Search Results (662)

Background: In Mexico, the measles vaccine was first introduced in 1971. The last case of measles acquired through endemic transmission was recorded in 1995. In 1998, the monovalent measles vaccine was replaced by the combined measles–mumps–rubella (MMR) vaccine. The MMR vaccination schedule consists of two doses: the first is administered at 12 months of age, and the second is administered at either 18 months or 6 years of age. Materials and Methods: A retrospective analysis was conducted using secondary data from 2006 to 2024. Vaccine procurement and administration records from IMSS, ISSSTE, and SSA were reviewed to evaluate the performance of both the MMR and MR programs, focusing particularly on the trends in coverage and data consistency across institutions. Results: The analysis revealed persistent inconsistencies between vaccine procurement and administration for both the MMR and MR vaccines across all institutions. Several years exhibited notable mismatches, including surpluses and deficits in the administered doses relative to their procurement. Between 2006 and 2024, only 69 million of the 91.6 million required MMR doses were administered in Mexico, leaving a deficit of approximately 22.5 million doses (25% of the target population). For MR, a cumulative deficit of approximately 24.6 million procured but unadministered doses was identified. National coverage remained suboptimal, with significant variability across years and institutions. Comparisons with WHO and ENSANUT data indicated marked discrepancies. The seroprevalence findings, along with the 2025 measles outbreak, confirm significant gaps in immunity. Discussion: This study highlights systemic challenges in Mexico’s MMR vaccination program, including inconsistencies in vaccine procurement, administration, and reported coverage across institutions. Overestimated official MMR coverage rates and unclear target definitions for MR contribute to program inefficiencies and missed vaccination opportunities. The resurgence of measles in 2025, along with persistently high incidences of mumps, aligns with the observed immunity gaps, although a direct causal relationship cannot be established from this study. These findings are consistent with previous national studies and seroprevalence data. Conclusions: Despite limitations in the data, this study effectively evaluated the performance of Mexico’s MMR vaccination program, identifying critical gaps in coverage, data reliability, and operational alignment. The findings underscore the need for improved procurement planning, harmonized coverage estimates, and robust monitoring systems. To address the existing gaps in immunity, catch-up campaigns should prioritize the use of the MMR vaccine over MR. Strengthening nominal coverage tracking and implementing evidence-based strategies are essential to restoring public trust and maintaining the goals of measles elimination. Full article

Background: The introduction of prophylactic HPV vaccination has transformed cervical cancer prevention worldwide, yet many low- and middle-income countries face persistent challenges in implementation, coverage gaps, and vaccine hesitancy. This article presents a narrative review of global and Brazilian HPV vaccination programs, highlighting achievements, pitfalls, and lessons for future strategies. Methods: We reviewed peer-reviewed literature and official reports from WHO, PAHO, CDC, Brazilian institutions, and others, focusing on programmatic performance, coverage trends, and vaccine acceptance. Results: In high-income settings such as Australia and the United Kingdom, school-based vaccination programs have driven sharp declines in HPV prevalence, genital warts, and precancerous lesions, in some cases approaching elimination thresholds. The United States has made progress but continues to struggle with disparities in uptake linked to socioeconomic and cultural factors. In India and several African nations, recent evidence supports single-dose regimens as a cost-effective and logistically feasible strategy. In Brazil, HPV vaccination was introduced in 2014 via the National Immunization Program (PNI), initially targeting girls aged 9–13 years through school campaigns. First-dose coverage exceeded 80% in the first year but subsequently declined, with full-schedule completion rates dropping below 60%. Contributing factors include misinformation, weakening of school-based delivery, and pandemic-related disruptions. Brazil later expanded eligibility to boys and immunocompromised populations and, more recently, extended catch-up vaccination to older adolescents. Conclusions: HPV vaccination has the potential to substantially reduce cervical cancer incidence globally. However, sustained impact depends not only on infrastructure and universal access but also on consistent school-based delivery, adaptive policies such as single-dose regimens, and robust communication strategies to counter misinformation. Brazil’s experience offers both inspiration and caution, providing lessons for countries striving to meet the WHO 90-70-90 targets. Full article

