HEALTH MAINTENANCE ORGANIZATION ENVIRONMENT: AN EMPIRICAL STUDY OF THE RELATIONSHIP OF EXTERNAL CONTEXT AND PERFORMANCE

The research project is an extension of a series of administrative science and health care research projects evaluating the influence of external context, organizational strategy, and organizational structure upon organizational success or performance. The research will rely on the assumption that there is not one single best approach to the management of organizations (the contingency theory). As organizational effectiveness is dependent on an appropriate mix of factors, organizations may be equally effective based on differing combinations of factors. The external context of the organization is expected to influence internal organizational strategy and structure and in turn the internal measures affect performance (discriminant theory). The research considers the relationship of external context and organization performance.^ The unit of study for the research will be the health maintenance organization (HMO); an organization the accepts in exchange for a fixed, advance capitation payment, contractual responsibility to assure the delivery of a stated range of health sevices to a voluntary enrolled population. With the current Federal resurgence of interest in the Health Maintenance Organization (HMO) as a major component in the health care system, attention must be directed at maximizing development of HMOs from the limited resources available. Increased skills are needed in both Federal and private evaluation of HMO feasibility in order to prevent resource investment and in projects that will fail while concurrently identifying potentially successful projects that will not be considered using current standards.^ The research considers 192 factors measuring contextual milieu (social, educational, economic, legal, demographic, health and technological factors). Through intercorrelation and principle components data reduction techniques this was reduced to 12 variables. Two measures of HMO performance were identified, they are (1) HMO status (operational or defunct), and (2) a principle components factor score considering eight measures of performance. The relationship between HMO context and performance was analysed using correlation and stepwise multiple regression methods. In each case it has been concluded that the external contextual variables are not predictive of success or failure of study Health Maintenance Organizations. This suggests that performance of an HMO may rely on internal organizational factors. These findings have policy implications as contextual measures are used as a major determinant in HMO feasibility analysis, and as a factor in the allocation of limited Federal funds. ^

Child Welfare Workers’ Perceptions of the Influence of the Organizational Environment on Permanency Decisions for Families

The findings of this study suggest that while child welfare workers are consistently distracted by competing priorities from unexpected events, most are committed, and to understand perspectives is more inclusive and may improve retention rates. Notably, while it is recognized that permanency decisions are not made in an intellectual, legal or clinical vacuum and certain traditional aspects of the bureaucratic structure do not impact decision making, this study advances the body of knowledge on child welfare decision making. Examined in this study are child welfare case workers’ perceptions of the extent to which the organizational environment influences the permanency decisions they make to reunify or terminate parental rights of children placed out-of-home. This study includes a sample of 95 child welfare social workers employed in three public child welfare agencies in the Baltimore and Washington, DC metropolitan area. It used a cross-sectional research design, employing a survey instrument to examine bureaucratic distraction, role conflict, and supervisory adequacy as contextual factors in the organizational environment's influence on permanency outcome decisions. Implications are made for child welfare policy, practice, and research.

El aborto y los derechos fundamentales. Análisis de la constitucionalidad de la prohibición penal de la interrupción del embarazo en supuestos de violación sexual y de malformaciones fetales incompatibles con la vida extrauterina

El Derecho, como sistema de regulación de conductas, establece cuáles están permitidas, prohibidas u ordenadas. En el caso del aborto, un enfoque conservador se orienta a su prohibición absoluta, lo que equivale a que el sistema legal indica que todos los embarazos deben culminar en nacimientos, proscribiéndose cualquier intervención en ese transcurso. No obstante lo anterior, existe otra tendencia en materia de aborto: aquella orientada a su permisión en determinados supuestos que son más bien excepcionales. En ese contexto, algunos ordenamientos jurídicos otorgan tratamientos diferentes al aborto que se produce en circunstancias en los que las mujeres no han podido decidir sobre el embarazo, pues las relaciones sexuales les fueron impuestas, como es el caso de las víctimas de violación sexual o en circunstancias en las que a mujeres a quienes han consentido continuar con su embarazo se les indica médicamente que el feto tiene malformaciones que hacen no viable su vida extrauterina. No es el caso peruano en que ambas situaciones son consideradas delitos.

Aborto, sistema penal y derechos humanos de las mujeres

La Coordinadora de Derechos Humanos del Paraguay (Codehupy) presenta este trabajo denominado Aborto, sistema penal y derechos de las mujeres como un aporte inicial al tratamiento de un tema pocas veces abordado desde la perspectiva de los derechos humanos, aun cuando tiene importantes implicancias en cuanto a la obligación del Estado paraguayo de garantizar, proteger, respetar y promover los derechos humanos de todas las personas y, en lo referente a este tema, los derechos de las mujeres en particular.

