Search Results (446)

Background and Objectives: Metacognition-related processes (e.g., confidence calibration, self-evaluation and the use of feedback) have been linked to cognitive insight, self-evaluation, and daily functioning in psychosis. However, clinic-based assessments only provide limited information. Digital methods may capture state-like variations and contextual factors, but it is unclear to what extent they operationalise core metacognitive monitoring constructs versus adjacent self-evaluative/insight-related constructs. We mapped digital approaches used to assess metacognition-related constructs across the psychosis spectrum, summarising the associated feasibility and validity. Materials and Methods: We conducted a scoping review (PRISMA-ScR) of psychosis-spectrum studies that used digital tools to assess metacognition-related targets. These included ecological momentary assessment/experience sampling (EMA/ESM), task-based paradigms with confidence ratings, and hybrid approaches. Searches covered MEDLINE (via PubMed), Scopus, and IEEE Xplore, with the final search run on 15 December 2025. We charted constructs, operationalisations, feasibility/engagement indices and reported links with clinical or functional measures. Results: The empirical evidence map comprised 13 studies directly assessing metacognition-related constructs; eight additional implementation/methodological sources were synthesised separately to contextualise feasibility, reporting, ethics, and governance. EMA studies more often assessed adjacent self-evaluative constructs, including context-linked self-appraisal bias, conviction, and self-report–context mismatch in daily life, whereas task-based studies more directly assessed confidence–accuracy calibration and feedback updating. Across EMA studies, greater momentary symptom severity and more restricted contexts were often associated with inflated self-evaluations and divergence from observer-rated functioning. Task-based studies indicated that confidence calibration and feedback utilisation may diverge from objective performance; in performance-controlled paradigms, some studies reported comparable metacognitive sensitivity/efficiency, but the overall evidence remains uncertain. Passive sensing was common in psychosis research but was rarely explicitly tied to metacognitive constructs. Conclusions: Current digital work spans both core metacognitive monitoring constructs and adjacent self-evaluative/insight-related constructs, rather than a single unitary construct. Clinical translation remains hypothesis-generating: interpretability may be improved by combining clinical anchors, low-burden EMA, and optional contextual streams, but thresholds, workflows, and signal-action rules require prospective validation. Full article

While spirituality and contemplative practices are increasingly invoked in response to environmental crisis, the specific mechanisms by which they may mediate professional ethical action remain underdeveloped. This is particularly evident regarding nuclear harm, an existential planetary threat often siloed from health scholarship. This paper investigates the mediating mechanism of contemplative formation as the analytical link between spiritual ethics and planetary health. By centering this link, we demonstrate how professional nursing identity can be restructured to address existential threats like nuclear harm, which are currently under-integrated in health scholarship. We employed a convergent, integrative design combining a scoping review of the literature published in 2015–2025 with a contemplative autoethnography. The scoping review (n = 39) maps the scholarly evidence of spiritual–ecological constructs, while the autoethnography provides a situated, analytical account of the first author’s professional and spiritual formation. Integration was achieved through a four-step thematic synthesis that explicitly identifies where first-person lived experience and third-person scholarly evidence converge to illuminate the process of ethical integration. Four convergent themes describe the pathways linking contemplative practice to planetary health: (1) embodied practice (somatic resilience); (2) narrative meaning-making (transforming grief into purpose); (3) interconnected ethics (reframing remote harms as proximate responsibilities); and (4) reflective integration (the reflexive weaving of clinical and spiritual identities). The findings reveal that while contemplative traditions offer robust resources for systems thinking and equity, nuclear harm and nursing perspectives remain significantly under-integrated in the current planetary health literature. Contemplative formation functions as the mediating mechanism that turns planetary threats into sustained professional advocacy. The Interbeing Planetary Health Framework provides a pragmatic guide for nursing ethics under existential risks. Full article

Contemporary societies are facing converging crises, including environmental degradation, worsening social inequalities, aging populations, and increasingly costly healthcare systems, prompting sustainable health to be proposed as an integrative conceptual perspective for rethinking health, its determinants, and collective action. This narrative review aims to trace the historical evolution of the concept, clarify the vision it offers for public health, and identify its implications for research, policy, and intervention. A literature search (May 2025) was conducted in PubMed, Google Scholar, and Google, with no restrictions on language, time period, or document type. Of 40 relevant documents, 21 were selected for in-depth analysis by two independent reviewers, with duplicate data extraction. The results show that sustainable health broadens the World Health Organisation (WHO) definition of health by incorporating sustainability, intergenerational justice, ecological limits, and social equity. Close to, but distinct from Planetary Health, One Health, and EcoHealth, sustainable health is based on ecological, social and ethical, economic, behavioral, intergenerational, and systemic/intersectoral dimensions. Sustainable health thus emerges as a systemic and transdisciplinary conceptual approach for transforming health systems, living environments, and public policy, requiring further conceptual clarification, robust interdisciplinary research programs, and intersectoral initiatives involving communities. Full article

