Level Of Quality Research Articles

Overlapping markets and quality competition among community health centers.

To examine the response of community health center (CHC) quality to quality levels at neighboring CHCs in the presence of non-price competition. A quasi-experimental study of US community health centers. Outcome variables were indices that measured overall quality of CHC care. Using patient flow data, we constructed CHC-specific Hirschman-Herfindahl index (HHI) and competitors' composite quality measure. The plausibly exogenous change in characteristics of "competitors' competitors" was exploited to identify the relationship between competition and quality of care, using a generalized two-stage least square model with instrumental variables. Using the Health Center Program Uniform Data System (2014-2018), linked with American Community Survey and Medical Expenditure Panel Survey, we analyzed 1098 unique federally funded CHCs in 50 states and District of Columbia which had at least one neighboring CHC and had non-missing data for 2015-2018 (4226 CHC-years). Most of CHCs served populations in overlapping geographic markets, with median market concentration decreasing during the study period. A one-percent increase in competitors' quality was associated with a 0.71-percent increase in an index CHC's composite quality (p < 0.01), consisting of a 0.59-percent increase in chronic condition control rates (p < 0.01); a 0.68-percent increase in the screening and assessment rates (p < 0.01); and a 0.78-percent increase in medication management rates (p < 0.01). The association was stronger at CHCs serving a smaller proportion of uninsured patients. No significant quality reaction was observed at CHCs with a percentage of uninsured patients larger than the 75th percentile. We observed no significant associations between HHI and quality. Increasing competition does not harm quality of care at CHCs. A CHC appears to improve its quality if its competitors improved quality. The beneficial quality effect was less pronounced in CHCs providing a significant proportion of care to uninsured patients, suggesting lack of incentives faced by these CHCs.

Examining The Impact of Macroeconomics Factors on Carbon Emissions in Selected 7-ASEAN Members: A Panel Data Analysis

This study investigates the relationships between urbanization, economic growth, energy consumption, transportation, and carbon emissions in seven ASEAN countries from 2011 to 2022. As released by the World Health Organization (WHO), more than 80 percent of the world’s population living in urban areas were exposed to air quality levels that were above the WHO limits. The region that is most affected comes from those nations categorized as low to middle-income countries. Hence, it is best to examine why these 7 ASEAN nations categorized from the lower to upper-middle income countries are not able to control the increase in the level of their carbon emissions. The analysis would also identify the appropriate empirical model suitable for the data. Using panel data analysis applying econometric modeling which are the Pooled Ordinary Least Square, Fixed Effects Model, and Random Effects Model, the findings support the Environmental Kuznets Curve hypothesis, revealing that urbanization and economic growth significantly increase carbon emissions. The study emphasizes the need for renewable energy adoption and sustainable urban planning to reduce carbon footprints. Key recommendations include enhancing energy efficiency and promoting cleaner transportation technologies to achieve sustainable economic growth in the ASEAN region.

The effect of environmental and anthropogenic factors on the microbiome of the sponge, Halichondria panicea, at three coastal sites with different bathing water quality in North east England

The breadcrumb sponge, Halichondria panicea, is a cosmopolitan marine species. Life functions, such as feeding, metabolism and defence, are maintained through microbial symbiosis. As such, perturbations to the symbiotic balance can be expected to affect the health and survival of the sponge. Although generally tolerant of environmental variables, such as temperature, pH and salinity, responses to anthropogenic factors are poorly understood. In this study, the microbial community of the H. panicea was examined over the course of 1 year. Sponge and seawater samples were collected in January, April, July and October 2022, from three locations with different levels of bathing water quality, according to the UK’s Environment Agency. Samples were sequenced using the 16S ribosomal RNA (rRNA) gene, and amplicon sequence variants (ASVs) were inferred from the generated data. Differences in bacterial diversity and abundance among sponge samples from the three locations were examined. A correlation test was used to study the effect of physical and chemical environmental factors along with faecal indicator bacteria on the abundance of the top ten most abundant bacterial phyla. Environmental factors (determined from seawater physicochemical properties) and pollution (determined from trace metals, nutrients and faecal bacteria levels) were found to play an important role in shaping the microbial community of this sponge. The sponge microbiome showed a noticeable seasonal shift, with some species flourishing in January and others emerging in April, notably the faecal and coliform bacteria. Sponge microbiomes from sites with poor-quality bathing water were generally less diverse and had lower microbial abundance, resulting in a greater range of intra-species dispersion than those of sponges living in excellent–good quality waters.

