Search Results (8,797)

Designing cost-effective, reliable diagnostic sensor suites for complex assets remains challenging due to conflicting objectives across stakeholders. A holistic framework that integrates the Normalised Diagnostic Contribution Index (NDCI)—which scores sensors by separation power, severity sensitivity, and uniqueness—with a Multi-Objective Sensor Optimisation Framework (MOSOF) is presented. Using a high-fidelity virtual aircraft model coupling engine, fuel, electrical power system (EPS), and environmental control system (ECS), NDCI against minimum Redundancy-maximum Relevance (mRMR) is benchmarked under a rigorous nested cross-validation protocol. Across subsystems, NDCI yields more compact suites and higher diagnostic accuracy, notably for engine (88.6% vs. 69.0%) and ECS (67.7% vs. 52.0%). Then, a multi-objective optimisation reflecting an airline use-case (diagnostic performance, cost, reliability, and benefit-to-cost) is executed, identifying a practical Pareto-optimal ‘knee’ solution comprising 12–14 sensors. The recommended suite delivers a normalised performance of ≈0.69 at ≈USD36k with ≈145 kh MTBF, balancing the cross-subsystem information value with implementation constraints. The NDCI-MOSOF workflow provides a transparent, reproducible pathway from raw multi-sensor data to stakeholder-aware design decisions, and constitutes transferable evidence for model-based safety and certification processes in Integrated Vehicle Health Management (IVHM). The limitations (simulation bias, cost/MTBF estimates), validation on rigs or in-service fleets, and extensions to prognostics objectives are discussed. Full article

Background: Better understanding factors leading to suicide and prevention opportunities is a global public health priority. This qualitative pilot study tested whether reviewing inquest recordings could generate insights during COVID-19 and inform public health prevention programmes across a predominantly rural and coastal area where there are significant health inequalities. Methods: Fifty-five inquest recordings reached a suicide conclusion between March 2020 and January 2021. Stratified sampling was used to obtain two samples from each month. Template analysis was employed to thematically analyse data from 30 inquests. Results: Risk factors during this period were social isolation, anxiety, difficulty in routine creation and maintenance, low mood and economic impact. Remote working in a more rural/coastal area impacted both healthcare service users and staff. Lockdown and other multiple risk factors impacted those at increased risk of poor mental health and suicide. Conclusions: There is a need to identify those at risk and with deteriorating mental health. All age trauma-informed approaches are needed to prevent individuals from reaching crisis along with more equitable services and community support due to the complex nature of suicide. This requires consideration of digital access/exclusion, training, continuity of care and enhanced care of those with additional needs and multiple vulnerabilities. Full article

This paper addresses the problem of ensuring the continuous operation of cyber–physical systems (CPS) under conditions of component degradation and wear. To achieve this goal, a transition to the concept of Proactive Prognostics and Health Management (PPHM) is proposed, focused on proactive control of the technical condition of equipment. A key stage of PPHM is the generation of control actions aimed at extending the remaining useful life by adapting the operational parameters of the system. This paper proposes an intelligent support method for generating control actions to optimize the operational conditions. The proposed method integrates an RUL prediction model with optimization procedures based on genetic algorithm. The method was experimentally validated using XJTU-SY Bearing test rig and a bearing-degradation dataset. The obtained results demonstrate its effectiveness and confirm its applicability for extending the service life of technical systems. The proposed method is general and can be adapted to any CPS where controllable parameters affect the degradation rate Full article

Treatment-resistant depression (TRD) remains a significant public-health challenge, with many patients failing to respond to conventional therapies. Ketamine has emerged as a rapid-acting intervention, but quantitative outcomes alone do not capture patients’ lived experiences, which shape engagement, acceptability, and adherence. We conducted a narrative review of qualitative and mixed-methods studies to enable conceptual integration and thematic synthesis of patients’ experiences with ketamine treatment for depression, guided by established narrative review methodology and the SANRA framework. A targeted search of MEDLINE and Scopus (November 2025) identified studies reporting adult patients’ perspectives on therapeutic ketamine or esketamine use, with qualitative data synthesized iteratively in keeping with narrative review principles. Across the literature, patients’ perspectives coalesce around key thematic domains, including motivations and expectations for treatment, the phenomenology of the treatment experience, post-treatment trajectories, side effects and reasons for discontinuation, relational and environmental factors, and information and education needs. By focusing on these thematic groups, the review highlights the experiential dimensions that influence the perceived value and acceptability of ketamine, underscoring the need for patient-centered service design. Integrating these insights can guide the development of ketamine programs that are both evidence-based and aligned with patients’ priorities and perspectives. Full article

