Search Results (990)

The integration of sustainable development into biology education has been a growing area of interest. Biology education for sustainability is considered through competencies and skills, taking different dimensions of knowledge into account. Solving problems requires not only knowledge but also communicative and strategic activity. Thus, biology education must emphasize the main visions of scientific literacy proposed in the literature, supporting students to understand society and everyday socioscientific challenges at the local as well as at the global level, and to deal with differing scientific results and uncertain information. However, there are very few studies from a holistic didactic viewpoint on the implementation of sustainable education (SE) in biology education in the context of teacher education and school education for promoting a sustainable future. This study addresses this gap via a bibliometric and content analysis of the literature (n = 165 and 131, respectively) based on the categories of the sustainable development goals (SDGs), subject aims, learning objectives, content knowledge, teaching methods, competencies and skills, and assessment methods. The literature analyzed emphasizes the environmental and social SDGs, the development of students’ factual and conceptual knowledge and learning, interactive teaching and learning methods, critical thinking and reflection, and summative and formative assessment methods. There is much less attention on economic and institutional SDGs, scientific skills, environmental attitudes, knowledge creation, strategic thinking and empathy, and diagnostic assessment methods. Compared to earlier studies performed in the 2010s, teaching and learning methods have become more diverse in contrast to the earlier focus on teacher-centered methods. Overall, the conclusion is that biology education must evolve beyond content mastery to integrate ethical, technological, and transdisciplinary dimensions—empowering learners not only to understand life but to sustain it—aligned with quality education (SDG 4), good health and well-being (SDG 3), and life on land (SDG 15). The findings also suggest that powerful knowledge needs to be emphasized for providing essential insights into ecosystems, biodiversity, and the processes that sustain life on Earth. They also highlight the importance of regular evaluations of teaching and learning for detecting how pedagogical and didactic approaches and strategies have supported students’ learning focused on sustainable development. Full article

Advance care planning (ACP) is fundamentally important for patients diagnosed with glioblastoma (GBM), a highly aggressive primary brain tumor with a grim prognosis. The urgency for early ACP is profoundly amplified by the characteristic, progressive neurocognitive decline that frequently impairs critical reasoning and leads to the loss of decisional capacity. ACP is a proactive process ensuring that future medical interventions align with a patient’s deeply held values and goals. Proactive ACP discussions are associated with less aggressive end-of-life (EOL) care, improved quality of life for patients and care partners, earlier hospice enrollment, and reduced psychological distress for surrogate decision makers. Despite guidelines recommending early integration, ACP prevalence remains low due to clinician discomfort with EOL discussions, a perceived lack of adequate training, and a widespread “culture of shared avoidance”. Experts recommend initiating ACP at or shortly after diagnosis, normalizing it as standard cancer care. Using structured communication strategies, such as the REMAP tool, and empowering allied health providers to champion these conversations are key integration strategies. Ultimately, early and skillful ACP is an ethical imperative that safeguards patient autonomy and minimizes the burden on loved ones. Full article

Based on extensive ethnographic fieldwork conducted in Mianning County, Liangshan Yi Autonomous Prefecture between 2023 and 2024, this paper analyzes the “xiō bū” (ꑭꁮ) ritual of the Liangshan Yi people. Framed within contemporary approaches to religious anthropology and social memory theory, the study explores how this ritual constructs Yi ecological ethics, social integration, and cultural identity through nature worship, ancestral spirit beliefs, and ritual practices. The ethnographic evidence reveals that the “xiō bū” ritual, by designating wooded mountains as sacred space and performing sacrifices to nature deities and ancestral spirits, integrates “humans—nature—ancestors” into a symbiotic system of the “community of life.” This reflects the Yi people’s relational ontology and embedded ecological knowledge. The sacrificial offerings, shared meals, and purification practices in the ritual not only reinforce reverence for nature through symbolic acts but also unify the community through Durkheimian “collective effervescence,” thereby restoring the community’s spiritual order. As a carrier of social memory, the “xiō bū” ritual, through epic chanting, symbolic performances (such as clothing, ritual implements), and bodily practices (like the ritual specialist’s movements), embeds individual memories into the collective historical narrative of the group, dynamically constructing the cultural boundaries of the “Yi” people. The ritual specialists (Bimo or Suni), as intermediaries of knowledge and power, maintain religious authority through bricolage-like symbolic reorganization and foster the creative transformation of tradition in response to the challenges of modernity. The study further reveals that while the ritual faces challenges in the contemporary context, such as secularization and population mobility, it continues to activate ethnic identity by simplifying rituals, preserving core symbols, and coupling with ecological discourses, offering a model for the modern adaptation of traditional religions. This paper argues that ritual studies should engage with contemporary theoretical approaches like the ontological turn, focus on the agency of individuals, and reflect on the insights traditional knowledge systems offer in the face of globalization and ecological crises. Full article

