United States Trade Flows for Selected Categories of Specialty Crops and the General Policy Implication

International Relations/Trade,

Economic Asymmetries, Trade Liberalization and Integration: Issues and Policy Implications for CARICOM Countries

Much has been written about the challenges facing CARICOM as a result of the liberalization, globalization and integration phenomena. This paper adds value to the conversation by addressing the nexus between and among economic asymmetries, trade liberalization and economic integration, as it relates to CARICOM as small developing economies. The paper seeks to highlight the salient issues of CARICOM economic adjustment challenges under trade liberalization and integration imperatives, particularly as they may be subjected to the constraints of economic asymmetries. In doing so, it steps away from the conventional approach of reciting a series of data usually associated with the issues and instead, engages in commentary and assessment regarding the changing economic landscape in the Region and elsewhere. The issues are indeed very complex and the arguments and conclusions flowing from this type of evaluation may not be in lock-step with the conventional wisdom. However, it is our contention that the regional trade and development policy solutions does not lie in denial of the existence of the problems; but rather, in tackling them head-on and incorporating them into existing and proposed systems of economic relations.International Relations/Trade,

United States Trade Flows for Selected Categories of Specialty Crops

Nationally, Florida ranked second in farm cash receipt from all crops and second, based on value, in vegetable production (USDA, 2003). It also ranked fourteenth out of all the states with respect to agricultural exports with its top exports, fruits and vegetables, falling within the category of specialty crops. According to the USDA (2003), Florida's agricultural exports helped to boost farm prices and income and supported approximately 17,000 jobs both on and off farm in 2001. As such, its agricultural exports are important to Florida's agricultural and statewide economy. From a Florida farm cash receipts perspective, increased imports could undermine revenue earnings from specialty crop production, especially if there is not a comparable growth in the exports of these crops. This report covered the period 1991 to 2002 and examined trade flows for selected specialty crops deemed important to Florida's agriculture. Overall, the US had a relatively high import level of the selected specialty crops. This was apparent from the widening trade gaps and the declining surpluses experienced by all commodities, with the exception of oranges and strawberries. CANMEX was the dominant supplier of vegetables, and growing imports from this group drove the growing vegetable trade deficit. With respect to fruits, CANMEX was also a dominant supplier and affected trade balances however, many of the declining fruit trade balances were due to declining exports to markets such as Asia and the Europe. CANMEX played a major role in the trade of foliage and floriculture but did not dominate the trade. Over the period 1991 to 2002 there were changes in the trade flows of the selected vegetables, fruits and foliage and floriculture. Two noticeable trends were the concentration of trade with CANMEX, especially with respect to vegetable exports and declining exports to Asia and Europe. Also noticeable were declining trade balances experienced by the majority of the commodities in this study. With free trade agreements, an increased inflow of goods is expected as trade barriers are lowered. Preparing for additional imports resulting from expanded regional free trade agreements in the western hemisphere requires the commitment of additional resources toward the expansion of existing markets and the development of potentially new markets.Crop Production/Industries, International Relations/Trade,

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy

How patients understand depression associated with chronic physical disease - A systematic review

Background: Clinicians are encouraged to screen people with chronic physical illness for depression. Screening alone may not improve outcomes, especially if the process is incompatible with patient beliefs. The aim of this research is to understand peoples beliefs about depression, particularly in the presence of chronic physical disease. Methods: A mixed method systematic review involving a thematic analysis of qualitative studies and quantitative studies of beliefs held by people with current depressive symptoms. MEDLINE, EMBASE, PSYCHINFO, CINAHL, BIOSIS, Web of Science, The Cochrane Library, UKCRN portfolio, National Research Register Archive, Clinicaltrials.gov and OpenSIGLE were searched from database inception to 31st December 2010. A narrative synthesis of qualitative and quantitative data, based initially upon illness representations and extended to include other themes not compatible with that framework. Results: A range of clinically relevant beliefs was identified from 65 studies including the difficulty in labeling depression, complex causal factors instead of the biological model, the roles of different treatments and negative views about the consequences of depression. We found other important themes less related to ideas about illness: the existence of a self-sustaining depression spiral; depression as an existential state; the ambiguous status of suicidal thinking; and the role of stigma and blame in depression. Conclusions: Approaches to detection of depression in physical illness need to be receptive to the range of beliefs held by patients. Patient beliefs have implications for engagement with depression screening

