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Communicating accurately is essential for maintaining credibility as a source of information. However, it is unclear whether being inaccurate impacts perceptions of sources equivalently. Across two experiments, we investigated whether correcting inaccuracies differentially impacted credibility for high and low credibility sources (i.e., doctors and politicians, respectively). Participants read a vignette about a high or low credibility source and rated their credibility. Participants were randomly allocated to a correction or a no correction control condition (Experiment 1) or a correction condition with different misinformation frames (highlighting that the source was unintentionally inaccurate, intentionally inaccurate, or uncertain about the information’s veracity; Experiment 2). Finally, participants rated belief in the source’s misinformation and re-rated credibility. In both experiments, we found that doctors were perceived as more credible and believed more than politicians pre-correction. In Experiment 1, correcting inaccuracies reduced doctors’ credibility more than politicians’, but belief in misinformation reduced equivalently. In Experiment 2, sources who were uncertain were perceived as less credible pre-correction, and being intentionally inaccurate was associated with the greatest post-correction credibility reduction. However, unlike Experiment 1, corrections impacted the credibility of sources equivalently. These findings underscore the importance of communicating accurately for maintaining trust and demonstrate that the reputational consequences of inaccuracy are sensitive to framing context.

Financing fragmentation in health systems refers to the coexistence of uncoordinated financing and payment control mechanisms that hinder the achievement of universal health coverage. This study aimed to identify the political and institutional determinants of the Colombian health system's financing fragmentation, based on the experiences and perceptions of health sector stakeholders and policymakers. An exploratory qualitative study was conducted. A total of 28 stakeholders and policymakers, including government officials, elected politicians, healthcare insurance and provider managers, and health-professional-association representatives, participated in semi-structured interviews. Initial coding and categorization (deductive analysis) were performed, followed by data clustering and content analysis (inductive analysis) using a framework analysis approach. Synthesis was graphical and narrative. From the interviewees' perspective, the political determinants that may perpetuate the Colombian health system financing fragmentation were: governance issues, including corruption, armed conflict, poor debate and political polarization, decisions made by politicians without adequate knowledge of the health system, limited civil society participation, media influence, and lack of funding for the immigrant population's healthcare. The institutional determinants were: corruption, underfunding of the system, poor information systems, limited research, resource management by insurers, vertical integration, and the medical-industrial complex's role. The results suggest that financing fragmentation in the Colombian health system has determinants rooted in social struggles, armed conflict, and state-society interactions. Addressing these determinants requires political commitment, stronger governance, civil society engagement, and technically skilled decision-makers to develop public policies that ensure integrated financing, robust resource monitoring, and interoperable information systems to achieve universal health coverage. To identify the political and institutional determinants of financing fragmentation in the Colombian health system from the perspectives of stakeholders and policymakers, this study included elected politicians, government members, health insurance and provider managers, and health professional association representatives involved in the formulation, regulation, implementation, or debate of healthcare reforms.

A survey by the IfD Allensbach Institute for Public Opinion Research yielded that 60% of German deputies to different parliaments (members of the German National Parliament, the State Parliaments and the European Parliament) consider the social conditions in Germany to be just, while 28% of the population do so. Also, 56% of the population, but 28% of deputies, consider their country unjust. Based on the Justice Motive Theory and research, the current study aimed to explore whether German politicians and the voting public differ in their just-world beliefs and perceptions of justice. These beliefs and perceptions of 116 members of the 18th German National Parliament and 998 citizens (a representative sample of the German population) were analysed by latent structural equation modelling, including randomly drawn subsamples of 116 citizens each. The politicians indicated significantly lower beliefs in a just world, an unjust world, immanent justice, ultimate justice, perceived performance and equality distributive-justice principles than the citizens. However, the citizens indicated a significantly lower belief in justice according to an individual's needs than the participating members of the German national parliament. The findings offer insights into how distributive justice principles are perceived across societal roles.

