Psychometric properties of stigma and discrimination measurement tools for persons living with HIV: a systematic review using the COSMIN methodology.

BACKGROUND: The development of antiretroviral therapy broadly extends the life expectancy of persons living with HIV (PLHIV). However, stigma and discrimination are still great threat to these individuals and the world's public health care system. Accurate and reproducible measures are prerequisites for robust results. Therefore, it is essential to choose an acceptable measure with satisfactory psychometric properties to assess stigma and discrimination. There has been no systematic review of different stigma and discrimination tools in the field of HIV care. Researchers and clinical practitioners do not have a solid reference for selecting stigma and discrimination measurement tools. METHODS: We systematically searched English and Chinese databases, including PubMed, EMBASE, CINAHL, Web of Science, PsycINFO, ProQuest Dissertations and Theses, The Cochrane Library, CNKI,, and Wanfang, to obtain literature about stigma and discrimination measurement tools that have been developed and applied in the field of HIV. The search period was from 1st January, 1996 to 22nd November 2021. The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guideline (2018 version) was applied to assess the risk of bias for each involved study and summarize the psychometric properties of each tool. The modified version of the Grading of Recommendations Assessment, Development, and, Evaluation (GRADE) method was used to grade the evidence and develop recommendations. RESULTS: We included 45 studies and 19 PROMs for HIV/AIDS-related stigma and discrimination among PLHIV. All studies had sufficient methodological quality in content validity, structural validity, internal consistency, and the hypothesis testing of structural validity. Limited evidence was found for cross-cultural validity, stability, and criterion validity. No relevant evidence was found concerning measurement error and responsiveness. The Internalized AIDS-related Stigma Scale (IARSS), Internalized HIV Stigma Scale (IHSS), and Wright's HIV stigma scale (WHSS) are recommended for use. CONCLUSIONS: This study recommends three PROMs for different stigma and discrimination scenarios, including IARSS for its good quality and convenience, IHSS for its broader range of items, higher sensitivity, and greater precision, and WHSS for its comprehensive and quick screening. Researchers should also consider the relevance and feasibility of the measurements before putting them into practice. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42022308579.

The effectiveness and sustainability of peer support interventions for persons living with HIV: a realist synthesis.

BACKGROUND: Peer support is an important supplement to medical resources for persons living with HIV (PLHIV). However, previous studies have shown mixed results about intervention effects. It is necessary to explain the mechanism of peer support interventions' effectiveness and sustainability to help design more valid peer support interventions. OBJECTIVE: To identify and explain the mechanisms that drive the effectiveness and maintain the sustainability of peer support interventions. METHODS: A preliminary theoretical framework was developed through a scoping review of the grey literature and international project frameworks in five professional websites. We then refined the framework by systematically searching evidence in databases including PubMed, EMBASE, Web of Science, ProQuest, CINAHL, CNKI and Wanfang. Qualitative methods were used to generate codes and themes relating to the studies' context, mechanisms and outcomes. We checked chains of inference (connections) across extracted data and themes through an iterative process. RESULTS: A total of 6345 articles were identified, and 52 articles were retained for final synthesis. The refined theoretical framework presents five areas of peer support, including informational support, instrumental support, emotional support, affiliational support and appraisal support; five types of outcomes that peer support can improve for PLHIV, including physiological outcomes, psychological outcomes, behavioural outcomes, cognitive outcomes and social outcomes; the effectiveness mechanism coding system from peer volunteers and the relationship between peer volunteers and PLHIV; and the sustainability mechanism coding system in terms of peer volunteers, PLHIV and study context. CONCLUSIONS: Given that peer support has huge potential human resources, that is, all the qualified PLHIV, irreplaceable advantages in dealing with barriers to HIV-related discrimination and potential comprehensive benefits for PLHIV, it is necessary to develop and organise more peer support projects for PLHIV. Our study highlights that the expansion of peer support projects should be based on their effectiveness and sustainability. PROSPERO REGISTRATION NUMBER: CRD42022339079.

Psychometric properties of measurement tools of active aging: A systematic review.

BACKGROUND: Active aging has become a global goal under the current aging situation. Accurate and reproducible assessment tools are prerequisites to robust and reliable results for prevalence evaluation, associated factor exploration, and intervention effect assessment. However, there remains no systematic review to summarize all active aging assessment tools and report their psychometric properties. OBJECTIVE: To identify and assess the psychometric properties of patient-reported outcome measures of active aging in older adults. DESIGN: Systematic review of measurement properties using the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) methodology. METHODS: Eight databases (PubMed, EMBASE, CINAHL, Web of Science, Cochrane library, ProQuest Dissertations and Theses, CNKI, and Wanfang) were searched from January 2002 to February 2022. Studies that aim to validate patient-reported outcome measures of active aging in older adults aged 60 and over and report one or more psychometric properties were eligible for this systematic review. Methodological quality was assessed using the COSMIN Risk of Bias Checklist. We used the COSMIN criteria to summarize and rate the psychometric properties of each patient-reported outcome measure. A modified Grading, Recommendations, Assessment, Development, and Evaluation system was used to assess the certainty of evidence. RESULTS: Twenty studies reported on the psychometric properties of 18 identified patient-reported outcome measures. Of the 20 included studies, seven explored more than five psychometric properties. Limited information was retrieved on cross-cultural validity/measurement invariance, reliability, criterion validity, hypothesis testing for construct validity, measurement error, and responsiveness. High-quality evidence on psychometric properties was provided for the Active Aging Scale and individual-level Active Aging Index. CONCLUSIONS: The findings from the included studies highlighted that the Active Aging Scale and individual-level Active Aging Index are strongly recommended to evaluate active aging in research and clinics based on the specific aims of assessment and the response burden for participants. Future studies should also develop or translate more active aging individual-level assessment tools and pay attention to the evaluation of psychometric properties. REGISTRATION: PROSPERO (CRD42021287395).

Carbon dioxide and methane fluxes from mariculture ponds: The potential of sediment improvers to reduce carbon emissions.

The CO2 and CH4 fluxes across the water-air interface were determined in two groups of swimming crab (Portunus trituberculatus)-ridgetail white prawn (Exopalaemon carinicauda) polyculture ponds. One group of ponds with sediment improver application were referred to as SAPs, and the other group receiving no sediment improver were as NSPs. During the farming season, both the SAPs and NSPs acted as CO2 sinks and CH4 sources. The cumulative CO2-C fluxes from the SAPs and NSPs were -26.78 and -23.49 g m-2, respectively, and the cumulative CH4-C emissions from the SAPs and NSPs were 0.24 and 0.28 g m-2, respectively. CO2 fluxes were significantly related to net primary production and water pH, and CH4 fluxes were mainly regulated by water temperature during the farming season. The application of the oxidation-based sediment improver had a positive effect on reducing the CH4 emissions across the water-air interface but had no effect on CO2 fluxes. The sediment improver reduced the organic matter contents and improved the sediment pH and redox potential, which may have facilitated a decrease in CH4 production in the sediment. The CO2 produced through the oxidation of organic material in the sediment may have been absorbed by strong photosynthesis, resulting in a nonsignificant difference in CO2 fluxes between the SAPs and NSPs. The results indicated that the application of sediment improvers in coastal polyculture ponds can reduce carbon emissions, especially CH4 emissions, during the farming period and could help mitigate global warming with regard to the sustained-flux global warming potential (SGWP) and sustained-flux global cooling potential (SGCP) models over a 20-year time horizon. Future studies on the CO2 and CH4 production rates of the sediment and the related microbial community could improve our understanding of the effect mechanism of the application of sediment improvers on CO2 and CH4 emissions from mariculture ponds.