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  • Open access
  • 99 Reads
Relieving Suffering as a Health System Responsibility: Governance and Global Inequities in Palliative Care

Palliative care evolved with the recognition of subjectively experienced human suffering at the end of life. However, suffering becomes addressable at scale only when recognised, prioritised, and acted upon through social institutions. This paper examines how an understanding of consciousness and suffering shapes the governance and distribution of palliative care within health systems, with implications for global inequities in palliative care. Based on an interdisciplinary synthesis of social science, bioethics, and the global health policy literature, this paper analyses why palliative care remains unevenly integrated, despite strong normative commitments at the international level.

There are persistent asymmetries between high-income and low- and middle-income countries (LMICs) in palliative care coverage and access to essential medicines, especially opioids. These inequities are not attributable solely to differences in economic resources, but are also mediated by institutional mechanisms, such as regulatory regimes, health financing structures, workforce authority, and political prioritisation. Examples are used to illustrate how alternative institutional arrangements, such as task shifting in opioid prescribing and community-based care platforms, can expand access even in resource-constrained settings.

Palliative care should be conceptualised as a social institution grounded in shared human consciousness. Inequitable access reflects differences in how societies value, govern, and operationalise suffering. Addressing these disparities requires not only clinical capacity but policy coherence, proportionate regulation, and accountability mechanisms that recognise the relief of suffering as a core obligation of health systems.

  • Open access
  • 7 Reads
Care, Knowledge, and Crisis: Institutional Memory and Situated Technologies in a Public Hospital in the Global South

How public health institutions in the Global South mobilize institutional memory, everyday practices, and situated technologies to manage extreme uncertainty during health crises? Based on long-term qualitative research conducted at a Brazilian public infectious disease hospital between 1980 and 2022, the study examines organizational responses to successive epidemics, including HIV/AIDS, H1N1, yellow fever, COVID-19, and a suspected Ebola case. Rather than focusing solely on formal governance structures or biomedical protocols, the analysis foregrounds how care is practically enacted through historically accumulated knowledge, improvisation, and ethical decision-making in everyday institutional life.
Methodologically, the research draws on oral history interviews with health professionals, analysis of institutional documents, and narrative reconstruction of crisis situations. These materials reveal persistent tensions between standardized, technology-driven models of clinical management and context-sensitive forms of care shaped by local constraints, professional experience, and social inequalities. Special attention is given to the role of technological infrastructures, such as clinical protocols, surveillance systems, and decision-support tools, and to how they are interpreted, adapted, and sometimes contested by frontline workers.
Rather than treating technology or artificial intelligence as neutral or universally progressive forces, the paper argues that technological tools acquire meaning only through situated use within specific institutional, historical, and political contexts. Building on critical perspectives in social sciences and science and technology studies, the paper proposes the concept of a biopolitics of care to capture how care practices operate simultaneously as organizational strategies, ethical commitments, and political responses to crisis.
By centering empirical evidence from a public hospital in Brazil, the study contributes to debates on society and technology, health governance, and Global South knowledge production. It challenges dominant narratives that frame technological innovation as detached from history and power relations, suggesting instead that institutional resilience depends on the interplay between technology, memory, and socially embedded practices of care.

  • Open access
  • 5 Reads
Child Protection Involvement and Youth Justice Among Emerging Adults: A Life Course Analysis
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Introduction: Individuals with histories of child protection involvement (CPI) are disproportionately represented in justice systems, yet the institutional mechanisms linking welfare contact to later justice involvement remain underexamined, particularly in Global South contexts. Drawing on life course theory and situating outcomes within the developmental stage of emerging adulthood, this study examines whether CPI is associated with youth justice involvement (YJI) among emerging adults, and whether educational disruption (ED) and psychological distress (PD) operate as parallel pathways.

Methods: The sample comprised justice-involved individuals aged 18 to 25 years in Punjab, Pakistan, recruited from community-based supervision programs following court involvement or institutional release. Partial least squares structural equation modelling was employed to test direct and indirect associations among CPI, ED, PD, and YJI.

Results: CPI was positively associated with ED and PD. Both ED and PD were significantly associated with YJI and functioned as parallel mediating mechanisms. CPI also demonstrated a direct association with YJI, indicating cumulative institutional exposure across the life course.

