116 resultados para USD


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

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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BACKGROUND: Trauma care is expensive. However, reliable data on the exact lifelong costs incurred by a major trauma patient are lacking. Discussion usually focuses on direct medical costs--underestimating consequential costs resulting from absence from work and permanent disability. METHODS: Direct medical costs and consequential costs of 63 major trauma survivors (ISS >13) at a Swiss trauma center from 1995 to 1996 were assessed 5 years posttrauma. The following cost evaluation methods were used: correction cost method (direct cost of restoring an original state), human capital method (indirect cost of lost productivity), contingent valuation method (human cost as the lost quality of life), and macroeconomic estimates. RESULTS: Mean ISS (Injury Severity Score) was 26.8 +/- 9.5 (mean +/- SD). In all, 22 patients (35%) were disabled, causing discounted average lifelong total costs of USD 1,293,800, compared with 41 patients (65%) who recovered without any disabilities with incurred costs of USD 147,200 (average of both groups USD 547,800). Two thirds of these costs were attributable to a loss of production whereas only one third was a result of the cost of correction. Primary hospital treatment (USD 27,800 +/- 37,800) was only a minor fraction of the total cost--less than the estimated cost of police and the judiciary. Loss of quality of life led to considerable intangible human costs similar to real costs. CONCLUSIONS: Trauma costs are commonly underestimated. Direct medical costs make up only a small part of the total costs. Consequential costs, such as lost productivity, are well in excess of the usual medical costs. Mere cost averages give a false estimate of the costs incurred by patients with/without disabilities.

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Objective: The aim of this literature review, performed within the framework of the Swiss governmental Program of Evaluation of Complementary Medicine (PEK), was to investigate costs of complementary and alternative medicine (CAM). Materials and Methods: A systematic literature search was conducted in 11 electronic databases. All retrieved titles and reference lists were also hand-searched. Results: 38 publications were found: 23 on CAM of various definitions (medical and non-medical practitioners, over-the-counter products), 13 on homeopathy, 2 on phytotherapy. Studies investigated different kinds of costs (direct or indirect) and used different methods (prospective or retrospective questionnaires, data analyses, cost-effectiveness models). Most studies report 'out of pocket' costs, because CAM is usually not covered by health insurance. Costs per CAM-treatment / patient / month were AUD 7-66, CAD 250 and GBP 13.62 +/- 1.61. Costs per treatment were EUR 205 (range: 15-1,278), USD 414 +/- 269 and USD 1,127. In two analyses phytotherapy proved to be cost-effective. One study revealed a reduction of 1.5 days of absenteeism from work in the CAM group compared to conventionally treated patients. Another study, performed by a health insurance company reported a slight increase in direct costs for CAM. Costs for CAM covered by insurance companies amounted to approximately 0.2-0.5% of the total healthcare budget (Switzerland, 2003). Publications had several limitations, e.g. efficacy of therapies was rarely reported. As compared to conventional patients, CAM patients tend to cause lower costs. Conclusion: Results suggest lower costs for CAM than for conventional patients, but the limited methodological quality lowers the significance of the available data. Further well-designed studies and models are required.

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Assessment of regional blood flow changes is difficult in the clinical setting. We tested whether conventional pulmonary artery catheters (PACs) can be used to measure regional venous blood flows by inverse thermodilution (ITD). Inverse thermodilution was tested in vitro and in vivo using perivascular ultrasound Doppler (USD) flow probes as a reference. In anesthetized pigs, PACs were inserted in jugular, hepatic, renal, and femoral veins, and their measurements were compared with simultaneous USD flow measurements from carotid, hepatic, renal, and femoral arteries and from portal vein. Fluid boluses were injected through the PAC's distal port, and temperature changes were recorded from the proximally located thermistor. Injectates of 2 and 5 mL at 22 degrees C and 4 degrees C were used. Flows were altered by using a roller pump (in vitro), and infusion of dobutamine and induction of cardiac tamponade, respectively. In vitro: At blood flows between 400 mL . min-1 and 700 mL . min-1 (n = 50), ITD and USD correlated well (r = 0.86, P < 0.0001), with bias and limits of agreement of 3 +/- 101 mL . min-1. In vivo: 514 pairs of measurements had to be excluded from analysis for technical reasons, and 976 were analyzed. Best correlations were r = 0.87 (P < 0.0001) for renal flow and r = 0.46 (P < 0.0001) for hepatic flow. No significant correlation was found for cerebral and femoral flows. Inverse thermodilution using conventional PAC compared moderately well with USD for renal but not for other flows despite good in vitro correlation in various conditions. In addition, this method has significant technical limitations.

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The jatropha plant produces seeds containing 25–40% oil by weight. This oil can be made into biodiesel. During the recent global fuel crisis, the price of crude oil peaked at over USD 130 per barrel. Jatropha attracted huge interest – it was touted as a wonder crop that could generate biodiesel oil on “marginal lands” in semi-arid areas. Its promise appeared especially great in East Africa. Today, however, jatropha’s value in East Africa appears to lie primarily in its multipurpose use by small-scale farmers, not in large-scale biofuel production.

