Search Results (3,044)

Background: Undernutrition among children under five years remains a major public health challenge, particularly in low- and middle-income countries and rural communities where poverty, food insecurity, and limited access to health services persist. Maternal and caregiver perceptions play a critical role in shaping feeding practices and health-seeking behaviours that influence child nutritional outcomes. Objective: This study explored mothers’ and caregivers’ perceptions of factors contributing to undernutrition among children under five years in a rural community of Ngqeleni, Eastern Cape, South Africa. Methods: A qualitative descriptive study was conducted at a primary healthcare clinic in the Ngqeleni sub-district. Purposive sampling was used to recruit mothers and caregivers of children under five years. Data were collected through seven in-depth interviews and three focus group discussions involving a total of 25 participants. Interviews were conducted using a semi-structured guide and analyzed thematically. Results: Five major themes emerged: caregivers’ perceptions of nutrition, household food insecurity and unemployment, limited dietary diversity, culturally influenced feeding practices, and gaps in practical nutrition knowledge. Caregivers demonstrated concern for child nutrition but described constrained feeding choices shaped by poverty, reliance on social grants, environmental challenges, and limited access to diverse foods. Environmental challenges such as drought and lack of piped water further limited food production. Limited nutrition knowledge and reliance on informal information sources contributed to suboptimal feeding practices. Conclusions: Undernutrition in this rural setting is shaped by a complex interaction of economic hardship, environmental constraints, and limited caregiver knowledge. Community-based nutrition education, strengthened primary healthcare counselling, and multisectoral interventions addressing poverty, water access, and food security are essential to improve child nutrition outcomes. Full article

Background: Childhood obesity is a major public health concern associated with adverse metabolic outcomes later in life. Despite increased awareness, unhealthy lifestyle behaviors—including suboptimal diet quality, physical inactivity, insufficient sleep, and unfavorable body composition—remain prevalent in pediatric populations. Effective, child-centered educational tools for early prevention are still limited. Methods: We developed the Lifestyle Tridimensional Pyramid, an educational model integrating nutrition, physical activity, and sleep within a single, three-dimensional framework. The model also addresses body composition by emphasizing the balance between skeletal muscle and adipose tissue and the interdependence of lifestyle behaviors. This narrative review is supported by an umbrella review of 17 systematic reviews and meta-analyses published between 2010 and 2025, synthesizing evidence on lifestyle behaviors of pediatric obesity. Results: High- to moderate-quality evidence indicates that adherence to Mediterranean-style dietary patterns, regular moderate-to-vigorous physical activity, adequate sleep duration, and a healthier body composition might prevent the development of obesity and improved cardiometabolic profiles in children and adolescents. The pyramid provides a structured, visually accessible tool to support lifestyle counseling in pediatric outpatient settings and is adaptable to school- and community-based health promotion. Conclusions: Although prospective validation studies are warranted, the Lifestyle Tridimensional Pyramid represents a practical, evidence-informed framework to support integrated lifestyle education and improve primary and secondary prevention of pediatric obesity. Full article

The rapid integration of artificial intelligence (AI) into educational systems is transforming how student performance is analysed and how educational policies are informed by large-scale data. Within this context, machine learning techniques are increasingly used to identify patterns associated with academic success and educational inequality. However, the use of predictive algorithms in education also raises important questions regarding transparency, fairness, and potential algorithmic bias. This study examines the predictive performance and fairness implications of machine learning models used to identify academically resilient students using data from the Programme for International Student Assessment (PISA) 2022. The analysis is based on a dataset containing more than 600,000 student observations across multiple national education systems. Academic resilience is operationalised following the OECD framework, identifying students who belong to the lowest quartile of the socioeconomic status index (ESCS) within their country while simultaneously achieving mathematics performance in the top quartile (PV1MATH). A predictive framework incorporating six supervised learning algorithms—Logistic Regression, Random Forest, Gradient Boosting, XGBoost, LightGBM, and CatBoost—was implemented. The modelling pipeline includes data preprocessing, missing value imputation, class imbalance correction using SMOTE, and model evaluation through multiple classification metrics, including accuracy, F1-score, and the area under the ROC curve (AUC). In addition, fairness diagnostics are conducted to examine potential disparities in prediction outcomes across gender groups, while feature importance analysis and SHAP-based explanations are used to interpret the contribution of key predictors. The results indicate that ensemble-based models achieve the highest predictive performance, particularly those based on gradient boosting techniques. At the same time, the analysis reveals that socioeconomic status, migration background, and school repetition constitute the most influential predictors of academic resilience. Although gender displays relatively low predictive importance, measurable differences in positive prediction rates across gender groups suggest the presence of potential algorithmic disparities. These findings highlight the importance of integrating fairness evaluation, transparency, and interpretability into educational data science workflows. The study contributes to ongoing discussions on the responsible use of artificial intelligence in education by emphasising the need for governance frameworks capable of ensuring that algorithmic systems support equity-oriented educational policies. Full article

