The costs and benefits of eastern enlargement: the impact on the EU and central Europe

EU enlargement Small costs for the west, big gains for the east Eastern enlargement of the EU is a central pillar in Europe's post-Cold War architecture. Keeping the eastern countries out seriously endangers their economic transition, and economic failure in the east could threaten peace and prosperity in western Europe. The perceived economic costs and benefits will dictate the enlargement's timing. There are four parts to the calculus - the costs and the benefits in the east and in the west. Here we break new ground in estimating the economic benefits of enlargement for east and west using simulations in a global applied general equilibrium model. Our analysis includes a scenario in which joining the EU significantly reduces the risk premium on investment in the east - with resulting huge benefits to the new entrants. We also review the existing literature on the EU budget costs and arrive at a surprisingly well-determined ‘consensus' estimate, which we support with a new political economy analysis of the budget. The bottom line is unambiguous and strongly positive: enlargement is a very good deal for both the EU incumbents and the new members. — Richard E. Baldwin, Joseph F. Francois and Richard Porte

Monitoring of the arterial pressure in effort. dominant, not dominant arm or both?

Objetivo: evaluar la diferencia de los valores de Presión arterial (PA) entre ambos brazos, medida simultáneamente, durante una prueba de esfuerzo. Diseño del estudio: estudio transversal. Series de casos. Nivel de evidencia: 3 Material y Métodos: La población se compone de 225 deportistas sanos que realizaron una prueba de esfuerzo en nuestro centro. 128 hombres y 97 mujeres. Edad: 17± 5,5 años. Resultados: La PA tanto sistólica como diastólica no difiere significativamente entre ambos miembros superiores. No obstante, hemos encontrado casos de variabilidad individual donde la PA predomina en un brazo durante el reposo y en el otro brazo durante el máximo esfuerzo. Los valores de TA son independientes del brazo dominante. Conclusiones: La posibilidad que el brazo donde predomina la PA de Reposo no coincida durante el máximo esfuerzo, hace necesario, en nuestra opinión, que se mida la PA en ambos miembros superiores durante la prueba de esfuerzoObjective: To evaluate different blood pressure readings between both arms. Study design: cross-sectional study. Case series. Level of evidence: 3. Methods: a population of 225 healthy athletes underwent stress tests in our center: 128 males and 97 females. Age range: 17 +/- 5.5 years. Results: no significant differences in systolic or diastolic blood pressure readings were found between the right or left arm. We did, however, find cases where blood pressure is higher in one arm while resting and in the other arm during maximal exercise. Blood pressure readings were not associated with the dominant arm. Conclusions: The possibility that the arm in which there is a predominant rest blood pressure does not coincide during maximum stress, makes it necessary, according to our judgment, to measure blood pressure in both upper limbs during stress test

The use of the Alvarado score in the management of right lower quadrant abdominal pain in the adult

AIM OF THE STUDY: The Alvarado score is a validated test in clinical adult surgery practice which can be helpful in the diagnosis of acute appendicitis. This study aimed to assess the reliability and the reproducibility of this score for patients presenting in the emergency room with acute right lower quadrant abdominal pain. MATERIAL AND METHODS: A prospective monocenter study included all adults who presented in the emergency room with right lower quadrant abdominal pain. The score was calculated by assessing six symptoms and two laboratory values weighted by coefficients. The diagnosis of acute appendicitis was confirmed by the histological examination of the resected appendix. Three groups of patients with high, low, and intermediate scores were defined as described in the literature. RESULTS: Of the 233 patients studied, 174 underwent surgery: three had a normal appendix on histological exam. The statistical analysis of the results showed that a score lower than 4 was significantly associated with the absence of acute appendicitis while a score higher than 6 was significantly associated with acute appendicitis which required surgical care. But a score between 4 and 6 was not discriminant. CONCLUSION: The Alvarado score is a reliable, cheap and reproducible tool for the diagnosis of acute appendicitis in the emergency room; if the score is higher than 6 or lower than 4, there is no need for complementary exams. Patients with a score between 4 and 6, require serial reassessment of physical findings and score over 24 hours and/or complementary diagnostic exam such as ultrasound or CT scan

Relación entre capacidades físicas, Indice de Masa Corporal (IMC) y la discriminación dentro de la clase de educación física en alumnos de 10 y 11 años, en cuatro colegios de Chillan, Chile