The 2030 Bilingual Policy was introduced in Taiwan to strengthen citizens’ English communication skills, especially among young people, and to enhance their global competitiveness. Within Taiwan’s educational context, several challenges have emerged. In response, researchers have examined the key factors contributing to effective bilingual education, including policy implementation, bilingual instruction models, teacher professional development, and the availability of teaching resources. Despite their important role in bilingual instruction, bilingual professional learning community (BPLC) remains an underexplored topic of discussion. In particular, how BPLC can support subject teachers with limited English proficiency, a common phenomenon in Taiwan, is a question that needs further investigation. Thus, this study aims to implement a sustained BPLC to examine its functional role and influence on bilingual instructional transformation among teachers with limited English proficiency. The study draws on classroom observation notes, BPLC discussions, and interview data collected from fall 2024 to summer 2025. The findings show that regular classroom observations and bilingual professional conversation meetings benefit teachers across various areas, including classroom management, lesson planning, and language development. The BPLC provides real-time feedback and long-term developmental guidance, thereby facilitating more effective bilingual instruction. To conclude, this study contributes to the understanding of the dynamic relationship between bilingual instruction and BPLC. It also offers insights into how BPLC can support teachers with limited English proficiency in various ways. Full article

Although the COVID-19 pandemic negatively affected the health and quality of life of older people (OP), it provided an opportunity for the implementation of telehealth in the areas of Gerontology and Geriatrics, globally and in the countries of Latin America and the Caribbean, which enabled the continuity of healthcare interventions. Therefore, this literature review aimed to (a) conceptualize telehealth in OP through the lens of Gerontology and Geriatrics; (b) analyze the implementation, facilitators, and barriers of telehealth for OP during the COVID-19 pandemic at both global and Latin American and Caribbean regional levels; (c) identify lessons learned and considerations for improving implementation and reducing barriers to telehealth for OP; and (d) discuss challenges related to the integration of telehealth for OP in the region. The databases consulted were PubMed, Scopus, and Scielo; scientific articles in both English and Spanish were considered, including research conducted globally and in Latin American and Caribbean countries that contributed to the objectives of the literature review; the search was conducted from the year 2020 onwards. In addition, government documents and non-governmental technical guidelines from countries in the region were included, whether they focused specifically on older populations or the general population; the search was not limited to a specific time period. Initially, in our search strategy, 1631 scientific articles and 20 governmental and non-governmental documents were identified for the literature review. After eliminating duplicate and applying the inclusion and exclusion criteria, 84 documents were selected for the literature review (46 analyzed the implementation, barriers, and facilitators of telehealth during the COVID-19 pandemic). This literature review presents a conceptual analysis of the implementation and facilitators of, as well as barriers to, telehealth among OP during the COVID-19 pandemic from the perspective of healthcare providers and OP themselves. The paper synthesizes a number of international and Latin American experiences and proposes several recommendations for the implementation of telehealth for OP in the Latin American and Caribbean region. Despite the ongoing challenges regarding telehealth research and training, this review describes telehealth for OP as an intervention approach that improves the provision of holistic care, favoring OP autonomy, functionality, and overall quality of life. This review also proposes telehealth as a regular intervention approach to clinical practice in Gerontology and Geriatrics in the region. Collaborative endeavors are needed to further regulate and promote public policy on telehealth, telemedicine and telerehabilitation for OP. Full article

This narrative review examines how ecological and economic perspectives can be integrated to support ecosystem services management and biodiversity conservation. We synthesize core valuation approaches (accounting-based exchange values versus welfare-based measures), discuss their appropriate uses and limitations, and illustrate implications through selected cases in watershed protection, protected areas, and forest carbon. We then review design features of Payments for Ecosystem Services (PES) with attention to additionality, leakage, and equity, and distill lessons for policy mixes that combine market-based instruments with regulatory and informational tools. Finally, we outline opportunities and risks in applying artificial intelligence to ecological–economic analysis, emphasizing accuracy–energy trade-offs and responsible data practices. Across topics, we prioritize mechanism-focused interpretation, triangulate findings from representative studies, and highlight decision-relevant takeaways rather than comprehensive coverage. We conclude with practical recommendations for analysts and policymakers: align valuation method with decision context; pair PES with targeting and monitoring; embed price-based instruments in adaptive policy mixes; and adopt transparent, efficiency-aware analytic workflows—especially when using computationally intensive methods. Full article

