HIV Services Uptake Among People Living with HIV in Jiangsu Province, China: A Cross-Sectional Study.

Healthcare disparities are common among people living with HIV (PLWH) in China and likely impact access to HIV services. This study aimed to assess the current status of access to HIV services among PLWH and explore the correlates of service uptake using baseline data from a prospective cohort study among PLWH in Jiangsu Province. Guided by Andersen's behavioral model, univariable and multivariable logistic regressions were conducted to identify factors associated with access to HIV services. Out of 8989 eligible PLWH included in this study, 46.4% perceived difficulty in seeing a healthcare professional for HIV treatment services in 2021-2022. PLWH aged 18-34 years (adjusted odds ratio [AOR] = 1.69, 95% CI 1.32-2.15), 35-39 years (AOR = 1.33, 95% CI 1.08-1.65), identified as a bisexual/other (AOR = 1.14, 95% CI 1.01-1.29), had a college and above education (AOR = 1.32, 95% CI 1.07-1.63), and perceived moderate (AOR = 1.70, 95% CI 1.51-1.91) and severe (AOR = 2.20, 95% CI 1.94-2.49) levels of HIV stigma were more likely to perceive difficulty in seeing healthcare professionals for HIV treatment in 2021-2022. Living in northern Jiangsu was also associated with increased odds of perceiving difficulty in seeing healthcare professionals for HIV treatment (AOR = 1.12, 95% CI 1.00-1.26). These findings underscore the need for innovative solutions to eliminate the practical barriers to HIV services utilization among PLWH who are bisexual, well-educated, and effective HIV-related stigma reduction interventions.

Disparities in healthcare access and utilization among people living with HIV in China: A scoping review and meta-analysis.

BACKGROUND: This review aims to assess the status of healthcare disparities among people living with HIV (PLWH) in China and summarize the factors that drive them. METHODS: We searched PubMed, Web of Science, Cochrane Library, Scopus, China National Knowledge Infrastructure (CNKI) and China Wanfang for studies published in English or Chinese. Studies focusing on any disparities in healthcare services among PLWH in China and published between January 2000 and July 2022 were included. RESULTS: In all, 51 articles met the inclusion criteria, with 37 studies reporting HIV-focused care, and 14 reporting non-HIV-focused care. PLWH aged ≥45 years (vs. <45 years), female (vs. male), ethnic minority (vs. Han), and cases attributed to sexual transmission (vs. injecting drug use) were more likely to receive ART. Females living with HIV have higher ART adherence than males. Notably, 20% [95% confidence interval (CI): 9-43%, I2 = 96%] of PLWH reported any illness in the previous 2 weeks without medical consultation, and 30% (95% CI: 12-74%, I2 = 90%) refused hospitalization when needed in the previous year. Barriers to HIV-focused care included inadequate HIV/ART knowledge and treatment side effects at the individual level; and social discrimination and physician-patient relationships at the community/social level. Structural barriers included medical costs and transportation issues. The most frequently reported barriers to non-HIV-focused care were financial constraints and the perceived need for medical services at individual-level factors; and discrimination from physicians, and medical distrust at the community/social level. CONCLUSION: This review suggests disparities in access and utilization of healthcare among PLWH. Financial issues and social discrimination were prominent reasons. Creating a supportive social environment and expanding insurance policies could be considered to promote healthcare equity.

Cross-sectional study of factors affecting the receipt of mental health education in older migrants in China.

BACKGROUND: Population migration in China has increasingly included middle-aged and older populations. Relatedly, the lack of mental health education among China's older migrants is still an important but neglected problem. This study aimed to understand the current situation of mental health education received by the older migrant population in China and to explore related influencing factors. METHODS: This cross-sectional study included 5729 older migrants who participated in the 2017 China Migrants Dynamic Survey. The independent variables included four components: demographic and socioeconomic characteristics, migration factors, public health service utilization, and social integration factors. Data were analyzed using the chi-square test for single factors and a binary logistic regression model for multiple factors. RESULTS: A total of 1749 older migrants received mental health education, for a receipt rate of 30.53%. Regression analysis showed that older migrant individuals who had an average monthly household income > 3000 CNY, self-rated their health as healthy, had chronic diseases, had heard of National Basic Public Health Services, had established health records, received ≥2 types of health education were willing to integrate into the local population, and were highly involved in the community were more likely to receive mental health education. Older migrants who were ≥ 70 years old, had an elementary school education or below, had difficulties in the local community, had migrated ≥11 years prior, moved for their offspring, and moved across provinces were less likely to receive mental health education. CONCLUSIONS: The older migrant population does not receive sufficient mental health education. Mental health interventions should be tailored to the characteristics of older migrants to increase their mental health literacy and meet their psychological needs.