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BACKGROUND Chemotherapy plus bevacizumab is a standard option for first-line treatment in metastatic colorectal cancer (mCRC) patients. We assessed whether no continuation is non-inferior to continuation of bevacizumab after completing first-line chemotherapy. PATIENTS AND METHODS In an open-label, phase III multicentre trial, patients with mCRC without disease progression after 4-6 months of standard first-line chemotherapy plus bevacizumab were randomly assigned to continuing bevacizumab at a standard dose or no treatment. CT scans were done every 6 weeks until disease progression. The primary end point was time to progression (TTP). A non-inferiority limit for hazard ratio (HR) of 0.727 was chosen to detect a difference in TTP of 6 weeks or less, with a one-sided significance level of 10% and a statistical power of 85%. RESULTS The intention-to-treat population comprised 262 patients: median follow-up was 36.7 months. The median TTP was 4.1 [95% confidence interval (CI) 3.1-5.4] months for bevacizumab continuation versus 2.9 (95% CI 2.8-3.8) months for no continuation; HR 0.74 (95% CI 0.58-0.96). Non-inferiority could not be demonstrated. The median overall survival was 25.4 months for bevacizumab continuation versus 23.8 months (HR 0.83; 95% CI 0.63-1.1; P = 0.2) for no continuation. Severe adverse events were uncommon in the bevacizumab continuation arm. Costs for bevacizumab continuation were estimated to be ∼30,000 USD per patient. CONCLUSIONS Non-inferiority could not be demonstrated for treatment holidays versus continuing bevacizumab monotheray, after 4-6 months of standard first-line chemotherapy plus bevacizumab. Based on no impact on overall survival and increased treatment costs, bevacizumab as a single agent is of no meaningful therapeutic value. More efficient treatment approaches are needed to maintain control of stabilized disease following induction therapy. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov, number NCT00544700.

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This study explored the health, education, social assets, needs, attitudes, and behaviors of residents of Ferrocarril #4, a small urban community in Tamaulipas, Mexico. A collaborative Participatory Action Research approach was used to emphasize community involvement. Using Triangulation to ensure validity, qualitative methods included key informant in depth interviews, participant observation and participatory discussion groups with women and men. A personal interview with a probability sample of women was done. The median age of interviewees was 37 years. The majority was married or had a partner. Over half of respondents completed grades 6-9. Employed women (25%) earned a median weekly salary equivalent to ∼56 USD. Women with health insurance (67.7%) were covered mainly through Social Security and Seguro Popular. One in 5 reported bad health. Barriers to care were primarily money and transportation. To improve health care, women wanted a full service clinic in or close to the community and affordable health care. Socially, 28% of respondents had no close friends in the community and most did not participate in beneficial community activities. Many women did not socialize with others and help from neighbors was situational. Primary school teachers lacked parental support and it interfered with classroom efforts. Healthy community discussion groups focused on personal and environmental hygiene and safety. Valuable assets exist in the community. To date, collaborative efforts resulted in a school First Aid station, a school nurse visit weekly, posting of emergency contact phone numbers in the school and community center, and development of a student health information form. ^

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This paper assesses the impact of climate change on China's agricultural production at a cross-provincial level using the Ricardian approach, incorporating a multilevel model with farm-level group data. The farm-level group data includes 13379 farm households, across 316 villages, distributed in 31 provinces. The empirical results show that, firstly, the marginal effects and elasticities of net crop revenue per hectare with respect to climate factors indicated that the annual impact of temperature on net crop revenue per hectare was positive, and the effect of increased precipitation was negative when looking at the national totals; secondly, the total impact of simulated climate change scenarios on net crop revenues per hectare at a Chinese national total level, was an increase of between 79 USD per hectare and 207 USD per hectare for the 2050s, and an increase from 140 USD per hectare to 355 USD per hectare for the 2080s. As a result, climate change may create a potential advantage for the development of Chinese agriculture, rather than a risk, especially for agriculture in the provinces of the Northeast, Northwest and North regions. However, the increased precipitation can lead to a loss of net crop revenue per hectare, especially for the provinces of the Southwest, Northwest, North and Northeast regions.

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The data set shows energy consumption per hour of work (in MJ/hour), and labour productivity (in USD/hour) in the PS economic sector (Energy & Mining + Industry + Construction) for the period 1970-2009 and for the following countries: Germany, Spain, USA, Canada, Italy, UK, France, Japan. The intention is to look at the relationship between energy consumption as a driver of improvements in the productivity of labour. This is of particular relevance for the discussion of reducing working time in the context of the 'degrowth' debate, as it is done in the article to which this data is a suplement.

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Estimates show that fossil fuel subsidies average USD 400–600 billion annually worldwide while renewable energy (RE) subsidies amounted to USD 66 billion in 2010 and are predicted to rise to USD 250 billion annually by 2035. Domestic political rationales for energy subsidies include promoting innovation, job creation and economic growth, energy security, and independence. Energy subsidies may also serve social and environmental goals. Whether and to what extent subsidies are effective to achieve these goals or instead lead to market distortions is a matter of much debate and the trade effects of energy subsidies are complex. This paper offers an overview of the types of energy subsidies that are used in the conventional and renewable energy sectors, and their relationship with climate change, in particular greenhouse gas emissions. While the WTO’s Agreement on Subsidies and Countervailing Measures (ASCM) is mostly concerned with harm to competitors, this paper considers the extent to which the Agreement could also discipline subsidies that cause harm to the environment as a global common. Beyond the existing legal framework, this paper surveys a number of alternatives for improving the ability of subsidies disciplines to internalize climate change costs of energy production and consumption. One option is a new multilateral agreement on subsidies or trade remedies (with an appropriate carve-out in the WTO regime to allow for it if such an agreement is concluded outside it). Alternatively, climate change-related subsidies could be included as part of another multilateral regime or as part of regional agreements. A third approach would be to incorporate rules on energy subsidies in sectorial agreements, including a Sustainable Energy Trade Agreement such as has been proposed in other ICTSD studies.

