Search Results (222)

Climate hazards increasingly disrupt schooling, revealing the limits of preparedness models that treat teachers only as implementers. This study reframes teacher empowerment as a climate-resilience capability and examines how governance arrangements enable (or constrain) hazard-ready education systems. Guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR), searches of Web of Science, Scopus, and Google Scholar (2000–2025) identified 53 eligible studies. Across diverse hazards and settings, the evidence converges on a governance-to-capability pathway: empowerment becomes resilient performance only when the delegated decision space is matched with financed capacity (time, training, contingency resources), timely risk information and functional communication/digital infrastructure, institutionalized cross-sector coordination (education–DRR–health–protection–local government), and learning-oriented accountability (after-action review and adaptive revision rather than punitive compliance). Reported outcomes include higher preparedness quality, earlier protective action, improved learning continuity and safeguarding, and more sustainable teacher well-being/retention. Predictable failure modes include mandate–resource mismatch, accountability overload, unstable centralization–autonomy dynamics, and inequitable empowerment distribution affecting rural schools, women, and contract teachers, and disability inclusion. The evidence gaps remain pronounced for chronic hazards (especially heat and wildfire smoke), high-vulnerability contexts (fragile/conflict settings and informal settlements), and standardized measures of equity, burden distribution, governance performance, and cost-effectiveness. Policies should prioritize integrated governance packages with explicit protection and equity safeguards. Full article

School classrooms represent complex, interconnected systems where indoor environmental quality critically influences student health, cognitive performance, and educational equity. Yet traditional approaches operate in disciplinary silos, creating systemic failures in design, operation, and maintenance. This narrative review adopts a systems engineering framework to demonstrate how integrated interventions—spanning policy, design, technology, and operations—create resilient, sustainable, and healthy classroom climates. Amid escalating climate change impacts (rising temperatures, heatwaves, wildfires) and emerging threats (airborne pathogens, urban pollution), reactive measures like school closures prove pedagogically counterproductive. This review synthesizes evidence on natural, mechanical, and mixed-mode ventilation systems optimized through advanced control strategies, smart technologies, and health-centred policies. Key findings reveal that synergistic integration of Policy, Management, Construction, Operation, and Smart Technologies, in a systems engineering framework, outperforms singular strategies. Critical interventions include hybrid ventilation coupled with layered defences (HEPA filtration, UVGI), AI-driven adaptive controls using IoT sensors and Model Predictive Control to optimize energy while managing pollutant concentrations, and mandatory IAQ standards rooted in stakeholder education. By framing classrooms as interconnected engineering systems, this work provides actionable insights for architects, engineers, policymakers, and administrators, positioning future school design toward resilience, sustainability, and human-centred health outcomes. Full article

This article argues that the da’wa movements initiated by Islamic mass organizations such as Muhammadiyah and Nahdlatul Ulama (NU) through the concept of Islamic locality constitute one of the key factors contributing to the failure of the caliphate idea in Indonesia. This locality is characterized by the synthesis of Islamic theology, law, and practice with the sociocultural, political, and historical realities of the Archipelago. Employing a historical–sociological method and document analysis, this article traces how these da’wa movements have embedded a distinctly Indonesian notion of Islamic locality. The findings reveal that through the establishment of socio-educational institutions (schools, hospitals, pesantren), cultural adaptation, and participation in the nation-building project, these Islamic da’wa movements have addressed the social and spiritual needs of Indonesian Muslims within the framework of the nation state. Therefore, the failure of the caliphate idea is not due to a lack of religiosity of Indonesian Muslims, but rather because localized Islamic understanding has rendered the caliphate not only irrelevant but also theologically incongruent with the perspectives of the majority of Indonesian Muslims. Full article

The aim of the study was to explore the characteristics of social problem-solving, school burnout, and school life of sixth-grade (12-year-old, n = 181) and eighth-grade (14-year-old, n = 196) Hungarian students, as well as the relationship between these fields, exploring profiles based on connections between measured areas. Three questionnaires were used in the study: Social Problem-Solving Inventory–Revised; School Burnout Inventory and School Life Questionnaire. We identified similar profiles in both social problem-solving (e.g., rejective and optimistic-reflective) and school life (e.g., negative school experience with low support and positive school adjustment with high support) in both age groups. The association between students’ social problem-solving and school life profiles and their level of school burnout was tested using multinomial logistic regression analyses. A structural equation model was specified to assess the interrelations among school life experiences, social problem-solving processes, and school burnout. Among sixth graders, a more positive school environment was associated with higher levels of adaptive social problem-solving and lower levels of maladaptive social problem-solving. In contrast, none of the predictors in the model showed a significant correlation with school burnout. In the case of eighth graders, school life factors only showed a significant positive correlation with adaptive social problem-solving. The findings refine existing assumptions by showing that while students’ social problem-solving tendencies and school experiences are interrelated, their contribution to burnout differs in early adolescent stages. Full article