Commercial complexes, as major sources of urban energy consumption and carbon emissions, face urgent demands for efficiency improvement under the “dual-carbon” strategy. This paper develops a Building Information Modeling (BIM)-enabled life-cycle energy management framework to address fragmented monitoring, weak coordination, and data silos inherent in traditional approaches. Methodologically, a structured literature review was conducted to identify inefficiencies and draw lessons from global practices. An enhanced Delphi method was then applied to refine 12 key evaluation indicators spanning six dimensions—policy, economic, social, technological, environmental, and compliance—which were subsequently integrated into a BIM platform. This integration enables real-time energy monitoring, multi-system diagnostics, and cross-phase collaboration across the design, construction, and operation stages. An empirical case study of the Zhongjian Plaza project in Shanghai demonstrates that the proposed framework not only enhances energy efficiency and reduces life-cycle costs, but also improves user comfort while aligning with both domestic green building standards and international sustainability targets. Overall, the study provides a replicable methodology and practical reference for the smart and low-carbon operation of large-scale commercial complexes, thereby offering strategic insights for advancing sustainable urban development. Full article

Energy security remains a central challenge in the context of global sustainability, as geopolitical dynamics, technological advancements, and environmental imperatives converge to reshape energy systems worldwide. This comprehensive review explores the intricate relationship between geopolitics and energy policy, with a particular focus on Türkiye’s evolving energy landscape. It examines how diversification of energy sources, investments in renewable technologies, resilient infrastructure development, and international collaborations collectively contribute to securing national and global energy futures. The study highlights the geopolitical significance of strategic energy corridors, resource competition, and the emergent role of renewable energy in redefining power structures. Drawing on comparative case studies, including Germany’s Energiewende, Norway’s resource management, Japan’s post-Fukushima challenges, and the United States’ shale revolution, the review distills lessons applicable to Türkiye and other emerging economies navigating energy transitions. Future trends discussed include the rising importance of energy storage, smart grids, digitalization, cybersecurity, and equitable energy access. Policy recommendations emphasize integrated approaches that balance economic growth, environmental stewardship, and national security, advocating for proactive diversification, innovation, and multilateral cooperation. The article concludes that achieving a resilient, low-carbon, and geopolitically stable energy system requires coordinated global efforts anchored in adaptive governance and inclusive stakeholder engagement. This work provides a valuable framework for policymakers, researchers, and practitioners committed to advancing sustainable and secure energy pathways in Türkiye and beyond. Full article

Background/objectives: Despite global efforts to improve childhood immunization rates, gender-related barriers continue to hinder equitable access to vaccines worldwide. This study synthesizes gender barrier analyses conducted in various countries to better understand these challenges. This evidence synthesis aims to (1) identify the main gender-related barriers affecting immunization focusing on zero-dose targets, HPV, and COVID-19 vaccination campaigns; and (2) summarize key recommendations and lessons that have emerged from countries to overcome those gender barriers. Methods: A documentary analysis was used by reviewing data from gender barrier analyses that were conducted by multiple governments with UNICEF support. The study classified barriers using the socio-ecological model (SEM), encompassing systemic, health service, community, household, and individual-level gender barriers. Descriptive statistics and inductive thematic coding were used to analyze data. Results: This synthesis includes 24 documents representing gender barrier analyses across 29 countries. Findings highlight multiple barriers, including systemic discrimination against women in public and healthcare spaces, limited political will to address gender disparities, and limited (sex)-disaggregated and gender data. At the community and household levels, social norms restrict women’s autonomy in seeking immunization services, while household duties (culturally assigned to women) also restrict their access to immunization services. Adolescents face additional challenges, particularly regarding HPV vaccination, due to misconceptions and stigma from families and peers. Conclusions: Addressing gender-related barriers requires a multi-level approach, integrating gender-responsive policies, and comprehensively addressing gender barriers that are hindering the progress of vaccination efforts. UNICEF’s commitment to gender-responsive immunization strategies is critical for achieving the Immunization Agenda 2030 and ensuring equitable vaccine access for all. Full article

