Exploration for the Priority of HIV Intervention:Modelling Health Impact and Cost-Effectiveness—Six Cities,Eastern China,2019-2028

Introduction:In order to enhance the effectiveness of resource allocation,regions must tailor their responses to their specific epidemiological and economic situations.Methods:Utilizing Spectrum software,we projected the cost-effectiveness of 10 chosen HIV interventions in six cities in eastern China from 2019 to 2028.We assessed three scenarios—Base,Achievable,and Idealized—for each city.The analysis included the projected number of HIV infections and deaths averted,as well as the incremental costeffectiveness ratios for each intervention in the six cities.Results:In Shijiazhuang,Wuxi,Yantai,and Zhenjiang,cities with initially low antiretroviral therapy(ART)coverage,ART showed significant effectiveness,especially for males.Conversely,in Foshan and Ningbo,where ART coverage was notably high,oral pre-exposure prophylaxis(PrEP)for men who have sex with men(MSM)proved effective in the Idealized scenario.MSM outreach,ART for males,and ART for females demonstrated cost-effectiveness across all six cities in both Achievable and Idealized scenarios at the predefined thresholds for each city.Discussion:Maintaining an appropriate coverage rate for outreach to MSM can lead to costeffectiveness.In cities with low ART coverage,scaling up ART remains a crucial intervention.In regions with high ART coverage,consideration may be given to the utilization of oral PrEP for MSM individuals,requiring budget allocation.

The Impact of Delays during the Pandemic Months on Survival of Lung Cancer Patients in Canada in 2020

Background and Purpose: Most cancer deaths in the world are due to lung cancer and diagnosis and treatment delays sharply reduce survival in lung cancer patients. This study examined the impact of delays during the early months of the pandemic on the survival of newly identified lung cancer patients in Canada in 2020. Method: This was a secondary data analysis from published literature and openly available data sources. Cancer Statistics from existing literature were used as a proxy for the month-wise distribution of lung cancer cases in Canada. The incidence of lung cancer, using population statistics from Statistics Canada and incidence rates from the Canadian Cancer Statistics in 2020, was estimated. The population-based Excel model employed compounded cuts on the incidence to arrive at the outcomes. Plotdigitzer.com tool was used to digitize the survival versus time curves for each stage from secondary sources. Stage-wise incidences for each sex were calculated for each age group for each month of 2020. Using delay impact on each stage the final results were calculated. Results: A total of 5004 life years would have been lost due to 448 deaths in the long term (40 months) attributed to the delays caused during March, April, May and June in Canada. The estimated incidence for all stages of lung cancer for these months was 9801 although the observed incidence was expected to be 6571 due to reduced screenings. Hence, it was within the missing 3231 cases that delays would occur. Over the short term (10 months) there are expected to be 151 early deaths and 273 deaths in the intermediate-term (20 months). Conclusions: This study using a mathematical model showed that in 2020, the COVID epidemic resulted in higher mortality and fewer lung cancer diagnoses in Canada. As a result of the delays in assessment, screening, and treatment that accompanied the pandemic lockdowns, there has been a rise in total life years lost due to lung cancer, demonstrating the pandemic’s huge impact on lung cancer patients.

The impact of organizational resources and managerial interpretation on willingness to participate in carbon market

On the basis of resource-based view and managerial cognition,this research aims to explore which and how organizational resources facilitate organizational willingness to participate in carbon market(WTP-CM).In particular,it classifies resources into two dimensions,general resources(GR)and professional resources(PR),and investigates how these two types of resources interact with managerial interpretation and then influence organizational WTP-CM using a sample of 222 Chinese industrial firms.The findings show that environmental talents(PR)and low-carbon technologies(PR)have positive influences on organizational WTP-CM not only directly,but also indirectly through accelerating managers to interpret carbon trading as an opportunity,rather than a threat.On the contrary,only via managerial interpretation can capital reserve(GR)and environmental practices(PR)affect organizational WTP_CM positively.Furthermore,the impact of environmental practices on managerial interpretation does not depend on the performance of environmental practices(i.e.,success or failure).It means,regardless of environmental performance,the cumulation of environmental experience would promote managers to interpret carbon market as an opportunity and then advance their WTP-CM.Last,this partial mediating role of managerial interpretation between organizational resources and WTP-CM varies depending on organizational social position.Compared to centralfirms,peripheralfirms tend to be more responsive to managerial interpretation.The chain from organizational resources,to interpretation of carbon market as an opportunity,andfinally to the willingness to participate is stronger for peripheralfirms than for central ones.

