Preference for care models among older people living with HIV: cross-sectional study.

BACKGROUND: The number of people living with HIV (PWH) aged 50 and above is increasing. The question of care among older PWH (aged ≥ 50 years) is an increasing concern. Understanding the care preference of older people can better provide care services for them. The purpose of this study was to investigate the care preference (home-based care, self-care, institutional care, community-based care, and mutual-aid care) among older PWH and identify the factors affecting their care preference. METHODS: A cross-sectional survey was conducted among older PWH (aged ≥ 50 years) about care preference from May to November 2021. We enrolled 319 participants using convenience sampling. We designed a questionnaire to assess the care preference of older PWH. The Chi-square test and Fisher's exact test were used to conduct univariate analysis of care preference. Multinomial logistic regression was used to identify factors influencing care preference. RESULTS: Most older PWH (72.7%) preferred home-based care, and few (15.7%) preferred self-care. Fewer older PWH preferred community-based care (5.3%), institutional care (5.0%) and mutual-aid care (1.3%). Multivariate analysis showed that older PWH with a house, spouse and more children were more inclined to choose home-based care (p < .05). Older PWH living alone, having higher monthly income and higher HIV stigma preferred to choose self-care (p < .05). CONCLUSION: Home-based care was the most preferred model of older PWH, and self-care ranked second. The number of those who preferred institutional care, community-based care and mutual-aid care were few. Nation and government should take measures to allocate care resources for older adults reasonably to better meet the care needs of older PWH. It is important to strengthen social security, reduce internalized HIV stigma, improve social support, and explore diversified care models for improving the quality of life of older PWH.

Healthcare workers' (HCWs) attitudes and related factors towards COVID-19 vaccination: a rapid systematic review.

Herd immunity through vaccination is a key measure to control COVID-19 pandemic. However, vaccine hesitancy remains a public health threat, which is still common among healthcare workers (HCWs). This systematic review aimed to synthesise evidence on HCWs' attitudes towards COVID-19 vaccination and analyse associated factors to provide information for vaccine policy development and practice. We searched PubMed, Embase, ScienceDirect, Web of Science and three Chinese databases for literature published on 12 February 2021. Two researchers screened the literature independently, and 13 studies were included in the systematic review. Vaccine acceptance varied widely and ranged from 27.7% to 77.3%. HCWs had positive attitudes towards future COVID-19 vaccines, while vaccine hesitancy was still common. Demographic variables such as men, older age and physicians were positive predictive factors. Women and nurses had more vaccine hesitancy. Previous influenza vaccination and self-perceived risk were facilitators. Concerns for safety, efficacy and effectiveness and distrust of the government were barriers. Influences of direct (COVID-19) patient care towards vaccination intention were less conclusive. Tailored communication strategies were needed to increase the uptake rate of COVID-19 vaccines among HCWs. More importantly, more data and information on the safety and efficacy of vaccines should be provided with transparency.

The People's War Against Pandemic: protocol for a randomized control trial based on a virtual interactive training system intervention to improve the emergency preparedness of public for major emerging infectious diseases.

BACKGROUND: The frequent occurrence and increasing severity of major emerging infectious diseases (MEIDs) have posed considerable public health, economic and social issues worldwide. The emergency preparedness of public is inadequate to respond to and recover from MEIDs. Due to the limitation of time, space and resources, it is also difficult to carry out large-scale emergency preparedness training related to MEIDs. Then we developed a virtual interactive training system to improve emergency preparedness of public, including preparation of legal compliance, emergency knowledge, emergency capacity, economic estimation, material reserve and physical and mental health. METHODS: A protocol for conducting a randomized controlled trail to evaluate the People's War against Pandemic, a virtual interactive training system aimed to improve emergency preparedness of public for MEIDs. During the intervention, participants need to complete the storyline task at least once a day, watch at least one article and one video in the knowledge corner, and complete a retest of wrong choices in the intelligent evaluation module. The primary outcome is emergency preparedness of public for MEIDs. The secondary outcome is prevention and control knowledge of MEIDs. DISCUSSION: The People's War Against Pandemic may be an effective approach to provide public with a panoramic understanding of the response to MEIDs, so as to promote their comprehensive preparation and finally achieve effective response. TRIAL REGISTRATION: This study was funded in 2021 and registered in the Chinese Clinical Trial Registry (registration number: ChiCTR2200060919) in June 2022. Recruitment and enrollment of participants began in July 2022.