Most primitive religions originated from the devout worship of celestial deities, earthly spirits, and ghosts. In oracle bone inscriptions, rituals related to praying for rain, temple worship, river deity worship, and the worship of great deities were referred to as “fang” 方 or “yi fang” 以方. The Supreme God was the paramount deity of the Yin Shang Dynasty people; by the early Zhou Dynasty, the Supreme God and ancestral spirits began to merge. The hexagram of Contemplation 觀卦 (guan gua) establishes instruction through the concept of “contemplation” fully presenting the entire process of shamans, sorcerers, or ritual hosts participating in temple sacrifices, and completing the hand-washing ritual 盥 (guan) and the sacrifice-offering ritual 薦 (jian). It emphasizes the sincere communication between humans and Heaven. When a monarch performs the guan ritual, he embodies inner “sincerity and clarity” 誠明 (chengming); in response, the celestial deities will “show trust” 有孚 (youfu). Thus, it can be verified that deities exist in Heaven, and an interactive, responsive relationship is formed between Heaven and humans. The nine in the fifth place (the dominant line) possesses great inspiring power. The two fundamental dimensions for interpreting the hexagram structure are “the great view is above” 大觀在上 (da guan zai shang) and “[t]hose below look toward him and are transformed” 下觀而化 (xia guan er hua). These dimensions not only highlight the infinite transcendence, charisma, and appeal of the worshipped deities but also underscore humans’ profound reverence and faith in deities and the absolute existence. Sages 聖人 (sheng ren), as intermediaries between humans and deities, established religion for the sake of human life but did not regard themselves as religious leaders. However, from the Shang and Zhou dynasties to the Spring and Autumn period, a transition occurred in the spiritual life of the Chinese people: from shamanism to ritual propriety 禮 (li), and from theistic culture to humanistic culture. This transition laid the fundamental direction for the development and evolution of Chinese culture over the following 2500 years. Confucius attempted to replace or eliminate the shamanistic elements in early Confucians with personalized moral experience and ethical consciousness. Full article

Background: Population aging has increased attention on the quality of life and successful aging of older adults. Objective: To examine urban–rural differences in subjective quality of life and self-rated successful aging, explore associations with psychosocial factors, and identify predictors of successful aging, including potential moderating effects of place of residence and chronic illness. Methods: A cross-sectional study was conducted among 403 adults aged ≥ 60 years in Eastern Croatia. Measures included a sociodemographic questionnaire, the Self-assessment of Successful Aging Scale (SSAS), and the Personal Wellbeing Index (PWI). Data were analyzed using nonparametric tests (Mann–Whitney U, Spearman’s correlation), linear regression, and moderation analyses. Significance was set at p < 0.05. Ethical approval was obtained (Class: 602-01/24-12/02; IRB: 2158/97-97-10-24-36). Results: Rural participants reported lower PWI scores (p = 0.005) and self-rated successful aging (p < 0.001) than urban participants. Active community involvement was positively associated with quality of life (Rho = 0.46; p < 0.001), whereas regret about missed opportunities and past actions was negatively associated (Rho = −0.20; p < 0.01). Regression analyses explained 48.3% of the variance in SSAS, with higher PWI scores being strongly associated with higher SSAS scores, and rural residence and chronic illness being associated with lower SSAS scores. Moderation analyses indicated that the association between PWI and SSAS was consistent across different environmental contexts and in the presence of illness. Conclusions: Older adults living in rural areas reported lower quality of life and self-rated successful aging compared with those in urban and suburban areas, with subjective wellbeing emerging as a key predictor. Promoting social engagement and addressing psychosocial barriers may enhance successful aging, particularly in rural populations. Findings suggest that social engagement and psychosocial support are associated with higher level of perceived successful aging, indicating potential areas for future community-based or healthcare interventions. Full article

