Shanghai Experience Research Articles

Smoking relapse reasons among current smokers with previous cessation experience in Shanghai: A cross-sectional study.

Quitting smoking can lead to substantial health gains, even later in life. Many smokers who attempt to quit experience several relapses before achieving sustainable cessation. This study aims to ascertain the differences between quitters with short and long abstinence time and to explore relapse reasons among smokers with cessation experience in Shanghai. From January to December 2022, 1745 current smokers were recruited in Minhang, Jiading, Qingpu and Songjiang districts of Shanghai. We used an electronic questionnaire to collect data. We implemented logistic regression for odds ratio (OR) and 95% confidence interval (CI) calculation to explore factors associated with long cessation time among smokers with cessation experience of ≥3 months, ≥6 months, and ≥12 months. Of the 1745 smokers included, 1452 (83.2%) were males, with an average age of 44.2 years, and 48.0% (838/1745) had cessation experience but relapsed. Logistic regression indicated that smokers aged ≥45 years had a longer cessation duration (adjusted odds ratio, AOR=3.10; 95% CI: 1.97-4.88). Moreover, longer cessation duration among smokers was positively associated with low education level of junior high or lower (AOR=2.30; 95% CI: 1.42-3.72) and senior high (AOR=2.19; 95% CI: 1.53-3.15), older age at first tobacco smoking (AOR=1.62; 95% CI: 1.1.16-2.25), but was negatively associated with longer smoking duration (AOR=0.67; 95% CI: 0.43-0.00) and higher smoking burden (AOR=0.44; 95% CI: 0.28-0.72). The main reasons for cessation relapse were social interaction needs (34.5%) and discomfort due to abstinence (29.1%). The relapse rate was high among smokers even after 12 months of abstinence. Smokers with older age, lower education level, shorter smoking duration and lower tobacco burden had longer cessation duration. Social interaction needs and withdrawal symptoms were the main relapse reasons. It is highly recommended that health bureaux consistently conduct tobacco control initiatives to spread awareness about the detrimental effects of tobacco smoke and the advantages of quitting smoking, even after achieving cessation.

Supply of basic necessities to vulnerable populations during the COVID-19 pandemic: Empirical evidence from Shanghai, China.

In spite of initial widespread skepticism, city lockdown has been proved to be an effective short-term tool in containing and delaying the spread of a viral epidemic. The measures to ensure the supply of the basic necessities adequately and equitably, especially for those vulnerable ones has become a major challenge faced by all countries taking a city lockdown measure during the epidemic. Data was collected through relevant government documents, work records, policy reports, media reports and the online-work information platform designed by the research group. Based on these references, the study analyzed the mainly technical difficulties and the countermeasures of the supply process, and summarized the key characteristics of basic necessities supply strategy for vulnerable groups in Shanghai. The supply strategy for vulnerable groups in Shanghai covers 16 districts, 232 streets and 6,028 neighborhood communities, which has already been in test running in April in some districts. The practical experience in Shanghai solved three key materials supply problems (lack of purchase channels, insufficient material reserves, insufficient transportation capacity) faced by government during the city lockdown, and showed three essential characteristics (overall coordination, community-centered intervention, technical support). The findings in this study may provide some suggestions to other countries about how to better manage the preparation, dispatch and transportation of basic necessities in shortage for those vulnerable ones during the city lockdown.

Which Factors Affect User Satisfaction with ETC? Evidence from Shanghai and Beijing

Owing to the current development trend of globalization and informatization, traditional transportation technologies and means can no longer meet the needs of economic and social development. Thus, intelligent transportation will be an inevitable and revolutionary choice for the development of the transportation industry. As a subsystem of the intelligent transportation system, the electronic nonstop toll collection (ETC) system provides a good solution to the problems of traffic congestion, environmental pollution, energy consumption, and low toll operation efficiency caused by expressway toll collection. This high-technology system is utilized in many fields, such as radio communication and computer and automatic control in the transportation field. China’s expressway ETC systems have evident effects on congestion reduction at toll stations. Although the advantages of ETC lanes are significant, and China actively implements ETC-handling policies, some drivers are reluctant to install ETC on-board systems or they have negative experiences after handling them. According to a survey, existing literature lacks research on the factors affecting user satisfaction with ETC. On the basis of the questionnaire data of ETC user experience in Shanghai and Beijing, we comprehensively investigate the reasons of banking, ETC equipment, and drivers’ personal factors and travel characteristics to establish an ordinal logistics model. Through cluster analysis, drivers in the two cities are divided into three groups, and the significance of related variables is further analyzed. This research can help us understand the degree of influence of different factors on user satisfaction with ETC to a certain extent. Moreover, effective methods and measures can be used to promote the popularity of ETC vehicle equipment and the utilization rate of ETC-dedicated lanes.

