This paper explores whether constitutional litigation contributes to sustaining the equity element of the right to health. Equity entails a fair distribution of the burden of healthcare financing across the different socio-economic groups of the population. A shift towards uncontrolled private healthcare provision and financing raises equity challenges by disproportionately benefitting those who are able to afford such services. The extent to which equity is enforced is an indicator of the strength of the right to health. However, do domestic constitutional courts second-guess, based on equity, policy decisions that impact on healthcare financing? Is it the task of constitutional courts to scrutinize such policy decisions? Under what conditions are courts more likely to do so? The paper addresses these questions by focusing on the case of Hungary, where the right to health has been present in the Fundamental Law adopted in 2010 and the Constitutions preceding it. While the Hungarian Constitutional Court has been traditionally cautious to review policy decisions pertaining to healthcare financing, the system has been struggling with equity issues and successive government coalitions have had limited success in tackling these. The paper discusses the role of constitutional litigation in addressing such equity concerns. In doing so, it contributes to the discussion on the role of domestic constitutional courts in the protection of social and economic rights.
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BACKGROUND: The INHERIT (INtersectoral Health and Environment Research for InnovaTion) project has evaluated intersectoral cooperation (IC) in 12 European case studies attempting to promote health, environmental sustainability, and equity through behavior and lifestyle changes. These factors are the concerns of multiple sectors of government and society. Cooperation of health and environmental sectors with other sectors is needed to enable effective action. IC is thus essential to promote a triple win of health, sustainability, and equity.OBJECTIVE: This paper describes the design of a qualitative study to gain insights into successful organization of IC, facilitators and barriers, and how future steps can be taken to improve IC in the evaluated case studies.METHODS: Each case study was assessed qualitatively through a focus group. A total of 12 focus groups in 10 different European countries with stakeholders, implementers, policymakers, and/or citizens were held between October 2018 and March 2019. Five to eight participants attended each focus group. The focus group method was based on appreciative inquiry, which is an asset-based approach focusing on what works well, why it is working well, and how to strengthen assets in the future. A stepped approach was used, with central coordination and analysis, and local implementation and reporting. Local teams were trained to apply a common protocol using a webinar and handbook on organizing, conducting, and reporting focus groups. Data were gathered in each country in the local language. Translated data were analyzed centrally using deductive thematic analysis, with consideration of further emerging themes. Analyses involved the capability, opportunity, motivation-behavior (COM-b) system to categorize facilitators and barriers into capability, motivation, or opportunity-related themes, as these factors influence the behaviors of individuals and groups. Web-based review sessions with representatives from all local research teams were held to check data analysis results and evaluate the stepped approach.RESULTS: Data collection has been completed. A total of 76 individuals participated in 12 focus groups. In December 2019, data analysis was nearly complete, and the results are expected to be published in fall 2020.CONCLUSIONS: This study proposes a stepped approach that allows cross-country focus group research using a strict protocol while dealing with language and cultural differences. The study generates insights into IC processes and facilitators in different countries and case studies to filter out which facilitators are essential to include. Simultaneously, the approach can strengthen cooperation among stakeholders by looking at future cooperation possibilities. By providing knowledge on how to plan for, improve, and sustain IC successfully to deal with today's multisectoral challenges, this study can contribute to better intersectoral action for the triple win of better health, sustainability, and equity. This protocol can serve as a tool for other researchers who plan to conduct cross-country qualitative research.INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR1-10.2196/17323.
