The study included women aged 18 years or older who were referred for a specialised sexual health consultation at the hospital between January 2016 and December 2023. The intervention was a structured, stepwise approach delivered by gynaecologists with postgraduate training in clinical sexology. Outcomes included continuity within the planned follow-up pathway, treatment delivery, sexual activity and overall sexual well-being. Clinical outcomes were derived from assessments documented at each participant’s last recorded consultation, and no validated patient-reported outcome measures were used. Participants had a mean age of 41.6 years, with a standard deviation of 13.1 years.

The proportion of participants documented as sexually active rose from 58.7% at baseline, representing 108 of 184 women with a 95% confidence interval of 51.2% to 65.9%, to 84.8% at the last documented assessment, representing 156 of 184 women with a 95% confidence interval of 78.8% to 89.6%. Among the 76 women who were sexually inactive at baseline, 48, or 63.2% with a 95% confidence interval of 51.3% to 73.9%, had resumed sexual activity by the final documented assessment. This difference was reported as statistically significant in an exact McNemar test, with p less than 0.001. Overall, 101 participants, or 54.9% with a 95% confidence interval of 47.4% to 62.2%, experienced improvement in sexual health, defined as resolution of symptoms or adaptation to a satisfactory sexual life despite persistent symptoms. Another 33 participants, or 17.9% with a 95% confidence interval of 12.7% to 24.3%, reported a neutral or non-prioritised sexual life. Continuity within the planned follow-up pathway was documented for 118 of 184 participants, or 64.1%, with a 95% confidence interval of 56.7% to 71.1%.

These findings describe the real-world implementation and recorded outcomes of one pathway in one hospital over an eight-year referral period. The investigators identified the retrospective, uncontrolled design as a limitation on causal inference. The absence of validated patient-reported outcome measures also means that improvement was based on documented clinical assessments rather than a standardised instrument for measuring patient-reported sexual health outcomes. Because the study was confined to a single tertiary public hospital, the abstract does not support claims about effectiveness in other settings, scalability or resource efficiency.

Subject of Research: Real-world implementation and documented outcomes of a structured sexual healthcare pathway for women with gynaecological conditions

Article Title: Integrating structured sexual healthcare into a public gynaecological service: a single-centre retrospective implementation study

Article References: Anglès-Acedo, S., Barfull, A., Ribera-Torres, L., López-Frías, L., Sánchez, E., & Castelo-Branco, C. (2026). Integrating structured sexual healthcare into a public gynaecological service: a single-centre retrospective implementation study. BMC Public Health. https://doi.org/10.1186/s12889-026-29633-x

Image Credits: AI Generated

DOI: 10.1186/s12889-026-29633-x

Keywords: sexual health, gynaecological care, structured care pathway, sexual activity, sexual well-being, retrospective study, clinical sexology, Barcelona, women’s health, Integrating, structured, sexual

The work focused on Hospital Clínic de Barcelona, a predominantly adult tertiary hospital with limited pediatric services. Because notification rules in Spain and Catalonia include both communicable and some noncommunicable conditions, the investigators included every notifiable-disease episode reported at the hospital during the three-month period, rather than selecting diseases in advance. The sample covered 25 conditions grouped into 10 categories, including sexually transmitted infections, mosquito-borne diseases, respiratory infections, hepatitis, zoonoses and asthma. Of the analyzed episodes, 173 involved males, 110 females and one person whose sex was recorded as unknown. Median age was 42 years, with an interquartile range of 25 years. One episode with no information in the clinical record was excluded from subsequent analyses, leaving 283 for assessment by healthcare setting and document type.

Sexually transmitted diseases formed the largest notified group, accounting for 73 episodes, or 25.8%. Most notifications originated in the outpatient clinic, which accounted for 145 episodes, or 51.2%; 96, or 33.9%, came from the emergency room and 42, or 14.8%, from hospital care. Medical doctors reviewed whether sufficient information was available on the reporting date to justify notification under Catalonia’s public health criteria. They classified 210 episodes, representing 74.2%, as adequately suspected and 73, or 25.8%, as inadequate. The investigators also calculated the interval between the first appearance of suspicion in the electronic health record and the actual report.

Among the adequately notified episodes for which relevant records could be identified, 170 were subsequently confirmed as having the reported condition. Thirty-three episodes, equal to 15% of the adequately notified group, had been reported before suspicion was recorded in the electronic health record and were excluded from the delay calculation. Among the remaining 177 episodes, the median delay was zero days and the interquartile range was three days. Sixty-two percent were reported on the same day that the first suspicion appeared, but 10% were reported more than two weeks later. The authors said explanations for reports preceding the electronic record, such as telephone calls or internal messages, remained hypotheses because the original notification source had not been registered.

The leading cause of inadequate reporting was the treatment of a chronic condition as a new reportable event, which explained 34.2% of the 73 inadequate notifications. References to a disease in a patient’s medical history accounted for 26.0%, while disease-related language whose clinical context did not support current suspicion accounted for 23.3%. A further 12.3% lacked supporting information, and 4.1% involved a mismatch between the disease reported and the condition suggested by the available records. Importantly, 83% of inadequate notifications contained at least one term from the disease-specific thesaurus. The results therefore show that the mere presence of a disease word or clinical concept is not enough to establish that an episode warrants notification.

Manual review of six types of electronic health record documents revealed where suspicion-related terms were most likely to appear. When the corresponding document was available, investigators found such terms in 93.0% of hospital discharge notes, 89.0% of unreleased clinical drafts, 84.7% of emergency-room discharge notes, 78.7% of clinical course reports, 63.3% of microbiology reports and 45.4% of laboratory reports. These percentages describe the content of available documents, however, and do not mean that every document type was equally accessible across episodes. Availability differed substantially by healthcare setting and disease group, making the importance of a source depend on where and how a patient was being treated.