Effect of dredging and capping with clean soil on the mitigation of algae-induced black blooms in Lake Taihu, China: A simulation study.

Sediment is an important source of matter that causes blackening and odor formation in a water body. The restoration of polluted sediment can suppress algae-induced black blooms to a certain degree. In this study, we compared the control effects of sediment dredging and capping with clean soil on algae-induced black blooms in Lake Taihu using indoor simulation experiments. In addition, we explored the driving effect of temperature on algae-induced black blooms using the method of gradual warming (18, 23, and 28 °C) during the experiment. No blackening of the water body was observed in the simulation stages I (18 °C) and II (23 °C), and the blackening and odor formation occurred within 3 d when the temperature increased to 28 °C in stage III, implying that high temperature was an important driving factor for algae-induced black blooms. Dredging and capping inhibited the blackening and odor formation to some extent, and the colorimetric values in the water columns were lower in the treatment groups than in the control group. At the end of the experiment, the colorimetric values of dredging and capping treatments were 56.5% and 96.7% of the colorimetric value of the control group, respectively. The control effect of dredging on the blackening elements, i.e., Fe2+ and S2- and the main odor forming compounds, i.e., dimethyl disulfide (DMDS) and dimethyl trisulfide (DMTS) was observed in stage II (11-20 d) and stage III (21-27 d), respectively, and the inhibition ability of dredging to suppress algal-induced black blooms was superior than that of capping with clean soil.

COVID-19 Information Dissemination Using the WeChat Communication Index: Retrospective Analysis Study.

BACKGROUND: The COVID-19 outbreak has tremendously impacted the world. The number of confirmed cases has continued to increase, causing damage to society and the economy worldwide. The public pays close attention to information on the pandemic and learns about the disease through various media outlets. The dissemination of comprehensive and accurate COVID-19 information that the public needs helps to educate people so they can take preventive measures. OBJECTIVE: This study aimed to examine the dissemination of COVID-19 information by analyzing the information released by the official WeChat account of the People's Daily during the pandemic. The most-read COVID-19 information in China was summarized, and the factors that influence information dissemination were studied to understand the characteristics that affect its dissemination. Moreover, this was conducted in order to identify how to effectively disseminate COVID-19 information and to provide suggestions on how to manage public opinion and information governance during a pandemic. METHODS: This was a retrospective study based on a WeChat official account. We collected all COVID-19-related information, starting with the first report about COVID-19 from the People's Daily and ending with the last piece of information about lifting the first-level emergency response in 34 Chinese provinces. A descriptive analysis was then conducted on this information, as well as on Qingbo Big Data's dissemination index. Multiple linear regression was utilized to study the factors that affected information dissemination based on various characteristics and the dissemination index. RESULTS: From January 19 to May 2, 2020, the People's Daily released 1984 pieces of information; 1621 were related to COVID-19, which mainly included headline news items, items with emotional content, and issues related to the pandemic's development. By analyzing the dissemination index, seven information dissemination peaks were discerned. Among the three dimensions of COVID-19 information-media salience, content, and format-eight factors affected the spread of COVID-19 information. CONCLUSIONS: Different types of pandemic-related information have varying dissemination power. To effectively disseminate information and prevent the spread of COVID-19, we should identify the factors that affect this dissemination. We should then disseminate the types of information the public is most concerned about, use information to educate people to improve their health literacy, and improve public opinion and information governance.

Nitrogen and Phosphorus Exchanges Across the Sediment-Water Interface in a Bay of Lake Chaohu.

A year-long field investigation was carried out in the most heavily polluted bay of Lake Chaohu to assess the temporal exchanges of ammonium nitrogen () and soluble reactive phosphorus (SRP) across the sediment-water interface (SWI) and to provide remediation advises. Results showed that the monthly average fluxes of and SRP were 31.38 and 6.98 mg m-2 d-1, respectively, both of which were higher than those in many other hyper-eutrophic lakes around the world. The exchanges of and SRP were both closed related to the oxygen penetration. Low oxygen penetration depth and generally negative oxygen uptake rates provoked the dissolution of redox sensitive phosphorus and labile in the sediment and increased the fluxes. In addition, the generally higher fluxes during late spring to autumn should be noted during the reduction of internal loadings, when applicable techniques should be implemented accordingly to achieve better reduction effects.

