Exploratory qualitative descriptive study. We aimed to explore how dietitians assess and diagnose malnutrition in individuals with spinal cord injury (SCI), limitations of current practice, and barriers to optimal practice, as well as improvements that could be made. Twelve dietitians working in hospital, rehabilitation, and community contexts across Australia, the United Kingdom, the United States, Norway, South Africa, and New Zealand. Semi-structured interviews were conducted via Microsoft Teams between April and August 2024. Data were recorded, transcribed, and analysed thematically using Braun and Clarke's six-step thematic analysis method. Participants primarily relied on generic screening tools due to institutional policy and ease of use. They expressed concerns about distinguishing obligatory post-injury weight changes from true undernutrition, and the minimal focus on overnutrition. Practical barriers to effective malnutrition identification included limited equipment access and staffing constraints, exacerbating screening challenges. Participants advocated for SCI-specific guidelines to improve diagnostic accuracy and reduce misclassification. Weight-centric approaches risk misclassifying malnutrition in SCI. Tailored frameworks that incorporate functional, clinical, and psychosocial factors are needed, alongside institutional support for successful implementation. Refined tools may standardise assessment and better address malnutrition's complex aetiology in SCI. Future research should explore and validate these approaches and evaluate their implementation in diverse SCI contexts.

ABSTRACT Gender inequalities remain embedded in Brazilian women’s football, influencing athletes’ opportunities and experiences. This study explores how U-20 and senior players perceive gender equality and empowerment, using the EMERGE framework to assess critical consciousness, agency, and self-determined goals. A total of 67 players (20.1 ± 3.2 years) participated: 52 from U-20 teams across four clubs and 15 from a senior team. Data were collected via a 37-item questionnaire adapted from EMERGE instruments. Although most players do not explicitly identify as feminists, they express feminist attitudes and navigate different stages of empowerment, from recognizing inequalities to engaging in collective action. Differences between U-20 and senior players reflect unequal institutional support across generations. Intersections of race, religion, and education further shaped feminist engagement and experiences of empowerment. This study highlights players as agents of change and calls for feminist and intersectional education within sport institutions to promote gender equity in Brazilian football.

This article examines patterns of gender sensitivity in divorce rulings issued by female judges in Indonesian Religious Courts and analyzes the factors shaping their judicial reasoning. Using an empirical legal research design, the study combines document analysis of selected divorce decisions with in-depth interviews of female judges in several Religious Courts across Sulawesi. Guided by Alimatul Qibtiyah’s framework of gender sensitivity, the findings identify two dominant patterns: moderate and progressive. The moderate pattern is reflected in judicial reasoning that balances religious norms with social realities, emphasizing maṣlaḥah, harm prevention, and the psychological welfare of women and children within existing legal frameworks. The progressive pattern is evident in decisions that explicitly recognize domestic violence, economic neglect, and psychological abuse, and actively enforce women’s post-divorce rights, including nafkah ‘iddah, mut’ah, past maintenance, and child support, even in wife-initiated divorce cases. These patterns are influenced by factors such as gender-based empathy, professional experience, judicial training, and the implementation of Supreme Court regulations on gender-sensitive adjudication. This study highlights the role of female judges in advancing substantive justice in Islamic family law and underscores the importance of strengthening institutional support to ensure consistent protection of women’s rights in Religious Courts.

Emotional exhaustion among ICU professionals poses a significant threat to both health care quality and staff well-being. While patient safety culture (PSC) is recognized as a potential buffer, its longitudinal impact on emotional exhaustion remains underexplored, particularly within high-intensity clinical environments like ICUs. This study investigates how ICU professionals' perceptions of PSC influence the progression of emotional exhaustion over a 5-year period, highlighting shifts in organizational and psychological predictors. A 5-year longitudinal survey (2020-2024) was conducted in a regional teaching hospital in Taiwan. A total of 1213 valid responses were collected from ICU physicians and nurses using the Chinese version of the Safety Attitudes Questionnaire (CSAQ), which includes 6 PSC dimensions and an emotional exhaustion scale. Stepwise multiple regression was used annually to identify significant predictors of emotional exhaustion. Findings revealed a temporal shift in the predictors of emotional exhaustion. In 2020, organizational support factors-job satisfaction (β=-0.523, p<0.001) and perceptions of management (β=-0.443, p<0.001)-were significant negative predictors, while safety climate showed a counterintuitive positive association (β=0.264, p=0.004). From 2021 to 2024, stress recognition emerged as the most consistent protective factor (β range=-0.366 to -0.537, p<0.001). Interestingly, teamwork climate, often considered beneficial, was positively associated with emotional exhaustion in later years, suggesting added interpersonal burdens in collaborative ICU settings. Emotional exhaustion in ICU professionals is shaped by dynamic interactions between organizational structures and individual-level coping resources. Early burnout prevention should focus on institutional support, while long-term strategies should promote stress awareness and carefully manage team-based expectations. These findings provide health care leaders with actionable insights to design adaptive, stage-specific interventions to sustain psychological resilience in high-stress clinical environments.