Background/Objectives: Risk for eating disorders (ED risk) in adolescents is strongly influenced by psychosocial factors, particularly family dysfunction. The COVID-19 pandemic may have intensified these risks by disrupting family dynamics and increasing stress exposure. This study aimed to examine the association between family dysfunction and ED risk among school adolescents in Lambayeque, Peru, in the post-pandemic context. Methods: An analytical cross-sectional study including 1219 students from five schools (September–December 2022) was conducted. ED risk was screened using the SCOFF questionnaire (≥2), and family functioning was assessed with the Family APGAR (functional, mild, moderate, or severe dysfunction). Additional sociodemographic, behavioral, and mental health variables were analyzed. Adjusted prevalence ratios (PRs) were estimated using Poisson regression with robust variance clustered by school. Results: The ED risk in adolescents was 39.3% (95% CI: 36.5–42.1). Moderate family dysfunction was reported in 10.0% and severe dysfunction in 29.8% of participants. In the multivariable model, moderate family dysfunction was associated with higher ED risk (PR = 1.11). Other factors associated with higher risk included obesity (PR = 1.17), family history of mental illness (PR = 1.18), course failure (PR = 1.18), alcohol consumption ≥4 times per week (PR = 1.75), and having a family member hospitalized due to COVID-19 (PR = 1.14). Protective associations were found for male sex, frequent contact with friends, higher resilience, and living in peri-urban areas. Conclusions: Moderate family dysfunction was associated with an increased at ED risk in adolescents. These findings highlight the importance of school-based screening, family-centered interventions, and resilience promotion in adolescent mental health strategies. Given the cross-sectional design, causal relationships cannot be inferred. Full article

Objectives: This study aims to assess the prevalence of complications and failures associated with impacted canine eruption in a specialized referral center, with the goal of identifying factors that contribute to these outcomes. Methods: This retrospective cohort study included cases of impacted canines treated at the School of Dental Medicine between 2010 and 2020. Clinical and radiographic data were collected and evaluated for failures and complications by two independent clinicians (MK, MG). In addition, specialists in oral and maxillofacial surgery and orthodontics (YM, TS, NS) independently assessed all complications and failures. Results: Among the 214 impacted maxillary canines included, 23 (10.7%) failed to erupt following initial surgical–orthodontic treatment and required re-intervention. Eruption difficulty was attributed to orthodontic factors in 43.5% of cases, surgical factors in 13.0%, and combined factors in the remainder. Following a second procedure, 15 canines erupted successfully, while 8 did not, resulting in an overall failure rate of 3.7%. Treatment failure was significantly associated with both anatomical and procedural factors. Canines with centrally positioned crowns exhibited a significantly higher failure rate than those with buccal or palatal positions (χ² test, p = 0.025). Failure was also more common when the canine root apex was located in close proximity to a cortical plate. Lateral incisor root resorption was significantly associated with treatment complications (p = 0.030). In the multivariable logistic regression analysis, root resorption remained an independent predictor of treatment failure, increasing the odds of failure approximately fourfold (OR = 0.255, CI = 0.077–0.843, p = 0.025). Timing and surgical technique were also significantly associated with treatment outcome. Surgical exposure performed shortly after diagnosis was linked to an increased risk of treatment complications (p = 0.006). Closed surgical exposure demonstrated a significantly higher failure rate compared with open exposure (Pearson exact test, p = 0.009). Although open exposure was associated with a greater likelihood of successful eruption, it was also significantly associated with increased gingival morbidity (Fisher’s test, p = 0.030). Conclusions: Failure of impacted maxillary canine eruption following combined surgical–orthodontic treatment is uncommon but is significantly associated with distinct anatomical and procedural risk factors. Central crown position, cortical plate involvement, lateral incisor root resorption, early surgical exposure, and the use of closed exposure techniques all increase the likelihood of treatment failure and complications. Although open exposure enhances the probability of successful eruption, it may also negatively affect gingival outcomes, underscoring the need for individualized, multidisciplinary treatment planning. Full article

