This article examines historical polio outbreaks in three Dutch towns (1963, 1966, 1971) to show how vaccination refusal became an expression of and contribution to local solidarity shaped by religion, place, and tradition. In doing so, it demonstrates how medical history contributes to ongoing conversations in medical humanities about vaccination refusal. I argue that refusal was neither simply resistance nor misunderstanding but a deliberate act that reaffirmed local community boundaries. Drawing on archival research, I explore how public health interventions and national media scrutiny made previously unnoticed communities visible, fostering their collective self-awareness and sense of distinctiveness. Following Anna Tsing, I describe the productive yet uneasy interaction between national public health practices and local ways of living as an example of "friction." Historical analysis reveals how friction during vaccination campaigns brought these communities into public view, highlighting tensions between collective responsibility for public health and respect for traditional, place-specific ways of living. By emphasizing the spatial dimensions of refusal, I suggest that effective public health interventions may benefit from greater sensitivity to local cultural contexts.

This study analysed Malaysian English and Malay newspaper coverage of the citizen-led White Flag (WF) movement using the Discourse Historical Approach. The movement involved people in need hanging a white cloth to request community aid. Analysis of 87 articles in 10 newspapers published in June–July 2021 showed that Malays were most frequently portrayed as needing help, followed by Chinese, Indians, Indigenous people and foreigners. Malay newspapers tended to depict more female recipients and male helpers compared to English newspapers. Across all newspapers, aid was mostly attributed to politicians, government agencies and individuals, and recipients were commonly framed as grateful but distressed rather than exploitative. Most articles legitimised WF as a timely citizen response, while a few highlighted abuse of aid. Minor counter-arguments questioned faith, government capability or personal resilience. Helper perspectives dominated over the voices of those in need. Newspapers used direct speech to personalise suffering and indirect speech to generalise collective responsibility. Modal verbs expressing mitigation and intensification appeared in almost equal measure, with Malay articles stressing duty while English reports conveyed contingency. The findings show how newspapers framed need, aid and responsibility through ethnic, gendered and moral lenses.

<p><em>The Professional Learning Community (PLC) serves as a means of contextual teacher professional transformation that aligns with the school environment, particularly in addressing instructional challenges. This study examines the gap between the conceptual framework of PLCs as defined in the literature and their practical implementation in schools. The research aims to analyze how the management of Professional Learning Communities (PLCs) can promote teachers’ professional transformation in educational settings. Using a literature review approach, this study synthesizes national and international research findings concerning the effectiveness of learning community management in enhancing teachers’ pedagogical competence, collaboration, and professional reflection. The synthesis reveals that effective and sustainable management of learning communities significantly contributes to improving teacher professionalism, especially when implemented through an iterative cycle of initial reflection, planning, implementation, and evaluation. Proper management not only strengthens teachers’ ability to design and conduct contextual learning but also fosters a culture of collaboration and collective responsibility among educators. Nevertheless, a gap remains between the ideal concept of PLCs and their actual practice in schools, particularly regarding management and program sustainability. Therefore, this study emphasizes the importance of applying cyclical management principles and institutional support to ensure that teacher learning communities truly function as strategic mechanisms for professional development that positively impact teaching quality and student learning outcomes.</em></p>

This article explores the social and philosophical transformation of the mahalla institution a traditional form of neighborhood self-governance deeply rooted in Uzbek society in the context of modern state and civil society development. Drawing upon the theories of social solidarity (É. Durkheim), communicative rationality (J. Habermas), and social modernization (A. Giddens), the study analyzes how the mahalla system has evolved from a traditional moral community into a semi-formal structure integrated with state administration and civic participation. The author argues that Uzbekistan’s mahalla model represents a unique synthesis between tradition and modernity, where local values, collective responsibility, and moral culture play a stabilizing role in social modernization. The philosophical significance of the mahalla system lies in its ability to preserve ethical coherence and social cohesion amid rapid political, digital, and cultural change.