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The aviation companies are facing some problems that argue in favor of biofuels: Rising cost of traditional fuel: from 0.71 USD/gallon in May 2003 to 3.09 USD/gallon in January 2012. Environmental concerns: direct emissions from aviation account for about 3 % of the EU’s total greenhouse gas emissions. The International Civil Aviation Organization (ICAO) forecasts that by 2050 they could grow by a further 300-700 %. On December 20th 2006 the European Commission approved a law proposal to include the civil aviation sector in the European market of carbon dioxide emission rights (European Union Emissions Trading System, EUETS)

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El 10 de octubre de 2008 la Organización Marítima Internacional (OMI) firmó una modificación al Anexo VI del convenio MARPOL 73/78, por la que estableció una reducción progresiva de las emisiones de óxidos de azufre (SOx) procedentes de los buques, una reducción adicional de las emisiones de óxidos de nitrógeno (NOx), así como límites en las emisiones de dióxido de Carbono (CO2) procedentes de los motores marinos y causantes de problemas medioambientales como la lluvia ácida y efecto invernadero. Centrándonos en los límites sobre las emisiones de azufre, a partir del 1 de enero de 2015 esta normativa obliga a todos los buques que naveguen por zonas controladas, llamadas Emission Control Area (ECA), a consumir combustibles con un contenido de azufre menor al 0,1%. A partir del 1 de enero del año 2020, o bien del año 2025, si la OMI decide retrasar su inicio, los buques deberán consumir combustibles con un contenido de azufre menor al 0,5%. De igual forma que antes, el contenido deberá ser rebajado al 0,1%S, si navegan por el interior de zonas ECA. Por su parte, la Unión Europea ha ido más allá que la OMI, adelantando al año 2020 la aplicación de los límites más estrictos de la ley MARPOL sobre las aguas de su zona económica exclusiva. Para ello, el 21 de noviembre de 2013 firmó la Directiva 2012 / 33 / EU como adenda a la Directiva de 1999. Tengamos presente que la finalidad de estas nuevas leyes es la mejora de la salud pública y el medioambiente, produciendo beneficios sociales, en forma de reducción de enfermedades, sobre todo de tipo respiratorio, a la vez que se reduce la lluvia ácida y sus nefastas consecuencias. La primera pregunta que surge es ¿cuál es el combustible actual de los buques y cuál será el que tengan que consumir para cumplir con esta Regulación? Pues bien, los grandes buques de navegación internacional consumen hoy en día fuel oil con un nivel de azufre de 3,5%. ¿Existen fueles con un nivel de azufre de 0,5%S? Como hemos concluido en el capítulo 4, para las empresas petroleras, la producción de fuel oil como combustible marino es tratada como un subproducto en su cesta de productos refinados por cada barril de Brent, ya que la demanda de fuel respecto a otros productos está bajando y además, el margen de beneficio que obtienen por la venta de otros productos petrolíferos es mayor que con el fuel. Así, podemos decir que las empresas petroleras no están interesadas en invertir en sus refinerías para producir estos fueles con menor contenido de azufre. Es más, en el caso de que alguna compañía decidiese invertir en producir un fuel de 0,5%S, su precio debería ser muy similar al del gasóleo para poder recuperar las inversiones empleadas. Por lo tanto, el único combustible que actualmente cumple con los nuevos niveles impuestos por la OMI es el gasóleo, con un precio que durante el año 2014 estuvo a una media de 307 USD/ton más alto que el actual fuel oil. Este mayor precio de compra de combustible impactará directamente sobre el coste del trasporte marítimo. La entrada en vigor de las anteriores normativas está suponiendo un reto para todo el sector marítimo. Ante esta realidad, se plantean diferentes alternativas con diferentes implicaciones técnicas, operativas y financieras. En la actualidad, son tres las alternativas con mayor aceptación en el sector. La primera alternativa consiste en “no hacer nada” y simplemente cambiar el tipo de combustible de los grandes buques de fuel oil a gasóleo. Las segunda alternativa es la instalación de un equipo scrubber, que permitiría continuar con el consumo de fuel oil, limpiando sus gases de combustión antes de salir a la atmósfera. Y, por último, la tercera alternativa consiste en el uso de Gas Natural Licuado (GNL) como combustible, con un precio inferior al del gasóleo. Sin embargo, aún existen importantes incertidumbres sobre la evolución futura de precios, operación y mantenimiento de las nuevas tecnologías, inversiones necesarias, disponibilidad de infraestructura portuaria e incluso el desarrollo futuro de la propia normativa internacional. Estas dudas hacen que ninguna de estas tres alternativas sea unánime en el sector. En esta tesis, tras exponer en el capítulo 3 la regulación aplicable al sector, hemos investigado sus consecuencias. Para ello, hemos examinado en el capítulo 4 si existen en la actualidad combustibles marinos que cumplan con los nuevos límites de azufre o en su defecto, cuál sería el precio de los nuevos combustibles. Partimos en el capítulo 5 de la hipótesis de que todos los buques cambian su consumo de fuel oil a gasóleo para cumplir con dicha normativa, calculamos el incremento de demanda de gasóleo que se produciría y analizamos las consecuencias que este hecho tendría sobre la producción de gasóleos en el Mediterráneo. Adicionalmente, calculamos el impacto económico que dicho incremento de coste producirá sobre sector exterior de España. Para ello, empleamos como base de datos el sistema de control de tráfico marítimo Authomatic Identification System (AIS) para luego analizar los datos de todos los buques que han hecho escala en algún puerto español, para así calcular el extra coste anual por el consumo de gasóleo que sufrirá el transporte marítimo para mover todas las importaciones y exportaciones de España. Por último, en el capítulo 6, examinamos y comparamos las otras dos alternativas al consumo de gasóleo -scrubbers y propulsión con GNL como combustible- y, finalmente, analizamos en el capítulo 7, la viabilidad de las inversiones en estas dos tecnologías para cumplir con la regulación. En el capítulo 5 explicamos los numerosos métodos que existen para calcular la demanda de combustible de un buque. La metodología seguida para su cálculo será del tipo bottom-up, que está basada en la agregación de la actividad y las