Search Results (266)

Background/Objectives: Thirst is a common and distressing symptom experienced by individuals undergoing hemodialysis. It can affect patients’ comfort, adherence to fluid restrictions, and overall quality of life. Understanding how patients perceive and cope with thirst is essential for developing evidence-based nursing interventions that enhance patient comfort and support adherence to care recommendations. Aim: To investigate the perceptions, experiences, and perceived factors related to thirst among hemodialysis patients using a mixed-methods design. Methods: This study adopted a convergent parallel mixed-method design. Quantitative data were obtained from 72 hemodialysis patients using the Thirst Discomfort Scale and a structured questionnaire. Qualitative data were collected through in-depth semi-structured interviews with 22 patients. Data were analysed using SPSS 23.0 for the quantitative phase and descriptive phenomenological analysis (Colaizzi’s method) for the qualitative phase to explore underlying perceptions and experiences. Results: Quantitative findings indicated substantial thirst discomfort, reflected by elevated Thirst Discomfort Scale and VAS scores. Qualitative findings highlighted persistent dry mouth, emotional distress, perceived loss of control, and coping strategies such as limiting fluids, distraction, oral rinsing, consuming cold items, and faith-based coping. On integration, qualitative narratives aligned with the high burden captured by quantitative scores, underscoring the multidimensional nature of thirst in hemodialysis. Conclusions: This study demonstrates that thirst in hemodialysis patients is a multidimensional experience encompassing physiological, psychological, and behavioural components. The findings highlight the need for individualised, holistic nursing approaches that extend beyond fluid restriction alone. Relevance to clinical practice: Nurses should adopt holistic approaches addressing emotional and spiritual dimensions of thirst management, providing individualised education and psychosocial support. Full article

Reducing energy demand and carbon emissions in residential buildings requires more than technological upgrades; it demands a nuanced understanding of occupant behaviour. Residential energy use is shaped by both physical design and human actions, yet behavioural factors remain underexplored, contributing to the energy performance gap. This study addresses this issue by developing and validating a behavioural framework grounded in the Theory of Planned Behaviour (TPB) to examine how attitudes, social norms, perceived control, and environmental awareness influence energy-related decisions. Data were collected through an online survey of 310 households in metropolitan Sydney and analysed using Stata v17 software employing principal component analysis and regression modelling. Results reveal that environmental awareness is the most significant predictor of pro-environmental intention, which strongly correlates with actual behavioural outcomes. While attitudes and perceived control were generally positive, subjective norms and awareness remained moderate, limiting behavioural change. The proposed framework demonstrates strong validity and reliability, offering a practical tool for policymakers, designers, and educators to integrate behavioural insights into sustainable building strategies. By prioritising awareness campaigns and normative interventions, stakeholders can complement technical retrofits with behavioural measures, accelerating progress towards low-carbon housing and benefiting both households and the broader community. Full article

Background/Objectives: Urinary tract infections (UTIs) are the primary indication for antibiotic use in nursing homes (NHs); yet inappropriate prescribing, including incorrect initiation, excessive prophylactic prescribing and prolonged treatment duration, is common. This study aimed to identify key determinants of appropriate antibiotic prescribing for UTIs in NHs by exploring the behaviours and perspectives of relevant stakeholders. Methods: Interviews and focus group sessions with regard to a purposive sample of 4 NHs and healthcare professionals were conducted between June 2023 and April 2024 in Flanders (Belgium). The topic guide was developed based on the Theoretical Domains Framework (TDF). A combination of deductive and inductive coding was used to identify behavioural determinants within each TDF domain. Key behavioural determinants were identified based on their importance, relevance, and feasibility. Results: We conducted 31 semi-structured interviews with residents/relatives (n = 13), physicians (n = 9), pharmacists (n = 10), and NH management (n = 5) and held 4 focus group sessions with nurses (n = 16) and nurse aides (n = 10). Appropriate antibiotic prescribing for UTIs in NHs was influenced by a complex interplay of behavioural determinants. Key behavioural determinants included lack of knowledge of guidelines, lack of self-reflection and monitoring, fear of missing complications, feelings of powerlessness, prioritising residents’ comfort, hierarchical relations with treating physicians being dominant, social pressure to prescribe, and the NH as a challenging context. Conclusions: This study identified key behavioural determinants that should be targeted to optimise antibiotic prescribing for UTIs in NHs. These findings underscore the need to conduct a theory-informed, multifaceted intervention to support behaviour change across professional roles and improve antimicrobial stewardship in this setting. Full article