The rapid adoption of immersive and adaptive digital technologies is redefining sustainability education, but the mechanisms by which these technologies support perceived sustainability outcomes remain unclear. This paper models the Digital Experiential Learning Ecosystem (DELE), including simulation, AR/VR, gamification, AI personalization, and collaborative digital platforms, as a higher-order construct. It discusses its role in Perceived Sustainability Outcomes through learning engagement. Basing the study on the Stimulus-Organism-Response framework, the study hypothesizes that the digital ecosystem design can be viewed as an environmental stimulus, engagement as the organismic processing state, and Perceived Sustainability Outcomes as the developmental response. The results, obtained using Partial Least Squares Structural Equation Modeling (PLS-SEM), indicate that DELE is positively associated with learning engagement and Perceived Sustainability Outcomes. Learning engagement is found to be the leading mechanism through which digital experiential environments are converted into perceived sustainability outcomes, but a smaller yet significant direct structural relationship also remains. These findings indicate that digital transformation within the education sector creates sustainable value not only through technological sophistication but also through carefully planned engagement-based learning environments that support systems thinking, applied problem-solving, and adaptive readiness to work in multifaceted environments. The research also advances the body of research on sustainability education by developing a model of digital learning as an integrated ecosystem and by explaining the psychological and structural processes of perceived sustainability outcomes. Full article

Vocational high school students represent a substantial yet understudied population in school-based mental health research. Drawing on positive psychology and bioecological theory, this study examined whether personal growth initiative (PGI) shows a statistical indirect effect with respect to the relationships between multidimensional school climate and mental health outcomes among Chinese vocational students. Participants were 14,006 students from 112 vocational high schools. Two-level path models simultaneously entered different climate dimensions to estimate their unique associations with PGI, depressive symptoms, and Subjective well-being (SWB) at the within- and between-school levels, controlling for gender and socioeconomic status. Within schools, Safety, Interpersonal Relationships, Rules and Norms/Career Development Support, and Teaching and Learning/Diversity were positively associated with PGI, which in turn was associated with lower depressive symptoms and higher SWB. Wald tests indicated that Safety showed the strongest overall association with depressive symptoms, whereas Interpersonal Relationships showed the strongest overall association with SWB. At the between-school level, school-average climate and school-average PGI were associated with both outcomes, although these findings should be interpreted cautiously given the limited between-school power and substantial overlap among aggregated climate indicators. Overall, the findings are consistent with PGI being an important student-level pathway linking school climate to mental health in vocational education. Full article

The well-being of university students is deteriorating, highlighting the need for accessible, non-stigmatizing supports beyond clinical care. Positive psychology (PP) interventions have shown strong potential for improving mental well-being, yet they remain largely underutilized in Nigerian universities. This pilot study evaluated the impact of an eight-week education and intervention incorporating acts of kindness, gratitude, positive reframing, and character strengths in improving subjective well-being among university students in Nigeria. Students were assigned randomly to an education + PP group or an education-only control group and assessed at baseline and post-intervention. Independent-samples t-tests were used to examine group differences in outcomes, while mixed-design ANOVA models assessed the effects of group and time. Compared with controls, the intervention group showed significantly higher mental well-being, positive affect, and resilience, with moderate to large effects. While significant main effects emerged across outcomes, time-by-group interactions were observed only for positive affect and resilience. Given rising psychological distress among Nigerian university students, these preliminary results showed that brief, strengths-based PP exercises can meaningfully improve students’ subjective well-being. They can serve as low-cost, non-stigmatizing additions to university mental health services and a scalable complement to traditional care in low-resource settings. Full article

