Study on Competency Elements of Excellent Front-Line Health Inspector Based on BEI

Background: In order to find out the competency elements of excellent front-line health inspector, and to improve the comprehensive quality and law enforcement level, we conducted this study. Methods: From May to September in 2020, seven health inspectors engaged in front-line inspection and law enforcement work in the Pudong New Area Health Inspection agency were interviewed by using the method of key Behavior Event Interview (BEI). The competency differences of front-line personnel with different performance levels were compared. Combined with the results of expert consultation, the prominent competency elements of excellent front-line health inspector were found out. Results: The total 6 prominent competency elements were investigation and evidence collection ability, on-site control ability, legal awareness, career love, communication and coordination ability, teamwork ability. Cohen's Kappa coefficient of the two coders was more than 0.6, which had high consistency. Conclusion: The key Behavior Event Interview (BEI) is scientific and reasonable method to find out prominent competency elements of excellent front-line health inspector, and the prominent competency elements found out will be helpful in the human resources planning and management of health inspection in the future.

A Cluster of COVID-19 Among the Staff of a Logistics Company at Pudong International Airport after Exposure to Virus-contaminated Foreign Aircraft Cabins

Background: Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused a severe burden worldwide. “Environment to human” transmission by non-cold chain is causing alarm and attention. Methods: Epidemiological information of the COVID-19 cases were collected to determine epidemiological links and analyze transmission chains. Respiratory specimens were collected and tested for SARS-CoV-2 nucleic acid by rRT-PCR assay. Results: A total of five cases were diagnosed in Pudong New Area during November 20 to 22, 2020. Case 1, 3 and 5 worked for the same logistics company at Pudong International Airport, and had close contact with each other during work. Case 2 is the wife of case 1, case 4 is the wife of case 3. The source of infection was exposure to virus-contaminated foreign aircraft cabins, the virus transmitted among colleagues of a logistics company due to close contacts without effective protection, and then led to intra-household transmissions. The epidemic has been rapidly brought under control, and all the five cases recovered after 13 to 42 day’s treatment.Conclusions: Regular surveillance and testing of high-risk groups were necessary for COVID-19 control and prevention. Strict management measures and disinfection of imported goods were still need to be implemented in view of severe foreign epidemic situation.

Identifying multimorbidity patterns of non-communicable diseases in paediatric inpatients: a cross-sectional study in Shanghai, China

ObjectivesTo enhance the understanding of non-communicable disease (NCD) multimorbidity in children who are inpatients by delineating the characteristics of and identifying patterns among paediatric inpatients with multimorbidity in China.DesignCross-sectional study.SettingPaediatric wards (n=17) in Pudong New Area, Shanghai, China.ParticipantsA total of 193 432 paediatric inpatients in the electronic health record systems of 17 hospitals from 2011 to 2016 participated in the study, and 91 004 children with NCDs were extracted and classified based on International Classification of Diseases, 10th version codes.Main outcome measuresNumber of the NCDs and multimorbidity patterns of the paediatric inpatients.ResultsIn total, 47.05% (95% CI 46.83 to 47.27) of the paediatric inpatients had one or more chronic diseases, and 16.30% (95% CI 16.14 to 16.46) had multimorbidity. Congenital anomalies accounted for 19.43% (95% CI 19.25 to 19.61) of the principal diagnoses among the paediatric inpatients. Five common multimorbidity patterns were identified: a neurological-respiratory cluster, a neurological-respiratory-ear cluster, a cardiovascular-circulatory cluster, a genitourinary cluster (boy group) and a musculoskeletal-connective cluster (10–18 years age group).ConclusionsMultimorbidity in paediatric inpatients suggests that decisions about reasonable allocation of paediatric inpatient resources should be fully considered. Multimorbidity patterns in paediatric inpatients revealed that prevention, including innovative treatments targeting children, should be further studied.

