<p>The purpose of this research is to examine the impact of liberalisation of trade in services on African LDCs by highlighting the importance of services trade through Mode 4 (temporary movement of natural persons).37 The paper will examine the nature of liberalisation to this Mode under the existing GATS framework, critically analyse the constraints on engaging in negotiations, specifically the national barriers that are hindering this movement, and make suggestions on ways of improving the nature of commitments on movement of natural persons in terms of Mode 4 to favour LDCs as laid down in Article VI of the GATS.</p>

Debate over Intellectual Property Rights ‘IPRs’ particularly patent and copyrights is mainly on forward-looking industries in computer software. As part of a trade deal reached in 1994, the member nations of the World Trade Organisation must adhere to a global agreement known as TRIPS, for the Trade- Related Aspect of Intellectual Property Rights. This study is to analyse the ethical conception of Intellectual Property Rights and in particular its implications on the developing countries in relation to TRIPS. The approach will be to analyse a broad philosophical theories of property to see if there is any justification for a software program to be treated as private property and also argue base on John Rawls two principles of justice in relation to TRIPS Agreement. Some reflections will be put on the use of open-source software by less developing countries. From the study it was asserted that, strong IPRs protection would hinder technological transfer and indigenous learning activities in the early stage of industrialisation when learning takes place through reverse engineering. And policy makers should consider differentiation in terms of the level of economic and industrial development, if protection and enforcement of IPRs is intended to enhance technological development.

There is growing consensus that unless resource-rich developing countries improve their domestic governance systems, rising exploitation of mineral, oil and gas resources may result in long-term adverse developmental outcomes associated with the “resource curse”. Despite the consensus, reforms do not abound. This dissertation investigates the obstacles to such reforms, and the mechanisms and strategies that can possibly overcome these obstacles. I argue that two trapping mechanisms are binding these countries to a “weak governance curse”. One mechanism is the phenomenon of path dependence, which makes a dysfunctional governance path initiated at a past historical juncture resistant to change over time. The other mechanism is rent-seeking behaviour associated with high resource rents, which creates perverse incentives for political and economic actors to resist reforms. The Law and Development literature has recently produced a rich body of knowledge on governance reform in developing countries, yet it has largely neglected the potential role of innovative global regulatory mechanisms, beyond development assistance, in this process. I argue that this evolving literature ought to draw from global regulation studies to investigate the interaction between unconventional global regulatory mechanisms and domestic governance reform. In this thesis I analyze whether extraterritorial home country regulations, such as anti-bribery, anti-money laundering and securities disclosure regulations, and transnational public-private partnerships, such as the Extractive Industries Transparency Initiative, may offer institutional opportunities for external and internal actors to facilitate policy reforms in resource-rich and governance-poor countries. My conclusion is twofold. First, there is reason for cautious optimism regarding the potential for unconventional global regulatory mechanisms to provoke positive feedback effects in domestic governance reform. These mechanisms can open innovative institutional pathways of influence to outsiders and insiders promoting governance reform. Second, instead of searching for a regulatory silver bullet, the most promising way to promote reforms in resilient dysfunctional governance systems is to make use of the wide range of conventional and unconventional mechanisms available. A constellation of regulatory instruments opens up the possibility for outside and inside reformers to benefit from a different policy mix of available mechanisms, depending on the specific circumstances of a given country at a particular time.

