Supporting Water Governance and Climate Change Adaptation Through Systemic Praxis

Understanding and working with multiple perspectives on issues of change is an essential part of managing “common pool” water resources. In uncertain and complex situations arising from changes in human settlements and climate, both lives and livelihoods can be at stake. One individual’s or group’s choices can adversely affect others and traditional processes of participation and legislation are often inadequate. Discourse on environmental law recognises that noncompliance with legislation is associated with weak national governance structures. A systemic approach to managing change is required to appreciate interconnections among issues at various levels and to mediate different stakeholdings. Yet there are no blueprints for effecting systemic transformations of complex situations. This paper explores how the implementation of climate change adaptation can be supported when grounded in situations, such as water governance. It draws on the authors’ experiences of systemic praxis in the water sector

A Model for Judicial Leadership: Community Responses to Juvenile Substance Abuse

Outlines the Reclaiming Futures initiative, which brings juvenile courts and systems of care together under judges' leadership in a team effort toward systemic change. Offers lessons learned, guidance, and recommendations for starting similar projects

Hospital Community Benefits After the ACA: Partnerships for Community Health Improvement

Examines states' and localities' efforts to promote community health and systemic change through collaborations focused on community health needs assessments, priority setting, strategic planning, and the implementation of health improvement initiatives

The Urban High School's Challenge: Ensuring Literacy for Every Child

Looks at comprehensive adolescent literacy reform initiatives in school districts across the nation that are beginning to address the need for effecting systemic change by teaching reading to all students

Making Evaluation Work in the Nonprofit Sector: A Call for Systemic Change

This position paper is a call for systemic changes that will create an ecosystem within which it is straightforward, efficient, and rewarding for nonprofits and funders to invest in evaluation work. It is also intended to further critical conversations to build a nonprofit sector that is more responsive, accountable, and focused on the best ways to support the communities in which they work

Nintedanib for systemic sclerosis–associated interstitial lung disease

BackgroundInterstitial lung disease (ILD) is a common manifestation of systemic sclerosis and a leading cause of systemic sclerosis-related death. Nintedanib, a tyrosine kinase inhibitor, has been shown to have antifibrotic and antiinflammatory effects in preclinical models of systemic sclerosis and ILD. MethodsWe conducted a randomized, double-blind, placebo-controlled trial to investigate the efficacy and safety of nintedanib in patients with ILD associated with systemic sclerosis. Patients who had systemic sclerosis with an onset of the first non-Raynaud's symptom within the past 7 years and a high-resolution computed tomographic scan that showed fibrosis affecting at least 10% of the lungs were randomly assigned, in a 1:1 ratio, to receive 150 mg of nintedanib, administered orally twice daily, or placebo. The primary end point was the annual rate of decline in forced vital capacity (FVC), assessed over a 52-week period. Key secondary end points were absolute changes from baseline in the modified Rodnan skin score and in the total score on the St. George's Respiratory Questionnaire (SGRQ) at week 52. ResultsA total of 576 patients received at least one dose of nintedanib or placebo; 51.9% had diffuse cutaneous systemic sclerosis, and 48.4% were receiving mycophenolate at baseline. In the primary end-point analysis, the adjusted annual rate of change in FVC was -52.4 ml per year in the nintedanib group and -93.3 ml per year in the placebo group (difference, 41.0 ml per year; 95% confidence interval [CI], 2.9 to 79.0; P=0.04). Sensitivity analyses based on multiple imputation for missing data yielded P values for the primary end point ranging from 0.06 to 0.10. The change from baseline in the modified Rodnan skin score and the total score on the SGRQ at week 52 did not differ significantly between the trial groups, with differences of -0.21 (95% CI, -0.94 to 0.53; P=0.58) and 1.69 (95% CI, -0.73 to 4.12 [not adjusted for multiple comparisons]), respectively. Diarrhea, the most common adverse event, was reported in 75.7% of the patients in the nintedanib group and in 31.6% of those in the placebo group. ConclusionsAmong patients with ILD associated with systemic sclerosis, the annual rate of decline in FVC was lower with nintedanib than with placebo; no clinical benefit of nintedanib was observed for other manifestations of systemic sclerosis. The adverse-event profile of nintedanib observed in this trial was similar to that observed in patients with idiopathic pulmonary fibrosis; gastrointestinal adverse events, including diarrhea, were more common with nintedanib than with placebo

Moderation through exclusion? The journey of the Tunisian Ennahda from fundamentalist to conservative party

The success of processes of democratic change is often predicated on the moderation of anti-systemic and extremist parties. The literature on such parties argues that such moderation, namely the acceptance of democratic procedures, human rights, and a market economy, comes about through inclusion. This seems to be borne out when one analyses a number of Islamist parties having contributed to the progressive democratization of their respective countries. The Tunisian case, however, offers a different perspective on moderation. This article argues that it has been exclusion through repression and social marginalization that has led the Islamist party Ennahda to move from its extreme anti-systemic position of the 1970s to become the mainstream conservative party it is today

Systemic Failure of Private Banking: A Case for Public Banks

The current crisis represents systemic failure of private banking. The private nature of banks has created opacity, and exacerbated problems of liquidity, bad assets and capital shortage. Furthermore, private banks have failed in information gathering and risk management, as well as in mediating the acquisition of vital goods by households. It is paradoxical that, confronted with such systemic failure, post-Keynesian and other heterodox economists have generally made non-systemic reform proposals. This paper draws on Marxist theory to argue that systemic change is necessary, including conversion of failed private into public banks run transparently and with democratic accountability. Public banks could more easily confront the problems of liquidity and solvency; they could also play a long-term role by providing stable flows of social credit to households as well as to small and medium enterprises. Finally, public banks could provide long-term credit redirecting mature economies toward new economic activities.

Promoting Systemic Change in Industrial Relations: Creating the Conditions of Effective Workplace Participation

Report Presented to International Evidence: Worker-Management Institutions and Economic Performance Conference, U.S. Commission on the Future of Worker-Management Relations.Report_Streeck.pdf: 889 downloads, before Oct. 1, 2020

Black Male: Why the Mid South Cannot Afford to Ignore the Disparities Facing Its Black Men and Boys

In the Mid South -- Arkansas, Louisiana, Mississippi -- there is a particular need and opportunity for advocacy, funding, and systemic change to address the inequities faced by black males. The region is not only widely impoverished and rural but also home to a large African-American population. This report presents knowledge on education, health, and criminal justice disparities as well as suggestions for how to take action