Preference to Family Doctor Contracted Service of Patients with Chronic Disease in Urban China: A Discrete Choice Experiment.

ObjectiveShanghai is one of the pioneers proposing family doctor contract service (FDCS). However, there is no quantitative research focusing on the Shanghai experience from a demand-side perspective. This study investigated Shanghai chronic patients’ relative preferences for FDCS using a discrete choice experiment method.MethodsA face-to-face discrete choice experiment (DCE) was performed to elicit the preference with 300 samples. Attributes and levels were extracted from the literature review and focus group consultation with patients. Seven attributes, follow-up frequency, medicine accessibility, family doctor competency, health management, referral convenience, appointment flexibility, and shared decision-making, were decided. Three levels were attached to each attribute. A mixed logit model was used to evaluate the multiple-choice data.ResultsA total of 248 patients completed the survey. Patient valued FDCS medicine accessibility (β=0.57, P < 0.05), and high family doctor competency (β= 0.43, P < 0.05), regular health management activities (β=0.36, P < 0.05), high follow-up frequency (β=0.31, P < 0.05) the most. The good doctor-patient shared decision-making atmosphere (β=0.12, P < 0.05), high referral convenience (β=0.06, P < 0.05) and high appointment flexibility (β=0.04, P < 0.05) are valued as less important. No significant preference heterogeneity was identified for patients with different sociodemographic characteristics. Respondents reported other FDCS needs, including online health consultation, specialist services in local institutes, higher reimbursement rates, free rehabilitation guidance for the disabled and personal health management.ConclusionThis research is the first discrete choice experiment FDCS preference research targeting on Chinese urban population. The results suggested that to increase the quality of FDCS, policy-makers should prioritize follow-up frequency, medicine accessibility, family doctor competency and health management. The service package should consider a higher reimbursement rate and rehabilitation guidance for the disabled if extra health-care resources available. Future FDCS policy should consider stated societal preference and be congruent with it.

Correlation Between Dynamic Changes of Chest CT Findings and Therapeutic Response of COVID-19: A Multicenter Experience in Shanghai, China

Background: The novel coronavirus disease 2019 (COVID-19) has become a global public health emergency. Computed tomography (CT) offers valuable clues to the diagnosis of COVID-19. However, little is known about the correlation between dynamic changes of CT scores and therapeutic response in the course of COVID-19. Objectives: To describe the temporal changes of CT findings and characterize the time window of disease progression on the follow-up CT scans of patients with COVID-19. Patients and Methods: In this historical cohort study performed in Shanghai, China, the follow-up chest CT images of 91 patients with COVID-19 with different therapeutic responses were reviewed in multiple centers, with an emphasis on characterizing the changing trend of CT scores for lung lesions at 13 - 15 days after the symptom onset and thereafter. The CT score curve patterns were categorized into type 1 (characterized by an increase to the peak level, followed by a decrease), type 2 (characterized by a steady change without an obvious peak), and type 3 (characterized by a progressive increase). Results: The CT scores of the progression group (n = 9) with a longer time to the peak were significantly higher than those of the non-progression group (n = 82) on the first day and days 13 - 15 (P &lt; 0.05), except for the median CT scores before days 13 - 15. The CT curve type 1 and type 2 were commonly observed in the non-progression group (63.4% and 36.6%, respectively), while type 3 was more common in the progression group (88.9%). Conclusion: Most patients with COVID-19 show favorable responses to clinical treatments in Shanghai. Thirteen to fifteen days after the symptom onset can be considered as a turning point for the therapeutic response. The CT curve type 3 usually represents a poor response. The CT scores of patients with different therapeutic responses may overlap before days 13 - 15. The changing trend of longitudinal CT scores may contribute to the prediction of disease progression.

Exhibiting Coca-Cola at universal exhibitions

ABSTRACT In this article, I will focus on a specific product that has been present in universal exhibitions since the 1930s: Coca-Cola. I will address the evolution of promotional narratives associated with the brand by examining the Coca-Cola exhibits in the world’s fairs from 1933 to 2015. The case of Coca-Cola is itself interesting insofar as it illustrates a number of tendencies since the mid-twentieth century in both the form and content of brand narratives. I will show how these narratives exemplify different versions of “the global” by highlighting industrial production in the 1930’s, international distribution and consumption in Brussels 1958 and New York 1964/65, and sustainable development as well as individual consumer experience in Shanghai 2010 and Milan 2015.