This study examines the systemic and political dynamics shaping the professional trajectories of Palestinian educators trained for boundary-crossing roles in Jewish state schools in Israel. While specialized programs successfully cultivated intercultural competence and pedagogical readiness, these gains were undermined by entrenched structural and ideological barriers. 12 in-depth semi-structured interviews with 12 Palestinian teachers were analyzed as well as findings from a telephone survey with 99 graduates. Findings reveal that institutional absorption failure, manifested through contractual precarity, geographic misalignment, and organizational inertia, prevented the conversion of individual readiness into stable tenure. Inclusion was found to be conditional, requiring sustained emotional labor, linguistic self-censorship, and political alignment, particularly during periods of heightened sociopolitical tension following 7 October 2023. These patterns reflect deeply rooted power asymmetries that marginalize Palestinian citizens and perpetuate tokenistic integration. This study argues that durable professional integration in contested spaces demands a paradigmatic shift: from viewing inclusion as a temporary concession to embedding stability and equity as structural principles. Such transformation requires dismantling institutional mechanisms that reproduce asymmetry and investing in long-term ecological supports, such as permanent contracts, culturally responsive leadership, and inclusion protocols. Without these systemic reforms, intercultural competence remains insufficient to overcome the political and structural forces. Full article

Measles resurgence threatens elimination achievements in the Americas. We conducted a nationwide analysis of Mexico’s 2025–2026 measles outbreak, integrating individual-level surveillance data from the Special Surveillance System for Febrile Exanthematous Diseases with municipal-level social determinants from eight national databases, complemented by molecular surveillance data. We analyzed 6892 confirmed cases using spatial autocorrelation (Moran’s I and LISA), effective reproduction number estimation, logistic regression models for municipal case presence, and multivariable logistic regression for risk factors for complications. Cases concentrated in Chihuahua (65.2%), with 47 LISA hot-spot municipalities containing 64.4% of cases. Molecular surveillance confirmed two independent introductions: D8/MVs/Ontario.CAN/47.24 (98.1%), linked to the North American outbreak, and B3 (1.9%) in Oaxaca. Transmission followed a three-stage pattern: introduction through seasonal agricultural worker networks, amplification in undervaccinated communities, and diffusion to marginalized indigenous populations. A dual-model analysis revealed that school non-attendance among children aged 6–14 years may have mediated the effect of very high marginalization on municipal case presence (OR 1.26; p < 0.001), identifying a potentially actionable vaccination pathway. Vaccine effectiveness was 98.1%, confirming susceptible accumulation rather than vaccine failure. Wave-stratified analysis showed late outbreak phase as an independent risk factor for complications (aOR 1.68, 95% CI: 1.42–2.00), converging with an age of <1 year (aOR 3.36), indigenous status (aOR 1.89), and unvaccinated status (aOR 1.96) in the most marginalized communities. Indigenous individuals comprised 29.1% of cases but 76% of the 25 deaths. This outbreak demonstrates that national vaccination thresholds are insufficient when municipal pockets of susceptibility remain systematically underserved. Full article

There are practical gaps and issues in the implementation of maritime transport decarbonization, and the industry is still lagging in comprehensive implementation. In scholarly terms, this is exacerbated by a lack of research on pathways to implementation and a lack of research on the integration of relevant theories. This study employs a narrative (theoretical) review with respect to all the schools of implementation theory. It aims to investigate the applicability of implementation theory and to apply its insights to maritime transport decarbonization implementation, particularly with respect to shipping and ports. The findings, firstly, structure the literature into three schools of implementation theory. Secondly, the applicability of implementation theory and its parameters has been overlaid on maritime transport, resulting in two frameworks for shipping and ports. Thirdly, the determinants of maritime transport decarbonization implementation, derived from top-down and bottom-up theories (i.e., what impedes or leads to successful implementation), have been discussed, supported by literature from the theory and from port and shipping environmental implementation. The determinants include seven policy and management tools, including behavioural, institutional, organizational, and characteristic determinants related to implementing agencies and implementers (here called implementing agencies’ drivers for successful implementation). While this study enriches the literature by highlighting pathways and determinants of maritime transport decarbonization, it also has managerial implications. The findings envision and inspire shipping and port practitioners and policy and decision makers by showing the process of decarbonization implementation, factors for success or failure, and what is needed to reconfigure and improve them. Full article