características de cada tipo de buque. El resultado está basado en la potencia instalada de cada buque, porcentaje de carga del motor y su consumo específico. Para ello, analizamos el número de buques que navegan por el Mediterráneo a lo largo de un año mediante el sistema AIS, realizando “fotos” del tráfico marítimo en el Mediterráneo y reportando todos los buques en navegación en días aleatorios a lo largo de todo el año 2014. Por último, y con los datos anteriores, calculamos la demanda potencial de gasóleo en el Mediterráneo. Si no se hace nada y los buques comienzan a consumir gasóleo como combustible principal, en vez del actual fuel oil para cumplir con la regulación, la demanda de gasoil en el Mediterráneo aumentará en 12,12 MTA (Millones de Toneladas Anuales) a partir del año 2020. Esto supone alrededor de 3.720 millones de dólares anuales por el incremento del gasto de combustible tomando como referencia el precio medio de los combustibles marinos durante el año 2014. El anterior incremento de demanda en el Mediterráneo supondría el 43% del total de la demanda de gasóleos en España en el año 2013, incluyendo gasóleos de automoción, biodiesel y gasóleos marinos y el 3,2% del consumo europeo de destilados medios durante el año 2014. ¿Podrá la oferta del mercado europeo asumir este incremento de demanda de gasóleos? Europa siempre ha sido excedentaria en gasolina y deficitaria en destilados medios. En el año 2009, Europa tuvo que importar 4,8 MTA de Norte América y 22,1 MTA de Asia. Por lo que, este aumento de demanda sobre la ya limitada capacidad de refino de destilados medios en Europa incrementará las importaciones y producirá también aumentos en los precios, sobre todo del mercado del gasóleo. El sector sobre el que más impactará el incremento de demanda de gasóleo será el de los cruceros que navegan por el Mediterráneo, pues consumirán un 30,4% de la demanda de combustible de toda flota mundial de cruceros, lo que supone un aumento en su gasto de combustible de 386 millones de USD anuales. En el caso de los RoRos, consumirían un 23,6% de la demanda de la flota mundial de este tipo de buque, con un aumento anual de 171 millones de USD sobre su gasto de combustible anterior. El mayor incremento de coste lo sufrirán los portacontenedores, con 1.168 millones de USD anuales sobre su gasto actual. Sin embargo, su consumo en el Mediterráneo representa sólo el 5,3% del consumo mundial de combustible de este tipo de buques. Estos números plantean la incertidumbre de si semejante aumento de gasto en buques RoRo hará que el transporte marítimo de corta distancia en general pierda competitividad sobre otros medios de transporte alternativos en determinadas rutas. De manera que, parte del volumen de mercancías que actualmente transportan los buques se podría trasladar a la carretera, con los inconvenientes medioambientales y operativos, que esto produciría. En el caso particular de España, el extra coste por el consumo de gasóleo de todos los buques con escala en algún puerto español en el año 2013 se cifra en 1.717 millones de EUR anuales, según demostramos en la última parte del capítulo 5. Para realizar este cálculo hemos analizado con el sistema AIS a todos los buques que han tenido escala en algún puerto español y los hemos clasificado por distancia navegada, tipo de buque y potencia. Este encarecimiento del transporte marítimo será trasladado al sector exterior español, lo cual producirá un aumento del coste de las importaciones y exportaciones por mar en un país muy expuesto, pues el 75,61% del total de las importaciones y el 53,64% del total de las exportaciones se han hecho por vía marítima. Las tres industrias que se verán más afectadas son aquellas cuyo valor de mercancía es inferior respecto a su coste de transporte. Para ellas los aumentos del coste sobre el total del valor de cada mercancía serán de un 2,94% para la madera y corcho, un 2,14% para los productos minerales y un 1,93% para las manufacturas de piedra, cemento, cerámica y vidrio. Las mercancías que entren o salgan por los dos archipiélagos españoles de Canarias y Baleares serán las que se verán más impactadas por el extra coste del transporte marítimo, ya que son los puertos más alejados de otros puertos principales y, por tanto, con más distancia de navegación. Sin embargo, esta no es la única alternativa al cumplimiento de la nueva regulación. De la lectura del capítulo 6 concluimos que las tecnologías de equipos scrubbers y de propulsión con GNL permitirán al buque consumir combustibles más baratos al gasoil, a cambio de una inversión en estas tecnologías. ¿Serán los ahorros producidos por estas nuevas tecnologías suficientes para justificar su inversión? Para contestar la anterior pregunta, en el capítulo 7 hemos comparado las tres alternativas y hemos calculado tanto los costes de inversión como los gastos operativos correspondientes a equipos scrubbers o propulsión con GNL para una selección de 53 categorías de buques. La inversión en equipos scrubbers es más conveniente para buques grandes, con navegación no regular. Sin embargo, para buques de tamaño menor y navegación regular por puertos con buena infraestructura de suministro de GNL, la inversión en una propulsión con GNL como combustible será la más adecuada. En el caso de un tiempo de navegación del 100% dentro de zonas ECA y bajo el escenario de precios visto durante el año 2014, los proyectos con mejor plazo de recuperación de la inversión en equipos scrubbers son para los cruceros de gran tamaño (100.000 tons. GT), para los que se recupera la inversión en 0,62 años, los grandes portacontenedores de más de 8.000 TEUs con 0,64 años de recuperación y entre 5.000-8.000 TEUs con 0,71 años de recuperación y, por último, los grandes petroleros de más de 200.000 tons. de peso muerto donde tenemos un plazo de recuperación de 0,82 años. La inversión en scrubbers para buques pequeños, por el contrario, tarda más tiempo en recuperarse llegando a más de 5 años en petroleros y quimiqueros de menos de 5.000 toneladas de peso muerto. En el caso de una posible inversión en propulsión con GNL, las categorías de buques donde la inversión en GNL es más favorable y recuperable en menor tiempo son las más pequeñas, como ferris, cruceros o RoRos. Tomamos ahora el caso particular de un buque de productos limpios de 38.500 toneladas de peso muerto ya construido y nos planteamos la viabilidad de la inversión en la instalación de un equipo scrubber o bien, el cambio a una propulsión por GNL a partir del año 2015. Se comprueba que las