Investors use information about companies’ social and environmental performance to make investment decisions, a strategy known as Environmental, Social, and Governance (ESG) investment analysis. ESG screening may offer a mechanism to incentivize corporations to improve their health impact. However, there has been limited investigation of the extent to which ESG investment frameworks capture corporate health impacts in major industries. In this study, we sought to characterize the extent to which ESG frameworks address the health-impacting activities of the food and beverage (F&B) industry. To do this, we conducted a deductive framework analysis during the period of September 2023 to March 2024. Specifically, we identified gaps in existing ESG frameworks by comparing the content of five ESG reporting standards and rating systems to the HEALTH-CORP-FB typology, an evidence-based typology that describes the health-impacting activities of the F&B industry across seven domains (Governance Practices, Political Practices, Preference and Perception Shaping Practices, Economic Practices, Employment Practices, Products and Services, and Environmental Practices). To further assess how ESG frameworks account for the health-impacting activities of the F&B industry, we classified health-focused ESG fields in the packaged foods subindustry by two attributes: relevance to the assigned HEALTH-CORP-FB activity (low, medium, high) and type of business operations addressed (e.g., process, performance). Results indicate that, on average, the ESG fields (n = 1348) covered 39% of the 89 HEALTH-CORP-FB activities (range across frameworks: 27–48%). Higher proportions of activities in the Governance, Environmental, Employment, and Economic Practices domains (range across domains: 43–87%) were represented than activities in the Products and Services, Preference and Perception-Shaping Practices, and Political Practices domains (17–36%). Fields assigned to the latter domains were also less likely to be deemed highly relevant and to measure corporate performance. We conclude that the ESG frameworks included in this study capture some of the activities of the F&B industry that affect population health and health equity; however, critical gaps remain. We discuss how integrating key health-focused ESG indicators (e.g., revenue generation from ultra-processed foods) into existing frameworks could enable investors, public health organizations, civil society, and shareholder advocates to strengthen the accountability of the F&B sector with respect to health. Full article

Background: With ageing populations and increasing labour force participation among women over 50, their mental health and psychological well-being require attention. The multifactorial etiology of depression has been extensively studied at both the individual and societal levels. Longitudinal analyses exploring socioeconomic and political determinants and whether they influence depression severity across European countries are lacking. Objective: The objective of this study was to examine a possible correlation between socioeconomic and political factors with depression severity in women aged 50 and older in Europe and to what extent these possible correlations vary across countries. Methods: This longitudinal observational study was conducted using data from 47,426 women aged 50–89 years across 15 European countries, drawn from seven waves (2004–2015) of the Survey of Health, Ageing and Retirement in Europe (SHARE). Depression symptoms were measured by the validated European Depression Scale (EURO-D). The Andersen Model of Health Service Utilization was applied to contextualize twelve macro-level predictors of depression. These were organized into four overarching domains—health, education/employment/finance, equality, and security. Mean EURO-D scores were calculated with respect to age group and country. Correlations between predictors and depressive symptoms were assessed using Pearson’s and Adjusted Pearson’s correlation coefficients to determine the strength and rank of associations. Results: Significant correlations between predictor variables and depression were identified in nine countries, especially among women aged 80–89 years. Spain and Estonia showed strong predictors across several age groups. Eastern European countries exhibited the broadest range of significant correlations. Italy and France, despite high depression levels, revealed few significant predictors. Sweden, the Netherlands, and Switzerland had lower depression scores and demonstrated clearer correlations. Factors related to LGBTQ+ rights, perceived corruption, and peace indices emerged as influential. Conclusions: Country-specific historical, cultural, and sociopolitical factors appear to shape severity of depression in older women, with the strongest effects in the oldest age groups. Predictors of EURO-D scores varied by country and age group, with differences in explanatory power. The importance of predictors varied across age groups; listing them without context misrepresents the findings. The interplay between objective indicators and public perception, especially concerning minority rights and governance, highlights the need for culturally sensitive interventions. Future prevention efforts should incorporate these determinants to improve mental health across Europe. Full article

Background: Prehospital emergency professionals are exposed to high psychosocial demands that may impact their mental health, but pre-COVID-19 baseline data from Spanish services are scarce. This study aimed to assess the general health and psychosocial risk factors in a regional prehospital emergency service before the COVID-19 pandemic. Methods: We conducted a cross-sectional descriptive study (September–December 2019) including 51 physicians, nurses, and emergency medical technicians working at the 061 Health Emergency Center in Granada (Andalusia, Spain). General health and chronic problems were assessed with the Goldberg General Health Questionnaire (GHQ-28/CGHQ-28), and work-related psychosocial risks were evaluated using the COPSOQ-ISTAS21 questionnaire. Descriptive statistics, group comparisons, and exploratory Spearman correlations between health indicators and psychosocial dimensions were performed. Results: Most participants reported good self-perceived general health, but the chronic coding of the GHQ (CGHQ-28) indicated long-term difficulties mainly related to social dysfunction, somatic symptoms, and anxiety/insomnia. Exposure to unfavorable psychosocial risk was frequent, particularly in psychological demands, double presence (work–family conflict), and low esteem, with intermediate–unfavorable patterns in active job/development, insecurity, and social support/leadership. Exploratory correlations suggested that double presence was the psychosocial factor most consistently associated with chronic distress. Conclusions: In this pre-COVID-19 cohort of prehospital emergency professionals, good perceived general health coexisted with chronic psychological strain and high exposure to adverse psychosocial work factors. These findings support the need for organizational measures to reduce psychological demands and work–family conflict and to strengthen social support and leadership in prehospital emergency teams. Full article

Background/Objectives: Sepsis survivors frequently experience long-term complications known as Post-Sepsis Syndrome. Many survivors and their relatives express ongoing dissatisfaction with the quality and accessibility of health information. Yet the specific informational needs and preferred formats remain insufficiently defined. To identify the informational needs of sepsis survivors and their relatives across different stages of illness and recovery. Methods: This qualitative study, conducted within the AVENIR project, included semi-structured telephone interviews with 12 survivors and 6 relatives in Germany. Interviews were transcribed verbatim and analyzed using qualitative content analysis according to Mayring. Results: Eighteen interviews highlighted phase-specific gaps in information. Relatives reported urgent needs for timely, comprehensible and empathetic communication during the ICU phase, often while under decision pressure. Survivors described limited capacity to process information during the acute phase and sought orientation only after cognitive and emotional stabilization. After discharge, both groups reported an “information vacuum”, marked by insufficient guidance on long-term physical and psychological consequences, rehabilitation, vaccination, and follow-up care. Many participants received no informational material, or only general or inconsistent information. Desired content emphasized basic sepsis knowledge, explanations of persistent symptoms, practical coping strategies, and navigation of support services. Preferred formats included peer support and repeated, personal conversations with healthcare professionals, complemented by trusted online and printed resources. Conclusions: Sepsis survivors and relatives experience notable, role- and phase-specific information deficits that extend from the ICU into long-term recovery. Timely, reliable, and accessible information may help reduce uncertainty, support coping, and strengthen autonomy for both survivors and relatives. Full article

Urban Green Space Per Capita (UGSPC) is one of the oldest and most widely applied indicators in urban planning, providing a measure of green areas in relation to the population size. Despite its century-long application and decades of research, no global systematic review has previously synthesized how UGSPC has been applied, interpreted, and evolved across different contexts. This study aims to fill that gap by conducting the first comprehensive systematic review, following PRISMA guidelines, examining the usage, trends, and effectiveness of UGSPC in both developed and developing countries. Thematic analysis revealed that most studies were published in journals focused on sustainability and environmental science. The results show a surge in publications following the COVID-19 pandemic, reflecting a growing recognition of the importance of urban green spaces for public health and livability. Moreover, 67% of the studies were conducted in developing countries, while 30% of the publications were in developed countries. Higher UGSPC values are generally found in developed cities; however, this was not a rule. Time series studies showed a decline in UGSPC in some developed and developing countries, influenced by factors such as population density, urbanization stage, climate, and economic conditions. Although UGSPC is widely used, most municipalities typically develop their plans based on this measurement. In total, 95% of the included research incorporated additional measurements, including accessibility, social equity, spatial patterns, ecological services, ecosystem benefits, and human health. This study suggests that UGSPC is still used as an indicator in urban planning and policy and integrating it with other indicators can serve as contemporary indicators to capture better equity, functionality, and sustainability in urban environments. Full article

This study examines the perceptions and experiences of Indigenous Kankuamo women in northern Colombia regarding their sexual and reproductive rights (SRR), exploring how cultural traditions and public policies shape their exercise. The main objective was to understand the tensions between ancestral values, community leadership, and internationally recognized rights. A mixed-methods approach (qualitative–quantitative) was employed, based on semi-structured interviews conducted with 30 women. The instrument included closed Likert-type questions and open-ended items addressing perceptions, cultural practices, access to health services, and government programs. Data were analyzed using descriptive statistics, Spearman correlations, and content analysis through thematic development. The findings revealed a strong correlation between trust in health services, accessibility, cultural compatibility, and the frequency of adolescent pregnancies. Divided perceptions regarding the role of community leaders were identified, along with a recurring demand for education and awareness-raising on sexuality and rights. Participants also noted limitations in state programs, mainly due to their limited cultural relevance. Kankuamo women face ongoing tensions between cultural preservation and sexual autonomy. Strengthening education, inclusive leadership, and policies with an ethnic and gender perspective is recommended to ensure the full exercise of their SRR. Full article

This article examines the maternal healthcare experiences of ten Brazilian women during Portugal’s obstetric crisis, focusing on access, use, and quality of care throughout the perinatal and childbirth periods. Using a qualitative approach based on semi-structured interviews, this study explores women’s perceptions of the adequacy and quality of maternal healthcare, contributing to a deeper understanding of their experiences within the Portuguese health system. Thematic analysis revealed persistent barriers to accessing services, linked to limited knowledge of the healthcare system, lack of awareness of legal rights, discrimination, and other structural obstacles. Participants expressed dissatisfaction with the clarity and quality of information provided by healthcare professionals, their communication skills, and the limited access to specialized care. They also described feeling undervalued by healthcare providers and reported an absence of emotional and psychosocial support during pregnancy, childbirth, and the postpartum period. Accounts of disrespectful and abusive practices highlight the vulnerability of migrant women. This study underscores the urgent need to recognize and address migrant women’s needs. Beyond access, policies should promote equity, cultural responsiveness, and intercultural dialogue to ensure respectful, person-centered maternal care. Full article

Background: Optimal nutritional care is essential to improving outcomes in hemodialysis, yet translation of evidence into routine practice remains uneven across settings. To inform health system planning and implementation priorities, we mapped global research on hemodialysis-related nutrition. Methods: We searched the Web of Science Core Collection for English-language original articles on nutrition and hemodialysis from 1 January 2006 to 13 October 2025. Publication trends, productivity by country and institution, influential journals and authors, citation impact, and conceptual structure via Keyword Plus co-occurrence, trend, and thematic evolution analyses were assessed using the bibliometrix package (version 5.0) in R. Results: A total of 332 articles from 115 journals were identified, with substantial growth and multidisciplinary authorship, though international collaboration remains limited. The United States contributed 21.4% of publications and achieved the highest citation impact, while China, Japan, Iran, and Brazil formed the next tier of contributors. The Journal of Renal Nutrition accounted for 16.6% of papers. Highly cited studies established links between dietary intake, mineral and electrolyte management, and survival, while supporting the use of intradialytic oral nutritional supplements. Thematic evolution showed a shift from biochemical markers toward patient-centered priorities, including diet quality, adherence, body composition, mental health, and quality of life. Emerging directions point to whole-diet approaches and microbiome-modulating strategies. Conclusions: Global research on diet and hemodialysis has progressed from foundational nutrient studies to multidimensional, patient-focused approaches. Our findings suggest opportunities for health systems to strengthen dietitian-led models of care, integrate patient-reported outcomes, and prioritize scalable nutrition interventions within routine dialysis services. Full article

This study aimed to identify scientific evidence that addresses women’s experiences in the process of illness and care during tuberculosis treatment. A systematic review of qualitative studies was conducted based on the Joanna Briggs Institute’s Manual for Evidence Synthesis and the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Searches were performed in the Web of Science, MEDLINE, Embase, SciVerse Scopus, and LILACS databases. The following descriptors were used: “Women,” “Tuberculosis,” “Gender Perspective,” and “Qualitative Approach.” Studies reporting the experiences of women with active tuberculosis, published in any language, without time restrictions, were included. Of the 16,029 studies initially identified, 7079 duplicates were removed and 8895 were excluded after title and abstract screening. A total of 55 studies were read in full, of which 41 did not meet the eligibility criteria, resulting in a final inclusion of 14 studies. Most selected studies were conducted in high-tuberculosis-burden, low- and middle-income countries between 2000 and 2024. All studies focused on pulmonary tuberculosis, with one addressing drug-resistant tuberculosis. The results revealed that women’s experiences with tuberculosis are shaped by the following four thematic categories: (1) stigma and social vulnerability of women with tuberculosis; (2) gender factors in access to health services and in the interruption of tuberculosis treatment among women; (3) intersectionality and social determinants of health; and (4) the importance of social, family, and healthcare support in the experience of tuberculosis illness. The experience of illness due to tuberculosis among women is profoundly shaped by vulnerabilities related to gender, stigma, and social class, which intensify social exclusion, hinder access to diagnosis and treatment, and deepen physical and emotional suffering. Stigma reinforces isolation and weakens support networks, while the burden of domestic labor, caregiving responsibilities, and economic dependence makes it difficult for women to prioritize their own health. In this context, family support and gender-sensitive, humanized healthcare are essential. Therefore, the implementation of public policies that address these specificities and confront structural inequalities is urgent to ensure comprehensive care and a dignified, effective recovery for women with tuberculosis. Full article

Background/Objectives: Amputation often leads to decreased body image satisfaction and self-acceptance, affecting mental health and social integration. The Amputee Body Image Scale (ABIS) is a validated tool designed to assess satisfaction and measure body image acceptance. The scale has been translated into many languages to improve rehabilitation services for individuals with amputation worldwide; however, a validated Arabic version of this scale does not currently exist. The study aims to cross-culturally adapt and validate the ABIS for Arabic-speaking individuals with lower-limb amputation. Methods: A cross-cultural adaptation was performed according to the International Test Commission (ITC) guidelines. The adapted Arabic version of the scale was completed by 100 Jordanian individuals with lower-limb amputations. Their responses were then statistically analyzed using factor analysis to assess content and construct validity and Cronbach’s α to assess internal consistency (reliability). Results: The Arabic version of the ABIS demonstrated strong construct validity (KMO = 0.898; Bartlett’s test p < 0.001) and high internal consistency (Cronbach’s alpha = 0.92), while factor analysis suggested the multidimensionality of the scale after cross-cultural adaptation. Conclusions: The findings suggest the preliminary validity and reliability of the Arabic version of the ABIS, supporting its potential use in rehabilitation centres to assess body image satisfaction among Arabic-speaking individuals with amputation. Nevertheless, further improvements are warranted to adapt the scale to Arabic culture. Full article

In Mexico, the Deaf community faces persistent communication barriers that restrict their integration and access to essential services, particularly in healthcare. Even though approximately two million individuals use Mexican Sign Language (MSL) as their primary form of communication, technological tools for supporting effective interaction remain limited. While recent research in sign-language recognition has led to important advances for several languages, work focused on MSL, particularly for healthcare scenarios, remains scarce. To address this gap, this study introduces a health-oriented dataset of 150 signs, with 800 synthetic video sequences per word, totaling more than 35 GB of data. This dataset was used to train recurrent neural networks with regularization and data augmentation. The best configuration achieved a maximum precision of 98.36% in isolated sign classification, minimizing false positives, which is an essential requirement in clinical applications. Beyond isolated recognition, the main contribution of this study is its exploratory evaluation of sequential narrative inference in MSL. Using short scripted narratives, the system achieved a global sequential recall of 45.45% under a realistic evaluation protocol that enforces temporal alignment. These results highlight both the potential of recurrent architectures in generalizing from isolated gestures to structured sequences and the substantial challenges posed by continuous signing, co-articulation, and signer-specific variation. While not intended for clinical deployment, the methodology, dataset, and open-source implementation presented here establish a reproducible baseline for future research. This work provides initial evidence, tools, and insights to support the long-term development of accessible technologies for the Deaf community in Mexico. Full article