Community Disaster Resilience in the COVID-19 Outbreak: Insights from Shanghai's Experience in China.

PurposeCommunities are central to the practice of public health emergency preparedness and response. This article mainly focuses on COVID-19 and discusses the formation and structure of community disaster resilience, which is an effective method for coping with such a public health emergency.MethodsBased on the management of the COVID-19 outbreak in China, this article uses Shanghai’s experience to illustrate how a community disaster resilience was formed for risk management. Resorting to the analytical framework of risk city, principles of community disaster resilience are given.ResultsFour actions can be recommended based on Shanghai’s experience: 1) Applying a vulnerability analysis matrix for targeted risk governance, 2) empowering volunteer groups for emergency response, 3) policy and action for public health emergency prevention, and 4) risk communication for uncertainty-oriented planning.ConclusionShanghai's experience offers a reference to tackle the COVID-19 at the global level. The COVID-19 outbreak highlights that humans still face various unpredictable health risks in the future. Forming a connection-based resilience at the community level is an effective way to risk management.

Jewish Settlement in Shanghai during WWII in Fiction and Other Media of Cultural Memory

From 1938 to 1945, Shanghai was a temporary haven to more than 20,000 Jews originally from Europe. Most of the Jewish refugees in Shanghai survived to see the end of WWII. However, the Jewish settlement in Shanghai during WWII remains a little-known chapter of the history of the Holocaust. Recent decades have witnessed significant changes in this regard. In addition to historical studies, memoirs, and popular culture, the Shanghai experience of European Jews also found its way into literary fiction. Drawing on theories of cultural memory and media studies and based on readings of two novels—Marion Cuba's Shanghai Legacy (2005) and Beila's The Cursed Piano (2007, English edition 2017), this article argues that literary fiction contributes, albeit belatedly, to the collective efforts to preserve this important legacy, and may do so in a more compelling way than other media, through special perspectives, engaging storytelling, and broader accessibility.

Achieving Universal Wearing of Face Masks During the COVID-19 Pandemic: A Practical Solution from Shanghai, China.

BackgroundFace masks are basic protective equipment for preventing respiratory infectious diseases. The measures to properly dispose of and allocate face masks during the early stage of an epidemic caused by respiratory infectious diseases deserve worldwide attention.MethodsA qualitative research approach was used to document the practice of a citywide face mask–wearing strategy of the Shanghai Municipal Government (called the “Shanghai solution” in this article). Based on data from government work documents, an online face mask–allocation and sales system was built to offer real-time updates of face-mask appointments and sales information in all designated pharmacies and neighborhood committees in Shanghai.ResultsIn the Shanghai solution, a total of 24.8 million residents in 6,031 committees were covered, in order to achieve universal wearing of face masks during the COVID-19 crisis. Up to 110 million face masks were dispensed to residents in six rounds of face-mask allocation during February to April. This practical experience in Shanghai solved two key problems (insufficient face-mask capacity, protection of vulnerable population) with the supply of face masks by addressing four essential characteristics: overall coordination, on-demand distribution, efficient distribution, and technical support.ConclusionThe practice of the citywide face mask–supply strategy of Shanghai could provide several pointers for management of a shortage of emergency materials, dispatch, and transport to other countries during the pandemic.

How to Set Up Central Isolation Sites to Prevent Re-outbreaks From Imported Cases of COVID-19: The Experience of Shanghai, China.

As strict measures were taken, the coronavirus disease 2019 (COVID-19) epidemic has been gradually brought under control. As a port city, Shanghai's main problem has shifted from treating local cases to preventing foreign imports. To prevent the re-outbreak of COVID-19 caused by imported cases, the Shanghai government has set up central isolation sites for all people entering the country from abroad to be placed under medical observation. This report describes how to set up central isolation sites and run them effectively. We put isolation sites in transformed hotels, arranged personnel according to a huge data network, and set up specific procedures to manage guests. The epidemic situation in Shanghai has confirmed the feasibility and effectiveness of the methods that other jurisdictions can adapt for their use.

Between Global Governance and Local Governance: the Shanghai Model of Anti-Covid-19 Epidemic Measures

Given its special geographical location and size, Shanghai is a key hub linking world and locality, in this case China, in the implementation of anti-Covid-19 measures. By coordinating all the work according to the rule of law, Shanghai has outlined the basic framework for fighting the epidemic; by establishing the community grid governance model, Shanghai has soundly harnessed the ‘political potential energy’ and effectively filled in the internal mechanism of anti-Covid-19 and urban governance; and by respecting professionalism and the role of the masses, Shanghai seized the best opportunity to fight against the epidemic. Therefore, Shanghai has built up public value and gained spiritual support to fight against the epidemic and fundamentally improved the governance efficiency of the city. The experience of Shanghai’s anti-epidemic measures and governance forms an organic whole through mutual embedding and ultimately relies on efficient and fair governance.

