Turnover Intention and Influencing Factors of Staffs in Centers for Disease Control and Prevention in the Post-Corvid-19 Era / 中山大学学报(医学科学版)

ObjectiveTo investigate the current situation of turnover intention of staffs in Center for Disease Control and Prevention（CDC） in the post-COVID-19 era and analyze the influencing factors of turnover intention， so as to provide policy suggestions and reference basis for maintaining the stability of the team of CDC and promote the development of health industry in China. MethodsA questionnaire survey on 1，508 staffs in Shenzhen Center for Disease Control and Prevention by means of WenJuanXing electronic questionnaire from January to February 2023 was conducted .Logistic stepwise regression analysis were used to analyze the influencing factors of turnover intention. ResultsAmong the 1，508 respondents， 583 （38.66%） had resignation intention. Logistic stepwise regression analysis showed that the scores of work arrangement， salary level ，professional title promotion system， occupational will，worry about job prospects were related to the generation of turnover intention ［OR 95%CI： 0.783（0.643， 0.952）； 0.531（0.452， 0.623）； 0.738（0.614， 0.887）； 0.605（0.520， 0.703）； 0.614（0.529， 0.714）］. In addition， job title， age and education were also related to generation of turnover intention （P <0.05）. ConclusionDisease prevention and control institutions should reduce the turnover intention of staffs in CDC through reasonable work arrangement， improvement of salary， adjustment of professional title promotion system， strengthening of professional cognition and enhancing confidence of personnel in career prospects.

Construction of an evaluation index system of public health emergency preparedness capacity in county-level centers for disease control and prevention / 预防医学

Objective@#To construct an evaluation index system of public health emergency preparedness capacity in county-level centers for disease control and prevention (CDC), so as to provide the evidence for improving the public health emergency preparedness capacity in county-level CDC.@*Methods@#An index system framework was created based on review of health emergency policies, laws and regulations released in China from 2003 to 2023. The importance, sensitivity and accessibility of indicators were scored and screened through two rounds of Delphi expert consultations, and the weights of indicators were calculated using precedence charts. The efficiency of Delphi expert consultations was evaluated using the active coefficient, authority coefficient and coordination coefficient. @*Results@#Eighteen experts participated in consultations, including 9 men, 15 with educational levels of master degree and higher, 12 with preventive medicine or public health as the specialty, and 12 with deputy senior professional titles and higher. The active coefficients of two rounds of consultations were 100.00% and 94.44%, and the authority coefficients were 0.83 and 0.84, respectively. The coordination coefficients of secondary and tertiary indicators during the second round consultation were 0.341 and 0.241, which were both higher than those during the first round (both P<0.05). The final evaluation index system included 8 primary indicators, 21 secondary indicators and 58 tertiary indicators. Among primary indicators, health emergency organization and management (0.203 1), health emergency team building (0.203 1) and financial support for health emergency (0.203 1) had the highest weights, and of secondary indicators, completion degree of health emergency administration regulations (initial weight/global weight: 0.750 0/0.152 3), health emergency team building (0.750 0/0.152 3) and financial support for emergency (0.750 0/0.152 3) had the highest weights, while among tertiary indicators, defining the duty of health emergency administration sectors had the highest weight (0.750 0/0.114 2). @*Conclusion@#The created evaluation index system is feasible for evaluation of the public health emergency preparedness capacity in county-level CDC.

