Захист від недобросовісної конкуренції у медичній сфері: проблеми правововго регулювання

Кожна людина має право на здорові умови життя, але напевно ще жодному не вдавалось уникнути звернень до лікарень, аптек, та інших організацій медичної сфери. Метою даної статті є дослідження захисту від недобросовісної конкуренції у медичній сфері в Україні та інших країнах та розроблення наукових рекомендацій щодо вдосконалення українського законодавства щодо врегулювання відносин щодо здійснення господарювання в медичній сфері

The diverse nature of island isolation and its effect on land bridge insular faunas

Aim: Isolation is a key factor in island biology. It is usually defined as the distance to the geographically nearest mainland, but many other definitions exist. We explored how testing different isolation indices affects the inference of impacts of isolation on faunal characteristics. We focused on land bridge islands and compared the relationships of many spatial and temporal (i.e., through time) isolation indices with community‐, population‐ and individual‐level characteristics (species richness, population density and body size, respectively). Location: Aegean Sea islands, Greece. Time period: Current. Taxon: Many animal taxa. Methods: We estimated 21 isolation indices for 205 islands and recorded species richness data for 15 taxa (invertebrates and vertebrates). We obtained body size data for seven lizard species and population density data for three. We explored how well indices predict each characteristic, in each taxon, by conducting a series of ordinary least squares regressions (controlling for island area when needed) and a meta‐analysis. Results: Isolation was significantly (and negatively) associated with species richness in 10 of 15 taxa. It was significantly (and positively) associated with body size in only one of seven species and was not associated with population density. The effect of isolation on species richness was much weaker than that of island area, regardless of the index tested. Spatial indices generally out‐performed temporal indices, and indices directly related to the mainland out‐performed those related mainly to neighbouring islands. No index was universally superior to others, including the distance to the geographically nearest mainland. Main conclusions: The choice of index can alter our perception of the impacts of isolation on biological patterns. The nearly automatic, ubiquitous use of distance to the geographically nearest mainland misrepresents the complexity of the effects of isolation. We recommend the simultaneous testing of several indices that represent different aspects of isolation, in order to produce more constructive and thorough investigations and avoid imprecise inference

Aeolianite and barrier dune construction spanning the last two glacial-interglacial cycles from the southern Cape coast, South Africa

The southern Cape region of South Africa has extensive coastal aeolianites and barrier dunes. Whilst previously reported, limited knowledge of their age has precluded an understanding of their relationship with the climatic and sea-level fluctuations that have taken place during the Late Quaternary. Sedimentological and geomorphological studies combined with an optical dating programme reveal aeolianite development and barrier dune construction spanning at least the last two glacial–interglacial cycles. Aeolianite deposition has occurred on the southern Cape coast at ca 67–80, 88–90, 104–128, 160–189 and >200 ka before the present. Using this and other published data coupled with a better understanding of Late Quaternary sea-level fluctuations and palaeocoastline configurations, it is concluded that these depositional phases appear to be controlled by interglacial and subsequent interstadial sea-level high stands. These marine transgressions and regressions allowed onshore carbonate-rich sediment movement and subsequent aeolian reworking to occur at similar points in the landscape on a number of occasions. The lack of carbonates in more recent dunes (Oxygen Isotope Stages 1/2 and 4/5) is attributed not to leaching but to changes to carbonate production in the sediment source area caused by increased terrigenous material and/or changes in the balance between the warm Agulhas and nutrient-rich Benguela ocean current

Accuracy and repeatability of wrist joint angles in boxing using an electromagnetic tracking system

© 2019, The Author(s). The hand-wrist region is reported as the most common injury site in boxing. Boxers are at risk due to the amount of wrist motions when impacting training equipment or their opponents, yet we know relatively little about these motions. This paper describes a new method for quantifying wrist motion in boxing using an electromagnetic tracking system. Surrogate testing procedure utilising a polyamide hand and forearm shape, and in vivo testing procedure utilising 29 elite boxers, were used to assess the accuracy and repeatability of the system. 2D kinematic analysis was used to calculate wrist angles using photogrammetry, whilst the data from the electromagnetic tracking system was processed with visual 3D software. The electromagnetic tracking system agreed with the video-based system (paired t tests) in both the surrogate ( 0.9). In the punch testing, for both repeated jab and hook shots, the electromagnetic tracking system showed good reliability (ICCs > 0.8) and substantial reliability (ICCs > 0.6) for flexion–extension and radial-ulnar deviation angles, respectively. The results indicate that wrist kinematics during punching activities can be measured using an electromagnetic tracking system