Responding to the Coronavirus Pandemic: A Tale of Two Cities

This study compares the experiences of Shanghai in China and Los Angeles in the United States to illustrate four tension points in pandemic responses: immediacy versus thoroughness, transparency versus secrecy and security, centralization versus decentralization, and state-driven solutions versus coproduction. Based on the case analysis, strategic management and planning practices in six stages of pandemic response are recommended. The study also suggests research questions for future comparative research to examine more carefully how pandemic responses should vary due to institutional differences and local contextualization and adaptation.

Run by others: school autonomy in Shanghai’s entrustment management reform

ABSTRACT The promotion of school-to-school collaboration and school autonomy has popularized in the global trends of school system reform over the past few decades. This article examines the Shanghai experience by specifically taking the entrustment management reform as an illustrative example. Since 2007, the government has contracted ‘good’ schools in urban districts and private non-profit educational organizations to manage a group of relatively ‘weak’ schools in rural districts. Three ‘weak’ schools and their entrusted bodies were investigated in this study to elaborate the nature and structure of school autonomy in the new hierarchical management system. This article argues that rather than leading to substantial redistribution of the autonomy between the government and the school as stated, the reform has reconstructed the school leadership. A kind of ‘one-side-collaboration’ has emerged in ‘weak’ schools’ decision-making processes, which has in effect decreased their autonomy. Nevertheless, the reform has generally proceeded smoothly. This can be articulated through understanding Confucian moral and interrelated autonomy, in contrast to the Western autonomy premised on egoism and rationality and emphasizing the self-other tension, and in China’s political and bureaucratic contexts.

Epidemiological and clinical characteristics of 333 confirmed cases with coronavirus disease 2019 in Shanghai, China.

Coronavirus disease 2019 (COVID‐19) is an emerging infectious disease first identified in Wuhan City, Hubei Province, China. As of 19 February 2020, there had been 333 confirmed cases reported in Shanghai, China. This study elaborates on the epidemiological and clinical characteristics of COVID‐19 based on a descriptive study of the 333 patients infected with COVID‐19 in Shanghai for the purpose of probing into this new disease and providing reference. Among the 333 confirmed cases in Shanghai, 172 (51.7%) were males and 161 (48.3%) were females, with a median age of 50 years. 299 (89.8%) cases presented mild symptoms. 139 (41.7%) and 111 (33.3%) cases were infected in Wuhan and Shanghai, respectively. 148 (44.4%) cases once had contact with confirmed cases before onset, while 103 (30.9%) cases had never contacted confirmed cases but they had a sojourn history in Wuhan. The onset date of the first case in Shanghai was 28 December, with the peak appearing on 27 January. The median incubation period of COVID‐19 was estimated to be 7.2 days. 207 (62.2%) cases had fever symptoms at the onset, whereas 273 (82.0%) cases experienced fever before hospitalization. 56 (18.6%) adults experienced a decrease in white blood cell and 84 (42.9%) had increased C‐reactive protein after onset. Elderly, male and heart disease history were risk factors for severe or critical pneumonia. These findings suggest that most cases experienced fever symptoms and had mild pneumonia. Strengthening the health management of elderly men, especially those with underlying diseases, may help reduce the incidence of severe and critical pneumonia. Time intervals from onset to visit, hospitalization and diagnosis confirmed were all shortened after Shanghai's first‐level public health emergency response. Shanghai's experience proves that COVID‐19 can be controlled well in megacities.

Profiles of Teen Dating Violence and Association With Depression Among Chinese Teens.

Teen dating violence (TDV) is a major global public health concern. Few studies, however, have examined profiles of TDV in Chinese societies and how these profiles might be associated with teens' mental health. The current study analyzed a sample of 891 middle and high school students with dating experience in Taiwan, Hong Kong, and Shanghai. Latent class analysis (LCA) and multinomial logit regression analysis were performed in an attempt to identify profiles of TDV and then investigate possible associations between class membership and self-reported depression. The results of LCA suggested that a four-class model was the best fit for the data: Severe/Multi-Type TDV (5.51%), Controlling Behavior (13.08%), Non/Low TDV (64.50%), and Physical Violence (16.91%). The best-fit model suggested bidirectionality, meaning among teen partners in an abusive relationship, both tended to participate in violent acts and controlling behaviors. The results of the multinomial regression showed that, compared with the Non/Low TDV class, teens in the Severe/Multi-Type TDV class or Controlling Behavior class had greater odds of screening positive for depression. There was no significant difference in the risk of depression between the Physical Violence class and the Non/Low TDV class. Implications for future research and practice are also discussed herein.

