Osteoporosis has been recognized as a civilization disease. This chronic condition needs a long-term management plan with a holistic approach to patients. The specificity of the patient’s response to the disease and coping strategies are very important in the treatment process. The aim of this research was to analyze the strategies of coping with disease preferred by patients treated for osteoporosis, and to determine the relationship between the self-assessment of patients’ health, time of treatment, sociodemographic variables, and strategies of coping with a chronic disease such as osteoporosis. The study was conducted from August 2016 to July 2018 at an osteoporosis clinic in eastern Poland. Coping Orientations to Problems Experienced (COPE) by C.S. Carver, M. F. Scheier, and J. K. Weintraub in the Polish adaptation and our own questionnaire were used. The study participants were 312 patients treated for osteoporosis. The respondents treated in the osteoporosis clinic used the strategies of seeking support and focusing on emotions to the greatest extent, and avoidance strategies the least. Sociodemographic features and self-assessment of health condition significantly differentiate the strategies of coping with the disease. The analysis showed that the higher the assessment of the individual perception of one’s own health, the more often the respondents used active coping strategies. Full article

Background: The Standardized Residency Training Program (SRTP) is a significant initiative to deepen health systems and medical education in developing countries like China. Despite the promotion of the SRTP nationwide and its implementation with various improvements, Chinese continuous medical education is still in its infancy. Compared with the residents, little is known about clinical teachers under the SRTP in China. However, clinical teachers effectively determine the training quality as critical disseminators of knowledge, skills, and values in medical practice. Thus, the study aims to analyze critical factors affecting their cognitive job satisfaction and provide continuous improvements for SRTP. Methods: From 1 December 2018 to 31 May 2019, we conducted a self-designed questionnaire with 13 SRTPs (including both training bases and professional bases) in Shaoxing city to evaluate clinical teachers’ satisfaction. Altogether, 574 clinical teachers responded to the survey expressing generally high overall satisfaction. We adopted a Chi-square test and Fisher’s Exact Test to evaluate the single impact factors affecting the satisfaction of clinical teachers. The multiple factors analysis applied the logistic regression model. Results: The male clinical teachers had significant differences in satisfaction with the teaching content (OR: 0.675, [95% CI: 0.477~0.953]), conflicts between study and work (OR: 0.542, [95%CI: 0.371~0.791]), the attention of leaders (OR: 0.403, [95%CI: 0.252~0.645]), and the subsidies of teachers (OR: 0.527, [95%CI: 0.347~0.805]). Compared with internal medicine, clinical teachers from surgery (OR: 2.396, [95%CI: 1.365–4.206]) and other departments (OR: 2.409, [95%CI: 1.406–4.129]) were more satisfied when they considered that residents have high motivation to attend training. In addition, compared with the attending physicians, the deputy chief physicians (OR: 0.493, [95%CI: 0.310–0.783]) and the chief physicians (OR: 0.683, [95%CI: 0.471–0.991]) disagreed more regarding the residents’ wage being good enough. Conclusion: Clinical teachers widely recognize the SRTP. However, teachers’ satisfaction varied due to different genders, working departments, and professional titles. The study also discussed possible reasons and strategy implications behind these findings, which combined unique Chinese society characteristics. Further, we believe the analysis and interpretations remind us of the applications of residency training methods from other Western countries, which should also consider the unique socio-cultural challenges. Full article

Emerging literature is highlighting the huge toll of the COVID-19 pandemic on frontline health workers. However, prior to the crisis, the wellbeing of this group was already of concern. The aim of this paper is to describe the frequency of distress and wellbeing, measured by the expanded 9-item Mayo Clinic Wellbeing Index (eWBI), among general practitioners/family physicians during the COVID-19 pandemic and to identify levers to mitigate the risk of distress. Data were collected by means of an online self-reported questionnaire among GP practices. Statistical analysis was performed using SPSS software using Version 7 of the database, which consisted of the cleaned data of 33 countries available as of 3 November 2021. Data from 3711 respondents were included. eWBI scores ranged from −2 to 9, with a median of 3. Using a cutoff of ≥2, 64.5% of respondents were considered at risk of distress. GPs with less experience, in smaller practices, and with more vulnerable patient populations were at a higher risk of distress. Significant differences in wellbeing scores were noted between countries. Collaboration from other practices and perception of having adequate governmental support were significant protective factors for distress. It is necessary to address practice- and system-level organizational factors in order to enhance wellbeing and support primary care physicians. Full article