Beyond hypoxia: occurrence and characteristics of black blooms due to the decomposition of the submerged plant Potamogeton crispus in a shallow lake.

Organic matter-induced black blooms (hypoxia and an offensive odor) are a serious ecosystem disasters that have occurred in some large eutrophic shallow lakes in China. In this study, we investigated two separate black blooms that were induced by Potamogeton crispus in Lake Taihu, China. The main physical and chemical characteristics, including color- and odor-related substances, of the black blooms were analyzed. The black blooms were characterized by low dissolved oxygen concentration (close to 0 mg/L), low oxidation-reduction potential, and relatively low pH of overlying water. Notably higher Fe2+ and sigmaS(2-) were found in the black-bloom waters than in waters not affected by black blooms. The black color of the water may be attributable to the high concentration of these elements, as black FeS was considered to be the main substance causing the black color of blooms in freshwater lakes. Volatile organic sulfur compounds, including dimethyl sulfide, dimethyl disulfide, and dimethyl trisulfide, were very abundant in the black-bloom waters. The massive anoxic degradation of dead Potamogeton crispus plants released dimethyl sulfide, dimethyl disulfide, and dimethyl trisulfide, which were the main odor-causing compounds in the black blooms. The black blooms also induced an increase in ammonium nitrogen and soluble reactive phosphorus levels in the overlying waters. This extreme phenomenon not only heavily influenced the original lake ecosystem but also greatly changed the cycling of Fe, S, and nutrients in the water column.

Residual levels, tissue distribution and risk assessment of organochlorine pesticides (OCPs) in edible fishes from Taihu Lake, China.

Tissue distribution and bioaccumulation of organochlorine pesticides (OCPs) in edible fishes collected from Taihu Lake, Cyprinus carpio (C. carpio) and Ctenopharyngodon idellus (C. idellus), were studied. OCPs were detected in all samples with hexachlorocyclohexanes (HCHs), aldrins (including aldrin, dieldrin, endrin, endrin aldehyde, and endrin ketone), heptachlors (heptachlor and heptachlor epoxide) and dichlorodiphenyltrichloroethanes (DDTs) being the predominant compounds for both fish species. Gill and gonad were found to be the dominant tissues for OCP bioaccumulation followed by liver, while muscle showed the least affinity of OCPs for both fishes. Tissue distribution indicated the exchange of contaminants between water and gill, as well as the food intake from environment were the dominant pathways for OCP bioaccumulation in gill-breathing fish, and the following tissue distribution was affected by both the physiological properties of target tissues and physicochemical characteristics of pesticides. OCP residues in fish were species-specific (45.63-1575.26 ng/g dry weight (dw) for C. idellus; 8.40-60.23 ng/g dw for C. carpio) mainly due to the growth rate of individuals as well as the metabolic capacity difference among species. HCHs and DDTs observed in fishes from Taihu Lake were comparable and moderate with other reported places in China. Human exposure risk assessment performed with the estimated daily intake values demonstrated the consumption of target fish species in Taihu Lake at present was safe.

Effects of sludge dredging on the prevention and control of algae-caused black bloom in Taihu Lake, China.

Algae-caused black bloom (also known as black water agglomerate) has recently become a critical problem in some Chinese lakes. It has been suggested that the occurrence of algae-caused black bloom was caused by the cooperation of nutrient-rich sediment with dead algae, and sludge dredging was adopted to control black bloom in some lakes of China. In this article, based on the simulation of black bloom using a Y-shape apparatus for modeling natural conditions, both un-dredged and dredged sites in three areas of Taihu-Lake, China were studied to estimate the effects of dredging on the prevention and control of black bloom. During the experiment, drained algae were added to all six sites as an additional organic load; subsequently, the dissolved oxygen decreased rapidly, dropping to 0 mg/L at the sediment-water interface. Black bloom did not occur in the dredged sites of Moon Bay and Nan Quan, whereas all three un-dredged sites at Fudu Port, Moon Bay and Nan Quan experienced black bloom. Black bloom also occurred at the dredged site of Fudu Port one day later than at the other sites, and the odor and color were lighter than at the other locations. The color and odor of the black water mainly result from the presence of sulfides such as metal sulfides and hydrogen sulfide, among other chemicals, under reductive conditions. The color and odor of the water, together with the high concentrations of nutrients, were mainly caused by the decomposition of the algae and the presence of nutrient-rich sediment. Overall, the removal of the nutrient-rich sediment by dredging can prevent the occurrence and control the degree of algae-caused black bloom in Taihu Lake.

