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Purpose In education concerning environmental issues, there are two predominant currents in the world, environmental education (EE) and education for sustainable development (ESD). ESD is the formal commitment and therefore promoted by the United Nations, to ensure that countries achieve sustainable development. In contrast, EE was the first educational trend with an environmental protection approach. The purpose of this systematic review that seeks to show whether the migration from EE to ESD is being effective and welcomed by researchers and especially by universities is presented. With the above, a global panorama can be provided, where the regions that choose each model can be identified. In the same sense, it was sought to determine which of the two currents is more accepted within engineering education. Design/methodology/approach The review followed the preferred reporting items for systematic reviews and meta-analyzes parameters for systematic reviews. In total, 198 papers indexed in Scopus, Science Direct, ERIC and Scielo were analyzed. With the results, the advancement of ESD and the state of the EE by regions in the world were identified. Findings It was possible to categorize the geographical regions that host either of the two EE or ESD currents. It is important to note that ESD has gained more strength from the decade of ESD proposed by the United Nations Educational, Scientific and Cultural Organization. For its part, EE has greater historical roots in some regions of the planet. In turn, there is evidence of a limited number of publications on the design and revision of study plans in engineering. Originality/value Through this systematic literature review, the regions of the world that are clinging to EE and those that have taken the path of ESD could be distinguished. Moreover, specific cases in engineering where ESD has been involved were noted.

Background/Objectives: Endoscopic submucosal dissection (ESD) is a state-of-the-art en bloc resection for early gastro-intestinal cancers and precursors developed and validated in Japan. Western expertise with this complex technique remains limited. Tutored training might be optimal for patients and ESD learning. We established ESD tutoring courses led by experienced Japanese experts to provide (i) optimal long-term curative outcomes and low complication rates for patients and (ii) hands-on training on difficult lesions for European endoscopists under direct expert supervision. Methods: Prospective data from 2011 to 2015 (follow-up to 12/2024) were analyzed. A total of 118 neoplasms (50% HGIEN and cancer) in 101 patients (median age 68 [37–91] years; 38% with significant comorbidities) were treated with expert or tutored ESD. Japanese experts performed 28 ESDs, while 22 trained beginners conducted 90 supervised procedures on difficult lesions during 5 live and 20 tutoring events (1–4 days each). Results: Analysis of the complete data showed curative and en bloc resection rates of 88% and 95%, respectively, with no recurrence after R0 resections during a median follow-up of 9.8 [1.5–14.9] years. Long-term survival remained recurrence-free after endoscopic resection of 3 recurrent adenomas (at R1/Rx) and curative surgery/2nd ESD for 5 non-curative ESDs. Adverse events occurred in 9.3% without emergency surgery or 30-day mortality. Comparing expert-only vs. tutored ESD procedures, beginners correctly applied curative ESD indications in 94% of 118 neoplasms. Experts resected larger lesions (22 cm2) at a rate of 9.3 cm2/h in 121 min. Tutored beginners achieved a 75% [25–100] self-completion rate on 33% smaller lesions in 112 min. Conclusions: ESD tutoring courses led by Japanese experts ensure excellent patient outcomes and standardized procedural training. This model may foster professional ESD performance across European referral centers.

Background and aimsA new external additional working channel (AWC) was recently introduced by which endoscopic submucosal dissection (ESD) can be converted to a technique termed “ESD+ ”. We aim to systematically evaluate this novel technique in flat gastric lesions and compare it to classical ESD.MethodsThe study was prospectively conducted in a pre-clinical ex vivo animal model (EASIE-R simulator) with porcine stomachs. Prior to intervention, we set standardized lesions measuring 3 cm or 4 cm in antegrade as well as in retrograde positions.ResultsOverall, 64 procedures were performed by an experienced endoscopist. Both techniques were reliable and showed en bloc resection rates of 100%. Overall, ESD+ reduced time of procedure compared to ESD (24.5 vs. 32.5 min, p = 0.025*). Particularly, ESD+ was significantly faster in retrograde lesions with a median of 22.5 vs. 34.0 min in 3 cm retrograde lesions (p = 0.002*) and 34.5 vs. 41.0 min (p = 0.011*) in 4 cm retrograde lesions. There were 0 perforations with both techniques. In ESD+ , 1 muscularis damage occurred (3.13%) compared to 6 muscularis damages with ESD (18.75%, p = 0.045*).ConclusionsBy its grasp-and-mobilize technique, ESD+ allows potentially faster and safer resections of flat gastric lesions compared to conventional ESD in an ex vivo porcine model. The potential advantages of ESD+ in terms of procedure time may be particularly relevant for difficult lesions in retrograde positions.