A multicentre, randomised controlled trial to compare the clinical and cost-effectiveness of Lee Silverman Voice Treatment versus standard NHS Speech and Language Therapy versus control in Parkinson’s disease: a study protocol for a randomised controlled trial

Abstract: Background: Parkinson’s disease (PD) affects approximately 145,519 people in the UK. Speech impairments are common with a reported prevalence of 68%, which increase physical and mental demands during conversation, reliance on family and/or carers, and the likelihood of social withdrawal reducing quality of life. In the UK, two approaches to Speech and Language Therapy (SLT) intervention are commonly available: National Health Service (NHS) SLT or Lee Silverman Voice Treatment (LSVT LOUD®). NHS SLT is tailored to the individuals’ needs per local practice typically consisting of six to eight weekly sessions; LSVT LOUD® comprises 16 sessions of individual treatment with home-based practice over 4 weeks. The evidence-base for their effectiveness is inconclusive. Methods/design: PD COMM is a phase III, multicentre, three-arm, unblinded, randomised controlled trial. Five hundred and forty-six people with idiopathic PD, reporting speech or voice problems will be enrolled. We will exclude those with a diagnosis of dementia, laryngeal pathology or those who have received SLT for speech problems in the previous 2 years. Following informed consent and completion of baseline assessments, participants will be randomised in a 1:1:1 ratio to no-intervention control, NHS SLT or LSVT LOUD® via a central computer-generated programme, using a minimisation procedure with a random element, to ensure allocation concealment. Participants randomised to the intervention groups will start treatment within 4 (NHS SLT) or 7 (LSVT LOUD®) weeks of randomisation. Primary outcome: Voice Handicap Index (VHI) total score at 3 months. Secondary outcomes include: VHI subscales, Parkinson’s Disease Questionnaire-39; Questionnaire on Acquired Speech Disorders; EuroQol-5D-5 L; ICECAP-O; resource utilisation; adverse events and carer quality of life. Mixed-methods process and health economic evaluations will take place alongside the trial. Assessments will be completed before randomisation and at 3, 6 and 12 months after randomisation. The trial started in December 2015 and will run for 77 months. Recruitment will take place in approximately 42 sites around the UK. Discussion: The trial will test the hypothesis that SLT is effective for the treatment of speech or voice problems in people with PD compared to no SLT. It will further test whether NHS SLT or LSVT LOUD® provide greater benefit and determine the cost-effectiveness of both interventions. Trial registration: International Standard Randomised Controlled Trials Number (ISRCTN) Registry, ID: 12421382. Registered on 18 April 2016

A multicentre, randomised controlled trial to compare the clinical and cost-effectiveness of Lee Silverman Voice Treatment versus standard NHS Speech and Language Therapy versus control in Parkinson’s disease: a study protocol for a randomised controlled trial