Automatic Train Operation (ATO) systems are widely deployed in metro networks to improve punctuality, service regularity, and ultimately the sustainability of rail operation. Although eco-driving optimisation has been extensively studied, no previous work has provided a systematic, side-by-side comparison of the two ATO control philosophies most commonly implemented in metro systems worldwide: (i) Type 1, based on speed holding followed by a single terminal coasting at a kilometre point, and (ii) Type 2, which uses speed thresholds to apply either continuous speed holding or iterative coasting–remotoring cycles. These strategies differ fundamentally in their control logic and may lead to distinct operational and energetic behaviours. This paper presents a comprehensive comparison of these two ATO philosophies using a high-fidelity train movement simulator and Pareto-front optimisation via a multi-objective particle swarm algorithm. 40 interstations of a real metro line were evaluated under realistic comfort and operational constraints, and robustness was assessed through sensitivity to three different passenger-load variations (empty train, nominal load and full load). Results show that, once nominal profiles are implemented, Type 1 has up to 5% variability in running times, and Type 2 has up to 20% variability in energy consumption. In conclusion, a new ATO deployment combining both strategies could better balance energy efficiency and timetable robustness in metro operations. Full article

The design-related behaviour of structural dynamics for electric-assisted bicycle (e-bike) drive units significantly influences the mechanical system—e.g., vibrations and durability, stresses and loads, or functionality and comfort. Identifying the underlying mechanical principles opens up optimisation possibilities, such as improved e-bike design and user experience. Despite its potential to enhance the system, the structural dynamics of the drive unit have received little research attention to date. To improve the current situation, this paper uses a flexible multibody modelling approach, enabling new insights through virtual trials and analyses that are not feasible solely from measurements. The incorporation of the drive unit’s system-level topology regarding mass, moment of inertia, stiffness, and damping enables the analysis of critical system states. Experiments accompany the analysis and validate the model by demonstrating a load-dependent shift of the first torsional mode around 35 Hz to 60 Hz, capturing comparable resonance frequency ranges up to 6 kHz, and yielding qualitatively consistent peak positions in both steady-state and ramp-up analyses (mean deviations of 0.03% and 0.06%, respectively). Theoretical considerations of the multibody system highlight the effects, and the stated modelling restrictions make the method’s limitations transparent. The key findings are that the drive unit’s structural dynamic behaviour exhibits solely one structural mode until 0.5 kHz, and further 27 modes up to 10 kHz, solely originating due to the multibody arrangement of the drivetrain. These modes are also load-dependent and lead to resonances during operation. In summary, the approach enables engineers, for the first time, to significantly improve the structural dynamics of the e-bike drive unit using a full-scale system model. Full article

Background/Objectives: Trauma-related distress poses significant mental health challenges, with psychotherapy serving as a primary intervention. The Walters Method is a promising new alternative that may help where traditional methods fall short (i.e., in complex or violent cases), but before it can be implemented widely, the existing evidence on the effectiveness of other psychotherapies for trauma-related distress must be mapped to see how and where it relates to other techniques. The aim of this scoping review was to provide an overview of existing evidence on the effectiveness of psychotherapy for trauma-related distress. Methods: A scoping review was conducted to better understand the effectiveness of psychotherapies for trauma-related distress (including PTSD, acute stress disorder, or other serious mental health issues). Results: Thirty-three articles were analysed. Included articles included adults with PTSD, incarcerated women, childbirth trauma survivors, female survivors of sexual abuse, hospitalised COVID-19 patients, adults with serious mental illness, veterans and active soldiers, firefighters, and refugees. Eye Movement Desensitisation and Reprocessing and Cognitive Behavioural Therapy were the most studied and effective treatments. Prolonged Exposure and Narrative Exposure Therapy were less common but noteworthy. Other therapies, including psychodynamic approaches, are seldom studied but have proven effective when explored, highlighting knowledge gaps and potential missed opportunities. Success with these alternative approaches—especially in complex trauma cases like intimate partner violence or child loss where EMDR and CBT may be less effective—suggests they have potential, but further research is needed for validation. Conclusions: This review offers novel contributions to the field by emphasising innovative therapeutic perspectives that extend beyond traditional, more studied, evidence-based approaches such as CBT and EMDR, thereby expanding treatment options for diverse clinical presentations. Alternative therapies show promise, particularly for complex trauma cases like intimate partner violence or child loss where established approaches may be less effective; however, further research is needed to validate their efficacy across diverse populations. Selection of psychotherapy should be based on clients’ goals and comfort, and the cultural and contextual compatibility between the person and intervention. Future research should prioritise underexplored therapies to address current knowledge gaps and improve treatment accessibility for varied clinical needs. Full article