Number, distribution, and predicted needed number of general practitioners in China

Family Medicine and Community Health 2018;6(3):154–159154 www.fmch-journal.org DOI 10.15212/FMCH.2018.0120.2018 Family Medicine and Community Health.Creative Commons Attribution-NonCommercial 4.0 International License CHINA FOCUS CHINA FOCUS Number,distribution,and predicted needed number of general practitioners in China*Baoling Wu1,Hanxiang Gong1,Zhenni Luo1 Abstract Objective:We aimed to investigate the number and distribution of general practitioners(GPs)in China,and to predict the number of GPs needed in the future.Methods:From China Health Statistics Yearbook 2014,China Health Statistics Yearbook 2016 and China Statistical Yearbook 2016,we obtained the number of GPs and the populations in China and each of its regions from 2012 to 2015.IBM SPSS Statistics version 22.0 was used to conduct descriptive statistical analysis.Grey model GM(1,1)and the manpower-to-population ratio method were used to predict the number of GPs needed in China from 2016 to 2020.Results:The total number of GPs in China was 109,794 in 2012,145,511 in 2013,172,597 in 2014,and 188,649 in 2015.The number increased by 78,855 from 2012 to 2015,and the average annual growth rate was 19.77%.By the end of 2015,of the GPs in all of China and in eastern,central,and western China,those who had achieved a GP qualification certificate following training accounted for 63.76%(120,285/188,649),60.06%(62,474/104,015),65.20%(29,565/45,344),and 71.89%(28,246/39,290),respectively,of the total.The number of GPs per 10,000 population in all of China and in eastern,central,and western China was 1.37,1.83,1.05,and 1.06,respectively,and the number of GPs needed for all of China and the eastern,central,and western parts would be 86,275,9787,40,764,and 34,976,respectively,calculated on the basis of the standard of two GPs per 10,000 population.Grey model GM(1,1)predicted that,in accordance with the natural growth trend of GPs,the number of GPs in China would be 220,314 in 2016,253,728 in 2017,293,101 in 2018,339,928 in 2019,and 396,228 in 2020.Moreover,the number of GPs in China in 2020 would be 277,000–415,500 if the calculated number of GPs to the population ratio is based on the standard of two to three GPs per 10,000 population.Conclusion:In recent years,although the number of GPs has increased rapidly,GPs are still greatly needed in all of China and in eastern,central,and western China.Moreover,the distribution of GPs is not balanced,and the number of qualified GPs is far from enough.Therefore,team building for GPs should be strengthened,and the training system for GPs should be improved.

Estimating Costs of the HIV Comprehensive Intervention Using the Spectrum Model--China,2015-2019

Introduction:In order to facilitate human immunodeficiency virus(HIV)treatment and prevention,the resource needs for HIV national strategic planning in developing regions were estimated based on Spectrum,the universal HIV costeffectiveness analysis software.Methods:Based on the theoretical framework of Spectrum,the study developed a cost measurement tool for HIV,and calculated the cost of HIV prevention and control in 6 sampled cities in China during 2015–2019 using the Spectrum model.Results:From 2015 to 2019,the average annual costs for HIV prevention and control for Shijiazhuang,Yantai,Ningbo,Zhenjiang,Foshan,and Wuxi cities were 46.78,47.55,137.49,24.73,74.37,and 58.30 million Chinese yuan(CNY),respectively.The per capita costs were 4.37,6.73,17.33,7.77,17.56,and 8.91 CNY,respectively.In terms of the cost structure,the ratio of preventive intervention funds to therapeutic intervention funds(antiviral treatment)varied in sampled cities.Discussion:Developing comprehensive and systematic HIV fund calculation methods can provide a research basis for rational resource allocation in the field of HIV.

Gender-specific differences in associations between economic status and systolic blood pressure or diastolic blood pressure

Hypertension is a significant contributor to cardiovascular diseases.When controlled ineffectively,hypertension can lead to heart diseases and stroke,which together constitutes the leading causes of global premature death and disability.According to a national cross-sectional survey in China,the prevalence of hypertension among adults aged≥18 years was 23.2%in 2015.