Exploring the green development path of the Yangtze River Economic Belt using the entropy weight method and fuzzy-set qualitative comparative analysis.

Green development is an effective way to achieve economic growth and social development in a harmonious, sustainable, and efficient manner. Although the Yangtze River Economic Belt (YREB) plays an important strategic role in China, our understanding of its spatiotemporal characteristics, as well as the multiple factors affecting its green development level (GDL), remains limited. This study used the entropy weight method (EWM) to analyze the temporal evolution and spatial differentiation characteristics of the GDL in the YREB from 2011 to 2019. Further, fuzzy-set qualitative comparative analysis (fsQCA) was used to analyze the influence path of GDL. The results showed that the GDL of the YREB increased from 2015 to 2019, but the overall level was still not high, with high GDL mainly concentrated in the lower reaches. The GDL model changed from being environmentally driven and government supported in 2011 to being environmentally and economically driven since 2014. The core conditions for high GDL changed from economic development level (EDL) to scientific technological innovation level (STIL) and environmental regulation (ER). The path for improving GDL is as follows: In regions with high EDL, effective ER, moderate openness level (OL), and high STIL are the basis, supplemented by a reasonable urbanization scale (US). In areas with low EDL, reasonable industrial structure (IS) and STIL are the core conditions for development; further, EDL should be improved and effective ER and OL implemented. Alternatively, without considering changes to EDL, improvement can be achieved through reasonable OL and US or effective ER. This study provides a new method for exploring the path of GDL and a reference for governments to effectively adjust green development policies.

Developing a community-supported risk reduction intervention for syringe exchange registrants and their drug-free family or friends: a pilot study.

BACKGROUND: People engaged in injection opioid use often have drug-free family or friends that could be mobilized to support risk reduction and treatment seeking. OBJECTIVE: This pilot study evaluated the feasibility and preliminary efficacy of a 6-week community-supported risk reduction group intervention for syringe exchange program (SEP) registrants and drug-free network members. METHOD: The group provided risk reduction and treatment readiness education, with weekly assignments for participants to engage together in community activities designed to meet other drug-free people. RESULTS: Thirty-nine SEP registrants (and 39 community supports) enrolled in the study, and 21 pairs attended at least one group. For this smaller sample, participants attended 67% of scheduled sessions and engaged in scheduled activities during 42% of the study weeks, with 48% of SEP participants (n = 10) choosing to enter substance use disorder treatment. SEP participants who entered treatment reported reduced rates of injection drug use, opioid use, and cocaine use. CONCLUSIONS: While this intervention shows promise for linking syringe exchange and substance use disorder treatment participation in select SEP registrants, outcomes demonstrating low demand and modest acceptability suggest that additional research is necessary to understand barriers to participation and motivate higher levels of engagement.

Fatigue Symptoms During the First Year Following ARDS.

BACKGROUND: Fatigue is commonly reported by ARDS survivors, but empirical data are scarce. RESEARCH QUESTION: This study evaluated fatigue prevalence and associated variables in a prospective study of ARDS survivors. STUDY DESIGN AND METHODS: This analysis is part of the ARDSNet Long-Term Outcomes Study (ALTOS) conducted at 38 US hospitals. Using age- and sex-adjusted, time-averaged random effects regression models, we evaluated associations between the validated Functional Assessment of Chronic Illness Therapy-Fatigue Scale with patient and critical illness variables, and with physical, cognitive, and mental health status at 6 and 12 months following ARDS. RESULTS: Among ARDS survivors, 501 of 711 (70%) and 436 of 659 (66%) reported clinically significant symptoms of fatigue at 6 and 12 months, respectively, with 41% and 28% reporting clinically important improvement and worsening (n = 638). At 6 months, the prevalence of fatigue (70%) was greater than that of impaired physical functioning (50%), anxiety (42%), and depression (36%); 46% reported both impaired physical function and fatigue, and 27% reported co-existing anxiety, depression, and fatigue. Fatigue was less severe in men and in those employed prior to ARDS. Critical illness variables (eg, illness severity, length of stay) had little association with fatigue symptoms. Worse physical, cognitive, and mental health symptoms were associated with greater fatigue at both the 6- and 12-month follow-up. INTERPRETATION: During the first year following ARDS, more than two-thirds of survivors reported clinically significant fatigue symptoms. Due to frequent co-occurrence, clinicians should evaluate and manage survivors' physical, cognitive, and mental health status when fatigue is endorsed.