The Impact of Intellectual Property Protection on Technological Innovation - A Literature Review Incorporating New Quality Productive Forces in the Chinese Economy

Abstract: This article explores the impact of intellectual property (IP) protection on technological innovation, particularly concerning Chinas recent emphasis on high-quality productivity. The paper reviews existing literature, discussing the differences in the effects of IP protection between developed and developing countries. This literature review shows that strengthened IP protection has a positive impact on technological innovation in China, but with a nonlinear relationship. The concept of new quality productive forces focuses on achieving high levels of quality and promoting disruptive technology innovation. Combining this concept, this article analyzes the influence of IP protection on its development and provides specific policy recommendations. Future studies should focus on empirical analysis to assess the actual effectiveness of IP protection within the existing policy framework. Appropriate evaluation systems are suggested to establish, and IP laws should be gradually improved so as to effectively facilitate Chinas technological innovation and industrial advancement.

Universal Fingerprint Generation: Controllable Diffusion Model with Multimodal Conditions.

The utilization of synthetic data for fingerprint recognition has garnered increased attention due to its potential to alleviate privacy concerns surrounding sensitive biometric data. However, current methods for generating fingerprints have limitations in creating impressions of the same finger with useful intra-class variations. To tackle this challenge, we present GenPrint, a framework to produce fingerprint images of various types while maintaining identity and offering humanly understandable control over different appearance factors such as fingerprint class, acquisition type, sensor device, and quality level. Unlike previous fingerprint generation approaches, GenPrint is not confined to replicating style characteristics from the training dataset alone: it enables the generation of novel styles from unseen devices without requiring additional fine-tuning. To accomplish these objectives, we developed GenPrint using latent diffusion models with multimodal conditions (text and image) for consistent generation of style and identity. Our experiments leverage a variety of publicly available datasets for training and evaluation. Results demonstrate the benefits of GenPrint in terms of identity preservation, explainable control, and universality of generated images. Importantly, the GenPrint-generated images yield comparable or even superior accuracy to models trained solely on real data and further enhances performance when augmenting the diversity of existing real fingerprint datasets.

Harnessing the potential of exemplars to facilitate learning: insights from translation training

Exemplars are key examples chosen to represent designated levels of competence or quality. This study attempts to explore the use of exemplars in a Chinese-English translation teaching context. It involved the teacher-researcher using three exemplars of different quality to help 31 third-year translation majors evaluate their own translation and generate internal feedback. Drawing on multiple sources of data, including student self-assessment, reflective journal writings, and questionnaire responses, we have found that mediated exemplar use could help students make more accurate evaluative judgement of their own translation work and generate internal feedback at various levels (task, discipline, meta-cognitive, and affective). The significance of this research lies in illustrating the potential of exemplar use in facilitating learning, and offering pedagogical implications for productive exemplar-based practice in higher education contexts.