To assess food safety conditions among family farmers supplying the National School Feeding Program (PNAE) in the Federal District, Brazil. This exploratory mixed-methods study was subdivided into two main phases: (i) samples of fruits, vegetables, water, soil, and farmers’ feces were analyzed microbiologically and/or parasitologically across nine properties; (ii) sociodemographic and Good Agricultural Practices (GAP) questionnaires were administered, followed by semi-structured interviews to evaluate their perceptions of food safety. Participants were males (100%), of mixed race (88.9%), aged 41–50 years (44.4%), with secondary education (33.3%), and an income between USD 1000 and USD 2000 (33.3%). Samples from food (n = 162), water (n = 18), soil (n = 90), and feces (n = 6) were analyzed. All fruit and vegetable samples, and 83.3% of water samples exceeded acceptable limits for at least one of the microorganisms analyzed. 86.7% of the soil samples showed high levels of contamination. Parasitic contamination was detected in 50.6% of the fruit and vegetable samples, in 63.3% of the soil samples, and in none of the water samples. Most farms used deep or artesian wells (77.7%) and non-connected septic pits (77.7%). Organic fertilization predominated (88.8%), with chemical fertilizers occasionally used (11.2%). Farmers demonstrated strong environmental awareness but limited technical knowledge of food safety. Results indicate persistent vulnerability despite ethical and ecological commitment. Continuous training and stronger public policies are essential to enhance GAP adherence, ensure food microbiological safety, and sustain PNAE objectives. Full article

Background/Objectives: Antimicrobial resistance (AMR) remains a major global health threat, strengthening the case for antimicrobial stewardship strategies that limit unnecessary broad-spectrum empiric therapy while preserving timely escalation when clinically warranted. Before any clinical deployment of large language model (LLM)-based antibiotic decision support can be considered, structured offline evaluation is needed to assess whether model outputs align with auditable stewardship constraints under real-world admission contexts. We therefore evaluated whether post hoc LLM-generated empiric antibiotic recommendations showed greater concordance with a pre-specified stewardship benchmarking framework than clinician-initiated regimens in a retrospective shadow-mode setting. Methods: Single-center retrospective paired evaluation at Clinical Emergency Hospital of Bucharest (Internal Medicine, 2020–2024). The unit of analysis was the admission (N = 493), with paired 24 h empiric regimens (clinician-prescribed vs. post hoc LLM-recommended via OpenAI API; not visible to clinicians; no influence on care). Local laboratory-derived epidemiology was precomputed from microbiology exports and provided as structured prompt context to approximate information parity with clinicians’ implicit local ecology knowledge. Primary (prespecified) endpoint: any contextual guardrail violation (unjustified carbapenem/antipseudomonal/anti-MRSA under prespecified structured severity/MDR-risk rules), exact McNemar. Key secondary (prespecified): Δ contextual guardrail penalty (LLM − Clin), sign test and Wilcoxon signed-rank (ties reported). Ethics committee approval was obtained. Results: Guardrail violations occurred in 17.0% of clinician regimens vs. 4.9% of LLM regimens (paired RD −12.2%; matched OR 0.216, 95% CI 0.127–0.367; McNemar exact p = 1.60 × 10⁻¹⁰). Δ penalty had median 0 with 398/493 ties; among non-ties, improvements (Δ < 0) exceeded adverse shifts (79 vs. 16; sign-test p = 3.47 × 10⁻¹¹). Conclusions: In this offline, non-interventional paired evaluation, LLM-generated empiric regimens showed greater concordance with a pre-specified stewardship benchmarking framework than clinician empiric regimens for the same admissions. These findings should not be interpreted as evidence of clinical superiority, patient safety, or causal effectiveness, but rather as process-level benchmarking within a rule-based stewardship construct. As such, reproducible guardrail-based benchmarking may serve as an early pre-implementation step to identify alignment and potential failure modes before prospective, safety-governed evaluation. Full article

