Implementation and Operational Research: Risk Charts to Guide Targeted HIV-1 Viral Load Monitoring of ART: Development and Validation in Patients From Resource-Limited Settings.

BACKGROUND HIV-1 RNA viral load (VL) testing is recommended to monitor antiretroviral therapy (ART) but not available in many resource-limited settings. We developed and validated CD4-based risk charts to guide targeted VL testing. METHODS We modeled the probability of virologic failure up to 5 years of ART based on current and baseline CD4 counts, developed decision rules for targeted VL testing of 10%, 20%, or 40% of patients in 7 cohorts of patients starting ART in South Africa, and plotted cutoffs for VL testing on colour-coded risk charts. We assessed the accuracy of risk chart-guided VL testing to detect virologic failure in validation cohorts from South Africa, Zambia, and the Asia-Pacific. RESULTS In total, 31,450 adult patients were included in the derivation and 25,294 patients in the validation cohorts. Positive predictive values increased with the percentage of patients tested: from 79% (10% tested) to 98% (40% tested) in the South African cohort, from 64% to 93% in the Zambian cohort, and from 73% to 96% in the Asia-Pacific cohort. Corresponding increases in sensitivity were from 35% to 68% in South Africa, from 55% to 82% in Zambia, and from 37% to 71% in Asia-Pacific. The area under the receiver operating curve increased from 0.75 to 0.91 in South Africa, from 0.76 to 0.91 in Zambia, and from 0.77 to 0.92 in Asia-Pacific. CONCLUSIONS CD4-based risk charts with optimal cutoffs for targeted VL testing maybe useful to monitor ART in settings where VL capacity is limited.

Collecting the Painted Netherlands: The Art Collection of Ernest of Austria in Brussels

The (art) collection of Archduke Ernest of Austria (1553-1595) is widely unknown when it comes to early-modern Habsburg collections. Ernest, younger brother of Emperor Rudolf II (b. 1552) and educated at the Madrid court, was appointed Governor-General of the Netherlands by King Philip II of Spain, his uncle, in summer 1593. Ernest relocated his court from Vienna to Brussels in early 1594 and was welcomed there with lavish festivities: the traditional Blijde Inkomst, Joyous Entry, of the new sovereign. Unfortunately, the archduke died in February 1595 after residing in Brussels for a mere thirteen months. This investigation aims to shed new light on the archduke and his short-lived collecting ambitions in the Low Countries, taking into account that he had the mercantile and artistic metropolis Antwerp in his immediate reach. I argue, that his collecting ambitions can be traced back to one specific occasion: Ernest’s Joyous Entry into Antwerp in June 1594. There the archduke received a series of six paintings of Pieter Bruegel the Elder (1525/30-1569) known as The Months (painted in 1565), hanging today in separate locations in Vienna, New York and Prague. These works of art triggered Ernest’s collecting ambitions and prompted him to focus mainly on works of art and artefacts manufactured at or traded within the Netherlands during the last eight months of his lifetime. Additionally, it will be shown that the archduke was inspired by the paintings’ motifs and therefore concentrated on acquiring works of art depicting nature and landscape scenes from the 1560s and 1590s. On the basis of the archduke’s recently published account book (Kassabuch) and of the partially published inventory of his belongings, it becomes clear that Ernest of Austria must be seen in line with the better-known Habsburg collectors and that his specific collection of “the painted Netherlands” can be linked directly to his self-fashioning as a rightful sovereign of the Low Countries.

L'œanecdotier moderne : der neueste französische Anekdotenkrämer, oder Tausend biographische Skizzen, Erzählungen, Anekdoten, witzige Einfälle, Schwänke, Calembours, Räthsel etc., aus der neuesten Zeit geschöpft, zur Veredlung des Verstandes und des Herzens, für solche Leser, die sich im Französischen auf eine angenehme und nützliche Art üben wollen

von J. B. Hofstetter

La construcción del consenso en el gobierno de Cristina Fernández de Kirchner en torno a la ley de medios y la ley de reforma política (período 2009-2010)

Esta investigación no es la primera en lo que hace al modo de construcción de consenso en la gestión del ex presidente Néstor Kirchner y en la de la presidente Cristina Fernández, ya que es un tema muy controvertido que actualmente reúne posturas tanto a favor, como en contra. El objetivo propuesto es detectar y analizar los principales mecanismos de construcción de consenso utilizados en el proceso de sanción de la ley de Servicios de Comunicación Audiovisuales, y en el de la ley de Democratización de la Representación Política, la Transparencia y la Equidad Electoral, sancionadas en 2009.

Ley Nacional de Microcrédito

Las crisis socio-económicas que se viven en distintas partes del mundo generan desigualdades en todos los niveles que afectan la dignidad de las personas. Más aún, en numerosas realidades, las mismas están naturalizadas culturalmente. Estas situaciones fueron y son percibidas por diversas personas e instituciones que sensibilizadas por estas fuertes verdades, han intervenido con pequeños y/o grandes aportes para contribuir a revertirlas. El autor profundiza en el tema del microcrédito proponiéndose diversos cuestionamientos y debates que tiendan a realizar un aporte en pos de mejorar la utilización de esta valiosa herramienta, más específicamente, en lo relativo a la implementación de la Ley Nacional de Microcrédito. Estas opiniones que en algunos casos han sido analizadas por otros investigadores con anterioridad, y otras no, requieren repensarlas permanentemente; ya que las condiciones históricas, sociales, políticas, geográficas y económicas suelen ser cambiantes y puede ocasionar que conclusiones válidas en algún momento o lugar determinado, luego no sean igual de correctas. Ante esto, el autor se hace algunas preguntas basadas en tres categorías generales: las condiciones de la operatoria, las instituciones de las microfinanzas y los beneficiarios.