Perspectives towards, and experiences of clean sport in international Cerebral Palsy Football: A cross-cultural qualitative exploration of players and athlete support personnel.

Physical inactivity (PI) has emerged as a "forgotten pandemic" in global health. Over a quarter of adults worldwide fail to meet recommended physical activity (PA) levels, a proportion that has remained largely unchanged since 2001. This inactivity drives a rising non-communicable disease burden, deepens health inequities, and generates substantial economic costs. Yet preventive action and dedicated funding remain insufficient. Despite international frameworks and national PA plans, with nearly 75% of countries reporting relevant policies, implementation remains inconsistent and population-wide impact elusive. Global efforts are constrained by systemic policy blind spots. Health in All Policies, a governance approach that integrates health considerations into policy decisions across sectors such as urban planning and education, remains widely endorsed but rarely enacted, foreclosing opportunities for action. Viewed through an equity lens, existing strategies disproportionately benefit more advantaged populations, leaving underserved groups behind. These shortcomings are compounded by short political cycles and chronic underinvestment in prevention, which prioritize short-term political wins over long-term gains. A fundamental paradigm shift is required, from fragmented, individually focused initiatives towards a multilevel, systems-based approach that aligns global, national, and local action. PA must be reframed as a societal investment, rather than a lifestyle choice contingent on individual responsibility. Genuine population-level empowerment stems not from placing the burden on individuals, but from creating environments and policies that enable active living. We call on global health leaders to elevate PA promotion to the forefront of political agendas, supported by increased funding, long-term vision, rigorous implementation, and targeted interventions for underserved populations.

Tuition-free lower secondary education and women's healthcare decision-making in Sub-Saharan Africa.

To support Canada's efforts in addressing underwater radiated noise (URN), a novel ship noise rating system was developed using the distribution of Radiated Noise Levels (RNL) measurements from over 49,000 transits of 5947 different ships. The system sets category-specific URN targets for nine ship categories and allows for URN evaluations using semi-controlled measurements made during routine ship operations. The approach extends the framework recommended by the national Underwater Vessel Noise Reduction Targets (UVNRT) Working Group, by using scaled RNL measurements to account for operating condition differences during measurements, and vessel dimensional differences within the same ship category. Ships are rated according to their URN quartile, allowing for future refinements as vessel RNL distributions evolve. Integration into automated monitoring tools, including the Boundary Pass Underwater Listening Station, facilitates cost-effective ratings of large numbers of ships and allows for data-driven refinements. The rating system contributes to Canada's development of ship URN management methods and target setting approaches and provides information to support the country's continued engagement at the International Maritime Organization (IMO) as international policy frameworks evolve.

Reproductive donation tourism is a complex phenomenon with profound ethical implications which also affects Iran. However, studies in this context are limited. This study explores the ethical challenges associated with donor-based reproductive tourism from the perspective of Iranian clinicians, focusing on how they interpret these challenges within Iran's legal, religious, and institutional context. A conventional content analysis study was used to explore the ethical concerns in donation-related reproductive tourism perceived by clinicians in Iran. Twenty-two experts who were actively involved in the field of infertility treatment, were recruited purposefully from ART centers in Tehran and the Ministry of Health of Iran in 2025. Data collection was done through in-depth, semi-structured interviews. Analysis was carried out by MAXQDA.24 software and the Graneheim and Lundman approach. A conceptual model was also proposed to explain the interaction of challenges involved in this phenomenon. Data analysis resulted in four themes: (1) Legal and structural heterogeneity of countries; (2) Clinical uncertainty and physical and genetic concerns in reproductive donation; (3) Synergistic moral, psychological, identity, social, and cultural-religious implications and secrecy in reproductive donation; (4) Justice, commodification, exploitation and demand in fertility tourism. These challenges can raise concerns related to justice, exploitation, commodification, and the rights of donor-conceived children. This treatment method in Iran is surrounded by multidimensional and interwoven concerns that mutually reinforce each other. These findings indicate that reproductive donation tourism is not merely a legal and clinical issue but one that raises significant ethical concerns, requiring careful consideration of fundamental principles of medical ethics in both national and international policy-making. Therefore, developing and sharing integrated international legal and ethical frameworks to support ethically responsible and regulated reproductive care, is essential.