Conclusion: Fragmented child protection responses in childhood appear to contribute to justice system involvement during emerging adulthood through educational and psychological pathways. The study advances crossover research in a Global South context and highlights the need for integrated educational and mental health services within child protection systems to reduce subsequent justice contact.

  • Open access
  • 9 Reads
Automation and Labor Market Restructuring in Viticulture: Evidence from DOCa Rioja (Spain)

Introduction: Viticulture is undergoing rapid technological change, from harvest mechanization to data-driven precision practices. In DOCa Rioja (Spain), sectoral innovation increasingly incorporates digital tools and artificial intelligence (AI) initiatives (e.g., the DATADOC project promoted by the regulatory council). While these innovations promise efficiency gains, they may also reshape rural labor markets and reinforce inequalities among producers and workers. This study examines how technologisation is transforming labor demand and workforce profiles in DOCa Rioja.

Methods: We conducted an exploratory mixed-methods case study. Quantitatively, we synthesized secondary evidence on agrarian employment dynamics and mechanization, including an official series of agricultural Social Security affiliations in La Rioja (Jan 2009–Jul 2025) and sectoral indicators related to machinery adoption. We also compared indicative harvesting costs (manual vs. mechanical) using cost estimates reported for the region. Qualitatively, we conducted three semi-structured interviews with local stakeholders (a small vineyard owner, a seasonal worker, and an enology student) to capture perceptions of adoption drivers, constraints, and social impacts. A documentary analysis of institutional materials describing DATADOC and AI-enabled precision tools was used to contextualize the regional innovation agenda.

Results: Findings indicate labor reorganization consistent with "creative destruction". Mechanical harvesting reduces operational costs (about EUR 260/ha vs. about EUR 480/ha for manual harvesting; approximately a 40% difference) and helps address seasonal labor scarcity, but it also displaces low-skilled manual tasks. At the same time, new profiles emerge (e.g., specialized machinery operators, agricultural remote-sensing technicians, and vitivinicultural data analysts), with unequal access shaped by age, education, and training opportunities. Adoption capacity is uneven: better-capitalized actors invest more easily, while smaller operators rely on external service providers.

Conclusions: Technological innovation in DOCa Rioja is not socially neutral. To avoid widening rural inequalities, innovation strategies should be coupled with workforce transition policies, including targeted training and inclusive access to precision-agriculture tools.

  • Open access
  • 14 Reads
‘Pelebe’ Culture: Sachet Alcohol Consumption and Its Social and Health Implications for Nigerian Youth

Introduction:
The increasing availability of inexpensive sachet-packaged alcohol, commonly referred to as “pelebe” in many Nigerian communities, has generated growing public health and social concerns. Its low cost, portability, and widespread street-level distribution make it easily accessible to adolescents and young people in contemporary Nigerian society. This accessibility raises concerns about early initiation into alcohol consumption and associated risky behaviours among youth. Despite regulatory efforts by the National Agency for Food and Drug Administration and Control (NAFDAC) to control the production and sale of sachet alcohol, its use remains widespread. This study examines patterns of sachet alcohol consumption among Nigerian youth and explores its social and health implications.

Methods:
The study employed a cross-sectional survey design among youth in southwestern Nigeria. Data were collected using a structured questionnaire designed to assess patterns of sachet alcohol consumption, motivations for use, and perceived consequences associated with its intake. Descriptive and inferential statistical techniques were used to analyse the data.

Results:
The findings indicate that sachet alcohol consumption is relatively common among youth, largely due to its affordability, ease of access, and peer influence. Participants also associated its use with several negative outcomes, including engagement in risky behaviours, reduced academic concentration, and potential health complications.

Conclusion:
The study highlights the potential public health risks associated with the widespread availability of sachet alcohol among young people. Strengthening regulatory enforcement, public health education, and youth-focused intervention programmes is essential to mitigate the harmful effects of sachet alcohol consumption among Nigerian youth.

  • Open access
  • 9 Reads
Bridging the Digital Opportunity Gap: Youth Access, Skills, and Technology Adoption in Developing Societies

Introduction:

Digital technologies are increasingly shaping education, employment, and civic participation worldwide. However, in many developing societies, young people continue to face structural barriers that limit their ability to benefit fully from technological advancements. This study examines the digital opportunity gap among youth, focusing on access, skill development, and real-world technology adoption within a developing country context.

