383 research outputs found

    The effectiveness of clinical networks in improving quality of care and patient outcomes: a systematic review of quantitative and qualitative studies.

    Get PDF
    BACKGROUND: Reorganisation of healthcare services into networks of clinical experts is increasing as a strategy to promote the uptake of evidence based practice and to improve patient care. This is reflected in significant financial investment in clinical networks. However, there is still some question as to whether clinical networks are effective vehicles for quality improvement. The aim of this systematic review was to ascertain the effectiveness of clinical networks and identify how successful networks improve quality of care and patient outcomes. METHODS: A systematic search was undertaken in accordance with the PRISMA approach in Medline, Embase, CINAHL and PubMed for relevant papers between 1 January 1996 and 30 September 2014. Established protocols were used separately to examine and assess the evidence from quantitative and qualitative primary studies and then integrate findings. RESULTS: A total of 22 eligible studies (9 quantitative; 13 qualitative) were included. Of the quantitative studies, seven focused on improving quality of care and two focused on improving patient outcomes. Quantitative studies were limited by a lack of rigorous experimental design. The evidence indicates that clinical networks can be effective vehicles for quality improvement in service delivery and patient outcomes across a range of clinical disciplines. However, there was variability in the networks' ability to make meaningful network- or system-wide change in more complex processes such as those requiring intensive professional education or more comprehensive redesign of care pathways. Findings from qualitative studies indicated networks that had a positive impact on quality of care and patients outcomes were those that had adequate resources, credible leadership and efficient management coupled with effective communication strategies and collaborative trusting relationships. CONCLUSIONS: There is evidence that clinical networks can improve the delivery of healthcare though there are few high quality quantitative studies of their effectiveness. Our findings can provide policymakers with some insight into how to successfully plan and implement clinical networks by ensuring strong clinical leadership, an inclusive organisational culture, adequate resourcing and localised decision-making authority

    Between Tradition and Progress: A Comparative Perspective on Polygamy in the United Satates and India

    Get PDF
    Both the United States and India have had longstanding experiences with polygamy and its regulation. In the United States, the dominant Protestant majority has sought to abolish Mormon practices of polygamy through criminalization. Moreover, the public policy exception has been used to deny recognition of plural marriages conducted legally elsewhere. India’s approach to polygamy regulation and criminalization has been both similar to and different from that of the United States. With a sizable Muslim minority and a legal framework that recognizes religious law as family law, India recognizes polygamy in the Muslim minority community. However, it has criminalized it in the Hindu majority community. Despite the existence of criminal sanctions for Hindus, the incidence of polygamy among the majority community is roughly equivalent to that of Muslims for whom it is permitted. In the United States, despite harsh measures to abolish the practice, it continues and might even be growing in urban communities. This article takes seriously the feminist critique of traditional polygamy as distributionally unfair to women. However, it also acknowledges that polygamy may be an attractive alternative and an acceptable family form. This is particularly true if it is reformed and made to progress as was monogamous marriage in the mid-twentieth century. This article argues that rather than focusing on the criminalization of a family form that has been in existence for millennia, a more fruitful approach to regulating polygamy is focus on the distribution of rights and obligations within the family. This approach accepts that abolition is a goal that is unlikely to be met and that women and men may choose polygamy for rational reasons. As such, feminists are more likely to see gains for women by directing their efforts toward reform and recognition rather than criminalization and abolition

    IMPLEMENTATION OF ECO-INNOVATION IN ENTERPRISES

    Get PDF
    Implementing eco-innovation in the face of critical environmental degradation has become a necessity. It is necessary to create procedures that companies could apply when they implementing green initiatives. This article presents a proposal for an eco-innovationimplementation procedure that highlights the importance of the planning stage. The scheme was developed on the basis of a critical review of the literature and conclusions of the research that was carried out as part of the doctoral dissertation ‘Environmental management in SME enterprises of the śląskie voivodship’

    Introduction

    Get PDF

    Reflections on the Christchurch Massacre: Incorporating a Critique of Islamophobia and TWAIL