The rapid digital transformation of health systems worldwide demands an interdisciplinary public health workforce proficient in digital technologies, ethical frameworks and systems-level thinking. However, current public health curricula remain largely discipline-specific and fail to systematically embed digital competencies or foster collaboration across sectors such as technology, ethics, law, and policy. This position paper emerges from a high-level workshop held during the Digital Public Health Conference 2025, where international experts and educators debated strategies for advancing interdisciplinary education. Drawing on multilevel evidence, including participant reflections, international frameworks, and case studies, we identify and analyse five critical challenges shaping the future of digital public health education: (1) embedding ethics and regulation into digital public health education; (2) strengthening digital public health literacy with a salutogenic approach; (3) defining interdisciplinary competencies for the future workforce; (4) integrating real-world applications into classroom learning; and (5) enabling long-term, cross-border collaboration in education. For each theme, we propose actionable goals rooted in pedagogical innovation, policy alignment, and institutional governance. Designing inclusive, ethical, and practice-informed education models is essential to prepare a digitally fluent and socially accountable public health workforce.

Artificial intelligence (AI) is fundamentally reshaping analytical chemistry by enabling automated data interpretation, intelligent method optimization, and increasingly autonomous analytical workflows across pharmaceutical quality control, environmental monitoring, and clinical diagnostics. Despite remarkable recent advances, widespread regulatory-ready deployment remains constrained by critical translational barriers, including insufficient external validation, inadequate model interpretability, and the absence of coherent lifecycle governance frameworks. This review critically evaluates the current landscape of AI-driven analytical chemistry with particular emphasis on hyphenated chromatographic platforms-especially reverse-phase high-performance liquid chromatography (RP-HPLC) and its hyphenated configurations-as primary technological substrates for AI integration. The roles of Explainable AI (XAI), Uncertainty Quantification (UQ), FAIR data governance, and continuous lifecycle validation are assessed against key international regulatory frameworks, including ICH Q2(R2), ICH Q14, GAMP 5, FDA Computer Software Assurance (CSA) guidance, Good Machine Learning Practice (GMLP), and EMA AI perspectives. Two translational gaps are defined and critically examined: the Validation Gap (disconnect between high internal model performance and limited external reproducibility evidence) and the Discrepancy Gap (deterioration of model performance under real-world deployment conditions due to domain shift and instrument heterogeneity). The review further presents a milestone timeline for RP-HPLC hyphenation, a critical comparative analysis of hyphenated techniques including LC-MS/MS, LC-NMR, LC-ICP-MS, and LC-HRMS, and a new comprehensive table of reported AI/ML applications in chromatographic method development. Key recommendations are provided for bridging the path from proof-of-concept AI tools to trustworthy, decision-ready analytical ecosystems.

Objectives This study develops and applies a Delphi-informed environmental audit framework to examine spatial responsiveness in community-based day centers for older adults. Background Daytime socialization spaces play an important role in supporting mobility, orientation, and psychosocial well-being in later life. Although international frameworks such as WHO Age-Friendly Cities, Universal Design, and NICE provide environmental guidance, structured evaluation tools for non-clinical community settings remain limited. Methods A three-round Delphi process involving experts in architecture, interior design, and gerontology refined an 18-item checklist organized into three macro domains and five subdomains addressing accessibility, environmental quality, safety, and supportive spatial features. The framework was applied to eight municipally operated day centers in Turkey. Group comparisons were conducted using non-parametric statistical tests, and visual-comparative synthesis incorporated photographic documentation. Results Item-level differences were identified in selected safety-critical and perceptual dimensions, including flooring safety, color contrast, and handrail provision ( p < 0.05). No significant differences were observed in total checklist scores, suggesting comparable baseline performance across facility types. Configurational analysis indicated greater spatial compactness and clearer entrance articulation in Type 1 centers, whereas more fragmented layouts in Type 2 centers may increase orientation demands. Conclusions Findings suggest that spatial responsiveness in community day centers extends beyond basic accessibility compliance to the coherent integration of sensory, safety-related, and circulation cues. Given the limited sample size and single-city context, results should be interpreted as exploratory. The Delphi-informed framework demonstrates practical applicability; however, broader multi-site validation and integration of user-reported outcomes are needed to strengthen generalizability.