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Introduction: Learning is essential for sustainable employability. However, various factors make work-related learning more difficult for certain groups of workers, who are consequently at a disadvantage in the labour market. In the long term, that in turn can have adverse health implications and can make those groups vulnerable. With a view to encouraging workers to continue learning, the Netherlands has a policy on work-related learning, which forms part of the 'Vitality Package'.Aim: A Health Impact Assessment with equity focus (HIAef) was undertaken to determine whether the policy on work-related learning affected certain groups of workers and their health in different ways, and whether the differences were avoidable.Methods: The HIAef method involved the standard phases: screening, scoping, appraisal and recommendations. Equity was the core principle in this method. Data were collected by means of both literature searches (e.g., Scopus, Medline) and interviews with experts and stakeholders (e.g., expertise regarding work, training and/or health).Results: The HIAef identified the following groups as potentially vulnerable in the field of work-related learning: the chronically sick, older people, less educated people, flexi-workers/the self-employed and lay carers (e.g., thresholds to learning). Published literature indicates that work-related learning may have a positive influence on health through (work-related) factors such as pay, employability, longer employment rate and training-participation. According to experts and stakeholders, work-related learning policy could be adapted to take more account of vulnerable groups through alignment with their particular needs, such as early support, informal learning and e-learning.Conclusion: With a view to reducing avoidable inequalities in work-related learning, it is recommended that early, low-threshold, accessible opportunities are made available to identified vulnerable groups. Making such opportunities available may have a positive effect on (continued) participation in the labour market and thus on the health of the relevant groups.
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BackgroundTackling challenges related to health, environmental sustainability and equity requires many sectors to work together. This “intersectoral co-operation” can pose a challenge on its own. Research commonly focuses on one field or is conducted within one region or country. The aim of this study was to investigate facilitators and barriers regarding intersectoral co-operative behaviour as experienced in twelve distinct case studies in ten European countries. The COM-B behavioural system was applied to investigate which capabilities, opportunities and motivational elements appear necessary for co-operative behaviour.MethodTwelve focus groups were conducted between October 2018 and March 2019, with a total of 76 participants (policymakers, case study coordinators, governmental institutes and/or non-governmental organisations representing citizens or citizens). Focus groups were organised locally and held in the native language using a common protocol and handbook. One central organisation coordinated the focus groups and analysed the results. Translated data were analysed using deductive thematic analysis, applying previous intersectoral co-operation frameworks and the COM-B behavioural system.ResultsAmongst the main facilitators experienced were having highly motivated partners who find common goals and see mutual benefits, with good personal relationships and trust (Motivation). In addition, having supportive environments that provide opportunities to co-operate in terms of support and resources facilitated co-operation (Opportunity), along with motivated co-operation partners who have long-term visions, create good external visibility and who have clear agreements and clarity on roles from early on (Capability). Barriers included not having necessary and/or structural resources or enough time, and negative attitudes from specific stakeholders.ConclusionsThis study on facilitators and barriers to intersectoral co-operation in ten European countries confirms findings of earlier studies. This study also demonstrates that the COM-B model can serve as a relatively simple tool to understand co-operative behaviour in terms of the capability, opportunity and motivation required amongst co-operation partners from different sectors. Results can support co-operators’ and policymakers’ understanding of necessary elements of intersectoral co-operation. It can help them in developing more successful intersectoral co-operation when dealing with challenges of health, environmental sustainability and equity.
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The future of age-friendly cities and communities (AFCC) needs to adapt and be more agile to the changing needs of residents of all ages. The UN Decade of Healthy Ageing ‘the Decade' provides a unique opportunity to further strengthen age-friendly environments. The Decade brings together governments, civil society, international agencies, professionals, academics, the media and the private sector for 10 years of concerted action to improve the lives of older people, their families and the communities in which they live. This editorial serves as a thought piece and outlines recommendations for the imminent and future discourse surrounding digital transformation, digital skills/literacy and financial implications on societal citizens in the AFCC discourse. Action is needed now, and this can only be achieved by talking openly about the real issues and concerns affecting people in our communities and in the future.
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This paper is a summary paper of the Thematic Working Group (TWG) on Adult Mathematics Education (AME). The theme AME made its first appearance on CERME11 and in this paper we provide an overview of the growing and blossoming field of AME and the results of the working group. The main themes associated with AME are: the definition, scope, and assessment of numeracy, the role of language and dialogue, the role of affect, including motivation, and the role of societal power structures, including subthemes like equity, inclusion, vulnerable learners, agency and self-efficacy. We conclude with the opportunities and challenges for this theme from both scientific and societal perspective.