Health care providers' opinions on abortion: a study for the implementation of the legal abortion public policy in the Province of Santa Fe, Argentina

Background: In Argentina, abortion has been decriminalized under certain circumstances since the enactment of the Penal Code in 1922. Nevertheless, access to abortion under this regulatory framework has been extremely limited in spite of some recent changes. This article reports the findings of the first phase of an operations research study conducted in the Province of Santa Fe, Argentina, regarding the implementation of the local legal and safe abortion access policy. Methods: The project combined research and training to generate a virtuous circle of knowledge production, decision-making, and the fostering of an informed healthcare policy. The project used a pre-post design of three phases: baseline, intervention, and evaluation. It was conducted in two public hospitals. An anonymous self-administered questionnaire (n = 157) and semi-structured interviews (n = 27) were applied to gather information about tacit knowledge about the regulatory framework; personal opinions regarding abortion and its decriminalization; opinions on the requirements needed to carry out legal abortions; and service’s responses to women in need of an abortion. Results: Firstly, a fairly high percentage of health care providers lack accurate information on current legal framework. This deficit goes side by side with a restrictive understanding of both health and rape indications. Secondly, while a great majority of health care providers support abortion under the circumstances consider in the Penal Code, most of them are reluctant towards unrestricted access to abortion. Thirdly, health care providers’ willingness to perform abortions is noticeably low given that only half of them are ready to perform an abortion when a woman’s life is at risk. Willingness is even lower for each of the other current legal indications. Conclusions: Findings suggest that there are important challenges for the implementation of a legal abortion policy. Results of the study call for specific strategies targeting health care providers in order to better inform about current legal abortion regulations and to sensitize them about abortion social determinants. The interpretation of the current legal framework needs to be broadened in order to reflect a comprehensive view of the health indication, and stereotypes regarding women’s sexuality and abortion decisions need to be dismantled.

La penalidad de la ebriedad en el código penal y en la praxis judicial bonaerense 1878-1888

La sanción del código penal en la provincia de Buenos Aires en el año 1877, fijó en el homicidio la penalidad y determinó las circunstancias del delito mediante la enumeración de los atenuantes y agravantes. El objetivo era contemplar todas las posibilidades del delito para reducir el "arbitrio judicial". Sin embargo, deteniéndonos en los cambios operados en cuanto a la ebriedad en la normativa legal y en la práctica judicial, se puede observar que la función del juez no se redujo únicamente a computar la pena según el delito. A su cargo quedó la apreciación de las pruebas y la interpretación legal. En este sentido, la ley dejó márgenes para considerar a la ebriedad como atenuante o no de la penalidad. Sin embargo, los jueces le negaron tal beneficio al imputado, lo cual marcó una ruptura con respecto al período anterior. Interpretación que estuvo determinada no por un cambio en la percepción sobre el efecto del alcohol como perturbador de la conciencia, sino por ciertos prejuicios que otorgaron una jerarquía y un valor a los motivos que pudieran cegar al trasgresor. Considerada aun como un vicio y no una patología, revelaron la condena a esta práctica social determinando que hechos ya no quedaban comprendidos como circunstancias atenuantes. En definitiva, la ebriedad posibilita apreciar el complejo proceso de codificación que consistió no únicamente en la aplicación literal de la ley sino también en la interpretación que de ella se hiciera.

La penalidad de la ebriedad en el código penal y en la praxis judicial bonaerense 1878-1888

La sanción del código penal en la provincia de Buenos Aires en el año 1877, fijó en el homicidio la penalidad y determinó las circunstancias del delito mediante la enumeración de los atenuantes y agravantes. El objetivo era contemplar todas las posibilidades del delito para reducir el "arbitrio judicial". Sin embargo, deteniéndonos en los cambios operados en cuanto a la ebriedad en la normativa legal y en la práctica judicial, se puede observar que la función del juez no se redujo únicamente a computar la pena según el delito. A su cargo quedó la apreciación de las pruebas y la interpretación legal. En este sentido, la ley dejó márgenes para considerar a la ebriedad como atenuante o no de la penalidad. Sin embargo, los jueces le negaron tal beneficio al imputado, lo cual marcó una ruptura con respecto al período anterior. Interpretación que estuvo determinada no por un cambio en la percepción sobre el efecto del alcohol como perturbador de la conciencia, sino por ciertos prejuicios que otorgaron una jerarquía y un valor a los motivos que pudieran cegar al trasgresor. Considerada aun como un vicio y no una patología, revelaron la condena a esta práctica social determinando que hechos ya no quedaban comprendidos como circunstancias atenuantes. En definitiva, la ebriedad posibilita apreciar el complejo proceso de codificación que consistió no únicamente en la aplicación literal de la ley sino también en la interpretación que de ella se hiciera.