This study explores how school principals evacuated from their schools in the wake of the 7 October 2023 war perceived their unique challenges, the strategies they adopted, and the ways in which their agency was shaped during the extreme crisis. Using semi-structured, in-depth interviews with 33 displaced principals from elementary, middle, secondary, and special education schools, we identified four interconnected dimensions of the principals’ agency during wartime. Intrapersonal agency reflected the principal’s inner identity as a foundation for action. Critical agency emerged from frustration with systemic failures and bureaucratic obstacles, motivating the pursuit of meaningful change. Collaborative agency was expressed in building and maintaining trust-based networks and partnerships that enabled effective solutions. Finally, proactive agency was driven by an internal desire for growth and influence, promoting innovative strategies and renewal processes at organizational, emotional, and community levels. This leadership framework for understanding principalship in wartime highlights agency as a holistic framework that enables principals not only to ensure the survival of their schools, but also to respond to chaotic realities. Practically, the findings inform the design of models for ensuring educational continuity in emergencies, and tailored support mechanisms for displaced educational communities. Full article

Postural alignment can be influenced by intrinsic and extrinsic factors; failure to control these confounding factors and the use of invalid tools increase the risk of bias and may distort the results. Objective: The first objective is to identify the confounding factors that may influence the evaluation of body posture in children. The second objective is to determine which methods or tools are used to analyze postural alignment and to review the evidence regarding their validity and reliability, in order to strengthen the credibility of the results obtained. Methods: A systematic review was performed following the PRISMA 2020 criteria. Eligible studies were searched in the Virtual Health Library, Scopus, Medline, Web of Science, PEDro, and the Cochrane Library throughout the entire month of December 2024. Observational studies written in English, Portuguese, or Spanish that analyzed body posture (as the dependent variable) in children under 12 years of age were included. Articles not available in full text or those that assessed only a single body region were excluded. The methodological quality of the studies was assessed using the Newcastle–Ottawa scale, while the ROBINS-E tool was used to assess risk of bias. The synthesis of results was presented as a narrative review. Results: A total of 42 observational articles were included. No meta-analysis was conducted, and the findings are synthesized through a narrative review. The ROBINS-E tool showed a generalized result of high risk of bias, while the Newcastle–Ottawa scale reported moderate quality for longitudinal and case–control studies, with worse scores for cross-sectional studies. Methodological limitations: The differences found in the designs, population, and outcome measures generate high methodological variability that limits the possibility of quantitative synthesis. Likewise, the available evidence on the reliability of the tools is insufficient, which conditions the interpretation of the reported results. Conclusions: The findings with the strongest scientific support suggest that anthropometric variables or those related to body composition may be associated with body alignment. By contrast, there is still controversy regarding the influence of sex and age on postural variables. Sport modality or the weight of the school backpack could also play a role in posture; however, more high-quality studies are needed to contrast the results. The quality of the evidence is limited by heterogeneity in study designs, insufficient control of confounding factors, and the use of tools with inadequate validity and reliability. Other: The study was registered in PROSPERO under the number CRD42024618753. This research received no external funding. Full article

Physical activity (PA) is a cornerstone of non-pharmacological hypertension management, yet evidence on its determinants remains limited in African populations. We conducted a cross-sectional study among 383 hypertensive patients in two referral hospitals in Cameroon to assess PA levels and associated factors. PA was classified as insufficiently active (<600 MET-min/week) or active (≥600 MET-min/week). Overall, 54% of participants were insufficiently active, 37.9% had moderate activity, and 8.1% reported vigorous activity. Older age was strongly associated with inactivity, particularly for ages 60–74 (aOR = 2.84, p < 0.001) and for ≥75 years (aOR = 18.67, p < 0.001). Comorbidities also predicted inactivity, including renal failure (aOR = 2.41, p < 0.001) and diabetes/other complaints (aOR = 4.92, p < 0.001). Female sex increased the odds of inactivity (aOR = 1.42, p = 0.038). Whereas higher education was protective, particularly secondary (aOR = 0.12, p < 0.001) and high-school level (aOR = 0.05, p < 0.001). Among inactive participants, the most frequent barriers were lack of motivation (38.6%), physical impairment (37.2%), lack of prescription (23.2%), and space constraints (21.7%), whereas perceived benefits (39.1%), motivation (26.1%), and available space (32.4%) were the most cited facilitators; however, none of these factors showed a significant association with PA in chi square analysis. The high prevalence of inactivity and the strong influence of sociodemographic and clinical characteristics underscore the need for tailored interventions that target older adults, women, and patients with comorbidities, while strengthening education and structured support for PA within hypertension care pathways. Full article