This article examines planetary health in the Anthropocene through a relational ontology that recognizes nonhuman agency and conceptualizes ecological spirituality as a relational and practice-oriented mode of ethical responsiveness within planetary entanglements. Although recent ecological discourses increasingly acknowledge the agency of nonhuman beings, planetary health debates have developed sophisticated scientific and policy-oriented frameworks, yet often remain oriented toward material causality or technocratic governance, while comparatively underarticulating relational, more-than-human, and practice-oriented ethical and spiritual dimensions. This study argues that an adequate response to the planetary crisis requires clarifying how nonhuman agency becomes perceptible and actionable within everyday ethical practice. Methodologically, the article adopts a comparative theoretical approach. First, it engages Jane Bennett’s concept of “thing-power” to reinterpret spirituality as an immanent sensitivity arising from material vitality. Second, drawing on Catherine Keller’s theology of planetary entanglement, it reframes planetary ethics as “response-ability” grounded in interdependence rather than mastery. Third, it examines the Donghak’s practice of gyeongmul (revering all beings) as a non-Western model of embodied ethical reverence. By placing new materialism, ecological theology, and Korean indigenous thought in dialogue, the article reconceptualizes ecological spirituality as a relational mode of responsiveness. It concludes by reinterpreting planetary health as a relational and practice-oriented condition that gestures toward a broader horizon of planetary well-being, rather than environmental stability alone. Full article

Through the combined lenses of ecofeminism, masculinity studies, and critical animal studies, this article examines the cultural functions of animal metamorphosis in two Walt Disney animated feature films, Beauty and the Beast and The Princess and the Frog. It argues that animality operates as a narrative and symbolic space in which dominant gender norms and human–animal hierarchies are temporarily destabilized and reconfigured. Drawing on film analysis, this study shows how the animal figure enables the emergence of alternative masculinities—sensitive, relational, and ecologically attuned—while simultaneously exposing the structural limits of this apparent subversion. Although these films challenge toxic masculinity and propose more egalitarian interspecific relationships, their narrative resolutions ultimately reinstate anthropocentric and heteronormative frameworks by reasserting human centrality and normative romantic closure. By situating Disney’s representations within broader Western dualistic logics of domination (culture/nature, masculine/feminine, human/animal), I demonstrate that animality functions less as an autonomous mode of existence than as a transitional narrative device facilitating human self-transformation. In doing so, this article contributes to current discussions on how culturally mediated representations of animals shape human social imaginaries, ethical frameworks, and understandings of interspecies relationships. Full article

Modern healthcare remains structurally and conceptually fragmented, with profound clinical and policy implications. At its root lies an ontological fracture: the prevailing biomedical model reduces patients to discrete biological systems (organs, biomarkers, and symptoms) detached from the psychological, social, and ecological contexts in which health and illness are experienced. This is compounded by epistemological fragmentation, where medical knowledge is compartmentalized into increasingly narrow specialties, limiting holistic understanding. These philosophical divisions manifest in downstream operational, informational, financial, and policy dysfunctions duplicative testing, misaligned incentives, disconnected care pathways, and population health failures. To address these multilevel fractures, we propose a unified architecture grounded in three interlocking components. First, the Precision and Personalized Population Health (P3H) framework offers a principle-based realignment toward care that is integrated, personalized, proactive, and population wide. P3H addresses the conceptual shortcomings of fragmented care by focusing on the full human trajectory across time, systems, and determinants. Second, General Purpose Technologies including artificial intelligence, biosensors, mobile diagnostics, and multimodal data systems enable the operationalization of whole-person care at scale, especially in low-resource settings. Third, the AI-WHOLE policy framework (Alignment, Integration, Workflow, Holism, Outcomes, Learning, and Equity) provides governance principles to guide ethical, equitable, and context-specific implementation. We argue that this triadic blueprint is particularly critical for Global South nations, where the lack of legacy infrastructure offers an opportunity for leapfrogging toward integrated, intelligent systems of care. Early models illustrate how policy-aligned, technology-enabled care rooted in whole-person principles can yield improvements in continuity, cost-efficiency, and chronic disease outcomes. This manuscript offers a systems-level strategy to overcome fragmentation and reimagine healthcare delivery, not only by refining clinical tools, but by redefining what it means to care for the human being in full. Full article

