Regional Industrial integration: the case op the Arab Middie East

The general theme of this thesis is that economic integration in the case of developing countries ought to be conceived as a strategy for economic development, rather than as a tariff issue. Considering that developing countries are still in the process of realising their economic potential, they can benefit from the dynamic effects of integration. It is argued that economic integration among such countries is marked with uncertainty. Its success hinges to a large extent on the ability of the integrating countries to adopt an "allocative" approach which simultaneously avoids the occurrence of crises in the distribution of benefits and costs of integration and ensures the coordination of investment and production programmes to take advantage of the enlarged market. The "allocative" approach aims initially at partial integration, as it concentrates on the sector or industry where integration can be most effective. After some gains are realised, integration could be extended gradually to include other sectors. This framework is discussed in the context of the Arab Middle East countries, and an approach and a strategy for industrial integration among these countries are suggested. The study comprises two parts. In Part I, an attempt is made to develop a theoretical framework for the study of economic integration among developing countries. It starts by examining in Chapter One the theory of economic integration and its relevance to developing countries, and then in Chapter Two develops an operational methodology for identifying and measuring integration effects of regional projects. Chapter Three reviews the alternative approaches to regional industrial integration experienced by various groupings in Latin America, Africa, and Asia, with a view to appraise the "package deal" approach as an innovative solution to the problem of distribution of benefits and costs, and its desirability for a regional grouping such as the Arab Middle East countries«In Part II, the case for integration among the Arab Middle East countries (to include the Arab countries in Asia together with Egypt and the Sudan) is examined, with an attempt to devise a strategy for an integrated industrial development among these countries* As a starting point, Chapter Pour gives a critical account of the attempts at regional economic cooperation and integration in the Arab Middle East region, and the emerging role of capital surpluses accruing to the oil countries in promoting the idea of integration. Chapter Five discusses the economic framework of the countries under consideration, in order to assess the role of economic integration as a desirable alternative to national development. Chapter Six discusses the developing industrial growth patterns in the above countries, and relates integration to future industrial growth. Chapter Seven explores some of the possibilities for integration among the Arab Middle East countries in specific industries in a number of industrial sectors whose economic viability can be enhanced by the pooling of scarce resources, skills, and markets. This will be followed in Chapter Eight by a methodological study for the assessment of the integration potential in one of these industries which is fertilizers. Chapter Nine focuses on the elements which are deemed central in the framing of a strategy for an integrated industrial development based on the "package deal" approach in the region. Finally, Chapter Ten presents a concluding summary of the study

Anaesthesiological management of postpartum hemorrhage in Germany - a national survey

