Objective To analyze the current situation of senile nursing agency in Shanghai community and raise up the countermeasures. Methods The senile nursing system and model were analyzed in Shanghai community, and find out the current situation and existing problem in Shanghai community. Results Senile nursing system in Shanghai community lacked policy support, medical and nursing cost of senile people was over-burden, lacking specialized nursing staff. The existing problem included insufficient funding, unnormative establishment of nursing agency, undefined evaluation standard, lacking of nursing staff. Conclusions We should rationally allocate health resources by various ways, push forward various levels of senile medical and nursing service system, strengthening function orientation, perfecting admission sign in order to establish rational senile health care evaluation system.

Objective:To survey the practice of hospice care and influencing factors among health providers in Shanghai.Methods:From November to December in 2019, a sampling survey on the practice of hospice care was conducted among 2 982 health providers from 217 institutions in 16 districts of Shanghai by using the self-designed scale.Results:The overall behavior frequency of hospice care in health providers was between "occasionally" (3 points) and "often" (4 points). The item score was (3.7±0.9), and the total score was (52.1±10.0). In the aspect of building a good relationship with patients and family(77.7%, 2 317/2 982), the participants had the highest work-practice(46.4%, 1 383/2 982). However, they practiced less in recommending the hospice care institutions to terminal patients. In terms of work-practice, the average score in male providers, those with education of undergraduate and above, those being married (including divorced or widowed), medical staff, those with associated senior titles, with witness of dying, or those currently working in the hospice care service department was higher.Conclusions:The hospice care work-practice of health providers in Shanghai is generally satisfactory, however, there is still some discrepancy among health providers with various characteristics. To further improve quality of hospice care, it is necessary to strengthen policy implementation, to encourage multidisciplinary team cooperation and carry out various forms of professional training for health providers.

Objective:To investigate the knowledge level of hospice care and the related influencing factors among health providers in Shanghai.Methods:From November to December 2019,a questionnaire survey on the hospice care knowledge was conducted among 7 074 health providers from 223 registered hospice care clinics or institutions in 16 districts of Shanghai.Results:A total of 7 027 valid questionnaires were recovered, with an effective recovery rate of 99.3%. Among the 7 027 responders, there were 1 460 males (20.8%) and 5 567 females (79.2%) with an mean age of (36.9±9.3) years; 2 682 nurses (38.2%) and 2 442 doctors (34.8%); 5 065 (72.1%) from community health service centers; 2 982 (42.4%) involving in hospice care services and 4 039 (57.5%) willing to work in hospice care. The average score of hospice care knowledge was (8.9±2.6), and the average accuracy for questions was 59.0%. Health providers had the highest awareness rate for the composition of hospice care professional team (93.9%, 6 597/7 027) and the lowest awareness rate for the emotional commitment in hospice care service (16.6%, 1 165/7 027). Health providers with junior colleges degree ( B=-0.429), vocational college degree and below ( B=-0.544), nurses ( B=-0.652), working in suburban areas ( B=-0.278), social office ( B=-0.891), without witness of dying process of end-of-life patients ( B=-0.329), not involving in hospice care services ( B=-0.283), and not willing to participating in hospice care ( B=-0.820) had low knowledge scores ( P<0.05). Conclusions:The overall level of hospice care knowledge of health providers in Shanghai is generally at a medium level, and the training of hospice care knowledge should be strengthened for the better development of hospice care.

Objective:To investigate the current training needs of hospice care among health providers in Shanghai.Methods:Based on the B.S. Bloom classification of educational objectives,a questionnaire on the training needs of hospice care for health providers in Shanghai was developed. From November to December 2019,a questionnaire survey on the training needs of hospice care was conducted among 7 074 health providers in 223 medical institutions in Shanghai.Results:A total of 7 027 valid questionnaires were recovered, with an effective recovery rate of 99.3%. The training needs of health providers in Shanghai exceeded 71.0% for all items,with the average score of (2.58±0.63). The degree of training needs in each dimension ranges from high to low were knowledge(2.59±0.64), action(2.57±0.68) and motion(2.56±0.70). The top three training needs were“living will and law”(80.5%,5 660/7 027),“social work methods for hospice care”(75.3%, 5 290/7 027)and“stress and adaption in hospice care services”(75.1%,5 279/7 027). Female health providers(2.61±0.62), administrators, medical personnel and other post workers(2.68±0.56),those with junior professional title(2.61±0.62), with no witness of dying process(2.65±0.58),and those without participating in hospice care service(2.68±0.55)had higher training needs( P<0.05). Conclusion:The training needs of hospice care for health providers are very high in all hospitals. It is suggested to conduct stratified and targeted training for health providers in different positions and institutions according to the different training needs of hospice care.