Generative Artificial Intelligence (GenAI) has rapidly spread worldwide, driving structural changes and redefining approaches to knowledge. This trend has introduced significant challenges, particularly within higher education, where its adoption and acceptance are crucial for pedagogical transformation. However, the increasing integration of GenAI also raises pressing questions related to sustainability, encompassing both its environmental impact (e.g., energy consumption and carbon footprint of AI models) and social and ethical implications (e.g., responsible use, equity, and digital inclusion). This study investigates the factors influencing the adoption and acceptance of GenAI among higher education students, considering these sustainability dimensions. Using an adapted version of the UTAUT2 (Unified Theory of Acceptance and Use of Technology) model, the research analysed data from 229 students, collected in 2025, employing the Partial Least Squares method. By integrating the sustainability perspective, this work seeks to offer an understanding of the challenges and opportunities that GenAI presents for a more equitable and ecologically conscious educational future. The study demonstrates that habit and performance expectancy are the primary drivers of GenAI adoption among students, suggesting that its integration into higher education should prioritize functional value and ethical habit-building over social or hedonic factors. Full article

Scientists estimate that humanity has exceeded seven of nine planetary boundaries, threatening the entire planet with potentially catastrophic consequences for all species. We therefore have a moral imperative for future generations and other species to return to the safe side of those boundaries. Threats to these boundaries take the form of social dilemmas, defined as situations in which individuals acting in their own interest undermine collective welfare, which can only be solved through cooperation. Western economic theory has conditioned us to believe that humans are inherently selfish. This assumption has led economists, scientists, and policymakers to increasingly pursue market-based solutions to conservation approaches, which have yielded limited success. In contrast, this article argues that humans are inherently cooperative. We employ Multi-Level Selection Theory (MLS) to depict the evolutionary advantages of cooperation and to define morality as putting the group ahead of the individual. We examine two examples of MLS in action: Territories of Life (TOL) and Ubuntu. The paper provides guidance for pathways of Ecozoic governance, planning, and restoration. Applied in a Western context in Burlington, Vermont, the philosophies hold true, showing that social norms and group identity already shape ecological behavior in Burlington residents’ lawn care practices. Ultimately, providing an alternative economic model built on these ethical foundations, we introduce the Neighbor’s Goodwill that reframes social dilemmas in a game theory context. The Neighbor’s Goodwill demonstrates how loyalty, reciprocity, and social belonging alter payoff structures. This research is founded on the fact that humans are inherently social and tend to make decisions in the interest of the whole group over their own. Full article

Visual arts education (VAE) offers a promising pedagogical space for addressing sustainability challenges by engaging the cognitive, emotional, and ethical dimensions of learning. This study examines how engagement with contemporary visual arts and art-based pedagogical practices can foster ecological thinking, ecological literacy, and sustainability awareness among pre-service teachers. The research was conducted over one academic year (2022/2023) within two visual arts courses attended by a total of 69 second- and third-year students enrolled in a teacher education programme. Using a qualitative, interpretative research design, the study investigated how selected contemporary artworks addressing ecological themes were pedagogically contextualised and discussed, and how students engaged with these artworks through dialogue, reflection, and their own art-making processes. Data were collected from students’ written reflections, group discussions, and visual works, and analysed using an interpretative framework informed by visual hermeneutics and sustainability education discourse. The findings indicate that engagement with contemporary visual art can foster the development of ecological literacy by enabling students to integrate experiential, affective, reflective, and relational dimensions of sustainability into their understanding of environmental issues. In line with the objectives of SDG 4 (Quality Education), SDG 12 (Responsible Consumption and Production), and SDG 13 (Climate Action), the study contributes to existing literature by demonstrating the pedagogical potential of visual arts education within teacher education and Education for Sustainable Development. Full article

In climate adaptation plans, national sustainability strategies, and agency-level resilience frameworks, planetary limits are routinely acknowledged, yet proposed responses continue to center on expansion, replication, and scalability. This paper argues that this tension is not merely political or technical but grammatical. It reflects the dominance of the grammar of scale—a patterned way of organizing, evaluating, and legitimizing sustainability action through expansion, metrics, piloting, and exit. While indispensable in many contexts, scale increasingly struggles to secure durable ecological responsibility amid irreversibility, uneven exposure, and intergenerational harm. The paper advances a framework of plural sustainability grammars to diagnose this mismatch. In addition to scale, it identifies six alternative grammars—attachment, settlement, sufficiency, inheritance, exposure, and refusal—that already circulate, often implicitly, within sustainability discourse. Each grammar foregrounds dimensions of responsibility that scalability tends to background, including permanence, restraint, cumulative consequence, and ethical limits. The paper traces these grammars through climate adaptation planning frameworks across governance levels, showing how plural grammars are prominent in problem framing and diagnosis but are progressively narrowed as plans move toward implementation, monitoring, and accountability, where scale becomes dominant. The paper concludes by reflecting on the implications of this grammatical narrowing for practitioners, policymakers, and scholars concerned with adaptation, justice, and the governance of sustainability under planetary limits. Full article