Extracorporeal Membrane Oxygenation for Coronavirus Disease 2019 in Shanghai, China.

Severe cases of coronavirus disease 2019 (COVID-19) cannot be adequately managed with mechanical ventilation alone. The role and outcome of extracorporeal membrane oxygenation (ECMO) in the management of COVID-19 is currently unclear. Eight COVID-19 patients have received ECMO support in Shanghai with seven with venovenous (VV) ECMO support and one veno arterial (VA) ECMO during cardiopulmonary resuscitation. As of March 25, 2020, four patients died (50% mortality), three patients (37.5%) were successfully weaned off ECMO after 22, 40, and 47 days support, respectively, but remain on mechanical ventilation. One patient is still on VV ECMO with mechanical ventilation. The partial pressure of oxygen/fractional of inspired oxygen ratio before ECMO initiation was between 54 and 76, and all were well below 100. The duration of mechanical ventilation before ECMO ranged from 4 to 21 days. Except the one emergent VA ECMO during cardiopulmonary resuscitation, other patients were on ECMO support for between 18 and 47 days. In conclusion, ensuring effective, timely, and safe ECMO support in COVID-19 is key to improving clinical outcomes. Extracorporeal membrane oxygenation support might be an integral part of the critical care provided for COVID-19 patients in centers with advanced ECMO expertise.

Minimally Invasive Surgery and the Novel Coronavirus Outbreak: Lessons Learned in China and Italy.

Minimally Invasive Surgery and the Novel Coronavirus Outbreak: Lessons Learned in China and Italy.

Local Nuances of Authoritarian Environmentalism: A Legislative Study on Household Solid Waste Sorting in China

Faced with an unprecedented increase in the amount of solid waste, China aims to tighten its waste management regulation. Corresponding local policy experiments are encouraged. This study explores China’s authoritarian environmentalism through an examination of local legislations on Household Solid Waste (HSW) sorting. We present a full picture of relevant local legislation from five key dimensions: local legislative outputs, local standards of HSW classifications, reward and penalty provisions, the use of the social credit system and duties imposed on local governments. We then compare policy-making models based on the experience of Shanghai and Guangzhou. We find China’s HSW sorting policy has been dominated by the central state. The local lawmaking process is generally non-transparent and non-participative. When attempting to mobilize the public, local policymakers emphasize educating the public about “how to” instead of “why to sort wastes”. Also, while the central waste management policies are generally undermined locally, some sub-national governments do demonstrate a strong commitment to push the national policy through. Multiple factors account for this pattern. Though civic engagement did emerge in certain localities where civil society was relatively active, authoritarian environmentalism will continue to prevail in China in the near future.

Psychological crisis intervention during the outbreak period of new coronavirus pneumonia from experience in Shanghai

Since the middle of December 2019, human-to-human transmission of novel coronavirus pneumonia (NCP) has occurred among close contacts. At the same time, greater attention should be paid to psychological crisis intervention (PCI) among affected populations, for the timely prevention of inestimable damage from a secondary psychological crisis. PCI has been initiated via remote (telephone and internet) and onsite medical services to help medical workers, patients, and others affected to overcome any psychological difficulties. This paper outlines experiences based on the work of the Shanghai Medical Team.

Facilitating the continuous decline on the incidence rates of hepatitis B and liver cancer through cutting off the mother-to-child viral transmission, based on the "prevention first" strategy, in China

There have been 6-10 million reported patients with chronic hepatitis B virus (HBV) infection worldwide, and the United Nations (UN) called for a "90% reduction by 2030" strategy. Since the wide practice of HBV vaccination, the numbers of HBV cases have been reduced by 85% and the incidence of hepatocellular carcinoma has also decreased by 50%. As formulated by the UN in 2015, the sustainable development agenda for the eradication of hepatitis B included the success rate of preventing mother-to-child viral transmission by 95%, together with the reduction of new hepatitis B infections by 90% in 2030. In order to achieve the agenda, we proposed a strategy to achieve the "three 96%" goals derived from the Shanghai experience. In brief, hepatitis B vaccine should cover for 96% newborns within 24 h, and the vaccination boosting rate should reach 96% for both one and six months after birth. If cutting off the mother-to-child viral transmission strategy can be successfully achieved, the future of hepatitis B prevention will be promising, and the task of eliminating hepatitis B and controlling hepatocellular carcinoma can be completed ahead of 2030, time proposed by the UN.