Influence of chironomid larvae on oxygen and nitrogen fluxes across the sediment-water interface (Lake Taihu, China).

The microscale distribution of oxygen, the nitrogen flux and the denitrification rates in sediment inhabited by chironomid larvae (Tanypus chinensis) were measured in eutrophic Lake Taihu, China. The presence of the chironomids in the sediment increased the oxygen diffusional flux from 10.4 +/- 1.4 to 12.7 +/- 2.5 mmol O2/(m2 x day). The burrows of the larvae represented "hot spots" and strongly influenced the nitrogen cycles and diagenetic activity in the sediment. The results indicate that the bioturbation effects of Tanypus chinensis chironomid larvae increased the capacity of the sediment as a sink for nitrate and a source for ammonium. Nitrate influx and ammonium outflux were increased 8.8 and 1.7 times, respectively. Under bioturbation, the amount of nitrate consumed was greater than the amount of ammonium released. The total denitrification rate was also enhanced from 0.76 +/- 0.34 to 5.50 +/- 1.30 mmol N/(m2 x day). The net effect was that the bioturbated sediments acted as a net sink for inorganic nitrogen under direct and indirect bioturbation effects compared to the control.

Sulfur-containing amino acid methionine as the precursor of volatile organic sulfur compounds in algea-induced black bloom.

After the application of methionine, a progressive and significant increase occurred in five volatile organic sulfur compounds (VOSCs): methanethiol (MeSH), dimethyl sulfide (DMS), dimethyl disulfide (DMDS), dimethyl trisulfide (DMTS) and dimethyl tetrasulfide (DMTeS). Even in the untreated control without a methionine addition, methionine and its catabolites (VOSCs, mainly DMDS) were found in considerable amounts that were high enough to account for the water's offensive odor. However, blackening only occurred in two methionine-amended treatments. The VOSCs production was observed to precede black color development, and the reaching of a peak value for total VOSCs was often followed by water blackening. The presence of glucose stimulated the degradation of methionine while postponing the occurrence of the black color and inhibiting the production of VOSCs. In addition, DMDS was found to be the most abundant species produced after the addition of methionine alone, and DMTeS appeared to be the most important compound produced after the addition of methionine+glucose. These results suggest that methionine acted as an important precursor of the VOSCs in lakes suffering from algea-induced black bloom. The existence of glucose may change the transformation pathway of methionine into VOSCs to form larger molecular weight compounds, such as DMTS and DMTeS.

Speciation of organic phosphorus in a sediment profile of Lake Taihu. II. Molecular species and their depth attenuation.

The understanding of organic phosphorus (P) dynamics in sediments requires information on their species at the molecular level, but such information in sediment profiles is scarce. A sediment profile was selected from a large eutrophic lake, Lake Taihu (China), and organic P species in the sediments were detected using solution phosphorus-31 nuclear magnetic resonance spectroscopy (31P NMR) following extraction of the sediments with a mixture of 0.25 mol/L NaOH and 50 mmol/L EDTA (NaOH-EDTA) solution. The results showed that P in the NaOH-EDTA extracts was mainly composed of orthophosphate, orthophosphate monoesters, phospholipids, DNA, and pyrophosphate. Concentrations of the major organic P compound groups and pyrophosphate showed a decreasing trend with the increase of depth. Their half-life times varied from 3 to 27 years, following the order of orthophosphate monoesters > phospholipids > or = DNA > pyrophosphate. Principal component analysis revealed that the detected organic P species had binding phases similar to those of humic acid-associated organic P (NaOH-NRP(HA)), a labile organic P pool that tends to transform to recalcitrant organic P pools as the early diagenetic processes proceed. This demonstrated that the depth attenuation of the organic P species could be partly attributed to their increasing immobilization by the sediment solids, while their degradation rates should be significantly lower than what were suggested in previous studies.

Effects of physical and chemical characteristics of surface sediments in the formation of shallow lake algae-induced black bloom.