The pattern changed markedly across care environments. In emergency-room episodes, emergency-room discharge notes contained suspicion-related information in 85.4% of cases, while unreleased clinical drafts did so in 83.8%. Clinical course reports were less frequent in that setting, and hospital discharge notes and microbiology reports were often unavailable. For hospitalized patients, clinical course reports contained relevant information in every episode in which they were assessed, with additional contributions from hospital discharge notes and unreleased drafts. Outpatient records had a different profile: clinical course reports contained relevant terms in 96.8% of episodes, and laboratory and microbiology reports also contributed, whereas the three other document types were not frequently available. These differences argue against a surveillance tool based on one fixed electronic record source.

Disease group also altered the contribution of each document. Clinical course reports were the most consistently available source, appearing in more than 80% of episodes in every disease group; when available, they contained suspicion-related terms in 81.2% of episodes. Unreleased clinical drafts were present in more than half the episodes of six disease groups and contained relevant terms in 94.8% of those available documents. Emergency-room discharge notes were representative for asthma, exanthematous viral diseases and mumps, and heatstroke, while hospital discharge notes were representative only for respiratory infectious diseases. Microbiology reports were available in at least half the episodes of six groups and contained relevant terms in 81.1% of available reports. Their contribution was particularly prominent for exanthematous viral diseases and mumps, foodborne and waterborne diseases, mosquito-borne diseases, and sexually transmitted infections.

The authors say the findings point toward a future system that selects document sources according to disease and care pathway, maps variations in language to standardized clinical concepts, and interprets those concepts in context rather than treating them as isolated keywords. A system would need to distinguish active suspicion from chronic disease, past history, negation and contextual mentions that do not support notification. The analysis was performed on raw clinical documentation, retaining abbreviations, misspellings, typographical errors, idiomatic expressions and colloquialisms; investigators manually identified and then standardized concepts for classification. A future system would also need expert review in a human-in-the-loop workflow, particularly because the study found overnotification as well as delays.

This work does not demonstrate that natural language processing or large language models can improve disease surveillance. No automated system was tested, and the researchers could not calculate the sensitivity, specificity or diagnostic performance of a future pipeline. The analysis included only episodes that had already been notified, rather than independently identifying cases that escaped reporting, and it did not include prior notification records needed to verify repeated reports. Its three-month summer sample may underrepresent conditions with different seasonal patterns, while the single hospital setting limits generalizability. Future research would need larger and more representative datasets, automated testing on unprocessed text, and direct measurement of accuracy and reporting time. Even with those limitations, the study offers a concrete starting point: the documents most likely to contain early signals, the conditions that generate false alerts, and the clinical pathways any future surveillance tool would have to understand.

Subject of Research: Evaluation of notifiable-disease reporting and clinical documents for future NLP-assisted hospital surveillance

Article Title: Setting the basis for a natural language processing tool to improve the reporting of notifiable diseases: a descriptive study

Article References: Cano-Escobar, C., Barón-Miras, L. E., Gualda-Gea, J. J., Frid, S., & Bertran, M. J. (2026). Setting the basis for a natural language processing tool to improve the reporting of notifiable diseases: a descriptive study. Frontiers in Digital Health, 8, Article 1882377. https://doi.org/10.3389/fdgth.2026.1882377

Image Credits: AI Generated

DOI: 10.3389/fdgth.2026.1882377

Keywords: natural language processing, notifiable diseases, public health surveillance, electronic health records, clinical informatics, disease reporting, hospital epidemiology, text mining, Barcelona, Setting, basis, natural

The findings emerge from the RECETAS project, short for Re-imagining Environments for Connection and Engagement, a major European Union-funded initiative launched in 2021 with a 5.6 million dollar grant. Under the leadership of Jill Litt, professor of environmental health at CU Boulder and a researcher with the Barcelona Institute for Global Health, the project has tested a social prescribing model called Friends in Nature in 1,200 adults across six cities spanning Europe, Latin America, and Australia. Randomized controlled trials have been conducted in Barcelona, Spain; Prague, Czech Republic; and Helsinki, Finland, while quasi-experimental studies have taken place in Marseille, France; Cuenca, Ecuador; and Melbourne, Australia. According to Litt, the field has long been driven more by enthusiasm than by data. There has been a lot of passion about nature-based prescriptions, she noted, but not a lot of evidence. That evidence gap is now beginning to close.

The newest results, drawn from a randomized controlled trial of 320 lonely adults in Barcelona and published in the October issue of The Lancet Regional Health, represent a rigorous test of the approach. The trial was observer-blinded, meaning that assessors measuring outcomes were unaware of which participants had received which intervention, a design feature that strengthens confidence in the findings. Participants were recruited from twelve low-income neighborhoods in the city, a population chosen precisely because vulnerable urban adults face elevated risks of social isolation yet often lack access to structured, affordable opportunities for connection. The study’s method of research was a randomized controlled clinical trial, the gold standard for determining whether an intervention actually causes the benefit it claims, rather than merely being associated with it.

The design of the Barcelona trial was straightforward but carefully constructed. Half of the participants were placed in small groups of eight to ten people that met for two hours each week over nine weeks. Accompanied by two trained facilitators, these groups engaged in activities such as gardening, birdwatching, and nature-based art programs in green spaces near their neighborhoods. The other half of the participants were given a menu of the same free, easily accessible nature-based activities but were left to do them on their own, without the group structure. This two-arm comparison allowed the researchers to separate two distinct ingredients of the intervention: the benefit of spending time in natural settings, and the added benefit of sharing that time with others in a facilitated group.

Both strategies worked. On average, participants showed an 11 percent reduction in loneliness scores at three months, a 12 percent reduction at six months, and a 17 percent reduction at one year. The pattern of results is notable because the benefits did not diminish once the formal programs ended. Instead, the reduction in loneliness deepened over the course of the year, suggesting that participants carried the connections and habits formed during the nine-week programs into their everyday lives. For those participants who began the study with lower emotional wellbeing, the group intervention proved more effective than the solo option, an important finding for identifying which patients are most likely to benefit from the facilitated, socially embedded version of the prescription.