Against the backdrop of the new era, China's higher education has entered a phase of high-quality development, with institutional support policies for student development becoming increasingly refined alongside the optimization of financial aid systems. This paper, grounded in the practical work of university counselors, systematically analyzes the current challenges faced by economically disadvantaged students in areas such as academic motivation, social psychology, integrity cultivation, and gratitude awareness. It elucidates the significance of enhancing the quality and capabilities of such students in the new era for implementing moral education, promoting educational equity, and cultivating new generations for the times. The paper proposes a comprehensive strategy of "strengthening value guidance, focusing on psychological development, Solidifying Professional Foundations, and Cultivating Innovative Practical Abilities." This comprehensive strategy aims to help economically disadvantaged students holistically enhance their comprehensive qualities and achieve high-quality growth and development.

This activity explores the concept of green waqf as an Islamic philanthropic instrument supporting environmental sustainability and examines the responses of café business actors, specifically the Kopishop “Kopimu” located within the Muhammadiyah University of Makassar (Unismuh) campus environment. The objectives are to (1) assess the awareness and understanding of green waqf among Kopimu stakeholders, (2) analyze their perceptions and responses toward environmental sustainability issues, and (3) formulate potential collaborative strategies between green waqf programs and sustainable business practices. A descriptive qualitative approach was employed through educational activities, short surveys, and semi-structured discussions with Kopimu managers and employees. The findings reveal that literacy on green waqf remains low, while sustainability awareness is relatively high, driven by consumer demands and institutional academic culture. Kopimu demonstrates openness to environmental collaboration initiatives, yet emphasizes the need for clear mechanisms, institutional support, and promotional incentives. The activity concludes that green waqf has the potential to serve as a complementary sustainability instrument for Kopimu, provided that literacy and partnership platforms are strengthened.

Educators, including teachers and professional associates, increasingly face challenges that extend beyond traditional pedagogical roles, particularly when working with children with developmental difficulties in inclusive educational settings. In addition to instructional responsibilities, they are expected to respond to diverse learning and behavioral needs, collaborate with multidisciplinary teams, communicate with families, and provide sustained emotional support to students. These demands require high levels of professional competence, flexibility, and emotional engagement, which can place considerable strain on educators’ psychological resources. This issue is particularly relevant in Bosnia and Herzegovina, where inclusive education has been formally promoted, but where structured support for educators is often fragmented. In such conditions, educators may rely heavily on personal commitment to compensate for systemic gaps, which may further increase vulnerability to stress and burnout. Thus, the aim of this review paper is to provide a systematic analysis of literature published between 2010 and 2025 focusing on psychological challenges faced by educators in Bosnia and Herzegovina. Both empirical and review studies addressing professional stress, emotional labor, emotion regulation, social support, and mental health interventions were examined. The findings indicate that effective emotion regulation, supportive work environments, and strong institutional and collegial support are key protective factors in preventing burnout and sustaining professional well-being.

The Open Science (OS) movement is rapidly expanding globally, enhancing the accessibility of scientific knowledge. However, awareness and practices of OS among researchers in Tanzania remain unclear. This study aimed to assess OS awareness and practices among Tanzanian scholars and to identify the challenges they encounter. A digital survey was conducted among academicians, researchers, students, librarians, and science communicators in Tanzania, using a Google Form shared via social media and institutional mailing lists. Analysis was performed using Microsoft Excel and SPSS. Results indicated that 84 per cent of respondents (n = 144) were aware of OS, primarily through peers and online platforms. Open access (OA) publishing emerged as the most prevalent OS practice, underscoring the need for greater awareness of other OS activities. Respondents reported several barriers to OS adoption, including insufficient knowledge, lack of institutional support, and concerns over data security. The study underscores the significance of peer learning and online resources in promoting OS awareness and advocates for supportive institutional policies, infrastructure development, and guidelines to encourage OS practices among Tanzanian scholars.