Background/Objectives: Patau syndrome (trisomy 13) is a rare genetic disorder with high mortality, and poor prognosis. Patients surviving beyond infancy usually present with severe psychomotor delays, failure to thrive, intellectual disabilities and seizures. Female sex and mosaic trisomy 13 are considered positive prognostic factors. Methods: Here we report an 8-year-old female patient with Patau syndrome, diagnosed prenatally, born prematurely at 35 + 4 weeks of gestation via vaginal delivery as a third child of 33 years old healthy and unrelated parents. The birth weight was 2087 g, Apgar scored 9 at 1 min and 10 at 5 min, also self-ventilating in room air since birth. The patient has several associated congenital abnormalities; however, medical adjustments such as multiple surgeries, PEG, hearing aids, glasses, anti-epileptic medications, and suction support the girl’s daily life. The patient attends a primary school with specialist support that fosters her physical and sensory development and promotes progress in communication. Despite the numerous obstacles she faces, the girl’s journey demonstrates remarkable growth and development with the support of an interdisciplinary care team. It highlights the critical role of personalized care and early intervention. Conclusions: Due to the increasing survival rates of patients with Patau syndrome, complex and multidisciplinary care is required for both the patients and their families to achieve the best possible outcomes and ensure proper care, growth, and development of the child. All medical procedures must be thoroughly assessed for potential complications and viable improvement in quality of life. Full article

The circadian phase difference between morning and evening types is a fundamental aspect of chronotype. However, results of categorizations into chronotypes based on reported sleep times show low concordance with those based on measurements of the hormonal or physiological or molecular rhythm–markers of the circadian phase. This might be partially explained by the profound individual differences in the phase angle between the sleep–wake cycle and these rhythms that depends on chronotype, age, sex, and other factors. Here, we examined the possibility of using self-reported sleep times in the condition of 5-days-on/2-days-off school/work schedule to estimate circadian phase differences between various chronotypes. In an in silico study, we determined that, for such an estimation, similarities of the compared chronotypes in weekend sleep duration and weekend–weekday gap and in risetime are required. In the following empirical and simulation studies of sleep times reported by 4940 survey participants, we provided examples of the estimation of circadian differences between chronotypes, and the model-based simulations of sleep times in morning and evening types exemplified a way to confirm such estimations. The results of in silico, empirical, and simulation studies underscore the possibility of using bedtimes and risetimes for direct estimation of the circadian phase differences between individuals in real-life situations, such as a 5-days-on/2-days-off school/work schedule. Additionally, the results of these studies on different chronotypes provided further mathematical modeling and empirical evidence for our failure to sleep more on weekends to recover/compensate/pay back/ catch up on lost sleep. Full article

Twice-exceptional learners, students with both giftedness and disability (e.g., ADHD, ASD, dyslexia), face significant educational barriers in schools. This study examined stakeholder perspectives on the most pressing issues affecting twice-exceptional students in Australia. An online survey collected responses from 118 adult stakeholders. Reflexive thematic analysis identified five interconnected themes: absence of national guidelines and supports, inadequacies in educator skills and training, challenges in recognizing multiple exceptionalities, inequitable learning conditions, and significant toll on students and families. The study introduces a novel four-point explanatory model identifying systematic recognition failure mechanisms: masking effects, behavior-first interpretations, output-dependent bias, and executive function misreading. Findings reveal that twice-exceptional learners experience compounded disadvantage through multiplicative effects where each systemic failure amplifies others, creating cycles of educational inequity. The study identified policy asymmetry as a critical structural barrier, where mandated disability support exists alongside discretionary gifted education, inevitably privileging deficit-focused over strengths-based approaches. Results revealed a hidden equity crisis where family resources instead of student need influenced access to appropriate support, creating a two-tiered stratification system, which contradicts fundamental educational equity. Consensus across stakeholders indicated these challenges reflected structural issues requiring mandated national frameworks and coordinated interventions to address inadequacies in responses to twice-exceptionality. Full article