    Get PDF
    On March 15, 2019 in Christchurch, New Zealand, a white supremacist entered a mosque full of worshippers and gunned down over 50 people. He was welcomed into the house of worship as Muslim immigrants and converts were about to start their Friday prayers. News of the attack spread quickly across the globe. Social media news feeds and online sources provided near-instantaneous updates. There were calls to prioritize the lives and stories of the victims and survivors. Although there were calls not to glorify or even humanize the shooter, people understandably professed interest in his writings and his motivation. Once it became known that he was an Islamophobic, anti-immigrant, white supremacist, it did not take long to connect the Christchurch terrorist to others who have gained notoriety for similar mass murders in the West. In the wake of this tragedy and in stark contrast to the race-baiting Donald Trump, the world was treated to a view of a compassionate leader unafraid to state unequivocally that the New Zealand shooter believed in a radical ideology of racism that had to be confronted. Prime Minister Jacinda Ardern did everything right in that moment: she called out the white supremacy, comforted the Muslim community, and showed her respect for their beliefs. Shortly after the shootings, Ardern called for a global war against racism and she was widely praised for it. In her speech, Arden proclaimed: To the global community who have joined us today, who reached out to embrace New Zealand, and our Muslim community, to all of those who have gathered here today, we say thank you. And we also ask that the condemnation of violence and terrorism turns now to a collective response. The world has been stuck in a vicious cycle of extremism breeding extremism and it must end. We cannot confront these issues alone, none of us can. But the answer to them lies in a simple concept that is not bound by domestic borders, that isn’t based on ethnicity, power base or even forms of governance. The answer lies in our humanity

    Exporting Subjects: Globalizing Family Law Progress through International Human Rights

    Get PDF
    In our popular culture and social consciousness, women are no longer the second-class citizens they used to be. Magazines, television advertisements, and billboards featuring women show us how we have achieved independence, wealth, desirability, and our intelligence. We are no longer the supporting role in movies and entertainment but stars in our own right. For this, we can thank both changing society and the unrelenting work of many women who refused to bring the coffee for the boss. The women\u27s movement in the United States has made large gains for women through the use of social activism and legal action. Their successes have led to increased acceptance of women in the corridors of business and government; greater access to education; recognition of the harms of domestic violence, sexual harassment and rape; and the securing of reproductive rights. Like the Virginia Slims advertisement used to say: You\u27ve come a long way, baby. Despite these victories, Liberal legal feminism has also been critiqued by black feminists and Third World feminists for its narrow construction of women\u27s rights and its failure to include women at the margins of Liberal society. Its relationship to cultures and religions that are illiberal and non-Western has been fraught with tension and its track record on fighting for the rights of subordinated women of color both at home and abroad has been inconsistent at best. This Article examines the ways in which the prioritization of individual rights and freedom promoted by Liberal legal feminism, specifically with regard to family law reform, dictates the reform priorities articulated by transnational activists for women\u27s rights. As the Article explains, this American-born reform package is exported through international human rights channels, and at transnational meetings among transnational elites with an aim to reform local, traditional societies. When these reform priorities arrive at the intended local/ tradition society, they are met with resistance and alternative priorities that do not necessarily comport with Liberal feminist agendas. With this process in mind, the Article traces the journey of key familylaw reforms, namely with regard to reproductive rights and domestic violence, as these projects move from the United States through the transnational sphere and into local destinations in South Asia to show how these core projects are received and reprioritized. Further, the Article attempts to uncover the feminist subject that is concurrently exported. The feminist subject is comprised of a very particular set of ideas of what it means to be a woman, defining how women should be and what they should value and prioritize in both law and society. While the Liberal feminist subject may not necessarily be dangerous or destructive, this Article questions the ways in which such reforms impact local women themselves and explores the costs of that impact

    Shari\u27ah Law as National Security Threat?