BackgroundEsophageal endoscopic submucosal dissection (ESD) is the gold standard for the treatment of precancerous lesions or superficial esophageal cancers. This procedure is currently performed by expert endoscopists only, and poorly standardized. We aimed to assess the technical results and outcomes of a \"tunnel + clip\" strategy for esophageal ESD procedures performed by less experienced operators for the treatment of superficial neoplasms.MethodsAll consecutive esophageal ESDs performed with the “tunnel + clip” technique for patients with early esophageal cancer in 3 centers were enrolled. Procedural characteristics, clinical outcomes, and complications were recorded.ResultsAmong 195 esophageal ESD procedures performed, early adenocarcinomas or high-grade dysplasia complicating Barrett’s esophagus were predominant (132/195, 67.7%) compared with early squamous cell carcinomas (63/195, 32.3%). The en bloc, R0 and curative resection rates were 100% (195/195), 78.5% (153/195) and 67.2% (131/195), respectively. The mean rate of ESD was 29.7 mm2/min. One (0.5%) perprocedural perforation and 7 (3.6%) postprocedural bleedings occurred, all managed endoscopically. No delayed perforation occurred. Overall, 31 patients (31/195; 15.9%) of patients developed stenosis.ConclusionsThe “tunnel + clip” strategy is safe, and allows to achieve high en bloc, R0 and curative resection rates. This standardized procedure could be used by physicians with little experience and might help spreading esophageal ESD in Western countries.

Societies need to develop more sustainable ways of living, working, and doing business. Education for sustainable development (ESD) plays a pivotal role in this endeavor. The aim is to provide people with the necessary knowledge, values, and skills for the needed transformation. Therefore, organizations of adult and continuing education must address issues of climate protection and sustainability in their programs and act accordingly in the way the organization is managed. This article reports on a qualitative study that involves leaders of adult education institutions in China, Germany, and the USA. This study seeks to investigate what these leaders do and how they act to implement ESD in their organizations. It specifically looks at current challenges, management strategies, beliefs, and values of the leaders. The results of this study show that leaders of adult and continuing education organizations recognize the need to address sustainability in adult education. However, they face many challenges in implementing ESD, including a lack of resources (e.g., finances and staff), structural barriers, and difficulties in reaching new target groups. Despite these challenges, many participants strive to develop their organizations in a more sustainable way, such as through curriculum design and campus management. Some leaders take a comprehensive approach, guided by the Whole Institution Approach, by integrating ESD into their institution’s vision and mission, establishing dedicated working groups, and forming new partnerships with external stakeholders. Overall, this study highlights the crucial role of leadership in advancing sustainability efforts.

The call for integration of competences in tertiary education for sustainable development (ESD) has been heard. Helpful competence models for ESD are available but little exists about how to put them into practice. As illustrated in this article in an initial review of competence models for change agency, this is not easy because competences are fundamentally context-bound and generalized models make little sense. Faculty staff who wish to foster competences for SD therefore need help with contextualising and operationalising competences. They often lack the pedagogic-didactic understanding needed to implement competence orientation in their teaching, in an institutional context where knowledge transmission is traditionally rated higher than competence development. Using a reflective practitioner approach, this paper addresses the need for methodological guidance by introducing a heuristic procedure and a didactic planning tool from adult education that enable lecturers to establish coherent ESD teaching-and-learning environments and curricula: the tree of science model and constructive alignment. Two case studies show how these instruments can be used to increase coherence when operationalising competences for SD. The article concludes by outlining three factors that foster integration of competence orientation in ESD: pedagogic-didactic tools, professional development for ESD, and institutional change.

