The Evolution of Modal Split for Goods Transport in South America

This FAL bulletin analyzes data for commodities traded and transportation used between nine South American countries, during the years 2000, 2006, and 2010.

Facilitation of international trade in goods

The FAL Bulletin is reverting to its original concept, that is, facilitation of trade in the broad sense. In the context of ECLAC, this is a topic covered by the International Trade Unit in the International Trade and Development Finance Division, to which the Transport Unit also belonged until it was incorporated into the Natural Resources and Infrastructure Division in April 1999.In an effort at inter-divisional cooperation starting with this issue, the International Trade Unit will be responsible for preparing four articles per year on trade facilitation for the FAL Bulletin. These are certain to be of great interest not only to those of our readers concerned with multi-modal ocean transport and customs procedures but also to those with links to the broader issue of promoting foreign trade in the region.

Trade and Development Nexus: reflections on the performance of trade in goods under the Cariforum-European Union Partnership agreement a Cariforum perspective

Given the asymmetry in the levels of development and capacity which exist between the EU and CARIFORUM States, the architects of the CARIFORUM-European Union (EU) Economic Partnership Agreement (EPA)1 anticipated the need for review and monitoring of the impacts of implementation. Article 5 and other provisions in the Agreement therefore specifically mandate that monitoring be undertaken to ensure that the Agreement benefits a wide cross-section of the population in member countries. The paper seeks to provide a preliminary assessment of the impact of the EPA on CARIFORUM countries. In so doing, it highlights some critical information and implementation gaps and challenges that have emerged during the implementation process. The analysis however, is restricted to goods trade. The services sector will be the subject of a separate report. The paper draws on a combination of quantitative and qualitative analyses. While the paper undertakes a CARIFORUM-wide analysis for the most part, five CARIFORUM member states including Barbados, Dominican Republic, Guyana, Saint Kitts and Nevis and Saint Lucia are examined more closely in some instances. These economies were selected by virtue of economic structure and development constraints, as a representative subset of CARIFORUM, which comprises the CARICOM membership as well as the Dominican Republic.

Mexico: industrial policies and the production of information and communication technology goods and services

This study investigates the extent to which the digital boom has had repercussions on productive activity, in terms of both manufacturing (ict goods) and services (ict services), in addition to its potential ramifications in the rest of the Mexican economy. Input-output matrices are used and compared to those of Brazil and the United States. Mexico has fallen behind, particularly in the production of ict goods, and the productive chains of this activity have weakened. The ict services sector offers much greater potential than has been exploited thus far, with the advantage that it involves comparatively more value added and has major diversification possibilities. It is considered essential to find more effective industrial policies targeted on the ict goods and services sectors; but the experience of countries such as Brazil, which have applied more proactive approaches with mixed results, suggests that this will be challenging.

The Incidence of Dysphagia in Patients Receiving Cerebral Reperfusion Therapy Poststroke

Background: The high prevalence of dysphagia after stroke leads to increased mortality, and cerebral reperfusion therapy has been effective in reducing neurologic deficits. The aim of this study was to investigate the severity and evolution of dysphagia and the occurrence of pneumonia in patients submitted to cerebral reperfusion therapy. Methods: Seventy ischemic stroke patients were evaluated. Of these, 35 patients (group 1) were submitted to cerebral reperfusion therapy and 35 (group 2) did not receive thrombolytic treatment. The following were evaluated: severity of dysphagia by means of videofluoroscopy, evolution of oral intake rate by means of the Functional Oral Intake Scale, and the occurrence of pneumonia by international protocol. The relation between the severity of dysphagia and the occurrence of pneumonia with the treatment was evaluated through the chi-square test; the daily oral intake rate and its relation to the treatment were assessed by the Mann-Whitney test and considered significant if P is less than .05. Results: The moderate and severe degrees of dysphagia were more frequent (P = .013) among the patients who were not submitted to cerebral reperfusion therapy. The daily oral intake evolved independently of the treatment type, without statistical significance when compared between the groups, whereas pneumonia occurred more frequently in group 2 (28%) in relation to group 1 (11%) and was associated with the worst degrees of dysphagia (P = .045). Conclusions: We can conclude that there is improvement in the oral intake rate in both groups, with lower severity of dysphagia and occurrence of pneumonia in ischemic stroke patients submitted to cerebral reperfusion therapy. (C) 2014 by National Stroke Association

Nutritional status of patients with gastrointestinal cancer receiving care in a public hospital, 2010-2011

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Determinant factors for mortality of patients receiving mechanical ventilation and effects of a protocol muscle training in weaning

