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Gives a detailed account of the parameters for technical standards and measures seeking to protect health and environment. This work also includes commentaries on those provisions of GATT 1994, which are equally relevant in this context, namely Articles III, IX and XX. It is useful for practitioners and academics working in this field of WTO law.

Kathrin Zippel explores the globalization and diffusion of the concept of sexual harassment from the US to Europe, and the different paths countries have embarked on to change employers' practices and the culture in the workplace. Comparative and uniquely comprehensive, it will appeal to students and scholars alike

Overview: services issues for the western hemisphere -- pt. 1. Crosscutting services issues / Sherry M. Stephenson. Improving the architecture of the General Agreement on Trade in Services / Geza Feketekuty -- Liberalization, regulation, and recognition for services trade / Kalypso Nicolaïdis and Joel P. Trachtman -- Making progress on trade and investment: multilateral versus regional perspectives / Pierre Sauvé -- Regional agreements on services in multilateral disciplines: interpreting and applying GATS Article V / Sherry M. Stephenson -- Dispute settlement in the services area under GATS / Hector A. Millán Smitmans. pt. 2. Services liberalization at the regional level. Mexico's free trade agreements: extending NAFTA's approach / Carlos Piñera González -- Services in MERCOSUR: the protocol of Montevideo / María-Angélica Peña -- Integration in Central America and the liberalization of services trade / Alvaro R. Sarmiento -- Andean Community Decision 439 on Services Trade / María Esperanza Dangond -- Services in the Caribbean: Protocol II on Establishment, Services, and Capital / Pamela Coke Hamilton. pt. 3. Challenges and conclusions. Liberalizing trade in services: a developing-country perspective / Eduardo Lizano -- The GATS, subregional agreements, and the FTAA: how much is left to be done? / Francisco Javier Prieto -- Negotiating services agreements: challenges ahead / Maryse Robert.

The introduction of COVID-19 vaccination passes (VPs) by many countries coincided with the Delta variant fast becoming dominant across Europe. A thorough assessment of their impact on epidemic dynamics is still lacking. Here, we propose the VAPSIRS model that considers possibly lower restrictions for the VP holders than for the rest of the population, imperfect vaccination effectiveness against infection, rates of (re-)vaccination and waning immunity, fraction of never-vaccinated, and the increased transmissibility of the Delta variant. Some predicted epidemic scenarios for realistic parameter values yield new COVID-19 infection waves within two years, and high daily case numbers in the endemic state, even without introducing VPs and granting more freedom to their holders. Still, suitable adaptive policies can avoid unfavorable outcomes. While VP holders could initially be allowed more freedom, the lack of full vaccine effectiveness and increased transmissibility will require accelerated (re-)vaccination, wide-spread immunity surveillance, and/or minimal long-term common restrictions. ; peer-reviewed

International audience ; Background: Morbidity and mortality associated with non-valvular atrial fibrillation (NVAF) imposes a substantial economic burden on the UK healthcare system. Objectives: An existing Markov model was adapted to assess the real-world cost-effectiveness of rivaroxaban and apixaban, each compared with a vitamin K antagonist (VKA), for stroke prevention in patients with NVAF from the National Health Service (NHS) and personal and social services (PSS) perspective. Methods: The model considered a cycle length of 3 months over a lifetime horizon. All inputs were drawn from real-world evidence (RWE): baseline patient characteristics, clinical event and persistence rates, treatment effect (meta-analysis of RWE studies), utility values and resource use. Deterministic and probabilistic sensitivity analyses were performed. Results: The incremental cost per quality-adjusted life year was £14,437 for rivaroxaban, and £20,101 for apixaban, compared with VKA. The probabilities to be cost-effective compared with VKA were 90% and 81%, respectively for rivaroxaban and apixaban, considering a £20,000 threshold. In both comparisons, the results were most sensitive to clinical event rates. Conclusions: These results suggest that rivaroxaban and apixaban are cost-effective vs VKA, based on RWE, considering a £20,000 threshold, from the NHS and PSS perspective in the UK for stroke prevention in patients with NVAF. This economic evaluation may provide valuable information for decision-makers, in a context where RWE is more accessible and its value more acknowledged.

