A two-stage Data Envelopment Analysis Approach Incorporating Global Bounded Adjustment Measure to evaluate the efficiency of medical waste recycling systems with undesirable inputs and outputs (preprint)

With the ever-increasing focus on sustainable development, recycling waste and renewable use of waste products has earned immense consideration from academics and policy-makers. The serious pollution, complex types, and strong infectivity of medical waste (MW) have brought serious challenges to management. Although several researchers have addressed the issue of the MW by optimizing MW management networks and systems, there is still a significant gap in systematically evaluating the efficiency of MW recycling systems. Therefore, this paper proposes a two-stage data envelopment analysis (DEA) approach that combines the virtual frontier and the global bounded adjustment measure (BAM-VF-G), considering both undesirable inputs and outputs. In the first stage, the BAM-G model is used to evaluate the efficiency of MW recycling systems, and the BAM-VF-G model is used to further rank super-efficient MW recycling systems. In the second stage, two types of efficiency decomposition models are proposed. The first type of models decomposes unified efficiency into production efficiency (PE) and environment efficiency (EE). Depending upon the systems structure, the second type of models decomposes unified efficiency into the efficiency of the MW collection and transport subsystem (MWCS) and the efficiency of the MW treatment subsystem (MWTS). The novel approach is used to measure the efficiency of the MW recycling systems in China's new first-tier cities (CNFCs), and we find that: (1) Foshan ranks the highest in efficiency, followed by Qingdao and Dongguan, with efficiency values of 0.3593, 0.1765, and 0.1530, respectively. (2) EE has always been lower than PE and is a critical factor influencing the overall efficiency of MW recycling systems in CNFCs. (3) The MWCS lacks resilience, with an efficiency 0.042 lower than that of the MWTC. Following the outbreak of COVID-19, the efficiency of the MWCS has been decreasing year by year, reaching only 0.762 in 2021, which is a decline of 0.111 compared to 2017.

Mental health status of primary school students during the coronavirus disease 2019 epidemic and its influencing factors

Objective To study the mental health status of primary school students and the factors influencing the mental health status during the coronavirus disease 2019 (COVID-19) epidemic. Methods Online questionnaire surveys were conducted among 3 600 primary school students aged 6-12 years in Jilin Province, China in April, 2020 (during the epidemic) and 3 089 primary school students in September, 2020 (during the regular epidemic prevention and control). The general information and the data related to the Mental Health Scale for Child and Adolescent were collected by the questionnaire surveys. The multivariate logistic regression analysis was used to evaluate the factors influencing the mental health status of the students during the epidemic. Results The students during the epidemic had a significantly poorer mental health status in the emotional experience and volitional behavior than those during the regular epidemic prevention and control (P<0.05). The multivariate logistic regression analysis showed the risk of psychological problems of the students decreased with age (OR=0.895). The girls were at a higher risk of psychological problems than boys (OR=1.453). The students with father's and mother's charater between irritability and gentle were at a lower risk of psychological problems (OR=0.496 and 0.470 respectively). The students from a family with a parental education style of a combination of encouraging and scolding were at a lower risk of psychological problems (OR=0.263). The students from a single-parent family or an extended family were at a higher risk of psychological problems (OR=2.995 and 3.446 respectively). Conclusions The COVID-19 epidemic has a certain impact on emotional experience and volitional behavior of primary school students. During the epidemic, particular attention should be paid to the mental health of primary school students, especially girls, younger students, and students from single-parent families, extended families or families with impatient parents and improper parental education.