Relationship between parameters of the urethrovesical segment and quality of life in women with stress urinary incontinence

Aim of the study. To determine the relationship between ultrasound parameters of the urethro-vesical segment and the quality of life of women with stress urinary incontinence before and after surgical treatment. Materials and methods. We studied the quality of life and the severity of symptoms according to the UDI-6, I-Qol, IIQ-7, ICIQ-SF questionnaires, as well as ultrasound examination of the urethro-vesical segment in 40 women with stress urinary incontinence before and after surgery for the period 2023-2024. Correlation analysis among the listed indicators was performed. The mean age in the analyzed group was 49.7±9.7 years. Results and discussion. There was a significant improvement in postoperative quality of life scores for all the questionnaires used. There was a direct correlation between UDI-6 and urethral diameter in the Valsalva test, between IIQ-7 and the distance between the pubic symphysis and the bladder neck in the Valsalva test, the severity of symptoms according to the ICIQ-SF scale and the size of the posterior urethro-vesical angle at rest before surgery. After surgery, an inverse correlation was found between the distance from the pubic symphysis to the bladder neck in the Valsalva test and the data of the I-Qol questionnaire, as well as I-Qol and the values of the posterior urethro-vesical (β) angle in the Valsalva test. A direct correlation was found between the distance from the pubic symphysis to the bladder neck in the Valsalva test and the results of the IIQ-7 questionnaire, as well as between the β-angle value and the severity of symptoms according to the ICIQ-SF questionnaire. Conclusions. The results of the analysis confirmed the researchers' hypothesis that ultrasound parameters of the urethro-vesical segment correlate with the severity of symptoms and the level of quality of life in patients with stress urinary incontinence before and after surgical treatment.

Exploring the long-term disability outcomes in Trauma patients: study protocol

ObjectivesTrauma registries are essential tools for improving trauma care quality and efficiency, but many fail to capture long-term patient-reported outcome measures (PROMs). Focusing on these outcomes is crucial for understanding the extent of disability patients experience and identifying potential post-discharge interventions to optimize recovery. Studies reflecting the experience from low- and middle-income countries in this area are limited. Therefore, we aim to develop a digital trauma registry in Pakistan to prospectively capture patient-reported outcome measures at one, three, six, and twelve months post-injury.MethodsWe will develop and implement a digital trauma registry at two tertiary care facilities in Karachi, Pakistan: Aga Khan University Hospital and Jinnah Postgraduate Medical Center. The registry will include all admitted adult trauma patients (≥ 18 years). Data collection will be conducted digitally using tablets, with mortality, level of disability, functional status, and quality of life as primary outcomes. Follow-up data will be collected through telephone interviews with patients and caregivers. We will employ descriptive statistics to summarize participant’s socio-demographic and clinical characteristics. Additionally, we will perform survival analysis using Kaplan-Meier curves and Cox proportional hazard models and utilize mixed-effects linear regression to adjust for potential confounders for primary outcomes.DiscussionThe trauma registry will fill the current gap in knowledge regarding long-term outcomes among trauma patients in low- and middle-income countries (LMICs). This study will delineate future direction for capturing post-discharge data, enhancing our understanding of recovery, and informing the design of interventions aimed at improving long-term outcomes.

International comparison and assessment of the quality of drug clinical trial implementation in China based on scientific regulatory system

Objective: To analyze the international status and level of clinical trial quality in China, and explore the advantages and value of scientific regulation of clinical research quality in China. Methods: The data is sourced from the relevant reports publicly released by the National Medical Products Administration (NMPA), the inspection reports and announcements published by the Center for Food and Drug Inspection of the NMPA, the inspection data displayed on the official website of the U.S. Food and Drug Administration (FDA), as well as clinical diagnosis and treatment guidelines issued by the National Comprehensive Cancer Network (NCCN) of United States and the Chinese Society of Clinical Oncology (CSCO) (data as of July 21, 2023). This data provides an analysis of the regulatory status of the implementation of clinical drug trials in China, inspection data, and the approval and market entry of new oncology drugs and feedback from their practical application. Results: The clinical trial quality inspection systems of China and the United States are generally aligned, with similar inspection subjects, focus areas, and public disclosure pathways. However, each has its characteristics in terms of inspection targets and types. The quality of clinical trial data in China has been continuously improving. Between 2009-2015 and 2016-July 2023, China underwent 25 and 20 FDA Bioresearch Monitoring (BIMO) inspections, respectively. The inspection results showing "No Action Indicated" (NAI) improved from 48.0% to 85.0%, while "Voluntary Action Indicated" (VAI) decreased from 44.0% to 15.0%. Official Action Indicated (OAI) measures were required in 2009 and 2012. Compared to the 2009-2015 period, there has been a clear upward trend in the quality of clinical trial data since 2016. From 2016 to July 2023, the number of new oncology drugs developed by Chinese pharmaceutical companies and included in professional guidelines has steadily increased. Specifically, 37 drugs (58.7%) were included in the 2022 edition of the CSCO guidelines, and 15 drugs (23.8%) were included in the 2023 edition of the NCCN guidelines, with 10 of these drugs featured in both guidelines. Conclusions: The implementation quality of clinical trials in China has gained a certain level of international recognition and competitiveness. This progress is attributed to national macro-level guidance, a unique institutional model, and clinical practices aligned with international standards. In the future, it will be necessary to further strengthen the scientific regulatory system and enhance clinical research capabilities to continue advancing the high-quality development of clinical trials.