dos variables que más impactan sobre la conveniencia de la inversión son el tiempo de navegación del buque dentro de zonas de emisiones controladas (ECA) y el escenario futuro de precios del MGO, HSFO y GNL. Para realizar este análisis hemos estudiado cada inversión, calculando una batería de condiciones de mérito como el payback, TIR, VAN y la evolución de la tesorería del inversor. Posteriormente, hemos calculado las condiciones de contorno mínimas de este buque en concreto para asegurar una inversión no sólo aceptable, sino además conveniente para el naviero inversor. En el entorno de precios del 2014 -con un diferencial entre fuel y gasóleo de 264,35 USD/ton- si el buque pasa más de un 56% de su tiempo de navegación en zonas ECA, conseguirá una rentabilidad de la inversión para inversores (TIR) en el equipo scrubber que será igual o superior al 9,6%, valor tomado como coste de oportunidad. Para el caso de inversión en GNL, en el entorno de precios del año 2014 -con un diferencial entre GNL y gasóleo de 353,8 USD/ton FOE- si el buque pasa más de un 64,8 % de su tiempo de navegación en zonas ECA, conseguirá una rentabilidad de la inversión para inversores (TIR) que será igual o superior al 9,6%, valor del coste de oportunidad. Para un tiempo en zona ECA estimado de un 60%, la rentabilidad de la inversión (TIR) en scrubbers para los inversores será igual o superior al 9,6%, el coste de oportunidad requerido por el inversor, para valores del diferencial de precio entre los dos combustibles alternativos, gasóleo (MGO) y fuel oil (HSFO) a partir de 244,73 USD/ton. En el caso de una inversión en propulsión GNL se requeriría un diferencial de precio entre MGO y GNL de 382,3 USD/ton FOE o superior. Así, para un buque de productos limpios de 38.500 DWT, la inversión en una reconversión para instalar un equipo scrubber es más conveniente que la de GNL, pues alcanza rentabilidades de la inversión (TIR) para inversores del 12,77%, frente a un 6,81% en el caso de invertir en GNL. Para ambos cálculos se ha tomado un buque que navegue un 60% de su tiempo por zona ECA y un escenario de precios medios del año 2014 para el combustible. Po otro lado, las inversiones en estas tecnologías a partir del año 2025 para nuevas construcciones son en ambos casos convenientes. El naviero deberá prestar especial atención aquí a las características propias de su buque y tipo de navegación, así como a la infraestructura de suministros y vertidos en los puertos donde vaya a operar usualmente. Si bien, no se ha estudiado en profundidad en esta tesis, no olvidemos que el sector marítimo debe cumplir además con las otras dos limitaciones que la regulación de la OMI establece sobre las emisiones de óxidos de Nitrógeno (NOx) y Carbono (CO2) y que sin duda, requerirán adicionales inversiones en diversos equipos. De manera que, si bien las consecuencias del consumo de gasóleo como alternativa al cumplimiento de la Regulación MARPOL son ciertamente preocupantes, existen alternativas al uso del gasóleo, con un aumento sobre el coste del transporte marítimo menor y manteniendo los beneficios sociales que pretende dicha ley. En efecto, como hemos demostrado, las opciones que se plantean como más rentables desde el punto de vista financiero son el consumo de GNL en los buques pequeños y de línea regular (cruceros, ferries, RoRos), y la instalación de scrubbers para el resto de buques de grandes dimensiones. Pero, por desgracia, estas inversiones no llegan a hacerse realidad por el elevado grado de incertidumbre asociado a estos dos mercados, que aumenta el riesgo empresarial, tanto de navieros como de suministradores de estas nuevas tecnologías. Observamos así una gran reticencia del sector privado a decidirse por estas dos alternativas. Este elevado nivel de riesgo sólo puede reducirse fomentando el esfuerzo conjunto del sector público y privado para superar estas barreras de entrada del mercado de scrubbers y GNL, que lograrían reducir las externalidades medioambientales de las emisiones sin restar competitividad al transporte marítimo. Creemos así, que los mismos organismos que aprobaron dicha ley deben ayudar al sector naviero a afrontar las inversiones en dichas tecnologías, así como a impulsar su investigación y promover la creación de una infraestructura portuaria adaptada a suministros de GNL y a descargas de vertidos procedentes de los equipos scrubber. Deberían además, prestar especial atención sobre las ayudas al sector de corta distancia para evitar que pierda competitividad frente a otros medios de transporte por el cumplimiento de esta normativa. Actualmente existen varios programas europeos de incentivos, como TEN-T o Marco Polo, pero no los consideramos suficientes. Por otro lado, la Organización Marítima Internacional debe confirmar cuanto antes si retrasa o no al 2025 la nueva bajada del nivel de azufre en combustibles. De esta manera, se eliminaría la gran incertidumbre temporal que actualmente tienen tanto navieros, como empresas petroleras y puertos para iniciar sus futuras inversiones y poder estudiar la viabilidad de cada alternativa de forma individual. ABSTRACT On 10 October 2008 the International Maritime Organization (IMO) signed an amendment to Annex VI of the MARPOL 73/78 convention establishing a gradual reduction in sulphur oxide (SOx) emissions from ships, and an additional reduction in nitrogen oxide (NOx) emissions and carbon dioxide (CO2) emissions from marine engines which cause environmental problems such as acid rain and the greenhouse effect. According to this regulation, from 1 January 2015, ships travelling in an Emission Control Area (ECA) must use fuels with a sulphur content of less than 0.1%. From 1 January 2020, or alternatively from 2025 if the IMO should decide to delay its introduction, all ships must use fuels with a sulphur content of less than 0.5%. As before, this content will be 0.1%S for voyages within ECAs. Meanwhile, the European Union has gone further than the IMO, and will apply the strictest limits of the MARPOL directives in the waters of its exclusive economic zone from 2020. To this end, Directive 2012/33/EU was issued on 21 November 2013 as an addendum to the 1999 Directive. These laws are intended to improve public health and the environment, benefiting society by reducing disease, particularly respiratory problems. The first question which arises is: what fuel do ships currently use, and what fuel will they have to use to comply with the Convention? Today, large international shipping vessels consume fuel oil with