Mediating role of resilience in relationship between occupational stress and depression of staff of centers for disease control and prevention / 环境与职业医学

Background Since the outbreak of the COVID-19 epidemic, staff of the centers for disease control and prevention (CDC) have been burdened with heavy epidemic prevention control, and excessive occupational stress can cause depression and other psychological problems. Objective To explore the status of occupational stress, resilience, and depression of CDC staff and potential relationships between them. Methods From December 2020 to April 2021, a survey was conducted at provincial and municipal levels, and the stratified cluster sampling method was used at county (district) level to select a total of 3514 samples. Their occupational stress, resilience, and depression status were evaluated using the Chinese Effort-Reward Imbalance Scale (ERI), the Chinese Connor-Davidson Resilience Scale (CD-RISC), and the Patient Health Questionnaire (PHQ-9). Independent sample t test, analysis of variance, χ2 test, Pearson correlation analysis, and mediation test (structural equation model) were conducted. Results The positive rate of occupational stress was 34.29% in the CDC staff, the resilience score was 66.28±15.32, and the positive rate of depression was 48.58%. Significant differences were found in the positive rates of occupational stress among different groups of gender, age, education background, marital status, administrative duty, weekly exercise frequency, chronic disease prevalence, and participation in epidemic control (P<0.05); in the resilience scores among different groups of gender, age, administrative duty, weekly exercise frequency, chronic disease prevalence, and participation in epidemic control (P<0.05); in the positive rates of depression among different groups of gender, age, educational background, personal monthly income, weekly exercise frequency, chronic disease prevalence, and participation in epidemic control (P<0.05). Occupational stress was negatively correlated with resilience (r=−0.165, P<0.01). Resilience was negatively correlated with depression (r=−0.383, P<0.01). Occupational stress was positively correlated with depression (r=0.343, P<0.01). The structural equation embracing a partial mediating effect of resilience on the relationship occupational stress and depression was established, and the partial mediating effect was 0.039, accounting for 10.46% of the total effect. Conclusion High positive rates of occupational stress, reduced resilience, and depression are shown among CDC staff in the context of the COVID-19 epidemic, and resilience partially mediates the effect of occupational stress on depression. The study findings suggest that improving resilience may reduce occupational stress and depression in CDC staff.

Bibliometric and visual analysis of Chinese-language scholarly journal papers published by China provincial centers for disease control and prevention from 2011 to 2020：based on CSCD data / 环境与职业医学

Background By analyzing the publication of scientific and technological papers of the provincial centers for disease control and prevention (CDCs) in China, we can understand their scientific research strength, dominant disciplines, research hotspots, and talent development, which is conducive for further optimizing the scientific research construction of the disease control system. Objective To conduct a bibliometric analysis and draw a visual map of the Chinese Science Citation Database (CSCD) sourced papers published by 31 provincial CDCs in China from 2011 to 2020, to understand the scientific research status of China's provincial CDC system in the past ten years. Methods In April 2021, China National Knowledge Infrastructure was used to retrieve CSCD sourced papers published by 31 provincial CDCs (excluding Taiwan Province, Hong Kong and Macau Special Administrative Regions) in China as the primary unit from 2011 to 2020, and finally 5231 CSCD papers were included. Bibliometric analysis indicators include number of CSCD papers published and financial support rate, proportion of CSCD papers to total Chinese papers, distribution of CSCD papers published in high-volume journals, and number of papers for a specific CDC that their first authors affiliated with. Citespace 5.8.R1 software was used to draw author's cooperation network map, keyword co-occurrence map, keyword clustering information table, and keyword emergence map. Results The number of CSCD papers published every year showed a stationary trend, and the total funding rate was 61%, showing an year-by-year upward trend (increased from 49.3% in 2011 to 68.7% in 2020). Jiangsu Province, Fujian Province, and Beijing CDCs ranked the top three in the total number of CSCD papers contributed by a specific CDC. The Chinese Journal of Epidemiology, Chinese Journal of Public Health, Chinese Journal of Zoonoses, Chinese Journal of Preventive Medicine, and Chinese Journal of Endemic Diseases were the top five high-volume journals. The top three authors of CSCD papers (counted as co-authors) were Xu Bianli of Henan Provincial Center for Disease Control and Prevention (110 papers), Yan Yansheng of Fujian Provincial Center for Disease Control and Prevention (72 papers), and Wang Quanyi of Beijing Center for Disease Prevention and Control (71 papers), and they studied the epidemiology of parasitic diseases and infectious diseases, the prevention and treatment of natural epidemic diseases and AIDS, and the epidemiology of infectious diseases, respectively. The keyword co-occurrence map showed that AIDS, zoonotic diseases, hand-foot-mouth disease, etc. (frequency ≥90) were the key research directions of provincial CDCs in the past ten years. The keyword clustering categories were closely related, although there were subtle differences, the topics focused on virus and chronic disease research. The keyword emergence results suggested that the frontiers of research had gradually shifted from infectious diseases such as enterovirus, hantavirus, and Zika virus to food-borne diseases and chronic non-communicable diseases such as tumors and senile diseases over time. Conclusion The number of papers issued by the provincial CDCs in China in the past ten years has shown an overall steady and rising trend. The leading themes of researchers and institutions are infectious diseases, parasitic diseases, etc., while food-borne diseases and elderly diseases are the hot frontiers.

