The role of candidates in shaping voting choice has generated much research—and at least as much controversy—since modern electoral behavior research began in the 1960s. Much of the controversy surrounds the personalization of politics and whether political systems—and especially parliamentary systems—are becoming more leader-oriented. Three fundamental changes in electoral behavior underpin the study of candidates and voting choice behavior: the declining impact of social structure on the vote; partisan dealignment, with voters drifting away from their traditional party attachments; and the decline in the mass memberships of political parties. Researchers argue that because of these changes, fostered by the growth of television, candidates have assumed a greater role in structuring the vote. While there is impressionistic evidence that leaders have become more important, empirical evidence of an underlying change in voter behavior is more difficult to identify. Accordingly, this essay focuses mainly on changes in the political context within which candidates operate, since we expect this to be the source of any change. The design of political institutions shapes the level of attention that candidates receive, and that is especially the case with electoral systems. Electoral systems with fewer parties are more likely to focus voters’ attentions on candidates when compared to systems with larger numbers of parties. Weak party organizations coupled with partisan dealignment within the electorate can also alter the role and profile of candidates, although their impact is difficult to quantify. Changes in the mass media—and particularly the advent of television in the 1960s and the visual images on which it relies—are often viewed as the major cause of the personalization of politics. A new disruptive technology, the Internet, looks likely to stimulate additional political change for candidates and voting in the 21st century. Finally, what voters look for in their candidates appears to be stable both over time and cross-nationally and can be reduced to two overarching qualities: character and competence.
José Jesús Trujillo Vargas
We live in a multicultural society that must bet on a vision of openness and exchange, whose start must begin in the education system from a perspective that clearly supports interculturality, and which aims to achieve a more just society through the exchange of different ways of life. We can only aspire to this if we start from a personalized vision of education—rather than stereotyping groups—to create a pedagogical experience for each person (student) while taking into consideration the sociofamily context. Therefore, personalized education must start from principles such as uniqueness, autonomy, and openness to promote an exchange of experiences, culture, and traditions, and from how each one lives and how it interferes or helps this to be configured as a whole person, open to new learning, and able to self-regulate in the broadest sense. However, there are a series of sociopolitical and economic obstacles at a formative academic level that must be overcome in order for personalized education and its principles to become a utopian entity.
Personalized health care (PHC) is a broad term that describes how we leverage our growing understanding of the human body and developing technology to provide more effective health care. PHC requires that health care providers consider prevention and treatment in the context of available advanced technologies, best practices, and known variables that define us as individuals. These variables or characteristics may run the gamut from genetic, to biologic, to environmental, to even personality, personal values, and choice. By considering how these characteristics interact with specific illnesses and available interventions, outcomes can be improved. The purpose of this article is to: describe PHC’s current conceptualization including relationship with personalized medicine and patient-centered models of care, discuss its development and application by specific stakeholders, and review pertinent economic, legislative, and ethical issues.
Michael Latzer and Natascha Just
Internet-based services that build on automated algorithmic selection processes, for example search engines, computational advertising, and recommender systems, are booming and platform companies that provide such services are among the most valuable corporations worldwide. Algorithms on and beyond the Internet are increasingly influencing, aiding, or replacing human decision-making in many life domains. Their far-reaching, multifaceted economic and social impact, which results from the governance by algorithms, is widely acknowledged. However, suitable policy reactions, that is, the governance of algorithms, are the subject of controversy in academia, politics, industry, and civil society. This governance by and of algorithms is to be understood in the wider context of current technical and societal change, and in connection with other emerging trends. In particular, expanding algorithmizing of life domains is closely interrelated with and dependent on growing datafication and big data on the one hand, and rising automation and artificial intelligence in modern, digitized societies on the other. Consequently, the assessments and debates of these central developmental trends in digitized societies overlap extensively. Research on the governance by and of algorithms is highly interdisciplinary. Communication studies contributes to the formation of so-called “critical algorithms studies” with its wide set of sub-fields and approaches and by applying qualitative and quantitative methods. Its contributions focus both on the impact of algorithmic systems on traditional media, journalism, and the public sphere, and also cover effect analyses and risk assessments of algorithmic-selection applications in many domains of everyday life. The latter includes the whole range of public and private governance options to counter or reduce these risks or to safeguard ethical standards and human rights, including communication rights in a digital age.
Ciaran N. Kohli-Lynch and Andrew H. Briggs
Cost-effectiveness analysis is conducted with the aim of maximizing population-level health outcomes given an exogenously determined budget constraint. Considerable health economic benefits can be achieved by reflecting heterogeneity in cost-effectiveness studies and implementing interventions based on this analysis. The following article describes forms of subgroup and heterogeneity in patient populations. It further discusses traditional decision rules employed in cost-effectiveness analysis and shows how these can be adapted to account for heterogeneity. This article discusses the theoretical basis for reflecting heterogeneity in cost-effectiveness analysis and methodology that can be employed to conduct such analysis. Reflecting heterogeneity in cost-effectiveness analysis allows decision-makers to define limited use criteria for treatments with a fixed price. This ensures that only those patients who are cost-effective to treat receive an intervention. Moreover, when price is not fixed, reflecting heterogeneity in cost-effectiveness analysis allows decision-makers to signal demand for healthcare interventions and ensure that payers achieve welfare gains when investing in health.
Roxanne L. Parrott, Amber K. Worthington, Rachel A. Smith, and Amy E. Chadwick
The public, including lay members who have no personal or familial experience with genetic testing or diagnosis, as well as individuals who have had such experiences, face many intrinsic decisions relating to understanding genetics. With the sequencing of the human genome and genetic science discoveries relating genes to cancer, heart disease, and diabetes, the scope of such decisions broadened from prenatal genetic testing related to reproductive choices to genetic testing for contributors to common causes of morbidity and mortality. The decision about whether to seek genetic testing encompasses concerns about stigma and discrimination. These issues lead some who can afford the cost to seek screening through online direct-to-consumer sites rather than in clinical settings. Many who may benefit from genetic testing lack awareness of family health history that could guide physicians to recommend these diagnostic tests. Families may not discuss health history due to genetic illiteracy, with the public’s genetic illiteracy increasing their illness uncertainty and decreasing the likelihood that physicians will engage in conversations about personalized medicine with their patients. Physicians may nonetheless order genetic tests based on patients’ symptoms, during preoperative workups, or as part of opportunistic screening and assessment associated with a specific genetic workup. Family members who receive positive genetic test results may not disclose them to life partners, other family members, or insurance companies based on worries and anxiety related to their own identity, as well as a lack of understanding about their family members’ risk probability. For many, misguided beliefs that genes absolutely determine health and disease status arise from media translations of genetic science. These essentialist beliefs negatively relate to personal actions to limit genetic expression, including failure to seek medical care, while contributing to stereotypes and stigma communication. As medical science continues to reveal roles for genes in health across a broad spectrum, communicating about the relationships that genes have for health will be increasingly complex. Policy associated with registering, monitoring, and controlling the activities of those with genetic mutations may be coercive and target individuals unable to access health care or technology. Communicating about genes, health, and risk will thus challenge health communicators throughout the 21st century.