This study explores the impact of the coronavirus disease 2019 (COVID-19) pandemic on outpatient visits for all-cause and chronic diseases in 2020. We extracted the data of patients who visited medical institutions over the past five years (2016–2020) from nationwide claims data and measured the number of monthly outpatient visits. A negative binomial regression model was fitted to monthly outpatient visits from 2016 to 2019 to estimate the numbers of 2020. The number of all-cause outpatient visits in 2020 was 12% lower than expected. However, this change was relatively stable in outpatient visits for chronic diseases, which was 2% lower than expected. Deficits in all-cause outpatient visits were observed in all months except January; however, deficits in outpatient visits for chronic diseases have rebounded since April 2020. The levels of change in healthcare utilization were observed differently among disease groups, which indicates that the impacts of the pandemic were disproportionate. This study calls for a policy response to emerging and reemerging infectious diseases, as the findings confirm that a health crisis, such as the COVID-19 pandemic, could disrupt the healthcare system. Assessing the mid-to long-term impacts of COVID-19 on healthcare utilization and health consequences will require further research. Full article

With the development of technology, the concepts of “green” and “sustainable” have gradually been popularized in all walks of life. With the continuous development of the world mining industry, the efficiency of resource development in various countries has been improved, but mining activities and production will undoubtedly bring many environmental pollution problems. As a mining power, China is one of the first countries to put forward the concept of “green mining”. Over the years, as people emphasize safety and environmental protection, green mining technology has become the hot topic. At the same time, groundwater pollution caused by mining has become the focus of China’s “green mine construction”: with the continuous development of mining, mining activities and production will also undoubtedly bring significant environmental pollution. The environmental pollution of the mined area has a vital influence on the surrounding environment. The pollutants mainly come from mining operations and production of the mineral processing industry, including process wastewater, gas waste, smelting slag, etc., which are all acidic. Acid mine drainage (AMD) occurs in the process of mining production, due to the structure of minerals and the complex reactions between oxygen and minerals, and results in heavy metal ions leaching into groundwater. Once the groundwater is polluted, it will slowly flow to the surrounding area, resulting in the migration and diffusion of pollutants in the groundwater, affecting the surrounding rivers, farmland, and drinking water for residents. In recent years, environmental damage caused by groundwater pollution from underground mines in Shijiazhuang, China, and Selangor, Malaysia, has had a negative impact on rivers, farmland, and human health. At the same time, the paper introduces many key technologies of green mine construction, such as the backfill mining method. In cooperation with China Road & Bridge Corporation, this paper also introduces the progress in the reuse of mining waste, especially the use of mining waste as aggregate to prepare concrete materials for road and bridge construction. This information article introduces the development status of green mine construction in China and briefly reviews the key technologies of green mine construction in China. Full article

This study was conducted to identify the trends in obesity prevalence among adolescents and changes in the risk factors related to obesity. The study analyzed secondary data obtained from Korean Youth Risk Behavior Web-based Surveys conducted from 2009 to 2019. The Korean Youth Risk Behavior Web-based Survey is an annual survey of a nationwide representative sample of enrolled students aged 13–18 years in middle and high schools in Korea. Linear and trend analyses showed that the prevalence of obesity increased by 0.47% on average annually; this increase was statistically significant. Healthy food intake decreased significantly, but the prevalence of unhealthy food intake and the prevalence of skipping breakfast increased significantly. Vigorous-intensity physical activity, physical activity for over 60 min a day, and muscle-strengthening exercise for more than 3 days a week increased significantly, but so did the adolescents’ sedentary time. Therefore, health care providers and public policymakers need to actively manage adolescent obesity, which has been continuously increasing since 2009. In addition, long-term trends in obesity-related risk factors such as physical activity and dietary behaviors need to be considered in the development of obesity management strategies. Full article

