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Objective To analyze the staff structure, turnover and income of human resources in disease control and prevention institutions(CDCs)at different levels in China, to identify the existing problems, and to make policy recommendations accordingly. Methods A questionnaire survey was used to collect the data on the staff of CDCs at different levels in China from 2016 to 2018. Descriptive analysis and trend analysis were conducted on the number of staff, recruitment and turnover, income and other indicators in the three years. Results A total of 606 CDCs were included in the study. The proportion of job openings was 11.97% in 2018. Although the median proportion of professional personnel and health professional personnel in the CDCs reached the national standard(85% and 70%, respectively), a considerable number of institutions failed to meet the national standard. From 2016 to 2018, staff turnover in the CDCs has been increasing, with a minimum of 0.73(in 2016, municipal CDCs)and a maximum of 10.52(in 2018, provincial CDCs). In the staff who quit the CDCs, the proportion of junior professionals was the highest, while that of medium and senior professional increased gradually. Of them, the proportion of staff with graduate education in eastern China and provincial CDCs was higher than that of undergraduate education, while the proportion of staff with graduation education in other regions also increased. From 2016 to 2018, the average annual income in the CDCs in most regions did not reach the national average wage level of urban employees in health, social security and social welfare field in the same period. In county and district level CDCs in central and western China, personal income in 2018 was even less than the national average wage level in 2016. Conclusion Human resources in the CDCs at different levels in China remains insufficient and unbalanced, which warrants a"supporting policy"mechanism for public health personnel. The loss of the personnel in the CDCs continues to increase, in which the loss of senior professionals become increasingly serious. It raises a new concern to establish and improve the incentive mechanism of public health personnel. Furthermore, personal income in the CDCs is lower than the local average level. It is necessary to set personal income reasonably according to local economic level.
RESUMO
OBJECTIVE: To evaluate the effects of jejunal-ileal bypass(JIB) in addition to sleeve gastrectomy(SG) on glycemic regulation and body weight in Zucker Diabetic Fatty(ZDF) rats and underlying mechnisms. METHODS: Twelve ZDF(fa/fa) rats were randomly divided into two groups based upon the procedure performed including sleeve gastrectomy plus jejunal-ileal bypass surgery group(SG+JIB,n=6) and sleeve gastrectomy plus sham procedure group(SG+Sham,n=6). In addition,five healthy ZDF(fa/+) rats were employed as normal controls. Body weight,fasting blood glucose,food intake,oral glucose tolerance test and plasma GLP-1 levels were measured before surgery and at 2 and 4 weeks after surgery. RESULTS: Preoperatively,all baseline parametes had no statistical difference between SG+JIB and SG+Sham groups. In comparison with SG+Sham group,fasting plasma glucose levels at postoperative week 2(17.3 mmol/L vs. 8.7 mmol/L) and 4(21.4 mmol/L vs. 11.9 mmol/L)were significantly lower in SG + JIB group(P<0.0001). Oral glucose tolerace was significantly improved,represented by glucose excursion area under curve for 180 minutes period(4221 vs.2964,P<0.0001 at postoperative week 2;and 4104 vs. 3388,P<0.01 at postoperative week 4). Simutaneously,plasma GLP-1 levels were significantly higher in SG + JIB group than SG + Sham group(64.58 pmol/L v.s.30.52 pmol/L,P<0.001). However,SG + JIB had less food intake and body weight only decreased at postoperative week 2,but not at week 4. CONCLUSION: By adding JIB onto SG,the metabolic regulation capability is able to be furtherly enhanced. However,it seems that there is not additional benefit in weight loss.Therefore,based upon these results,we suggest that SG + JIB should be recommended to the patients who needs additional metabolic effects,but not to the patients for the purpose of additional weight loss above SG alone.