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The purpose of this paper is to explore the characteristics of adults with intellectual disabilities supported by a Community Forensic Learning Disability Team (CFT) and interventions delivered. It discusses the clinical implications of these and examines outcomes such as recidivism.

A retrospective case note review of all 70 service users open to the CFT during June 2013 was carried out, using a structured service evaluation tool.

The majority of service users (74.3 per cent) had a mild intellectual disability. Multiple mental health and/or physical health diagnoses were common, and 28 per cent had problematic drug or alcohol abuse. Almost half of service users had been victims of physical or sexual abuse, or neglect. Sexual offences were the most common index offence, followed by assault and fire-setting. A wide range of multi-disciplinary interventions were delivered within the Community Forensic Team. Following CFT involvement there was an increase in service users living in supported living in the community and a decrease in people in secure or out of area placements. Over half of service users engaged in no further offending behaviour since their referral, and those who did offend generally showed a decrease in the severity of offending behaviours. There was a large decrease in the number of convictions received.

The study shows the benefits of a multi-disciplinary Community Forensic Team for offenders with intellectual disabilities in terms of reduced recidivism and range of interventions delivered. It highlights the importance of clinicians within such a team having the skills to work with people with co-morbid diagnoses (e.g. autism) and people with trauma backgrounds and problematic substance use.

This paper demonstrates the complexity of the service users who are supported by the CFT, as well as the integral role played in supporting individuals to move to less restrictive settings, with positive outcomes.

The purpose of this paper is to pilot‐test the feasibility and impact of protocol‐driven point‐of‐care HbA1c testing on levels of glycemic control and on rates of diabetic regimen intensification in an urban community health center serving low‐income patients.

The paper suggests a primary care process re‐design, using point of care finger‐stick HbA1c testing under a standing order protocol that provided test results to the provider at patient visit.

The paper finds that the protocol was well received by both nurses and physicians. HbA1c testing rates increased from 73.6 percent to 86.8 percent (p=0.40, n=106). For the 69 patients who had both pre‐ and post‐intervention results, HbA1c levels decreased significantly from 8.55 to 7.84 (p=0.004, n=69). At baseline, the health center as a system was relatively ineffective in responding to elevated HbA1c levels. An opportunity to intensify, i.e. a face‐to‐face visit with lab results available, occurred for only 68.6 percent of elevated HbA1c levels before the intervention, vs. 100 percent post‐intervention (p<0.001). Only 28.6 percent of patients with HbA1c levels >8.0 had their regimens intensified in the pre‐intervention phase, compared with 53.8 percent in the post‐intervention phase (p=0.03).

This was a pilot‐study in one urban health center. Larger group‐randomized controlled trials are needed.

The health center's performance as a system, improved significantly as a way of intensifying diabetic regimens thereby achieving improved glycemic control.

This intervention is feasible, replicable and scalable and does not rely on changing physician behaviors to improve primary care diabetic outcomes.

A curious reaction to the Post‐War Policy Report of the Library Association is beginning to make itself articulate. Educationists, who are likely to be vocal in the matter, say that the three principles on which it is based are not in sufficient agreement for practical use. The Library Association wants local autonomy, while interfering most drastically with the small towns which are the very foundation of such autonomy; it advocates the educational value of libraries but is emphatic that they must live separately from the official education organization; and they should have government grants but be absolved from government control. There is a symposium covering some of these points in the Spring, 1944, number of Library Review, where are brought to bear the views of Professor H. J. Laski, as a former chairman, Mr. Frederick Cowles, as representing a small town library, Mr. F. M. Gardner, from a rather larger one, Mr. Edward Green, the former librarian of Halifax, whose enthusiasm is as great as ever, and Mr. Alfred Ogilvie, who speaks for county libraries, from Lanarkshire. Most of the contributions are severely critical and all are worth study.

WITH eloquence which we cannot imitate, or repeat, the national loss has been sufficiently expressed by others. It is true, Kipling and William Watson being dead, and Alfred Noyes silent, the poets have not risen to the height of a great occasion, but that is by the way. Our own tribute to the late King must be based on his work for libraries, since any other tribute is general to a whole Empire. Kings can have few hours in which to read and yet some of the stories, true or apocryphal, of King George V. touch upon his reading. He showed, however, a closer interest of late years in libraries than any other of our monarchs has done, and at the opening ceremonies of the National Central Library and the Manchester Public Library he uttered words which are the best slogans that libraries have received. Even if he did not write them—a matter which we have no right to affirm or deny—his utterance of them gave them the royal superscription. We repeat them, as they cannot be too often repeated:—

This article analyzes the economic policy reform experience of three less developed countries (LDCs) during the 1980s -- Costa Rica, Ghana and Jamaica -- in three policy areas, exchange rate, trade, and agriculture. A political management model that shows how strong but skillful political leadership is as critical to policy reform success as is economic content is used for the analysis. The model proposes that government officials have to make policy reforms politically feasible if the reforms are to succeed. The assumption is that successful decision makers will take three kinds of political initiatives: (1) appeal to national sentiments, (2) seek the collaboration of affected interest groups, and (3) manage external actors. The article provides evidence that the economic perfomance of three countries correlated with the degree of political initiative taken. Costa Rican policy elites demonstrated the highest level of 1initiative. Ghana ranked second in political management, and Jamaica ranked third. The success of some LDCs also provides instructive experience for the Clinton Administration as it moves forward with a variety of policy reforms.