Sepsis is a life-threatening syndrome characterized by marked clinical heterogeneity and complex host–pathogen interactions. Although traditional mechanistic studies have identified key molecular pathways, they remain insufficient to capture the highly dynamic, multifactorial, and systems-level nature of this condition. The advent of high-throughput omics technologies—particularly integrative multi-omics approaches encompassing genomics, transcriptomics, proteomics, and metabolomics—has profoundly reshaped sepsis research by enabling comprehensive profiling of molecular perturbations across biological layers. However, the unprecedented scale, dimensionality, and heterogeneity of multi-omics datasets exceed the analytical capacity of conventional statistical methods, necessitating more advanced computational strategies to derive biologically meaningful and clinically actionable insights. In this context, artificial intelligence (AI) has emerged as a powerful paradigm for decoding the complexity of sepsis. By leveraging machine learning and deep learning algorithms, AI can efficiently process ultra-high-dimensional and heterogeneous multi-omics data, uncover latent molecular patterns, and integrate multilayered biological information into unified predictive frameworks. These capabilities have driven substantial advances in early sepsis detection, molecular subtyping, prognosis prediction, and therapeutic target identification, thereby narrowing the gap between molecular mechanisms and clinical application. As a result, the convergence of AI and multi-omics is redefining sepsis research, shifting the field from descriptive analyses toward predictive, mechanistic, and precision-oriented medicine. Despite these advances, the clinical translation of AI-driven multi-omics approaches in sepsis remains constrained by several challenges, including limited data availability, cohort heterogeneity, restricted interpretability and causal inference, high computational demands, difficulties in integrating static molecular profiles with dynamic clinical data, ethical and governance concerns, and limited generalizability across populations and platforms. Addressing these barriers will require the establishment of standardized, multicenter datasets, the development of explainable and robust AI frameworks, and sustained interdisciplinary collaboration between computational scientists and clinicians. Through these efforts, AI-enabled multi-omics research may progress toward reproducible, interpretable, and equitable clinical implementation. Ultimately, the synergy between artificial intelligence and multi-omics heralds a new era of intelligent discovery and precision medicine in sepsis, with the potential to transform both research paradigms and bedside practice. Full article

Education systems worldwide face a growing pressure to align with Sustainable Development Goal 4.7 by embedding Education for Sustainable Development (ESD) into school life. This study examines how primary school headteachers in Cyprus interpret and enact sustainable leadership to advance ESD within a small, highly centralised system. Drawing on sustainable and distributed leadership theories and a whole-school lens, the study employed semi-structured interviews with ten headteachers from diverse regions (urban, rural, and semi-rural). Reflective thematic analysis identified four patterns: (1) leaders sought a strategic integration of ESD into planning and culture; (2) empowerment and participation were pursued through teacher working groups, student eco-councils, and community partnerships; (3) systemic constraints, a rigid curriculum, limited autonomy, and scarce professional development produced a policy–practice gap; and (4) leaders relied on adaptive, collaborative micro-practices to sustain momentum. The findings suggest that, in Cyprus, sustainable leadership operates as a values-based stewardship enacted through ‘quiet activism’. The study highlights implications for leadership development, such as reflexivity, systems thinking, and ethical reasoning, as well as policy design, such as time, autonomy, and structured support for whole-school ESD, in small-state contexts. Full article

This paper analyzes Daisaku Ikeda’s concept of global citizenship from the perspective of ecological citizenship required in today’s climate crisis. Western ethical traditions, as well as the cosmopolitan ideas of Kant, Habermas, and Marx, remain largely anthropocentric and fail to adequately account for the relationships between humans, nature, and other living beings. In contrast, Ikeda understands human beings as “life itself,” intrinsically interconnected with all forms of life. By expanding Aristotelian virtue ethics to a global and holistic level, Ikeda proposes an alternative ecological model of global citizenship that transcends anthropocentrism and is more suited to the contemporary ecological era. Full article

In this paper I aim to draw attention to the continued emphasis on ‘moral tales in stories of family construction. In research projects on both conventional family practices such as marriage and non-conventional ones such as living apart together (LAT) and mixed-sex civil partnerships, morality continues to emerge as a core guiding principle for how relationships are organised and maintained. Yet beyond the importance of children in these moral tales, little consideration is given to the other dimensions and shapes that this ‘morality’ may take. Here I bring together three qualitative research projects to illustrate the strong drive of moral obligations in the face of family fluidity, relationship plurality, and individualised therapeutic discourse. With this data I argue that obligations continue to organise relationship decision-making, and we can imagine these obligations as formed of three interrelated dimensions: (1) social ‘oughts’, formed of culture, norms, and values (e.g., we ought to get married because that is the normal thing to do in our society), (2) relational ‘oughts’, including children, family, friends, life/family course, death, health (e.g., we ought to live apart to protect the children), and (3) individual ‘oughts’, which involve strongly held personal beliefs, and an ethic of self-care (e.g., we ought to get a civil partnership because it aligns with my feminist values). Understanding the shape of contemporary intimate morality is an important step in developing future theory, policy, and practice in the field. Full article