The Bees Quarter episode in Amish Tripathi’s Ram Chandra Series rearticulates dharma by relocating it from a transcendent cosmic mandate to a framework enacted through spatial and procedural ethics. Traditionally understood as a sustaining principle of moral and social order, dharma in Tripathi’s narrative is reconfigured through the spatial reorganization of Mithila, where environmental vulnerability and infrastructural design shape the conditions of ethical governance. Interpreting this transformation through the framework of just sustainabilities, the article argues that the episode reconfigures dharma not as a transcendent principle but as a practice grounded in resource equity, institutional responsibility, and the consistent application of law. The crisis surrounding the Battle of the Bees Quarter and Ram’s subsequent self-exile further dramatizes a dharmic dilemma between sovereign authority and procedural justice, foregrounding tensions between power and legitimacy. Read through this lens, Tripathi’s retelling situates dharma within contemporary debates on sustainability and justice, reframing it as a normative response to ecological precarity and institutional fragility. Full article

Theological engagement with artificial intelligence has largely focused on applied ethics, addressing bias, governance, and labor displacement. While indispensable, this framing often presumes that algorithmic systems operate as external instruments acting upon already constituted subjects. This article argues that contemporary predictive architectures intervene at a deeper anthropological level by structuring attention, expectation, and habituation prior to deliberative judgment. It introduces the concept of ordo extractionis to designate a technologically mediated regime of formation characterized by behavioral trace extraction, probabilistic modeling, and recursive projection of statistically inferred continuity. Drawing on Augustine’s account of ordered love and temporality and Aquinas’s doctrine of habitus and the invisible mission of the Spirit, the article distinguishes algorithmic projection from sanctification as divergent pedagogies of temporal formation. Predictive systems stabilize continuity by extrapolating from measurable past behavior; sanctification reorders desire teleologically toward a final end not deducible from prior pattern and grounded in non-competitive divine causality. Algorithmic mediation is therefore interpreted pedagogically rather than metaphysically: it does not rival divine agency but participates creaturely in shaping the ecology within which habituation unfolds. Engagement with contemporary AI research on recommender systems, reinforcement learning, and generative models situates the argument within technological realism and resists determinism. The digital twin is analyzed as a probabilistic representation that acquires institutional authority when operationalized in ranking, profiling, and evaluative systems, without constituting a metaphysical competitor to the imago Dei. In response to anticipatory closure, Eucharistic anamnesis and epiclesis are developed as practices that re-situate memory and expectation within eschatological promise. The article concludes that the central theological question posed by AI is not whether machines can think, but how formative sovereignty over desire is exercised within technologically mediated modernity. Full article

The intricate relationships between humans and animals have long shaped philosophical, cultural and scientific inquiry. This narrative review examines evolving conceptions of animal consciousness, agency and sentience within broader historical, ethical and epistemological contexts. Drawing on philosophy, ethology, neuroscience, psychology and animal studies, it critically engages debates on anthropocentrism, cognitive ethology, moral considerability and relational ontology. By tracing the shift from mechanistic models of animality to embodied and affective accounts of consciousness, the analysis highlights how contemporary scholarship destabilises traditional forms of human exceptionalism. Building on this interdisciplinary synthesis, the article advances a symbiotic humanist orientation that integrates evolutionary continuity with multidimensional models of consciousness and differentiated normative responsibility. The argument culminates in the articulation of a Stratified Relational Responsibility Model (SRRM), which reconciles ontological continuity with asymmetrical accountability. Within this framework, shared evolutionary conditions ground moral considerability, while the emergence of reflexive and institutional normativity intensifies human ethical obligation. The model offers a non-anthropocentric yet normatively robust account of human–animal relations, situating human distinctiveness not in metaphysical superiority but in heightened responsibility within multispecies ecological systems. Full article