Understanding why the intervention works requires understanding what loneliness actually is. As Litt explains, loneliness is not simply a matter of physical isolation. It is a subjective disconnect between one’s expectations of their social relationships and one’s reality. A person can be surrounded by others and still feel profoundly alone, and many people who live by themselves do not feel lonely at all. This subjective quality makes loneliness difficult to detect in clinical settings. People are often reluctant to admit they are lonely, may not recognize the feeling in themselves, and instead attribute the physical discomfort they experience to something else. Litt has heard people describe it like a knot in their stomach, like something is just not right, and she notes that you could be in a room full of people and still feel lonely.

The stakes of untreated loneliness are considerable. Studies show that chronic loneliness increases the risk of cardiovascular disease, dementia, stroke, depression, and anxiety. It also burdens the healthcare system in visible ways: people suffering from loneliness tend to visit their doctors more frequently, and they are more likely to turn up at emergency departments with vague complaints on Friday afternoons, a phenomenon that has been dubbed Friday afternoon syndrome. Litt argues that once clinicians really begin to drill down to the root causes of these visits, they often discover that loneliness is a major underlying factor, and that the solutions may lie outside the traditional medical system entirely. This is precisely the logic of social prescribing, a model that treats connection, activity, and environment as legitimate components of care rather than as luxuries beyond a physician’s remit.

Nature itself appears to do distinctive therapeutic work within the model. Litt suggests that the vivid sounds, smells, and sights of natural settings act as an additional facilitator, augmenting the benefits that come from structured social contact. Even time spent in nature alone can alleviate loneliness, according to the research, hinting that natural environments may prepare people emotionally for connection even when no one else is present. Louise Chawla, an environmental psychologist and professor emerita at CU Boulder who recently coauthored a paper with Litt on the role nature can play in fostering social connections, describes time outdoors as a kind of reservoir of calm that people can return to later in life during stressful times. In her view, nature is not just restorative while you are in a place, but also when you go back to it in memory, a psychological resource that persists well beyond the visit itself.

The model is already moving from research into practice. Public health agencies in Spain have begun to recognize the Friends in Nature model as a best practice for addressing the loneliness epidemic, a significant endorsement for an intervention that has only recently accumulated trial evidence. Litt is now working to bring similar trials to the United States, with the long-term ambition that insurers might one day cover things like a membership in a community garden or a birdwatching club, the way they cover medications or therapy sessions. The appeal of the approach lies partly in its efficiency: as Litt points out, cities already have nature in them, and governments have already invested in green infrastructure. What has been missing is a mechanism to bridge those resources with health systems, offering person-centered care that leverages the power of nature for healing and wellbeing. With randomized controlled trials now showing that the impacts are real and that they last, that mechanism no longer looks like a hopeful idea. It looks like a prescription waiting to be written.

Subject of Research: Nature-based social prescribing as a randomized controlled intervention to reduce loneliness in vulnerable urban adults

Article Title: Prescriptions for nature shown to ease loneliness

Article References: Prescriptions for nature shown to ease loneliness. (n.d.). Original publication

Image Credits: AI Generated

DOI: Not provided

Keywords: loneliness, social prescribing, nature-based interventions, public health, RECETAS project, randomized controlled trial, mental health, green spaces, University of Colorado Boulder, Barcelona, Lancet Regional Health, community health

Payment for Ecosystem Services, commonly abbreviated as PES, is a policy instrument that translates the ecological work performed by natural systems into economic value. In a water context, this might mean compensating landowners for maintaining forested catchments that filter rainfall naturally, rewarding farmers for reducing nutrient runoff into rivers, or funding the restoration of urban wetlands that buffer neighbourhoods against flooding. The underlying logic is that when the beneficiaries of a healthy watershed—utilities, municipalities, residents—contribute financially to its upkeep, the incentives for conservation become embedded in everyday economic decisions rather than resting solely on regulation or goodwill. What distinguishes PES4URBANWATER from earlier work, however, is its explicit focus on systemic services and on the fairness of how costs and benefits are distributed.

The project will analyze how payments for systemic services can improve water quality, protect water resources and support climate change adaptation through an equitable approach across different organizational contexts. That emphasis on equity is not incidental. Previous studies have often assessed the economic or environmental feasibility of PES schemes in isolation, asking whether they deliver measurable improvements in water quality or whether they generate a positive return on investment. PES4URBANWATER instead places distributive justice at the heart of its analysis, examining how the burdens and benefits of urban water management models are actually shared among the communities, institutions and industries involved.

Dr Cecilia Higa Gonzales Morilla, an MSCA Postdoctoral Fellow working on the project, framed the rationale in stark terms. A water management model, she explained, is only truly viable if its burdens and benefits are distributed fairly and transparently. By comparing contexts such as Barcelona and Melbourne, the research team aims to demonstrate that environmental protection, financial viability and social justice are three deeply interconnected dimensions that must be managed together rather than traded off against one another. That framing challenges a long-standing tendency in environmental economics to treat equity as a secondary consideration—something to be addressed after efficiency has been secured—rather than as a precondition for durable policy.

The choice of case studies is central to the project’s analytical power. Barcelona and Melbourne were selected because they operate two distinct and pioneering water governance models. Barcelona is characterised by a centralised water management model, in which decision-making authority and infrastructure operation are concentrated within a unified institutional framework. Melbourne, by contrast, operates under a decentralised, multi-level governance system, where responsibilities are distributed across multiple institutions, scales and actors. This unprecedented comparison allows researchers to isolate how a city’s institutional and organisational structure influences the design, acceptance and ultimate success of economic incentives aimed at conserving riverine and urban ecosystems.