Investigation of public health emergency core capacity of district-level disease prevention and control institutions under normalized epidemic prevention and control / 上海预防医学

ObjectiveBased on the investigation of the core capacity development of health emergency response of Shanghai disease prevention and control institutions after the COVID-19 pandemic， to analyze the shortcomings of health emergency response capacity of Shanghai disease prevention and control institutions， and to put forward suggestions to improve the core capacity of Shanghai's disease prevention and control system in the face of public health emergencies. MethodsUsing questionnaire surveys， investigations and evaluations were conducted on the emergency system development， epidemic monitoring and risk assessment， emergency team manpower and equipment， and actual response to COVID-19 in 16 district-level disease prevention and control institutions in Shanghai. ResultsThe overall public health emergency response capacity building of the district-level disease control agencies in Shanghai is relatively good， and the effect of capacity building has been proven during the handling of the new coronavirus. But at the same time， it also exposed some specific problems such as imperfect system construction， lack of emergency personnel and materials， insufficient on-site handling capabilities of personnel， and uneven allocation of emergency personnel and materials among different agencies. ConclusionShanghai district-level disease control should focus on the specific problems， such as strengthening the development of health emergency system， improving the human resources and material reserves of the emergency teams， and optimizing the laboratory testing ability， to further improve the core health emergency capacity of Shanghai disease control system.

Current status and problems of human resources of centers for disease control and prevention in Kashgar District， Xinjiang Uygur Autonomous Region / 上海预防医学

ObjectiveTo evaluate the current situation of human resource allocation in district and county centers for disease control and prevention （CDCs） in Kashgar ， identify existing problems and influencing factors， and to provide scientific evidence for optimizing the human resource allocation. MethodsA survey was conducted among all CDCs in Kashgar in February 2022. The questionnaire included the institutional and individual questions. ResultsThe overall staff size approved for the CDCs in Kashgar was 604， with a staffing rate of 76.17%， among which the staffing rates in 5 county CDCs were less than 60%. Currently， there were a total of 524 approved staff members in all CDCs， resulting in a vacancy rate of 13.25%. In the district CDC， 85 staff members were on duty， while the median of staff on duty was 34 in each county CDC. The staff in the district CDC was ageing， of which those aged over 45 accounted for 67.06%. The staff in the county CDCs was generally young， of which those aged less than 35 accounted for 54.22%. Moreover， the proportion of staff with bachelor’s degree or above in the district and county CDCs was 31.76% and 24.95%， respectively. The proportion of staff without professional title was 32.94% and 48.03%， respectively. In contrast， the proportion of those with middle and senior professional title was 57.89% and 22.02%， respectively. In addition， in recent 3 years， 24 staff members resigned in the CDCs， all of whom had professional titles. ConclusionHuman resources are insufficient in CDCs in Kashgar. Furthermore， staff structure is unreasonable， with a serious loss of human resources. In particular， the district CDC needs to optimize the allocation of human resources.