Lifestyle and BMI Changes after the Release of COVID-19 Restrictions: Do Humans Go ‘Back to Normal’?

Humans adapt their life history strategy and lifestyle behavior to the environment. The social restrictions during the COVID-19 pandemic in the years 2020–2021 led to changes in diet and physical activity habits in large parts of populations worldwide. Additionally, many people reported an increase in body weight during the pandemic. We investigated how diet quality, physical activity, and BMI changed since the end of the COVID-19 restrictions in Switzerland (2019–2023). We assessed diet and physical activity using a standardized questionnaire. We measured anthropometry and BMI using a stadiometer and a balance of a medical bioimpedance analyzer. Our results show a stable BMI in men and women during the pandemic. In both sexes, diet quality and physical activity levels did not change significantly during this time. Among women, physical activity and age were associated with BMI, while in men, apart from physical activity, high diet quality and living in the agglomeration were associated with BMI. Overall, we did not find evidence for a transient “unhealthier” lifestyle immediately after the COVID-19 pandemic. However, we found constituent sex differences in BMI determinants. Our results could indicate a higher resilience in highly educated persons and might contribute to more personalized approaches to prevent obesity.

The effect of psychoeducation-based intervention on sleep quality and anxiety level in third trimester pregnant women: a randomized controlled trial

The effect of psychoeducation-based intervention on sleep quality and anxiety level in third trimester pregnant women: a randomized controlled trial

Comparison of different concentrations atropine in controlling children and adolescent myopia: an umbrella review of systematic reviews and meta-analyses.

To evaluate the myopia control effect of different concentrations atropine in children and adolescent. Meta-analyses and systematic reviews available in the Pubmed, Embase, and Cochrane Library databases from the databases' inception to August 2023 were searched to evaluate the efficacy and tolerability of different concentrations' atropine in controlling myopia progression. Overall effects were performed using random-effects model. AMSTAR 2 tool was used to assess the quality of included studies. Prespecified outcomes were weight mean difference (WMD) with 95% credible interval (95% CI) of annual spherical equivalent refraction (SER) changes and annual axial length (AL) changes. 19 systematic reviews/meta-analyses of different atropine concentrations were included in the analysis. 14 studies reported SER changes, and 17 reported AL changes. In terms of the studies' overall methodological quality level (measured using AMSTAR 2), 1 study was rated high, 7 moderate, 7 low, and 4 critically low. The 0.01% atropine was found to have statistically significance (annual SER change WMD 0.27 [95% CI 0.21 - 0.34] D/year; annual AL change WMD -0.09 [95% CI -0.1 to -0.07]) mm/year), 0.05% atropine was preferred considering efficacy and tolerability (annual SER change WMD 0.54 [95% CI 0.49 - 0.58] D/year; annual AL change WMD -0.21 [95% CI -0.12 to -0.02]) mm/year). Different atropine concentrations alleviated children and adolescent myopia progression. However, higher-quality evidence and further investigation are needed to clarify the dose-response relationship, and practical guidelines must be developed to determine myopia control efficacy.