The technical significance of this comparative design should not be underestimated. PES schemes do not operate in a vacuum; their effectiveness depends on who holds the legal authority to contract payments, how monitoring and verification of ecosystem outcomes are organised, whether local communities trust the institutions administering the scheme, and how costs are passed through water tariffs or public budgets. A centralised system may be able to implement a catchment-wide payment scheme quickly and coherently, but it may struggle to capture local knowledge or secure community buy-in. A decentralised, multi-level system may be more adaptive and participatory, but it risks fragmentation, duplicated effort and gaps in accountability. By studying both models in parallel, PES4URBANWATER aims to generate insights that transcend either city and speak to the structural conditions under which PES succeeds or fails.

Methodologically, the project integrates environmental and economic evaluations with public policy analysis, a multidisciplinary combination that reflects the reality that water governance sits at the intersection of hydrology, finance and politics. Central to this approach is the deployment of Water-Oriented Living Labs, or WOOLs—collaborative innovation spaces where public institutions, industry partners, researchers and local communities co-develop solutions together. These living labs are paired with innovative regulatory sandboxes, controlled environments in which new policy instruments and governance arrangements can be tested without the full weight of existing regulation, allowing experimentation with PES designs before they are scaled up.

The knowledge generated through these labs and sandboxes will be translated into strategic recommendations and decision support tools for policymakers, water authorities, water utility companies and other key stakeholders. Crucially, the project’s designers have emphasised transferability: the suite of tools is intended to guide urban planners, managers and policymakers in any major city worldwide, not only in the two study cities. In an era when climate change is stressing water systems from Cape Town to Chennai, from Sydney to São Paulo, a framework that can be adapted across institutional contexts could prove far more valuable than findings locked to a single governance model.

The project’s ambitions also extend to the global policy agenda. PES4URBANWATER is explicitly designed to align with and directly support major frameworks, including the EU Biodiversity Strategy for 2030, the European Green Deal and the United Nations Sustainable Development Goals. Each of these agendas calls for scaling up nature-based solutions and ensuring that the transition to sustainability is just and inclusive, and each recognises that healthy freshwater ecosystems underpin everything from biodiversity to public health to economic productivity. By demonstrating how economic incentives for ecosystem services can be structured equitably, the project seeks to provide a practical bridge between high-level policy commitments and the messy, contested realities of urban water management on the ground.

For the cities involved, the stakes are immediate and concrete. Barcelona faces recurring drought pressure on its Mediterranean water supply, while Melbourne contends with the hydrological volatility of a climate that swings between bushfire and flood. Both cities have invested heavily in alternative water sources, integrated urban water management and community engagement, making them natural laboratories for testing whether PES can complement hard infrastructure with investments in the living systems that regulate water naturally. If the project succeeds in showing that well-designed payment schemes can simultaneously improve water quality, protect resources, support climate adaptation and distribute costs fairly, it could reshape how cities around the world finance their relationship with the ecosystems they depend upon—moving urban water governance toward models that are more effective, more inclusive and grounded in evidence rather than ideology.

Subject of Research: Payment for Ecosystem Services schemes for equitable and resilient urban water management

Article Title: PES4URBANWATER drives fairer, more sustainable and resilient urban water management

Article References: PES4URBANWATER drives fairer, more sustainable and resilient urban water management. (n.d.). Original publication

Image Credits: AI Generated

DOI: Not provided

Keywords: PES4URBANWATER, payment for ecosystem services, urban water management, water governance, Barcelona, Melbourne, distributive justice, climate change adaptation, Water-Oriented Living Labs, Horizon Europe, Marie Skłodowska-Curie Actions, water quality

The Hospital Clínic of Barcelona functions as the reference centre for sexual assault care in its region and has developed a comprehensive care model for recent sexual violence. The centre reports between 400 and 500 sexual assaults annually, and substance use is involved in roughly one-third of those cases. Until now, however, detailed and current data on the victims, the circumstances of the assaults and the specific substances involved have been limited. Alcohol and cocaine had previously been described as the most frequently detected substances, but the research team sought to update and expand that picture using five years of clinical records.

The study’s demographic findings are striking in their consistency. Eighty-five percent of the DFSA cases assessed involved women, and 73 percent involved individuals aged between 18 and 35 years. This concentration in young adulthood, the authors note, has direct implications for how prevention messages and clinical screening protocols should be targeted. Rather than being confined to any single community, the affected population spans a broad swath of the city’s young adult residents and visitors, making general awareness campaigns and routine toxicological screening in emergency and forensic settings essential components of the response.

Perhaps the most consequential finding concerns location. Contrary to the popular image of drug-facilitated assaults as crimes committed in nightclubs and bars, the most frequently reported setting was the private home, accounting for 42 percent of cases, followed by public spaces at 23 percent. Nightlife settings, while significant, did not dominate the data. This distribution matters for prevention strategy: interventions focused solely on drink-spiking in bars may miss the majority of cases, which occur in residential environments where the dynamics of substance consumption and vulnerability may be quite different.

The toxicological profile of the cases reflects both persistent patterns and emerging trends. Alcohol was detected in 55 percent of cases and cocaine in 28 percent, confirming their status as the most prevalent substances. But newer and less commonly monitored drugs featured prominently as well. MDMA appeared in 23 percent of cases and GHB, a central nervous system depressant long associated with sedation-facilitated assault, in 15 percent. The researchers describe these emerging substances as increasing, a trend they argue demands closer monitoring because detection windows, clinical presentation and forensic interpretation differ substantially from those of alcohol and cocaine.

The COVID-19 pandemic introduced a natural experiment into the study period, and the data show that both the contexts of assault and the substances involved shifted during that time. Notably, cases in which drugs were supplied by the perpetrator rose, constituting 17 percent of DFSA cases by 2022. This distinction between voluntary consumption and perpetrator-supplied substances is central to the clinical and legal understanding of DFSA, and its increase over the study period represents one of the study’s most concerning signals.

