Trends in detectable viral load by calendar year in the Australian HIV observational database

Background Recent papers have suggested that expanded combination antiretroviral treatment (cART) through lower viral load may be a strategy to reduce HIV transmission at a population level. We assessed calendar trends in detectable viral load in patients recruited to the Australian HIV Observational Database who were receiving cART. Methods Patients were included in analyses if they had started cART (defined as three or more antiretrovirals) and had at least one viral load assessment after 1 January 1997. We analyzed detectable viral load (>400 copies/ml) in the first and second six months of each calendar year while receiving cART. Repeated measures logistic regression methods were used to account for within and between patient variability. Rates of detectable viral load were predicted allowing for patients lost to follow up. Results Analyses were based on 2439 patients and 31,339 viral load assessments between 1 January 1997 and 31 March 2009. Observed detectable viral load in patients receiving cART declined to 5.3% in the first half of 2009. Predicted detectable viral load based on multivariate models, allowing for patient loss to follow up, also declined over time, but at higher levels, to 13.8% in 2009. Conclusions Predicted detectable viral load in Australian HIV Observational Database patients receiving cART declined over calendar time, albeit at higher levels than observed. However, over this period, HIV diagnoses and estimated HIV incidence increased in Australia

Colorado Homestead Ranches – Our Success Story: How Do We Sell Branded Beef Direct to the Consumer

Colorado Homestead Ranches (CHR) markets natural beef, pork and lamb direct to Western Slope consumers. CHR is a partnership of six ranches that own their own USDA packing plant, a wildgame processing facility, and two storefronts. CHR markets direct to consumers via retail and farmers markets, restaurants, and wholesale distributors. CHR produces and markets value added sausage, jerky, meat sticks, and ready to cook entrees. The current strategic position of CHR is marketing of a niche, differentiated line of beef products, targeted at consumers who want a consistent quality product, raised on Colorado ranches, with natural production practices

Influence of Using Different Databases and 'Look Back' Intervals to Define Comorbidity Profiles for Patients with Newly Diagnosed Hypertension: Implications for Health Services Researchers.

To determine the data sources and 'look back' intervals to define comorbidities.Hospital discharge abstracts database (DAD), physician claims, population registry and death registry from April 1, 1994 to March 31, 2010 in Alberta, Canada.Newly-diagnosed hypertension cases from 1997 to 2008 fiscal years were identified and followed up to 12 years. We defined comorbidities using data sources and duration of retrospective observation (6 months, 1 year, 2 years, and 3 years). The C-statistics for logistic regression and concordance index (CI) for Cox model of mortality and cardiovascular disease hospitalization were used to evaluate discrimination performance for each approach of defining comorbidities.The comorbidities prevalence became higher with a longer duration. Using DAD alone underestimated the prevalence by about 75%, compared to using both DAD and physician claims. The C-statistic and CI were highest when both DAD and physician claims were used, and model performance improved when observation duration increased from 6 months to one year or longer.The comorbidities prevalence is greatly impacted by the data source and duration of retrospective observation. A combination of DAD and physicians claims with at least one year observation duration improves predictions for cardiovascular disease and one-year mortality outcome model performance

Rethinking Europe and modernity in light of global transformation The making of a post-western Europe

Anstatt die Geschichte Europas in Begriffen von Nationalhistorien und EU-Transnationalismus zu erzaehlen, kann nach Ansicht des Autors eine Annaeherung auf der Basis der Historischen Soziologie und einer Gesellschaftstheorie der Modernitaet einen weitaus differenzierten und tieferen Einblick in die europaeische politische und kulturelle Modernitaet geben, zumal die Entwicklung des Nationalstaats seine Grenzen erreicht hat. Der Autor diskutiert neuere theoretische Konzepte der Modernitaet, in deren Mittelpunkt der Begriff von 'multiplen Modernitaeten' in einer globalisierten Welt steht. Er erlaeutert ferner seine These, wonach sich die europaeische Modernitaet aus einer Konstellation von drei unterschiedlichen, aber sich ueberschneidenden Zivilisationen herausgebildet hat: aus der okzidentalen christlichen Zivilisation, der byzantinisch-slawisch-russischen Zivilisation und der islamisch-osmanischen Zivilisation. Diese Zivilisationen koennen nicht getrennt voneinander betrachtet werden, sondern sie haben sich in einem kontinuierlichen Interaktionsprozess von Anleihen, Verhandlungen und Selektionen geformt. Der Autor skizziert abschliessend die Zukunft eines 'Post-Westeuropas' und die Entstehung neuer Beziehungen zwischen Europa und Asien. (ICI)German title: Europa neu denken und Modernitaet im Lichte globaler Transformation: die Schaffung eines post-westlichen EuropasAvailable from UuStB Koeln(38)-20030106925 / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekSIGLEDEGerman