Search Results (5,919)

Life expectancy (LE) varies widely across Organization of Islamic Cooperation (OIC) countries, reflecting differences in economic, social, environmental, and health-system conditions. This review aimed to synthesize quantitative evidence on determinants of LE at birth in OIC member countries. The study was conducted in accordance with the PRISMA guidelines, and a systematic search of electronic databases was performed up to September 2025. After screening 5312 records and assessing full texts, studies were appraised using the Joanna Briggs Institute checklists, with an inclusion threshold of ≥80%. A total of 54 studies, mainly ecological, time-series, and panel analyses using national-level data, were included. Higher gross domestic product per capita, education, employment, and health expenditure were consistently associated with longer LE. In contrast, poverty, income inequality, air pollution, and carbon dioxide emissions were associated with shorter LE. Clear differences were observed across World Bank income groups, with LE being lowest in low-income OIC countries and highest in high-income Gulf Cooperation Council states, where gains were driven more by health-system resources than by income growth. Improving LE in OIC countries requires integrated economic, social, environmental, and health-system policies. Full article

With global life expectancy steadily rising, promoting healthy aging is becoming a critical objective of public health. Physical function tends to decline gradually, often beginning in midlife, when subtle changes start to occur and accumulate undetected until later years. This study examines the feasibility of using DNA methylation-based epigenetic clocks as biomarkers for cumulative physical performance in 24 community-dwelling adults aged 39 years and older. Our findings reveal that several epigenetic age estimators, particularly DNAmAgeHannum, are significantly associated with a novel composite score criterion derived from standardized motor function assessments (DNAmAge: ρ = −0.48, p < 0.026; DNAmPhenoAge: ρ = −0.48, p < 0.026) with DNAmAgeHannum (ρ = −0.59, p < 0.005). These findings support the potential of using epigenetic aging markers to detect early physiological decline, even in relatively healthy, midlife populations, offering a promising tool for the early identification of age-related functional deterioration. Full article

Aging is a complex physiological process influenced by various factors, including individuals’ mental attitude. This interaction between biological vulnerability and psychological resources characterizes the entire life course; however, in older age, it becomes particularly salient due to the higher prevalence of multimorbidity, frailty, functional decline, and existential transitions (e.g., retirement, bereavement, loss of social roles), which intensify the impact of mental outlook on adaptation and quality of survival. Optimism has gained growing attention in clinical practice as a psychological asset associated with better health. This has also encouraged the incorporation of optimism-enhancing strategies into geriatric care. However, encouraging optimism in older patients, although well intentioned, can create ethical tensions in clinical communication, decision-making, and care planning. Sensitivity should be paid to aspects such as education, cultural background and religion within interactions with older adult patients. Uncritical promotion of optimism can undermine autonomy, foster unrealistic expectations, or place emotional burdens on patients who may already feel vulnerable. The appeal of optimism should therefore be balanced with careful ethical consideration. Full article

While previous studies have established the positive effects of minimalism on well-being, the issue of how minimalism shapes satisfaction within specific consumption contexts remains underexplored. This study investigates the relationships among minimalism, satisfaction with collaborative consumption (CC), and life satisfaction, examining the moderating role of corporate service sincerity. Drawing on goal satisfaction theory, we conceptualize minimalism as an intrinsic goal orientation that drives psychological fulfillment through value-congruent consumption. Survey data from 430 Japanese consumers with recent CC experience were analyzed using the SPSS PROCESS macro. Results indicate that minimalism positively predicts both satisfaction with CC and life satisfaction, and that these effects are amplified when the CC service is perceived as sincere. However, contrary to theoretical expectations, satisfaction with CC was negatively associated with life satisfaction, suggesting that domain-specific satisfaction in access-based consumption may not spill over to global well-being under certain conditions. We propose that this paradox reflects a boundary condition of goal satisfaction theory: when CC participation is constraint-driven rather than autonomously chosen, satisfaction may coexist with unfulfilled ownership aspirations. These findings advance the minimalist consumption literature by specifying mechanisms linking lifestyle values to consumption outcomes and offer practical guidance for sharing economy platforms seeking to engage value-driven consumers through authentic brand communication. Full article

Background. Cardiometabolic diseases (CMDs) have become a major health concern among adults living with HIV (ALWH) as antiretroviral therapy (ART) extends life expectancy. Metabolic syndrome (MetS)—a cluster of abdominal obesity, hypertension, hyperglycemia, hypertriglyceridemia, and hypoalphalipoproteinemia—is a key predictor of CMD risk. Despite high HIV prevalence in Panama, data on MetS among ALWH are scarce. Thus, the Colón C3 Study aimed to estimate the prevalence of MetS and its criteria in a large cohort of ALWH in Colón, Panama. Methods. Between April–December 2024, 659 ALWH aged ≥18 years were enrolled at the province’s sole ART Clinic (78.1% of active patients). Participants completed a computer-assisted survey on demographics and social determinants of health (SDoH), underwent anthropometry and body composition assessment, and provided ≥8 h fasting blood samples for glucose, lipid profiles, HbA1c, and high-sensitivity C-reactive protein (hsCRP). MetS was defined using NCEP-R ATP-III criteria, and analyses were stratified by sex. Results. Mean age was 43.9 (range 18–79) years; 55% were female, and 51% identified as Black/Afro-Caribbean. The overall prevalence of MetS was 38.6% (binomial 95% CI 34.5%, 42.9%), exceeding pooled estimates for ALWH in the Americas (30.4%). Among individual criteria, hypoalphalipoproteinemia (59.6%) and hypertension (52.6%) were most prevalent, followed by abdominal obesity (45.2%), hyperglycemia (33.5%), and hypertriglyceridemia (22.5%). Women exhibited significantly higher body fat mass and BMI than men. Mean hsCRP was 7.2 mg/L, indicating persistent inflammation despite virologic suppression. Socioeconomic vulnerabilities, food insecurity (30%), and housing instability (>40%) were common. Conclusions. Findings reveal a substantial cardiometabolic burden among ALWH in Colón and underscore the need for integrated HIV–CMD care models, earlier screening, and natal sex–responsive interventions. The results provide foundational evidence for improving long-term, equitable cardiometabolic outcomes in HIV care across Panama and the broader Latin American region. Full article

Background/Objectives: The comparative evaluation of health system performance is becoming increasingly critical for policy makers in the context of rising health expenditures, demographic ageing, and the deepening of health inequalities between countries. In the existing literature, a substantial proportion of studies addressing health performance either examine causal relationships based on single health outcomes or rely on a single multi criteria decision making (MCDM) method based on equal or subjective weighting. This situation may lead to limitations in terms of method sensitivity and the reliability of the resulting rankings. This study addresses an important gap in the literature by directly tackling method sensitivity through the integrated use of objective weighting and multiple ranking methods. The aim of this study is to evaluate the health system performance of OECD countries within an integrated MCDM framework based on objective weighting. Methods: The analysis covers 27 OECD countries and is based on key indicators representing health performance, such as life expectancy, avoidable mortality, infant mortality rate, and maternal mortality rate. Criterion weights are determined objectively using the CRITIC method, and country performance rankings are obtained using the MAIRCA and MARCOS methods. Results: The findings indicate that there are substantial differences in health system performance among OECD countries. The high level of consistency between the results obtained from different ranking methods supports the methodological robustness of the findings. Conclusions: In this respect, the study contributes to the literature on health system performance evaluation at both methodological and applied levels and provides policy makers with a more reliable framework for comparative analysis. Full article