Sex-specific patterns in substance detection added another layer of complexity. MDMA and cocaine were more prevalent among female victims, while methamphetamine and GHB were more prevalent among male victims. These differences suggest that prevention messaging, clinical suspicion and toxicological screening panels may need to be tailored rather than uniform, since the substances most likely to be involved vary with the victim’s sex and, as the multivariate analysis showed, with the setting in which the assault took place.

The multivariate analysis among female victims produced several statistically robust associations. Cases involving both alcohol and drugs were more frequently associated with public spaces than with nightlife settings, with an odds ratio of 3.75 (95 percent confidence interval 1.55 to 9.05). Cases involving drugs alone were less frequently observed among women aged 18 to 25 than among those aged 25 to 35, with an odds ratio of 0.55 (95 percent confidence interval 0.32 to 0.97), suggesting that drug-only involvement rises with age within this cohort. Meanwhile, assaults occurring in private homes were more frequently classified in the drug-only category compared with nightlife settings, with an odds ratio of 2.46 (95 percent confidence interval 1.14 to 5.45). Taken together, these associations paint a picture in which the combination of substances and the location of the assault are systematically linked rather than randomly distributed.

Methodologically, the study relied on univariate, bivariate and multivariate analyses of clinical records from the reference centre, allowing the researchers to describe victim characteristics and identify independent associations between substance categories, victim demographics and assault settings. The retrospective design means the findings capture patterns among victims who presented for care rather than the full incidence of DFSA in the community, a limitation common to studies of sexual violence. Even so, the size of the cohort and the five-year span give the results unusual weight for this field, where single-centre data are often fragmented or outdated.

The authors conclude that most DFSA cases involved women aged 18 to 35 and that residential settings were the most frequently reported locations, with alcohol and cocaine remaining the most commonly detected substances while newer substances showed distinct patterns according to assault setting and victim sex. Their central recommendation is the establishment of surveillance systems capable of continuously monitoring evolving patterns of substance use and assault contexts, so that prevention programmes and victim care protocols can adapt in near real time. As novel psychoactive substances circulate and consumption habits shift, the study suggests, static assumptions about drug-facilitated sexual assault quickly become obsolete, and only systematic, data-driven monitoring can keep clinical and preventive responses aligned with the reality on the ground.

Subject of Research: Epidemiology and toxicology of drug-facilitated sexual assault cases treated at a Barcelona referral centre from 2018 to 2022

Article Title: Unveiling dynamics of drug-facilitated sexual assault: an observational retrospective study in Barcelona (2018–2022)

Article References: Camps, A., Salgado, E., García-Esteve, L., Echevarría, T., & Bertran, M. J. (2026). Unveiling dynamics of drug-facilitated sexual assault: an observational retrospective study in Barcelona (2018–2022). BMC Public Health. https://doi.org/10.1186/s12889-026-29101-6

Image Credits: AI Generated

DOI: 10.1186/s12889-026-29101-6

Keywords: drug-facilitated sexual assault, DFSA, sexual violence, toxicology, alcohol, cocaine, GHB, MDMA, Barcelona, Hospital Clínic, public health, victim care

The scale of that mortality burden helps explain why ESE has chosen to invest in a focused, small-cohort training programme rather than relying on general continuing medical education. Obesity is no longer viewed simply as a consequence of lifestyle choices; it is increasingly understood as a chronic, relapsing, multifactorial endocrine disease involving dysregulation of appetite pathways, adipose tissue function, insulin signalling and reproductive hormones. As the scientific understanding of obesity continues to evolve, endocrinologists play an essential role in its prevention, diagnosis and management. The new School has been developed to complement existing obesity education across Europe, with a specific and deliberate focus on obesity as an endocrine disease, an angle that distinguishes it from broader weight-management courses aimed at general practitioners or public health specialists.

The three-day, in-person programme will cover both the clinical and mechanistic aspects of obesity, bringing together leading experts from across Europe to explore the latest developments in this rapidly evolving field. According to Gregory Kaltsas, chair of the ESE Education Committee, the format is built around interactive learning, case-based discussions and networking opportunities, so that participants gain valuable scientific knowledge while building relationships that support future collaboration and research. The curriculum reads like a survey of the field’s current frontiers. Topics include the genetics of obesity, adipose tissue biology and function, food noise, weight regain, treatments, new frontiers in the field, and the intersections between obesity and endocrinology across the life course, including puberty, menopause and polyendocrine metabolic ovarian syndrome.

Several of those topics deserve closer attention, because they map directly onto the most active areas of obesity science today. The genetics of obesity, for instance, has been transformed by large-scale genome-wide association studies that have identified hundreds of genetic variants influencing body mass index, many of which act through the central nervous system’s regulation of hunger and satiety. Understanding monogenic and polygenic forms of obesity allows clinicians to stratify patients, anticipate disease trajectories and, in a growing number of cases, select targeted therapies. Adipose tissue biology, meanwhile, has shifted from viewing fat as a passive energy store to recognising it as a dynamic endocrine organ that secretes hormones such as leptin and adiponectin, modulates inflammation and determines metabolic health outcomes in ways that vary dramatically between individuals of the same body weight.

The inclusion of food noise and weight regain on the syllabus reflects two of the most discussed clinical phenomena of the current treatment era. Food noise, a term popularised by patients describing persistent intrusive thoughts about food, has become a focal point for research into how brain reward and hunger circuits drive eating behaviour, and how modern pharmacotherapies appear to quieten it. Weight regain, conversely, remains the central challenge of long-term obesity management: physiological adaptations, including reduced resting energy expenditure and elevated appetite signalling, conspire to restore lost weight after almost every intervention, whether dietary, surgical or pharmacological. Teaching early-career clinicians why regain happens, and how emerging combination therapies might counteract it, is precisely the kind of mechanistic training the School intends to provide.

The target audience is equally specific. The School is aimed at Fellows and early-career clinicians with experience in the obesity field who are seeking to further specialise in this area of endocrinology. Participation is application-based and limited to a maximum of 25 fellows, a deliberately small number intended to create a highly interactive learning environment in which every attendee can engage directly with faculty. All successful applicants will also be invited to present a clinical case report during dedicated programme sessions, an element that transforms passive attendance into active scholarly contribution and gives young clinicians experience in presenting complex, real-world patient scenarios to senior experts.

