Joint spatial modelling of disease risk using multiple sources: an application on HIV prevalence from antenatal sentinel and demographic and health surveys in Namibia

Regional maldistribution of human resources of rehabilitation institutions in China Mainland based on spatial analysis

Objective

With the demand for rehabilitation has been increasing faster for the aging of China's population, the equity of rehabilitation resource has aroused great concern. This study aimed to analyze the spatial distribution and evolution of the human resources of rehabilitation institutions and propose targeted countermeasures and suggestions to promote optimal allocation.

Methods

A total of 31 provinces in China Mainland were identified and geocoded. The spatial weight matrix was introduced to analyze the spatial correlation. Spatial autocorrelation analysis and tests were used to analyze the spatial distribution and evolution characteristics of rehabilitation institutions' human resources in China from 2016 to 2019.

Results

The average density of rehabilitation staff from 2016 to 2019 has been rising yearly (From 1.60 to 1.88). From 2018 to 2019, the proportion of rehabilitation professionals was higher than 75% in only 5 provinces, and no provinces met 75% from 2016 to 2017. Global Moran's I index from 2016 to 2019 showed no apparent aggregation phenomenon in the allocation of management personnel resources (P > 0.05). Three provinces in western China belonged to the Low-Low area and a province in northeastern China fitted to the Low-High area, with statistically significant differences. In addition, the changes in the spatial distribution and evolution trend of the human resources of rehabilitation institutions in different periods were affected by health policies.

Conclusions

Although the overall spatial distribution gap of human resource allocation of rehabilitation institutions is shrinking, there are still internal structural defects and a maldistribution at the provincial level. It is necessary to improve the overall number of staff in rehabilitation institutions and to ameliorate the proportion of different types of staffing.

Risky Sexual Behaviors and Associated Factors Among College Students in Lusaka, Zambia

Risky sexual behaviors are important factors driving the HIV/AIDS epidemic. Although Zambia experiences a high HIV prevalence, especially among youth, there is a dearth of information regarding risky sexual behaviors among young adults. Therefore, we investigated the prevalence and associated factors of risky sexual behaviors among college students in Lusaka, Zambia. A cross-sectional study was conducted in February 2017 among 427 college students at the University of Zambia. Participants reported their sexual behaviors, sexual attitudes, and lifestyle using self-administered questionnaires. Multinomial logistic regression models were employed to assess potential determinants of risky sexual behaviors. Among the 205 students who reported ever having sex, 148 (72.2%) engaged in risky sexual behaviors in the last 12 months. Participants who were older (OR 1.30, 95% CI 1.12-1.51), engaged in low physical activity (OR 2.25, 95% CI 1.05-4.84), and reported liberal sexual attitudes (OR 1.88, 95% CI 1.02-3.47) were more likely to engage in any risky sexual behavior, while frequent alcohol use (OR 8.38, 95% CI 4.60-15.27) and suicide attempts (OR 6.42, 95% CI 2.03-20.29) predicted multiple risky sexual behaviors. In conclusion, this study indicates that Zambian college students' risky sexual behaviors are associated with multiple behavioral health risks. Future research should consider using a multiple-behavior change intervention.