The Development and Validation of Multi-dimensional Resilience Scale for People Living with HIV in China.

The study aimed to provide a measurement tool for the assessment of resilience among people living with HIV (PLHIV) in China. The study period was from April 2019 to October 2020: first, 14 PLHIV were interviewed to build an item pool; 15 experts were invited to evaluate the scale items. The test-retest reliability of the scale was carried out with 29 PLHIV. Online and field investigation were used, and convenience sampling was conducted in Luzhou and Zigong. A pool of 31 items was formed and the Scale-Level Content Validity Index average was 0.96, while the that intra-class correlation coefficient for test-retest reliability was 0.816. From the exploratory factor analysis, four factors (Acceptance; Disease Management; Emotion Regulation; and Reconstruction) with 19 items were extracted. The Cronbach's alpha value of the Resilience Scale was 0.88. This scale could prove useful as a measuring tool for evaluating the level of resilience for PLHIV.

RESUMEN: El estudio tuvo como objetivo proporcionar una herramienta de medición para la evaluación de la resiliencia entre las personas que viven con el VIH (PVVIH) en China. El período de estudio fue de abril de 2019 a octubre de 2020: primero, se entrevistó a 14 PVVIH para construir un grupo de artículos; 15 expertos fueron invitados a evaluar los ítems de la escala. La confiabilidad test­retest de la escala se realizó con 29 PVVIH. Se utilizaron investigaciones en línea y de campo, y se realizó un muestreo de conveniencia en Luzhou y Zigong. Se formó un conjunto de 31 ítems y el índice de validez de contenido a nivel de escala promedio fue de 0,96, mientras que el coeficiente de correlación intraclase para la confiabilidad test­retest fue de 0,816. Del análisis factorial exploratorio se extrajeron cuatro factores (Aceptación; Manejo de la Enfermedad; Regulación de las Emociones y Reconstrucción) con 19 ítems. El valor alfa de Cronbach de la Escala de Resiliencia fue de 0,88. Esta escala podría resultar útil como herramienta de medición para evaluar el nivel de resiliencia de las PVVIH.

Sunset Without AIDS: protocol for a randomized controlled trial of a brief video-based intervention to improve the ability of AIDS prevention in elderly men.

BACKGROUND: Although progress has been made in the prevention and treatment of HIV in China, there are still a considerable number of new infections annually, especially in older men. HIV health education for older men is urgently needed. Evidence-based, acceptable, and scalable interventions are urgently needed to increase their capacity to prevent HIV. We describe a trial protocol to evaluate the effectiveness of a brief video-based intervention targeting older men's knowledge of HIV prevention. DESIGN: This study is a randomized controlled trial. The trial will be held in the residents' activity centers of three communities. METHODS: A total of 450 older men will be randomly divided into three groups (Sunset Without AIDS intervention group and two control groups) for 2 weeks. We will assess the feasibility and acceptability of intervention through interviews. The primary outcome includes changes in participants' knowledge related to AIDS after 2 weeks intervention and 1, 3, and 6 months of follow-up. The secondary outcomes, e.g., changes in participants' stigma attitude, risk behaviors attitude, and risk behaviors related to AIDS, will be respectively assessed 2 weeks, 1 month, 3 months, and 6 months after the second intervention. DISCUSSION: Sunset Without AIDS may be an innovative way to help older men improve HIV prevention knowledge, fill the gap in video-based HIV prevention education for the older men in China, and gain experience of HIV education. This project will innovate the HIV education ideas of older men and enrich the theoretical research content of AIDS-related education of older men. The findings may also provide the basis for the research and formulation of more reasonable AIDS education strategies, prevention, and control policies for the elderly. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR2100045708 . Registered on 23 April 2021.

Evaluation of an AIDS Educational Mobile Game (AIDS Fighter · Health Defense) for Young Students to Improve AIDS-Related Knowledge, Stigma, and Attitude Linked to High-Risk Behaviors in China: Randomized Controlled Trial.