The scientific calibre of the faculty is a central part of the offering. The Scientific Programme Committee comprises eight of Europe’s leading endocrinologists with a specialism in obesity: Blandine Gatta Cherifi (France), Karine Clément (France), Daniela Cota (France), Maeve Durkan (Ireland), Melania Manco (Italy), Uberto Pagotto (Italy), Kristina Saravinosvka (Serbia) and Liesbeth van Rossum (Netherlands). The group spans several of the continent’s most productive obesity research centres, and its multinational composition signals ESE’s intention to make the School a genuinely European platform rather than a national or single-centre initiative. For applicants, the prospect of three days of close contact with this level of expertise is likely to be the strongest draw.

Daniela Cota, speaking as a representative of the Scientific Programme Committee, framed the launch as an investment in the specialty’s future. She described obesity as one of the most pressing health challenges of our time and emphasised that endocrinologists have a vital role to play in improving outcomes for people living with the disease. Through the launch of the School, she said, ESE is supporting talented early-career clinicians and researchers to develop the expertise, networks and confidence needed to lead progress in the field. She added that the new School reflects ESE’s commitment to advancing endocrine science and clinical care while ensuring members have access to high-quality education in areas of growing importance, and expressed enthusiasm about welcoming applications for the inaugural event and supporting a new generation of obesity specialists.

The practical arrangements are designed to lower barriers to participation. Successful applicants will receive access to the full educational programme, accommodation and catering during the event, while a limited number of meeting grants will be available for eligible ESE members from low- and middle-income countries, a provision aimed at ensuring the School draws talent from across the entire WHO European Region rather than only its wealthier western half. The venue, Sabàtic Gavà Mar in Barcelona, a Tribute Portfolio Hotel, is conveniently located near Barcelona Airport, enabling participation from attendees across Europe and beyond with minimal travel friction, an apparently small logistical detail that matters considerably for a three-day intensive course drawing an international cohort.

The application window is already open and closes on 1 October 2026, giving prospective fellows a defined period to prepare their submissions. Applicants should submit a covering letter outlining their interest in attending, together with a curriculum vitae, a publication list and an optional supporting letter from a supervisor. Further information and application details are available on the ESE event website. For a field in which new drug classes, genetic insights and neuroscientific models of appetite are reshaping clinical practice at unprecedented speed, the arrival of a dedicated European training school for obesity endocrinology marks a significant institutional commitment, and the 25 fellows selected for the Barcelona inaugural will be among the first clinicians trained specifically to lead that transformation.

Subject of Research: A new European training school for early-career specialists in obesity endocrinology

Article Title: European Society of Endocrinology launches new Obesity and Endocrinology School for 2027

Article References: European Society of Endocrinology launches new Obesity and Endocrinology School for 2027. (n.d.). Original publication

Image Credits: AI Generated

DOI: Not provided

Keywords: obesity, endocrinology, European Society of Endocrinology, medical education, Barcelona, adipose tissue, weight regain, food noise, genetics of obesity, early-career clinicians, fellowship, WHO European Region

The research team set out to examine whether socioeconomic disparities influence admission to two distinct care models that both operate under the umbrella of Comprehensive Geriatric Assessment, a structured, multidisciplinary approach to evaluating the medical, functional, and psychosocial needs of older people. The first model was Hospital at Home, abbreviated HaH, which brings physician-led, nurse-supported acute care into the patient’s residence. The second was a bed-based intermediate care unit, or BBU, where patients receive comparable geriatric care but within a physical facility. Both services serve the same catchment population and are grounded in the same assessment philosophy, which makes them an ideal natural comparison: if admission decisions were driven purely by clinical criteria, the socioeconomic profiles of patients in the two pathways should look broadly similar. They did not.

To conduct the analysis, the researchers assembled a retrospective cohort of adults aged 65 and older who had been admitted to either the Hospital at Home service or the bed-based intermediate care unit at Parc Sanitari Pere Virgili between 2018 and 2023. Rather than relying solely on clinical records, the team linked these data to administrative health records that contained individual socioeconomic variables as well as small area-level indicators describing the neighborhoods in which patients lived. This dual-level design is technically important. Many studies of health inequality capture only individual characteristics such as income or education, but a person’s opportunity to receive care at home also depends on contextual factors — housing quality, caregiver availability, and the social fabric of the surrounding area — that individual variables cannot fully capture.

The statistical approach reflected this multi-layered structure. The researchers used mixed models, a class of regression techniques that can simultaneously estimate the effect of individual and area-level predictors while accounting for the clustering of patients within small geographic units. These models produced odds ratios quantifying how socioeconomic variables influenced the probability of being admitted to Hospital at Home rather than to the bed-based unit, adjusted for demographic and clinical characteristics. They also generated measures of clustering and heterogeneity, such as the intraclass correlation and interval-based odds ratio statistics, that reveal how much of the variation in admission decisions is attributable to where a patient lives rather than to who the patient is.

The headline finding was stark. After adjustment for demographic and clinical factors, patients with higher income had significantly greater odds of being admitted to Hospital at Home: the adjusted odds ratio was 1.68, with a 95 percent confidence interval of 1.45 to 1.96. In practical terms, this means that wealthier older adults were substantially more likely to receive their acute geriatric care at home, while economically disadvantaged patients with comparable clinical profiles were more often directed to the bed-based intermediate care unit. The unadjusted comparisons reinforced the pattern: Hospital at Home patients were, on average, younger, less burdened by multimorbidity, and more socioeconomically advantaged than their counterparts in the bed-based unit. Some of that difference reflects genuine clinical selection criteria, since home-based acute care requires a suitable home environment and a degree of stability, but the persistence of the income effect after adjustment indicates that clinical factors do not tell the whole story.

