Elected Mayors: Leading Locally?

The directly elected executive mayor was introduced to England a decade ago. Drawing inspiration from European and American experience, the elected mayor appealed to both New Labour and Conservative commentators in offering a solution to perceived problems of local leadership. There was a shared view that governance of local areas was failing and that elected mayors were the answer. The first local referendums were held in 2001. Most have continued to reject the idea of the elected mayor. During 2012, the coalition government initiated 10 further mayoral referendums in England's largest cities but only one, Bristol, opted for an elected mayor. Overall, there is no evidence of widespread public support, yet the prospect of more mayors - with enhanced powers - remains firmly on the policy agenda. Drawing from a decade of research, this paper considers reasons for the persistence of the mayoral experiment, the importance of local factors in the few areas where mayors hold office and the link to current policy debates. Using the authors' analytical leadership grid, this paper links the governmental, governance and allegiance roles of mayors to the problematic nature of local leadership. It then draws tentative conclusions about the strange case of the elected mayor in England

Rapid testing versus karyotyping in Down's syndrome screening: cost-effectiveness and detection of clinically significant chromosome abnormalities

In all, 80% of antenatal karyotypes are generated by Down's syndrome screening programmes (DSSP). After a positive screening, women are offered prenatal foetus karyotyping, the gold standard. Reliable molecular methods for rapid aneuploidy diagnosis (RAD: fluorescence in situ hybridization (FISH) and quantitative fluorescence PCR (QF-PCR)) can detect common aneuploidies, and are faster and less expensive than karyotyping

Simplicity in health teaching /

"Reprint no. 5"; "reprinted from Hygeia, October, 1927."Cover title.Mode of access: Internet

Out of the loop? Councillors and the new political management

As part of the local government modernisation agenda, and under the specific terms of the Local Government Act 2000, local authorities have been required to adopt one of the new models designed to strengthen their core executive: principally, the leader and cabinet, the elected mayor and cabinet, or the elected mayor and council manager. Although the new political management structures are now in place, little is yet known about how they have affected the lives and work of councillors. This paper presents the initial results from a study of elected members in four local authorities in the North of England. Based on a survey and interviews, the research explores the impact of the new arrangements, and other aspects of modernisation, upon the role of the councillor

Implementation of an innovative web-based conference table for community-dwelling frail older people, their informal caregivers and professionals: a process evaluation

Contains fulltext : 108253.pdf (publisher's version ) (Open Access)ABSTRACT: BACKGROUND: Due to fragmentation of care, continuity of care is often limited in the care provided to frail older people. Further, frail older people are not always enabled to become involved in their own care. Therefore, we developed the Health and Welfare Information Portal (ZWIP), a shared Electronic Health Record combined with a communication tool for community-dwelling frail older people and primary care professionals. This article describes the process evaluation of its implementation, and aims to establish (1) the outcomes of the implementation process, (2) which implementation strategies and barriers and facilitators contributed to these outcomes, and (3) how its future implementation could be improved. METHODS: Mixed methods study, consisting of (1) a survey among professionals (n = 118) and monitoring the use of the ZWIP by frail older people and professionals, followed by (2) semi-structured interviews with purposively selected professionals (n = 12). RESULTS: 290 frail older people and 169 professionals participated in the ZWIP. At the end of the implementation period, 55% of frail older people and informal caregivers, and 84% of professionals had logged on to their ZWIP at least once. For professionals, the exposure to the implementation strategies was generally as planned, they considered the interprofessional educational program and the helpdesk very important strategies. However, frail older people's exposure to the implementation strategies was less than intended. Facilitators for the ZWIP were the perceived need to enhance interprofessional collaboration and the ZWIP application being user-friendly. Barriers included the low computer-literacy of frail older people, a preference for personal communication and limited use of the ZWIP by other professionals and frail older people. Interviewees recommended using the ZWIP for other target populations as well and adding further strategies that may help frail older people to feel more comfortable with computers and the ZWIP. CONCLUSIONS: This study describes the implementation process of an innovative e-health intervention for community-dwelling frail older people, informal caregivers and primary care professionals. As e-health is an important medium for overcoming fragmentation of healthcare and facilitating patient involvement, but its adoption in everyday practice remains a challenge, the positive results of this implementation are promising