Background: Gastrointestinal discomfort affects up to 70% of individuals with spinal cord injury (SCI), largely due to gut dysbiosis caused by altered transit time and reduced gastrointestinal motility from autonomic disruption. Emerging evidence links prebiotics and probiotics to improved microbiome balance and reduced inflammation, yet data in SCI remain limited. Methods: Individuals aged ≥ 18 years, with a chronic SCI (≥1 year) experiencing significant gastrointestinal symptoms, will be invited to participate in this single-center randomized controlled crossover trial. Persons currently taking antibiotics, who have relevant eating or digestive disorders, or who have undergone a recent diet change will be excluded from the study. Participants will be randomized (1:1) into two groups. The first group will take a probiotic (Biotics-G, Burgerstein AG, Rapperswil-Jona, Switzerland) supplement for eight weeks, then after a four-week washout period, they will take a prebiotic (Oat Bran, Naturaplan, manufactured by Swissmill, Zurich, Switzerland) supplement for another eight weeks. The second group will receive the supplements in reverse order. The primary outcome is the Gastrointestinal Quality of Life Index, a questionnaire to assess quality of life related to gastrointestinal disorders. Secondary outcomes consist of gastrointestinal transit time, inflammatory blood markers, and gut microbiome composition. Ethics: The study will be conducted in accordance with the Declaration of Helsinki. The study was approved by the Ethics Committee for Northwest/Central Switzerland (EKNZ, ID: 2025-00238, 24.02.2025, Version 2.0). The study is registered at ClinicalTrials.gov (ID: NCT06870331, 02.04.2025). Written informed consent will be obtained from all participants involved in the study. Full article

This article will bring together and explore the relations between four aspects of Wittgenstein’s remarks on, and his relation to, religious language. The first is his sense of the special role that religious language can play in the lives of people. The focus is not on traditional issues in the philosophy of religion—not the Ontological Proof of the existence of God; not any of Aquinas’ Five Ways; not the argument from Design or the Cosmological Argument; and not any other philosophico-religious matter concerning arguments for the existence or non-existence of any deity. His interests lie elsewhere. Second, we see that what Wittgenstein is centrally concerned with is the life-structuring power that religious language can possess and exert; it concerns both the sense-making power of pattern-lives in religious narratives and the metaphorical content of religious ways of thinking and perceiving. The third aspect is the distinctive, and in its way transcendental, way of seeing the world and existence sub specie aeternitatis, that is, under the aspect of eternity. Or, I will suggest, under the aspect of timelessness, or of having the sense of being above and outside of time. Wittgenstein said that he was not a religious person, but that he could not help but to see every problem from a religious point of view. In this third theme of the article, I will attempt to explicate what that remark can mean—how it reveals what Wittgenstein elsewhere in his work calls “a way of seeing.” And then fourth, this article will connect these three aspects to the special, non-pragmatic (and often in the above sense, transcendental) way that we view works of art. In his Notebooks of 1914-16, Wittgenstein wrote, “The work of art is the object seen sub specie aeternitatis; and the good life is the world seen sub specie aeternitatis. This is the connection between art and ethics.” At the close, I suggest that the way we learn to see the world through and within religious language (again, apart from any theological claim concerning divine existence or not) is parallel to one important way of seeing art—where the parallel is one that casts light from each side to the other. Along with some other works, my most central example in art will be the paintings of Morandi: in conveying an unmistakable sense of timelessness, they both convey, and in viewing them invite us to enact, the special way of seeing objects sub specie aeternitatis. Full article

Multimodal methods provide valuable opportunities within Participatory Action Research (PAR), to foster meaningful participation, and amplify marginalized voices. However, conventional research approaches have not always adequately captured the complex realities of the lived experiences of families, and multimodal techniques have remained underutilized for the exploration of such experiences. This study aimed to explore the use of creative multimodal methods, within a PAR framework, grounded in care among vulnerable South African families. A qualitative design was adopted, incorporating Human-centered Design principles, within a PAR approach. The participants were recruited from the Saldanha Bay Municipality area (n = 70), as well as Mitchells Plain (n = 59). The multimodal methodology included Draw-and-Tell, painting, object and photo elicitation, I-Poems, and LEGO^®-based activities. Data were annotated and transcribed verbatim, followed by thematic analysis. A total of 42 participants contributed towards the validation of the methods. The participants described experiences of deep emotional insight, self-reflection, and self-recognition, through engagement with the multimodal activities. The findings revealed that these approaches were: (1) credible, producing internally valid and contextually rich data; (2) contributory, generating original and applicable insights into family life; (3) communicable, offering accessible and structured ways for diverse participants to express their experiences; and (4) conforming, ensuring ethical engagement through inclusive participation. These findings demonstrate the potential of creative, arts-based, and participatory approaches, to advance methodological innovation in qualitative family research. Full article