Purpose This study aims to explore the bibliometric indicators of the previous research on education for sustainable development (ESD) and to synthesise the critical outcomes of the most cited publications in the context of the further education (FE) and skills sector. Design/methodology/approach A mixed-method approach is adopted involving both quantitative and qualitative methodology through a bibliometric analysis including performance, collaboration and network analyses on 768 articles on ESD and thematic content analysis using inductive coding on the most influential publications on ESD. Findings Descriptive results indicate the current state of previous ESD research globally in terms of journals, authorship and citations. The collaboration trends in ESD research reveal a Western dominant relationship spread across five continents. The intellectual structure of ESD research dominantly consists of decision-making patterns, problem-based learning, future-oriented education, ESD-based culture, student perspectives in ESD, the role of universities in ESD, ecopedagogy and ecophilosophy. Finally, the conceptual dynamics of the most influential articles are grouped as policy-based, curriculum-based and teacher training implications. Originality/value This study contributes to the improvement of ESD in the FE and skills sector by exploring the current state of the previous research on ESD, clarifying the collaboration trends in the studies on ESD, the intellectual structure of ESD research and the conceptual dynamics of the most influential research on ESD. The results of this research depict a picture of both existing and missing approaches in the previous ESD studies with respect to the FE and skills sector.

If we are to understand and address today’s social, environmental and economic crises through education, we must introduce education for sustainable development (ESD) into classrooms and approach it from an integrated perspective. In so doing, this study aims to provide an overview of the current status of the still-emerging research agenda on the integration of ESD into mathematical education and statistical education. To this end, we conducted a systematic review of Scopus and Web of Science databases of theoretical and research articles published between 2010 and May 2023. In total, 32 studies were identified, conducted mostly in Europe, followed by South America, which mainly address teacher training. The results suggest that mathematics education and statistics education are an effective means of providing education focused on ESD, but that teachers still have limited knowledge and resistant attitudes. Therefore, initial and ongoing training must move towards characterizing proposals that provide examples and involve teachers in response to this challenge.

BackgroundEndoscopic submucosal dissection (ESD) and hybrid-ESD techniques are treatment modalities for colorectal neoplasia, although mostly used in the Eastern hemisphere. Only few data on ESD for colorectal neoplasia have been published in the West. We report the outcomes of colorectal ESD and hybrid ESD in a single Italian center.MethodsWe retrospectively evaluated the outcomes of all ESD and hybrid-ESD procedures for colorectal neoplasia performed over the first 2-year experience from a prospectively recorded database. Neuroendocrine tumors and adenocarcinoma with submucosal infiltration through the submucosal (SM) 2 layer or deeper were excluded. The primary outcome was the recurrence rate at the 6- to 12-month follow-up.ResultsFifty-two patients were included in the study, of which 23 underwent ESD and 29 hybrid ESD. The mean lesion sizes for ESD and hybrid ESD were similar (25.8 vs. 25.4 mm, p = 0.940), while median procedure length was significantly longer for ESD (120 vs. 60 min, p < 0.001). ESD and hybrid ESD yielded similar en-bloc resection rate (82.6 vs. 82.8%) and R0 resection rate (34.8 vs. 31%). ESD had a lower neoplasia recurrence rate than hybrid ESD (11.7 vs. 20%) and a lower bleeding rate (0 vs. 8.7%). One perforation occurred in the hybrid-ESD cohort and two perforations in the ESD cohort, of which one required surgical intervention. Non-recurrence at follow-up was associated with R0 status, en-bloc resection, and lesion size ≤ 20 mm.ConclusionOur outcomes are comparable with other studies in Western series. Studies addressing the cost effectiveness of ESD and comparing its long-term outcome with endoscopic mucosal resection in the West are needed.

Teaching formats involving non-university partners are increasingly gaining importance to deliver key competencies needed in higher education for sustainable development. Such teaching formats may also create new transdisciplinary spaces that allow different actors to impact regional transition towards sustainable development. Against this background, this article focuses on how universities foster regional transition through teaching, particularly in collaboration with local non-university. Using the interdisciplinary certificate programs on sustainable development offered by the German Universities of Tübingen and Duisburg-Essen as case studies, we analyze the potentials and challenges of teaching programs on sustainable development for promoting regional transition. Leaning on the multi-level-perspective-approach, we have used qualitative interviews to shed light on the design of cooperation between the university and regional partners as well as the creation and integration of transdisciplinary learning spaces. This paper shows that the impact of such teaching formats on the regional transition consists primarily of awareness and network building. One of the most fundamental challenges faced is unequal power relations in terms of access to resources, financing, and doing the course planning. Simultaneously, co-design, mutual understanding, and collective decisions on roles and responsibilities and—especially—empathy and trust are crucial factors for successfully teaching cooperation towards regional sustainability.