Transcutaneous calf-muscle electro-stimulation : a prospective treatment for diabetic claudicants?

Background: First-line therapy for claudicants with diabetes include supervised exercise programmes to improve walking distance. However, exercise comes with a number of barriers and may be contraindicated in certain conditions. The aim of this study was to evaluate whether calf-muscle electro-stimulation improves claudication distance. Method: A prospective, one-group, pretest-posttest study design was employed on 40 participants living with type 2 diabetes mellitus, peripheral artery disease (ankle-brachial pressure index < 0.90) and calf-muscle claudication. Calf-muscle electro-stimulation of varying frequencies (1-250 Hz) was applied on both ischaemic limbs (N = 80) for 1 h per day for 12 consecutive weeks. The absolute claudication distance was measured at baseline and following the intervention. Results: The cohort (n = 40; 30 males; mean age = 71 years; mean ankle-brachial pressure index = 0.70) registered a mean baseline absolute claudication distance of 333.71 m (standard deviation = 208). Following 91.68 days (standard deviation = 6.23) of electrical stimulation, a significant mean increase of 137 m (standard deviation = 136) in the absolute claudication distance was registered (p = 0.000, Wilcoxon signed rank test). Conclusion: Electrical stimulation of varying low to high frequencies on ischaemic calf muscles significantly increased the maximal walking capacity in claudicants with type 2 diabetes. This therapeutic approach may be considered in patients with impaired exercise tolerance or as an adjunct treatment modality.peer-reviewe

Brazil, the GATT, and the WTO: history and prospects

1. Brazil and the GATT, 1947-1980 Early years: GATT and ITO The first 20 years: rich men’s club and free riders Brazil and the Tokyo Round 2. Skirmishes before the Uruguay Round, 1980-86 3. The Uruguay Round, 1986-1994 4. Brazil and the GATT, 1980-1994 5. Brazil and the WTO after the Uruguay Round, 1994-1998 6. Brazilian diplomacy in the GATT and the WTO 7. Perspectives

Factors determining gender ratio in the Maltese population

Introduction: The Male/Female ratio at birth has been described to favour the male conceptus, a situation that persists throughout most of childhood and into the reproductive phase of life. The reasons behind this preferential male-favouring remain elusive. Methodology: The various relevant obstetric and population national registers kept by the Department of Health information and the National Statistics Office of the Maltese Islands were reviewed to elucidate the age-related M/F ratios differences in the population starting with the third trimester of the antenatal period. In addition, third trimester M/F ratios in women with specific metabolic-related disorders were assessed and compared to the on-affected individuals. The role of foetal congenital malformations was also investigated. Results: It would appear that the M/F ratio starts favouring the male conceptus as early as the third trimester of the antenatal period. It remains favoured right through the reproductive age reaching par after the age of 45 years when it shifts to favour the female. This relationship was significantly altered during the 1930s as a result of the emigration patters prevalent during that period. The results further show that the maternal nutritional and biochemical milieu may influence the M/F ratio at the beginning of the third trimester with women suffering from adiposity, diabetes and thyroid disease having higher M/R ratios. In spite of this preference to the male conceptus, malts have a higher mortality throughout life with mortality rates being higher for males from the third trimester up to the age of 75 years. On the other hand, female foetuses with malformations appear to have a higher mortality during intrauterine life than corresponding male foetuses. Conclusion: The M/F ratio appears to favour the male conceptus during antenatal life and is definitely evident by the beginning of the third trimester of pregnancy, the selection mechanism possibly being a greater predisposition of female foetal loss in the presence of malformations. These biological observations may present advantages within the breath of human reproductive ecology, ensuring a healthy reproductive female individual who has the option of choosing her mate from a competing male community.peer-reviewe

NAREA AWARDS

Outstanding Master's Thesis Award: The law and economics of "consumer only" financed export subsidies: a context for the WTO panel on Canadian dairy pricing policy, by Isabel Schleup; Assessing the market potential for character marked wood furniture, by Guanming Shi; The economics of 2-tier tariff-rate import quotas: an empirical application to the United States dairy industry, by Devry Seanna Boughner; Underemployment dynamics of women in the United States, by Qiuyan Wang Distinguished Member Award: Conrado M. (Bobby)Gempesaw and John M. Halstead Journal Article of the Year for 1999: Examining packer choice of slaughter cattle procurement and pricing methods, by Oral Capps, Jr., H. Alan Love, Gary W. Williams, and Wendi L. AdamsTeaching/Communication/Extension/Profession,