Abstract Climate change necessitates institutions and governments to be guided by principles of collective responsibility. In addressing this global challenge, the active involvement of citizens is essential, fostering the emergence of prosumers - individuals who both produce and consume energy. Public administration plays a pivotal role not only in influencing citizens’ behavioural change but also in promoting and facilitating green initiatives. Within this context, renewable energy communities (RECs) represent an innovative social model in which the development of renewable installations becomes an opportunity for collaboration and shared resource management. The research question guiding this work is whether public administration can function as an enabling actor in enhancing citizens’ awareness and participation in RECs. The aim is to conduct a social analysis through a dual online questionnaire administered to citizens and civil employees in Italy, to assess their knowledge, perceptions, and attitudes toward RECs. The results indicate that general knowledge of RECs remains limited among respondents, yet there is a shared perception that public administration holds a key role in raising awareness of the benefits of RECs and in promoting community participation. The findings further suggest that integrating technical-scientific expertise within public administration could strengthen institutional capacity and foster greater citizen engagement in sustainability projects. Consequently, a closer synergy between public authorities and local communities may facilitate the diffusion of renewable energy installations within energy communities and contribute to achieving sustainable energy development goals.

The COVID-19 pandemic exposed deep structural and psychological challenges in higher education, demanding leadership approaches that balance empathy with institutional resilience. This study explores how trauma-informed leadership mitigates resistance to change in Vietnam’s post-pandemic universities. Using qualitative data from three institutions, it examines how principles of safety, trust, empowerment, and cultural sensitivity shaped adaptation processes. Findings show that trauma-informed leadership reduced resistance by fostering psychological safety, transparent communication, and shared ownership of change. Leaders localized trauma-informed practices to align with Vietnamese collectivist and hierarchical values, reframing empathy and care as collective responsibilities. Despite resource limitations, these approaches strengthened engagement and resilience across university communities. The study extends the global literature by demonstrating trauma-informed leadership’s adaptability beyond Western contexts, highlighting its reliance on contextual sensitivity, emotional intelligence, and consistent communication to transform crisis recovery into sustainable organizational learning.

Participatory Guarantee Systems (PGS) have emerged in Latin America as an alternative to conventional market-driven certification, offering a community-based framework to validate sustainable agricultural and social practices. Rooted in collective responsibility and dialogue between producers, consumers, non-governmental organizations (NGOs) and state institutions, PGS aim to empower smallholders by reducing certification costs and strengthening agroecological transitions. This review examines their development across diverse Latin American contexts, highlighting both their innovative potential and the persistent challenges that limit their scalability and formal recognition. A literature-based approach combined with a stakeholder analysis was employed, integrating case studies from Brazil, Peru, Mexico, Bolivia, and other countries. To systematize findings, SWOT (Strengths, Weaknesses, Opportunities, Threats) and TOWS (Threats, Opportunities, Weaknesses, Strengths) frameworks were applied, assessing strengths and weaknesses from the perspective of producers and consumers and formulating strategies to enhance resilience and legitimacy. Results show that PGS foster social capital, technical learning, and access to local markets; however, they are constrained by high time commitments, reliance on voluntary labour, uneven participation, and limited consumer awareness. The analysis indicates that the most promising pathway is a combination of growth strategies, including leveraging short supply chains, community-based fairs, and digital platforms, with recovery strategies centred on consumer education and producer capacity building. More conservative strategies remain crucial in specific contexts: redistributing workloads, introducing compensation for administrative tasks, and strengthening conflict mediation can help preserve system viability when engagement or resources are scarce. Defence strategies, aimed at reinforcing autonomy and reducing dependence on external actors, are better conceived as long-term goals under current conditions.

ABSTRACT This article examines the influence of pedagogical values and their implication on refugee social inclusion based on an ethnographic case study of three refugee-hosting primary schools in Kampala, Uganda. I draw on classroom participatory observations and field notes from several months of ethnographic work to help unravel the intricate interplay of local integration policy, pedagogy, and societal perceptions of migration and childhood in shaping the lived experiences of refugee children. The analysis delves into the impact of convergent pedagogical practices and cultural values on refugee children's sense of belonging and well-being in the classroom. While acknowledging the broader influence of increasingly nationalistic and anti-migratory global discourse on refugee children's school experiences (McIntyre and Abrams 2021), this article contends that local definitions of belonging, membership, and well-being also exert significant influence. Specifically, the study examines how Ugandan teachers integrate convergent Western post-colonial influences and traditional Ubuntu-inspired, whole-class pedagogy to create an instructional environment that fosters unity among children while also emphasising mutual support, solidarity, and shared responsibility. This research exemplifies alternative conceptualizations of refugee inclusion originating from Ubuntu philosophy, emphasising a paradigm centered on collective responsibility, which diverges from approaches that frame refugees as individuals undertaking (or resisting) integration efforts.