    Get PDF
    This Article examines the recently proposed anti-shari’ah laws of Tennessee, Oklahoma and Arizona. It begins by examining the laws and their justifications and analyzes the 10th Circuit decision in Awad v. Ziriax upholding the injunction against Oklahoma’s Save Our State amendment. It then carefully analyzes the cases that have been cited as examples of shari’ah-creep and reveals that they are actually routine examples of comity and conflicts of law rules applied properly by a properly functioning judiciary. If these laws are not national security measures, what is their true purpose? The Article posits that the new laws are the latest in an ongoing legal and social resignification of Islam and Muslims in an effort to maintain a visible and “alien” threat. It argues that even if they are ineffective as national security laws and even if they are struck down as unconstitutional, anti-shari’ah laws have social effects on Muslims, marginalizing them from the mainstream and singling them out for differential treatment. The Article then analyzes the anti-shari’ah laws as part of a broad spectrum of social and legal methods used in the post 9/11 War on Terror that have the overall effect of “casting out” Muslims from the protection of both civil and human rights law. As such, the anti-shari’ah laws which form a part of this edifice of exclusion must be taken seriously. The Article concludes with the suggestion that states should refuse to participate in the Manichean construction of the Muslim enemy in a global War on Terror, and that we should recognize that our security depends, not on the ongoing exclusion of Muslims, but on their participation and cooperatio

    The COVID Care Crisis and its Implications for Legal Academia

    Get PDF
    From February 2020, when the SARS COVID virus began to have global effects until now, the world has been in the midst of the worst viral pandemic in recent memory. No country was prepared for the rapid escalation of the spread of the virus worldwide that has taken nearly five million lives globally and over 700,000 in the United States alone. Even in March and April 2020, although cities had begun to quarantine and lockdown, none could have predicted the surges of cases and the longevity of the pandemic. Schools and businesses were closed only to open again and close again as the unpredictable virus took its course and as we all tried to haphazardly change to keep up. For many families, parents working and children learning from home utterly collapsed the private/public distinctions that allowed for some semblance of work-life balance. Others who were deemed “essential workers” like medical professionals, grocery store workers, delivery and postal workers, earning a livelihood literally meant risking one’s life and the lives of near family to earn a wage and to provide critical services. It is safe to say that the pandemic upended most of our lives

    Shari\u27ah Law as National Security Threat?

    Get PDF
    The Article proceeds in three parts: in Part II, the Article describes three anti-shari’ah measures. It describes Oklahoma’s Save Our State amendment to show how these laws target Islam. It also reviews the recent decision by the Tenth Circuit Court of Appeals affirming the grant of a preliminary injunction against the certification of Oklahoma’s constitutional amendment. It then describes Arizona’s law that targets shari’ah as well as other legal traditions. It also examines the original version of the Tennessee bill to illustrate the motivations behind the revised, watered down version that was eventually passed by the legislature. Part II concludes with an examination of the chief architects of the model law disseminated to various states and their motivations. The aim is to show how the drafters of the laws were preoccupied not by protecting Americans from a threat of terrorists in their midst, but by defining “American” identity through the law. In Part III of this Article, I take a deeper look into the claim that the laws are necessary because “shari’ah creep” is occurring through family law and will eventually bleed into other doctrinal areas of our secular system. Consequently, I focus on a number of family cases here to show how the courts have dealt with religious law in the United States, particularly in enforcing foreign judgments from Muslim majority countries. This analysis makes clear that family law is not the gateway for shari’ah to enter the judicial system (thereby posing a threat to our security) and that such a view discounts the robust constitutional, choice of law rules and public policy preferences that restrain judges from diluting our secular system. Finally, in Part IV, I raise the question of what these laws are really about if they are not about shari’ah creep or our security. I argue that while these laws may be discounted as ineffectual or unconstitutional, they have an effect on society. They continue the socially acceptable expulsion of Muslims from the mainstream and their marginalization. Far from being innocuous, such strategies of (re)constructing Muslims as the enemy have real lived consequences such as heightened surveillance regulation, incarceration, and even death. I conclude with some observations about decoupling stereotypes of racial and religious identity from counter-terrorism and integration as opposed to assimilation as a way forward. In this final section, I argue that rather than being distracted by creating outsider groups based on identity, our security is better served through inclusion of all those who have a stake in the security of their communities and their families
    corecore