This article analyzes how international cross-border lending originating from advanced countries responds to the use of loan-to-value (LTV) ratios in advanced, eurozone, and emerging countries from 2000 to 2020. Over the last two decades, countries have implemented and adjusted this prudential tool at different levels and times, thereby differentially affecting cross-border banking activities. The literature recommends international coordination of prudential policies to improve their effectiveness. Using a panel data analysis, we explore the impact of differences in LTV ratios across countries on the dampening of bilateral credit growth. The results provide evidence that the policies of lending and borrowing countries do not always simultaneously mitigate bilateral credit. Tightening LTV ratios in lending countries reduces credit flows, while tightening LTV ratios in borrowing countries tends to increase demand for bilateral credit. The level differential across countries can explain the volume of credit flows, which implies heterogeneous LTV ratios can reduce the ability to manage credit growth across countries. Therefore, an appropriate international coordination framework could support international credit stability; however, differences in financial and economic status, as well as the frequency of policy changes across countries, should also be considered, as they explain the direction and significance of bilateral credit flow.

Collagen, predominantly porcine (~ 41% of global production), is a ubiquitous pharmaceutical, cosmetic, and biomedical excipient. For the estimated 1.9 billion Muslim patients worldwide, this raises a recurrent concern with potential implications for medication adherence and patient counselling, including in rheumatology. This PRISMA 2020-compliant systematic review synthesises 56 studies retrieved from five databases (initial yield 1035 records), addressing four domains: Islamic jurisprudential classification by source, validated analytical authentication, halal-compliant alternatives, and international regulatory frameworks. Analytical studies were appraised with a modified QUADAS-2, jurisprudential sources with an internal-consistency checklist, certainty of evidence with a GRADE-informed framework. Across mainstream Sunni jurisprudence, porcine collagen is classified as prohibited (haram) regardless of industrial processing, with high inter-school agreement and convergent classical and contemporary fatwa support; bovine collagen is conditionally permissible subject to ritual (zabiha) slaughter and certified traceability; fish collagen is broadly accepted and is the most commercially mature alternative. Quantitative PCR (LOD ≈0.01%) offers the best balance of sensitivity and validation for native matrices, while LC-MS/MS proteomics is preferable for extensively hydrolysed products; orthogonal testing is advisable where stakes are high. Recombinant collagen offers the highest theoretical halal assurance but is constrained by cost, regulatory translation, and substrate certification. International harmonisation of halal pharmaceutical standards comparable to Malaysia's MS 2424:2019 is identified as a regulatory gap. Findings are most directly relevant to pharmacists, regulators, and clinicians serving Muslim populations; direct rheumatology-specific evidence remains limited and warrants dedicated study.

ABSTRACT Epistemological fragmentation constrains a comprehensive understanding of physical activity as leisure as a human right. This theoretical essay distinguishes free time physical activity, understood as a temporal and social domain, from physical activity as leisure, understood as a subjective and meaning-laden experience. To examine this distinction, the article brings into dialogue three perspectives often treated separately: legal, public health and health promotion policy, and phenomenological. The analysis adopts a hermeneutic approach inspired by Gadamer and draws on Bourdieu and Fairclough as critical lenses attentive to struggles over legitimacy and to the stabilization of dominant categories. Brazil is used as an analytical case to critically engage international frameworks. The findings show that each perspective is necessary yet insufficient in isolation, making their articulation both epistemologically and politically necessary.