Equally revealing was the geography of the disparity. The researchers found that area-level socioeconomic context explained roughly 20 percent of the variability in Hospital at Home admission, and that the strength of socioeconomic effects varied widely across small areas within the city. In some neighborhoods, socioeconomic position appeared to exert a powerful influence on whether a patient reached the home-based pathway; in others, the effect was muted. This heterogeneity, quantified through the mixed-model framework using measures such as the median odds ratio and the proportion of opposed odds ratios, suggests that access to hospital care at home is not uniformly patterned across Barcelona but is locally mediated — by differences in housing stock, social support networks, and possibly by the way services are organized and delivered in different primary care service areas.

The implications reach far beyond one Catalan health district. Hospital at Home models are expanding rapidly across Europe, North America, and beyond, propelled by aging populations, hospital capacity pressures, and evidence that many older patients fare better at home. Governments and health systems have embraced the model as a cornerstone of future acute care. Yet the Barcelona findings highlight a structural risk: if eligibility and referral processes implicitly favor patients with higher incomes, better housing, or stronger family support networks, the model could widen rather than narrow existing health inequalities. Patients who stand to benefit most from avoiding a hospital admission — those living in deprived neighborhoods, with fewer resources and more fragmented support — may be the very ones least likely to be offered home-based care, defaulting instead to institutional settings that carry higher risks of functional decline for frail older people.

The authors frame their conclusions as a call to action for health systems designing and scaling home hospital services. Ensuring equitable delivery, they argue, requires explicitly addressing the social barriers that shape access: identifying health-related social needs during the Comprehensive Geriatric Assessment, adapting services to patients whose homes or support networks are less favorable, and monitoring socioeconomic equity in referral patterns as rigorously as clinical outcomes are monitored. The study’s granularity matters here. By using small area-level indicators rather than crude citywide measures, the researchers demonstrated that disadvantage operates at a neighborhood scale, meaning that equity interventions may need to be locally targeted rather than uniformly applied.

Methodologically, the study has the strengths and limitations typical of retrospective administrative data research. Its cohort design captures real-world admission patterns over six years, and the linkage of individual records to area-level socioeconomic data provides a nuanced picture that single-level analyses would miss. Ethics approval was granted by the Vall d’Hebron Research Institute Ethics Committee under protocol PR(AG)107/2020, with informed consent waived because the analysis used anonymized retrospective datasets and was conducted in accordance with the Declaration of Helsinki. The work was funded by the Instituto de Salud Carlos III through project PI22/00845, co-funded by the European Union, and the authors declare no competing interests. Because the data reflect a single provider in Barcelona, the exact magnitudes of the disparities may differ elsewhere, but the analytical strategy — and the warning it carries — is readily transferable to any health system rolling out home-based acute care.

The article, published open access in BMC Geriatrics on 23 September 2026, arrives at a moment when the future shape of hospital care is being actively negotiated in legislatures, insurers’ boardrooms, and clinical guidelines. As Hospital at Home shifts from pilot projects to mainstream infrastructure, the Barcelona study offers a clear technical lesson: admission algorithms and referral pathways are not socially neutral. Without deliberate design, the comfort and clinical advantages of being treated at home will flow preferentially to those who already hold the most resources, while older adults with the greatest socioeconomic vulnerability remain on the ward. The research suggests that the measure of a successful hospital at home program should therefore be twofold — not only whether patients recover well at home, but also whether the patients admitted to those beds at home are there because of their clinical need, and not because of their income or their postcode.

Subject of Research: Socioeconomic inequalities in access to hospital at home care for older adults

Article Title: Beyond clinical need: socioeconomic inequalities in access to hospital at home among older adults

Article References: Belfiori, M., Pérez, L. M., Villa-García, L., Planesas-Pérez, O., Salucci, C., Inzitari, M., & Ribera, A. (2026). Beyond clinical need: socioeconomic inequalities in access to hospital at home among older adults. BMC Geriatrics. https://doi.org/10.1186/s12877-026-08310-z

Image Credits: AI Generated

DOI: 10.1186/s12877-026-08310-z

Keywords: Hospital at Home, socioeconomic inequality, older adults, geriatrics, Comprehensive Geriatric Assessment, health equity, Barcelona, intermediate care, income disparities, health services research, mixed models, BMC Geriatrics

The core problem the researchers set out to solve is deceptively simple to state and notoriously difficult to solve. Regulatory networks measure outdoor pollution at fixed stations, and increasingly sophisticated satellite products and land-use regression models can map street-level concentrations at fine spatial resolution. But people in temperate European cities spend the overwhelming majority of their time indoors, where concentrations of nitrogen dioxide are governed by a second set of processes entirely: infiltration of outdoor air through windows, cracks, and ventilation systems; indoor combustion sources such as gas stoves and boilers; and the building characteristics that determine how quickly pollutants accumulate or disperse. An exposure estimate that ignores these indoor dynamics can be badly biased, and the bias is rarely random. It tends to track income, housing age, building density, and access to ventilation, meaning that the people most poorly represented by outdoor monitors are often those whose true exposure is most underestimated.

The study’s answer to this challenge is a two-stage architecture that separates the problem into an outdoor prediction stage and an indoor transfer stage. In the first stage, the researchers estimate outdoor nitrogen dioxide concentrations at high spatial resolution across Barcelona, drawing on the established toolkit of land-use regression and related spatial models that relate measured concentrations to traffic intensity, road network characteristics, land cover, population density, and meteorology. This stage produces a continuous urban surface of ambient pollution, effectively filling in the gaps between monitoring stations so that every building in the city can be assigned a plausible outdoor concentration. The approach reflects two decades of methodological development in exposure science, refined in recent years by machine learning techniques that can capture nonlinear relationships between urban form and pollution gradients.