This study examined the adaptive teaching practices of teachers handling learners with learning difficulties at Barcelona Central School, focusing on how instructional responsiveness can be enhanced through supportive systems and professional development. Guided by the principles of learners with learning difficulties, the research aimed to identify the adaptive strategies currently implemented, determine teachers’ perceptions of their effectiveness, explore the barriers encountered, and assess the availability of institutional support that promotes adaptive practices. Anchored on the idea that quality education must be equitable and accessible to all, the study sought to provide actionable insights for improving the teaching and learning experiences of learners with learning difficulties. Using a descriptive research design, data were gathered from teachers through survey questionnaire and documentary analysis. Results revealed that teachers consistently apply adaptive strategies such as visual aids, scaffolding, peer collaboration, and differentiated instruction to accommodate diverse learner needs. Teachers perceived these practices as highly effective in improving comprehension, participation, and confidence among learners with difficulties. However, findings also indicated significant challenges, including limited access to instructional materials and assistive technologies, insufficient training, and inconsistent administrative support. Despite these barriers, teachers demonstrated creativity, commitment, and compassion in ensuring inclusive learning environments. The study concluded that adaptive teaching is both a pedagogical and moral commitment that reflects the teacher’s dedication to equity and learner success. To sustain adaptive teaching practices, the study recommends continuous professional development, strengthened administrative support, and resource allocation aligned with learners with learning difficulties policies. Ultimately, the research underscored that the realization of learners with learning difficulties depends on empowering teachers as catalysts of transformation who embody empathy, adaptability, and excellence in every classroom.

Introduction: Professional burnout is an escalating concern among healthcare personnel, undermining well-being, care quality, and system performance. Characterized by emotional exhaustion, depersonalization, and reduced personal accomplishment, burnout is now a major occupational hazard in healthcare. Materials and Methods: This article critically reviews international literature on professional burnout, examining its theoretical development and advances in conceptualization and measurement. The review emphasizes frontline professionals, especially physicians and nurses, who face high workloads, emotional demands, organizational pressures, and ethical challenges. The analysis addresses organizational, professional, and individual factors to provide a comprehensive perspective on causes and outcomes. Results: The literature identifies staffing shortages, administrative burdens, limited institutional support, role conflict, decision fatigue, and personal vulnerability as key causes of burnout among healthcare professionals. Major outcomes include lower job satisfaction, declining mental and physical health, higher staff turnover, and reduced patient safety. The review highlights the frequent use of the Maslach Burnout Inventory and related tools, as well as interventions such as organizational change and resilience-building. Conclusion: The findings indicate that burnout arises from a combination of organizational, professional, and individual factors, with significant consequences for healthcare quality and worker well-being. An integrated prevention approach is required that combines systemic reforms with individual support. Prioritizing burnout in policy agendas and developing support systems are essential. This review underscores the need for interdisciplinary strategies and identifies future directions for occupational health research.

The COVID-19 pandemic disrupted global education systems, forcing rapid shifts in teaching practices, technology integration, and assessment methods. However, little is known about how teacher efficacy, job satisfaction, and digital adoption vary across economic contexts. Insufficient research examines how income levels influence these factors, hindering equitable support for educators in post-pandemic recovery. This study examines variations in teacher efficacy (TE), job satisfaction (JS), assessment practices (AP), and technology adoption (UIT/UDT) across low-, upper-middle-, and high-income countries (LMICs, UMICs, HICs) before and after the COVID-19 pandemic. Guided by Bandura’s Social Cognitive Theory, the analysis explores how these factors interact and shift in response to pandemic-related disruptions in educational systems. The study utilizes PISA 2018 (pre-pandemic) and 2022 (post-pandemic) data from 128,866 teachers across 24 countries, employing structural equation modeling and machine learning as primary analytical techniques. Results indicate that job satisfaction significantly affects teacher efficacy but has minimal direct impact on the use of instructional technology tools. Teacher efficacy demonstrates a significant positive effect on both technology adoption (UIT) and assessment practices, while the use of digital learning and communication tools similarly influences assessment practices. These findings suggest that teacher efficacy and digital tool integration are key determinants of assessment practices. The study highlights how economic contexts shape teacher development, proposing targeted approaches for equitable post-pandemic education. HICs benefit from institutional support reinforcing the JS-TE relationship, while LMICs require solutions addressing resource gaps that impede consistent technology implementation. These evidence-based findings support context-specific policy interventions to enhance teacher support and digital integration globally.