Discussion on implementation of public health standards adopted in centers for disease control and prevention / 中华流行病学杂志

As the most important phase in standardization activity,implementation saves as the essence.CDC in China are the major institutions undertaking disease control and prevention.Implementing the standards of public health provides technical basis for CDC to complete the task of disease control and prevention.In the study,spot conversation and questionnaire were used to investigate the implementation of standards on public health in CDC.Results showed that the staff of CDC got to know the standards through the Intemet.The departments of CDC which conducted training and sent staff to attend training courses accounted for 50.00％(25/50) and 34.00％ (17/50),respectively.State mandatory rule is still the main reason for relevant departments to implement the standards of the public health.Government promotion activities facilitate the implementation of Standards,and the degree of familiarity with Standards affects the implementation as well.The paper summarizes the existing problems,such as the lack of coordination between departments of public health at provincial level or below,lack of access to standards,and the need to strengthen the training of the standard implementation etc.It puts forward some suggestions to strengthen the implementation of public health Standards.

Capacity and training demand of the emergency staff from centers for disease control and prevention at county and municipal levels in Zhejiang Province / 预防医学

Objective To study the emergency staff's knowledge, skills and their training demand in centers for disease control and prevention (CDC) at county and municipal levels in Zhejiang Province. Methods Using multistage cluster sampling, 518 emergency staff from 34 CDCs in Zhejiang Province were involved in this study. A questionnaire survey was conducted among the emergency staff to evaluate their emergency knowledge and training demand. The differences between the staff from CDCs at county and municipal levels were evaluated. Results The average score of the emergency staff was 2.93 about all emergency knowledge. Some items' scores were lower, such as nuclear radiation control, first aid, risk management, ethics, laws and emergency system. The score of the survey items were similar at county and municipal level except education degree, positional title, and proportion of staff in emergency training, score of epidemiology, risk management and first aid. The highest degree of training demand was professional knowledge related to emergency response. The emergency staff inclined to the training mode (≥4) about short-term training, field guidance, drill and exercise and case study. Conclusion We should improve the health emergency training according to the demand and target of fostering inter-disciplinary talents for fieldwork. We should strengthen training of basic theories, basic knowledge and basic skills, to cover the shortage. The short-term training and practical training should be the main training model.

Discussion on implementation of public health standards adopted in centers for disease control and prevention / 中华流行病学杂志

As the most important phase in standardization activity,implementation saves as the essence.CDC in China are the major institutions undertaking disease control and prevention.Implementing the standards of public health provides technical basis for CDC to complete the task of disease control and prevention.In the study,spot conversation and questionnaire were used to investigate the implementation of standards on public health in CDC.Results showed that the staff of CDC got to know the standards through the Intemet.The departments of CDC which conducted training and sent staff to attend training courses accounted for 50.00％(25/50) and 34.00％ (17/50),respectively.State mandatory rule is still the main reason for relevant departments to implement the standards of the public health.Government promotion activities facilitate the implementation of Standards,and the degree of familiarity with Standards affects the implementation as well.The paper summarizes the existing problems,such as the lack of coordination between departments of public health at provincial level or below,lack of access to standards,and the need to strengthen the training of the standard implementation etc.It puts forward some suggestions to strengthen the implementation of public health Standards.

Statistical analysis on scientific papers in Chinese Center for Disease Control and Prevention from 2002 to 2015 based on GoPubMed / 中华医学科研管理杂志

Objective This paper aimes to analyze the scientific research development trend,research emphasis and cooperation situation of Chinese Center for Disease Control and Prevention since its establishment,to provide the suggestions for policy making of scientific management and related decisions.Methods Based on GoPubMed,Literature quantitative analysis was used to analyze the publication time and journal distribution,research topics and core authors of the scientific papers from 2002 to 2015.Results A total number of 4 501 research papers had been published in 576 different kinds of periodicals.Research topics were based on population health with special focus on the epidemiological,microbiological and etiological studies of infectious disease.Chronic non-communicable disease and health research were paying more and more attention to.Core author group and the core research team have been formed.Conclusions The capability to conduct scientific research was increased and the international influence was increasing year by year,the ability of infectious disease control was strengthened,and the scientific research team worked together more closely.Thus,the Chinese Center for Disease Control and Prevention should reinforce scientific management,develop advanced disciplines,as well as improve the quality of scientific research in the future.