Objective:To investigate the attitude of health providers towards hospice care in Shanghai,and analyze the related influencing factors.Methods:From November to December 2019,a questionnaire survey on the attitude towards hospice care was conducted among 7 074 health providers from 223 medical institutions in 16 districts of Shanghai.Results:A total of 7 027 valid questionnaires were recovered, with an effective recovery rate of 99.3%. The total score of attitude to hospice care was (91.9±11.6),the average score of items was (3.7±0.5). The highest score rate was "perception of the benefits for the quality of life promotion" (87.08%),and the lowest score rate was "perception of the threats from the worsening conditions of advanced patients" (60.88%).Health providers who were doctors ( B=-1.207), nurses ( B=-0.912), those without witness of dying or end-of-life patients ( B=-1.417), those without involving in hospice care services ( B=-1.203), and not willing to participating in hospice care ( B=-7.849) had lower attitude scores (all P<0.05). Conclusions:The survey indicates that health providers in Shanghai have a positive attitude towards hospice care,but the initiative to engage in hospice care service is not high. It is necessary to conduct targeted training of relevant professional knowledge to enhance the attitude and enthusiasm to hospice care among health providers.

Objective: To investigate the gender difference of left-behind adolescents mental health in rural junior middle schools, and to explore possible moderating role of parent-child interaction. Methods: Based on the data of China Education Panel Survey (CEPS) from 2014 to 2015, the self-reported parent-child interaction frequency and mental health of 3 470 eighth grade students lived in rural area were analyzed. Results: Mental health scores were higher in left-behind boys (68.90±22.45) whose parents migration compared to left-behind girls (63.59±20.83)(t=3.02, P<0.01). The two-level mixed effect linear regression model showed that the negative impact of parental migration on the parentchild interaction and mental health of left behind girls was greater than that of left behind boys (B=-0.90, -4.02, P<0.05). The frequency of parent-child interaction moderated the gender difference of mental health of left behind adolescents (P<0.01). The above-mentioned gender differences decreased after adding the frequency of parent-child interaction (B=-3.65, P<0.1). Conclusion The negative impact of parental migration on mental health of left-behind girls in junior high school is stronger than boys. It is needed to take more care of the mental health and promote parent-child communication for left-behind girls.

Objective: To understand the relationship between school environment and campus bullying behavior of junior high school students, and to provide scientific basis for the intervention of campus bullying behavior. Methods: Based on the data of "China Education Panel Survey" from 2014 to 2015, the school environment and self reported campus bullying behaviors of 9 300 junior high school students were analyzed. Results: The two level mixed effect linear regression model showed that the frequency of boys campus bullying behavior was higher than girls( B =0.356, P <0.01). Junior high school students in the school with higher student teacher ratio and school average class status had higher frequency of campus bullying behavior( B =-0.007, -0.004, P < 0.05 ). The negative correlation between school average class status and the frequency of bullying behavior of boys was greater than girls( B = -0.006 , P <0.01). Conclusion Prevention and treatment of junior high school students campus bullying not only needs to start from the individual students, families and peer groups, but also needs to pay attention to the school environment, reduce the school socioeconomic segregation, and pay more attention to boys campus bullying behavior.

