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The article examines the employability of high-grade mental defectives by researchers from London, England. The employment of high grade mental defectives has been recognized as a problem of great social importance ever since attention was first drawn to the incidence of feeble-mindedness. While sociological studies have been comparatively frequent, psychological studies bearing employability of the group have been few.

The article presents a study concerning the work success of employed males with high-grade mental defects in a hospital in Dartford, England. They underwent intelligence and general locomotor coordination tests, while their employability was estimated between nine months. It reveals that Rail Walking and Progressive Matrices Tests are best predictors of employment success, while intelligence does not emerge as a cause. The emotional stability of the defectives show that they are easily more employable and have greater general locomotor coordination and manual dexterity than others.

The article compares the frequency of thrombophilia testing in district hospitals across the West Midlands, England, a large English region that contains some 20 hospitals serving a population of five million. Each hematology department was asked whether or not they vetted request though they were not asked to specify, although they were not asked to specify to specify who undertook the screening or what rules were in place.

Background: Living with a life-limiting illness, people with dementia benefit from palliative care which considers the holistic needs of the person and their family. However, little is known about how palliative care may be best provided to people living with dementia at home in the community. We examined four exemplary dementia palliative care services for people with dementia in the community, to see what activities they were providing, what were the commonalities and differences, and what lessons could be learned., Methods: A long-list of dementia palliative care services in Ireland, Northern Ireland, England, Scotland, and Wales, was identified through a survey, and four exemplar services were chosen based on criteria including: in operation >six months; provides identifiable activities; availability of routinely collected service data; not exclusively for people with dementia in final hours or days of life. Mixed-methods of data collection included interviews, focus-groups and surveys with service staff, surveys of service users, and routinely collected service data. The RE-AIM framework was used to describe and understand the sample of dementia palliative care services., Results: The four services had varied organisational structures and were led by different disciplines. However, they all provided common core activities including holistic and person-centred care, early advance care planning with service user involvement, carer support, integrated healthcare services, continuity of care, 24/7 support, bereavement support. All had needs-based referral criteria, accepting any age or dementia sub-type. All supported people with dementia to remain living at home and to have a comfortable, dignified death in their preferred place., Conclusions: An effective dementia palliative care service may take different forms. Whether the service is dementia-led or Specialist Palliative Care-led, efficacy is associated with providing a range of key activities and implementing them effectively. The data collected strongly suggests the benefits of the dementia palliative care services to a person with dementia and their families and offers valuable insight into the key factors for the establishment and successful running of such services., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Objective: To describe the strategies used by a collection of healthcare systems to apply different methods of identifying seriously ill patients for a targeted palliative care intervention to improve communication around goals and values., Methods: We present an implementation case series describing the experiences, challenges and best practices in applying patient selection strategies across multiple healthcare systems implementing the Serious Illness Care Program (SICP)., Results: Five sites across the USA and England described their individual experiences implementing patient selection as part of the SICP. They employed a combination of clinician screens (such as the 'Surprise Question'), disease-specific criteria, existing registries or algorithms as a starting point. Notably, each describes adaptation and evolution of their patient selection methodology over time, with several sites moving towards using more advanced machine learning-based analytical approaches., Conclusions: Involving clinical and programme staff to choose a simple initial method for patient identification is the ideal starting place for selecting patients for palliative care interventions. However, improving and refining methods over time is important and we need ongoing research into better patient selection methodologies that move beyond mortality prediction and instead focus on identifying seriously ill patients-those with poor quality of life, worsening functional status and medical care that is negatively impacting their families., Competing Interests: Competing interests: AG reports receiving royalties from publishers and media outlets worldwide for writing and other media on healthcare including the subject of serious illness care and checklists during the conduct of this study. AG is also employed as the CEO of the new non-profit-seeking healthcare venture parented by Amazon, Berkshire Hathaway and JP Morgan Chase. JRL reports grants from The Gordon and Betty Moore Foundation, during the conduct of the study; grants from Cambia Health Foundation, outside the submitted work; and JRL receives salary support funding for work related to the Serious Illness Care Program (studied in this manuscript) from his home institutions. Additionally, he receives teaching honoraria related to his academic work on the Program from government and academic entities. EKF reports grants and other from the Gordon and Betty Moore Foundation during the conduct of this study, and is the Director of the Serious Illness Care Program, the quality improvement program referenced in the paper., (© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.)

This study collected an area-wide snapshot of current handover practice in psychiatric settings which included acute care units and community mental health centres. The study was conducted in two stages. Firstly, a questionnaire was sent to all clinical mental health staff within an area-wide health service regarding normal handover procedures and processes. The second part of the study used non-participant observers to evaluate actual handovers in inpatient and community settings. Of the 1125 surveys distributed in stage one, 380 (34%) were returned completed. Of the 40 handovers observed in stage two in which 637 patients were discussed, 40% included at least one consultant psychiatrist or registrar as a participant. Almost all the handovers were completed face-to-face in a specific location with a set time and duration. Eighty-six per cent of respondents reported that deteriorating patients were escalated for rapid response. The results of the survey and structured observations support the issues emerging from the literature from medical, surgical and clinical team handovers. Additionally, the issue of identifiers for deterioration of a psychiatric patient emerged as an area worthy of further investigation and incorporation into clinical handover education and training for psychiatric services., (© 2011 Blackwell Publishing.)