Evaluation on human resource allocation in certain national institute of par⁃ asitic diseases in ten years / 中国血吸虫病防治杂志

@#Objective To evaluate the human resource in a national institute of parasitic diseases from 2007 to 2016，so as to provide a reference for the construction of a well⁃crafted human resource of national parasitic diseases control and prevention. Methods The basic information of the staff in the national institute of parasitic diseases was investigated and a related database was established to analyze the quantity and structure of the human resource allocation in 10 years through the annual statistics each year. Results The number of staff in the institute increased by 6.25% in 2016 compared with that in 2007，and 43.32% of the staff were under 35 years old. In 2016，59.36% of the staff had a master degree or a higher level degree，and 37.97% of the staff had senior technical titles. The difference value of the inflows and outflows was 3.21%. Conclusions The change of the structure and quality of human resource in this institute has a good tendency in the past ten years. The organization should optimize the human resource allocation and improve its capacity in disease control and prevention to broaden the methods of talent introduction and control the brain drain problem.

Africa Center for Disease Control and Prevention:analysis of its development strategy / 军事医学

Faced with huge demand for building public health capacity in the post-Ebola era, Africa Union has planned to establish Africa Center for Disease Control and Prevention ( Africa CDC,ACDC), with headquarters in Addis Ababa, Ethiopia, and at least 5 regional collaborating centers in each region of the continent .The strategic objectives of ACDC focus on building a continental integrated public health system and strengthening needed public health capacity .The current study analyzed the background , plans, development layout and strategy of ACDC , and provided references for China-Africa cooperation in the areas of public health and for the formulation of China global strategies of biosecurity and disease prevention and control .

Influencing factors on the efficiency of county-level centers for disease control and prevention in China via multilevel modeling / 中国卫生政策研究

Objective: To examine the influencing factors of the efficiency of county-level centers for disease control and prevention ( CDCs) in China. Methods:458 county-level CDCs were selected based on a systematic sam-pling method. Multilevel modeling was used to analyze the region-level and institution-level influencing factors affect-ing the efficiency of CDCs. Results: It was found that the region ( province) is associated with the efficiency of a CDC. The region-level factor of population density exhibited a significant influence, while the institution-level factors such as the proportion of health technicians, service income and CDC laboratories per capita also had an influence on overall efficiency. Conclusions: Both the region-level and institution-level determinants influence efficiency. Multi-level modeling can help researchers gain a comprehensive understanding of the influencing factors that affect the CDC efficiency.

Analyzing Financial Security Situation of Disease Prevention and Control System Construction in Jiangxi / 中国卫生经济

Objective: To understand current situation and existing problems in financial security of the center for disease control and prevention system in Jiangxi, to provide scientific references for advancing continuous, fast and healthy development of the system. Methods: combining three methods of questionnaire, group discussions and field surveys to investigate the situation of financial income from 112 centers of disease control and prevention in Jiangxi. Results: The government finance investment increased by year, but the funds of daily work and personnel is insufficient, public and regular business funds of some institution still depend on paid service income. Conclusion: It needs to further enhance financial structure adjustment and disease control investment, increase disease control input, change government appropriation method for disease prevention and control institutions, change the government ’ s funding mode to “purchase system” , reasonably pricing public product, the government on behalf of the people buying services according to quality and quantity from the disease prevention and control institutions.