a sulphur level of 3.5%. Do fuel oils exist with a sulphur level of 0.5%S? As we conclude in Chapter 4, oil companies regard marine fuel oil as a by-product of refining Brent to produce their basket of products, as the demand for fuel oil is declining in comparison to other products, and the profit margin on the sale of other petroleum products is higher. Thus, oil companies are not interested in investing in their refineries to produce low-sulphur fuel oils, and if a company should decide to invest in producing a 0.5%S fuel oil, its price would have to be very similar to that of marine gas oil in order to recoup the investment. Therefore, the only fuel which presently complies with the new levels required by the IMO is marine gas oil, which was priced on average 307 USD/tonne higher than current fuel oils during 2014. This higher purchasing price for fuel will have a direct impact on the cost of maritime transport. The entry into force of the above directive presents a challenge for the entire maritime sector. There are various alternative approaches to this situation, with different technical, operational and financial implications. At present three options are the most widespread in the sector. The first option consists of “doing nothing” and simply switching from fuel oil to marine gas oil in large ships. The second option is installing a scrubber system, which would enable ships to continue consuming fuel oil, cleaning the combustion gases before they are released to the atmosphere. And finally, the third option is using Liquefied Natural Gas (LNG), which is priced lower than marine gas oil, as a fuel. However, there is still significant uncertainty on future variations in prices, the operation and maintenance of the new technologies, the investments required, the availability of port infrastructure and even future developments in the international regulations themselves. These uncertainties mean that none of these three alternatives has been unanimously accepted by the sector. In this Thesis, after discussing all the regulations applicable to the sector in Chapter 3, we investigate their consequences. In Chapter 4 we examine whether there are currently any marine fuels on the market which meet the new sulphur limits, and if not, how much new fuels would cost. In Chapter 5, based on the hypothesis that all ships will switch from fuel oil to marine gas oil to comply with the regulations, we calculate the increase in demand for marine gas oil this would lead to, and analyse the consequences this would have on marine gas oil production in the Mediterranean. We also calculate the economic impact such a cost increase would have on Spain's external sector. To do this, we also use the Automatic Identification System (AIS) system to analyse the data of every ship stopping in any Spanish port, in order to calculate the extra cost of using marine gas oil in maritime transport for all Spain's imports and exports. Finally, in Chapter 6, we examine and compare the other two alternatives to marine gas oil, scrubbers and LNG, and in Chapter 7 we analyse the viability of investing in these two technologies in order to comply with the regulations. In Chapter 5 we explain the many existing methods for calculating a ship's fuel consumption. We use a bottom-up calculation method, based on aggregating the activity and characteristics of each type of vessel. The result is based on the installed engine power of each ship, the engine load percentage and its specific consumption. To do this, we analyse the number of ships travelling in the Mediterranean in the course of one year, using the AIS, a marine traffic monitoring system, to take “snapshots” of marine traffic in the Mediterranean and report all ships at sea on random days throughout 2014. Finally, with the above data, we calculate the potential demand for marine gas oil in the Mediterranean. If nothing else is done and ships begin to use marine gas oil instead of fuel oil in order to comply with the regulation, the demand for marine gas oil in the Mediterranean will increase by 12.12 MTA (Millions Tonnes per Annum) from 2020. This means an increase of around 3.72 billion dollars a year in fuel costs, taking as reference the average price of marine fuels in 2014. Such an increase in demand in the Mediterranean would be equivalent to 43% of the total demand for diesel in Spain in 2013, including automotive diesel fuels, biodiesel and marine gas oils, and 3.2% of European consumption of middle distillates in 2014. Would the European market be able to supply enough to meet this greater demand for diesel? Europe has always had a surplus of gasoline and a deficit of middle distillates. In 2009, Europe had to import 4.8 MTA from North America and 22.1 MTA from Asia. Therefore, this increased demand on Europe's already limited capacity for refining middle distillates would lead to increased imports and higher prices, especially in the diesel market. The sector which would suffer the greatest impact of increased demand for marine gas oil would be Mediterranean cruise ships, which represent 30.4% of the fuel demand of the entire world cruise fleet, meaning their fuel costs would rise by 386 million USD per year. ROROs in the Mediterranean, which represent 23.6% of the demand of the world fleet of this type of ship, would see their fuel costs increase by 171 million USD a year. The greatest cost increase would be among container ships, with an increase on current costs of 1.168 billion USD per year. However, their consumption in the Mediterranean represents only 5.3% of worldwide fuel consumption by container ships. These figures raise the question of whether a cost increase of this size for RORO ships would lead to short-distance marine transport in general becoming less competitive compared to other transport options on certain routes. For example, some of the goods that ships now carry could switch to road transport, with the undesirable effects on the environment and on operations that this would produce. In the particular case of Spain, the extra cost of switching to marine gas oil in all ships stopping at any Spanish port in 2013 would be 1.717 billion EUR per year, as we demonstrate in the last part of Chapter 5. For this calculation, we used the AIS system to analyse all ships which stopped at any Spanish port, classifying them by distance travelled, type of ship and engine power. This rising cost of marine transport would be passed on to the Spanish external sector, increasing the cost of imports and