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In this case study, we want to gain insight into how residents of three municipalities communicate about the new murder scenario of the cold case of Marianne Vaatstra and the possibility of a large-scale DNA familial searching. We investigate how stakeholders shape their arguments in conversation with each other and with the police. We investigate the repertoires that participants use to achieve certain effects in their interactions with others in three focus groups. The results show that the analyzed repertoires are strong normative orientated. We see two aspects emerge that affect the support for large-scale DNA familial searching. These are: 1. Cautious formulations: respondents showed restraint in making personal judgments and often formulated these on behalf of others. Participants would not fully express themselves, but adjusted to what seemed the socially desirable course. 2. Collective identity: respondents focused on the similarities between themselves and the needs, interests, and goals of other participants. Participants also tried in a discursive way to convince each other to participate in the large-scale familial searching. These two major discursive activities offered the communication discipline guidance for interventions into the subsequent communication strategy.
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In this case study, we want to gain insights into how residents of three municipalities communicate about the new murder scenario of the cold case of Marianne Vaatstra and the possibility of a large-scale DNA familial searching. We investigate how stakeholders shape their arguments in conversation with each other and with the police. We investigate the repertoires that participants use to achieve certain effects in their interactions with others in three focus groups. The results show that the analyzed repertoires are strong normative orientated. We see two aspects emerge that affect the support for large-scale DNA familial searching. These are: 1. Cautious formulations: respondents showed restraint in making personal judgments and often formulated these on behalf of others. Participants would not fully express themselves, but adjusted to what seemed the socially desirable course. 2. Collective identity: respondents focused on the similarities between themselves and the needs, interests, and goals of other participants. Participants also tried in a discursive way to convince each other to participate in the large-scale familial searching. These two major discursive activities offered the communication discipline guidance for interventions into the subsequent communication strategy.
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Aim: There is often a gap between the ideal of involving older persons iteratively throughout the design process of digital technology, and actual practice. Until now, the lens of ageism has not been applied to address this gap. The goals of this study were: to voice the perspectives and experiences of older persons who participated in co-designing regarding the design process; their perceived role in co-designing and intergenerational interaction with the designers; and apparent manifestations of ageism that potentially influence the design of digital technology. Methods: Twenty-one older persons participated in three focus groups. Five themes were identified using thematic analysis which combined a critical ageism ‘lens’ deductive approach and an inductive approach. Results: Ageism was experienced by participants in their daily lives and interactions with the designers during the design process. Negative images of ageing were pointed out as a potential influencing factor on design decisions. Nevertheless, positive experiences of inclusive design pointed out the importance of “partnership” in the design process. Participants defined the “ultimate partnership” in co-designing as processes in which they were involved from the beginning, iteratively, in a participatory approach. Such processes were perceived as leading to successful design outcomes, which they would like to use, and reduced intergenerational tension. Conclusions: This study highlights the potential role of ageism as a detrimental factor in how digital technologies are designed. Viewing older persons as partners in co-designing and aspiring to more inclusive design processes may promote designing technologies that are needed, wanted and used.
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Criminologists have frequently debated whether offenders are specialists, in that they consistently perform either one offense or similar offenses, or versatile by performing any crime based on opportunities and situational provocations. Such foundational research has yet to be developed regarding cybercrimes, or offenses enabled by computer technology and the Internet. This study address this issue using a sample of 37 offender networks. The results show variations in the offending behaviors of those involved in cybercrime. Almost half of the offender networks in this sample appeared to be cybercrime specialists, in that they only performed certain forms of cybercrime. The other half performed various types of crimes on and offline. The relative equity in specialization relative to versatility, particularly in both on and offline activities, suggests that there may be limited value in treating cybercriminals as a distinct offender group. Furthermore, this study calls to question what factors influence an offender's pathway into cybercrime, whether as a specialized or versatile offender. The actors involved in cybercrime networks, whether as specialists or generalists, were enmeshed into broader online offender networks who may have helped recognize and act on opportunities to engage in phishing, malware, and other economic offenses.
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