Objetivo: verificar relación entre IMC, capacidades físicas y discriminación en clase de Educación Física, alumnos entre 10 a 11 años, 4 colegios de Chillán, Chile. Metodología: medir flexibilidad, velocidad y resistencia; calcular IMC; posteriormente contestar cuestionario de auto percepción frente a sus pares en relación a discriminación en clases de Educación Física. Población: 178 sujetos; muestra: 44 indicaron discriminación. Resultados: IMC: 72,6 por ciento de la muestra, que sienten discriminación, no presentan niveles de obesidad. Velocidad: 47,7 por ciento sujetos discriminados se encuentran sobre el promedio; demuestra que la velocidad es un factor que influye en la discriminación debido a que menos de la mitad de los alumnos discriminados se encuentran sobre el nivel de aprobación. Resistencia: 75 por ciento superior y 25 por ciento bajo el promedio lo que demuestra que la resistencia no es un factor determinante en la discriminación. Flexibilidad: 11 por ciento de los sujetos bajo el promedio y un 89 por ciento sobre el nivel de aprobación; se indica que la flexibilidad no es un factor determinarte en la discriminación. Los resultados indicaron que la relación de IMC y las capacidades físicas, en base a la discriminación en la clase de Educación Física, existe relación entre ambas, pero con resultados diferentes, ya que el índice de masa corporal en sujetos que presentan el rango de bajo peso y son discriminados, tienen mejor capacidad física que en alumnos de rango normal, riesgo de obesidad y obesida

Reconceptualizing Context: A Multilevel Model of the Context of Reception and Second-Generation Educational Attainment

This paper seeks to return scholarly attention to a core intellectual divide between segmented and conventional (or neo-)assimilation approaches, doing so through a theoretical and empirical reconsideration of contextual effects on second-generation outcomes. We evaluate multiple approaches to measuring receiving country contextual effects and measuring their impact on the educational attainment of the children of immigrants. We demonstrate that our proposed measures better predict second-generation educational attainment than prevailing approaches, enabling a multilevel modeling strategy that accounts for the structure of immigrant families nested within different receiving contexts

Caracterização diamétrica de um povoamento de Araucaria angustifolia (bertol.) Kuntze sob alta competição.

Resumo

Competition index: a tool to define thinning in stands of Araucaria angustifolia.

IUFROLAT 2013. Disponibilizado online. Resumen

Pharmaceutical services in primary health care : are pharmacists and users on the same page?

This study investigated structural and organizational characteristics of the Pharmaceutical Services based on Primary Health Care (PHCPS) from the viewpoints of users and pharmacists. A mixed method design was applied, combining one-to-one semi-structured interviews with four pharmacists in charge of five public dispensing facilities and 69 users, with a secondary database analysis. Data were collected from February to August 2014 in Divinopolis, a municipality in Minas Gerais State. PHCPS were similar in terms of general activities performed and staff profile and background. While users were concerned about medicines' availability and improvements related to the PHCPS' conveniences and personnel, pharmacists pointed out problems regarding infrastructure to storage. Despite most users had low information on how to use their medicines, no pharmacists declared to participate in medicines dispensing activities. There was a low match between users and pharmacists viewpoints and advantages for concentrate medicines dispensing in a smaller number of facilities were not clear

The challenges of clinical trials in fragile X syndrome

RATIONALE: Advances in understanding the underlying mechanisms of conditions such as fragile X syndrome (FXS) and autism spectrum disorders have revealed heterogeneous populations. Recent trials of novel FXS therapies have highlighted several challenges including subpopulations with possibly differential therapeutic responses, the lack of specific outcome measures capturing the full range of improvements of patients with FXS, and a lack of biomarkers that can track whether a specific mechanism is responsive to a new drug and whether the response correlates with clinical improvement. OBJECTIVES: We review the phenotypic heterogeneity of FXS and the implications for clinical research in FXS and other neurodevelopmental disorders. RESULTS: Residual levels of fragile X mental retardation protein (FMRP) expression explain in part the heterogeneity in the FXS phenotype; studies indicate a correlation with both cognitive and behavioral deficits. However, this does not fully explain the extent of phenotypic variance observed or the variability of drug response. Post hoc analyses of studies involving the selective mGluR5 antagonist mavoglurant and the GABAB agonist arbaclofen have uncovered significant therapeutic responses following patient stratification according to FMR1 promoter methylation patterns or baseline severity of social withdrawal, respectively. Future studies designed to quantify disease modification will need to develop new strategies to track changes effectively over time and in multiple symptom domains. CONCLUSION: Appropriate selection of patients and outcome measures is central to optimizing future clinical investigations of these complex disorders

Organizational-Social-Capital, Time and International Family SMEs:An Empirical Study from the East of England

Previous studies on family-SME internationalization have largely focused on what resources are needed to drive an incremental process rather than how resource management occurs in historical time. This paper focuses on the latter, adopting a social capital perspective (capturing both internal, i.e. among family-SME board members, and external, cross border agent dyads, relations) in order to decipher case study data from the East of England. Findings show that it is not the presence or absence of organizational-social-capital that affects family-SME internationalization success but rather its variable use over the years driven by the future pursuit of longevity, not growth. Key within this context is the variable use of the international expertise and management capability of non-family managers in the family SME intra-organizational context. Ultimately this may lead to change and learning that occurs erratically, often including reversals, without causing family-SME progression across a sequence of incremental stages