Rodrik, Dani (2011). The globalization paradox. Democracy and the future of the world economy

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Problemas de competitividad de las exportaciones argentinas

The Argentine economy is showing high economic growth since 2003, in a favorable global context. Exports grow incessantly, but the global market share is not modified. This raises questions on the exporting performance, and this paper shows some bounding of the competitiveness of the exports. The empirical information of Argentina and of the world is useful to determine some restrictions on the exports growth associated with the productive structure and the informality.La economía argentina viene experimentando un elevado proceso de crecimiento desde 2003, en un contexto global muy favorable. Las exportaciones crecen incesantemente, pero su participación en el market share global no se modifica. Esto plantea interrogantes acerca de la performance exportadora. En este trabajo se analizan limitantes de la competitividad de las exportaciones. Al estudio de datos empíricos de Argentina y del mundo sucede un análisis para determinar algunas restricciones sobre el crecimiento de las exportaciones vinculadas con la estructura productiva y la informalidad

Algunas Consideraciones acerca de la Eficiencia del IVA en la Argentina

In this paper there are analyzed aspects related to the efficiency of the Value Added Tax (VAT)in the Argentine economy. The argentine tax structure is checked, and compared with the oneof the developed countries. Then one proceeds to realize estimations of evasion in the VAT, forthe period 1997-2005. The effects of the Monotributo tax on the taxable base of the VAT andits potential collection are not minor, and are an object of analysis in the estimations of evasion.The Corporate Income Tax, close to the Subnational Gross Earnings Tax, and the Social SecurityContributions, generate incentives to the evasion “in chain”, together with the VAT. This leadsto think about the close relation between the VAT and the Corporate Income Tax, and theeffects over the evasion decisions. Recommendations suggests the elimination of the Monotributo tax, so as to improve the collection results of the VAT, and the reduction of the Corporate Income Tax rate, which would have final favorable impacts in the fiscal total income.En este trabajo se analizan aspectos relacionados con la eficiencia del Impuesto al Valor Agregado (IVA) en la economía argentina. Se comienza revisando la estructura tributaria de la Argentina, comparándola con la vigente en naciones desarrolladas. Luego se procede a realizar estimaciones de evasión-elusión en el IVA, para el período 1997-2005. Los efectos del Monotributo sobre la base imponible del IVA y su recaudación potencial no son menores y son objeto de análisis en las estimaciones de evasión-elusión. Por su parte, el impuesto a las Ganancias, junto al impuesto a los Ingresos Brutos y los impuestos al trabajo generan incentivos a la evasión “en cadena” junto con el IVA, que llevan a reflexionar acerca de la relación cercana entre IVA y el impuesto a las Ganancias, y su impacto sobre las decisiones de evasión. Se concluye con recomendaciones acerca del IVA y de otros impuestos. Se propone la eliminación del Monotributo para potenciar el efecto recaudatorio del IVA, y la reducción de la alícuota del impuesto a las Ganancias de empresas, reinvertidas o totales, lo que tendría impactos finales favorables en los ingresos fiscales totales

Piketty, Thomas (2014). Capital in the Twenty-First Century

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Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700

BHPR research: qualitative1. Complex reasoning determines patients' perception of outcome following foot surgery in rheumatoid arhtritis