Different forms of participation have been employed to engage citizens in the planning of climate change mitigation and adaptation strategies. Arguments in favor of citizen participation highlight the limitations of traditional democratic practices to address climate change. Climate Assemblies (CAs), a form of deliberative democracy, have become an increasingly popular way for citizens and politicians to collaborate on climate decision-making. Using a mixed methods approach, this paper poses three questions. (1) To what extent do European cities and regions engage in CAs, and how are they embedded in policymaking? (2) What drives and impedes CAs? (3) To what extent are policymakers in European cities and regions ready and able to incorporate CAs and their results into policies? Findings reveal an increase in CAs in Europe on different levels, primarily commissioned by public authorities. However, the connection between CAs and policymaking differs across countries. Research revealed the significance of political culture, the specific roles of citizens, policymakers and administration therein, and the importance of political backing of CAs. Important drivers of CAs include measures that safeguard relevance to citizens, equality, inclusive access, and impact. Barriers include knowledge about climate change and deliberative democracy, lacking inclusiveness of CAs and asymmetry in political power. Survey data shows that climate policies have become established practices in many European cities and regions and that various engagement approaches are used to develop them. However, only 9.4% of respondents stated that city officials developed climate change policies with stakeholder input, including citizens. Citizen participation is infrequent, and involvement in policy development and implementation is unequally distributed, favoring some groups over others. While some results of stakeholder and citizen engagement activities were adopted, recommendations were not always translated into policies. Currently, CAs are rather an exception than the norm across Europe. There are various ways to engage citizens in the development of climate policies. Supporters of public involvement in these issues argue that traditional democratic processes are inadequate for addressing climate change and mitigation. One way people and politicians collaborate in this area is through a Climate Assembly (CA). At such an event, a group of citizens chosen at random from different backgrounds come together to learn about and discuss ways to tackle climate change. Then, they provide recommendations to policymakers. This paper asks three questions: (1) How often do European cities and regions use CAs, and how are they used to develop policies? (2) What enables or prevents CAs from happening? (3) How ready are policymakers to use CAs and their results? The results show that the number of CAs in Europe is increasing, often on behalf of public authorities. However, the relationship between CAs and policymaking varies. The research demonstrated the importance of political culture and support. Key factors of CAs include ensuring that topics are relevant to citizens, that everyone is treated equally and has equal access to CAs, and that CAs have an actual impact on policies. Three main barriers exist: First, when citizens and policymakers lack sufficient knowledge about climate change and deliberative democracy, Second, when CAs are not inclusive enough. (3) When political power is not distributed equally between citizens and policymakers. The survey shows that many European cities and regions have climate policies and use different methods to develop them. However, only 9.4% of respondents from European cities and regions said city officials developed climate change policies with stakeholder input, including from citizens. While some citizen engagement was used, their recommendations were not always turned into policies. CAs are the exception rather than the norm in Europe.

The COVID-19 pandemic represented a turning point for many scientists, challenging established motives and attitudes toward public communication and raising new questions about their willingness to communicate publicly. During this time, scientists faced unprecedented scrutiny, leading to both recognition and maltreatment by the media, politicians and the public. This paper examines whether the pandemic experience altered scientists' rationale for engaging in health communication-specifically, whether perceived benefits (e.g. contributing to the public good) still outweigh potential costs (e.g. exposure to hostility). Based on a survey of N = 4,207 researchers at German universities and research institutions, our findings indicate that negative perceptions of how politicians and journalists treated scientists diminished their assessment of public communication as a rational endeavor, leading to decreased willingness to communicate, particularly regarding self-interested motives.

Experts consider gun violence a public health crisis in the United States. Its increasing magnitude has pressured some Republican lawmakers to reconsider their responses to these events, moving away from sending condolences of "thoughts and prayers" to the victims and moving towards alternative, policy-oriented rhetoric. Ample literature in political science finds that how politicians speak about issues can shape voters' viewpoints on them. Could a Republican move away from "thoughts and prayers" rhetoric soften the cleavage on second amendment rights and lead to gun reform? Findings from a recent survey experiment suggest otherwise. Different rhetoric by Republican politicians did not move public opinion on firearm reform. There continues to be, however, substantial baseline support for several policies that would likely reduce gun violence. We comment on the implications of these findings on the politics of firearm policy reform in America.