Abstract: Background: Parkinson’s disease (PD) affects approximately 145,519 people in the UK. Speech impairments are common with a reported prevalence of 68%, which increase physical and mental demands during conversation, reliance on family and/or carers, and the likelihood of social withdrawal reducing quality of life. In the UK, two approaches to Speech and Language Therapy (SLT) intervention are commonly available: National Health Service (NHS) SLT or Lee Silverman Voice Treatment (LSVT LOUD®). NHS SLT is tailored to the individuals’ needs per local practice typically consisting of six to eight weekly sessions; LSVT LOUD® comprises 16 sessions of individual treatment with home-based practice over 4 weeks. The evidence-base for their effectiveness is inconclusive. Methods/design: PD COMM is a phase III, multicentre, three-arm, unblinded, randomised controlled trial. Five hundred and forty-six people with idiopathic PD, reporting speech or voice problems will be enrolled. We will exclude those with a diagnosis of dementia, laryngeal pathology or those who have received SLT for speech problems in the previous 2 years. Following informed consent and completion of baseline assessments, participants will be randomised in a 1:1:1 ratio to no-intervention control, NHS SLT or LSVT LOUD® via a central computer-generated programme, using a minimisation procedure with a random element, to ensure allocation concealment. Participants randomised to the intervention groups will start treatment within 4 (NHS SLT) or 7 (LSVT LOUD®) weeks of randomisation. Primary outcome: Voice Handicap Index (VHI) total score at 3 months. Secondary outcomes include: VHI subscales, Parkinson’s Disease Questionnaire-39; Questionnaire on Acquired Speech Disorders; EuroQol-5D-5 L; ICECAP-O; resource utilisation; adverse events and carer quality of life. Mixed-methods process and health economic evaluations will take place alongside the trial. Assessments will be completed before randomisation and at 3, 6 and 12 months after randomisation. The trial started in December 2015 and will run for 77 months. Recruitment will take place in approximately 42 sites around the UK. Discussion: The trial will test the hypothesis that SLT is effective for the treatment of speech or voice problems in people with PD compared to no SLT. It will further test whether NHS SLT or LSVT LOUD® provide greater benefit and determine the cost-effectiveness of both interventions. Trial registration: International Standard Randomised Controlled Trials Number (ISRCTN) Registry, ID: 12421382. Registered on 18 April 2016

CARICOM’s COMPETITIVENESS WITHIN THE US IMPORT MARKET FOR SPECIALTY CROPS: A SHIFT-SHARE ANALYSIS

This paper is based on the premise that if CARICOM’s agricultural sector in general, and more specifically the export sub-sector, is to thrive in the rapidly changing trade environment there has to be a continuous systematic assessment of market opportunities and competitiveness status. Such an assessment however, requires a clear understanding of the multifaceted concept of competitiveness and its major determinants. This paper seeks to contribute to the regional discussion of competitiveness, through the exploration of the theoretical and empirical dimensions of the concept within the context of CARICOM’s export of specialty crops to the United States. The paper uses a methodology heavily based on the Module to Analyze the Growth of International Commerce (MAGIC) software program developed by the Economic Commission for Latin America and the Caribbean (ECLAC). This programming module uses a variation of the classical and modified shift share or constant market share (CMS) analyses. Findings suggest that CARICOM, over the period 1991-2004, has generally not been competitive in the US import market for fresh (non-processed) specialty crops. Only three crops (pepper, papaya, and coffee (not roasted) exhibited increased competitiveness. However, these crops held very low market shares and exhibited the highly transient nature of competitiveness. The challenge for the Region is how to effectively move these very low market shares to higher levels within the context of transient behavior and a fierce rivalry for the US import market.

CARICOM’s COMPETITIVENESS WITHIN THE US IMPORT MARKET FOR SPECIALTY CROPS: A SHIFT-SHARE ANALYSIS

This paper is based on the premise that if CARICOM’s agricultural sector in general, and more specifically the export sub-sector, is to thrive in the rapidly changing trade environment there has to be a continuous systematic assessment of market opportunities and competitiveness status. Such an assessment however, requires a clear understanding of the multifaceted concept of competitiveness and its major determinants. This paper seeks to contribute to the regional discussion of competitiveness, through the exploration of the theoretical and empirical dimensions of the concept within the context of CARICOM’s export of specialty crops to the United States. The paper uses a methodology heavily based on the Module to Analyze the Growth of International Commerce (MAGIC) software program developed by the Economic Commission for Latin America and the Caribbean (ECLAC). This programming module uses a variation of the classical and modified shift share or constant market share (CMS) analyses. Findings suggest that CARICOM, over the period 1991-2004, has generally not been competitive in the US import market for fresh (non-processed) specialty crops. Only three crops (pepper, papaya, and coffee (not roasted) exhibited increased competitiveness. However, these crops held very low market shares and exhibited the highly transient nature of competitiveness. The challenge for the Region is how to effectively move these very low market shares to higher levels within the context of transient behavior and a fierce rivalry for the US import market. .Competitiveness, Specialty Crops, CARICOM, Shift-Share Analysis, MAGIC, Agricultural and Food Policy, Agricultural Finance, Crop Production/Industries, International Relations/Trade, Marketing,