Background: Foot surgery is common in patients with RA but research into surgical outcomes is limited and conceptually flawed as current outcome measures lack face validity: to date no one has asked patients what is important to them. This study aimed to determine which factors are important to patients when evaluating the success of foot surgery in RA Methods: Semi structured interviews of RA patients who had undergone foot surgery were conducted and transcribed verbatim. Thematic analysis of interviews was conducted to explore issues that were important to patients. Results: 11 RA patients (9 ♂, mean age 59, dis dur = 22yrs, mean of 3 yrs post op) with mixed experiences of foot surgery were interviewed. Patients interpreted outcome in respect to a multitude of factors, frequently positive change in one aspect contrasted with negative opinions about another. Overall, four major themes emerged. Function: Functional ability & participation in valued activities were very important to patients. Walking ability was a key concern but patients interpreted levels of activity in light of other aspects of their disease, reflecting on change in functional ability more than overall level. Positive feelings of improved mobility were often moderated by negative self perception ("I mean, I still walk like a waddling duck”). Appearance: Appearance was important to almost all patients but perhaps the most complex theme of all. Physical appearance, foot shape, and footwear were closely interlinked, yet patients saw these as distinct separate concepts. Patients need to legitimize these feelings was clear and they frequently entered into a defensive repertoire ("it's not cosmetic surgery; it's something that's more important than that, you know?”). Clinician opinion: Surgeons' post operative evaluation of the procedure was very influential. The impact of this appraisal continued to affect patients' lasting impression irrespective of how the outcome compared to their initial goals ("when he'd done it ... he said that hasn't worked as good as he'd wanted to ... but the pain has gone”). Pain: Whilst pain was important to almost all patients, it appeared to be less important than the other themes. Pain was predominately raised when it influenced other themes, such as function; many still felt the need to legitimize their foot pain in order for health professionals to take it seriously ("in the end I went to my GP because it had happened a few times and I went to an orthopaedic surgeon who was quite dismissive of it, it was like what are you complaining about”). Conclusions: Patients interpret the outcome of foot surgery using a multitude of interrelated factors, particularly functional ability, appearance and surgeons' appraisal of the procedure. While pain was often noted, this appeared less important than other factors in the overall outcome of the surgery. Future research into foot surgery should incorporate the complexity of how patients determine their outcome Disclosure statement: All authors have declared no conflicts of interes

Albiglutide and cardiovascular outcomes in patients with type 2 diabetes and cardiovascular disease (Harmony Outcomes): a double-blind, randomised placebo-controlled trial

Background: Glucagon-like peptide 1 receptor agonists differ in chemical structure, duration of action, and in their effects on clinical outcomes. The cardiovascular effects of once-weekly albiglutide in type 2 diabetes are unknown. We aimed to determine the safety and efficacy of albiglutide in preventing cardiovascular death, myocardial infarction, or stroke. Methods: We did a double-blind, randomised, placebo-controlled trial in 610 sites across 28 countries. We randomly assigned patients aged 40 years and older with type 2 diabetes and cardiovascular disease (at a 1:1 ratio) to groups that either received a subcutaneous injection of albiglutide (30–50 mg, based on glycaemic response and tolerability) or of a matched volume of placebo once a week, in addition to their standard care. Investigators used an interactive voice or web response system to obtain treatment assignment, and patients and all study investigators were masked to their treatment allocation. We hypothesised that albiglutide would be non-inferior to placebo for the primary outcome of the first occurrence of cardiovascular death, myocardial infarction, or stroke, which was assessed in the intention-to-treat population. If non-inferiority was confirmed by an upper limit of the 95% CI for a hazard ratio of less than 1·30, closed testing for superiority was prespecified. This study is registered with ClinicalTrials.gov, number NCT02465515. Findings: Patients were screened between July 1, 2015, and Nov 24, 2016. 10 793 patients were screened and 9463 participants were enrolled and randomly assigned to groups: 4731 patients were assigned to receive albiglutide and 4732 patients to receive placebo. On Nov 8, 2017, it was determined that 611 primary endpoints and a median follow-up of at least 1·5 years had accrued, and participants returned for a final visit and discontinuation from study treatment; the last patient visit was on March 12, 2018. These 9463 patients, the intention-to-treat population, were evaluated for a median duration of 1·6 years and were assessed for the primary outcome. The primary composite outcome occurred in 338 (7%) of 4731 patients at an incidence rate of 4·6 events per 100 person-years in the albiglutide group and in 428 (9%) of 4732 patients at an incidence rate of 5·9 events per 100 person-years in the placebo group (hazard ratio 0·78, 95% CI 0·68–0·90), which indicated that albiglutide was superior to placebo (p<0·0001 for non-inferiority; p=0·0006 for superiority). The incidence of acute pancreatitis (ten patients in the albiglutide group and seven patients in the placebo group), pancreatic cancer (six patients in the albiglutide group and five patients in the placebo group), medullary thyroid carcinoma (zero patients in both groups), and other serious adverse events did not differ between the two groups. There were three (<1%) deaths in the placebo group that were assessed by investigators, who were masked to study drug assignment, to be treatment-related and two (<1%) deaths in the albiglutide group. Interpretation: In patients with type 2 diabetes and cardiovascular disease, albiglutide was superior to placebo with respect to major adverse cardiovascular events. Evidence-based glucagon-like peptide 1 receptor agonists should therefore be considered as part of a comprehensive strategy to reduce the risk of cardiovascular events in patients with type 2 diabetes. Funding: GlaxoSmithKline

Effect of remote ischaemic conditioning on clinical outcomes in patients with acute myocardial infarction (CONDI-2/ERIC-PPCI): a single-blind randomised controlled trial.