ABSTRACT The fusion of artificial intelligence and neurotechnology has rendered the human mind increasingly accessible to external decoding and manipulation, challenging traditional boundaries of mental privacy under international human rights law. This article argues that the current framework, predominantly reliant on the relative and consent-based right to privacy under Article 17 of the ICCPR, is structurally insufficient to address the distinctive risks posed by these emerging technologies. While existing privacy and data protection frameworks remain an important starting point, practices capable of accessing or shaping mental states may implicate not merely informational privacy but also the protected inner sphere of thought under Article 18. Drawing on a comparative analysis of regulatory developments in Chile, the European Union, the United States, and China, as well as recent developments within United Nations human rights mechanisms, the article maps the limitations of existing approaches. It then proposes five core principles as a structured foundation for a future international normative framework. These principles are intended not as definitive solutions but as a basis for the international community to refine and ultimately translate into operational legal standards.

Effective transition from pediatric to adult care is essential in Duchenne muscular dystrophy (DMD), but evidence on how transition is delivered in everyday practice remains limited. In Turkey, no clinical framework specifies how transition should occur, although national regulation requires completion of transfer by age 23. This study aimed to describe current practice, identify barriers and facilitators from physician and patient perspectives, and compare findings with international frameworks to inform a national guideline. As part of the AIM-DMD (National plan of action to raise Awareness and Improve Medical care of Duchenne Muscular Dystrophy) initiative, we conducted a national cross-sectional survey between June and December 2025, comprising parallel sub-studies of physicians and patients with DMD and their caregivers. Two structured online questionnaires were developed, guided by the Got Transition Six Core Elements framework and international Delphi consensus statements. The physician survey was distributed through professional networks; the patient and caregiver survey through the DMD Families Association and neuromuscular reference centers. Sixty-two physicians (43 pediatric and 19 adult neurologists) from 28 cities and 48 patients and caregivers from 24 of these cities responded. Only 17.7% of physicians reported a systematic institutional transition program, 38.7% prepared individualized transition plans, and 9.7% described true readiness assessment. Joint pretransition consultations were held regularly by only 6.5% of physicians. Among transitioned patients, 72.4% first heard about transition at age 17 or later, and 62.1% considered their preparation inadequate. All physicians reported transferring medical data at transition, most commonly through institutional electronic health records (80.6%); however, 41.4% of patients and caregivers were unaware that any information had been conveyed to the adult team. Physicians, patients, and caregivers all identified the lack of a formal transition protocol, joint pediatric and adult consultations, multidisciplinary integration, and a designated coordinator role as priority areas for improvement. DMD transition care across Turkey lacks consistent structure. Key gaps include limited readiness assessment, delayed discussions, poor patient and caregiver awareness of the transition process, and lack of coordinated multidisciplinary structures. Our study identified common priorities raised by physicians, patients, and caregivers that need to be improved and could inform the development of standardized protocols.

Purpose Carbon footprint assessments have been mainstreamed, but not all organizations follow international protocols when making carbon neutrality claims. Biodiversity footprinting in organizations is a new arrival, and even organizations such as higher education institutions (HEIs) are largely yet to understand how to measure and address biodiversity footprints. Biodiversity footprint assessment helps organizations to identify their impacts on nature by estimating biodiversity loss caused by the organization’s consumption. Climate change is one of the drivers of biodiversity loss, so the biodiversity footprint also includes its carbon footprint. Despite the novelty of the calculation methods and lack of data, several HEIs have pledged to become nature positive. This paper aims to examine the scopes and challenges of HEIs’ carbon neutrality and nature-positive claims and suggests opportunities for improvement. Design/methodology/approach Two expert workshops on carbon neutrality and nature-positive claims of HEIs were held in Finland. Participants were Finnish sustainability experts currently working in research universities or universities of applied sciences. The focus of the workshops was to define the Scope 3 emission categories that should be included in the HEIs’ carbon neutrality claim and to set common climate and nature goals for the Finnish HEIs. In this paper, the carbon-neutral and nature-positive claims and definitions are discussed based on the results of the expert workshops, international frameworks and literature. Findings To contribute to the global nature-positive goal, HEIs must have a measurable net positive impact on biodiversity. To fully understand their impact on nature, HEIs should transition from carbon-only to carbon and biodiversity footprint assessments. Biodiversity footprint assessment is an important first step for setting measurable environmental targets. HEIs must be careful not to dilute the terms carbon neutral or nature positive. If a carbon neutrality claim is made, it should include all Scope 1 and Scope 2 emissions and most of the Scope 3 emissions categories. If specific emission categories are left out, this decision must be based on an international standard (like the greenhouse gas protocol) and communicated clearly. Based on the expert workshops, it is evident that the minimum required Scope 3 categories that should be included in the Finnish HEIs’ carbon neutrality claim are business travel, water, waste, procurement, real estate maintenance, construction, refrigerants, staff and student commuting and investments. Practical implications This study contributes to HEI’s sustainability strategies, target setting and reporting. Suggestions are given for organizational targets that contribute to the global nature-positive goal, and a new definition for Nature Positive University is proposed. Originality/value This paper encourages HEIs to lead humanity’s journey toward planetary well-being. It’s a call for action for HEIs to make measurable contributions to the global nature-positive goal while being prudent with their own organizational claims.

