Politicians’ view on their role in promoting health – developing a questionnaire

Background Although the political context is recognized as an important determinant of health, there is limited research on politicians' role in health promotion. No fitting questionnaire to study the subject could be identified, therefore a new questionnaire was developed. Methods An inductive approach was used and the first step was semi-structured interviews with six politicians. They represented two different municipalities and four different political parties from different sides of the Swedish political spectrum. The interviews focused on the politicians’ view on their role, responsibility and possibility to promote health. The data was analysed by means of qualitative content analysis. Five categories were created with several sub-categories each. The categories formed the sections of the questionnaire. Statements and questions were created to cover all the sub-categories. The statements were assigned Likert-scales (strongly agree to strongly disagree) for answers and some of the sentences were turned into questions. Lastly, face validity of the questionnaire was tested by the interviewees who filled out the questionnaires, two by thinking aloud as they did and three by filling out the online version of the questionnaire and leaving comments on the questionnaire. Results This resulted in a questionnaire with five sections focused on: Politicians view on health and health promotion; to affect health as a politician; collaboration between actors; the politics of health; the municipality/region organisation and prerequisites. Conclusions The questionnaire opens up for explorative studies on politicians' view on their role, responsibility and possibility to promote health. It is currently being used in a study exploring local and regional politicians in the north of Sweden and their role in health promotion. Key messages Politicians’ view on their role in health promotion is of importance to explore. The developed questionnaire can be used to study politicians’ role in health promotion.

Harm Reduction: Assessing the Educational Needs of Family Medicine Residents in Care of Persons Who Inject Drugs

Background and Objectives: Rates of injection drug use and associated medical complications have increased, yet engagement of persons who inject drugs (PWID) in primary care is limited, with significant barriers to care. Family physicians play an important role in caring for PWID, but residency training is limited. This study aimed to assess role responsibility, self-efficacy, and attitudes of family medicine residents in caring for PWID. Methods: Using a cross sectional design, family medicine residents in 2018 at three different programs completed Likert and open-ended survey questions assessing role responsibility, self-efficacy, and attitudes in caring for PWID. Results: Fifty-five percent (41/76) of residents completed surveys. Residents consistently agreed it is their responsibility to provide comprehensive care for PWID, while being less confident in key elements of screening, brief intervention, and referral to treatment (SBIRT). The largest gap between responsibility and confidence was in referral to treatment. Resident confidence was lowest for harm reduction strategies: discussing clean needle practices, prescribing naloxone and referral to medication-assisted treatment or needle exchange programs. Less than 60% of residents agreed they are able to work with or understand PWID. Conclusions: This study identifies gaps between provider responsibility and current graduate medical education training. We identified training that increases screening, harm reduction practices, and referrals to community resources as needs. This baseline assessment of family medicine residents can be used to develop educational interventions to meet regional and national health needs for harm reduction for PWID and workforce development.

Explanatory Obligations

In this paper, we argue that a person is obligated to explain why p just in case she has a role-responsibility to answer the question “Why p?”. This entails that the normative force of explanatory obligations is fundamentally social. We contrast our view with other accounts of explanatory obligations or the so-called “need for explanation,” in which the aforementioned normative force is epistemic, determined by an inquirer's interests, or a combination thereof. We argue that our account outperforms these alternatives.

Unjustifiably Irresponsible: The Effects of Social Roles on Attributions of Intent.

Three preregistered, high-powered experiments using vignettes (N=788) examined how people’s social roles change others’ perceptions of their intentions to cause harm. Results are consistent with the Tradeoff Justification Model, which argues that people reasonably use social information about the actor’s willingness to unjustifiably cause harm to infer intentions: Harms were judged as unjustified and intentional when the person neglected a role responsibility to prevent the harm, but justified and unintentional when caused by fulfilling a role responsibility. Mediation analyses were consistent with roles influencing intention judgments via their effects on a person’s responsibilities and how this changes what people consider justified. Experiment 3 conceptually replicated the side-effect effect (Knobe, 2003), and found that changing roles eliminated the effect, suggesting that social information about justification may be responsible for it.

STRATEGIC COMMUNICATIONS AS A NATO AND NATO NATIONS’ LEADERSHIP OPPORTUNITY

The global strategic environment has dramatically changed. We live in a highly complex information environment, where we are facing hybrid threats, terrorism, information confrontations, cyber threats, irregular war, massive migration and so on. In this environment, the Alliance needed to adapt and enhance the speed, connectivity and effectiveness of its Strategic Communications (StratCom) effort, which was created as NATO’s smart answer to the challenging information environment we live in. This article describes the NATO Strategic Communications concept to provide deeper understanding and increase knowledge of the context, tools, capabilities and processes conducted within the frame of it. The article explains the role, responsibility and opportunity leaders at every level have in conducting, leading, implementing and using the NATO concept of Strategic Communications.

Social Dominance, School Bullying, and Child Health: What Are Our Ethical Obligations to the Very Young?

BACKGROUND Recent research shows that by age 5, children form rigid social hierarchies, with some children consistently subordinated, and then later, bullied. Further, several studies suggest that enduring mental and physical harm follow. It is time to analyze the health burdens posed by early social dominance and to consider the ethical implications of ongoing socially caused harms. METHODS First, we reviewed research demonstrating the health impact of early childhood subordination. Second, we used philosophical conceptions of children’s rights and social justice to consider whether children have a right to protection and who has an obligation to protect them from social harms. RESULTS Collectively, recent studies show that early subordination is instantiated biologically, increasing lifetime physical and mental health problems. The pervasive, and enduring nature of these harms leads us to argue that children have a right to be protected. Further, society has a role responsibility to protect children because society conscripts children into schools. Society’s promise to parents that schools will be fiduciaries entails an obligation to safeguard each child’s right to a reasonably open future. Importantly, this role responsibility holds independently of bearing any causal responsibility for the harm. This new argument based on protecting from harm is much stronger than previous equality of opportunity arguments, and applies broadly to other social determinants of health. CONCLUSIONS Social institutions have a role responsibility to protect children that is not dependent on playing a causal role in the harm. Children’s rights to protection from social harms can be as strong as their rights to protection from direct bodily harms. Pediatrics 2015;135:S24–S30

The Role And Responsibility Of Public Notary To The Agreement Of Bequest Which Made (Legal Studies of the Revoked Bequest to the Children by Their Parents)

A bequest is a gift from someone to others in the end of his/ her life. A bequest can be given to anybody, including friend, relative, or the biological children. A bequest is included in the “free” agreement (om niet). It means there must be an achievement for one side, while another one doesn’t need giving contra-achievement as a reward. This kind of agreement is also called as “unilateral” as a contrary of “bilateral” agreement. Generally, the agreement has feedback, as commonly there should be the one who undertakes an achievement as he/she will receive a contra-achievement. The definition above is according to the content of paragraph 1666 of the Book of Civil Law, which explains that bequest cannot be revoked. Contrary to the paragraph 212 of the Compilation of Islamic Law that explains that parents’ bequest to their children can be revoked. Which law should be taken as a fundamental law to answer this case? Here, the role and responsibilities of a public notary are very needed to solve the case.Keywords: Bequest; Role; Responsibility; Public Notary.