Konfliktmatrix: Instrument des Risikomanagements im Operationssaal

Hintergrund In der Wirtschaft sind Konflikte als Ursache von hohen Kosten und Leistungseinbußen lange bekannt. Bei der Prozessoptimierung im OP-Management findet dieser Aspekt noch keine Beachtung. Gerade im Bereich der Ablauforganisation im OP führen unklare Arbeitsteilungen und mangelnde Kommunikation oft dazu, dass sich die verschiedenen Berufsgruppen als „Konkurrenten“ im Umfeld der Patienten sehen, anstatt als „multiprofessionelles Team“ zu agieren. Dies führt unweigerlich zur Entstehung und zur Eskalation von Konflikten. Fragestellung Die von uns entwickelte Konfliktmatrix soll es ermöglichen, mit minimalem Aufwand das Ausmaß der Konflikteskalation im multiprofessionellen OP-Team objektivierbar zu erfassen. Material und Methoden Im Bereich eines OP-Bereiches mit 8 OP-Tischen werden alle leitenden Mitarbeitenden aufgefordert, die Konflikteskalation zwischen den einzelnen Berufsgruppen auf einer Skala vonBackground In business conflicts have long been known to have a negative effect on costs and team performance. In medicine this aspect has been widely neglected, especially when optimizing processes for operating room (OR) management. In the multidisciplinary setting of OR management, shortcomings in rules for decision making and lack of communication result in members perceiving themselves as competitors in the patients environment rather than acting as art of a multiprofessional team. This inevitably leads to the emergence and escalation of conflicts. Objective We developed a conflict matrix to provide an inexpensive and objective way for evaluating the level of escalation of conflicts in a multiprofessional working environment, such as an OR. Material and methods The senior members of all involved disciplines were asked to estimate the level of conflict escalation between the individual professional groups on a scale of 09. By aggregating the response data, an overview of the conflict matrix within this OR section was created. Results No feedback was received from 1 of the 11 contacted occupational groups. By color coding the median, minimum and maximum values of the retrieved data, an intuitive overview of the escalation levels of conflict could be provided. The value range of all feedbacks was between(VLID)354395

Seabird species vary in behavioural response to drone census

This is the final version of the article. Available from the publisher via the DOI in this record.Unmanned aerial vehicles (UAVs) provide an opportunity to rapidly census wildlife in remote areas while removing some of the hazards. However, wildlife may respond negatively to the UAVs, thereby skewing counts. We surveyed four species of Arctic cliff-nesting seabirds (glaucous gull Larus hyperboreus, Iceland gull Larus glaucoides, common murre Uria aalge and thick-billed murre Uria lomvia) using a UAV and compared censusing techniques to ground photography. An average of 8.5% of murres flew off in response to the UAV, but >99% of those birds were non-breeders. We were unable to detect any impact of the UAV on breeding success of murres, except at a site where aerial predators were abundant and several birds lost their eggs to predators following UAV flights. Furthermore, we found little evidence for habituation by murres to the UAV. Most gulls flew off in response to the UAV, but returned to the nest within five minutes. Counts of gull nests and adults were similar between UAV and ground photography, however the UAV detected up to 52.4% more chicks because chicks were camouflaged and invisible to ground observers. UAVs provide a less hazardous and potentially more accurate method for surveying wildlife. We provide some simple recommendations for their use.We thank T. Leonard and the Seabird Ecological Reserves Advisory Committee for permission to work at Witless Bay, the Canadian Wildlife Service for permits to work at Newfoundland and Nunavut and the Government of Nunavut for permits to work in Nunavut. Newfoundland and Labrador Murre Fund, Bird Studies Canada and the Molson Foundation directly funded the work. An NSERC Discovery Grant, the Canada Research Chair in Arctic Ecology and Polar Continental Shelf Project also helped fund the project. We thank T. Burke, G. Sorenson, T. Lazarus and M. Guigueno for their help and J. Nakoolak for keeping us safe from bear