BACKGROUND: The AIDS epidemic among young students is serious, and effective preventive interventions are urgently needed. Game-based intervention has become an innovative way to change healthy behaviors, and we have developed an AIDS educational game called AIDS Fighter · Health Defense. OBJECTIVE: In this study, we tested the effect of AIDS Fighter · Health Defense on young students in improving AIDS-related knowledge, stigma, and attitude related to high-risk behaviors in Southwest China. METHODS: A randomized controlled trial was conducted from September 14 to 27, 2020. In total, 96 students from 2 classes in a middle school were selected by stratified cluster sampling in Luzhou City, Southwest China. The students were randomly divided into the intervention group (n=50, 52%) and the control group (n=46, 48%). The intervention group played the AIDS educational game AIDS Fighter · Health Defense; the control group learned AIDS-related knowledge through independent learning on the QQ chat group. An AIDS-related knowledge questionnaire, a stigma scale, and an attitude questionnaire on AIDS-related high-risk behaviors were used to measure the effect of the AIDS educational game via face-to-face interviews. The user experience of the game was assessed using the Educational Game User Experience Evaluation Scale. The difference was statistically significant at P≤.05. RESULTS: After the intervention, the AIDS knowledge awareness rate (X̅ [SD], %) of the intervention and control groups were 70.09 (SD 11.58) and 57.49 (SD 16.58), with t=4.282 and P<.001. The stigma scores of the 2 groups were 2.44 (SD 0.57) and 2.48 (SD 0.47), with t=0.373 and P=0.71. The positive rate (X̅ [SD], %) of attitudes of high-risk AIDS behaviors of the 2 groups were 82.00 (SD 23.44) and 79.62 (SD 17.94), with t=0.555 and P=0.58. The mean percentage of the game evaluation was 54.73% as excellent, 31.45% as good, 13.09% as medium, and 0.73% as poor. CONCLUSIONS: AIDS Fighter · Health Defense could increase AIDS-related knowledge among young students, but the effect of the game in reducing AIDS-related stigma and improving the attitudes of high-risk AIDS behaviors was not seen. Long-term effects and large-scale studies are needed to assess the efficacy of game-based intervention. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR2000038230; https://trialsearch.who.int/Trial2.aspx?TrialID=ChiCTR2000038230.

Design of a Virtual Reality Interactive Training System for Public Health Emergency Preparedness for Major Emerging Infectious Diseases: Theory and Framework.

BACKGROUND: Sufficient public health emergency preparedness (PHEP) is the key factor in effectively responding to and recovering from major emerging infectious diseases (MEIDs). However, in the face of MEIDs, PHEP is insufficient, so it is necessary to improve PHEP. The rapid development of virtual reality and human-computer interaction provides unprecedented opportunities for innovative educational methods. OBJECTIVE: This study designed a virtual reality interactive training system (VRITS) to provide an effective path for improving PHEP in the context of MEIDs so that the public can effectively respond to and recover from MEIDs. METHODS: This study used interactive narrative, situated learning and human-computer interaction theories as a theoretical framework to guide the design of the system. We used the literature research method and the Delphi method; consulted multidisciplinary experts, such as infectious diseases, disease control, psychology, and public health personnel, to determine the educational content framework; and set up an interdisciplinary team to construct an operating system framework for the VRITS. RESULTS: We named the VRITS "People's War Against Pandemic." The educational content framework includes 20 knowledge, emotion, and behavior skills in 5 aspects (cooperating with prevention and control work, improving emergency response ability, guaranteeing supplies and equipment, preparing economic resources, and maintaining physical and mental health). The operating system framework includes virtual interactive training, knowledge corner, intelligent evaluation, and community forum modules, and the core module is the virtual interactive training module. In this module, users control virtual characters to move in various scenes, and then identify and analyze the controllability and harmfulness of the evolving pandemic and select the correct prevention and control strategy to avoid infecting themselves and others. CONCLUSIONS: The development and sharing of the multidisciplinary theoretical framework adopted by People's War Against Pandemic can help us clarify the design ideas and assumptions of the VRITS; predict training results; understand the ability of training to change emergency knowledge, emergency emotion, and behavioral responses to MEIDs; and promote the development of more effective training systems based on virtual reality.

Hesitancy toward COVID-19 vaccines among medical students in Southwest China: a cross-sectional study.