Hypertrophic cardiomyopathy (HCM) is the most common genetic disease in the general population, with a variable phenotypic expression and symptomatology. Atrial fibrillation (AF) is the most common arrhythmia identified among patients diagnosed with HCM. Treatment of both AF and HCM has continuously evolved over time, leading to a significant improvement in the prognosis and life expectancy of symptomatic patients. Numerous studies have demonstrated that the risk of developing this arrhythmia correlates with atrial morphological, functional and electrical remodeling, a process known as atrial myopathy. Once a first episode of AF is diagnosed, permanent anticoagulation is required among patients diagnosed with HCM, regardless of the CHA₂ DS₂-VA score. Additionally, atrial cardiomyopathy is associated with an increased thromboembolic risk, independent of AF presence, in patients with stable sinus rhythm, in the context of atrial mechanical and endothelial dysfunction. This article aims to evaluate the current scientific evidence and treatment approaches in patients diagnosed with HCM. Full article

Urban green spaces are increasingly recognized as key elements of sustainable urban development; however, their economic implications, particularly for labor productivity, remain underexplored in developing countries. This study examines the impact of urban green spaces on labor productivity across 92 Indonesian cities over the period 2014–2024, while accounting for spatial dependence and dynamic effects. Urban green space is measured using the Normalized Difference Vegetation Index (NDVI), and labor productivity is defined as the ratio of regional economic output to employment. The analysis incorporates control variables including life expectancy, environmental quality (AOD), average years of schooling, and GDP per capita. To address spatial and temporal dynamics, this study employs a Spatial Dynamic Panel Data (SDPD) framework. The results show that urban green spaces have a positive and significant effect on labor productivity. In addition, spatial spillover effects are evident, indicating that productivity in one city is influenced by conditions in neighboring areas. Socio-economic factors, particularly health, education, and economic development, also play a significant role. These findings highlight the economic relevance of urban green infrastructure and underscore the importance of integrating environmental considerations into urban policy to enhance productivity in developing country contexts. Full article

With increasing life expectancy and an aging global population, the demand for orthopedic and dental implants is increasing. Recently developed, citric-acid-based anodization processes facilitate the production of more bioactive oxide layers by incorporating important bone minerals such as Ca, P, and Mg and forming bone-like crystalline compounds such as carbonated apatite on titanium implant materials. The primary goal of the present study was to evaluate the applicability of these anodization processes to solid and 3D-printed titanium alloy substrates. The anodized oxides produced on each solid or 3D-printed lattice substrate revealed multi-scaled surface roughness profiles as evidenced by scanning electron microscopy, optical microscopy, and surface roughness analyses. Additionally, each oxide group was shown to incorporate substantial amounts of Ca, P, and Mg bone-mineral dopants and form AB-type carbonated apatite, as shown using a combination of energy-dispersive spectroscopy, X-ray photoelectron spectroscopy, X-ray diffraction, and attenuated total reflectance–Fourier transform infrared spectroscopy analyses. Finally, each oxide group showed sustained Ca, P, and Mg ion release during an inductively coupled plasma spectroscopy dissolution assessment, and demonstrated early apatite-forming ability during simulated body fluid bioactivity testing. The findings of this study show much promise for the applicability of these novel oxide coatings to a wide variety of future titanium implant applications. Full article

The global population is ageing due to increased life expectancy, and the prevalence of diabetes is proportionally increasing. With advancing age, diabetes in older people is a complex condition due to associated morbidities and geriatric syndromes. As a result, the management of diabetes in old age is challenging. Due to the wide heterogeneity of older people, diabetes management in this age group should be personalised. While strict targets are accepted in fit individuals, relaxed targets should be considered in patients with multiple morbidities and a high risk of hypoglycaemia. The development of frailty changes the metabolic profile of older people, and their insulin resistance and diabetes trajectory, which will have an impact on the choice of glucose-lowering agents and the goals of therapy. For example, intensive therapy, the use of SGLT-2 inhibitors and GLP-1RA, and tight targets should be continued in frail, sarcopenic, obese individuals due to their increased insulin resistance and cardiovascular risk. On the other hand, relaxed targets and deintensification of therapy should be considered in anorexic, malnourished, frail individuals with significant weight loss due to their low insulin resistance, low prevalence of cardiovascular risk factors, and high risk of hypoglycaemia. Annual reviews of older people with diabetes should include screening for frailty, depression and dementia for early diagnosis, and appropriate interventions. The introduction of continuous glucose monitoring is increasingly used in older people with diabetes and has the potential to reduce the incidence of hypoglycaemia. With the expectation of a continued increase in the prevalence of older people with diabetes, the use of mobile health may allow care delivery on a wider scale without the need for face-to-face appointments. In addition, there is a promising scope for artificial intelligence to achieve better diabetes outcomes. Future research is still required to expand the use of these technologies in older age groups. Full article

