The Lay of the Land: The Geography of Traditional Cultural Expression

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Tensions and paradoxes in electronic patient record research: a systematic literature review using the meta-narrative method

Background: The extensive and rapidly expanding research literature on electronic patient records (EPRs) presents challenges to systematic reviewers. This literature is heterogeneous and at times conflicting, not least because it covers multiple research traditions with different underlying philosophical assumptions and methodological approaches. Aim: To map, interpret and critique the range of concepts, theories, methods and empirical findings on EPRs, with a particular emphasis on the implementation and use of EPR systems. Method: Using the meta-narrative method of systematic review, and applying search strategies that took us beyond the Medline-indexed literature, we identified over 500 full-text sources. We used ‘conflicting’ findings to address higher-order questions about how the EPR and its implementation were differently conceptualised and studied by different communities of researchers. Main findings: Our final synthesis included 24 previous systematic reviews and 94 additional primary studies, most of the latter from outside the biomedical literature. A number of tensions were evident, particularly in relation to: [1] the EPR (‘container’ or ‘itinerary’); [2] the EPR user (‘information-processer’ or ‘member of socio-technical network’); [3] organizational context (‘the setting within which the EPR is implemented’ or ‘the EPR-in-use’); [4] clinical work (‘decision-making’ or ‘situated practice’); [5] the process of change (‘the logic of determinism’ or ‘the logic of opposition’); [6] implementation success (‘objectively defined’ or ‘socially negotiated’); and [7] complexity and scale (‘the bigger the better’ or ‘small is beautiful’). Findings suggest that integration of EPRs will always require human work to re-contextualize knowledge for different uses; that whilst secondary work (audit, research, billing) may be made more efficient by the EPR, primary clinical work may be made less efficient; that paper, far from being technologically obsolete, currently offers greater ecological flexibility than most forms of electronic record; and that smaller systems may sometimes be more efficient and effective than larger ones. Conclusions: The tensions and paradoxes revealed in this study extend and challenge previous reviews and suggest that the evidence base for some EPR programs is more limited than is often assumed. We offer this paper as a preliminary contribution to a much-needed debate on this evidence and its implications, and suggest avenues for new research

CLS and Marxism: a history of an affair

This essay explores the relationship between the Critical Legal Studies movement and the Marxist tradition. What role did Marxism play in the formation of CLS's ideological and theoretical horizons? What part was it assigned in the movement's symbolic economy of discursive projects and practices? What kinds of critical challenges did CLS scholars mount against the Marxist legal-theoretic tradition and what sorts of broader lessons can the Marxist tradition extract today from those criticisms? The essay starts by summarising the standard account of the relationship between CLS and Marxism that has historically developed within the CLS's own internal discourse. It problematises a number of basic assumptions underlying this account before turning its attention to the examination of CLS's (potential) contribution to the development of a new wave of the Marxist legal-theoretic enterprise

Sociology

Sociology emerged in response to the problem of social order in modern society in the wake of the American and French Revolutions and the rise of industrialism and market capitalism. Sociology had its roots in the theories of August Comte and Herbert Spencer and in empirical work previously conducted by census bureaus, state labor boards, and reform organizations. By the 1880s, sociologists had perceived a threat in the alliance with biology: It undercut the need for a separate discipline and, in Spencer\u27s laissez-faire version, tainted the discipline among social reformers and other constituencies crucial to its success. In Dynamic Sociology, the American Lester Frank Ward addressed both issues. On the surface, American and European sociology during the interwar decades was a study in contrasts. The 1960s spelled the end of \u27modern\u27 sociology. In the United States, Parsons\u27s hegemony and Merton\u27s \u27middle range\u27 compromise gave way to a politically charged humanist/positivist divide

French responses to the Prague Spring: connections, (mis)perception and appropriation

Looking at the vast literature on the events of 1968 in various European countries, it is striking that the histories of '1968' of the Western and Eastern halves of the continent are largely still written separately.1 Nevertheless, despite the very different political and socio-economic contexts, the protest movements on both sides of the Iron Curtain shared a number of characteristics. The 1968 events in Czechoslovakia and Western Europe were, reduced to the basics, investigations into the possibility of marrying social justice with liberty, and thus reflected a tension within European Marxism. This essay provides an analysis specifically of the responses by the French left—the Communist Party, the student movements and the gauchistes—to the Prague Spring, characterised by misunderstandings and strategic appropriation. The Prague Spring was seen by both the reformist and the radical left in France as a moderate movement. This limited interpretation of the Prague Spring as a liberal democratic project continues to inform our memory of it

Rethinking sport, empire, and American exceptionalism

This article examines the correlation between sports history and American imperialism and exceptionalism. More specifically, the author argues against a view of sport historiography which excludes debates within social and cultural history. It is the author's suggestion that established themes in sports historiography, when considered within the context of American imperialism, can expand the understanding of American sports within global history, in effect, allowing sports historians to generate effective cross-cultural analysis. Particular focus is given by the author to the emphasis on how historical generalizations and anecdotes establish imperialism in the sporting history of America