Surface sediments are closely related to lake black blooms. The dissolved oxygen (DO) distribution and its penetration depth in surface sediments as well as the migration and transformation of redox sensitive elements such as Fe and S at the sediment-water interface are important factors that could influence the formation of the black bloom. In this study, dredged and undredged sediment cores with different surface properties were used to simulate black blooms in the laboratory. The Micro Profiling System was employed to explore features of the DO and sigmaH2S distribution at the sediment-water interface. Physical and chemical characteristics in sediments and pore waters were also analyzed. The results showed that sediment dredging effectively suppressed the black blooms. In the undredged treatment, DO penetration depth was only 50 microm. Fe(2+) concentrations, sigmaH2S concentrations, and sigmaH2S production rates were remarkably higher in surface sediments and pore waters compared to control and dredged treatments. Furthermore, depletion of DO and accumulation of Fe(2+) and sigmaH2S in surface sediments and pore waters provided favorable redox environments and necessary material sources for the blooms. The study results proved that physical and chemical characteristics in surface sediments are important factors in the formation of the black bloom, and could provide scientific guidance for emergency treatment and long-term pre-control of black blooms.

Speciation of organic phosphorus in a sediment profile of Lake Taihu. I: Chemical forms and their transformation.

Organic phosphorus (nonreactive P, NRP) is a major component of P in sediments, but information about its chemical forms and dynamic transformation is limited. The chemical forms and dynamic behaviors of NRP in a sediment profile from Lake Taihu, a freshwater and eutrophic lake in China, were investigated. Five forms of NRP in the sediments were extracted based on a chemical fractionation technique, including easily labile NRP (NaHCO3-NRP), reactive metal oxide-bound NRP (HCl-NRP), humic acid-associated NRP (NaOH-NRP(HA)), fulvic acid-associated NRP (NaOH-NRP(FA)) and residual NRP (Res-TP). There were notable transformations with increasing sediment depth from the labile NaHCO3-NRP and NaOH-NRP pools to the recalcitrant HCl-NRP and Res-TP pools, which caused the NRP to become increasingly recalcitrant as the early diagenetic processes proceeded. Further analyses showed that the relative changes in contents of organic matter and reactive Fe oxides in the sediment profile triggered a competition for binding NRP fractions and led to the transformation of NRP. The results highlighted the importance of abiotic processes in regulating the diagenesis of organic P and its stability in sediments.

Controlling internal nitrogen and phosphorus loading using Ca-poor soil capping in shallow eutrophic lakes: Long-term effects and mechanisms.

Clean soil is a potential capping material for controlling internal nutrient loading and helping the recovery of macrophytes in eutrophic lakes, but the long-term effects and underlying mechanisms of clean soil capping under in-situ conditions remain poorly understood. In this study, a three-year field capping enclosure experiment combining intact sediment core incubation, in-situ porewater sampling, isotherm adsorption experiments and analysis of sediment nitrogen (N) and phosphorus (P) fractions was conducted to assess the long-term performance of clean soil capping on internal loading in Lake Taihu. Our results indicate that clean soil has excellent P adsorption and retention capacity as an ecologically safe capping material and can effectively mitigate NH4+-N and SRP (soluble reactive P) fluxes at the sediment-water interface (SWI) and porewater SRP concentration for one year after capping. The mean NH4+-N and SRP fluxes of capping sediment were 34.86 mg m-2 h-1 and -1.58 mg m-2 h-1, compared 82.99 mg m-2 h-1 and 6.29 mg m-2 h-1 for control sediment. Clean soil controls internal NH4+-N release through cation (mainly Al3+) exchange mechanisms, while for SRP, clean soil can not only react with SRP due to its high Al and Fe content, but also stimulate the migration of active Ca2+ to the capping layer, thus precipitating as Ca-bound P (Ca-P). Clean soil capping also contributed to the restoration of macrophytes during the growing season. However, the effect of controlling internal nutrient loading only lasted for one year under in-situ conditions, after which the sediment properties returned to pre-capping conditions. Our results highlight that clean Ca-poor soil is a promising capping material and further research is needed to extend the longevity of this geoengineering technology.

Disparities in healthcare access and utilization among people living with HIV in China: a scoping review and meta-analysis.