This study aimed to evaluate the research engagement of STEAM faculty in Philippine State Universities and Colleges (SUCs) by applying the Commission on Higher Education (CHED) Researcher Classification Framework and the Department of Science and Technology (DOST) Scientific Career System. A convergent parallel mixed-methods design was employed, combining quantitative data on ISI- and Scopus-indexed publications, authorship patterns, research supervision, and training participation with survey responses from STEAM faculty members across five SUCs in Region II. Qualitative insights from administrators, research directors, and faculty narratives complemented the survey data. Quantitative data were analyzed using descriptive and inferential statistics, while qualitative interviews underwent thematic content analysis. Findings show that SUCs 1 to 3 generally meet CHED’s First Stage Researcher category and DOST’s Scientist I–II level, though none have advanced to higher classifications. By contrast, SUCs 4 and 5 exhibit deeper gaps, with no faculty members qualifying under either framework, despite having a relatively high number of master’s degree holders. Barriers across institutions include limited publication output, inconsistent mentoring, and insufficient institutional support for sustained research leadership. The study concludes that promoting inclusive, performance-oriented research requires strategies that align national goals with faculty development and match institutional practices to global academic standards.

The COVID-19 pandemic disrupted global education systems, forcing rapid shifts in teaching practices, technology integration, and assessment methods. However, little is known about how teacher efficacy, job satisfaction, and digital adoption vary across economic contexts. Insufficient research examines how income levels influence these factors, hindering equitable support for educators in post-pandemic recovery. This study examines variations in teacher efficacy (TE), job satisfaction (JS), assessment practices (AP), and technology adoption (UIT/UDT) across low-, upper-middle-, and high-income countries (LMICs, UMICs, HICs) before and after the COVID-19 pandemic. Guided by Bandura's Social Cognitive Theory, the analysis explores how these factors interact and shift in response to pandemic-related disruptions in educational systems. The study utilizes PISA 2018 (pre-pandemic) and 2022 (post-pandemic) data from 128,866 teachers across 24 countries, employing structural equation modeling and machine learning as primary analytical techniques. Results indicate that job satisfaction significantly affects teacher efficacy but has minimal direct impact on the use of instructional technology tools. Teacher efficacy demonstrates a significant positive effect on both technology adoption (UIT) and assessment practices, while the use of digital learning and communication tools similarly influences assessment practices. These findings suggest that teacher efficacy and digital tool integration are key determinants of assessment practices. The study highlights how economic contexts shape teacher development, proposing targeted approaches for equitable post-pandemic education. HICs benefit from institutional support reinforcing the JS-TE relationship, while LMICs require solutions addressing resource gaps that impede consistent technology implementation. These evidence-based findings support context-specific policy interventions to enhance teacher support and digital integration globally.

Purpose Learning transitions lead to the evolution of education and its consequences. This study investigates how changes in learning modalities affect the roles of self-esteem, self-efficacy and behavioral delay in determining academic achievement. Design/methodology/approach Using an integrated framework of social cognitive career theory, temporal motivation theory and transformative learning theory, this study involved 245 accounting students from 2019 to 2022 transitional cohorts of various universities in Indonesia. The analyses included t-tests, mediation and moderation analysis and multi-path modeling. Findings Self-esteem and self-efficacy significantly regulate behavioral delay, affecting academic achievement. Psychological conditions are crucial in uncertain learning situations, and this is pronounced for the FOL cohort. Whereas institutional support strengthens the influence of the OHL cohort’s self-efficacy, as a supportive environment helps increase student motivation. Research limitations/implications Specific interventions are required to enhance students’ confidence and reduce procrastination during learning disruptions. Policymakers and educators need to prepare support measures tailored to different situations and learning methods. Originality/value The integrated framework offers a comprehensive overview of how psychological and behavioral factors influence academic achievement when there is a change in learning modalities. The data were collected from various higher education institutions in Indonesia.