La penalidad de la ebriedad en el código penal y en la praxis judicial bonaerense 1878-1888

La sanción del código penal en la provincia de Buenos Aires en el año 1877, fijó en el homicidio la penalidad y determinó las circunstancias del delito mediante la enumeración de los atenuantes y agravantes. El objetivo era contemplar todas las posibilidades del delito para reducir el "arbitrio judicial". Sin embargo, deteniéndonos en los cambios operados en cuanto a la ebriedad en la normativa legal y en la práctica judicial, se puede observar que la función del juez no se redujo únicamente a computar la pena según el delito. A su cargo quedó la apreciación de las pruebas y la interpretación legal. En este sentido, la ley dejó márgenes para considerar a la ebriedad como atenuante o no de la penalidad. Sin embargo, los jueces le negaron tal beneficio al imputado, lo cual marcó una ruptura con respecto al período anterior. Interpretación que estuvo determinada no por un cambio en la percepción sobre el efecto del alcohol como perturbador de la conciencia, sino por ciertos prejuicios que otorgaron una jerarquía y un valor a los motivos que pudieran cegar al trasgresor. Considerada aun como un vicio y no una patología, revelaron la condena a esta práctica social determinando que hechos ya no quedaban comprendidos como circunstancias atenuantes. En definitiva, la ebriedad posibilita apreciar el complejo proceso de codificación que consistió no únicamente en la aplicación literal de la ley sino también en la interpretación que de ella se hiciera.

Professional Liability of the Construction Professional as an Expert Witness in the Spanish Legal Framework

Inside COBRA 2011 RICS International Research Conference, the present paper is linked to analyze the liability of the construction professional in his practice as a expert witness in the Spanish legal framework. In a large number of legal procedures related to the building it is necessary the intervention of the expert witness to report on the subject of litigation, and to give an opinion about possible causes and solutions. This field is increasingly importantly for the practice of construction professional that requires an important specialization. The expert provides his knowledge to the judge in the matter he is dealing with (construction, planning, assessment, legal, ...), providing arguments or reasons as the base for his case and acting as part of the evidence. Although the importance of expert intervention in the judicial process, the responsibilities arising from their activity is a slightly studied field. Therefore, the study has as purpose to think about the regulation of professional activities raising different aims. The first is to define the action of the construction professional-expert witness and the need for expert evidence, establishing the legal implications of this professional activity. The different types of responsibilities (the civil, criminal and administrative) have been established as well as the economic, penal or disciplinary damages that can be derived from the expert report

Legal Aspects which Implement Good Practice Measures in the Management of Construction and Demolition Waste

The construction industry, one of the most important ones in the development of a country, generates unavoidable impacts on the environment. The social demand towards greater respect for the environment is a high and general outcry. Therefore, the construction industry needs to reduce the impact it produces. Proper waste management is not enough; we must take a further step in environmental management, where new measures need to be introduced for the prevention at source, such as good practices to promote recycling. Following the amendment of the legal frame applicable to Construction and Demolition Waste (C&D waste), important developments have been incorporated in European and International laws, aiming to promote the culture of reusing and recycling. This change of mindset, that is progressively taking place in society, is allowing for the consideration of C&D waste no longer as an unusable waste, but as a reusable material. The main objective of the work presented in this paper is to enhance C&D waste management systems through the development of preventive measures during the construction process. These measures concern all the agents intervening in the construction process as only the personal implication of all of them can ensure an efficient management of the C&D waste generated. Finally, a model based on preventive measures achieves organizational cohesion between the different stages of the construction process, as well as promoting the conservation of raw materials through the use and waste minimization. All of these in order to achieve a C&D waste management system, whose primary goal is zero waste generation

1.6 Lloyd Hogsett, University of Missouri Legal Counsel

By March, 1936, the University of Missouri formally rejected Gaines because Missouri law would not permit a person of African descent to enter a white school. Within three weeks, the NAACP petitioned the court asking the University of Missouri to open its doors to Gaines on the grounds that it was the only public law school in Missouri.

Prisão preventiva: direito à razoável duração e necessidade de prazo legal máximo

O direito à razoável duração do processo, inserido expressamente no ordenamento jurídico brasileiro a partir do advento da Emenda Constitucional 45/2004, já poderia ser inferido desde a incorporação da Convenção Americana de Direitos Humanos, bem como ser considerado um corolário da garantia do devido processo legal. Todo indivíduo tem o direito a um processo sem dilações indevidas, em especial aquele que se encontre submetido a uma prisão preventiva, medida cautelar pessoal de extrema gravosidade. Nesse contexto, exsurge o direito que o indivíduo preso preventivamente tem de que o seu processo seja julgado em um prazo razoável ou de que ele seja desencarcerado, caso preso além da necessidade fática contida no caso concreto. Entretanto, a interpretação da garantia não pode restar somente à livre vontade dos aplicadores do direito, sendo necessária uma regulamentação legal efetiva da duração da prisão preventiva, por meio de prazos concretos nos quais o sujeito deverá ser posto em liberdade, ante a desídia estatal. Incorporando experiências estrangeiras, deve o legislador pátrio adotar marcos temporais legais, em que a prisão preventiva deverá cessar, caso excessivamente prolongada. Muito embora no ano de 2011 tenha sido reformada a tutela das medidas cautelares pessoais no Código de Processo Penal, o legislador ordinário não aprovou a imposição de limites de duração da prisão preventiva, permanecendo ao livre arbítrio das autoridades judiciárias a interpretação da garantia em referência. Assim, o Projeto de Lei do Novo Código de Processo Penal, atualmente em trâmite no Congresso Nacional, ao prever limites máximos de duração da prisão preventiva, dá uma efetiva regulamentação à garantia da duração razoável do imputado preso, devendo ser, espera-se, mantido no eventual texto final aprovado.