Development, field testing, and initial validation of an adherence rubric for caregiver coaching

IntroductionThe translation and use of evidence-based practices (EBPs) within early intervention (EI) systems presents challenges. The Office of Special Education (OSEP) has emphasized results-driven accountability to expand state accountability from compliance to also include quality services that align with EBPs. OSEP’s results-driven accountability provided states the opportunity to design State Systemic Improvement Plans (SSIP) to strengthen the quality of EI services by increasing the capacity of EI systems to implement, scale-up, and sustain use of EBPs. Caregiver coaching is widely accepted as an EBP within EI settings, yet uptake and fidelity to coaching practices remains limited. Such widespread implementation of caregiver coaching is partially limited by a lack of measurement tools that operationalize behaviors consistent with coaching. In this study, we describe the development of the Kentucky Coaching Adherence Rubric-Revised (KCAR-R) and psychometric testing of the instrument.MethodsWe developed and tested the KCAR-R to measure fidelity of coaching practices within a state-wide professional development program, the Coaching in Early Intervention Training and Mentorship Program. We define operational elements of the KCAR-R and rubric design elements related to: creators; users and uses; specificity, judgment complexity; evaluative criteria; quality levels; quality definitions; scoring strategies; presentation; explanation; quality processes; accompanying feedback information; secrecy; and exemplars. With regard to psychometric validation of the KCAR-R, interrater reliability was analyzed using intraclass correlation coefficients across eight raters and 301 randomly selected video submissions. Internal consistency was evaluated using Cronbach’s alpha across 429 video submissions.ResultsResults showed 0.987 agreement, indicating excellent interrater reliability; item level internal consistency values ranged from 0.860 to 0.882. for scale if item deleted and 0.834 for the total scale.DiscussionFindings from this study showed that the KCAR-R operationalized behaviors that exemplify caregiver coaching and may serve as a resource for other states or programs to document the quality and fidelity of evidence-based EI services. To influence EI provider practices at a systems level, we used implementation science to guide our work and provide examples of how EI systems seeking ways to create sustainable quality services may build upon our approach.

Understanding the effect of occupational stress on sleep quality in firefighters: the modulating role of depression and burnout.

Sleep quality of firefighters can be negatively affected by occupational stressors. A cross-sectional investigation was conducted to understand how work-related stress, post-traumatic stress, burnout and depression collectively contribute to sleep quality. Professional firefighters in Northern Iran completed a survey comprised of demographic information, the Pittsburgh Sleep Quality Index, HSE's Stress Indicator Tool, the Posttraumatic Stress Disorder Checklist, Maslach's Burnout Inventory, and the Beck Depression Inventory during a work rest break. Data were analysed using structural equation modelling. Mean age of the 2339 firefighters who completed the survey was 32.30 (5.74) years. Most experienced poor sleep quality, scoring above the established cut-off of 5. Levels of work-related stress, post-traumatic stress, burnout and depression were high. Fit indices of the final theoretical model were all adequate: the obtained and adjusted goodness-of-fit indices were 0.925 and 0.917 respectively. Comparative, and incremental fit indices were 0.946 and 0.948 respectively. Root mean squared error of approximation was 0.061. Post-traumatic stress was directly and indirectly related to sleep quality through eight paths, modulated by burnout variables and depression. Work-related stress was negatively related to sleep quality through four paths modulated, by burnout variables and depression. The findings illustrate the complex relationships of work-related stress and post-traumatic stress and sleep quality. High levels of poor sleep quality in this occupation emphasise the need to develop targeted and sustainable interventions to manage occupational stressors, burnout and depression to improve sleep quality in firefighters.