Background Healthcare disparities hinder the goal of ending the HIV pandemic by 2030. This review aimed to understand the status of healthcare disparities among people living with HIV (PLWH) in China and summarize driving factors. Methods We searched six databases: PubMed, Web of Science, Cochrane Library, Scopus, China National Knowledge Infrastructure (CNKI), and China Wanfang. English or Chinese articles published between January 2000 and July 2022 were included if they focused on any disparities in access to and utilization of healthcare among PLWH in China. Grey literature, reviews, conferences, and commentaries were excluded. A random effects model was used to calculate the pooled estimates of data on healthcare access/utilization and identified the driving factors of healthcare disparities based on a socio-ecological framework. Results A total of 8728 articles were identified in the initial search. Fifty-one articles met the inclusion criteria. Of these studies, 37 studies reported HIV-focused care, and 14 focused on non-HIV-focused care. PLWH aged ≥ 45 years, female, ethnic minority, and infected with HIV through sexual transmission had a higher rate of receiving antiretroviral therapy (ART). Females living with HIV have higher adherence to ART than males. Notably, 20% (95% CI, 9-43%, I 2 = 96%) of PLWH with illness in two weeks did not seek treatment, and 30% (95% CI, 12-74%, I 2 = 90%) refused hospitalization when needed. Barriers to HIV-focused care included the lack of knowledge of HIV/ART and treatment side effects at the individual level, and social discrimination and physician-patient relationships at the community/social level. Structural barriers included out-of-pocket medical costs, and distance and transportation issues. The most frequently reported barriers to non-HIV-focused care were financial constraints and the perceived need for medical services at individual-level factors; and discrimination from healthcare providers, distrust of healthcare services at the community/social level. Conclusion This review suggests disparities in ART access, adherence, and utilization of non-HIV-focused care among PLWH. Financial issues and social discrimination were prominent reasons for healthcare disparities in PLWH care. Creating a supportive social environment and expanding insurance policies, like covering more medical services and increasing reimbursement rates could be considered to promote healthcare equity.

The status of emotional labour and its influence on job burnout among village doctors during the COVID-19 pandemic in China: a cross-sectional study.

BACKGROUND: Village doctors in China are not only the gatekeepers of rural residents' health but also the net bottom of the medical security system. However, emotional labour is increasingly threatening the stability of the rural primary medical system. In addition, the ongoing coronavirus disease 2019 (COVID-19) pandemic has further exposed the vulnerability of human resources in China's rural health system. This study aims to evaluate the current situation of emotional labour among village doctors and explore the impact of emotional labour on job burnout during the COVID-19 pandemic in China. METHODS: A cross-sectional survey was conducted in December 2021 in Shandong Province. We used structured questionnaires to collect data, including sociodemographic characteristics, emotional labour, and job burnout. Data were analysed by t test, analysis of variance (ANOVA), Pearson correlation analysis, and hierarchical multiple linear regression. RESULTS: A total of 1,093 village doctors from Shandong Province participated in the study. More than half of the participants were male (62.40%) and were between 41 and 50 years old (53.43%). The total mean score of emotional labour was 3.17 ± 0.67, of which the surface acting (SA) score was 2.28 ± 0.90, and the deep acting (DA) score was 3.91 ± 0.93. There were significant differences in SA according to gender and work content (P < 0.05) and in DA according to gender, age, education level, and work content (P < 0.05). Pearson correlation analysis showed that SA was positively correlated with job burnout (P < 0.001), and DA was negatively correlated with job burnout (P < 0.001). Hierarchical multiple linear regression analysis revealed that 29% of the variance in job burnout is attributable to SA (ß = 0.530, P < 0.001) and DA (ß = -0.154, P < 0.001). CONCLUSION: Village doctors in Shandong Province performed moderate levels of emotional labour during the COVID-19 pandemic. SA had a significant positive effect on job burnout, while DA had a significant negative effect on job burnout among village doctors. Administrators should enhance training on emotional labour for village doctors to play a positive role in alleviating their job burnout.

Social Network Strategies to Distribute HIV Self-testing Kits: A Global Systematic Review and Network Meta-analysis.