L'Accord sur les Aspects des Droits de Propriété Intellectuelle qui touchent au commerce constitue l'un des principaux piliers des accords de l'Uruguay Round. C'est aussi l'un des plus controversés. Cet Accord renforce les droits de propriété intellectuelle, les associe au commerce et introduit une norme mondiale ayant force exécutoire. La mise en application de cet Accord, qui suppose notamment de reconnaître et de renforcer la protection des produits et procédés pharmaceutiques par des brevets, pose des problèmes particuliers aux pays en développement vu le manque de ressources professionnelles, financières et d'infrastructure. La manière dont se fait l'interprétation de cet Accord peut avoir d'importantes répercussions sur les politiques de santé publique et, en particulier, sur l'accès des populations aux médicaments. Soumis aux pressions des pays riches et des groupes pharmaceutiques, les gouvernements des pays en développement se retrouvent parfois pieds et poings liés et n'utilisent pas les flexibilités prévues à leur avantage dans l'Accord, ce qui rend la situation sanitaire de leur population encore plus précaire. Cette étude décrit les principaux acteurs et les étapes importantes de la négociation de l'Accord, ainsi que les différentes adaptations qui en ont été faites sous les pressions contradictoires des nombreux protagonistes. Elle donne des explications sur les mécanismes en place et les conséquences possibles de l'entrée en vigueur de l'Accord sur l'accessibilité des pays en développement aux médicaments. / The Agreement on Trade-Related Aspects of Intellectual Property Rights is one of the main pillars of the agreements of the Uruguay Round. It is also one of the most controversial. This agreement strengthens the intellectual property rights, ties them to trade regulation and introduces a global binding standard. The implementation of this Agreement, which includes the recognition and the strengthening of the protection of pharmaceutical products and processes by patents, raises particular problems for developing countries, given the in lack of professional over financial resources as well as their poor economics infrastructure. The interpretation of this Agreement can have important consequences on public health policies and in particular on people's access to medicines. Unless the pressure of rich countries and pharmaceutical companies, governments of developing countries sometimes find themselves bound hand and foot and do not use the flexibilities provided to them by the Agreement to improve their position, thus making the health situation of their people still more precarious. This study describes the main actors and the important stages of negotiating the Agreement, as well as the various adjustments that were made under the pressures of numerous actors. It provides explanations of the existing mechanisms and of the potential consequences of the implementation of the Agreement on the accessibility of developing countries to medicines.

<p>The purpose of this research is to examine the impact of liberalisation of trade in services on African LDCs by highlighting the importance of services trade through Mode 4 (temporary movement of natural persons).37 The paper will examine the nature of liberalisation to this Mode under the existing GATS framework, critically analyse the constraints on engaging in negotiations, specifically the national barriers that are hindering this movement, and make suggestions on ways of improving the nature of commitments on movement of natural persons in terms of Mode 4 to favour LDCs as laid down in Article VI of the GATS.</p>

There is growing consensus that unless resource-rich developing countries improve their domestic governance systems, rising exploitation of mineral, oil and gas resources may result in long-term adverse developmental outcomes associated with the “resource curse”. Despite the consensus, reforms do not abound. This dissertation investigates the obstacles to such reforms, and the mechanisms and strategies that can possibly overcome these obstacles. I argue that two trapping mechanisms are binding these countries to a “weak governance curse”. One mechanism is the phenomenon of path dependence, which makes a dysfunctional governance path initiated at a past historical juncture resistant to change over time. The other mechanism is rent-seeking behaviour associated with high resource rents, which creates perverse incentives for political and economic actors to resist reforms. The Law and Development literature has recently produced a rich body of knowledge on governance reform in developing countries, yet it has largely neglected the potential role of innovative global regulatory mechanisms, beyond development assistance, in this process. I argue that this evolving literature ought to draw from global regulation studies to investigate the interaction between unconventional global regulatory mechanisms and domestic governance reform. In this thesis I analyze whether extraterritorial home country regulations, such as anti-bribery, anti-money laundering and securities disclosure regulations, and transnational public-private partnerships, such as the Extractive Industries Transparency Initiative, may offer institutional opportunities for external and internal actors to facilitate policy reforms in resource-rich and governance-poor countries. My conclusion is twofold. First, there is reason for cautious optimism regarding the potential for unconventional global regulatory mechanisms to provoke positive feedback effects in domestic governance reform. These mechanisms can open innovative institutional pathways of influence to outsiders and insiders promoting governance reform. Second, instead of searching for a regulatory silver bullet, the most promising way to promote reforms in resilient dysfunctional governance systems is to make use of the wide range of conventional and unconventional mechanisms available. A constellation of regulatory instruments opens up the possibility for outside and inside reformers to benefit from a different policy mix of available mechanisms, depending on the specific circumstances of a given country at a particular time.