Influenza vaccine hesitancy in the elderly: Where do we stand?

"Swarth Se Pare: Illimitable Self", directed by Sourav Sarkar, is a cinematic exploration of care, resilience, and the ethical dimensions of selfhood in the context of disability and illness. The film foregrounds caregiver narratives, situating them within broader discourses of disability studies, medical humanities, and narrative medicine. Through its aesthetic choices and narrative structure, it interrogates the binary of self and other, proposing instead a model of relational subjectivity that extends “beyond the self” toward collective responsibility and compassion. The review evaluates how the film employs visual metaphor, silence, and testimonial voice to destabilize conventional representations of illness, offering instead an inclusive framework for empathy and shared human vulnerability. By engaging with philosophical notions of interdependence and the politics of representation, the review situates "Swarth Se Pare" as both a cultural text and a pedagogical resource, contributing to ongoing dialogues on the ethics of care, narrative embodiment, and the possibility of an “illimitable self” in contemporary society.

Abstract Care and housing are interrelated in daily practice, and profound crises have been observed in both areas. While policymakers and civil society pay significant attention to the housing crisis as a societal problem that must be collectively mitigated through diverse political measures, the care crisis still largely falls on households, families and institutions. To address the connections between these fields, this paper provides a theoretical framework for understanding the nexus between care and housing, as well as for determining whether cities develop in a caring or uncaring way. The proposed framework is twofold. First, the article theorises the care and housing crisis across five core dimensions: availability, affordability, compatibility, quality and social mixing. For each dimension, the key issues in both care and housing are highlighted to provide an analytical grid for studying uncaring or caring cities. Second, the article adopts a Lefebvrian urban perspective on these core dimensions in order to operationalise potential transformations towards a caring city. The main argument is that an urban theory that systematically focuses on the care–housing nexus helps to grasp the interrelated nature of the crises in each of the two areas and to contribute to its partial mitigation. This is because the approach seeks out chances for de-individualisation and de-gendering, thereby highlighting an intertwined societal and collective responsibility.

This paper examines how Christ-centered servant leaders are formed in the Democratic Republic of the Congo (DRC) through the educational model at Université Chrétienne Bilingue du Congo (UCBC)/Christian Bilingual University of Congo. Addressing the legacies of authoritarian leadership, UCBC fosters a generation of leaders rooted in the servant leadership exemplified by Jesus Christ. With the motto “being transformed to transform”, the university develops leaders who prioritize humility, service, and collective responsibility over personal ambition. This study uses Greenleaf's servant leadership framework and Ubuntu philosophy to explore how UCBC integrates spiritual development, academic inquiry, and community service in its educational approach. By prioritizing faith and learning, the university shapes leaders whose character and actions align with the biblical mandate to serve. The UCBC model is a replicable example for Christian institutions fostering servant leadership in post-colonial histories and socio-political challenges. Key words: servant leadership, Ubuntu, leadership formation, educational context in the DRC.

This article presents a critical analysis of UNESCO’s normative frameworks on artificial intelligence (AI) and education produced between 2021 and 2025. Drawing upon four key documents — the Recommendation on the Ethics of Artificial Intelligence (2021), the Guidance for Generative AI in Education and Research (2024) and the AI Competency Frameworks for Teachers and for Learners (2025) — the study examines how UNESCO’s human-centred approach redefines the ethical and pedagogical foundations of education in the digital age. Using qualitative documentary analysis, it explores the evolution of UNESCO’s discourse from a declarative and normative ethics to a pedagogical and operational one. The findings reveal that the recent frameworks translate universal human values — such as dignity, inclusion, justice, and sustainability — into observable educational competences that transform both teaching and learning practices. Teachers are redefined as ethical mediators and learners as reflective citizens, capable of co-creating responsible intelligences. The discussion introduces the concept of an ecopedagogy of intelligence, linking ethics and sustainability within digital education. By aligning ethical AI with the Sustainable Development Goals (SDGs 4, 10, 13 and 16), UNESCO proposes a model of digital humanism grounded in human dignity, ecological awareness, and collective responsibility.