The second stage is where the study makes its distinctive contribution. Rather than assuming that indoor concentrations simply mirror outdoor levels, the model estimates how outdoor pollution is translated into indoor air for individual dwellings. This translation depends on the infiltration factor, the fraction of outdoor particles or gases that penetrate and persist indoors, which varies systematically with building type, construction era, window behavior, and the presence of indoor sources. Gas cooking is a particularly important modifier for nitrogen dioxide, because a gas flame releases the pollutant directly into the kitchen air. By combining predicted outdoor concentrations with information on building characteristics and household features, the second stage produces estimates of the concentrations people actually experience inside their homes, the locations where exposure is typically longest and most sustained.

Barcelona is an ideal proving ground for this kind of model. The city’s compact Eixample district, with its characteristic chamfered blocks and enclosed interior courtyards, creates extraordinarily sharp pollution gradients: a dwelling on a wide traffic artery can face dramatically different ambient conditions from one a few tens of meters away on an inner courtyard. At the same time, Barcelona’s housing stock is dominated by apartment buildings of varying ages and construction quality, with a substantial share of households relying on gas appliances for cooking. This combination of steep spatial variability and heterogeneous building stock means that outdoor-only exposure estimates are likely to misclassify large numbers of residents, and it gives the two-stage model a demanding test case in which its added realism can matter most.

The practical payoff of the approach is a city-wide picture of indoor exposure that no measurement campaign could realistically deliver. Monitoring indoor air directly requires recruiting households, installing instruments, and sustaining them over weeks or months, which limits studies to samples of dozens or a few hundred homes. Those measurements remain indispensable for calibrating and validating models, but they cannot by themselves reveal how exposure is distributed across an entire population. The two-stage framework bridges that gap: a limited set of indoor observations anchors the model, and the model then extends those observations to every address in the city, generating exposure estimates that can be linked to health records, school locations, or demographic data. This capacity to produce individual-level or small-area exposure estimates at scale is precisely what modern environmental epidemiology requires, particularly for studying outcomes such as childhood asthma, where the indoor environment is believed to play a decisive role.

The findings carry implications that extend well beyond academic modeling. Nitrogen dioxide is a respiratory irritant with well-documented associations with asthma exacerbations, reduced lung function growth in children, and cardiovascular effects, and the World Health Organization has repeatedly tightened its air quality guidelines for the pollutant. If a meaningful fraction of exposure occurs indoors, then policies that focus exclusively on tailpipe emissions and traffic restriction, while essential, will not fully protect public health. The modeling framework makes it possible to ask targeted questions: which neighborhoods combine high outdoor pollution with poor building envelopes and prevalent gas cooking; how much exposure reduction would follow from electrifying household cooking versus tightening vehicle standards; and whether interventions such as improved ventilation or filtration deliver the benefits their proponents claim. Each of these questions becomes answerable once indoor exposure can be predicted systematically rather than measured only sporadically.

The study also speaks to a broader methodological shift in exposure science, one in which hybrid models that fuse measurements, spatial statistics, and increasingly machine learning are replacing both pure monitoring and purely statistical surrogates. The two-stage design has a particular virtue: interpretability. Because outdoor prediction and indoor transfer are modeled separately, researchers can diagnose which stage contributes most to uncertainty, and policymakers can see transparently how a change in traffic emissions or in housing characteristics propagates through to human exposure. This modularity also makes the framework portable. A city with a different climate, building stock, or pollution profile can retain the architecture while re-estimating the stage-specific parameters from local data, a flexibility that matters as exposure scientists attempt to generalize findings from well-studied European cities to rapidly urbanizing regions where monitoring infrastructure is thin.

Limitations remain, and the authors are candid about them. Indoor models are only as good as the household-level information feeding them, and data on cooking fuel, ventilation behavior, and window-opening habits are difficult to obtain at population scale. Seasonal variation adds another layer of complexity, since infiltration and ventilation patterns shift markedly between Barcelona’s mild winters and hot summers. Uncertainty in the second stage is therefore typically larger than in the first, and the resulting exposure estimates are best understood as probabilistic characterizations rather than precise measurements of any single dwelling’s air. Nonetheless, the study demonstrates that even with these constraints, two-stage modeling yields exposure surfaces that are demonstrably more faithful to the environments people inhabit than outdoor concentrations alone.

For residents of Barcelona and cities like it, the research reframes a familiar anxiety in sharper terms. The pollution that matters most to long-term health is not only the visible haze over a traffic-choked avenue but the quieter accumulation inside apartments, kitchens, and bedrooms, shaped by the building itself and the appliances within it. By giving researchers and policymakers a rigorous way to estimate that hidden half of the exposure equation, the two-stage approach moves the field closer to interventions that meet people where they actually live. As cities worldwide grapple with tightening air quality targets and aging housing stocks, models of this kind are likely to become standard instruments of environmental health policy, translating sparse measurements into the dense, actionable picture that protecting public health demands.

Subject of Research: Two-stage modeling of indoor nitrogen dioxide exposure in Barcelona residences

Article Title: A two-stage modeling approach to estimate indoor NO2 exposure: a Barcelona case study

Article References: Domínguez, A., Zhao, Y., Samuelsson, K., Jimenez-Arenas, P., Cirach, M., Arevalo, G., Barril, L., Lao, J., Foraster, M., Gascón, M., Persavento, C., Nieuwenhuijsen, M., Tonne, C., Moreno, T., Querol, X., Jerret, M., Schwartz, J., Sunyer, J., Dadvand, P., … Basagaña, X. (2026). A two-stage modeling approach to estimate indoor NO2 exposure: a Barcelona case study. Journal of Exposure Science & Environmental Epidemiology. https://doi.org/10.1038/s41370-026-00969-1

Image Credits: AI Generated

DOI: 10.1038/s41370-026-00969-1

Keywords: nitrogen dioxide, indoor air pollution, exposure modeling, Barcelona, land-use regression, infiltration factor, gas cooking, environmental epidemiology, air quality, respiratory health, two-stage model, urban pollution