Movement Law

In this Article we make the case for “movement law,” an approach to legal scholarship grounded in solidarity, accountability, and engagement with grassroots organizing and left social movements. In contrast to law and social movements—a field of study that unpacks the relationship between lawyers, legal process, and social change—movement law is a methodology for scholars across substantive areas of expertise to draw on and work alongside social movements. We identify seeds for this method in the work of a growing number of scholars that are organically developing methods for movement law. We make the case that it is essential in this moment of crisis to cogenerate ideas alongside grassroots organizing that aims to transform our political, economic, social landscape.In articulating movement law as a methodology for undertaking and shifting the scholarly enterprise, we identify four methodological moves. First, movement law scholars pay close attention to modes of resistance by social movements and local organizing. Paying attention to resistance is in itself significant, for it meaningfully diversifies the voices and sources relevant to legal scholarship. Second, movement law scholars work to understand the strategies, tactics, and experiments of resistance and contestation. By studying the range of strategies, tactics, and experiments—including but not limited to traditional law reform campaigns—movement law scholars engage new pathways to and possibilities for justice. Third, movement law scholars shift their epistemes, away from courts and silos of legal expertise, and toward the stories, strategies, and histories of left social movements. Adopting the episteme of social movement horizons denaturalizes the status quo and allows more radical possibilities to emerge—beyond the status quo, and toward political, economic, social transformation. Fourth, movement law scholars embody an ethos of solidarity, collectivity, and accountability with left social movements, rather than a hierarchical or oppositional relationship. Writing in solidarity with social movements displaces the legal scholar as an individual expert and centers collective processes of ideation and struggles for social change

Comparison Of Isoconazole Nitrate Versus Nystatin For The Treatment Of Otomycosis

Objective: To compare the efficacy and local adverse effects of Isoconazole Nitrate versus Nystatin for the treatment of patients having Otomycosis  Sudy Design: Group experimental study. Study Setting & Duration: Department of Otolaryngology, Head & Neck Surgery at Rawalpindi Teaching Hospital, Rawalpindi.  Duration of study was 6 months after approval by Ethical Committee from Feb 2023 to july 2023 Materials and Methods: Total of 64 patients were selected.  The study participants were individuals who, according to operational definitions had Otomycosis and who had presented for evaluation at the Department of Otolaryngology Rawalpindi teaching Hospital, Rawalpindi. They also met all inclusion and exclusion criteria requirements and these requirements were strictly adhered to in order to control confounders and bias. Isoconazole nitrate ointment was used to treat patients in Group A and Nystatin ointment was used to treat instances in Group B.  Patients were chosen by randomization using lottery method. SPSS 28 was used to determine the frequencies in the data. Results: 64 individuals (32 cases in each group) were chosen for the study by the ENT outpatient clinic. Out of which 33 (51.6%) being female and 31 (48.1) being male. The age ranged from 12 to 80 years, with a mean age of 44.29 ±19.13. After two weeks, there was a substantial improvement in 25 (39.06%) of the group A patients (p=0.08), a moderate improvement in 7 (10.9%), and a minor improvement in 5 (7.81%) patients (p=0.37) while in group B exhibited a substantial improvement in just 19 (10.9%) (p=0.08), a moderate improvement in 9 (39.0%) (p=0.38), and a small improvement in 7 (42.19%) (p=0.37). After four weeks 21 (32.81%) in Group B showed insignificant improvement, while 26 (40.63%) in Group A exhibited better improvement than Group B. The treatment for group A, which included isoconazole nitrate, was substantially more successful than the Nystatin treatment for group B. Isoconazole was found insignificantly more effective than   (p=0.08). The  majority of patients in both groups didn't notice any adverse  . Conclusion: Nystatin was shown to be significantly less efficacious than isoconazole nitrate ointment in treating otomycosis

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit