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Child welfare services (CWSs) globally continue to absorb high rates of children living with or suspected of fetal alcohol spectrum disorder (FASD). Such high prevalence rates render CWS with major ethical and moral dilemmas of meeting complex needs. Currently, many jurisdictions are challenged by diagnostic capacity and cost implications of formal FASD diagnosis. This paper aims to recommend a screening protocol to address management gap between FASD initial presentation and formal diagnosis.

This is a follow-up paper from a grounded-theory study of a sample (N = 18) of child welfare social workers (CWSWs), allied health professionals and foster parents. A stepwise protocol was developed through systematical interpretation of the final data.

The application of a five-step screening protocol would greatly support CWSW in meeting the needs of children with suspected FASD. This CWSWs-led assessment model incorporates a clinical evaluation to exclude neurodevelopmental conditions caused by known genetic disorders, followed by behavioral and neurocognitive psychosocial assessments.

This study had several limitations. Firstly, as a specific social work-based sample, it is not necessarily representative of the wider population of social workers globally due to different cultural responses to FASD in CWSs. The transferability of findings will have to be considered due to cultural variations concerning FASD.

By offering a management and nonlabeling approach, this five-step screening protocol offers a delineated pathway for CWSW and addresses the major professional frustrations while seeking to plan safe care for a child suspected of having FASD.

The research offers a pragmatic low-cost to society to alleviate the mounting social and monetary implications of FASD. A large percentage of children impacted by prenatal alcohol exposure do not qualify under formal clinical diagnostic guidelines. Leaving these children without intervention is problematic. The recommendation of this study addresses this critical gap in services. The primary aim is to alleviate the burden on this cohort of vulnerable children by offering nonlabeling neurodevelopmental screening.

The direct implications of FASD and how it impacts CWS are well documented. However, few studies focus on the critical interface of FASD and the role of CWSW responsible for planning their safe care. This paper offers a novel pragmatic and functional multistep protocol to aid CWSW in this complex area of practice.

In the early 1970s, clinical evidence emerged documenting causal links between prenatal alcohol exposure (PAE) and children’s behaviors as observed by child welfare social workers (CWSWs). Unfortunately, fetal alcohol spectrum disorders (FASD) remain on the margins of public health priorities. The purpose of this study was to elicit the views of child welfare social workers when responding to case of or suspected FASD.

A sample (N = 18) of CWSWs, allied health professionals and foster parents were interviewed.

Findings indicate that social workers struggle with their statutory duty to plan safe care for children with or suspected of having FASD. Emergent themes include struggling with advocacy, professional devaluation and lack of procedural guidance.

Social workers need a clear pathway and FASD knowledge to guide their interventions and enhance their capacity to advocate for affected children.

An abundance of research documents the direct effect of PAE on physical, cognitive and behavioral outcomes. However, few studies focus on the critical interface of children with an FASD entering public care and the social workers responsible for planning their safe care. This study sought to document social workers’ response to this vulnerable cohort of children.

A distinction must be drawn between a dismissal on the one hand, and on the other a repudiation of a contract of employment as a result of a breach of a fundamental term of that contract. When such a repudiation has been accepted by the innocent party then a termination of employment takes place. Such termination does not constitute dismissal (see London v. James Laidlaw & Sons Ltd (1974) IRLR 136 and Gannon v. J. C. Firth (1976) IRLR 415 EAT).

“Support a lawyer. go to med school” The above message on the car bumper stickers of members of the medical profession reflects their reaction to the current escalation of malpractice suits filed by attorneys against doctors and hospitals. The impact of these suits against medical personnel and institutions is not limited to patients, doctors and lawyers; the ripple‐effect reaches the entire community, because the rising incidence of malpractice suits tends to increase the cost of malpractice insurance and ultimately the total cost of health care to all members of society. Malpractice is but a small, though highly visible, part of a broader spectrum of interaction between medicine and law. “The complexities of modern society are causing law and medicine to interface with increasing frequency to the extent that contact with the legal process has become an inescapable aspect of the physician's life.” In recognition of this increasing frequency of contacts between medicine and law, a correspondingly increasing number of medicolegal reference works have been published, as exemplified by the selective list which follows this introduction. These should be of direct interest to doctors and members of allied health professions, to attorneys and paralegals and, indirectly, to all who deal with medical personnel and institutions. Traditionally, attorneys, particularly members of the trial bar, have demonstrated a continuing interest in medical literature. For example, the Merck Manual and Goldstein's Medical Trial Technique are familiar to most trial lawyers. They are expected to be well acquainted with anatomy charts, texts on internal medicine, eye, ear, nose and throat, orthopedics, obstetrics, and pediatrics, to name but a few generic medical works of interest to trial lawyers. It should be noted that the lawyer's interest in medical literature is not necessarily motivated by a desire to harass doctors, nurses and hospitals. Attorneys are bound by their Code of Professional Responsibility to represent their clients competently and zealously. In discharging this ethical obligation, the attorney frequently calls upon a physician to testify as an expert witness concerning the cause of a personal injury or death. Consequently, the attorney should be knowledgeable in medical theory and terminology. Furthermore, in pursuit of interdisciplinary competence, a significant number of individuals in the United States have earned both the medical degree and the law degree and appropriate licenses to practice, e.g., Cyril Wecht, M.D., J.D., Director, Pittsburgh Institute of Legal Medicine, Duquesne Law School, member, Faculty of the Pittsburgh School of Medicine and Dentistry, Coroner, Allegheny County, Pennsylvania.