Per- and polyfluoroalkyl substances (PFASs) present a critical challenge to global public health and environmental integrity due to the exceptional stability of the carbon-fluorine (C-F) bond. This review synthesizes current knowledge on PFAS physicochemical properties, exposure pathways, and toxicological outcomes, while evaluating global regulatory efficacy. A central problem addressed in this review is the widening discrepancy between rigid, yet deeply fragmented, international regulatory frameworks and the increasingly complex, non-linear epidemiological data regarding PFAS health risks. While historical paradigms focused heavily on direct carcinogenicity, recent high-resolution data reveal significant heterogeneity and methodological inconsistencies in cancer links. Instead, robust evidence points to severe systemic toxicities-including hepatotoxicity, immunotoxicity, and maternal-fetal disruptions-frequently driven by mixture co-exposures and sex-specific metabolic dimorphisms. Furthermore, the industrial transition to short-chain substitutes has inadvertently compounded the crisis due to their high environmental mobility and resistance to conventional water treatment. By critically evaluating these toxicological and regulatory contradictions, this review demonstrates that current substance-by-substance legislative models fail to mitigate real-world pollution trends. Ultimately, we emphasize the urgent need to transition to holistic mixture modeling, implement unified class-based global regulations, and accelerate advanced destructive remediation technologies to mineralize the resilient C-F bond.

ABSTRACT This article examines Virtual Exchange (VE) as a pedagogical approach for fostering intercultural learning and plurilingual practices in higher education. Drawing on translingual practices and transnational pedagogy, it analyses four VE initiatives that demonstrate how multimodal and multilingual collaboration can support intercultural dialogue and interdisciplinary knowledge construction. The discussion highlights how task design can foster the mobilisation of diverse linguistic repertoires and digital resources for meaning-making across contexts. By situating VE within a critical framework of internationalisation at home, the article argues that well-designed virtual exchanges can create inclusive and transformative learning spaces and contribute to a plurilingual curriculum.

The swift advancement of digital technologies has revolutionized how people communicate, learn, interact, and obtain information. Children, in particular, have become active participants in the digital world through social media, online gaming, educational technology, streaming services, and AI-based tools. In India, the recognition of privacy as a fundamental right in the case of Justice K.S. Puttaswamy v. Union of India established the constitutional basis for data protection laws. In response to increasing concerns about digital privacy, the Parliament passed the Digital Personal Data Protection Act, 2023 (DPDP Act), marking India's first comprehensive legislation on digital personal data. The Act includes specific protections for children by requiring verifiable parental consent and banning tracking, behavioral monitoring, and targeted advertising aimed at minors. This Article critically explores the legal framework for protecting children's personal data under the DPDP Act, 2023. The study examines the constitutional foundation of privacy, the development of data protection laws, and the child-specific provisions in the Act. It also assesses the effectiveness of the current framework by identifying practical challenges such as age verification issues, implementation obstacles, lack of digital literacy, regulatory ambiguities, and enforcement concerns. The research further conducts a comparative analysis of international frameworks like the General Data Protection Regulation (GDPR) and the Children’s Online Privacy Protection Act (COPPA).