Analysis on published scientific papers from 2001 to 2010 by professionals of provincial Center for Disease Control and Prevention in China / 中华医学科研管理杂志

Objectives Through analyzing the published scientific papers from 2001 to 2010 by the professionals of the 31 provincial Center for Disease Control and Prevention in China,offer reference for making plan about scientific research,disciplinary areas,personnel training.Methods Literature quantitative analysis and health statistics methods were used to analyze these papers.Results The professionals in 31 provincial CDC published a total of 22079 papers,Zhejiang 1669(7.56％),Guangxi 1579 (7.15 ％),Jiangsu 1410 (6.39 ％) are the top 3 provinces.The ratio of published papers in Zhonghua medical journal among all the papers are 1366(6.19％),the first three provinces Tianjinlll (13.67％).Beijing160 (13.57％).Shaanxi34 (10.59％).Average papers published by the eastern,central and western regions are 1131,452,444,eastern above western regions (P =0.0065.P =0.0028).Conclusion In recent ten years,the quantity and quality of papers published by the professionals of provincial CDC in China were improved.The unbalanced development exist among eastern,central and western regions,But the majority CDC's papers should be strengthened further.

Cholesterol reference method and HDL cholesterol designated comparison methods as Performed in the US CDC Cholesterol Reference Method Laboratory Network / 中华检验医学杂志

Objective To standardize total cholesterol (TC) and HDL cholesterol (HDLC) analytical systems with the US CDC TC reference method and HDLC designated comparison method (DCM). Methods CDC TC reference method and HDLC DCM were set up and the quality was controlled by participating in the CDC Cholesterol Reference Method laboratory Network (CRMLN) bimonthly survey. The performance of 21 TC or HDLC analytical systems from 3 manufacturers were tested with the methods according to the CRMLN certification protocols. Results The coefficient variation (CV) of TC analyses with the reference method in 18 surveys averaged 0.29% and the bias versus CDC target value 0.1%. The DCM HDLC CV in 17 surveys averaged 0.010 mmol/L(0.39 mg/dl) and the averaged biases versus CDC target and group mean were - 0.019 mmol/L (-0.72 mg/dl) and - 0.006 mmol/L (-0.25 mg/dl), respectively. Most of the TC and HDLC analysis events (> 90%) satisfied the CRMLN accuracy and precision criteria for the reference method and DCM. Eighteen of the 21 tested TC or HDLC systems met the performance criteria for analytical systems and were certified for traceability by CDC. Conclusions A reference method for cholesterol and a DCM for HDLC and performed within an international reference laboratory network have been established and used for certification of TC and HDLC analytical systems, Further application of the methods to the standardization of lipid analysis are expected.

Analysis on published scientific papers by professionals of Center for Disease Control and Prevention of Guangdong Province from 2001 to 2006 / 中华医学科研管理杂志

Objectives Through analyzing the published scientific papers by the professionals of the Center for Disease Control and Prevention of Guangdong Province(GDCDC) from 2001 to 2006,to put forward some suggestions for the research management,the discipline development and the personnel training.Methods Literature quantitative analysis and health statistics methods were used to analyze these papers.Results The professionals of GDCDC published a total of 924 papers with an annual average of 154 in 114 kinds of periodicals from 2001 to 2006 of the 924 papers.264 papers(28.6%) were published in the key Chinese periodicals,320 papers(34.6%)in the South China Journal of Preventive Medicine,68 papers (7.4%)in the Chinese Journal of Health Laboratory Technology and 51 papers(5.5%)in the China Public Health.Of the 924 papers,433 papers(46.9%)belonged in the field of health laboratory technology,354 papers(38.3%)in the field of disease prevention and control,and 70 papers(7.6%)in the field of public health.During the six years,79.2% of the total professionals Published at least one paper,58professionals published at least six papers.Of the 924 corresponding authors.56.8% aged 30～40 years old.48.9% had a bachelor degree,and 45.9% had a senior professional title.Conclusions In recent years,the quantity and quality of papers published by the professionals of GDCDC were improved.The professional's ability to conduct scientific research was enhanced and the research level of GDCDC wag raised year by year.The predominant specialties of the academic research were in the field of health laboratory technology and disease prevention and control.But the professional work and discipline development of Public health should be sirengthened further.