Salmonella Enteritidis is a major foodborne pathogen worldwide. In this study, a total of 276 S. enteritidis isolates, collected between 2016 and 2017 from human, food and farm/slaughterhouse samples, were studied to enhance the understanding of the epidemiology of human salmonellosis in Singapore. Results showed all 276 isolates belonged either to ST1925 (70.3%) or ST11 (29.7%), with ST11 being significantly more frequent in extra-intestinal isolates and chicken isolates. Food isolates, most of which were from poultry, showed the highest prevalence of resistance (33–37%) against beta-lactams or beta-lactams/beta-lactamase inhibitor combination (ampicillin, piperacillin and ampicillin/sulbactam). The analysis showed the detection of genes associated with resistance to aminoglycoside genes (99.6%), tetracycline (55.1%), and beta-lactams (14.9%) of all isolates. Nine types of plasmids were found in 266 isolates; the most common incompatibility group profiles were IncFIB(S)-IncFII(S)-IncX1 (72.2%) and IncFIB(S)-IncFII(S) (15.8%). Most plasmid harbouring isolates from chicken (63.6%, 14/22) and from human (73.8%, 175/237) shared the same plasmid profile (IncFIB(S)-IncFII(S)-IncX1). SNP analysis showed clustering of several isolates from poultry food products and human isolates, suggesting phylogenetic relatedness among these isolates. Lastly, this study provides important epidemiological insights on the application of phenotypic and next-generation sequencing (NGS) tools for improved food safety and public health surveillance and outbreak investigation of S.enteritidis. Full article

Plastics, as a polymer material, have long been a source of environmental concern. This paper uses polystyrene plastics as the research object, and the relative contribution of each component of plastic additives to plastic degradation is screened using the molecular dynamics method. The factorial experimental design method is combined with molecular dynamics simulation to adjust the additive composition scheme, analyze the mechanism of interaction between the additive components, and select the plastic additive combination that is most readily absorbed and degraded by microorganisms. Seven different types of plastic additives, including plasticizers, antioxidants, light and heat stabilizers, flame retardants, lubricants, and fillers, are chosen as external stimuli affecting the biodegradability of plastics. Using molecular dynamics simulation technology, it is demonstrated that plastic additives can promote the biodegradability of plastics. The factorial experimental design analysis revealed that all plastic additives can promote plastic biodegradation and plasticizer is the most favorable factor affecting plastic degradation, that hydrophobicity interactions are the primary reason for enhancing plastic degradation, and that screening No. 116–45 (plasticizer A, light stabilizer C, flame retardant E) is the most advantageous combination of biodegradable plastic additives. The plastic biodegradation effect regulation scheme proposed in this study is based on optimizing the proportion of additive components. To continue research on aquatic biodegradable plastics, the optimal combination of plastic components that can be absorbed and degraded by microorganisms is recommended. Full article

The conventional top-down scope of relying only on centralised sewerage has proven insufficient to reach the entire global population with safely managed sanitation and meet Sustainable Development Goals 6.2. and 6.3 by 2030. Citywide Inclusive Sanitation (CWIS) has emerged as an approach to accelerate progress by considering different technologies and service provision models within the same city to expand sanitation access equitably and sustainably. However, to generate an enabling environment for CWIS to be implemented successfully, regulatory frameworks must be adapted, as they are often unsuited for non-sewered sanitation solutions. By analysing the Colombian case study through a mixed qualitative methodology comprised of a policy review, semi-structured interviews, and workshops with key stakeholders in the urban sanitation sector, the country’s regulatory framework was evaluated to determine if it is adequate to implement CWIS. Regulations were identified to pose barriers for CWIS and produced a disabling environment for its application. This research proposes recommendations to adapt the regulatory framework to allow CWIS application in Colombia based on the encountered barriers. This is the first comprehensive study on regulations for CWIS in the Latin American context and therefore provides the basis for further research to understand the dynamics related to effective regulations for CWIS globally. Full article