Multi-objective optimisation is essential for balancing building energy efficiency and thermal comfort. Existing research primarily focuses on passive optimisation strategies that assume fixed behavioural patterns of a ‘rational occupant’. However, these studies often overlook the impact of stochastic occupant behaviour on building energy efficiency and thermal comfort. Furthermore, they fail to consider the inherent randomness, variability, dynamic nature, and feedback mechanisms of individual actions. As a result, this oversight can lead to suboptimal energy efficiency, insufficient thermal comfort, and a poor user experience. This study examines a naturally ventilated research building equipped with split-type air conditioning in China’s hot summer and cold winter climate zone. The research develops a rapid prediction model for air conditioning (AC) energy consumption and thermal comfort based on actual HVAC behaviours, incorporating the AC and natural ventilation (NV) operation schedules. The model utilises Artificial Neural Networks (ANNs), importance analysis, and batch simulation. Furthermore, a multi-objective optimisation decision-making model is developed to balance building AC energy consumption and indoor environmental thermal comfort, using the NSGA-II algorithm. The results indicate that when building design parameters comply with the current energy-saving design standards, behavioural optimisation can lead to a 31.4% reduction in energy use for building AC systems while enhancing thermal comfort by 37.5%. Furthermore, by implementing integrated optimisation strategies, comfort can be improved by as much as 92.6% without raising energy consumption. Full article

This review synthesises fault detection and diagnosis (FDD) methods for robotic actuation in healthcare, where precise, compliant, and safe physical human–robot interaction (pHRI) is essential. Actuator families—harmonic-drive electric transmissions, series-elastic designs, Cable/Bowden mechanisms, permanent-magnet synchronous motors (PMSM), and force–torque-sensed architectures—are mapped to characteristic fault classes and to sensing, residual-generation, and decision pipelines. Four methodological families are examined: model-based observers/parity relations, parameter-estimation strategies, signal-processing with change detection, and data-driven pipelines. Suitability for pHRI is assessed by attention to latency, robustness to movement artefacts, user comfort, and fail-safe behaviour. Aligned with ISO 14971 and the IEC 60601/80601 series, a validation framework is introduced, with reportable metrics—time-to-detect (TTD), minimal detectable fault amplitude (MDFA), and false-alarm rate (FAR)—at clinically relevant thresholds, accompanied by a concise reporting checklist. Across 127 studies (2016–2025), a pronounced technology-dependent structure emerges in the actuator-by-fault relationship; accuracy (ACC/F1) is commonly reported, whereas MDFA, TTD, and FAR are rarely documented. These findings support actuation-aware observers and decision rules and motivate standardised reporting beyond classifier accuracy to enable clinically meaningful, reproducible evaluation in contact-rich pHRI. Full article

Mixed-use development (MXD) is crucial for urban planning and travel. The COVID-19 outbreak had a significant impact on travel behaviour and MXD projects worldwide, particularly in high-income countries. However, limited studies have explored the predictors of MXD usage and travel patterns in low- and middle-income countries, including Malaysia, and how these events were affected by COVID-19. Using the Rowley and extended Hopenbrouwer and Louw models, this study investigates the travel patterns within MXD premises, their associated factors, and residents’ perspectives of internal and external trips before and during COVID-19 in Klang Valley, Malaysia. A mixed-method study was conducted by using a validated survey and performing a structured interview with MXD residents. A total of 134 and 52 respondents participated in the survey and qualitative interviews, respectively. Data were analysed using descriptive statistics, logistic regression models, and thematic analysis. A significantly higher proportion of MXD respondents engaged in external travel compared to internal travel before and during COVID-19. Before COVID-19, external travel was significantly higher among younger residents, government servants, higher-income earners, and those who owned a car and had recently moved to MXD areas. The odds of internal travel were significantly higher among private-sector employees, students, and low-income earners. During the pandemic, external travel frequency was significantly higher among male residents, older residents, government servants, high-income earners, and those with multiple vehicles. Residents with more parking lots tended to travel less internally compared to those with fewer parking lots allocated. Qualitative analyses revealed that cost-saving, convenience and comfort, social lifestyle, health and well-being, and green environment were the factors that shaped MXD residents’ perceived benefits of trip internalisation. Meanwhile, the barriers to internal trips included the lack of infrastructure, poor management, lifestyle activities/individual factors, and environmental factors. The recommended strategies to reduce external trips were to ensure diversified services and accessibility, inclusiveness in planning activities, promoting social interaction, and work-from-home policies. These findings reflect the strategies that can be incorporated to reduce external trips generated by MXD and enhance effective traffic management. Full article