Submitted by KAREN SANTOS BRAGHIROLI null (ka_braghiroli@hotmail.com) on 2016-03-14T00:21:49Z No. of bitstreams: 1 NOVO CORRETO-CORREÇÃO PÓS DEFESA- WORD-DISSERTAÇÃO DE MESTRADO-KAREN S BRAGHIROLI-DEFESA 24-2-2016.pdf: 812463 bytes, checksum: 5d0fe477b5ee642d2fd42d5a02dd5a18 (MD5) / Approved for entry into archive by Ana Paula Grisoto (grisotoana@reitoria.unesp.br) on 2016-03-15T12:13:23Z (GMT) No. of bitstreams: 1 braghiroli_ks_me_bot.pdf: 812463 bytes, checksum: 5d0fe477b5ee642d2fd42d5a02dd5a18 (MD5) / Made available in DSpace on 2016-03-15T12:13:23Z (GMT). No. of bitstreams: 1 braghiroli_ks_me_bot.pdf: 812463 bytes, checksum: 5d0fe477b5ee642d2fd42d5a02dd5a18 (MD5) Previous issue date: 2016-02-24 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / Pró-Reitoria de Pesquisa (PROPe UNESP) / A população mundial está envelhecendo e o número de procedimentos anestésico-cirúrgicos está aumentando na faixa etária de 60 anos, comparando-se com outros grupos etários. Considerando essa realidade e a existência de diferenças na segurança do paciente entre países desenvolvidos e em desenvolvimento, a presente revisão comparou a incidência de Parada Cardíaca (PC) perioperatória e por fator anestésico em pacientes geriátricos em países desenvolvidos e em desenvolvimento de acordo com o IDH (Índice de Desenvolvimento Humano) e em dois períodos de tempo. Comparou-se também a literatura mundial da incidência de PC perioperatória e por fator anestésico ao longo do tempo (pré-1990s e 1990-2014) e em relação ao IDH. Métodos: Realizou-se uma revisão sistemática de estudos transversais da literatura mundial sobre a incidência de PC perioperatória e por fator anestésico em pacientes geriátricos. Foi realizada meta-análise da incidência de PC perioperatória e por fator anestésico em 10.000 anestesias, de acordo com o IDH dos países e o período de tempo (pré-1990s e 1990-2014). Utilizou-se a análise de metarregressão para analisar a incidência de PC perioperatória e por fator anestésico ao longo do tempo e do IDH dos países. A meta-análise e a metarregressão foram realizadas considerando um intervalo de confiança (IC) de 95%. Resultados: Foram incluídos 16 estudos de nove países diferentes, com um total de 1.758.153 pacientes geriátricos submetidos à anestesia. A meta-análise mostrou que a incidência de PC perioperatória e por fator anestésico diminuiu significativamente nos países com alto-IDH (38,6 [IC 95%, 37,8-39,6] no período pré-1990s para 7,7 [IC 95%, 7,6-7,8] em 1990-2014, p<0,001; e 9,2 [ IC 95%, 8,9-9,5], no período pré-1990s para 1,3 [ IC 95%, 0,2-6,5] em 1990-2014, p<0,001, respectivamente). Em países com baixo-IDH, não há estudos disponíveis na literatura com a incidência de PC perioperatória e por fator anestésico no período pré-1990, não permitindo a comparação entre os períodos de tempo. A incidência de PC perioperatória em 1990-2014 foi quatro vezes maior nos países com baixo-IDH, em comparação com países de alto IDH (p<0,001). A metarregressão mostrou uma relação significativa com redução da incidência de PC por fator anestésico e o tempo independentemente do IDH do país (slope= -0,0699; 95% IC= -0,1394 a -0,0003; p=0,049) assim como em países com alto-IDH (slope= -0,1049; 95% IC= -0,1762 a -0,0336; p=0,015). Por outro lado, a metarregressão não mostrou relação significativa entre a incidência da PC por fator anestésico e o IDH dos países. Também não houve relação significativa da PC perioperatória em relação ao tempo e ao IDH dos países. Conclusão: A incidência de PC por fator anestésico em pacientes geriátricos diminuiu significativamente nos últimos 60 anos, especialmente em países com alto-IDH. Existe uma redução clara e significativa na incidência de PC por fator anestésico e perioperatória somente em países com alto-IDH, comparando-se os dois períodos de tempo (cinco vezes e sete vezes, respectivamente). / The world population is ageing and the number of anesthesia and surgical procedures are increasing in the sixty-years-old compared to other age groups. Considering this and the differences in patient safety in low- and high-income countries, the current study compared the perioperative and anesthesia-related CA rates in geriatric patients in low- and high-income countries in two time periods. Additionally, we compared global data on anesthesia-related and perioperative cardiac arrest (CA) rates according to Human Development Index (HDI) status and by time. Methods: A systematic review was performed to identify worldwide observational studies in which geriatric patients were submitted to anesthesia with perioperative and/or anesthesia-related CA rates. Meta-analysis per 10,000 anesthetics and meta-regression were performed with 95% confidence intervals (CIs) to compare the perioperative and anesthesia-related CA rates by country’s HDI status (low-HDI versus high-HDI) and by time period (pre-1990s versus 1990-2014), and to evaluate data on perioperative and anesthesia-related CA rates according to country’s HDI status and by time. Results: Sixteen studies from 9 countries assessing 1,758,153 anesthetic administrations in geriatric patients were included. The meta-analysis showed that the perioperative and anesthesia-related CA rates declined in high-HDI (38.6 [95% CI, 37.8-39.6] before the 1990s to 7.7 [95% CI, 7.6-7.8] in the 1990-2014, P<0.001; and 9.2 [95% CI, 8.9-9.5] before the 1990s to 1.3 [95% CI, 0.2-6.5] in the 1990-2014, P<0.001, respectively). In low-HDI countries, there were no studies in perioperative and anesthesia-related CA before 1990 disabling the comparison between the periods. The perioperative CA rate in the 1990-2014 was 4-fold higher in low-HDI compared with high-HDI countries (P<0.001). Meta-regression showed the significant relationship between anesthesia-related CA rate and time independently of HDI status (slope= -0.0699; 95% CI= -0.1394 to -0.0003; P=0.049) as well as in high-HDI countries (slope= -0.1049; 95% CI= -0.1762 to -0.0336; P=0.015), but not according HDI status. The relationship between perioperative CA by time and by HDI status was not significant. Conclusions: Anesthesia-related CA rate in geriatric patients has declined significantly in the past 60 years, especially in high-HDI countries. There is a clear and consistently reduction in perioperative and anesthesia-related CA rates only in high-HDI countries comparing the two time periods (5-fold and 7-fold, respectively). / FAPESP: 2013/11007-6 / PROPe/CDC UNESP: #0143/004/13