Population-based studies of individual-level residential greenspace and mental health outcomes are still limited. Thus, the present study investigates greenspace–mental health associations—including depressive symptoms, burnout symptoms, and life satisfaction—in a population-based sample of adults, the Swedish Longitudinal Occupational Survey of Health, in 2016 (n = 14,641). High-resolution land cover of greenspace and green–blue-space was assessed at 50, 100, 300 and 500 m buffers around residential addresses. Higher residential greenspace and green–blue-space were associated with lower levels of depressive and burnout symptoms among non-working individuals and with higher life satisfaction in the whole study population, after controlling for age, sex, individual income, and neighborhood socioeconomics. The immediate residential-surrounding environment (50 m) consistently showed the strongest associations with the outcomes. Having a partner was associated with better mental health outcomes and with having more residential greenspace, and adjusting for this rendered greenspace–health associations mostly statistically non-significant. In conclusion, higher levels of greenspace and green–blue-space in the immediate residential-surrounding environment were associated with better mental health outcomes in the present study, which contributes additional nuances to prior studies. The importance of residential greenspace for public health, urban planning, and development is discussed. Full article

We analyze the relationship between different dimensions of the quality of the political system and the outcome of the COVID-19 pandemic. Data are retrieved from open-access databases for 98 countries. We apply a multivariable regression model to identify the relationship between various factors likely to affect the number of COVID-19 deaths, in addition to different dimensions of the quality of the political system. We find that the high quality of the electoral process in a country is associated with more COVID-19 deaths, while good political culture is associated with fewer deaths. As expected, we also find that trust in government and experiences with pandemics in the past is negatively related to COVID-19 deaths. Finally, a high GDP per capita is significantly associated with more COVID-19 deaths. Our findings illustrate that rapid, effective, and comprehensive government measures can protect society from the spread of a virus, but citizen compliance is also essential to policy success. Full article

The demanding work context of physicians challenges their employability (i.e., their ability and willingness to continue to work). This requires them to proactively manage their working life and employability, for instance, through job crafting behaviour. This randomized controlled intervention study aimed to examine the effects of a personalized feedback report on physicians’ employability and job crafting behaviour. A total of 165 physicians from two hospitals in a large Dutch city were randomly assigned to a waitlist control or intervention group in May 2019. Physicians in the intervention group received access to a personalized feedback report with their employability scores, suggestions to improve these and to engage in job crafting. Participants completed a pre-test and eight weeks later a post-test. RM MANOVAs and RM ANOVAs showed that the intervention enhanced participants’ perceptions of their mental (F (1,130) = 4.57, p < 0.05) and physical (F (1,135) = 16.05, p < 0.001) ability to continue working. There was no effect on their willingness to continue to work. Furthermore, while job crafting behaviour significantly increased over time, the personalized feedback report did not account for this change. This low-investment intervention is relevant for organizations to stimulate employees’ proactivity and create positive perceptions of their ability to continue to work. Moreover, this study contributes to the literature by examining a novel approach of a job crafting intervention that does not require many resources to implement. Full article

Flats/houses in the COVID-19 pandemic era became the central place for living, working, learning, studying and entertainment. According to Maslow’s pyramid, all the basic needs had to be satisfied within a single space, which caused a change in the importance of certain locational and physical features of the flat/house. This study aimed to investigate how the COVID-19 pandemic changed the perception of the environmental features and the physical features of flats/houses. The research material was obtained from a questionnaire study disseminated through different online channels. The study was conducted in Poland, and citizens’ preferences are linked to the prevailing spatial and socio-economic determinants. A group of respondents were presented with 23 features describing the location and 17 features describing the physical features of flats/houses. They were also asked questions about the level of satisfaction with the current location and housing features. The results were analysed, and the statistical significance of the difference in the perception of the location features and the physical features of the flat/house was verified using a Chi-squared test. The results demonstrated a change in the importance of certain attributes concerning both external and internal factors. The physical features of the flat/house appeared to be more important (from the respondents’ perspective) than the features related to the location, as most changes occurred in that group. The respondents indicated that access to medical care facilities had gained importance (+8%), while good access to public transport had declined (−9%). For the physical features of flats/houses, respondents from other countries also indicated the importance of other attributes, i.e., the floor area (+12%), number of rooms (+14%), additional rooms (+14%), and access to broadband Internet and digital platforms (+28%). The study showed that over 30% of respondents would change their flats/houses if their financial means permitted. Full article