The impact of visionary leadership on product quality from the perspective of quality assurance managers in small and medium-sized companies: the mediating role of continual improvement

PurposeA review of relevant literature supported the need to examine the nature of the relationships (if any) between visionary leadership, continual improvement and product quality. This study examined the relationship between visionary leadership and product quality and investigated the mediating role of continual improvement in the relationship between visionary leadership and product quality.Design/methodology/approachVisionary leadership, continual improvement and product quality were measured through a questionnaire developed based on a theoretical framework derived from the literature and distributed to quality assurance managers in small and medium-sized companies in the engineering, electrical and information technology sectors in Jordan.FindingsThe results indicated that the levels of visionary leadership, continual improvement and product quality are good and more from the perspective of quality assurance managers in these companies. The results also indicated that there is a positive, statistically significant relationship between visionary leadership and continual improvement and between continual improvement and product quality. Moreover, the results indicated that the relationship between visionary leadership and product quality is partially mediated by continual improvement. This indicates that there is a direct, positive and statistically significant relationship between visionary leadership and product quality.Originality/valueTo the author’s knowledge, this is the first study that examined the relationship between visionary leadership, continual improvement and product quality and investigated the mediating role of continual improvement in the relationship between visionary leadership and product quality. This study concluded that visionary leadership is the driver of all improvement initiatives and activities, which in turn improve the final products. The study contributes to the literature by revealing that visionary leadership leads to continual improvement and thus product quality, supporting the sequential relationship between them. Accordingly, the study provides useful theoretical insights and practical implications.

The actor-partner interdependence model of fertility stress and marital quality among couples undergoing in vitro fertilization and embryo transfer: The mediating role of dyadic coping.

To explore the relationships among fertility stress, dyadic coping and marital quality in couples undergoing in vitro fertilization-embryo transfer (IVF-ET). Couples receiving IVF-ET treatment at the clinic of the reproductive medicine centre of a hospital in China from February 2023 to October 2023 were selected by convenience sampling. A general information questionnaire, the Infertility Fertility Stress Scale (COMP-FPSS-SF), the dyadic coping inventory, and the marital adjustment test were used to evaluate the results. AMOS24.0 software was used to construct an actor-partner interdependence model that extended to mediation to analyze the relationships among couples' fertility stress, dyadic coping, and marital quality. The fertility stress level of IVF-ET wives was significantly higher than that of their husbands (p<0.05). Wives' levels of dyadic coping and marital quality were significantly lower than those of husbands (p<0.05). Fertility stress, dyadic coping, and marital quality were positively correlated between IVF-ET couples (p<0.01). In terms of the actor effect, the fertility stress of IVF-ET couples had a significant impact on their marital quality through their dyadic coping (β=-0.188, p<0.05; β=-0.109, p<0.05). In terms of partner effects, wives' fertility stress significantly affected their husbands' marital quality through their own or their husbands' dyadic coping (β=-0.055, p<0.01; β=0.157, p<0.01). Dyadic coping mediates the relationship between fertility stress and marital quality in IVF-ET couples. Nurses can use husbands and wives as central individuals and dyadic coping as the starting point to formulate intervention measures to reduce fertility stress and improve marital quality.

Social Support and Quality of Life in Hemodialysis Patients: A Comparative Study with Healthy Controls

Background and Objectives: Hemodialysis patients face significant physical and psychological challenges, including diminished quality of life and reduced social support. This study aimed to assess the levels of social support and quality of life in hemodialysis patients and identify the sociodemographic and dialysis-related factors influencing these outcomes. Materials and Methods: This study included 115 hemodialysis patients and 107 healthy controls. Social support was measured using the Modified Social Support Survey (MSSS) and its abbreviated version (MSSS-5). Quality of life was assessed using the WHOQOL-BREF questionnaire. Demographic variables (age, sex, education, marital status) and dialysis-related factors (session duration, Kt/V, vascular access type, and urea reduction ratio) were analyzed to determine their effects on social support and quality of life. Results: Hemodialysis patients reported significantly lower scores in the Physical Health and Psychological Health domains of the WHOQOL-BREF compared to healthy controls. Males on hemodialysis scored lower than the controls in the Physical Health, Psychological Health, and Environment domains of the WHOQOL-BREF and the Affectionate Support and Positive Social Interaction subscales of MSSS. Conversely, hemodialysis females reported higher scores for Tangible Support, Emotional/Informational Support, and Affectionate Support. Longer dialysis sessions negatively impacted the Social Relationships domain. Married hemodialysis patients had higher Emotional/Informational Support and Affectionate Support scores. Conclusions: Hemodialysis patients experience diminished physical and psychological quality of life, particularly males. Social support, especially emotional and informational support, is crucial for hemodialysis patients, with marital status playing a key role. Addressing these psychosocial factors may improve outcomes for hemodialysis patients.