Tackling missed appointments has become a prominent part of conversations about the 'recovery' of the UK NHS from the COVID-19 pandemic. With long waiting lists, delays in access to primary care, and overburdened staff, it seems logical that efforts should be made to reduce the time lost to unused appointment slots. Yet care needs to be taken to reflect on how and why missed appointments have become an area of focus, and to be transparent about what this means for patient care and health inequalities. This article provides a critical perspective on the current mainstream approach to missed appointments in policy, research and practice. The study applies Bacchi's "what is the problem represented to be" method of policy analysis to provide critical commentary on findings from a realist review of 253 documents; interviews with 61 'key informants' whose personal and professional experiences relate to missingness; and a series of co-design workshops with a Stakeholder Advisory Group of 16 professionals and experts-by-experience. It also includes an informal analysis of national news media and NHS news pieces covering missed appointments since 2015. Analysis identified a consistent approach to missed appointments across research, practice and media and policy statements. This approach focuses on the impacts of missed appointments for services; places responsibility on the shoulders of patients; and limits interventions to things that seek to alter their behaviours in pursuit of a service-wide reduction in missed appointments. The hegemony of this approach is sustained by research that has failed to adequately engage with the most marginalised patients; failed to explore causes in depth; and failed to include an inequalities lens in its approach to interventions. We propose an alternative viewpoint - applying a missingness lens - built from an alternative evidence base that combines critical literature review, qualitative interviews, and participatory methods with those experiencing missingness and with key professionals. Embedding an alternative perspective in practice and in research has significant potential as a non-stigmatising, inequalities-based and effective approach to understanding and addressing missed appointments. How we define the causes and impacts of missed appointments in healthcare influences how they are addressed. How they are addressed has consequences for for people’s health. This paper explores how politicians, the media, NHS managers and researchers understand missed appointments. It argues that current approaches are based on flawed evidence, a narrow understanding of the issue, and use interventions that are likely to worsen health inequalities. They see missed appointments as a problem of waste for the struggling NHS, caused by irresponsible, misbehaving patients who must be punished or coerced to attend. This approach is now starting to influence Artificial Intelligence-based interventions that promise to predict who will miss appointments, saving even more money. Meanwhile, deeper causes are ignored because researchers have not carried out in-depth research with some patient groups, or developed different interventions to address access inequalities. Our paper describes the dangers of the current approach and outlines an alternative perspective. This focuses on how missed appointments impact the health of those who are ‘missing’, and how they can be addressed in a better, fairer way.

While the number of countries that have introduced or are trying to introduce statutory laws regulating the procedure of assisted dying is increasing, research has yet to address why some legislative attempts succeed and others fail. In Germany, which set out to regulate assisted suicide with an autonomy-based approach, two draft bills were unable to secure a parliamentary majority. This paper sets out to explain the underlying value disputes that contributed to the legislative failure. We conducted an interpretative analysis of 108 speeches and 18 declarations to the votes delivered in four parliamentary debates and 44 contributions from parliamentarians in the expert hearing in the Committee on Legal Affairs in Germany. For analysis of the publicly available stenographic protocols of the debates, we used MAXQDA Analytics Pro. Using thematic analysis, we aimed to capture the underlying value disputes as the core ideas driving politicians' statements to explain why the attempt at regulating assisted dying failed in Germany. Our analysis revealed that parliamentarians drew on beneficence-based reasoning when invoking the concept of autonomy. However, we identified two distinct camps that differ in how they interweave the concepts of autonomy and beneficence. Parliamentarians disagreed over which group is at greater risk of harm from inadequate assisted suicide legislation - eligible individuals denied access or ineligible individuals granted access. This determined whether they favoured a low-threshold or a more high-threshold approach toward regulating assisted suicide. By disagreeing over which group is at greater risk of harm from assisted dying legislation, German parliamentarians engaged in a discussion style characterized as a debate over false negatives and false positives. At present, scholarship offers no definitive basis for alleviating parliamentarians' concerns about the risks of either false negatives or false positives. Our analysis underscores that scholarship should engage with ethical reasoning and guide assisted dying policy by offering empirical insights into regulatory options that need to operate with accepting certain risks. Not applicable.

