Background: Cellular senescence is a fundamental characteristic of aging, marked by permanent cell cycle cessation and the release of pro-inflammatory mediators. Although senescence plays advantageous roles in tissue regeneration and tumor suppression, its accumulation leads to aging-related illnesses and functional deterioration. Objective: This review examines the processes of cellular senescence, its effects on aging and age-related disorders, and emerging therapeutic strategies to modulate senescence for promoting healthy aging. Methods: A thorough literature review was performed using peer-reviewed studies on cellular senescence, its molecular pathways, and therapeutic interventions. Emphasis was placed on senolytics, senomorphics, and lifestyle interventions that modulate senescence-associated pathways. Studies published in Scopus, Web of Science and PubMed between 2014– 2025 were selected. Results: Recent discoveries underscore the dual function of cellular senescence in aging and pathology. The senescence-associated secretory phenotype (SASP) fosters chronic inflammation and tissue dysfunction, connecting senescence to age-related diseases including cardiovascular conditions, dementia, and metabolic disorders. Therapeutic strategies, including senolytics (drugs that specifically eradicate senescent cells) and senomorphics (compounds that suppress SASP without killing cells), show promise in preclinical and clinical studies. Notably, dosing interals (intermittent vs continuous) influence both therapeutic efficacy and adverse events such as thrombocytopenia. Additionally, the state and limitations of clinical validation of aging biomarkers (eg, p16^INK4a, β-galactosidase) remain major hurdles for translation. Lifestyle interventions such as calorie restriction and exercise have also been identified as natural modulators of senescence pathways. Conclusion: Targeting cellular senescence offers a promising avenue for promoting healthy aging and mitigating age-linked diseases. Continued research into senescence-modulating interventions may lead to novel therapeutics designed to prolong healthspan and lifespan. Plain Language Summary: As we age, some of our cells stop dividing in a process called cellular senescence. These cells do not die, but instead release harmful substances that can cause inflammation and damage nearby healthy cells. While this process can be helpful early in life (like preventing cancer), too many of these cells in old age contribute to diseases such as heart problems, diabetes, and dementia. This study reviews recent research into ways to remove or control these “senescent” cells to support healthier aging. Two promising strategies are:Senolytics: drugs that kill senescent cells.Senomorphics: drugs that make senescent cells less harmful without killing them. Scientists are testing both types of drugs in animals and humans. Some natural compounds, like quercetin (found in apples and onions) and fisetin (found in strawberries), show potential benefits. Others like metformin and rapamycin, which are already used for diabetes or immune issues, might also help slow aging by targeting senescent cells. The study also emphasizes that healthy habits, like exercise and calorie restriction, naturally reduce the harmful effects of senescence. Despite promising results, challenges remain. We need more human studies to understand:Which treatments are safest and most effectiveHow to deliver them to the right parts of the bodyHow often they should be used The authors believe that combining senolytics, senomorphics, and lifestyle changes could significantly improve our health as we age.

Background: Hand hygiene is an important measure to prevent disease transmission. This scoping review identifies and summarises current tools and guidance for the implementation of hand hygiene recommendations in community settings. Methods: We conducted a scoping review following the Arksey and O’Malley framework. To identify relevant documents, we searched: 1) a grey literature database, 2) Google search engine, and 3) the websites of international organisations in August 2023. We included tools and implementation guidance relevant to hand hygiene in community settings, categorised as domestic, public, or institutional, and published in English by international organisations between January 1990 and August 2023. Tools and implementation guidance were mapped to an existing conceptual framework adapted for this review that includes a six-step implementation approach. Results: We included a total of 35 documents, comprising 30 implementation guidance documents and 5 stand-alone tools. Among these 35 documents, we identified 207 implementation recommendations and a total of 21 tools for the six implementation steps. The 21 tools include 5 stand-alone tools and 16 tools embedded within guidance documents. Most implementation guidance was mapped to steps 1 (prepare for action), 2 (analyse the situation), 3 (develop an action plan), and 5 (monitor, evaluate, and course correct) of the conceptual framework, with limited guidance for step 4 (executing the action plan) and step 6 (cross-cutting themes). Over half of identified tools are for step 2 (analyse the situation) and primarily for undertaking a situation analysis. Only two documents provided guidance or a tool across the six steps. Conclusion: Implementation guidance is available, yet inconsistently spread across the different implementation steps. There is also a limited number of tools to support implementation. Future work should focus on developing comprehensive practical tools for the implementation of hand hygiene recommendations in community settings, in line with international guidelines.