Introduction: Prognostic factors are used in the Intensive Care Unit (ICU) to predict morbidity and mortality , especially in patients on mechanical ventilation (MV ) . Training protocols are used in MV patients with the aim of promoting the success of the weaning process. Objective: To assess which variables determine the outcome of patients undergoing mechanical ventilation and compare the effects of two protocols for weaning. Method: Patients under MV for more than 48 hours had collected the following information: sex, age , ideal weight, height , Acute Physiology and Chronic Health Evaluation (APACHE II), risk of mortality, Glasgow Coma Scale (GCS) and index Quick and perfunctory (IRRS) breathing. Patients with unsuccessful weaning performed one of weaning protocols: Progressive T - tube or tube - T + Threshold ® IMT. Patients were compared for outcome (death or non- death in the ICU ) and the protocols through the t test or Mann-Whitney test was considered significant when P <0.05. Results: Of 128 patients evaluated 56.25% were men, the mean age was 60.05 ± 17.85 years and 40.62 % patients died, and they had higher APACHE II scores, mortality risk, time VM and IRRS GCS and the lower value (p<0.05). The age, initial and final maximal inspiratory pressure, time of weaning and duration of MV was similar between protocols. Conclusion: The study suggests that the GCS, APACHE II risk of mortality, length of MV and IRRS variables determined the evolution of MV patients in this sample. Not found differences in the variables studied when comparing the two methods of weaning.

Growth performance and meat quality of heifers receiving different forms of soybean oil in the rumen

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Pre- and postoperative evaluation by photoplethysmography in patients receiving surgery for lower-limb varicose veins

Objective. To evaluate the effectiveness of surgery in treating primary varicose veins in the lower limbs by photoplethysmography (PPG) and duplex mapping (DM). Method. Forty-eight lower limbs were clinically evaluated according to the CEAP classification system and subjected to PPG and DM exams. Each limb had a venous refill time (VRT) of <20 seconds and a normal deep vein system (DVS) by DM. Results. The mean pre- and postoperative VRTs were 13.79 and 26.43 seconds, respectively (P < 0.0001). After surgery, 42 limbs (87.50%) had normal results by PPG (VRT > 20 seconds). Four limbs (8.33%) showed improved VRTs, but the VRTs did not reach 20 seconds. In the 2 limbs (4.17%) that maintained their original VRTs, the DM exams showed the presence of insufficient perforating veins. Conclusion. In most cases, PPG allows for a satisfactory evaluation of the outcome of varicose vein surgery.

Evaluation of maturity levels in the management of product development: case studies in the capital goods industry

In recent approaches to the management of product development process (PDP), maturity levels have attracted the attention of practitioners and researchers. The CMMI model contributes to evaluate the maturity levels and improvement of the product development process management. This paper, based on CMMI model, analyzes the practices adopted in two companies of the capital goods industry, which develop and manufacture equipment upon request. It was observed that on account of market conditioning factors and different practices adapted to PDP management, these companies are at different maturity levels. One company is at the initial level of maturity while the other at the most advanced one. It was also noted that the application of CMMI model can provide improvement to PDP management, as well as present guidelines to achieve higher maturity levels, adequate to companies' needs.

Age-Related Maximum Heart Rate Among Ischemic and Nonischemic Heart Failure Patients Receiving beta-Blockade Therapy

Background: Equations to predict maximum heart rate (HRmax) in heart failure (HF) patients receiving beta-adrenergic blocking (BB) agents do not consider the cause of HF. We determined equations to predict HRmax in patients with ischemic and nonischemic HF receiving BB therapy. Methods and Results: Using treadmill cardiopulmonary exercise testing, we studied HF patients receiving BB therapy being considered for transplantation from 1999 to 2010. Exclusions were pacemaker and/or implantable defibrillator, left ventricle ejection fraction (LVEF) >50%, peak respiratory exchange ratio (RER) <1.00, and Chagas disease. We used linear regression equations to predict HRmax based on age in ischemic and nonischemic patients. We analyzed 278 patients, aged 47 +/- 10 years, with ischemic (n = 75) and nonischemic (n = 203) HF. LVEF was 30.8 +/- 9.4% and 28.6 +/- 8.2% (P = .04), peak VO2 16.9 +/- 4.7 and 16.9 +/- 5.2 mL kg(-1) min(-1) (P = NS), and the HRmax 130.8 +/- 23.3 and 125.3 +/- 25.3 beats/min (P = .051) in ischemic and nonischemic patients, respectively. We devised the equation HRmax = 168 - 0.76 x age (R-2 = 0.095; P = .007) for ischemic HF patients, but there was no significant relationship between age and HRmax in nonischemic HF patients (R-2 = 0.006; P = NS). Conclusions: Our study suggests that equations to estimate HRmax should consider the cause of HF. (J Cardiac Fail 2012;18:831-836)