Public backlash against scientists is drawing growing concern. It can come from citizens, politicians, or journalists and ranges from legitimate criticism to harassment and physical attacks. Backlash also affects science communication professionals, yet this has received comparatively little public and scholarly attention. Our study addresses this gap. Drawing on qualitative interviews with 15 university communicators from multiple countries, we develop a conceptual model of their perceptions of public backlash, its effects on them and their institutions, their response strategies, and contextual factors. We introduce criteria for distinguishing legitimate criticism from illegitimate harassment and describe both negative and positive effects on science communication. The results show proactive and reactive response strategies and highlight the influence of topic characteristics, routes of backlash, and sociopolitical contexts. Overall, they offer a new perspective on the normative imperative for public engagement. We discuss implications for science communication research and practice.

Social participation, a principle that has guided health reform processes globally, presents diverse barriers according to the political and social context, obstructing its effective exercise. This study examines the perceptions of various stakeholders regarding the barriers and opportunities for social participation in decision-making processes within Chile's National Cancer Plan and Law framework. A qualitative multiple-case study design (cases: politicians, academics, decision-makers, organisations) was employed. A total of 28 semi-structured online interviews were conducted with stakeholders involved in the planning and implementation of the National Cancer Plan and Law, as well as with its beneficiaries. Thematic analysis was carried out through the analytical framework method, a systematic and flexible approach to analysing qualitative data. Approved by the Scientific Ethics Committee of the Universidad del Desarrollo, Chile. The main perceived barriers were classified into four areas: (a) disarticulation of civil society organisations, (b) lack of validation of organisations in decision-making processes, (c) lack of access to information and (d) lack of tools for the professionalisation of organisations. Opportunities for action are proposed that involve joint actions from all actors in a paradigm shift exercise on social participation in health, and the degree of involvement that all stakeholders should have to achieve more significant equity in participation. The results suggest that persistent barriers to effective participation exist, primarily due to power imbalances and the dominance of biomedical perspectives. The findings emphasize the importance of authorities and decision-makers acknowledging the value of knowledge from civil society to encourage collaborative and sustained work that transcends individual leaders and governments.

Learning from medical errors prevents their recurrence. This study examined the management of safety incidents and medical errors, as well as the learning process. A semi-structured interview was conducted with NHS practitioners involved in invasive procedures. An inductive thematic analysis was followed to create descriptive themes. Analytical themes have been identified based on the descriptive themes. The interviews included 15 participants (11 consultants, two senior trainees, and two senior theatre nurses). Many are unfamiliar with the definitions and classification of medical errors. Concerns are raised about under-reporting important incidents and over-reporting futile incidents. There was a clear division in reporting near misses. The majority have a pathway for managing medical errors in their organisations. However, the main concern was the lack of feedback. The majority believe M&M meetings provide the best platform to discuss medical errors, though there are concerns about the meetings' length, case selection, and the absence of anonymised discussions. The participants believe central reporting could lead to change, but the lack of horizontal dissemination of lessons learned is a significant defect. Confidentiality, the reputation of trust, fear of public opinion and politicians, and the negative role of the media all hinder the publication of medical errors and the learning of lessons. There is a lack of formal support for the second victim and a prevalence of defensive medicine. There are concerns related to the process and purpose of incident reporting. M&M meetings are the preferred forum for clinicians to discuss and learn from errors. The main problems are the lack of feedback and the horizontal dissemination of learning lessons. Publishing about medical errors is a sensitive subject influenced by many factors. There is a need for a formal programme across the NHS to support the second victim. Defensive medicine is the new norm.