ABSTRACT The integration of artificial intelligence (AI) into education presents both opportunities and challenges, particularly in inquiry-based and context-sensitive science classrooms. Although commercial AI tools are increasingly available, it remains unclear how teachers can move from passive consumers of technology to active designers of AI-mediated instruction. This position paper proposes two professional competencies needed for teachers to maintain and enact expertise in AI-enhanced environments, digital integration competency and automation design competency. Digital integration competency refers to teachers’ ability to collect, connect, and analyze educational data for instructional purposes. Automation design competency refers to teachers’ ability to design digital automated workflows that are aligned with pedagogical goals. Both competencies depend on data preparation and require teachers to exercise professional judgment in evaluating and transforming instructional data. This conceptualization extends the TPACK framework by addressing the practical demands of AI integration in science teaching. These competencies support teachers’ professional agency, responsible innovation, and capacity to resist the risks of technological colonization in the age of AI. Drawing on classroom examples, international policy frameworks, and current research, this paper offers a conceptual foundation for rethinking teacher expertise in AI-integrated science education. It ultimately reimagines the teacher not as a passive user of technology, but as a designer of AI-supported instructional environments.

Genetic screening of gamete donors bears critical importance for protecting donor-conceived offspring. This case report describes a woman in her forties who discovered through genealogical testing that she carries a Lynch syndrome-related pathogenic MSH2 variant inherited from an anonymous sperm donor. Her genetic father died of colorectal cancer at a young age, and among her identified genetic half-siblings, one had already developed advanced colorectal cancer. Had the donor been screened for actionable pathogenic variants-such as the Lynch syndrome-associated mutation identified in this case, for which surveillance and preventive measures are available-this information could have enabled early surveillance, prevention, and informed reproductive decision-making for both the donor and offspring. We review current screening approaches, which rely on family history assessment that while requiring a three-generation pedigree per regulatory guidelines, may be incomplete due to the donor's young age, limited family knowledge, or low disease penetrance, and on targeted genetic panels that may miss actionable pathogenic variants. Recent advances in population genomic screening, including expanded carrier screening and testing for adult-onset conditions, now make screening for actionable pathogenic variants in gamete donors increasingly feasible. We address ethical considerations including donor autonomy, the right to know genetic information, and information disclosure policies. We examine international legal frameworks governing gamete donation and genetic screening. Our recommendations include comprehensive genetic screening of all donors for actionable pathogenic variants, centralized registries linking donors to offspring, standardized protocols for updating families with new genetic information, and clear policies addressing donor anonymity in the genomic era. Implementation of these recommendations would significantly reduce preventable morbidity and mortality in donor-conceived individuals while respecting the rights of all parties involved.

Environmental education occupies a paradoxical position in contemporary schooling: proclaimed as urgent by policymakers, endorsed across international frameworks, yet persistently marginalised in practice. This paper argues that the intractability of this paradox cannot be resolved at the level of curriculum design, pedagogical method, or institutional policy, because its roots are ontological. Drawing on recent literature across environmental education research, philosophy of education, and environmental philosophy, the paper traces the problem through four interconnected dimensions. The first concerns the contradictions embedded in what environmental education teaches and for what purpose. The second is the mismatch between the abstract, universal learner presumed by dominant frameworks and the culturally embedded, place-specific persons who actually inhabit classrooms. The third is the marginalisation of non-Western knowledge traditions by frameworks that position Western science as the default mode of environmental knowing. The fourth is the structural incapacity of the modern school—itself a product of the modernity that generated ecological crisis—to house genuinely transformative environmental education. The paper concludes by sketching the contours of an ontological reorientation, drawing on diverse philosophical traditions including Anthropocosmism, ancient natural philosophy, Indigenous epistemologies, and contemplative approaches. It argues that environmental education requires not better implementation of existing frameworks but a more fundamental rethinking of what it means for human beings to know, inhabit, and be responsible to a living world.