exports by sea in a country which relies heavily on maritime transport, which accounts for 75.61% of Spain's total imports and 53.64% of its total exports. The three industries which would be worst affected are those with goods of lower value relative to transport costs. The increased costs over the total value of each good would be 2.94% for wood and cork, 2.14% for mineral products and 1.93% for manufactured stone, cement, ceramic and glass products. Goods entering via the two Spanish archipelagos, the Canary Islands and the Balearic Islands, would suffer the greatest impact from the extra cost of marine transport, as these ports are further away from other major ports and thus the distance travelled is greater. However, this is not the only option for compliance with the new regulations. From our readings in Chapter 6 we conclude that scrubbers and LNG propulsion would enable ships to use cheaper fuels than marine gas oil, in exchange for investing in these technologies. Would the savings gained by these new technologies be enough to justify the investment? To answer this question, in Chapter 7 we compare the three alternatives and calculate both the cost of investment and the operating costs associated with scrubbers or LNG propulsion for a selection of 53 categories of ships. Investing in scrubbers is more advisable for large ships with no fixed runs. However, for smaller ships with regular runs to ports with good LNG supply infrastructure, investing in LNG propulsion would be the best choice. In the case of total transit time within an ECA and the pricing scenario seen in 2014, the best payback periods on investments in scrubbers are for large cruise ships (100,000 gross tonnage), which would recoup their investment in 0.62 years; large container ships, with a 0.64 year payback period for those over 8,000 TEUs and 0.71 years for the 5,000-8,000 TEU category; and finally, large oil tankers over 200,000 deadweight tonnage, which would recoup their investment in 0.82 years. However, investing in scrubbers would have a longer payback period for smaller ships, up to 5 years or more for oil tankers and chemical tankers under 5,000 deadweight tonnage. In the case of LNG propulsion, a possible investment is more favourable and the payback period is shorter for smaller ship classes, such as ferries, cruise ships and ROROs. We now take the case of a ship transporting clean products, already built, with a deadweight tonnage of 38,500, and consider the viability of investing in installing a scrubber or changing to LNG propulsion, starting in 2015. The two variables with the greatest impact on the advisability of the investment are how long the ship is at sea within emission control areas (ECA) and the future price scenario of MGO, HSFO and LNG. For this analysis, we studied each investment, calculating a battery of merit conditions such as the payback period, IRR, NPV and variations in the investors' liquid assets. We then calculated the minimum boundary conditions to ensure the investment was not only acceptable but advisable for the investor shipowner. Thus, for the average price differential of 264.35 USD/tonne between HSFO and MGO during 2014, investors' return on investment (IRR) in scrubbers would be the same as the required opportunity cost of 9.6%, for values of over 56% ship transit time in ECAs. For the case of investing in LNG and the average price differential between MGO and LNG of 353.8 USD/tonne FOE in 2014, the ship must spend 64.8% of its time in ECAs for the investment to be advisable. For an estimated 60% of time in an ECA, the internal rate of return (IRR) for investors equals the required opportunity cost of 9.6%, based on a price difference of 244.73 USD/tonne between the two alternative fuels, marine gas oil (MGO) and fuel oil (HSFO). An investment in LNG propulsion would require a price differential between MGO and LNG of 382.3 USD/tonne FOE. Thus, for a 38,500 DWT ship carrying clean products, investing in retrofitting to install a scrubber is more advisable than converting to LNG, with an internal rate of return (IRR) for investors of 12.77%, compared to 6.81% for investing in LNG. Both calculations were based on a ship which spends 60% of its time at sea in an ECA and a scenario of average 2014 prices. However, for newly-built ships, investments in either of these technologies from 2025 would be advisable. Here, the shipowner must pay particular attention to the specific characteristics of their ship, the type of operation, and the infrastructure for supplying fuel and handling discharges in the ports where it will usually operate. Thus, while the consequences of switching to marine gas oil in order to comply with the MARPOL regulations are certainly alarming, there are alternatives to marine gas oil, with smaller increases in the costs of maritime transport, while maintaining the benefits to society this law is intended to provide. Indeed, as we have demonstrated, the options which appear most favourable from a financial viewpoint are conversion to LNG for small ships and regular runs (cruise ships, ferries, ROROs), and installing scrubbers for large ships. Unfortunately, however, these investments are not being made, due to the high uncertainty associated with these two markets, which increases business risk, both for shipowners and for the providers of these new technologies. This means we are seeing considerable reluctance regarding these two options among the private sector. This high level of risk can be lowered only by encouraging joint efforts by the public and private sectors to overcome these barriers to entry into the market for scrubbers and LNG, which could reduce the environmental externalities of emissions without affecting the competitiveness of marine transport. Our opinion is that the same bodies which approved this law must help the shipping industry invest in these technologies, drive research on them, and promote the creation of a port infrastructure which is adapted to supply LNG and handle the discharges from scrubber systems. At present there are several European incentive programmes, such as TEN-T and Marco Polo, but we do not consider these to be sufficient. For its part, the International Maritime Organization should confirm as soon as possible whether the new lower sulphur levels in fuels will be postponed until 2025. This would eliminate the great uncertainty among shipowners, oil companies and ports regarding the timeline for beginning their future investments and for studying their viability.