The implementation of management systems has led employers to develop administrative processes, under the premise of regulatory compliance, to avoid sanctions or fines, activities that were previously carried out on an eventual or informal basis, according to customer needs, situations that have given relevance to the budget analyzes within the planning processes of the companies, allowing them an economic balance. Conditions that founded the approach of an analysis with a quantitative approach of the accounting recognition for the design, implementation and improvement of the management system in occupational health and safety in 150 companies in the commerce sector of the El Estero neighborhood, in Villavicencio. This process began with the characterization of the companies by regime, to continue with the analysis of the definition of the investment items, the accounting processes and finally determine the decision-making process of senior management according to the development of management versus occupational risks. This results suggest the strengthening and integration of financial planning in the occupational health and safety management system during the implementation process of the strategic and operational activities of the PDCA cycle (Plan, Do, Check, Act), in order to avoid the loss of resources and establish this management as an ally in the continuous improvement of the company, of working conditions, an added value for its clients and a competitive advantage in the market. ; La implementación de los sistemas de gestión ha llevado a los empresarios a desarrollar procesos administrativos bajo la premisa del cumplimiento normativo para evitar sanciones o multas, actividades que antes se llevaban de forma eventual o informal, de acuerdo con las necesidades del cliente. Estas situaciones han dado relevancia a los análisis presupuestales dentro de los procesos de planeación de las empresas, que les permiten a estas un equilibrio económico. Los cambios administrativos, técnicos y legales fundamentaron el planteamiento de un análisis con enfoque cuantitativo frente al diagnóstico del reconocimiento contable en el diseño, la implementación y la mejora del sistema de gestión en seguridad y salud en el trabajo en 150 empresas del sector del comercio del barrio El Estero, de Villavicencio. Este proceso inició con la caracterización de las empresas por régimen, para continuar con el análisis de la definición de los rubros de inversión, los procesos de contabilización y, finalmente, determinar el proceso de toma de decisiones de la alta dirección frente al desarrollo de la gestión con respecto a los riesgos laborales. Los resultados sugieren que hubo fortalecimiento e integración de la planeación financiera en el sistema de gestión en seguridad y salud en el trabajo durante el proceso de implantación de las actividades estratégicas y operacionales del ciclo PHVA (planear, hacer, verificar, actuar), a fin de evitar la pérdida de recursos y establecer esta gestión como un aliado en el mejoramiento continuo de la empresa y de las condiciones laborales, un valor agregado para sus clientes y una ventaja competitiva en el mercado.

International audience ; Background: Morbidity and mortality associated with non-valvular atrial fibrillation (NVAF) imposes a substantial economic burden on the UK healthcare system. Objectives: An existing Markov model was adapted to assess the real-world cost-effectiveness of rivaroxaban and apixaban, each compared with a vitamin K antagonist (VKA), for stroke prevention in patients with NVAF from the National Health Service (NHS) and personal and social services (PSS) perspective. Methods: The model considered a cycle length of 3 months over a lifetime horizon. All inputs were drawn from real-world evidence (RWE): baseline patient characteristics, clinical event and persistence rates, treatment effect (meta-analysis of RWE studies), utility values and resource use. Deterministic and probabilistic sensitivity analyses were performed. Results: The incremental cost per quality-adjusted life year was £14,437 for rivaroxaban, and £20,101 for apixaban, compared with VKA. The probabilities to be cost-effective compared with VKA were 90% and 81%, respectively for rivaroxaban and apixaban, considering a £20,000 threshold. In both comparisons, the results were most sensitive to clinical event rates. Conclusions: These results suggest that rivaroxaban and apixaban are cost-effective vs VKA, based on RWE, considering a £20,000 threshold, from the NHS and PSS perspective in the UK for stroke prevention in patients with NVAF. This economic evaluation may provide valuable information for decision-makers, in a context where RWE is more accessible and its value more acknowledged.

International audience ; Background: Morbidity and mortality associated with non-valvular atrial fibrillation (NVAF) imposes a substantial economic burden on the UK healthcare system. Objectives: An existing Markov model was adapted to assess the real-world cost-effectiveness of rivaroxaban and apixaban, each compared with a vitamin K antagonist (VKA), for stroke prevention in patients with NVAF from the National Health Service (NHS) and personal and social services (PSS) perspective. Methods: The model considered a cycle length of 3 months over a lifetime horizon. All inputs were drawn from real-world evidence (RWE): baseline patient characteristics, clinical event and persistence rates, treatment effect (meta-analysis of RWE studies), utility values and resource use. Deterministic and probabilistic sensitivity analyses were performed. Results: The incremental cost per quality-adjusted life year was £14,437 for rivaroxaban, and £20,101 for apixaban, compared with VKA. The probabilities to be cost-effective compared with VKA were 90% and 81%, respectively for rivaroxaban and apixaban, considering a £20,000 threshold. In both comparisons, the results were most sensitive to clinical event rates. Conclusions: These results suggest that rivaroxaban and apixaban are cost-effective vs VKA, based on RWE, considering a £20,000 threshold, from the NHS and PSS perspective in the UK for stroke prevention in patients with NVAF. This economic evaluation may provide valuable information for decision-makers, in a context where RWE is more accessible and its value more acknowledged.