BACKGROUND: Remote ischaemic conditioning with transient ischaemia and reperfusion applied to the arm has been shown to reduce myocardial infarct size in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). We investigated whether remote ischaemic conditioning could reduce the incidence of cardiac death and hospitalisation for heart failure at 12 months. METHODS: We did an international investigator-initiated, prospective, single-blind, randomised controlled trial (CONDI-2/ERIC-PPCI) at 33 centres across the UK, Denmark, Spain, and Serbia. Patients (age >18 years) with suspected STEMI and who were eligible for PPCI were randomly allocated (1:1, stratified by centre with a permuted block method) to receive standard treatment (including a sham simulated remote ischaemic conditioning intervention at UK sites only) or remote ischaemic conditioning treatment (intermittent ischaemia and reperfusion applied to the arm through four cycles of 5-min inflation and 5-min deflation of an automated cuff device) before PPCI. Investigators responsible for data collection and outcome assessment were masked to treatment allocation. The primary combined endpoint was cardiac death or hospitalisation for heart failure at 12 months in the intention-to-treat population. This trial is registered with ClinicalTrials.gov (NCT02342522) and is completed. FINDINGS: Between Nov 6, 2013, and March 31, 2018, 5401 patients were randomly allocated to either the control group (n=2701) or the remote ischaemic conditioning group (n=2700). After exclusion of patients upon hospital arrival or loss to follow-up, 2569 patients in the control group and 2546 in the intervention group were included in the intention-to-treat analysis. At 12 months post-PPCI, the Kaplan-Meier-estimated frequencies of cardiac death or hospitalisation for heart failure (the primary endpoint) were 220 (8·6%) patients in the control group and 239 (9·4%) in the remote ischaemic conditioning group (hazard ratio 1·10 [95% CI 0·91-1·32], p=0·32 for intervention versus control). No important unexpected adverse events or side effects of remote ischaemic conditioning were observed. INTERPRETATION: Remote ischaemic conditioning does not improve clinical outcomes (cardiac death or hospitalisation for heart failure) at 12 months in patients with STEMI undergoing PPCI. FUNDING: British Heart Foundation, University College London Hospitals/University College London Biomedical Research Centre, Danish Innovation Foundation, Novo Nordisk Foundation, TrygFonden

Distintos énfasis en el pensamiento social

"Un análisis de los cambios de énfasis en el pensamiento social de la Iglesia en las últimas décadas y las exhortaciones del papa Francisco. La enseñanza social de la Iglesia ha cobrado un renovado ímpetu desde el comienzo del pontificado de Francisco, si bien es un tema de activa preocupación eclesial desde hace más de un siglo. Con todo, el estilo frontal de Francisco, con tecnologías de la comunicación que permiten una multiplicación de sus mensajes, es realmente novedoso. Generando una empatía asombrosa, el papa argentino sorprende por la contundencia y profundidad de algunas definiciones, que suelen ser de fácil divulgación en la plataforma informática global...

Argentina ante el desafío educativo-laboral

Resumen: En todo país, la estrategia de largo plazo, asociada a políticas de Estado es esencial. Dentro de ella, el rol del sistema educativo y su relación con la inserción con el mundo laboral, como plataforma para el sistema nacional de innovación, es clave. En este artículo se analizan el financiamiento del gasto en educación en la Argentina, algunos resultados en calidad educativa (PISA), y se revisan las preferencias de los estudiantes/egresados universitarios. En comparación con las hoy a veces discutidas reformas de la Generación del ’80, que permitieron que la Argentina desarrollara un sistema educativo moderno y socialmente integrador basado en la calidad de la enseñanza estatal, el actual sistema educativo presenta algunos déficit de consideración