Vaccine hesitancy is an obstacle to COVID-19 vaccination. This study aims to inform the vaccine hesitancy and analyze related factors toward COVID-19 vaccination among medical students in China, so as to provide suggestions for increasing vaccines uptake. An online cross-sectional survey was conducted among medical students in a medical university and a health school. A total of 2,196 valid questionnaires were received. 41.2% vaccine hesitancy was reported among medical students in total. Female (OR = 1.336) and individuals with higher education (OR = 1.724) reported slightly higher vaccine hesitancy. Being in low-risk areas and no need to get vaccinated (OR = 2.285), fear of serious consequences of vaccination (OR = 1.929), being in good health and no need to be vaccinated (OR = 1.891), being concerned about short-term side effects (OR = 1.793) and being concerned that the vaccine was ineffective (OR = 1.694) had higher prevalence of vaccine hesitancy. Those who were believing the specialty of study or work environment made vaccination necessary (OR = 0.378), believing they were susceptible to COVID-19 (OR = 0.411) and the vaccine was free (OR = 0.519) were more willing to get vaccinated. Confidence in vaccines and perceptions of benefits and risk are associated with vaccine hesitancy. It is important to strengthen vaccine health literacy education for medical students and enhance vaccine confidence. Countries need to supervise the public opinions in social media, television broadcasting and other media, so as to ensure the correct orientation of public opinion. Open and transparent evidence-based information is also needed which can help improve the vaccination coverage rate of the public.

AIDS fighter health defense: protocol for a randomized controlled trial to test a game-based intervention to improve adolescents' AIDS prevention ability.

BACKGROUND: Although great progress has been made in the prevention and treatment of AIDS, there are still a considerable number of new infections annually, especially in adolescents. With the advance of technology, game-based education has gradually become an important tool for changing healthy behaviors among youth. METHODS: A protocol for conducting a randomized controlled trial to evaluate the "AIDS Fighter · Health Defense", a game-based AIDS education project aimed at improving the ability of adolescents to prevent AIDS. During the four-week intervention, participants will receive: 1) A virus combat game; 2) Goal setting to eliminate HIV; 3) Questions to be answered to be resurrected in the game; 4) Points ranking; 5) Recognition and Rewards. The primary outcomes include changes in participants' knowledge, stigma attitude, and risk behaviors attitude related to AIDS after four weeks of intervention. The secondary outcomes are the participants' AIDS-related risk behaviors three and six months after the intervention. DISCUSSION: AIDS Fighter· Health Defense may be an innovative approach to help adolescents improve AIDS prevention capabilities, fill the gap in game-based AIDS prevention education in China, and gain experience of AIDS management. TRIAL REGISTRATION: Chinese Clinical Trial Registry: ChiCTR2000040195 . Registered 25 November 2020.

Reparametrization of Protein Force Field Nonbonded Interactions Guided by Osmotic Coefficient Measurements from Molecular Dynamics Simulations.

There is a small, but growing, body of literature describing the use of osmotic coefficient measurements to validate and reparametrize simulation force fields. Here we have investigated the ability of five very commonly used force field and water model combinations to reproduce the osmotic coefficients of seven neutral amino acids and five small molecules. The force fields tested include AMBER ff99SB-ILDN, CHARMM36, GROMOS54a7, and OPLS-AA, with the first of these tested in conjunction with the TIP3P and TIP4P-Ew water models. In general, for both the amino acids and the small molecules, the tested force fields produce computed osmotic coefficients that are lower than experiment; this is indicative of excessively favorable solute-solute interactions. The sole exception to this general trend is provided by GROMOS54a7 when applied to amino acids: in this case, the computed osmotic coefficients are consistently too high. Importantly, we show that all of the force fields tested can be made to accurately reproduce the experimental osmotic coefficients of the amino acids when minor modifications-some previously reported by others and some that are new to this study-are made to the van der Waals interactions of the charged terminal groups. Special care is required, however, when simulating Proline with a number of the force fields, and a hydroxyl-group specific modification is required in order to correct Serine and Threonine when simulated with AMBER ff99SB-ILDN. Interestingly, an alternative parametrization of the van der Waals interactions in the latter force field, proposed by the Nerenberg and Head-Gordon groups, is shown to immediately produce osmotic coefficients that are in excellent agreement with experiment. Overall, this study reinforces the idea that osmotic coefficient measurements can be used to identify general shortcomings in commonly used force fields' descriptions of solute-solute interactions and further demonstrates that modifications to van der Waals parameters provide a simple route to optimizing agreement with experiment.