Background and Objectives: Diabetes is one of the most common chronic non-communicable diseases and represents a major public health problem. At the global level, the epidemic character of diabetes mellitus can be attributed to an extended life expectancy but also to lifestyle. The aim of this study was to examine the sociodemographic, health, and lifestyle characteristics of adults with type 2 diabetes mellitus in Serbia. Materials and Methods: The research is part of the Serbian Population Health Survey conducted in the period from October to December 2019 by the Republic Statistical Office, in cooperation with the Institute of Public Health of Serbia “Dr Milan Jovanović Batut” and the Ministry of Health of the Republic of Serbia. The research instrument was standardized questionnaires constructed in accordance with the European Health Interview Survey (EHIS—European Health Interview Survey, wave 3) questionnaire, which were adapted to the specifics of our area. The research was conducted as a cross-sectional study on a representative sample of the adult population of Serbia. Results: Among 1138 adults with type 2 diabetes in Serbia (52.8% female; mean age 66.0 ± 11.9 years), overweight and obesity were highly prevalent (40.1% and 34.4%, respectively), with Obesity I predominating. Significant gender differences were observed: female more often reported obesity, multimorbidity, and depressive symptoms, whereas men were more physically active and more frequently overweight. Most participants were physically inactive, consumed breakfast and bread daily, and had low engagement in cycling and sports. Alcohol consumption was significantly higher in men, while dietary habits differed by gender for bread intake. These findings highlight substantial gender- and lifestyle-related disparities among adults with type 2 diabetes in Serbia. Conclusions: Targeted interventions promoting healthy lifestyle, physical activity, psychosocial support, and chronic disease management are urgently needed to address gender- and lifestyle-related disparities in adults with type 2 diabetes in Serbia. Full article

The concept of “Healthocide,” first defined by Abi-Rached and colleagues, describes the deliberate and systematic destruction of health systems as a weapon of war. Nowhere is this phenomenon more extensively documented than in Gaza, where the collapse of healthcare infrastructure since October 2023 has been rapid, wide-ranging, and intentionally sustained. The consequence is not only immediate excess mortality, but also profound, long-term loss of population health measured in life-years, a metric that captures both premature death and reductions in expected lifespan. To address the aftermath of such destruction, we propose the framework of “Healthogenesis,” defined as a Palestinian-led, equity-driven, and rights-anchored approach to health system reconstruction in which international actors serve as enablers rather than agenda-setters. The aim of Healthogenesis is not merely to restore pre-war capacity, but to build a resilient, sovereign, and future-proof health ecosystem. Using available demographic and mortality data, we estimate that more than three million life-years have already been lost in Gaza since October 2023. Projection models suggest that an additional 1.1 to 2.2 million life-years could be lost over the coming decade unless an organized programme of reconstruction begins immediately. Quantifying harm in life-years reframes the discourse from moral outrage to measurable obligation. If Healthocide names the crime, then Healthogenesis outlines the cure: a coherent, data-anchored, ethically grounded roadmap for rebuilding a devastated health system and protecting the health futures of an entire population. Full article