Years of Life Lost Due to Premature Death and Their Trends in People With Selected Neurological Disorders in Shanghai, China, 1995–2018: A Population-Based Study

Background: Neurological disorders are the leading cause of long-term disability and the second leading cause of death in the world. We aimed to characterize the long-term trends in mortality and disease burden of selected neurological disorders and quantitatively analyze the contributions of demographic and non-demographic factors on the mortality of selected neurological disorders in Shanghai, China, 1995–2018.Methods: Mortality data were derived from the Vital Statistics System of Pudong New Area, Shanghai, China, during 1995–2018. Temporal trends for the mortality rates and burden of selected neurological disorders were analyzed by Joinpoint Regression Program. Years of life lost (YLL) was used to analyze the burden of disease. The increasing mortality rates related to demographic and non-demographic factors were estimated by the decomposition method.Results: A total of 4432 deaths from selected neurological disorders occurred during 1995–2018, accounting for 0.98% of total deaths. The crude mortality rates (CMR) and age-standardized mortality rates (ASMRW) of neurological disorders were 7.14/105 person–years and 4.08/105 person–years, respectively. Extrapyramidal and movement disorders, other degenerative diseases of the nervous system, and episodic and paroxysmal disorders were the three leading causes of mortality and YLL of selected neurological disorders. The CMR, ASMRW, and rate of YLL for deaths from selected neurological disorders showed significantly increasing trends in males, females, and the total population during 1995–2018 (all P < 0.001). The contribution rates of increased values of CMR related to demographic factors were more evident than non-demographic factors.Conclusion: The mortality rate and rate of YLL for death from selected neurological disorders increased significantly during 1995–2018 in Pudong New Area, Shanghai. The demographic factors, particularly aging, might be related to an increase in the mortality of neurological disorders. More effective prevention strategies are needed to prevent the aging-related death and burden from neurological disorders in the future.

The short term burden of ambient gaseous air pollution on chronic obstructive pulmonary disease in Pudong New Area, China: A time-stratified case-crossover study with a distributed lag nonlinear model

Background: Air pollution is a severe and dangerous public health problem. However, the effect of ambient gaseous air pollution exposure on years of life lost (YLL) attributable to chronic obstructive pulmonary disease (COPD) mortality has not been quantitatively verified.Methods: We collected the data of 12,781 COPD deaths and ambient gaseous air pollutants, including sulfur dioxide (SO2), nitrogen dioxide (NO2), Carbon monoxide (CO), and ozone (O3), during the years 2013-2019 in the Shanghai Pudong New Area (PNA). Then we performed a time-stratified case-crossover study combined with a distributed lag nonlinear model (DLNM) to estimate the impact of those air pollutants on daily COPD deaths counts and YLL. The confounders including long-term trend and meteorological factors have been controlled for, and effects of age and educational attainment as effect modifiers have also been evaluated.Results: During the 2013-2019 time frame, increases of 10μg/m3 in SO2 and NO2 were associated with a 4.93% (95% CI: 1.47%, 8.50%) and 1.47% (95% CI: 0.14%, 2.82%) in daily COPD death counts at lag0-1day, respectively, a 2.52 (95% CI: 0.31, 4.72) YLL increase and 0.85 (95% CI: 0.01, 1.68) YLL increase at lag0-1day, respectively. A 1mg/m3 increase in CO was associated with a 9.46% (95% CI: 0.40%, 19.35%) at lag0 increase in daily COPD death counts. No significant impact from O3 on both daily COPD deaths counts and YLL (P>0.05). The impact of gaseous air pollutants on the daily COPD death count and YLL were significant in populations of older adults and the lower educated population, while an insignificant effect was observed in the younger population and higher educated population. The YLL due to COPD related to SO2 and CO for the lower educated population was significantly higher than those for the higher educated population.Conclusion: Reducing specific gaseous air pollutants will help to control COPD deaths and improve the population’s life expectancy.

Cultural competence of nurses in Pudong New Area, Shanghai: a mixed-method study

ObjectiveCultural competence has gradually attracted attention from many countries, including China. This study was undertaken to determine the cultural competence of registered nurses in Shanghai, China, and to identify the cultural competence among registered nurses in Pudong New Area, Shanghai.MethodsQualitative interviews were conducted in combination with a quantitative survey. Fifteen clinical nurses were interviewed, and 1088 clinical nurses were recruited for the survey with cultural competence scale for registered nurses, based on the results of the qualitative and quantitative studies.ResultsThe overall level of cultural competence among registered nurses in Shanghai's Pudong New Area was moderate. Among the seven dimensions, cultural encounter had the highest score, followed by cultural practice, cultural awareness, cultural desire, cultural skill, cultural experience, and cultural knowledge. Age, level of hospital care, mastery of secondary level, and studying overseas were the influencing factors.ConclusionsHospitals and universities should be aware of the importance of studying cultural competence. Cultural competence-related courses should be increased, and various forms of training should be undertaken to enhance the interest of nurses.