Introduction: Public satisfaction with General Practice (GP) services has reached an all-time low, amid increasing demand for appointments and strain on resources. In response, the UK government launched the “Delivery Plan for Recovering Access to Primary Care,” which includes a commitment to modernise primary care and improve patient access through digital innovation. A key component of this transformation is the implementation of Total Patient Triage (TPT), a model that assesses all patient contacts to determine the most appropriate clinical pathway. Widely adopted during the COVID-19 pandemic, TPT facilitates remote consultations, reduces reliance on traditional telephone booking systems, and aims to optimise time for both patients and clinicians. Aim: This project aimed to evaluate whether training using simulation could enhance NHS staff understanding of the TPT model and foster collaborative working across all roles in General Practice. Methods: A tabletop simulation was developed using a bespoke “triage card” system. Fourty anonymised, real-life patient queries were printed on cards resembling a deck of playing cards. Each query was paired with a range of potential triage outcomes, such as referral to a GP, pharmacist, nurse, or digital response options like questionnaires. Participants were asked to decide on the appropriate clinician, mode of consultation (face-to-face or remote), and urgency (same day, two weeks, or routine). Additionally, a set of “CHANCE” cards, inspired by the Monopoly game, introduced unexpected scenarios (e.g., medical emergencies) to encourage discussion around managing unpredictable events and their ripple effects on workload. The simulation was conducted across five GP practices in Surrey during protected learning time (PLT), involving both clinical and administrative staff. The session was also delivered to GP trainees at the Royal Surrey County Hospital. Results: Participants completed an anonymous online feedback form, capturing their roles, prior interest in TPT, and session evaluation using a Likert scale. All respondents (100%) indicated they would recommend the session to colleagues. Feedback highlighted increased awareness of TPT and emphasised the value of multidisciplinary collaboration in improving patient flow and care prioritisation (Table 1). Discussion: The training simulation proved effective in promoting understanding of the TPT model and enhancing team-based decision-making. Bringing together diverse roles in a shared learning environment helped reinforce the collective responsibility and adaptability needed to manage modern primary care demands Ethics Statement: As the submitting author, I can confirm that all relevant ethical standards of research and dissemination have been met. Additionally, I can confirm that the necessary ethical approval has been obtained, where applicable.

BackgroundThe COVID-19 vaccine hesitancy continuum reflects an individual decision-making process regarding vaccination, ranging from fully willing to accept the vaccine to outright refusal. This study assessed COVID-19 vaccine hesitancy and compared the explanatory power of selected psycho-behavioral models for its variability among adults living in Southwest Ethiopia.MethodsA community-based cross-sectional study was conducted in Southwest Ethiopia from January 1 to 15, 2022. The calculated sample size was 879. A multistage sampling technique was used to select study participants. Data were collected using an interviewer-administered questionnaire comprising four sections: socio-demographic characteristics, COVID-19-related covariates, psycho-behavioral constructs, and a vaccine hesitancy scale. The data were entered into Epi-Data, and analysis was performed using Python in Jupyter Notebook. Descriptive statistics and hierarchical multiple linear regression were performed to compare the predictive ability of four psycho-behavioral models: the health belief model (perceived susceptibility, severity, benefit, barrier, and cues to actions); the theory of planned behavior (attitudes, subjective norms, behavioral control, and anticipated regret); five psychological antecedents (confidence, complacency, constraints, calculation, and collective responsibility); and vaccine conspiracy belief (conspiracy related to infection and the vaccine). Model comparison was done using adjusted R-squared and model selection criteria.ResultsThe mean age of the participants was 31.63 ± 8.28, and 365 (44.3%) of them were female. The mean score of the COVID-19 vaccine hesitancy continuum was 5.11 ± 2.41. Among the respondents, 91 (11%) were fully willing to accept the COVID-19 vaccine, while 97 (11.8%) were completely resistant. The remaining 624 (77.18%) participants were hesitant to make a decision about vaccination.The vaccine conspiracy belief demonstrated the most predictive ability (adjusted R2 = 0.43), followed by the 5C psychological antecedent (adjusted R2 = 0.36), the theory of planned behavior (adjusted R2 = 0.26), and the health belief model (adjusted R2 = 0.20).ConclusionCOVID-19 vaccine hesitancy in Ethiopia is most predicted by vaccine conspiracy belief. Therefore, public health intervention should focus on addressing misinformation and conspiracy narratives.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12889-025-24470-w.

