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LINKman, a supervisory control system embodying expert system techniques, is paying for itself in as little as six months.

This article is a report of a symposium on quality assurance in mental health services which took place on 10 March 1989 at Tone Vale Hospital, Taunton.

National treatment guidelines regarding Borderline Personality Disorder (BPD) (National Institute for Health and Clinical Excellence, 2009) make a number of recommendations relating to system and cultural treatment variables including: access to services, autonomy and choice, developing an optimistic and trusting relationship and managing endings and transitions. The purpose of this paper is to look at a model which could help organisational effectiveness across a range of service settings in relation to personality disorder.

Explanation of why the McKinsey 7S organisational model (Waterman et al., 1980) may be useful in assessing organisational effectiveness in relation to personality disorder.

Cultural and organisational factors across a range of levels need to be aligned to allow for effective service delivery. This is particularly important in working with this client group where strong emotional reactions and subsequent organisational splits are common.

The application of this tool within clinical leadership and service development would be particularly important for coherence within generalist (as opposed to specialist) settings.

To the authors’ knowledge this analysis is unique as a review of NHS culture across a range of settings and discussion of the implications for service delivery for patients with BPD.

If we could be made moral by Act of Parliament there would be no such things as “ hold ups ” and food sophistication. Of these two evils I should prefer the former had I the choice. It is no more blameworthy, it is less harmful, and it is not likely to become a permanent feature of our social life. A successful “ hold up ” is by the nature of the case self‐advertising. It forms the basis for a “ drama ” or a “ sensation.” It “sells well” and is honoured with “displayed” head lines. On the other hand, a police chase at sixty miles an hour over half a county when the true nature of raspberry jam is in question is unthinkable. Publicity, if you can get it, has, like adversity, its “ sweet uses.” It makes the public “ sit up and take notice” and brings the offence, if not the offender, into the limelight. But the chase of, what A. H. Allen, of Sheffield, once called, “ the poor unfortunate adulterator ” calls frequently for a degree of ingenuity on the part of the executive officers of a local authority that suggests the wonders of detective fiction. The sport may require a good deal of ground bait before the fish is hooked, or, to vary the metaphor, several full dress rehearsals before the one and only performance is staged and the fine of one guinea and costs inflicted. Our “hold up” friend “does time,” and for the period of his sentence can do no further mischief, while the merchant in search of illicit profits seldom gets further than the police court, and if a large business concern which has “ neither a body to be kicked or a soul to be damned ” happens to be the offender, then eminent counsel is briefed, legal entities and quiddities are politely discussed, no one's feelings are hurt, a fine may be inflicted—which, in any case, is relatively trifling and is written off as a bad debt—and “the prisoner leaves the court amid the congratulations of his friends.” In neither case is the slightest social injury inflicted. Bill of Pimlico or Walworth has nothing to lose, the “ directors ” have lost nothing. If the way of transgressors be hard, then the case of the adulterator is the exception which proves the rule.

EVERYONE interested in the British library movement will learn with sorrow and regret that one of its greatest friends and strongest champions has passed away, in the person of Thomas Greenwood, the kind‐hearted and generous advocate of libraries, who won the respect and regard of every English libiarian. From one of his own periodicals the following particulars are abstracted:—

Application of the numerical method to the art of Medicine was regarded not as a “trivial ingenuity” but “an important stage in its development”; thus proclaimed Professor Bradford Hill, accepted as the father of medical statistics, a study still largely unintelligible to the mass of medical practitioners. The need for Statistics is the elucidation of the effects of multiple causes; this represents the essence of the statistical method and is most commendable. Conclusions reached empirically under statistical scrutiny have mistakes and fallacies exposed. Numerical methods of analysis, the mathematical approach, reveals data relating to factors in an investigation, which might be missed in empirical observation, and by means of a figure states their significance in the whole. A simplified example is the numerical analysis of food poisoning, which alone determines the commonest causative organisms, the commonest food vehicles and the organisms which affect different foods, as well as changes in the pattern, e.g., the rising incidence of S. agona and the increase of turkey (and the occasions on which it is served, such as Christmas parties), as a food poisoning vehicle. The information data enables preventive measures to be taken. The ever‐widening fields of Medicine literally teem with such situations, where complexities are unravelled and the true significance of the many factors are established. Almost every sphere of human activity can be similarly measured. Apart from errors of sampling, problems seem fewer and controversy less with technical methods of analysis then on the presentation and interpretation of figures, or as Bradford Hill states “on the application of common sense and on elementary rules of logic”.

A boarding school research center annually invites students, professors, and others to collaborate with faculty members, forming interconnected communities of practice. The authors interviewed visitors to determine how their experience contributed to their identity as a scholar and the extent to which they felt part of a community of practice. Categorizing emergent themes according to Wenger's (1998) categories of communities of practice, we identified six subthemes that characterize their experience. All participants valued their stay and expressed a desire to remain connected to the school, visiting scholars, and other people they met and now consider part of their network.

At each New Year we stand at the threshold of fresh scenes and hopes, of opportunities and pastures new. It is the time for casting off shackles and burdens that have weighed us down in the old year; almost a new chapter of life. We scan the prevailing scene for signs that will chart the year's unrolling and beyond, and hope profoundly for a smooth passage. The present is largely the product of the past, but of the future, who knows? Man therefore forever seems to be entering upon something new—a change, a challenge, events of great portent. This, of course, is what life is all about. Trends usually precede events, often by a decade or more, yet it is a paradox that so many are taken by surprise when they occur. Trends there have been and well marked; signs, too, for the discerning. In fields particular, they portend overall progress; in general, not a few bode ill.

One of the major developments of the post‐War years has been the rise of consumer protection ‘watchdog’ committees galore, a flood of legislation and completely changed enforcement methods by existing local authority officers who to all and intents have become a completely new service. Voluntary agencies, national and local, based on the local High Street, have appointed themselves the watchdogs of the retail trade; legislation and central departments, the larger scene. The new service has proved of inestimable value in the changed conditions; it continues to develop. When shopping was a personal transaction, with the housewife making her purchases from the shopkeeper or his staff on the opposite side of the counter; when each was well known to the other and the relationship had usually lasted for many years, often from one generation to the next, things were very different, complaints few, unsatisfactory items instantly replaced, usually without question. This continuing state of equanimity was destroyed by the retail revolution and new methods of advertising and marketing. Now, the numbers of complaints dealt with by consumer protection and environmental health departments of local authorities are truly enormous. We have become a nation of “complainers,” although in all conscience, we have much to complain about. Complaints cover the widest possible range of products and services, of which food and drink form an integral component. The complaints to enforcement authorities include many said to be unjustified, but from the reports of legal proceedings under relevant enactments, it is obvious that the bulk of them now originate from consumer complaints. Not all complainants, however, relish the thought of the case going before the courts. Less is heard publicly of complaints to the numerous voluntary bodies. Enforcement authorities see complaints in terms of infringements of the law, although their role as honest broker, securing recompense to the aggreived customer, has become important; a few departments being able to claim that they secured reimbursements and replacements of value totalling upwards of amounts which annually run into six figures. The broker role is also that adopted by voluntary bodies but with much less success since they lack the supporting authority of legal sanction.