Padrão de especialização comercial e crescimento econômico : uma análise sobre o Brasil no contexto da fragmentação da produção e das cadeias globais de valor

Globalization and technological changes that has happened since the 80s have brought remarkable changes in the industrial and commercial paradigm, which are expressed mainly in the international fragmentation of production and in the formation of Global Value Chains (GVC). This thesis sought to understand such phenomena and discuss new relevant variables in this context for a more accurate analysis of the current trade patterns not addressed by the seminal economic theories that relate trade and economic growth. It sought to evaluate how the trade specialization pattern of Brazil evolved compared to other economies (China, India, Russia, United States, Japan and selected Latin American economies) in the light of these phenomena from 1995 to 2011. Therefore, we have used the methodology of gross exports decomposition in value added measures, developed by Koopman et al. (2014), and indicators estimated from data of two global matrices I-O: a WIOT (2013) and the TiVA (2015). It was also tested two hypotheses regarding the role of these phenomena as determinants of economic growth in recent years: 1º) fragmentation and participation in GVC ensure higher growth rates for countries; 2º) the place (stage) in which the country finds itself in GVC associated with sectoral technological aspects is also important for economic growth. For this, we used dynamic panel models (Difference GMM and System GMM) for a sample of 40 countries from 2003 to 2011. The studies carried out on Brazil show that the country is no longer on the margins of these phenomena, because it shows increasing rates of participation in GVC, including in sectors considered most strategic for fragmentation. However, there is not a standard convergence of trade specialization of the country to those presented by developed countries or movements earned by China and Mexico in terms of their position and profile of participating in GVC. Another important result obtained by the thesis is the identification of these phenomena are in fact new variables relevant for economic growth, because it shows empirical evidences to support the hypothesis 1 and, partially, the hypothesis 2. A joint analysis of the estimated econometric results with the results of the descriptive analysis of the Brazilian economy, it leads us to conclude that the trade specialization pattern of the country in the context of the new trade setups is presented unfavorably to its growth strategy.

Avaliação da eficácia da implementação de um pacote de medidas na prevenção de pneumonia associada à ventilação mecânica em unidade de terapia intensiva adulta

Background: Ventilator-associated pneumonia (VAP) is a health care related infection and the second leading cause of nosocomial infections linked to morbidity and mortality rates. Therefore, the implementation of care guideline protocols has become necessary for critically ill patients in ICUs in order to provide adequate treatment. Objective: To assess the impact of a package called FAST HUG in PAV ; analyze the risk factors for occurrence of VAP in adult patients at an ICU of a private hospital ; analyze the clinical characteristics of patients who were or were not submitted to the FAST HUG ; analyze the etiology of microorganisms related to EPI ; determine the cost of hospitalization in patients with pneumonia and in patients who received the FAST HUG.Methods: The study was performed in a private hospital that has an 8-bed ICU. It was divided into two phases: before implementing FAST HUG, from August 2011 to August 2012 and after the implementation of FAST HUG, from September 2012 to December 2013. An individual form for each patient in the study was filled out by using information taken electronically from the hospital medical records. The following data for each patient was obtained: age, gender, reason for hospitalization, the use of three or more types of antibiotics, length of stay, intubation time and progress. Findings: After the implementation of FAST HUG, there was an observable decrease in the occurrence of VAP (p <0.01), as well as a reduction in mortality rates (p <0.01). It also shows that the intervention performed in the study resulted in a significant reduction in ICU hospital costs (p <0.05).Conclusion: The implementation of FAST HUG reduced the cases of VAP. Thus, decreasing costs, reducing mortality rates and length of stay, which therefore resulted in an improvement to the overall quality of care.