The eye is a superficial organ directly exposed to the surrounding environment. Thus, the toxicity of nanoparticle (NP) pollutants to the eye may be potentially severer relative to inner organs and needs to be monitored. However, the cytotoxic mechanisms of NPs on the eyes remain rarely reported. This study was to screen crucial genes associated with NPs-induced retinal injuries. The gene expression profiles in the retina induced by NPs [GSE49371: Au20, Au100, Si20, Si100; GSE49048: presumptive therapeutic concentration (PTC) TiO₂, 10PTC TiO₂] and commonly used retinal cell injury models (optic nerve injury procedure: GSE55228, GSE120257 and GSE131486; hypoxia exposure: GSE173233, GSE151610, GSE135844; H₂O₂ exposure: GSE122270) were obtained from the Gene Expression Omnibus database. A total of 381 differentially expressed genes (including 372 mRNAs and 9 lncRNAs) were shared between NP exposure and the optic nerve injury model when they were compared with their corresponding controls. Function enrichment analysis of these overlapped genes showed that Tlr2, Crhbp, Ccl2, Cxcl10, Fas, Irf8, Socs3, Stat3, Gbp6, Casp1 and Syk were involved in inflammatory- and apoptotic-related processes. Protein-protein interaction network analysis revealed eight of them (Tlr2, Ccl2, Cxcl10, Irf8, Socs3, Stat3, Casp1 and Syk) were hub genes. Moreover, Socs3 could interact with upstream Stat3 and downstream Fas/Casp1/Ccl2/Cxcl10; Irf8 could interact with upstream Tlr2, Syk and downstream Cxcl10. Competing endogenous RNAs network analysis identified Socs3, Irf8, Gdf6 and Crhbp could be regulated by lncRNAs and miRNAs (9330175E14Rik-mmu-miR-762-Socs3, 6430562O15Rik-mmu-miR-207-Irf8, Gm9866-mmu-miR-669b-5p-Gdf6, 4933406C10Rik-mmu-miR-9-5p-Crhbp). CMap–CTD database analyses indicated the expression levels of Tlr2, Ccl2, Cxcl10, Fas, Irf8, Socs3, Stat3, Gbp6, Casp1 and Syk could be reversed by folic acid. Crhbp and Gdf6 were also verified to be downregulated, while Tlr2, Ccl2, Irf8, Socs3 and Stat3 were upregulated in hypoxia/H₂O₂-induced retinal injury models. Hereby, our findings suggest that Crhbp, Irf8, Socs3 and Gdf6 as well as their upstream mRNAs, lncRNAs and miRNAs may be potential monitoring biomarkers and therapeutic targets for NP-induced retinal injuries. Folic acid supplementation may be a preventive and therapeutic approach. Full article

Background: The purpose of the present study was to identify which, and to what extent, selected individual determinants of 10-year-old children may limit the final achievement in learning to swim. In view of the above, the research hypothesis was formulated that some children, despite regular attendance at swimming classes, do not achieve the learning outcomes set in the curriculum. The reason for this may be unfavorable (compared to their peers) morphological and functional characteristics, coordination motor abilities, and problems with fear of water. Methods: The study was conducted on a group of 271 students from the third grade of elementary schools who could not swim when they entered the physical education classes at the swimming pool and then participated in at least 25 swimming lessons during the school year. After these classes, the students performed swimming tests, and their somatic and functional characteristics and coordination motor abilities were measured. Results: In 46.1% of the participants, the final achievement level was lower than assumed in the school curriculum. The biggest problem for teachers and students in the initial teaching and learning to swim was the high fear of water, especially among girls. Furthermore, children characterized by lower body height and body weight, a lower sum of three skinfolds, and lower BMI had problems with progress in swimming. Despite the differences, these values did not correlate significantly with the final achievement level in swimming, except for body height in boys. Slower progress in swimming was also associated with lower vital capacity, whereas no relationship was found between final achievement level in swimming and trunk flexibility or foot mobility. However, significant correlations occurred for coordination motor abilities, as in almost all tests the participants characterized by the achievement level below the objectives set out in the curriculum performed significantly worse than children in the group with the achievement level meeting the objectives. Conclusions: In many cases, children who begin learning to swim from scratch make significant progress, but for many of them, the achievement levels are lower than the requirements set out in the school curriculum. The biggest problem for teachers and students in the initial teaching and learning to swim was the high fear of water, especially among girls. Full article