Disaster headlines often underscore devastation and loss while overlooking success stories where proactive disaster risk reduction (DRRM) measures have averted catastrophe, saved lives, and reduced economic damage. This study addresses the gap in documentation and analysis of DRRM success stories in Africa, particularly within the Southern African Development Community (SADC), arguing that the absence of such narratives hampers a shift from reactive to proactive disaster risk governance. The research aims to extract critical lessons from success stories for enhancing future preparedness and response frameworks. A qualitative research design was employed, integrating document analysis, expert interviews, field observations, and practitioner workshops. Data was triangulated from diverse sources, including national disaster management agency reports (e.g., South Africa’s NDMC, Botswana’s NDMO, Mozambique’s INGC), peer-reviewed literature, UNDRR reports, SADC policy documents, and first-hand experiences from the authors’ consultancy work in the African Union’s biennial DRRM reporting processes. Case studies examined include Mozambique’s response to Cyclone Idai in 2019, South Africa’s drought and flood risk governance (e.g., the 2023 floods in Eastern and Western Cape), and Malawi’s flood resilience programs. Findings reveal that successful DRRM outcomes are driven by a combination of anticipatory governance, community-based preparedness, integration of Indigenous Knowledge Systems (IKSs), and investment in infrastructure and ecosystem-based adaptation. These cases demonstrate that locally embedded, yet scientifically informed, interventions enhance resilience and reduce disaster impacts. The study underscores the relevance of theoretical frameworks such as resilience theory, narrative theory, and social learning in interpreting how success stories contribute to institutional memory and adaptive capacity. Policy recommendations emphasize the need for institutionalizing success-story documentation in national DRRM frameworks, scaling up community engagement in risk governance, and fostering regional knowledge-sharing platforms within the SADC. Furthermore, the paper advocates for making DRRM success stories more visible and actionable to transition toward more anticipatory, inclusive, and effective disaster risk management systems. Full article

The COVID-19 pandemic caused the world to pause temporarily on an almost planetary scale. The creation and diffusion of knowledge about environmental planning and public health are now almost taken for granted. However, such processes were rather different in pre-pandemic times. It took a substantial dose of labor and resources to generate the information needed to produce useful and usable knowledge, and especially to make it available to others in a timely and effective way. As automobility has come to occupy center stage in the lives of an increasing number of suburbanized dwellers, it has taken multiple energy and public health crises, bold leadership, and the real threat of climate change to create the conditions needed to bolster sustainable Non-Motorized Transportation (NMT) as a complement to cleaner and more convenient mass transit options in cities. How does knowledge about sustainable NMT get created? How are sustainable NMT innovations diffused? How can technological and societal transitions to more sustainable realities be nurtured and augmented? This article utilizes a longitudinal and integrated knowledge creation and diffusion model with a Participatory Planning Process to analyze the adoption of measures aimed at reducing the negative consequences of too much automobility and encouraging higher levels of walking, cycling, and mass transportation. The research methods comprised autoethnographic, qualitative, and policy evaluation techniques. The study makes use of the means and ends matrix to discuss cases from five distinct realms: personal, academic, institutional, volunteering NGO, and private sector. The key findings and lessons learned promote scenarios of managed degrowth and sustainable urban transitions. Full article

Background/Objectives: The COVID-19 (Coronavirus Disease, 2019) pandemic affected all countries in a variety of ways, and forced policymakers to adapt national health infrastructure. In this context, the strategic adaptation and policy evolution of small island states are understudied. Therefore, the objective of this study was to quantitatively analyse the relationship between confirmed COVID-19 cases and health policy decisions in Northern Cyprus. We also examined the shifting management strategies employed during the pandemic using a replicable statistical analysis framework. Methods: In this mixed-methods study, we used systematic thematic analysis to categorise official policy decisions from March 2020 to December 2022. Yearly linear regression models using SPSS and Python correlated the monthly number of decisions with the number of confirmed COVID-19 cases. The analyses included R² values, p-values, and visualisations with 95% confidence intervals. Results: The findings of this study highlight a three-phase strategic period. In 2020, the results (R² = 0.03, p = 0.63) showed no significant relationship, indicating initial uncertainty. The results (R² = 0.60, p = 0.003) indicate a strong negative correlation in 2021, which reflects the consistency of the proactive suppression strategies adopted. Conversely, for 2022, the results (R² = 0.79, p < 0.001) show a strong positive correlation representing the shift to a reactive mitigation strategy, in which the government responded based on case peaks. Conclusions: This study’s primary finding is that strategic agility was key to managing the pandemic. For small island states in particular, the effectiveness of geographic advantages like border control depends on a coherent strategy that transcends initial uncertainty. Our data-driven framework provides a tool for analysing this strategic evolution and guiding responses to future pandemics. Full article

