Resource scarcity and priority-setting: from management to leadership in the rationing of health care?

While continued interest in the application of priority-setting technologies is perhaps unsurprising in a time of austerity, they require sensitive implementation for their full potential benefits to be realized. This article looks at the role and value of leadership in addressing problems of a lack of perceived legitimacy and governance that have been raised in connection with the rationing enterprise. The potential and limitations of key leadership concepts such as ‘sense-making’ and ‘framing’ are explored, and notions of relational leadership and the importance of leading with political astuteness are discussed

Reducing incision length or intensifying rehabilitation: what makes the difference to length of stay in total hip replacement in a UK setting?

Minimal-incision surgery for hip arthroplasty and intensive post-op physiotherapy have both been shown to allow early mobilisation and to reduce hospital stay. Forty-five patients undergoing primary total hip arthroplasty using a standard posterior approach were compared with 51 patients using a minimal incision. In both groups, physiotherapy involved either a routine or intensive regime. Patients were matched in age, sex and body mass index. There was no significant difference in blood loss, post-operative stay and change in Oxford hip scores at one year between the mini- and standard-incision groups. There was a significant difference (P=0.003) in length of stay between routine- and intensive-physiotherapy groups (11.4 vs. 7.9 days). The dislocation rate was higher in the mini-incision group. This study suggests that in a standard UK setting, intensive physiotherapy can significantly decrease in-patient stay, but reducing the incision length does not

Otherness, Discrimination, and Cats in Eugene Trivizas's The Last Black Cat

This paper examines Greek writer Eugene Trivizas's 2001 crossover animal fantasy The Last Black Cat, considering the implications of using the trope of the animal both to interrogate the construction of black cats as Other and to challenge examples of prejudice, or rather the grounds of prejudice, discrimination, and scapegoating. Extended consideration is devoted to the ways in which the narrative produces black cats as the marginalised and demonised Other of both humans and other cats, while at the same time it questions the culturally established hierarchy between humans and animals, and the paradigm of animal victim. It is argued that the focus on how the human/animal relations are articulated in Trivizas's novel makes it possible to perceive both the irrationality of the ideology behind the discrimination and the beast in humankind; in others words, by using misfortunes of animals as a tool for social criticism it subverts dominant discriminatory discourses and redefines prevailing ideas of humanity

Will attracting the "creative class" boost economic growth in old industrial regions? A case study of Scotland

Attracting in-migration of the creative class has been argued by Florida (2002) to be a route to higher economic growth in the era of the knowledge economy. This paper critically evaluates this proposition in relation to old industrial regions using the example of Scotland. The paper presents an assessment of, in the first instance, to what extent there is a shortage of skilled, talented and entrepreneurial individuals and, in the second instance, whether a talent attraction strategy alone can hope to attract such people to Scotland. It is proposed that for most migrants the availability of appropriate economic opportunities is a prerequisite for mobility. However, despite uncertain evidence that place attractiveness is a catalyst to mobility among the so-called creative class, this is not a reason for dismissing talent attraction programmes. Instead it is argued that talent attraction programmes have the potential to contribute to old industrial economies, but their success will be greatest when talent attraction is carefully targeted and based on economic realities rather than the marketing of ethereal conceptions of place attractiveness