Reflections on Teachers’ Professional Ethics in Colleges and Universities

Teachers in colleges and universities are the nurturers of the core talents of the country. Teachers’ comprehensive quality levels in colleges and universities fundamentally determine the quality of talent cultivation in colleges and universities, the level of scientific research, and the contribution to society. Based on moral cultivation and teachers’ professional moral cultivation, this paper discusses the problems in the professional moral cultivation of college teachers and the measures to improve the professional moral cultivation of college teachers.

Factores de riesgo y protección para la ideación e intento de suicidio en adolescentes y jóvenes latinoamericanos: revisión sistemática

Suicidal behavior is constituted as a public health problem, and the literature is recognized extensively for enunciating risk and protection factors associated with the attempt of suicide. The evaluation of the methodological quality of the primary studies is required by systematic reviews, thus guiding decision-making regarding the design of interventions from the risk approach. The identification of the risk and protective factors associated with suicidal ideation and attempts in adolescents and young people in Latin America studies and the evaluation of the methodological quality of the included studies were the objectives of this systematic review. The databases CUIDEN, LILACS, Pubmed, Scielo, Science Direct, SCOPUS, EBSCO, and Medline were consulted, with the results being restricted to articles in the last 10 years.A total of 3,642 documents were obtained, from which 19 studies were included. Of the studies, 52.63% (n=10) were found to have a medium internal validity level, and 57.89% (n=11) were determined to have a medium global quality level. The most frequently reported family risk factors were family dysfunction and suicide background, with other factors including the presence of mental disorder, psychoactive substances consumption, physical violence, sexual violence, and the social factor.On the other hand, the study of protective factors was found to be limited, with family functionality and support being the most frequently reported evidence.

Air quality disparities and respiratory health risks in critically polluted and relatively non-polluted areas: a prospective child health study.

Air pollution, a significant global health concern, notably impacts human well-being. Children, owing to their distinctive physiology and behavior, are particularly susceptible to its adverse effects. This prospective study examines air quality variations and respiratory risks in children residing in critically polluted areas (CPA) compared to relatively non-polluted areas (NPA), utilizing a prospective design to understand the impacts of air pollution on children's respiratory health, including measures like relative risk (RR) and attributable risk (AR). This prospective study tracked 739 students of 5th- 7th grade residing in CPA and NPA for one year, and measured the ambient and indoor air quality levels in both these areas. Throughout the study, based on the observed respiratory symptoms new episodes of upper and lower respiratory tract illnesses were recorded for each child on a weekly basis. Incidence rate, RR and AR for both the illnesses were compared. Statistical analysis was performed with SPSS 26.0. The study observes higher concentration for particulate matter and gaseous pollutants at CPA in comparison to NPA. Children living in CPA exhibited a notably greater weekly occurrence of both upper and lower respiratory tract illnesses compared to those in NPA, with RR of 1.26 (95% CI: 1.16-1.37) and 1.74 (95% CI: 1.34-2.27), respectively. The AR associated with air pollution for upper and lower respiratory tract illnesses among CPA students was found to be 20.7% and 42.7%, respectively. This research underscores the pressing need to address air pollution in critically polluted areas and its profound effects on children's respiratory health. Public health interventions, such as reducing emissions from industries and creating green spaces, should be prioritized. Furthermore, early respiratory health screening in schools within polluted areas could aid in the timely diagnosis and management of respiratory issues in children.