Introduction: Social network strategies, in which social networks are utilized to influence individuals or communities, are increasingly being used to deliver human immunodeficiency virus (HIV) interventions to key populations. We summarized and critically assessed existing research on the effectiveness of social network strategies in promoting HIV self-testing (HIVST). Methods: Using search terms related to social network interventions and HIVST, we searched five databases for trials published between January 1st, 2010, and June 30th, 2023. Outcomes included uptake of HIV testing, HIV seroconversion, and linkage to antiretroviral therapy (ART) or HIV Care. We used network meta-analysis to assess the uptake of HIV testing through social network strategies compared with control methods. A pairwise meta-analysis of studies with a comparison arm that reported outcomes was performed to assess relative risks (RR) and their corresponding 95% confidence intervals (CI). Results and discussion: Among the 3,745 manuscripts identified, 33 studies fulfilled the inclusion criteria, including one quasi-experimental study, 17 RCTs and 15 observational studies. Networks HIVST testing was organized by peers (distributed to known peers, 15 studies), partners (distributed to their sexual partners, 10 studies), and peer educators (distributed to unknown peers, 8 studies). The results showed that all of the three social network distribution strategies enhanced the uptake of HIV testing compared to standard facility-based testing. Among social networks, peer distribution had the highest uptake of HIV testing (79% probability, SUCRA 0.92), followed by partner distribution (72% probability, SUCRA 0.71), and peer educator distribution (66% probability, SUCRA 0.29). Pairwise meta-analysis showed that peer distribution (RR 2.29, 95% CI 1.54-3.39, 5 studies) and partner distribution (RR 1.45, 95% CI 1.05-2.02, 7 studies) also increased the probability of detecting HIV reactivity during testing within the key population when compared to the control. Linkage to ART or HIV Care remained comparable to facility-based testing across the three HIVST distribution strategies. Conclusions: Network-based HIVST distribution is considered effective in augmenting HIV testing rates and reaching marginalized populations compared to facility-based testing. These strategies can be integrated with the existing HIV care services, to fill the testing gap among key populations globally.PROSPERO Number: CRD42022361782.

Understanding the Heavy Metal Pollution Pattern in Sediments of a Typical Small- and Medium-Sized Reservoir in China.

Heavy metal pollution in sediments is a common environmental issue in small- and medium-sized reservoirs not only in China but also worldwide; however, few interpretations of the pollution pattern exist. Based on the analyses of accumulation characteristics, ecological risks, and source apportionments of eight heavy metals (As, Cd, Cr, Cu, Hg, Pb, Ni, and Zn) in sediments, we derived a paradigm to describe the pollution pattern of heavy metals in sediments of a typical small- and medium-sized Tongjiqiao Reservoir. The results showed high levels of Cd, Hg, and As pollutants in the surface and upper sediment layers of the pre-dam area. Additionally, As, Cd, Hg, and Pb pollutants peaked in the middle layers of the inflow area, indicating a high ecological risk in these areas. The positive matrix factorization results implied that industrial, agricultural, and transportation activities were the main sources of heavy metals. The heavy metal pollution pattern exhibited three distinct stages: low contamination, rapid pollution, and pollution control. This pattern explains the heavy metal pollution process in the sediments and will provide scientific guidance for realizing the green and sustainable operation and development of the reservoir.

Association of individual resilience with organizational resilience, perceived social support, and job performance among healthcare professionals in township health centers of China during the COVID-19 pandemic.

Background: Primary healthcare professionals were overworked and psychologically overwhelmed during the COVID-19 pandemic. Resilience is an important shield for individuals to cope with psychological stress and improve performance in crises. This study aims to explore the association of individual resilience with organizational resilience, perceived social support and job performance among healthcare professionals in township health centers of China during the COVID-19 pandemic. Methods: Data from 1,266 questionnaires were collected through a cross-sectional survey conducted in December 2021 in Shandong Province, China. Descriptive analysis of individual resilience, organizational resilience, perceived social support, and job performance was conducted. Pearson correlation analysis was used to examine the correlations among these variables, and structural equation modeling was performed to verify the relationships between these variables. Results: The score of individual resilience was 101.67 ± 14.29, ranging from 24 to 120. Organizational resilience (ß = 0.409, p < 0.01) and perceived social support (ß = 0.410, p < 0.01) had significant direct effects on individual resilience. Individual resilience (ß = 0.709, p < 0.01) had a significant direct effect on job performance. Organizational resilience (ß = 0.290, p < 0.01) and perceived social support (ß = 0.291, p < 0.01) had significant indirect effects on job performance. Conclusion: During the COVID-19 pandemic, the individual resilience of healthcare professionals in township health centers was at a moderate level. Organizational resilience and perceived social support positively affected individual resilience, and individual resilience positively affected job performance. Furthermore, individual resilience mediated the effect of organizational resilience and perceived social support on job performance. It is recommended that multiple stakeholders work together to improve the individual resilience of primary healthcare professionals.