planning method named MIRAN (Modified Indicative Routes and Navigation) that takes a character’s region preferences into account. Given an indicative route as a rough estimation of a character’s preferred route, MIRAN efficiently computes a visually convincing path that is smooth, keeps clearance from obstacles, avoids unnecessary detours, and allows local changes to avoid other characters. To the best of our knowledge, MIRAN is the first path planning method that supports the above features while using an exact representation of the navigable space. Experiments show that with our approach a wide range of different character behaviors can be simulated. It also overcomes problems that occur in previous path planning methods such as the Indicative Route Method. The resulting paths are well-suited for real-time simulations and gaming applications

Stay off the lawn! Creating smooth paths based on region preferences.

Modern virtual environments can contain a variety of characters and traversable regions. Each character may have different preferences for the traversable region types. Pedestrians may prefer to walk on sidewalks, but they may occasionally need to traverse roads and dirt paths. By contrast, wild animals might try to stay in forest areas, but they are able to leave their protective environment when necessary. This paper presents a novel path planning method named MIRAN (Modified Indicative Routes and Navigation) that takes a character’s region preferences into account. Given an indicative route as a rough estimation of a character’s preferred route, MIRAN efficiently computes a visually convincing path that is smooth, keeps clearance from obstacles, avoids unnecessary detours, and allows local changes to avoid other characters. To the best of our knowledge, MIRAN is the first path planning method that supports the above features while using an exact representation of the navigable space. Experiments show that with our approach a wide range of different character behaviors can be simulated. It also overcomes problems that occur in previous path planning methods such as the Indicative Route Method. The resulting paths are well-suited for real-time simulations and gaming applications

Hope and hoping in the talk of dying cancer patients

Hope is the subject of increasing research and discussion within the healthcare literature. However, although deemed of vital import to patient welfare, there is little examination of how hope features within patients' speech. This qualitative study presents the discursive properties of hope as it emerged unprompted during semi-structured interviews with 28 patients in the final phase of terminal cancer recruited from the oncology clinic of the Royal Adelaide Hospital, Australia. In the context of discussions about decision-making at the end of a terminal illness, when used as a noun, hope invariably referenced the medical domain--focussing either on the objective probability of medical cure (typically taking the negative form "there is no hope"), or the subjective possession of the patient, needed to fight their disease. Positioning the patient as relatively powerless and subject to external forces, this hope was most commonly associated with absolute solutions, and life-and-death stakes. Hope as a verb emphasised the patient's active engagement in life, identifying what was good and positive for them. It was used to assign responsibility to others, to indicate and establish solidarity or agreement between the speaker and others, effectively strengthening interpersonal ties between individuals. Through hoping, patients established connection with others and with the future. In the context of interactions between patients and clinical staff, we conclude that the use of hope-as-a-verb may have benefits, enabling the patient--even when dying--to focus on the positive, to connect to others, and to continue to engage with life.Australia Hope Discourse analysis Bioethics Clinical interaction Cancer

Clinician acceptance is the key factor for sustainable telehealth services

Telehealth, the delivery of health care services at a distance using information and communications technology, has been slow to be adopted and difficult to sustain. Researchers developing theories concerning the introduction of complex change into health care usually take a multifactorial approach; we intentionally sought a single point of intervention that would have maximum impact on implementation. We conducted a qualitative interview study of 36 Australian telehealth services, sampled for maximum variation, and used grounded theory methods to develop a model from which we chose the most important factor affecting the success of telehealth. We propose that clinician acceptance explains much of the variation in the uptake, expansion, and sustainability of Australian telehealth services, and that clinician acceptance could, in most circumstances, overcome low demand, technology problems, workforce pressure, and lack of resourcing. We conclude that our model offers practical advice to those seeking to implement change with limited resources