Methods:

The research adopts a qualitative and observational approach, drawing on real-life experiences, youth engagement initiatives, and documented community-level practices. Informal interviews, participation in educational programs, and analysis of publicly available reports were used to understand how young individuals interact with technology in learning, networking, and career development environments. The study emphasizes practical realities rather than theoretical or computational modeling.

Results:

Findings indicate that limited access to quality digital infrastructure, lack of structured digital skills training, and insufficient institutional support significantly restrict youth participation in the digital economy. While social and professional platforms provide new opportunities for learning and networking, their effective use remains uneven due to awareness gaps and socioeconomic constraints. The research also highlights that motivated youth often rely on self-learning and community-driven initiatives to overcome these challenges.

Conclusions:

The study concludes that narrowing the digital opportunity gap requires coordinated efforts from educational institutions, policymakers, and technology platforms. Emphasis should be placed on affordable access, practical digital literacy, and inclusive technology policies. Addressing these issues can enable youth to participate more effectively in social, educational, and economic development, contributing to more equitable digital societies.

  • Open access
  • 7 Reads
KNOWLEDGE REGARDING REPRODUCTIVE HEALTH CARE AMONG ETHNIC MINORITY ADOLESCENTS IN VIETNAM
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Background: Insufficient knowledge of reproductive health care increases the risk of reproductive health issues among ethnic minority adolescents in Vietnam.

Object: This study aimed to evaluate the level of knowledge of reproductive health care among ethnic minority adolescents and the effect of intrapersonal and interpersonal factors.

Methods: This cross-sectional study was conducted on 305 ethnic minority adolescents who were Tay and Dao aged 15-19 living in the mountainous regions of Northern Vietnam. Descriptive and bivariate correlation techniques were used to describe the respondents’ knowledge of reproductive health care and determine the gaps in this regard. The qualitative data consisted of 22 in-depth interviews and focus group discussions.

Results: There were statistically significant differences in adolescents' knowledge of pregnancy according to gender and mother–child communication about reproductive health issues. Specifically, the percentage of girls who knew about the signs of pregnancy was nearly twice as high as that of male adolescents (72.1% and 37.1%, respectively ), and the proportion who openly conversed with their mothers knew more about the signs of pregnancy and how to take care of the fetus.

The percentage of adolescents who answered the questions assessing knowledge of contraception at good and very good levels was only 39.3%. The adolescent girls who were Tay and those who had good communication with their mothers also had better knowledge of contraception.

Furthermore, research showed a strong correlation between knowledge of sexually transmitted diseases and adolescents’ educational level, as well as the use of social media to access information about reproductive health. Accordingly, adolescents with higher educational attainment (college/university) and aged 18-19 had more comprehensive knowledge about sexually transmitted diseases and their prevention. Similarly, adolescents who received reproductive health care information from social media had a rate of knowing at least two sexually transmitted diseases that was 1.3 times higher than those who did not use social media to obtain reproductive health care information.

Conclusions: Our findings revealed a relatively good level of knowledge of pregnancy and sexually transmitted diseases among ethnic minority adolescents; however, there were gaps in contraceptive knowledge. Thus, it is necessary to enhance the dissemination of information about reproductive health care for boys, the Dao, and adolescents under 18 years, and to develop a culture of communication between parents and children on this topic.

  • Open access
  • 23 Reads
The Effects of Digital Transformation on Social Sustainability in the AI Era: A Conceptual Perspective

Artificial Intelligence (AI) is rapidly transforming and reshaping social institutions, work patterns, and day-to-day life. Although previous research has largely focused on the economic efficiency and technological benefits of AI-enabled transformation, its implications for social responsibility remain underexplored and under-theorised. This conceptual paper investigates how AI transformation influences social sustainability across different social domains, including work settings, education, governance, and social inclusion. By applying social sustainability and socio-technical systems theories, this paper identifies key ethical mechanisms through which AI-enabled digital transformation affects social sustainability outcomes. This paper also presents an integrated conceptual model that illustrates the relationships between AI-driven transformation and social sustainability outcomes, through some mediating mechanisms such as algorithmic fairness, transparency, accountability, workforce well-being, and the distribution of social benefits and risks associated with AI adoption. This review further highlights how uneven AI access to AI and digital infrastructure is, particularly in global south contexts, which vary significantly. This paper contributes to social science scholarship by advancing a theory-informed conceptualisation of social sustainability of AI-enabled digital transformation. It further highlights the need for comparative and global south-focused studies to capture the uneven social consequences of AI adoption in institutional contexts. This study also offers practical implications for organisations and policymakers to adopt ethical responsibility and social sustainability in AI-driven digital transformation.