Employee job satisfaction plays a crucial role in enhancing organizational performance, service quality, and employee retention in healthcare institutions. This study examines job satisfaction among doctors, nurses, and support staff at Rangpur Community Dental Medical College and Hospital in Bangladesh, focusing on seven key domains: job privileges, interpersonal relations and cooperation, working environment, patient relationships, organizational facilities, career development, and human resource practices. A descriptive, cross-sectional, and quantitative research design was employed, collecting data from 90 employees, including 35 doctors, 26 nurses, and 29 support staff, using a structured questionnaire and the validated Job Satisfaction Survey (JSS) scale. Findings indicate moderate overall satisfaction, with notable variations across domains. Interpersonal relations and cooperation were rated most positively, reflecting a supportive work culture, whereas financial benefits, organizational facilities, and certain career development opportunities were areas of dissatisfaction. Human resource practices, including recruitment transparency and workload management, also require attention. The study highlights the importance of enhancing job-related benefits, promoting professional growth, and providing institutional support to improve employee satisfaction. These insights provide actionable recommendations for hospital management to optimize workforce motivation, performance, and, ultimately, patient care outcomes.

The proposed research aims to analyse the effects of the relationship between Sustainability Governance (SG) and Climate Impact (CI), taking into consideration Green Finance (GF). Furthermore, it examines how Institutional Support (IS) enhances the governance systems governing these variables. The research provides a holistic approach for analysing the effects of financial dynamics on climate impacts. Partial Least Squares Structural Equation Modelling (PLS-SEM) was employed in this research study. The data were collected from various industries using a standardised questionnaire. The structural model examined the direct and indirect relationships between variables such as GF, SG, and CI. IS emerged as the moderated variable. The outcomes of the study confirmed that “GF has an important and direct as well as indirect (through SG as the mediator) impact on CI. IS significantly increases SG and thus exerts an overall enhancing effect on the impact of GF on the climate.” The study has supported the research objectives and aims. The limitations of this study comprised constraints related to both time and cost. The researchers encountered limitations in accessing senior managers and directors of various organisations for the study. IS emerged as an important intermediate factor that can significantly link various actions and activities that impact the climate. This study supports both global and local research objectives. The study offers significant insights, underscoring the critical role of SG within Green Business (GB). Additionally, IS emerges as a vital enabling tool that strengthens the overall governance framework. The study contributes significantly to the development of integrated frameworks for institutions seeking to effectively address environmental challenges. The implications for action indicate that furthering entrenched institutional structures and instilling good governance practices can add tremendous value to the transformation potential of GF and usher in accelerated efforts to achieve national and international objectives on climate change.

This research was carried out to highlight the importance of contextualising Gamification in higher education. Despite the fact, that gamification is such a ubiquitous tool employed for student engagement, there is a need for profundity in its application beyond its use as a peripheral or supplementary instructional strategy. This paper presents a theoretical model that aims to establish adoption of gamification along the dimensions of academic culture, institutional support, student motivation, curriculum alignment, faculty competence, and assessment integration. The methodology adopted was a Structural Equation Modelling (SEM) technique to examine these latent variables. Two gamification tools were administered to a sample size of 146 students at a university during the period December 2024 to December 2025 and their experiences were recorded on a 21- item survey. The findings suggest that although the research constructs are internally valid, the empirical findings are constrained due to weak structural relationship with Gamification (R2=0.06). The comparatively stronger association of Academic Culture (r = 0.23), and Institutional Support (r = 0.17) with gamification was found emphasizing the role of organizational climate and leadership endorsement to be salient factors in the success of gamification. Gamification was also found to be confined to engagement-oriented activities that are decoupled from formal learning outcomes and evaluative frameworks largely due to limited faculty agency in curriculum design or assessment reform, thereby constraining the structural integration of game-based elements into core academic processes. The paper contributes to the discourse on educational innovation by highlighting the need to reconceptualise gamification beyond isolated instructional interventions and advocates a curriculum-embedded approach and proves a structural disconnect between institutional innovation narratives and actual classroom integration.