In the mid-1970s, politicians and regulatory experts considered that the West German energy system was at a crossroads. They discussed whether energy saving and renewable energies or nuclear energy should be supported as a long-term technology. The debate on technology acceptance was not only sparked by questions of economic efficiency and the risks of nuclear energy use. It was also shaped by the dispute over regulatory instruments, consumer participation, and the organization of the energy system. The example of energy saving shows how much these scientific and political debates were determined by fears of technological as well as political path dependencies and their repercussions for the state. The paper thus proposes that the acceptance of state regulation be considered, for a better understanding of technology acceptance. The analysis of both the scientific debates and political negotiation processes together with letters from citizens to the federal government show that the criterion of distributive fairness influenced the acceptance of energy saving as a technology. Scientists, politicians, and citizens widely acknowledged that energy saving was compatible with a fair distribution of technical progress, private comfort, and economic growth, which promoted its acceptance. Moreover, their interpretation of distributive fairness also reveals an affirmative attitude towards the state and its ability to implement an acceptable energy system. Politiker und Regulierungsexperten sahen Mitte der 1970er Jahre das westdeutsche Energiesystem an einem Scheideweg angelangt. Sie diskutierten, ob das Energiesparen und Erneuerbare Energien oder die Kernenergie langfristig als Technologie bevorzugt werden sollten. Die Debatte um Technikakzeptanz entzündete sich nicht nur an Fragen der Wirtschaftlichkeit und den Risiken der Kernenergienutzung. Sie wurde insbesondere auch überformt von dem Streit um staatliche Regulierung, Verbraucherpartizipation und die Organisation des Energiesystems. Das Beispiel des Energiesparens zeigt, wie sehr diese wissenschaftlichen und politischen Debatten von Ängsten vor technologischen und politischen Pfadabhängigkeiten und deren Auswirkungen auf den Staat geprägt waren. Der Aufsatz schlägt hiermit vor, die Akzeptanz staatlicher Regulierung zu berücksichtigten, um ein besseres Verständnis von Technikakzeptanz zu erlangen. Die Untersuchung der wissenschaftlichen Debatten, der politischen Verhandlungsprozesse und der Briefe von Bürgern an die Bundesregierung zeigt, dass der Bewertungsmaßstab der Verteilungsgerechtigkeit die Akzeptanz des Energiesparens als Technologie beeinflusste. Wissenschaftler, Politiker und Bürger waren sich zunehmend einig, dass das Energiesparen mit einer gerechten Verteilung von technischem Fortschritt, privatem Komfort und Wirtschaftswachstum vereinbar sei, was seine Akzeptanz förderte. Ihre Interpretation von Verteilungsgerechtigkeit wies zudem eine affirmative Haltung zum Staat auf, dessen Steuerungsfähigkeit sie im Allgemeinen als notwendig erachteten, um ein akzeptables Energiesystem herbeizuführen.

Populist leaders are known for engaging supporters through compelling rhetoric, sparking debate about what persuasive strategies they use to mobilize voters. While research shows that leaders creatively frame their communication, the role of social media-especially its multimodal affordances-remains poorly understood. This study applies multimodal critical discursive psychology (MCDP) to examine the modalities used in TikTok videos of Finnish right-wing populist politician Sebastian Tynkkynen. Using the integrative social identity model of populist leadership (ISIMPL), we identified eight discursive and multimodal strategies, through which Tynkkynen performs populistic identity leadership and constructs a shared identity: 'performing populist prototypicality' by emphasizing authenticity and ordinariness, 'performing as the voice of the people' through heroism and self-sacrifice, 'mobilizing a populist "us"' through in-group celebration and shared victimhood, and 'othering the elite as "them"' through blame and ridicule. These are accomplished through various discursive and multimodal resources, with co-contextualization of elements playing a crucial role in creating an overall message. This study shows how multimodal communication enables populist politicians to innovatively perform leadership and construct shared identities online, enhancing understanding of the discursive and multimodal construction of populist identity leadership.

The pressure on publicly financed healthcare systems may necessitate decisions to not (or no longer) reimburse health technologies. Such decisions remain politically sensitive and often evoke public opposition, pressuring decision-makers to revoke or revise them. However, the elements that constitute public opposition remain unclear. This study addresses this gap by systematically reviewing the scientific literature. We searched Embase, Google Scholar, Google, and Startpage, and supplemented these with a hand search in 2021, updated in 2022 and 2024. Based on 81 articles, we developed a thematic framework of 21 categories grouped under the Five Ws-'Who, What, When, Where, and Why'-of public opposition to negative reimbursement decisions. Citizens, patients (and representatives), physicians, pharmaceutical companies, and politicians emerged as key actors. Opposition typically targets the outcomes and justifications of decisions, driven by high expectations, claims about effectiveness, or perceptions that decision-makers prioritize cost containment. Distrust in decision-makers and evidence-based decision-making may leave some actors-particularly citizens and patients-vulnerable to commercial driven information and misinformation. Other actors-including pharmaceutical companies, patient representatives, and politicians-may strategically use the media to shape opinion and amplify opposition. Public opposition is multifaceted. Understanding its dynamics may help align decision-making with public values and support efforts to address misconceptions and counter misinformation, thereby enhancing the acceptability of such decisions in healthcare.