Background Female teachers working in conflict and displacement settings are both crisis survivors and crisis responders, nurturing learning, stability, and hope and experiencing trauma, economic insecurity and systemic neglect. Their lived experiences and coping systems remain under-documented and undervalued. This review is a synthesis of multi-regional findings to shed light on the interaction of gender, precarity, and resilience on the development of professional and psychosocial pathways of women teachers during and after conflict. Methods This narrative systematic review was done using PRISMA 2020 guidelines. Thirty-four primary studies and several secondary sources in Sub-Saharan Africa, the Middle East and North Africa, and Eastern Europe were reviewed. Results Female teachers were subjected to the greatest instability and trauma, with post-traumatic stress (22-35%), burnout (40-70%), and acute psychological distress (over 70% under active crises) being the most prominent. The chronic attrition and “brain waste” were caused by structural deprivation in the form of salary arrears, invalidation of credential, and exclusion to continuous professional development (CPD). Relational and spiritual resilience were found to be strong buffers despite these limitations. Burnout was reduced by peer networks, faith-based coping and community support and agency was restored. Online and physical CPD programs in Kakuma, Lebanon and Ukraine assisted displaced women to maintain teaching identity and re-credential after displacement. Teacher Stability Index (TSI) showed that there was universal low interdependence resilience (0.50). Conclusion Women educators in conflict and displacement situations represent paradox: they perpetuate the educational process and survive the trauma and structural marginalization. It would take systematic reform to identify them as professionals in humanitarian work, rather than as a fringe volunteer. Some of the priority interventions are listed as the stabilization of salaries, transnational credential recognition, survivor-focused protection against GBV, and the scaling of culturally grounded and peer-based resilience networks.

Background Hand hygiene is an important measure to prevent disease transmission in community settings, such as households, public spaces, workplaces, and schools. There exist various international guidelines with recommendations on how to improve hand hygiene in these settings, but no review to date has been conducted to summarise these recommendations and assess to what extent they are consistent and evidence-based. Methods To identify international guidelines with recommendations on hand hygiene in community settings, categorised as either domestic, public, and institutional, we performed electronic and grey literature searches and contacted expert organisations and individuals. Recommendations extracted from included guidelines were mapped to four areas related to hand hygiene: i) effective hand hygiene; ii) minimum requirements; iii) behaviour change; and iv) government measures. We assessed if recommendations were supported by peer-reviewed literature and checked their consistency and concordance across settings. Results We identified 51 guidelines published between 1999 and 2021 by multilateral agencies and international non-governmental organisations containing 923 recommendations. Handwashing with soap is consistently recommended as the preferred method for hand hygiene across all community settings. Most guidelines specifically recommend handwashing with plain soap and running water for at least 20 seconds; single-use paper towels for hand drying; and alcohol-based hand rub (ABHR) as a complement or alternative to handwashing. There are inconsistent and discordant recommendations for water quality for handwashing, affordable and effective alternatives to soap and ABHR, and the design of handwashing stations. Further, there are gaps in recommendations on soap and water quantity, behaviour change approaches, and government measures required for effective hand hygiene. Overall, less than 10% of recommendations are supported by evidence. Conclusion While current international guidelines consistently recommend handwashing with soap in domestic, public, and institutional settings, the lack of consistent, evidence-based recommendations may constrain global efforts to ensure effective hand hygiene across community settings. What is already known on this topic Hand hygiene has been found to be a cost-effective intervention that can reduce the risk of certain infectious diseases. Yet, the practice of hand hygiene, and access to the facilities which enable this, is often limited in community settings, such as households, public spaces, workplaces, and schools. There are various international guidelines with recommendations on hand hygiene in community settings, but it is unclear whether guidelines provide consistent and evidence-based recommendations. What this study adds There are 51 guidelines with over 900 recommendations for hand hygiene in community settings published by multilateral agencies and international non-governmental organisations. Guidelines consistently recommend handwashing with soap, but there are several areas of inconsistency and discordance, as well as gaps in recommendations, related to minimum requirements, behaviour change, and government measures for effective hand hygiene in community settings. Very few recommendations are supported by peer-reviewed literature. How this study might affect research, practice, or policy This scoping review highlights a gap in global normative guidance on hand hygiene in community settings. More research is needed to address the current areas of inconsistency and discordance, and gaps in recommendations.