Objective: Postpartum haemorrhage (PPH) is a risk factor for maternal morbidity and mortality. This survey aims to provide an impression on the structural conditions and management of PPH in special consideration of different levels of maternal care in Germany. In addition differences in obstetric and anaesthesiologic care might be detected in 2015 before the release of the updated guideline on "Diagnostics and Therapy of postpartum haemorrhage" in 2016. Methods: The heads of anaesthesiologic departments with an included obstetric unit were identified by using a data set provided by the German Society of Anaesthesiology and Intensive Care and received a questionnaire asking about basic data and infrastructure of their departments, staff and both anaesthesiologic and obstetric management of PPH. The standardised questionnaire included 86 items of 20 different topics and was sent as hybrid (paper-based and electronic) survey to 529 departments in october 2014. The survey was closed in february 2015. Results: Altogether 156 questionnaires were returned and analysed which equals a response rate of 29%. The results were divided by level of maternal care (level 1 43%, 2a 11%, 2b 13%, 3 33%) and were presented as most common answer in each group. Number of PPH increases by level of maternal care (42% of level 1: none; 32% of 2b: 1-20; 48% of 3: >30 / Jahr). "Point-of-care-testing" is not provided in delivery rooms of more than 55% departments of level 2a and 2b, plus 75% departments of level 1. Postpartum blood loss is mainly estimated visually or quantified by suction device (>90% / >80%). 17% of the departments use calibrated bags, 20% regularly weigh their surgical towels after PPH. Approximately 7% document PPH in an anaesthesiologic database. Practical training is not implemented in more than 75% departments of level 1, 2b and 3. Arterial embolization is only provided full-time by 20% of level 1, 2a and 2b departments. Lyophilized plasma is not been used across 58% of all departments. Conclusion: Structural conditions for implementation of the updated guideline are given in most departments. Deviations in management of PPH are seen at all levels of maternal care and particularily affect "point-of-care-testing", estimation of blood loss, anaesthesiologic database and practical training. In obstetric management the reduced availabilty of arterial embolization is concerning. Lyophilized plasma is not generally been used.Zielsetzung: Die peripartale Hämorrhagie (PPH) ist ein Risikofaktor für maternale Morbidität und Mortalität. Ziel dieser Arbeit ist es zum einen die Erstaufnahme der strukturellen Gegebenheiten zur interdisziplinären Behandlung der PPH in Kliniken unterschiedlicher Versorgungsstufen in Deutschland zu evaluieren. Zum anderen sollen Unterschiede im geburtsmedizinischen und anästhesiologischen Management der PPH in Deutschland im Jahr 2015 erfasst werden, sodass eine Bestandsaufnahme vor der Veröffentlichung der S2k-Leitlinie zur „Diagnostik und Therapie der Peripartalen Blutung“ im Jahr 2016 existiert. Methodik: Hierfür wurden Chefärzte und Chefärztinnen anästhesiologischer Kliniken mit angeschlossener geburtsmedizinischer Abteilung mittels eines von der "Deutschen Gesellschaft für Anästhesie und Intensivmedizin (DGAI)" bereitgestellten Datensatzes (Stand 2014) ermittelt und bezüglich der Basisdaten ihrer Kliniken, personeller und struktureller Ausstattung, sowie Möglichkeiten zum gynäkologischen und anästhesiologischen Management der PPH (86 Fragen zu 20 Themenkomplexen) befragt. Der standardisierte Fragebogen wurde als Hybridumfrage, also mit Möglichkeit einer postalischen oder elektronischen Antwort, im Oktober 2014 an 529 anästhesiologische Kliniken versandt. Die Umfrage wurde Anfang Februar 2015 geschlossen. Ergebnisse: Insgesamt 156 Fragebögen wurden retourniert, welches einer Rücklaufquote von 29% entspricht. Die antwortenden Kliniken wurden anhand der geburtsmedizinischen Versorgungsstufe (VS) in Gruppe 1 (43%), 2a (11%), 2b (13%), und 3 (33%) eingeteilt. Die Ergebnisse wurden als häufigste Antwort der jeweiligen Gruppe dargestellt. Die Häufigkeit der PPH nimmt mit der VS zu (42% VS 1: keine; 32% VS 2b: 1-20; 48% VS 3: >30 / Jahr). In über 55% der VS 2a und 2b und 75% der VS 1 ist keinerlei „Point-of-Care-Testing“ im Kreißsaal verfügbar. Über alle VS wird der peripartale Blutverlust vornehmlich geschätzt oder mittels OP-Sauger quantifiziert (>90% bzw. >80% der Kliniken). In 17% der Kliniken kommen kalibrierte Auffangbeutel, in 20% regelhaftes Wiegen der Tücher zum Einsatz. Durchschnittlich 7% der Kliniken erfassen PPH mittels einer anästhesiologischen Datenbank. In über 75% der Kliniken der VS 1, 2b und 3 finden keine praktischen Trainingseinheiten der PPH statt. In 20% der VS 1, 2a und 2b ist die arterielle Embolisation der Aa. uterinae ganztägig verfügbar. Lyophilisiertes Plasma kommt in 58% der Kliniken aller VS nicht zum Einsatz. Schlussfolgerungen: Die strukturellen Voraussetzungenen für die Umsetzung der S2k-Leitlinie sind in den meisten Kliniken gegeben. Abweichungen im Management betreffen alle VS und bestehen insbesondere bei der Anwendung von „Point-of-care-Testing“, Messung des Blutverlustes, Aufbau anästhesiologischer Datenbanken für PPH und Implementierung von praktischen Trainingseinheiten. Im gynäkologischen Management imponiert die geringe Verfügbarkeit einer interventionellen Embolisation der Aa. uterinae. Die Anwendung von lyophilisierten Plasma zur Frühtherapie der PPH ist nicht flächendeckend vorhanden

Regional industrial integration The case of the Arab Middle East

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A Collation of Recently published Western European Formulae for Age Estimation of Subadult Skeletal Remains: Recommendations For Forensic Anthropology and Osteoarchaeology

The aim of this study is to provide an effective and quick reference guide based on the most useful European formulae recently published for subadult age estimation. All of these formulae derive from studies on postnatal growth of the scapula, innominate, femur, and tibia, based on modern skeletal data (173 ♂, 173 ♀) from five documented collections from Spain, Portugal, and Britain. The formulae were calculated from Inverse Regression. For this reason, these formulae are especially useful for modern samples from Western Europe and in particular on 20th century human remains from the Iberian Peninsula. Eleven formulae were selected as the most useful because they can be applied to individuals from within a wide age range and in individuals of unknown sex. Due to their high reliability and because they derive from documented European skeletal samples, we recommend these formulae be used on individuals of Caucasoid ancestry from Western Europe

Postnatal ontogenesis of the tibia. Implications for age and sex estimation

The growth of five variables of the tibia (diaphyseal length, diaphyseal length plus distal epiphysis, condylo-malleolar length, sagittal diameter of the proximal epiphysis, maximum breadth of the distal epiphysis) were analysed using polynomial regression in order to evaluate their significance and capacity for age and sex determination during and after growth. Data were collected from 181 (90♂ and 91♀) individuals ranging from birth to 25 years of age and belonging to three documented collections from Western Europe. Results indicate that all five variables exhibit linear behaviour during growth, which can be expressed by a first-degree polynomial function. Sexual significant differences were observed from age 15 onward in the two epiphysis measurements and condylo-malleolar length, suggesting that these three variables could be useful for sex determination in individuals older than 15 years. Strong correlation coefficients were identified between the five tibial variables and age. These results indicate that any of the studied tibial measurements is likely to serve as a useful source for estimating sub-adult age in both archaeological and forensic samples