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First published in 1997, this volume responds to a world in the midst of a telecommunications revolution. What this means is that societies throughout the world are now provided with new opportunities to solve nagging problems. One problem which is the focus of this book is the continual pockets of poverty that exist in countries around the world. In this regard, welfare reform has been slow in coming as nations struggle for allocating limited resources for meeting the needs of all citizens within its boundaries. This book describes a welfare model that is quite innovative, imaginative, but also practical. It can be readily implemented in any country in the world, although the example used in this book is that of one country. The welfare reform model suggested here is all about freedom, opportunity and equity. At its conclusion, it challenges the reader to take welfare reform to the next level

PurposeThe purpose of this paper pertains to the implementation of an occupational therapy service within a newly‐established medium secure service for 16 men with intellectual disabilities and additional diagnosis of personality disorder located in the North West of England.Design/methodology/approachThis is a general review, providing a descriptive account of the development and implementation of an occupational therapeutic provision for men residing in a medium secure unit with a dual diagnosis of intellectual disability and personality disorder and a service user account of its efficacy.FindingsThe paper seeks to illustrate the efficacy of occupational therapy implemented by a specifically recruited and trained staff team, describing engagement in meaningful, bespoke programmes of occupation used to assist service users to address deficit areas via mutual engagement in activities, serving to facilitate the formation and development of positive and trusting relationships between service users and staff. The impact of the service is described from a service user's perspective.Originality/valueThere is very little literature relating to those with intellectual disability also diagnosed with personality disorder. There appears to be no specific study of occupational therapy amongst those with dual diagnosis of intellectual disability and personality disorder. This paper is therefore unique in its approach and provides an overview of both the process and method used to implement occupational therapy, as well as a service user perspective and an illustration of its efficacy in a medium secure setting.

We investigated leadership competencies for developing senior and emerging leaders and the perceived effectiveness of leadership development programs in Health Research Organizations (HROs). A pilot study was conducted to interview HRO executives in Southern California. Respondents represented different organizational contexts to ensure a diverse overview of strategic issues, competencies, and development needs. We analyzed qualitative and quantitative data using an innovative framework for analyzing HRO leadership development. The National Center for Healthcare Leadership 'Health Leadership Competency Model' was used as the foundation of our competency research. Top strategic issues included economic downturn and external funding, the influence of governmental policies and regulations, operating in global markets, and forming strategic alliances. High priority NCHL leadership competencies required to successfully lead an HRO include talent development, collaboration, strategic orientation, and team leadership. Senior executives need financial skills and scientific achievement; emerging leaders need technical/scientific competence, information seeking, and a strong work ethic. About half of the respondents reported having no leadership development program (LDP). Almost all reported their organization encourages mentoring, but less than one-third reported an active formalized mentoring program. We conclude that uncertainties and challenges related to healthcare reform and the continued budget deficits will require HRO restructuring to contain costs, remove barriers to innovation, and show value-add in accelerating discovery to improve clinical care, patient outcomes, and community health. Successful leaders will need to become more strategic, entrepreneurial, and resourceful in developing research alliances, executing research operations, and continually improving performance at all levels of the HRO.