Background: Promoting handwashing with soap reduces risk of diarrhoea by 30% and respiratory infections by 17%. Handwashing promotion in nonhealthcare settings is widely considered cost-effective, but there is no systematic review on this topic. To inform resource allocation decisions, we reviewed the state and quality of evidence regarding cost-effectiveness and benefit-cost of interventions promoting handwashing with soap in domestic, educational, and childcare settings globally. Methods and findings: We searched Medline, Embase, Global Health, EconLit, and Web of Science for studies published from January 1, 1980 to September 3, 2025, as well as grey literature (PROSPERO CRD42021288727). We included full economic evaluations comparing the cost of two or more interventions with their outcomes. We included interventions promoting the practice of handwashing with soap, including those providing information, motivational campaigns, and/or handwashing facilities. We scored quality of reporting using the Consolidated Health Economic Evaluation Reporting Standards. We identified 15 studies of which 3 were in high-income countries. Five used empirical data collection to evaluate interventions actually implemented and 10 modelled from secondary data only. Amongst the 3 medium- or high-quality studies reporting cost per disability-adjusted life-year averted, estimates ranged from US$ 37 to 937 (2024 prices). Of these 3 estimates, 2 were cost-effective compared to plausible thresholds for the respective country. In the only medium- or high-quality benefit-cost study, the mean benefit-cost ratio was 2.1 with “medium” levels of handwashing adoption (40% of population) and adherence (50% of those adopting). Few studies measured or modelled adoption of handwashing over time, and none which focussed on diarrhoea also valued respiratory infections. Limitations of our review include that we excluded alcohol-based handrub interventions, and that there is high uncertainty about cost-effectiveness thresholds. Conclusions: Promoting handwashing with soap is very likely to be cost-effective for interventions that successfully increase and sustain adoption of handwashing behaviours. More empirical studies are needed, especially those comparing multiple promotion options and valuing reductions in respiratory infections as well as diarrhoea.

Background Promoting handwashing with soap reduces risk of diarrhoea by 30% and respiratory infections by 17%. Handwashing promotion in non-healthcare settings is widely considered cost-effective, but there is no systematic review on this topic. To inform resource allocation decisions, we reviewed the state and quality of evidence regarding cost-effectiveness and benefit-cost of interventions promoting handwashing with soap in domestic, educational, and childcare settings globally. Methods We searched Medline, Embase, Global Health, EconLit, and Web of Science for studies published to September 3, 2025, as well as grey literature (PROSPERO CRD42021288727). We included full economic evaluations comparing the cost of two or more interventions with their outcomes. We included interventions promoting the practice of handwashing with soap, including those providing information, motivational campaigns, and/or handwashing facilities. We scored quality of reporting using the Consolidated Health Economic Evaluation Reporting Standards. Results We identified 15 studies of which 3 were in high-income countries. Five used empirical data collection to evaluate interventions actually implemented and 10 modelled from secondary data only. Amongst the 3 medium- or high-quality studies reporting cost per disability-adjusted life-year averted, estimates ranged from US$ 37 to 937 (2024 prices). Of these 3 estimates, 2 were cost-effective compared to plausible thresholds for the respective country. In the only medium- or high-quality benefit-cost study, the mean benefit-cost ratio was 2.1 with “medium” levels of handwashing adoption (40% of population) and adherence (50% of those adopting). Few studies measured or modelled adoption of handwashing over time, and none which focused on diarrhoea also valued respiratory infections. Conclusion Promoting handwashing with soap is very likely to be cost-effective for interventions that successfully increase and sustain adoption of handwashing behaviours. More empirical studies are needed, especially those comparing multiple promotion options and valuing reductions in respiratory infections as well as diarrhoea.