Mexico’s Free Trade Agreements

[Excerpt] Mexico has had a growing commitment to trade integration through the formation of free trade agreements (FTAs) since the 1990s and its trade policy is among the most open in the world. Mexico\u27s pursuit of FTAs with other countries not only provides economic benefits, but could also potentially reduce its economic dependence on the United States. The United States is, by far, Mexico\u27s most significant trading partner. About 80% of Mexico\u27s exports go to the United States and 49% of Mexico\u27s imports come from the United States. Mexico\u27s second largest trading partner is China, accounting for approximately 6% of Mexico\u27s exports and imports. In an effort to increase trade with other countries, Mexico has a total of 11 trade agreements involving 41 countries. These include agreements with most countries in the Western Hemisphere including the United States and Canada, Chile, Costa Rica, Nicaragua, Guatemala, El Salvador, and Honduras. In addition, Mexico has negotiated FTAs outside of the Western Hemisphere and entered into agreements with Israel and the European Union in July 2000. Mexico also has an FTA with Japan. The large number of trade agreements, however, has not yet been successful in decreasing Mexico\u27s dependence on trade with the United States. Economic motivations are generally the major driving force for the formation of free trade agreements among countries, but there are other reasons countries enter into FTAs, including political and security factors. One of Mexico\u27s primary motivations for the unilateral trade liberalization efforts of the late 1980s and early 1990s was to improve economic conditions in the country, which policymakers hoped would lead to greater investor confidence and attract more foreign investment. Trade agreements were also expected to improve investor confidence, attract foreign investment, and create jobs. Mexico may have other reasons for entering into FTAs, such as expanding market access and decreasing its reliance on the United States as an export market. The slow progress in multilateral negotiations may also contribute to the increasing interest throughout the world in regional trade blocs. Some countries may see smaller trade arrangements as building blocks for multilateral agreements. Since Mexico began trade liberalization in the early 1990s, its trade with the world has risen rapidly, with exports increasing more rapidly than imports. Mexico\u27s trade balance with all countries went from a deficit of $13.5 billion in 1993 to surpluses of$7.1 billion in 1995 and $6.5 billion in 1996. Since 1998, Mexico\u27s trade balance has remained in deficit, reaching$17.5 billion in 2008. The trade balance with the United States went from a deficit of $2.4 billion in 1993 to a surplus of$82.0 billion in 2008. Exports to the United States increased 447% between 1993 and 2008, from $42.9 billion to$292.6 billion. Mexico\u27s imports from the United States increased 237% during the same time period, from $45.3 billion to$152.6 billion. In the 110th Congress, issues of concern related to the trade and economic relationship with Mexico involved mostly economic conditions in Mexico, issues related to the North American Free Trade Agreement (NAFTA), the effect of NAFTA on Mexico, and Mexican migrant workers in the United States. The 111th Congress will likely maintain an active interest concerning Mexico on these issues. This report provides an overview of Mexico\u27s free trade agreements, its motivations for trade liberalization and entering into free trade agreements, and some of the issues Mexico faces in addressing its economic challenges. This report will be updated as events warrant

Milichiella lacteipennis (Loew, 1866) is associated with beeswax (Diptera, Milichiidae)

The Milichiidae (Diptera, Schizophora) is a family of acalypterate Diptera of worldwide distribution. Some 240 species are recognised (Brake, 2000). The most comprehensive account on the biology and breeding habits of the family may be found in Ferrar (1987) from which most of the following information is taken.peer-reviewe

Changing clinical activity in Paediatrics in Malta, 1996-2011

Aim: This study reviews the clinical workload in paediatrics in Malta over a 16-year period. Methods: National statistics for live birth rates were obtained from the Directorate of Health Information and Research. Data for paediatric (birth to 14 completed years) and neonatal admissions, day cases, outpatient visits, attendance at Paediatric Accident and Emergency and the Community-based Developmental Unit were obtained from the Annual Reports, Department of Paediatrics, for the period 1996-2011. Results: During the study period, live births fell by 11% from 4,349 in 1996 to 3,857 in 2005, and recovered to 4,283 in 2011. Whereas neonatal admissions to NPICU remained constant at around 340(±22) per annum, inpatient admissions to the general Paediatric wards decreased by 19% (from 3,151 to 2,550), and casualty reviews dropped by 35% (11,831 to 7,773). In contrast, day care reviews increased by 66% (1,347 to 3,928), the total outpatient workload increased by 70% (13,500 to 22,998), and cases reviewed in the Community-based Child Developmental Unit increased by 184% from 413 to 1174. Changes observed in the clinical activity in Gozo General Hospital were similar but less marked. Conclusion: Over a 16 year period, there has been a significant shift in the paediatric workload in Malta from an in-patient bias in 1996 to increased day care and outpatient reviews in 2011. This shift is largely the result of improved hospital and community day health care services, and can be increased further with augmented community care. Health resources and future paediatric health care programmes will need to take heed of these trends.peer-reviewe

SEEKING AGRICULTURAL COMPETITIVENESS THROUGH TRADE NEGOTIATIONS: WANTING DOESN'T MAKE IT SO

International Relations/Trade,

The world trading system at the crossroads : multilateral trade negotiations in the era of regionalism

The multilateral trade negotiations in the Uruguay Round have stagnated for years. At the same time, the world economy has witnessed a strong revival of regional trade arrangements. This juxtaposition suggests that major trading partners are drifting away from the GATT. Systemic weaknesses in the GATT framework, particularly the lack of effective sanction mechanisms, and the overly ambitious agenda of the Uruguay Round have rendered it difficult to reach a multilateral trade accord. In the EC, the Internal Market programme has been given priority over the GATT negotiations. And the recent move by the United States towards regionalism also threatens to undermine the basis upon which multilateralism could rest in the future. The future of the world trading system depends critically on whether the trading partners realise that regionalism cannot be defeated successfully by forming countervailing protectionist blocs. To prevent a further erosion of the fundamental GATT principle of mostfavoured- nation treatment, sweeping decisions are required in three respects: — In concluding the Uruguay Round, swiftness is more important than completeness. An immediate agreement should comprise all tentative achievements reached so far. — Trade disputes left operf for the time being and new challenges such as ecologically motivated trade barriers should be tackled in follow-up negotiations to be started immediately after conclusion of the Uruguay Round. — The EC and the United States should commit themselves to open regionalism by relaxing restrictive accession procedures. Moreover, GATT obligations must be extended by a provision stipulating that third countries whose trade is negatively affected by regional integration schemes will be compensated. The responsibility to establish the conditions under which regional integration and multilateral trade liberalisation could reinforce each other rests with the world's leading trading partners. Open regionalism in a strong multilateral framework would not only break the vicious circle that is eroding the world trading system, but may even induce a virtuous circle of mutual trade liberalisation between regional groupings. --