China possesses abundant solar energy resources and remains heavily dependent on agriculture. The integration of photovoltaic (PV) power generation with agricultural production has emerged as a strategic pathway to advance China’s ecological transition and dual carbon goals. By 2023, PV power generation represented 21% of the nation’s total installed capacity. The cumulative capacity was projected to reach approximately 887 GW by 2024. The novelty of this study lies in offering a systematic and integrative review of PV agriculture in China. This paper used a combination of field research, case studies, policy analysis, and a comparative evaluation of diverse “PV+” development models. The findings reveal a pronounced spatial imbalance. Western China possesses 42% of the country’s solar energy resources, whereas the eastern provinces of Jiangsu, Zhejiang, and Anhui collectively comprise 37.8% of all PV agricultural projects. Three dominant “PV+” models are identified and categorized as follows: “PV + ecological restoration”, “PV + agriculture, forestry, animal husbandry, and fisheries,” and “PV + facility agriculture.” These models provide multiple benefits. They enhance land use efficiency, stimulate local economic development, and contribute to food security by expanding the supply of essential agricultural products. Based on these insights, the study highlights future priorities in technological innovation, ecological evaluation, intelligent equipment, digitalization, and region-specific policy support. Overall, this research fills a key gap in systematically and comprehensively describing the current development status of photovoltaic agriculture in China. It also offers transferable lessons for sustainable agriculture and global energy transitions. Full article

The aim of this study is to examine existing positive energy district (PED) initiatives by using an explanatory research approach for gaining insight, identifying patterns, clarifying underlying processes, exploring cause-and-effect relationships, and explaining phenomena in a greater depth. Specifically, studies from the existing literature that have explored multiple PEDs were analyzed. Current challenges, barriers, and obstacles, as well as success factors, good practices, and policy guidelines are thoroughly investigated, evaluated, categorized and compared to unveil lessons learnt from diverse existing international projects for turning urban areas into self-sustainable and greener urban neighborhoods. The proposed framework aims to reveal the required processes for successful PED creation and operation. It provides an overview of the current state of the art and enhances comprehension and know-how about the processes needed for the successful adoption and integration of PEDs based on lessons learnt from global challenges and success stories. Full article

Escalating extreme wildfires, fueled by the confluence of climate change, land use patterns alterations, ignitions by humans, and flammable fuels accumulation, pose significant and increasingly destructive risks to critical infrastructure (CI). This study presents a comprehensive comparative analysis of wildfire impacts and the corresponding CI resilience strategies employed across the EU and the US. It examines the vulnerability of CIs to the devastating effects of wildfires and their inadvertent contribution to wildfire ignition and spread. The study evaluates the EU’s CER Directive and the US National Infrastructure Protection Plan and assesses European Commission wildfire resilience-related initiatives, including FIRELOGUE, FIRE-RES, SILVANUS, and TREEADS flagship projects. It synthesizes empirical evidence and extracts key lessons learned from major wildfire events in the EU (2017 Portuguese fires; 2018 Mati wildfire) and the US (2023 Lahaina disaster; 2025 Los Angeles fires), drawing insights regarding the effectiveness of various resilience measures and identifying areas for improvement. Persistent challenges impeding effective wildfire resilience are identified, including governance fragmentation, lack of standardization in risk assessment and mitigation protocols, and insufficient integration of scientific knowledge and data into policy formulation and implementation. It concludes with actionable recommendations aimed at fostering science-based, multi-stakeholder approaches to strengthen wildfire resilience at both policy and operational levels. Full article

The European Union (EU) has been identified as a leading stakeholder relating to urban regeneration. In cases such as Spain, on which this research focuses, the EU influence has resulted in an understanding of urban regeneration as a policy of strategic nature. The literature on the urban dimension of regeneration has reinforced the need to implement strategic and statutory complementarity in urban transformation to address the complex physical problems of vulnerable urban areas. This work focuses on this policy issue using a qualitative methodology based on a literature review and the analysis of planning documents through the storyline analysis tool. The research identifies that under the urban EU Cohesion Policy (CP) 2014–2020, only 4 out of 28 integrated sustainable urban development strategies in Spain implemented the urban regeneration strategic approach in complementarity with statutory instruments. This has led to regeneration projects with restricted capacity to address the physical problems identified, a fact that perpetuates the disadvantage of the neighbourhoods where it operated and limits the efficiency of EU funding. The results highlight the value of reviewing urban instruments under the CP, advancing towards a vision in which statutory/strategic approaches work in complementarity in the post-2027 period. Full article