Healthy ageing--a patients' rights perspective

The demographic development is a challenge for the European healthcare systems, and to meet these challenges it is crucial to develop efficient health preventive strategies to ensure that the population is, and stays fit as long as possible. However, along with demographic development, Europe is also facing a boom in lifestyle diseases which constitute an impediment for healthy ageing. Smoking and obesity are considered to be the major causes in this regard. Both internationally and nationally there has been a strong commitment to reduce smoking, and it seems that a combination of information, economic incentives and legal regulation have been successful. The article explores whether the same public health strategy could be useful fighting obesity, and discusses whether such public health measures are compliant from a human and patients' rights perspective. Special questions regarding public health initiatives targeting elderly patients will also be addressed.     

Elections and landmark policies in Tanzania and Uganda

Much of the relevant literature on Africa downplays the salience of elections for policy-making and implementation. Instead, the importance of factors such as clientelism, ethnicity, organized interest groups, and donor influence, is emphasized. We argue that, in addition, elections now motivate political elites to focus on policies they perceive to be able to gain votes. This is based on analyses of six landmark decisions made during the last 15 years in the social, productive, and public finance sectors in Tanzania and Uganda. Such policies share a number of key characteristics: they are clearly identifiable with the party in power; citizens are targeted countrywide; and policy implementation aims at immediate, visible results.     

Land governance as grey zone: the political incentives of land reform implementation in Africa

Weak state capacity has often been in focus when explaining why land reform in sub-Saharan Africa is not implemented. However, an analysis of the deeper politics of land reform brings our attention to a set of incentives which allow rules governing land to be open to interpretation. This article demonstrates that in Uganda, the need to maintain the ruling coalition in a clientelist political settlement to build electoral support, and the desire to attract economic investors, constitute political incentives to maintain land governance as a grey zone, even if there is apparent political will to implement land reforms.     

Priming citizens to think about public participation initiatives: Does it impact their view of government?

Prior research has shown that public participation initiatives may have positive effects on how participating citizens view government. However, little is known about whether and how priming citizens to think about such initiatives influences the view of government among the larger public. Using a survey experiment, we find that the effect of priming citizens to think of a public participation initiative that includes a small group of citizens on their view of government is conditional on how proximate the service, which the initiative resolves around, is to citizens. Notably, across outcome measures we a find a negative priming effect among those for which the service is not proximate. These results are highly important, as they suggest that among the larger public, public participation initiatives—that involve few citizens—may have mixed results on the view of government, thus questioning the legitimacy of decisions reached by such initiatives.     

Forwards or backwards? New directions in Danish patients' rights legislation

The Danish Patients' Rights Act from 1998 was the first comprehensive piece of legislation addressing the basic legal values and principles governing the relation between patient and the health care services. Since the adoption of the Act there has been continuous legislative activity in the field, and the objective of the article is to discuss how recent developments in Danish patients' rights legislation shall be interpreted in terms of balancing interests of patients towards interests of society and the health care professions.     

Screening analysis for medicinal drugs and drugs of abuse in whole blood using ultra-performance liquid chromatography time-of-flight mass spectrometry (UPLC-TOF-MS)-Toxicological findings in cases of alleged sexual assault

An ultra-performance liquid chromatography time-of-flight mass spectrometry (UPLC-TOF-MS) method for simultaneous screening of 46 medicinal drugs and drugs of abuse in whole blood was developed and validated. The method includes most of the commonly used and abused drugs such as amphetamines, cocaine, benzodiazepines, and opioids. Chromatographic separation of the targeted drugs was achieved using a Waters ACQUITY UPLC coupled to a Waters Micromass LCT Premier XE time-of-flight mass spectrometer. The total chromatographic run time was 13.5min injection to injection. The estimated method LOQ is in the range of 0.06-27ng/g, which is below the therapeutic levels for each of the drugs analyzed but LSD. The extraction recovery ranged from 6% to 197% with median value 95% and mean value 82%. Matrix effect ranged from 81% suppression to 29% enhancement of the signals compared to signals obtained in the absence of biological matrix. The method was tested on 55 authentic forensic toxicology samples confirming the same positive results as found using the routine analytical procedures as well as some additional compounds. Recently there has been considerable attention paid to drug-facilitated sexual assault and the toxicological findings in these cases. As part of a pilot study to investigate the prevalence of medicinal drugs, drugs of abuse, and alcohol in victims of alleged sexual assault, biological specimens were obtained from 167 victims being examined at the Sexual Assault Center in Aarhus, Denmark. The obtained blood samples were analyzed using the novel screening method supported by additional analyses for e.g. THC and alcohol. 124 victims reported they have been drinking alcohol prior to the assault (74%). Alcohol analyses revealed 59 positive findings (48%). 35 of the cases were found positive for one or more drugs excluding alcohol (21%). 20 of the victims reported they have been subject to a drug-facilitated sexual assault (12%). For the victims suspecting drug-facilitated sexual assault, the toxicological analyses revealed four positive for alcohol and nine victims were positive for one or more drugs, with six of the victims found positive for benzodiazepines or other drugs with sedative effects. It was notable that victims tested positive for medicinal drugs and drugs of abuse as well as victims of alleged drug-facilitated sexual assault in average underwent medical examination later than the whole study population.     

Work Engagement in the Public Service Context: The Dual Perceptions of Job Characteristics

Interest in work engagement research has increased significantly due to its positive influence on both employee and organizational performance. Studies show how engagement is explained through job characteristics in the Job Demands-Resource model, yet a more nuanced approach has been proposed. In this qualitative study, home caregivers’ perceptions of job characteristics are investigated. Semi-structured interviews and observations reveal three main themes: Optimization, helping others, and emotional work. These show a dual perception of job characteristics consequently influencing the experienced engagement. Using Public Service Motivation literature, these dual perceptions are discussed.     

How Pro‐social Motivation Affects Job Satisfaction: An International Analysis of Countries with Different Welfare State Regimes

Employees' pro‐social motivation has been shown to be positively related to job satisfaction, especially when the perceived usefulness of the job to society and other people is high. There is, however, a lack of analyses which include both public and private employees, and it has not yet been studied whether the relationships are robust across welfare state regimes. This study therefore examines the moderated relationship between pro‐social motivation and job satisfaction. Using data from the cross‐national 2005 ISSP survey (14 countries, N = 10,630), it confirms that the relationship between pro‐social motivation and job satisfaction is moderated by perceived usefulness of the job for society and other people. Usefulness again depends on the individual's employment sector (public versus private), and this public–private difference in perceived usefulness also varies between different welfare state regimes. This indicates that sector differences in how pro‐social motivation affects job satisfaction depends on the broader institutional context, and the article therefore contributes with important knowledge for the recruitment and retention of motivated and satisfied employees in a period of changing public–private responsibilities in the provision of welfare services.     

Juridification and the Construction of Social Citizenship

The article elaborates on the legal construction of citizenship within the welfare state. The concept of citizenship is constructed from the perspective of rights and is closely related to the legal development of various fields of law. Juridification processes in the welfare state directly concern the construction of social citizenship and indirectly affect both political and civil citizenship. Concentrating on juridification within the framework of the welfare state implies that the development of welfare law is the focal point of the article. To understand the implications of juridification processes in the welfare state, we concentrate on the relationship between social citizenship, on one hand, and political and civil citizenship, on the other, and consider the implications of the legal and institutional construction of social citizenship. Social rights may confine the scope of political and civil citizenship and at the same time enhance individual freedom and the extent of political action.