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El cambio climático está alterando el comportamiento de los ciclos hídricos en diferentes partes del planeta y amenaza con fuertes repercusiones en la vida de muchas especies, incluida la humana. Sobran evidencias de que el estilo de vida y las formas productivas de la sociedad actual, principalmente de los países desarrollados, están contribuyendo a acelerar el cambio climático, posiblemente hasta niveles que rebasarían la capacidad de asimilación de la biota del planeta. Ante las alarmantes evidencias del problema ambiental en general y del problema hídrico en particular se han iniciado gestiones encaminadas a disminuir en lo posible las causas humanas. Pero la distribución de responsabilidades todavía entraña serios inconvenientes tanto a nivel internacional, como regional y local; uno de los desafíos es determinar el valor económico de los recursos afectados, como referencia para establecer compensaciones, prioridades, planes de gestión y también contribuciones por parte de los mismos beneficiarios de los recursos hídricos. En el presente estudio se ha analizado la situación particular de riesgo para un páramo andino, el Parque Nacional Cajas, fuente de agua que, potabilizada por una empresa estatal, cubre los requerimientos de la ciudad de Cuenca, en Ecuador. Con base en la teoría actual, el método de valor contingente resulta ser, si no el óptimo, uno de los más adecuados para estos casos. Mediante una muestra de familias usuarias del servicio y aplicando el modelo dicotómico de doble límite, se estableció en 3,44 USD el valor económico promedio asignado por las familias encuestadas. Los estadísticos de precisión dieron la razón en buena medida a las predicciones de Hanemann et al., y el valor resultante, comparado con el obtenido en otros países en desarrollo, presentó correlaciones altas con los PIB per cápita respectivos. Pese a haberse procedido canónicamente, en este estudio se planteó la hipótesis de que la DAP no mide el real valor económico del bien cuando se trata de un monopolio estatal, y se constató que el 91% de los encuestados, aunque con claras manifestaciones de disconformidad, finalmente se resignaron a pagar valores mayores al máximo DAP que declararon previamente, con lo cual se falsea este último como medida del valor económico, al menos en la perspectiva de la teoría utilitarista.

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In the third quarter of 2012, Ukraine’s economy recorded negative growth (-1.3%) for the first time since its 2009 economic crisis. Q4 GDP is projected to suffer a further decline, bringing Ukraine into formal recession. In addition to the worsening macroeconomic indicators, Ukraine is also facing a series of concomitant economic problems: a growing trade deficit, industrial decline, shrinking foreign exchange reserves, and the weakening of the hryvnia. Poor economic growth is expected to result in lower than projected budget revenues, which in turn could lead to the sequestration of the budget in December. The decline evident across the key economic indicators in the second half of 2012 brings to a close a period of relative economic stability and two years of economic growth, which had been seen as a significant personal achievement of President Viktor Yanukovych and the ruling Party of Regions. The health of the Ukrainian economy largely depends on the state of the country’s export- -oriented industries. The current economic forecasts for foreign markets are not very optimistic. It is impossible to determine whether the current economic downturn is likely to be merely temporary or whether it heralds the onset of a prolonged economic crisis. The limited capacity to deal with the growing economic problems may mean that Kiev will need to seek financial support from abroad. This is particularly significant with regard to external debt servicing, since in 2013 Ukraine will need to pay back around 9 billion USD, including over 5.5 billion USD to the International Monetary Fund. In order to overcome the recession and stabilise public finances, the government may be forced to take a series of unpopular measures, including raising the price of natural gas and utilities. These measures have been stipulated by the IMF as a condition of further financial assistance and the disbursement of the 12 billion USD stabilisation loan granted to Ukraine in July 2010. The only alternative for Western loans and economic reforms appears to be financial support from Russia. The price for Moscow’s help might however turn out to be very high, and precipitate a turn in Kiev’s foreign policy towards a gradual re-integration of former Soviet republics under Moscow-led geopolitical projects.