In Western Europe, and particularly in The Netherlands, speech is rarely neutral: to talk is to participate morally and civically, while silence is frequently marked as evasive, passive, or suspect. The capacities for speech, for being heard, understood, and responsive, are widely regarded as hallmarks of autonomous, transparent, free-thinking, and sovereign subjectivity, celebrated as expressions of a shared progressive modernity. These ideals of subjectivity are routinely placed in tension within the so-called secular–religious binary framework, in which the compatibility of non-secular sensibilities or non-Christian religions, especially Islam, with such Dutch societal values is persistently and heavily problematized. Within such accounts, speech becomes a criterion Muslims in Europe are then expected to meet, not merely by speaking but by doing so in ways deemed proper and intelligible. To complicate and deepen understanding of these dynamics, this article draws on ethnographic insights from (secular) Christian–Muslim couples in The Netherlands, looking at how the dynamics of speech–silence function within intimate contexts, where they take place, where they break down, and ultimately where their limits lie. Attuned to the cacophony of multivocal gestures, whether in acts of refusal, the quiet eloquence of silence, or the directness of vocal protest, the article reveals the intricate and consequential interplay between these dynamics and the structuring and affective forms of secular and religio-racial norms in everyday life. Full article

Therapeutic endoscopic ultrasound (t-EUS) has transformed the management of biliopancreatic diseases by enabling minimally invasive access and intervention through the gastrointestinal wall. This narrative review summarizes current indications and evolving roles of t-EUS in benign and malignant biliary disease, with a focus on the different modalities of transmural drainage, EUS-guided gastroenterostomy (EUS-GE), and EUS-guided radiofrequency ablation (EUS-RFA). In benign settings, EUS-gallbladder drainage (EUS-GBD) has emerged as a minimally invasive alternative to percutaneous cholecystostomy for high-risk patients with acute cholecystitis, offering internal drainage with fewer tube-related adverse events. In malignant biliary obstruction, transmural drainages are consolidated alternatives of endoscopic retrograde cholangiopancreatography (ERCP) as first-line or rescue strategies, providing durable internal biliary drainage, avoiding post-ERCP pancreatitis without deteriorating quality of life. In surgically altered anatomy, t-EUS overcomes the limitations of enteroscopy-assisted ERCP by creating direct access routes to the biliary tree or pancreatic duct. EUS-guided pancreatic duct drainage offers a rescue or primary approach in benign strictures, anastomotic stenosis, and disconnected duct syndrome. EUS-GE has rapidly become a preferred modality for palliation of gastric outlet obstruction in pancreatic cancer, while EUS-RFA provides a platform for locoregional therapy in selected cases of pancreatic neuroendocrine tumors, adenocarcinoma, and pancreatic cystic neoplasms. Collectively, these applications position t-EUS as a central tool in the multidisciplinary management of complex biliopancreatic disease, with ongoing innovations expected to further expand its indications and safety and to refine patient selection and training pathways. Full article

Background: Hypertension remains one of the leading causes of cardiovascular morbidity and mortality in South Africa. Although extensive evidence exists on modifiable risk factors, the translation of this evidence into strategic and equitable health investments remains limited. Current models such as the Global Burden of Disease (GBD) and WHO “Best Buys” identify key exposures, but lack operational mechanisms for context-specific prioritisation and dynamic resource allocation. The aim of this study is to develop and validate an integrated decision-support model that links evidence-based risk factor prioritisation with dynamic budget allocation to improve hypertension prevention and control in South Africa. Methods: This study adopts a two-phase mixed-methods design. Phase 1 develops a Risk Factor Prioritisation Model that ranks modifiable exposures using composite indices for the causality strength, implementation feasibility, policy integration, and equity. Phase 2 constructs a Dynamic Resource Allocation Model that distributes health budgets across interventions to maximise Disability-Adjusted Life Years (DALYs) averted, subject to budget and equity constraints. The model integrates data from systematic reviews, GBD 2019 estimates, WHO-CHOICE cost data, and national health expenditure databases. A validated quantitative Risk Priority Score (RPS) for major hypertension risk factors, an optimisation model for resource allocation, and an interactive dashboard that visualises efficiency and equity trade-offs under varying budget scenarios are expected. Conclusions: This study will provide a reproducible model for transforming epidemiological and economic evidence into actionable policy guidance. It bridges the gap between evidence generation and health planning, supporting more equitable and data-driven decision making in noncommunicable disease control. Full article