ObjectiveTo explore the correlation between angiotensin converting enzyme (ACE) gene polymorphism and hypertension accompanying atherosclerosis in Li people in Hainan province. MethodsTwo hundred and sixty patients with hypertension accompanying atherosclerosis were selected as hypertension plus atherosclerosis group, while two hundred and seventy-six healthy people were regarded as healthy control group. ACE I/D gene polymorphism was detected by polymerase chain reaction (PCR), and the genotype frequencies and allele frequencies of DD, DI and Ⅱ were investigated. The carotid intimal-medial thickness(IMT)was measured by high-resolution ultrasound technique and mean IMT (MIMT) was calculated. Results(1) In the hypertension plus atherosclerosis group, the genotype frequencies of DD, DI and Ⅱ were 15.0%, 37.3%, 47.7%,respectively, and the allele frequencies of D and I were 33.70% and 66.30%, respectively. In the healthy control group, the genotype frequencies of DD, DI and Ⅱ were 17.8% , 40.6% and 41.7%,respectively, and the allele frequencies of D and I were 38.0% and 62.0%, respectively. There were no significant differences both in the genotype frequencies of DD, DI and Ⅱ, and in allele frequencies of D and I between the two groups (P>0. 05). (2) The age,total serum cholesterol(TC),triglyceride (TG), systolic pressure(SBP), diastolic pressure(DBP), apolipoprotein A(apoA) and apolipoprotein B (apoB) levels were significantly higher in the hypertension plus atherosclerosis group than in the control group(P<0. 05). The high density lipoprotein cholesterol(HDL-C) level was significantly lower in the hypertension plus atherosclerosis group than in the control group(P<0. 05). Logistic regression analysis showed that TG (OR = 2.14), apoA(OR = 360. 39), SBP(OR = 1.21), DBP (OR=1.08) and ACE DD genetype (OR = 0. 30) had correlation with hypertension plus atherosclerosis(all P<0. 05). The MIMT level was significantly higher in ACE DD subset than in DI and Ⅱ subset (P<0.05). ConclusionsThe ACE DD genotype increases the susceptibility of carotid atheroselerosis, which is the risk factor for hypertension accompanying atherosclerosis in Li people in Hainan province. It may be an early predictive factor in atherosclerosis.

Objective To investigate the effect of ultrasound-guided stellate ganglion block ( SGB) on perioperative inflammatory responses and postoperative recovery of gastrointestinal function in patients un-dergoing gastrointestinal surgery. Methods Fifty-five American Society of Anesthesiologists physical classⅠ-Ⅲpatients of both sexes, aged 18-64 yr, weighing 50-75 kg, undergoing elective gastrointestinal sur-gery, were divided into SGB group ( n=18) and control group ( C group, n=37) using a random number table method. Ultrasound-guided SGB was conducted with 0. 5％ ropivocaine 7 ml at the left C6 level in SGB group. The equal volume of normal saline was given under ultrasound guidance at the same site in C group. Peripheral venous blood samples were collected at 5 min before SGB and 2, 4 and 24 h after SGB for deter-mination of plasma tumor necrosis factor-α ( TNF-α) , interleukin ( IL)-1β and IL-6 concentrations by en-zyme-linked immunosorbent assay. The increased level of leukocyte count ( leukocyte count at 24 h after SGB-leukocyte count at 24 h before SGB) was recorded. The recovery time of bowel sounds and anal or sto-ma exhaust time were also recorded. Results Compared with C group, the concentrations of TNF-αat 2 h after SGB and IL-1βat 2, 4 and 24 h after SGB were significantly decreased, the increased level of leuko-cyte count was decreased, and the recovery time of bowel sounds and anal or stoma exhaust time were short-ened in SGB group ( P<0. 05) . Conclusion Ultrasound-guided SGB can reduce perioperative inflammato-ry responses and promote the recovery of postoperative gastrointestinal function in the patients undergoing gastrointestinal surgery.

Palliative care, as an emerging discipline, is rapidly advancing in China. However, progress in quality management has been relatively slow, hindering the homogeneity of palliative care services in a certain degree. This article takes the Shanghai Palliative Care Service Management Center as an example, outlines its practical model and achievements in the field of quality management since its establishment, and further analyzes the existing problems based on the city-wide palliative care service quality evaluation results. The article summarizes relevant experiences and offers corresponding insights, enriching research cases and practical support in the quality management of palliative care, which may have practical application value for enhancing the homogeneity of palliative care services in the region.