The purpose of this paper is to investigate the extent, range and nature of literature concerning the mental health inpatient care of the young adult population (16-25 years) who have been admitted to adult mental health wards. This paper reports the findings and positions these in the context of the broader nature to adult inpatient care, evaluates the quality of the evidence and identify gaps in the literature.

This paper uses an adapted scoping review methodology, allowing for a broad search but utilised established steps that allowed for a structured, rigorous approach to be used. CINAHL, Cochrane Library, MEDLINE, PsycINFO, Google Scholar, plus a secondary hand search were conducted resulting in eight papers, of quantitative, qualitative and mixed methods papers.

Findings show admissions follow similar paths as to adults; admission reasons are largely unknown beyond simple descriptors; admission lengths are unknown whilst on adult wards; staff feel confident yet lack resources; young people feel the transition from CAMHS ward to adult ward can be beneficial if done sensitively; young people have positive experiences of adult wards, including factors that may not be present on CAMHS wards, e.g. role modelling by older patients; young people feel scared and vulnerable, including when excluded from decision making; however, involving young people can cause stress and be confusing if not done sensitively.

The scoping review identified a limited amount of research evidence for the care of young people admitted to adult wards. The research methods used in these papers were varied and none was of a high-quality standard. All studies contained methodological gaps which detract significantly from their findings and conclusions. The studies go some way to fill the gaps in knowledge and evidence base for this group, although in doing this scoping review was to unearth more gaps in knowledge.

This scoping review collates findings from the literature regarding young people’s admissions to adult mental health wards. This sensitive and controversial area of mental health care is shown to be lacking in high-quality research. Young people are being admitted to adult wards in increasing numbers year on year in the UK, yet little research has been conducted to identify when and where treatment has been appropriate. This review provides a start to understanding what is known about admission and treatment for this group and what is not known so that these gaps may be investigated in future research.

With the beginning of the twentieth century, preventive medicine is entering upon a new era. We are now confronted by a set of problems which are different in many respects from the problems so successfully attacked by the great masters of preventive medicine of the last century, and which call for the application of different preventive measures. The objects which Edwin Chadwick, John Simon, and our other great forerunners of the last century, sought to attain, and which to a large extent they did attain, may, I think, not unfairly be described by the phrase “ civic cleanliness.” They sought to provide pure water supplies ; to remove refuse and filth from the vicinity of human beings by establishing improved systems of drainage and sewerage, and better methods of dust collection ; to provide open spaces and wider streets; to pave streets, yards, etc.; to raise the sanitary standard of building construction; to provide proper burial grounds ; to regulate offensive trades ; and to abate the smoke nuisance and the pollution of rivers. Of course we all know that they did very much more than this. Their work was too great and its effect too far‐reaching to be described by any single phrase. Still, I think it not unfair to say that, broadly speaking, we may regard the attainment of civic cleanliness as the great object of cur public health administration in the nineteenth century. It cannot be said that this object has been wholly attained. In a country whose capital is still supplied with something like filtered sewage as drinking water, it is obvious that there is much yet to be done to secure civic cleanliness. But the point is that any further progress in this direction must, or should, take place on the lines already laid down by our predecessors. Their methods of civic sanitation have stood the test of experience, and all that is wanted is a further development on existing lines. It is otherwise with the new problems that now press for solution. These are problems of a different nature, and demand new methods of treatment, although the principles underlying the methods will be found, probably, to be the same. Preventive medicine in the nineteenth century was chiefly occupied with problems of civic cleanliness ; in the twentieth century we are confronted with the problems of personal hygiene, and the three problems of this kind which appear to me to call most urgently for solution at the present time are: (1) The problem of infantile mortality; (2) The problem of school hygiene; (3) The problem of the milk supply.

The term “medical” will be interpreted broadly to include both basic and clinical sciences, related health fields, and some “medical” elements of biology and chemistry. A reference book is here defined as any book that is likely to be consulted for factual information more frequently than it will be picked up and read through in sequential order. Medical reference books have a place in public, school, college, and other non‐medical libraries as well as in the wide variety of medical libraries. All of these libraries will be considered in this column. A basic starting collection of medical material for a public library is outlined and described in an article by William and Virginia Beatty that appeared in the May, 1974, issue of American Libraries.

Henry George came to maturity at a time when the simplicity and democratic values that had governed the United States were under assault. Slow and placid rhythms of life prevailed, but their future would be brief. Factories were flinging mass-produced goods into an economy accustomed to expecting a hat or a pair of shoes to come to an individual consumer from a local craftsman, or perhaps from a merchant drawing craft products from small shops at some distance. Canals and then rail tracks had begun slicing into the backcountry. Cities were taking on a character Americans might more quickly have expected of ancient times: overcrowded housing, uncollected sewage, the ravages of cholera, and the spread of street crime.