ABSTRACT OBJECTIVES The utilization of physician response vehicles (PRVs) in emergency medical services (EMS) in the United States (U.S.) is not well described, and previous studies have shown that EMS fellows value a PRV in their program. This study describes the function, staffing, and logistical support for PRVs affiliated with EMS fellowship programs across the U.S. METHODS We distributed an institutional review board exempt, anonymous, 33-question REDCap online survey to all Accreditation Council on Graduate Medical Education-accredited EMS fellowship programs. The survey collected data on current and planned PRVs in EMS fellowships, including how vehicles are acquired, equipped, used, and barriers to implementation. Deidentified responses were analyzed, and descriptive statistics performed. When appropriate, Chi-square and Fischer’s exact tests were used to assess statistical significance. RESULTS Ninety-two percent of existing programs responded, with 69% having PRVs and 14% in the process of obtaining them. Finances are a significant obstacle for existing (63%) and planned (70%) programs, which also (70%) worry about institutional support. Programs vary in who purchases, supplies, and maintains the PRVs. Fellows self-dispatch in 45% of programs, while in 13% they are routinely or automatically dispatched to specific calls, or when requested (18%). Fourteen provide 24/7 coverage, with a third offering twelve or fewer hours of coverage per week. Thirty-nine percent have fewer than 100 responses per vehicle, and 10% respond to over five hundred calls annually. The types of advanced procedures [most commonly thoracostomy (86%), ultrasound (86%), field amputation (76%)] performed correlate with the number of fellowship positions, equipment carried, and hours a PRV is in service. Orientation for fellows often (46%) lasts one to two months and varies in requirements. A quarter of the programs allow fellows to take the PRV home at any time. However, there is no correlation between response volume and whether fellows take the PRV home. CONCLUSIONS Most EMS fellowships have, or will soon have, PRVs, with notable differences in service hours, equipment and medications carried, procedures performed, and response volume. The use of PRVs in EMS fellowships will likely shape how PRVs are integrated into the EMS systems.

ABSTRACT Inclusive education (IE), an essential component of educational equity, has emerged as a prominent research area in China’s special education field since its introduction in the 1990s. Despite the growing body of literature, systematic reviews remain limited. Using CiteSpace bibliometric software, this study analysed publications from the China National Knowledge Infrastructure (CNKI) and Web of Science (WoS) core databases to map the development of inclusive education research in China. The analysis was structured around key stages in national special education policy. Findings show a steady increase in publication volume over time, and research trends are closely linked to policy developments. The evolution of research themes follows three phases: ‘inclusion without full integration’ (pre-2002), ‘equal emphasis on both access and quality’ (2003–2011), and ‘appropriate education tailored to individual differences’ (2012–2025). These shifts reflect China’s efforts to advance inclusive education through the Learning in Regular Class (LRC) model. More recently, research has moved from broad, macro-level discussions to practical, micro-level concerns such as teacher attitudes, institutional support, and localised implementation. This review offered a comprehensive overview of the field, highlighting key themes, trends, and gaps to inform future policy, research, and practice towards a more inclusive educational environment in China.

This article explores how parents in Japan navigate the entangled terrain of caregiving and coercion in the context of involuntary psychiatric hospitalization. Drawing on qualitative interviews with parents whose children were hospitalized without consent, this study foregrounds the complex moral and emotional labor that caregiving entails under conditions of limited institutional support and deep-rooted familial responsibility. The analysis identified two recurring patterns in post-hospitalization relationships: one in which caregiving bonds are sustained but increasingly strained and the other in which hospitalization catalyzes shifts in family dynamics, enabling new forms of distance or reconfiguration. These trajectories were shaped not only by the child's condition but also by the presence or absence of external support, including care quality, and by parents' internal struggles with guilt, obligation, and ambivalence. By situating these narratives within Japan's long-standing reliance on the family as the primary site of psychiatric care, this article contributes to the debate on care, agency, and coercion in psychiatric contexts. It calls for closer attention to how families navigate moral uncertainty and negotiate caregiving roles within a system where family involvement is not only common but often prioritized in the admission process, particularly in cases of hospitalization for medical care and protection.