The paper introduces ‘transformative’ curriculum initiatives such as education for sustainable development (ESD) and global citizenship education (GCED), which address ‘macro’ challenges such as climate change, together with ‘holistic’ approaches to student learning such as ‘social and emotional learning’ (SEL) and education for ‘life skills’, ‘21st century skills’, ‘transversal competencies’, AI-related ethics, and ‘health and well-being.’ These are reflected in Section 6 of the 2023 UNESCO Recommendation on Education for Peace, Human Rights and Sustainable Development. It is suggested that such broad goals put forward at global policy level may serve as inspiration for national context-specific programming, while also needing better integration of national insights and cultural differences into global discourse. The paper aims to provide insights to education policy-makers responsible for national curriculum, textbooks and other learning resources, teacher training and examination processes, helping them to promote the human values, integrity and sense of agency needed by students in a time of multiple global and personal challenges. This requires an innovative approach to curricula for established school subjects and can be included in curricula being developed for AI literacy and related ethics. Research into the integration of transformative and holistic dimensions into curricula, materials, teacher preparation, and assessment is needed, as well as ongoing monitoring and feedback. AI-supported networking and resource sharing at local, national and international level can support implementation of transformative and holistic learning, to maintain and strengthen the human dimensions of learning. Full article

Background/Objectives: Neonatal Intensive Care Units (NICUs) constitute a highly complex clinical environment characterized by patient fragility and frequent ethically sensitive decisions. To date, systematic studies investigating how Italian NICUs address these challenges and what forms of ethics support are effectively available are lacking. The aim of this study is therefore to assess how ethical issues are managed in Italian NICUs, with particular attention to the availability, use, and perceived usefulness of clinical ethics support in everyday practice. Methods: A 25-item questionnaire was developed by adapting an existing tool for investigating clinical ethics activities to the neonatal context. Following expert review by the GIBCE (Gruppo Interdisciplinare di Bioetica Clinica e Consulenza Etica in ambito sanitario), the final instrument covered four areas (general data, experience with ethical dilemmas, tools and procedures, opinions and training needs). A manual web search identified all Italian NICUs and their clinical directors, who were asked to disseminate the survey among staff. Participation was voluntary and anonymous. Data collection was conducted via Google Forms and analyzed through qualitative thematic analysis. Results: A total of 217 questionnaires were collected. The most frequent ethical dilemmas concern quality of life with anticipated multiple or severe disabilities (72.4%) and decisions to withdraw or withhold life-sustaining treatments (64.5%). Major challenges include fear of medico-legal repercussions (57.6%) and communication divergences between physicians and nurses (49.8%). More than half of respondents (52.1%) reported no formal training in clinical ethics, and 68.7% had never developed a Shared Care Plan (Shared Document for healthcare ethics planning) as defined by the Italian Law 219/2017. Conclusions: Findings highlight marked fragmentation in ethical practices across Italian NICUs. On this basis, establishing structured and accessible CEC services could help promote consistency, reinforce shared ethical standards, and support transparent and equitable decision-making in critical neonatal care. Full article

Objective—Partial do-not-resuscitate (DNR) orders, directives specifying limited resuscitative efforts, are intended to align medical interventions with patient preferences. However, their complexity may introduce ambiguity, inconsistent care, and ethical challenges. Design—A retrospective review was conducted of inpatient partial code order entries over a three-year period at a single institution with a pediatric oncology and immunology cohort. Partial DNR orders were identified and categorized based on included or excluded interventions (chest compressions, defibrillation, intubation, mechanical ventilation, medications). Data was analyzed to assess the frequency, variation, and internal consistency of documented preferences as well as alignment with institutional definitions and clinical feasibility. Results—Partial DNR orders represented a small (n = 15, 7%) but notable proportion of total code status entries. Wide variability was observed in the combinations of permitted and withheld interventions, with orders containing internally conflicting instructions. Documentation of inconsistencies and unclear terminology were common, raising concerns about interpretability during emergent situations. Conclusions—Partial DNR orders demonstrate heterogeneity and potential for miscommunication. These findings suggest that while partial codes may reflect nuanced patient preferences, they pose operational and ethical risks that could compromise care clarity. Clinical implications are reviewed. These findings will guide institutional deliberations regarding whether to refine, restrict, or eliminate partial code order options to enhance patient safety and decision-making transparency. Full article