The Facilitation of trade in some integration agreements in the Americas

This article reviews the main progress observed as regards facilitation of trade in the North American Free Trade Agreement (NAFTA), the Andean Community (CAN), the Central American Common Market (CACM) and the Caribbean Community (CARICOM). The article does not refer to the Southern Common Market (Mercosur) or the Free Trade Area of the Americas (FTAA), these integration agreements being dealt with in FAL Bulletins Nos. 171 and 175, respectively.

Regional integration in the Caribbean: The role of trade agreements and structural transformation

Despite having relatively open economies and a dedicated strategic focus on export expansion, Caribbean economies still account for a small proportion of global trade (goods and services). This paper therefore posits that the subregion adopt a new dais of regional integration, which favours deeper trade and economic integration with countries which are the region’s natural trading partners.

An assessment of the performance of CARICOM extraregional trade agreements: An initial scoping exercise

Despite its active embrace of trade liberalization and the maintainance of relatively open economies, CARICOM trade performance both within the region and extraregionally has been poor. The nexus between bilateral Free Trade Agreements (FTAs), Partial Scope Agreements (PSAs) and preferential trade arrangements, which was intended to assist in compensating for the small size of domestic and regional markets, while providing an additional tier of trade and economic integration, has thus far failed to deliver its intended results. This paper makes this conclusion in assessing the performance of these extraregional trade agreements and sheds light on issues not often discussed.

Observational study on efficacy of negative expiratory pressure test proposed as screening for obstructive sleep apnea syndrome among commercial interstate bus drivers - protocol study

Abstract Background Obstructive sleep apnea (OSA) is a respiratory disease characterized by the collapse of the extrathoracic airway and has important social implications related to accidents and cardiovascular risk. The main objective of the present study was to investigate whether the drop in expiratory flow and the volume expired in 0.2 s during the application of negative expiratory pressure (NEP) are associated with the presence and severity of OSA in a population of professional interstate bus drivers who travel medium and long distances. Methods/Design An observational, analytic study will be carried out involving adult male subjects of an interstate bus company. Those who agree to participate will undergo a detailed patient history, physical examination involving determination of blood pressure, anthropometric data, circumference measurements (hips, waist and neck), tonsils and Mallampati index. Moreover, specific questionnaires addressing sleep apnea and excessive daytime sleepiness will be administered. Data acquisition will be completely anonymous. Following the medical examination, the participants will perform a spirometry, NEP test and standard overnight polysomnography. The NEP test is performed through the administration of negative pressure at the mouth during expiration. This is a practical test performed while awake and requires little cooperation from the subject. In the absence of expiratory flow limitation, the increase in the pressure gradient between the alveoli and open upper airway caused by NEP results in an increase in expiratory flow. Discussion Despite the abundance of scientific evidence, OSA is still underdiagnosed in the general population. In addition, diagnostic procedures are expensive, and predictive criteria are still unsatisfactory. Because increased upper airway collapsibility is one of the main determinants of OSA, the response to the application of NEP could be a predictor of this disorder. With the enrollment of this study protocol, the expectation is to encounter predictive NEP values for different degrees of OSA in order to contribute toward an early diagnosis of this condition and reduce its impact and complications among commercial interstate bus drivers.