Fiscal discipline and public sector efficiency became prominent issues in Latin America and the Caribbean in the late 1980's following external debt crises that troubled many countries in the region. Resolution of the debt crises necessitated a first wave of reforms that largely focused on upgrading legal and regulatory frameworks or improving information systems. Nearly twenty years later progress in matching OECD practices and performance in public financial management and procurement has been uneven and has been one of the factors that impeded higher growth and competitiveness in Latin America and the Caribbean. Countries such as Chile, Brazil and Costa Rica with relatively good performance, in this respect, have shown what other countries in the region can do and how they would benefit. Increased globalization, seemingly intractable issues of income inequality, the onset of the recent global financial crises and the emergence of an assertive middle class that demands better governance, are all reasons why Latin America and the Caribbean governments should closely examine incomplete financial management and procurement reform programs and embark on trajectories that will improve their performance and be better responsive to the needs of their citizens. This book sets out, based on more than a decade of World Bank diagnostics, key areas that remain to be addressed by governments in the Latin America and the Caribbean region to underpin sustainable arrangements that deliver efficient and effective services, which are accountable to citizens. Success will have the important additional benefit of serving to notify international financial markets of the integrity of their stewardship function.
Dr. Perloff, the founding father of the field of adult congenital heart disease, presents a decade's worth of research and clinical data in the completely redefined 3rd edition to bring you the most current information. With advances in diagnosis and treatment in children, more and more of those with CHD survive well into adulthood. Expert contributors in various fields offer a multi-disciplinary, multi-system approach to treatment so you get comprehensive coverage on all aspects of the subspecialty, including basic unoperated malformations, medical and surgical perspectives, postoperative residue, and sequelae. As someone who treats these patients, you need to be ready to provide the continual care they require. Conveys a multidisciplinary, multi-system approach to the lifelong care of adult CHD patients to put treatment in a broader context. Presents information in a consistent, logical style so the information you need is easy to find and apply. Supplements the text with 600 clear conceptual illustrations to clarify difficult concepts. Features completely rewritten chapters to include the latest developments in the field-such as major advances in surgical and interventional techniques-and the various needs of patients with adult CHD. Incorporates recently published trials such as those involving cyanotic CHD and atherogenesis, coronary microcirculation, and pathogenesis of thrombocytopenia to supplement the chapter on cyanotic CHD. Emphasizes advances in imaging in a new section-edited by an expert-that covers echocardiography as well as specialized imaging techniques. Illustrates the full range of advances in the field with 600 images that reflect the latest progress. Includes new chapters-Global Scope of ACHD; Cardiac Transplantation; Electrophysiologic Abnormalities in Unoperated Patients and Residue and Sequelae After Cardiac Surgery-to provide you with the latest information on the growth of the subspecialty and its effect on treatment. Presents revisions by a new authorship of experts in infectious disease, genetics and epidemiology, sports medicine, neurology, cardiac surgery, cardiac anesthesiology, and more.
Fiscal discipline and public sector efficiency became prominent issues in Latin America and the Caribbean in the late 1980's following external debt crises that troubled many countries in the region. Resolution of the debt crises necessitated a first wave of reforms that largely focused on upgrading legal and regulatory frameworks or improving information systems. Nearly twenty years later progress in matching OECD practices and performance in public financial management and procurement has been uneven and has been one of the factors that impeded higher growth and competitiveness in Latin America and the Caribbean. Countries such as Chile, Brazil and Costa Rica with relatively good performance, in this respect, have shown what other countries in the region can do and how they would benefit. Increased globalization, seemingly intractable issues of income inequality, the onset of the recent global financial crises and the emergence of an assertive middle class that demands better governance, are all reasons why Latin America and the Caribbean governments should closely examine incomplete financial management and procurement reform programs and embark on trajectories that will improve their performance and be better responsive to the needs of their citizens. This book sets out, based on more than a decade of World Bank diagnostics, key areas that remain to be addressed by governments in the Latin America and the Caribbean region to underpin sustainable arrangements that deliver efficient and effective services, which are accountable to citizens. Success will have the important additional benefit of serving to notify international financial markets of the integrity of their stewardship function.
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