Medication safety: a collective responsibility; a specialist calling

This study critically examines the BBC's COVID-19 discourse on the social media platform X (previously Twitter) to explore how media language shaped public attitudes and health behaviors during the pandemic. The research investigates the BBC tweets posted between January 2020 and May 2023 using a Critical Discourse Analysis (CDA) framework. By analyzing the inclusive pronoun, metaphor, and modality, the study reveals how the BBC crafted messages of collective responsibility, urgency, and empathy to promote public compliance with health guidelines. The methodology follows Fairclough's three-dimensional model which includes textual analysis of linguistic features, discursive practice of intertextuality and framing, and social practice analysis of societal contexts. Tweets were purposively sampled based on engagement metrics and relevance, enabling a comprehensive analysis of the evolving discourse throughout the pandemic's progression. This comprehensive approach highlights how BBC discourse aligned with authoritative sources (including government policies and scientific findings) to reinforce credibility and influence public understanding. Key findings demonstrate the BBC's role in framing health behaviors through emotive storytelling which humanized the pandemic's impact and fostered empathy. Repetition of key slogans strengthened public commitment to collective responsibility and compliance with health measures. The study also uncovers underlying power dynamics and social inequalities reflected in the discourse, emphasizing the media's influence in shaping public responses during the crises. This research contributes to understanding the intersection of language, power, and ideology in pandemic reporting. It underscores the need for ethical media practices and enhanced public media literacy to navigate health emergencies effectively.

Family members of frail elderly intensive care unit (ICU) patients shoulder complex surrogate decisions under prognostic uncertainty, cultural expectations and moral strain-particularly in Middle Eastern settings where collective responsibility and religion shape choices. To explore how families experience and navigate ICU decision-making for frail elderly relatives and to identify culturally distinctive mechanisms. Qualitative descriptive study using reflexive thematic analysis. Fifteen Arabic-language, in-depth interviews (45-90 min) with family decision-makers in Saudi Arabia were audio-recorded, transcribed, translated and analysed following Braun and Clarke's six phases. Rigour was supported by memoing, interpretive meetings and an audit trail. Sample adequacy was justified via information power (sufficiency at n = 13 with two confirming interviews). Three themes emerged: (1) Burden of Decision-emotional paralysis, moral ambivalence about withholding/withdrawing life-sustaining treatment and episodic isolation within surrogate roles; (2) Consultative Family Deliberation (shūrā)-distributed roles, intergenerational negotiation and prioritisation of family harmony; and (3) Faith-Driven Acceptance-tawakkul (trust in divine will), prayer/ritual as anchors and reframing death as a spiritual transition rather than treatment failure. Frailty (Clinical Frailty Scale ≥ 5) heightened uncertainty and, for some, oriented preferences towards comfort-focused care. Family decision-making for frail elderly ICU patients is culturally embedded, relational and spiritually mediated. Nurse-led, culturally responsive supports-structured inclusive family meetings, Arabic values-clarification aids and facilitation of spiritual needs-may reduce decisional burden, enhance trust and align care with family values.

Best practices to reduce microbial contamination during media-fill testing process in hospital pharmacies: a scoping review of literature.

A joint optimization approach for bug triage leveraging individual ability and collective responsibility of developers