Conventional hearing aid circuitry is often unable to provide children with hearing loss with sufficient high frequency information in order to develop adequate oral language skills due to the risk of acoustic feedback and the narrower frequency spectrum of conventional amplification. The purpose of this study was to investigate word recognition abilities of children with moderate-to-severe hearing loss using hearing aids with linear frequency transposition. Seven children with moderate-to-severe sensorineural hearing loss between the ages of 5 years 0 months and 7 years 11 months were selected for the participant group. Word recognition assessments were first performed with the participants using their own previous generation digital signal processing hearing aids. Twenty-five-word lists from the Word Intelligibility by Picture Identification (WIPI) test were presented to the participants in three test conditions, namely: at 55 dB HL in quiet, 55 dB HL with a +5 dB signal-to-noise ratio (SNR) and at 35 dB HL. The participants were then fitted with an ISP-based hearing aid without linear frequency transposition, and the word recognition assessments were repeated with different WIPI word lists under the same conditions as the first assessment. Linear frequency transposition was then activated in the ISP-based hearing aid and different WIPI word lists were presented once more under identical conditions as the previous assessments. A 12-day acclimatization period was allowed between assessments, and all fittings were verified according to the DSL v5 fitting algorithm. Results indicated a significant increase of more than 12% in word recognition score for some of the participants when they used the ISP-based hearing aid with linear frequency transposition. A significant decrease was also seen for some of the participants when they used the ISP-based hearing aid with linear frequency transposition, but all participants presented with better word recognition scores when they used the ISP-based hearing aids without linear frequency transposition compared to their previous generation digital signal processing hearing aids. This study has shown that linear frequency transposition may improve the word recognition skills of some children with moderate-to-severe sensorineural hearing loss, and more research is needed to explore the criteria that can be used to determine candidacy for linear frequency transposition. / Dissertation (MCommunication Pathology)--University of Pretoria, 2010. / Speech-Language Pathology and Audiology / Unrestricted

