Assessing the relationship between physician availability and viral load suppression in British Columbia

In 2014, the Joint United Nations Programme on HIV/AIDS set the target of dramatically reducing the burden of HIV through expansion of access to timely HIV treatment. In order to achieve this target, it is necessary to expand access to care along the HIV cascade of care. This study examines the relationship between viral suppression and the availability of physicians providing HIV treatment in British Columbia, Canada. Data from the Drug Treatment Program of the British Columbia Centre for Excellence in HIV/AIDS was analyzed. The floating catchment method was used to assess physician availability and multivariable logistic regression was used to implement a confounder selection technique to independently assess the relationship between physician availability and viral load suppression. Individuals with more than 25 physicians within a one‐hour catchment were more likely to reside in urban areas and almost twice as likely to have a suppressed viral load (adjusted odds ratio: 1.97; 95% CI 1.50 – 2.58). This study highlights the impact of physicians’ availability on viral load levels. Mapping technology was used to identify the locations in which patients were most impacted by the lack of physicians.     

Estancias of Buenos Aires Province,Argentina: Rural Heritage,Sustainable Development and Tourism

Rural settlements growing crops and rearing animals are known as estancias in several South American countries. They played a prevailing role in the political and economic history of Argentina, particularly during the second half of the 19th century and the beginning of the 20th century. At present, many estancias are developing alternative activities, as recreation and tourism, in order to be able to subsist. The main problem lies in the fact that a non‐sustainable activity, frequently focused on the greatest economic yield, leads to the destruction of the heritage, instead of achieving its long‐term conservation. The purpose of this paper is to develop and verify a suitable model for the planning, execution and management of recreational and tourist activities in these rural settlements. As regards the scope of the concept of sustainable development, this methodology aims at achieving a balance between the recreational and tourist operation and the conservation of the rich heritage concerned.     

'Proactive fast-tracking' diffusion of supermarkets in developing countries: implications for market institutions and trade

Supermarkets have spread extremely rapidly in developing countriesafter the ‘take-off’ in the early to mid-1990s.Former analyses of supermarket diffusion have not adequatelyexplained the sudden burst and then exponential diffusion ofsupermarkets in the late 1990s and early 2000s. We argue thatrather than taking demand and market institutional and organizationalconditions as ‘exogenous’, as former analyses havetended to do, modern food retailers instead have treated localconditions as substantially ‘endogenous’. To enabletheir rapid growth, supermarkets undertake ‘proactivefast-tracking strategies’ to alter the ‘enablingconditions’ of entry and growth. Beside the retail investmentsthat have been extensively treated in recent literature, theseproactive strategies focus on improving the ‘enablingconditions’ via (i) procurement system modernization and(ii) local supply chain development. One important strategyretailers have used to facilitate (i) and (ii) is to form symbioticrelationships with modern wholesale, logistics and processingfirms. An example we address is ‘follow sourcing’,where a transnational retailer encourages transnational logisticsand wholesale firms with whom the retailer is working in homemarkets, to locate to the developing country. This is a spurto globalization of services in support of retail. Follow-sourcinghas been treated for example in the automobile manufacturessector (follow-sourcing from spare parts manufacturers)—butnot in the food sector. A second important strategy is thatof multi-network-sourcing, in which supermarkets source fromnational, regional and global networks. We analyze that strategyhere, adding to the literature which to date has touched onthis theme only scantly, and for the first time identify typicalpaths, present preliminary evidence (from Central America andIndonesia) concerning this multi-sourcing-network strategy anddiscuss trade implications. One of these is the move to primacyof South–South trade in supermarket sourcing—a newdimension of globalization. By introducing this link of retailertransformation and trade into the literature, we hope to spura new line of research that is timely in light of the trade,development and globalization debates in developing countries.