In social science degree programs, where Statistics is not a core subject, students often experience anxiety and negative attitudes that influence their engagement and may hinder academic performance. This study examines the role of positive emotions in the teaching of Probability Calculus and Inferential Statistics in Business Administration and Management studies, analyzing their relationship with students’ engagement in Problem-Based Learning (PBL). The research is framed as an exploratory single-campus case study conducted with a modestly sized sample of undergraduate students from a single Faculty. Moving beyond traditional approaches that view emotions merely as outcomes of learning, our model assumes that positive emotions, both prior to and following the PBL experience, shape students’ perceptions of its usefulness, their collaborative behaviors, and their communication with instructors. Using Structural Equation Modeling (SEM) and Cluster Analysis, the findings show that positive emotions are a key driver of students’ predisposition toward and engagement with PBL, indicating that cultivating a supportive emotional climate enhances participation and deepens the understanding of statistical concepts. These results suggest that fostering emotional engagement is essential not only for improving motivation and academic outcomes in Statistics but also for developing transversal and sustainability-related competencies such as critical thinking, collaboration, communication, and evidence-based decision-making. The study contributes to current discussions on sustainable and inclusive teaching practices by highlighting the importance of integrating socio-emotional dimensions into active learning methodologies in higher education. Full article

The current study aimed to examine whether Joint Commission International (JCI) accreditation is associated with higher patient satisfaction. A cross-sectional, questionnaire-based comparative study was conducted between April and July 2025 in outpatient departments of one JCI-accredited hospital (University Medical Center) and two nationally accredited public polyclinics in Astana, Kazakhstan. The questionnaire was designed to assess satisfaction across four domains: communication, staff responsiveness, hospital environment, and perceived quality of care. The patients attending the JCI-accredited hospital demonstrated significantly higher satisfaction across all domains compared to those of nationally accredited hospitals (p < 0.01). The largest difference was observed in staff responsiveness. In the multivariable regression analysis, the accreditation status emerged as the strongest independent predictor of overall patient satisfaction score (β = 0.42; 95% CI: 0.31–0.53; p < 0.001), even after adjusting for age, gender, education, employment status, and prior hospital visits. Education level and previous hospital experience were modest yet statistically significant predictors, whereas age, gender, and employment status were not significant in the adjusted analyses. JCI accreditation was associated with higher patient satisfaction scores in outpatient care settings, indicating a positive relationship between accreditation status and patient-centered outcomes. Full article

Telemedicine can address access barriers in childhood obesity management by supporting continuity of care and caregiver engagement. This randomized controlled trial compared a telemedicine-based program with guideline-based usual care among 70 children with obesity (aged 5–15 years) and their caregivers, randomized to telemedicine (n = 35) or usual care (n = 35) for 6 months. The telemedicine program included online consultations, digital caregiver education, remote monitoring, and secure messaging via the SUTH application integrated with the hospital information system. The control group received standard outpatient care with routine counseling and printed materials; baseline characteristics were similar between groups. Baseline demographic and clinical characteristics were comparable between groups. After 6 months, both groups showed modest reductions in BMI; however, ANCOVA-adjusted analyses indicated no significant between-group difference in post-intervention BMI. Weight-for-height decreased in both groups, with a slightly greater percentage reduction in the telemedicine group. Caregiver satisfaction and knowledge were significantly higher in the telemedicine group at follow-up (all p < 0.01; knowledge p < 0.001). These findings suggest that telemedicine-based care may contribute to modest improvements in anthropometric outcomes while substantially enhancing caregiver knowledge and healthcare service satisfaction, supporting its role as a scalable adjunct in pediatric obesity management. Full article

This study advances the conceptual and practical scope of social education by integrating Security and Safety Education (SSE) categories into its theoretical foundation. We demonstrate that SSE encompasses multidimensional areas highly relevant to social education and offer a structured competence model to guide curriculum design. Using a mixed-methods approach, 2926 Web of Science publications were analysed through an NVivo Word Frequency Query to identify key domains associated with security and safety. The temporal scope of the corpus (2019–2021) provides a coherent analytical baseline, capturing intensified security and health-related discourse during the COVID-19 period while preceding geopolitical disruptions that could otherwise distort thematic patterns. The results show that security is associated with broad social and geopolitical issues, including food, political, economic, public, national, and international affairs, as well as health and information. In contrast, safety is mainly linked to transport-related concerns, although both domains converge in areas such as health, social, public, national, and information matters. These findings indicate that SSE encompasses multidimensional areas relevant to social education. To support curricular integration, we propose an eMEDIATOR-derived competence model that structures SSE content into measurable, outcomes-based components. Ultimately, this research provides actionable tools to elevate social education and promote active, informed citizenship in times of global uncertainty. Full article