Apart from isolated programs in private and public health care sectors, South Africa has no existing systematic public infant hearing screening program at community level. As a result, early identification of hearing loss is certainly not being attained for the majority of infants in South Africa with far-reaching effects for individuals, families and society at large. Screening programs at primary health care immunization clinics have been proposed as an alternative to hospital-based programs in South Africa. The objective of this study was to evaluate the first systematic community-based infant hearing screening program in a developing South African community in the Western Cape. A combined descriptive and exploratory research methodology was followed incorporating aspects of a program evaluation design. The study was of a quantitative nature and the required data were collected by means of a questionnaire and OAE testing conducted by clinic nurses on subjects. A community-based universal infant hearing screening program initiated at eight primary health care clinics in the Cape Metropolitan area was evaluated over a 19-month research period. During this time 6227 infants who were candidates for screening attended their 6, 10 or 14-week immunization visit at the relevant clinic. Clinic nurses were trained as screening personnel. A two-stage distortion product otoacoustic emissions screening protocol was utilized. The target disorder for this study was bilateral permanent congenital and early onset hearing loss and infants referring the first screen were scheduled for a 4-week follow-up visit at the clinic. Diagnostic audiological and medical evaluations were scheduled at referral hospitals when indicated. The study evaluated the efficacy of the program based on coverage, referral and follow-up rates and diagnostic outcomes according to guidelines specified by the Health Professions Council of South Africa 2007 Position Statement. Overall coverage rate across the eight clinics was 32.4% with 2018 infants (aged 0- 14 weeks) screened. The mean age of the sample at first stage screen was 3.9 weeks of age and 13.5 weeks of age for first hospital visit. Overall first stage screen referral rate was 9.5% with 62 subjects (3%) referred for diagnostic services at hospital level after a follow-up screen. The average follow-up rate for rescreens at clinic level was 85.1% and for initial diagnostic assessments at hospital level it was 91.8%. Although minimal hearing loss was not the primary focus of the screening program the outcomes did include those subjects with fluctuating conductive hearing loss and permanent unilateral hearing loss. Prevalence rates were 4.5/1000 with significant hearing loss, including sensorineural (1.5/1000) and conductive (3/1000) losses, and 12.9/1000 for subjects with middle ear effusion.<p-> The community-based infant hearing screening program was valuable in attaining high follow-up return rates but reaching sufficient coverage may require dedicated screening personnel as opposed to existing nursing personnel. Furthermore, consideration of an alternative community-based platform such as midwife obstetric units may improve coverage and referral rates and prevalence of permanent congenital and early onset hearing loss. / Dissertation (MCommunication Pathology)--University of Pretoria, 2013. / Speech-Language Pathology and Audiology / Unrestricted

This dissertation examines the effects of trade liberalization policies (represented by membership in the General Agreement on Tariffs and Trade/World Trade Organization on selected Least Developed Countries' (LDCs) human development (represented by the Human Development Index). In this dissertation, General Agreement on Tariffs and Trade (GATT) and World Trade Organization (WTO) policies are theorized to have two distinct types of effects: their direct effect and their indirect effect. Two questions are focused on: first, what is the effect (total, direct and indirect) of WTO policies on human development for selected LDCs? Second, what is the effect (total, direct and indirect) of WTO policies on human development for selected developing/developed countries (i.e. non-LDCs) holding economic development constant? Using the dependency theory of development as a theoretical basis, this dissertation examines the assumptions of modernization-theory-based policies as expressed in trade liberalization policies (i.e. the implementation of comparative advantage and now market fundamentalism) with world-system analysis techniques. To examine these questions, four panel regression models are constructed to measure the total, direct and indirect effects of WTO policies during the near-term (1998-2003) and during a longer historical term (1975-2000). The data for the analyses are taken from seven different sources of international data. The analyses seemingly demonstrate that there are quantifiable negative effects of GATT/WTO membership (trade liberalization policies) on human development in selected LDCs. The current implementation of trade liberalization policies does not benefit the well-being of all concerned as promoted by the WTO.