The global drive toward sustainability and energy efficiency has accelerated the development of smart buildings integrating the Internet of Things (IoT) and Artificial Intelligence (AI). These technologies optimise energy use, enhance occupant comfort, and advance building management systems. This study examines the integration of IoT and AI in energy-efficient smart buildings, emphasising applications and challenges. A qualitative methodology, combining systematic literature review, case study analysis, and systems analysis, underpins the research. Findings indicate that IoT enables smart metering, real-time energy monitoring, automated lighting and HVAC, occupancy-based energy optimisation, and renewable energy integration. AI complements these functions through predictive maintenance, energy forecasting, demand-side management, intelligent climate control, indoor air quality automation, and behaviour-driven analytics. Together, they reduce carbon emissions, lower operational costs, and improve occupant well-being. However, challenges remain, including data security and privacy risks, interoperability gaps, scalability and cost constraints, and retrofitting difficulties. To address these, the paper proposes a systems thinking-enabled conceptual framework structured around three pillars: adopting IoT and AI as enabling technologies, overcoming integration barriers, and identifying application areas that advance sustainability in smart buildings. This framework supports strategic decision-making toward net-zero and resilient building design. Full article

The amount of attention paid to the welfare of animals and their maintenance conditions has grown considerably in recent years. This paper examines the effects of extensive and intensive housing systems on the environmental, behavioural, health, nutritional and social aspects of sheep welfare. It presents the current state of knowledge regarding this welfare, and its significant contributing factors, based on a search of PubMed, Web of Science, Google Scholar and Scopus using defined keywords. It compares the impact of the two systems on the physical, psychological and social comfort of the animals, and identifies husbandry practices conducive to improving welfare. In doing so, it pays particular attention to the role of social bonding and the importance of grooming interventions. The paper reviews the factors shaping welfare in different production systems, with a particular focus on extensive and intensive rearing. It demonstrates that while the extensive system is conducive to the realisation of natural behaviour and the formation of social bonds, it can also be associated with a higher risk of nutritional deficiencies and environmental stressors. In contrast, an intensive system allows better control of health and nutrition, but often limits the ability to meet behavioural needs. The study also discusses the importance of feeding strategies, herd structure and thermal comfort, as well as the impact of routines such as shearing and hoof correction. It demonstrates that high levels of welfare can be achieved in both extensive and intensive systems, provided that husbandry practices are appropriately adapted to the needs of sheep as a species. Full article

The use of semi-transparent photovoltaic (Solar PV) glass in buildings is an effective strategy for integrating renewable energy generation, solar control, and thermal comfort. However, conventional simulation models rely on global optical properties, neglecting spectral radiation and its propagation within the material. This limits the accurate assessment of thermal comfort, light distribution, and performance in complex systems such as multi-layer glazing. This study presents the development, implementation, and experimental validation of a numerical model that reproduces the thermal, electrical, and optical behaviour of semi-transparent Solar PV glass, explicitly incorporating radiative transfer. The model simultaneously solves the conduction, convection, and electrical generation equations together with the radiative transfer equation, solved via the finite volume method across two spectral bands. The refractive index and extinction coefficient, derived from manufacturer-provided optical data, were used as inputs. Experimental validation employed 10% semi-transparent a-Si glass, comparing surface temperatures and electrical power generation. The model achieved average relative errors of 3.8% for temperature and 3.3% for electrical power. Comparisons with representative literature models yielded errors between 6% and 21%. Additionally, the proposed model estimated a solar factor of 0.32, closely matching the manufacturer’s 0.29. Full article