Background/Objectives: Children and adolescents on the autism spectrum often experience delays in both gross and fine motor skills, which can limit their participation in physical activity and everyday tasks. Methods: This narrative review synthesizes evidence from 88 peer-reviewed studies examining fundamental motor skills, broader motor competence, and perceived motor competence in individuals aged 3–18 years with a formal diagnosis of autism. Results: Across the literature, children with autism consistently demonstrate lower proficiency in locomotor and object control skills compared with their typically developing peers, while perceived competence emerges as an important factor influencing motivation and engagement. Intervention studies—most commonly school-based or structured physical activity programs—generally report short-term improvements in motor performance, although outcomes vary depending on study design, dosage, and assessment tools. The review also highlights substantial methodological heterogeneity and a notable lack of evidence concerning adolescents, underscoring the need for longitudinal and developmentally sensitive research. Conclusions: Practical implications are discussed for creating supportive movement environments in educational and adapted physical activity settings. This review follows a narrative synthesis approach informed by a structured search strategy. Full article

Residential college (RC) activities represent a creative form of engagement beyond formal classroom teaching, integrating experiential, social, and community-based learning. China is promoting holistic education through the RC activities. Student motivation directly influences their engagement in practice-based learning. Yet, the motivation profile of Chinese students’ participation in RC activities remains largely unexplored. To address this gap, the exploratory cross-sectional study involved 403 undergraduates from an RC-based university in the Guangdong–Hong Kong–Macao Greater Bay Area. Based on a standardized questionnaire, we explored descriptive patterns of three forms of motivation, namely intrinsic motivation, extrinsic motivation, and amotivation, as well as four influencing factors: activity logistics, experiential value, outcome expectations, and social context. We then conducted hierarchical linear regression analyses with the three motivation types as outcomes. The primary results indicated that intrinsic motivation was the dominant motivation type among RC students. Experiential value emerged as a key influencing factor, positively associated with intrinsic and extrinsic motivation, and negatively associated with amotivation. Additionally, activity hosting experience was identified as another important correlate, positively linked to both intrinsic and extrinsic motivation. Motivational patterns further varied across gender, academic year, ID place, weekly RC stay duration, and part-time employment. The findings provide empirical support for more targeted RC activity planning aimed at boosting student motivation in the Chinese context. Full article

Background/Objectives: Food insecurity affects college students at nearly twice the rate of US households, with documented impacts on student academic performance, physical and mental health, and socialization. While frameworks exist to conceptualize general food insecurity and food insecurity in specific contexts, researchers and practitioners lack resources to guide system-level responses to food insecurity on college and university campuses and assess those responses. In this study, we aimed to develop and validate a simple yet comprehensive framework for assessing food insecurity responses within the context of higher education. Methods: We adapted an eight-phase process for framework development: (1) map selected data sources within the multidisciplinary literature, (2) read and categorize selected sources, (3) identify and name concepts, (4) deconstruct and categorize concepts based on their features, (5) group similar concepts together, (6) synthesize concepts into a framework, (7) validate the framework using expert panel review, and (8) revise as necessary. Results: The developed Campus Food Aid Self-assessment (CFAS) framework consists of six dimensions: Student Services and Supports; Involvement; Advocacy; Awareness and Culture Efforts; Education and Training; and Research, Scholarship, and Creative Works. Expert panelists (n = 7) reviewed the proposed framework and confirmed the clarity, comprehensiveness, and representativeness of the proposed dimensions, conceptual definitions, and operational variables. Conclusions: With a comprehensive yet accessible structure, the CFAS framework supports the development, coordination, and improvement of campus-based strategies to address food insecurity and support positive student outcomes. Full article

With the rapid technological advancements, persistent retention disparities, and career stability concerns among Generation Z learners, higher education in the United States needs a re-examination of student success. Student support efforts and previous student-centered frameworks require re-examination in light of the current socio-cultural context. In response, this paper proposes the CIRCLE model. This conceptual model is faculty-driven and includes evidence-based practices that predict successful outcomes by benefiting students’ socio-emotional factors. The model stems from an integrated conceptual framework that synthesizes established student success theories, contemporary research on faculty–student relationships, and digital integration in higher education. Traditional student-centered theories are merged with contemporary digital integration models and applied to the realities of Generation Z and first-generation college students. From this, the author delivers a clear, context-responsive plan for faculty supporting a diverse cohort of learners, as we all live in today’s post-pandemic, digitally immersed world. Full article