  • Open access
  • 13 Reads
Bridging the AI Divide: Intergenerational AI Literacy for Older Adults

Generative AI adoption in Poland remains below the EU average, with particularly low use among older adults (a few per cent in Poland according to OECD), which may deepen digital inequalities. This paper explores how future educators conceptualize the opportunities and risks of introducing AI literacy to older adults within an intergenerational geragogical framework. Particular attention is given to the ways in which AI literacy can support older adults’ everyday functioning, social participation, autonomy, and access to information, while also raising concerns related to exclusion, dependency, misinformation, and ethical use. To analyze these issues, this study draws on the relational model of digital competence, linking seniors’ life needs with the digital competences required to respond to them.

This study used an exploratory qualitative design. Written statements from pedagogy students to pre-service teachers (phase I of the PRODIGI project; January 2026) were analyzed using thematic analysis. In the analysis of qualitative data, categories were identified in accordance with the thematic analysis approach proposed by Braun and Clarke. The process involved identifying recurring themes in the participants’ statements, coding the material, and gradually grouping the codes into broader thematic categories. The analytical framework organized meaning into two overarching areas: opportunities and risks while preserving methodological transparency and an inclusive, non-stereotyping perspective on later-life learning.

Students consistently framed AI education for older adults as a pathway to digital inclusion: reducing technological barriers, increasing autonomy in everyday online activities, improving access to information, supporting communication, and offering cognitive stimulation. Simultaneously, they highlighted key risks: technostress and cognitive overload, vulnerability to misinformation and “hallucinated” content, excessive trust/anthropomorphization of AI, privacy and data-security threats, and the potential for problematic overuse. Importantly, respondents emphasized that effective courses should go beyond tool operation and integrate content verification, critical thinking, and digital hygiene, with teaching paced and contextualized to older adults’ lived experiences.

Findings suggest that AI literacy interventions for older adults should be designed as technologically responsible education combining operational skills with epistemic and protective competences. The results also underline the strategic role of younger adults (future educators) in intergenerational support models aimed at reducing the emerging AI-related digital divide. The presentation also showcased the effects of intergenerational training conducted by education students among older adults.

  • Open access
  • 25 Reads
Too human to resist: AI Anthropomorphism and manipulation vulnerability in Gen Z

Generation Z has grown up with artificial intelligence as a daily companion, yet anthropomorphism (attributing human characteristics to non-human entities) shapes how they perceive and interact with AI systems. While anthropomorphic perceptions can enhance engagement, they create a vulnerability: when adolescents perceive AI as having intentions, emotions, or moral agency, they become susceptible to manipulation through emotionally persuasive or deceptive AI design. This study explores how adolescents anthropomorphize AI across four dimensions: cognitive (agency, intelligence), emotional (empathy, social connection), moral (responsibility, threat perception), and technological/instrumental (tool-like attributes); with particular attention to how these perceptions relate to manipulation awareness.

Using a two-phase mixed-method design, Generation Z participants (n=125) completed free association tasks, spontaneously responding to "artificial intelligence." Analysis of these responses informed the design of our second phase: four focus groups (11-15 participants each) where adolescents engaged in discussions, brainstorming exercises, and card-sorting activities according to how well given attributes fit with AI. Qualitative coding followed established theoretical frameworks on multidimensional anthropomorphism.

All four anthropomorphism dimensions emerged across both phases. Participants frequently attributed intentionality and deceptive capabilities to AI, viewing it as potentially manipulative; meanwhile simultaneously expressing trust and emotional connection. This combination is particularly concerningas emotional anthropomorphism paired with moral agency attribution creates heightened manipulation vulnerability. Focus groups revealed varied levels of critical awareness regarding risks. Some participants expressed explicit concerns about being manipulated or developing cognitive dependency, while others described deeply personal, trusting relationships with AI—using it for emotional support and personal advice—without articulating such concerns. Despite extensive AI experience, Generation Z demonstrates persistent anthropomorphism with highly variable risk awareness: recognition of potential harms is neither universal nor consistently protective. These findings highlight that AI literacy education must address not only risk recognition but also the emotional and habitual factors that sustain anthropomorphic engagement.

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