Indoor air quality (IAQ) and thermal comfort influence the health and cognitive performance of school occupants. This study investigated carbon dioxide (CO₂), nitrogen dioxide (NO₂), thermal comfort, and ventilation rates (VRs) in eight naturally ventilated (NV) primary school classrooms in Ireland during October 2024, combining environmental monitoring with teacher surveys. Mean CO₂ concentrations ranged from 796 ppm to 2469 ppm, exceeding national guidelines in seven of the eight classrooms. NO₂ levels ranged from 3.4 µg/m³ to 7.2 µg/m³, with indoor/outdoor ratios increasing with VRs and influenced by window orientation and road proximity. Indoor temperatures remained within recommended limits, while relative humidity ranged from 53% to 78% mirroring CO₂ trends and exceeding guideline levels in classrooms with lower VRs and temperatures. Occupied VRs ranged from 1.2 L/p/s to 4.1 L/p/s with window opening behaviours, reliant on teachers’ perceptions of thermal comfort, accounting for 84% to 96% of VRs. Ventilation in NV classrooms is often insufficient, yet increasing VRs can compromise thermal comfort and increase ingress of outdoor pollutants and noise. The findings highlight the ineffectiveness of current school ventilation standards, which rely heavily on user operation. Integrating occupant-led strategies, including scheduled purging, awareness campaigns, and pre-emptive air quality alerting, into policy offers practical, immediate pathways to improving IAQ, fostering healthy, sustainable learning environments. Full article

Animal welfare is increasingly recognised as a core component of sustainable dairy production, yet objective assessment at the herd level remains challenging. This study evaluated whether milk biomarkers can serve as non-invasive indicators of cow welfare. Thirty-seven dairy farms were assessed using the Welfare Quality^® protocol and various milk analysis parameters. As a first line of results, Spearman correlations revealed strong associations between milk biomarkers and welfare indicators. For example, a higher fat-to-protein ratio was linked to better feeding, lower prevalence of hunger, and improved human–animal relationships. In contrast, elevated somatic cell count and differential somatic cell count were associated with mastitis, lameness, dirtiness, and reduced emotional well-being. Using Principal Component Analysis (PCA), three dimensions were identified, health–hygiene, socio-behavioural, and metabolic stress, explaining 44.7% of variance. K-means clustering distinguished three herd profiles: feeding–metabolic balance, behavioural–comfort, and clinical–hygiene risk. These findings demonstrated that routine milk biomarkers provide integrated, non-invasive information on herd health, behaviour and, comfort. Incorporating routine milk analysis into welfare assessments can support the early detection of issues, facilitate evidence-based decision-making, and promote sustainable dairy management. Full article

Developing sustainable textile finishes that enhance moisture management and breathability remains a significant challenge in designing high-performance apparel. In this study, we propose an eco-friendly coating strategy utilizing an aqueous dispersion of poly(3-hydroxybutyrate)-diol (PHB.E.0), a member of the polyhydroxyalkanoate (PHA) family. This coating was applied to woven polyester (PES) and cotton (CO) fabrics using a low-impact spray-coating technique, aiming to improve functional properties while maintaining environmental sustainability. This solvent-free process significantly reduces chemical usage and energy demand, aligning with sustainable manufacturing goals. Successful deposition of the coating was confirmed by scanning electron microscopy (SEM), attenuated total reflectance Fourier-transform infrared spectroscopy (ATR-FTIR), elemental (C/O) analysis, and thermogravimetric analysis (TGA), which also revealed substrate-dependent thermal behaviour. Wettability, water absorption, and permeability tests showed that the coated fabrics retained their hydrophilic character. PHB.E.0 coatings led to a significant reduction in air permeability, particularly after hot pressing at 180 °C, from ≈670 to ≈171 L·m⁻² s⁻¹ for PES and from ≈50 to ≈30 L·m⁻²·s⁻¹ for CO, without compromising water vapor permeability. All coated samples maintained high breathability, essential for wearer comfort. These results demonstrate that PHB.E.0 coatings enhance wind resistance while preserving moisture vapor transport, offering a sustainable and effective solution for functional sportswear. Full article