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The purpose of this paper was to evaluate health conditions prior to and at least two months after the start of consuming raw fermented milk (RFM) products.

One-Item health score, 1-item immunity score, immune status (ISQ), mood, bowel and skin conditions were rated for the period prior and post switching to RFM products. A linear mixed model was used to evaluate the post to prior RFM health and mood scores, taking into account gender, location of living and health group. Data from 390 participants (mean age of 54 years old) were included for the analysis, of which 277 (45 per cent) were allocated to the poor health group. Participants were allocated to the poor health group if they reported being immune depressed or suffering from a chronic disease prior to RFM; otherwise, they were allocated to the normal health group.

The highest intake of RFM was from RF kefir. Post RFM, people consumed around 1 glass (200 ml) of RF kefir per day. After switching to RFM, significant improvements on health and mood scores were reported. The strongest improvements after switching to RFM consumption were seen in subjects from the poor health group. With the exception of skin score, all measured health items significantly improved (p < 0.001). Health, immunity, bowel and mood scores increased with around 20 per cent in the poor health group and around 8 per cent in the normal health group. Women had more health complaints prior to RFM and had stronger health improvement post RFM compared to men. Bowel and mood scores were overall lower in women than in men. Living location had no significant impact on RFM-related health changes. This consumer survey suggests that positive health and mood changes are associated with the consumption of RFM products.

The consumption of RFM products improved the self-reported health status of adults. Immune-depressed people or people suffering from a chronic disease prior to RFM reported the strongest impact on their health, immunity, bowel and mood scores post switching RFM consumption compared to people with a normal health.

Our objective was to compare the physical health status of adult prisoners with and without a mental illness. Mental illness was diagnosed in a sample of 557 Australian prisoners using the Composite International Diagnostic Interview (CIDI). Physical health measures included self‐reported chronic health conditions, recent health complaints and symptoms, self‐assessed health using the Short‐Form 36 Health Survey (SF‐36), and markers of infectious diseases known to be highly prevalent among prisoner populations (hepatitis A, hepatitis B, and hepatitis C). Men and women with a mental illness had lower scores on the SF‐36 compared with those without a mental illness indicating poor overall health. Adjusting for age and sex, a diagnosis of any mental illness (symptoms of psychosis, anxiety or affective disorder) was positively associated with a history of head injury, back problems, asthma, peptic ulcers, cancer, and epilepsy/seizures. There was a significant association between post traumatic stress disorder and asthma, a history of head injury, peptic ulcers, and cancer. There was no significant difference in the proportion of current tobacco smokers in the mentally ill and nonmentally ill groups (81% vs. 77%, p = 0.33). However, those with a mental illness were less likely than those with no diagnosis to exercise in the past 4 weeks (79% vs. 89%, p = 0.002). Mentally ill prisoners also have significant physical co‐morbidity compared with the non‐mentally ill. These findings suggest that those providing mental health services to prisoners should adopt a holistic approach embracing both mental and physical health.

Thailand, like a number of other less‐developed countries, has experienced a rapid rise in the share of its national product that is being devoted to health. This paper examines the ways in which the country is paying for its preventive and curative care. Section 1 provides the context by discussing age‐structure and geographical distribution of the population, together with the rates of mortality and morbidity. Section 2 explores the delivery of medical attention, private and State. Section 3 evaluates seven ways in which medical care is financed in Thailand. It also makes recommendations for the future of social insurance which are of relevance both to Thailand and to other countries at a similar stage of economic development.

The purpose of this paper is to investigate the impact of total quality management (TQM) and supply chain management (SCM) practices on operational performance, and their interlinkage between each other.

Constructs those are critical to pharmaceutical quality and supply chain have been identified with the help of literature and experts from industry. The impact of TQM practices on supply chain practices and on operational performance has been evaluated. Similarly, the impact of supply chain practices on operational performance has been evaluated. Further, alternate models are tested and evaluated through structural equation modeling.

It was observed during testing of alternate models that TQM practices have a direct impact on operational performance. However, TQM practices also directly impact supply chain components, which, in turn, influence overall operational performance. In comparison of alternate models, the model in which TQM practices affect supply chain practices and supply chain practices further affect the operational performance is found most appropriate.

This study provides some useful implications from industry point of view. TQM practices are critical to pharmaceutical industry. TQM practices are the core of attaining a smooth supply chain, which will have greater impact to achieve operational performance. Strategic supplier partnership, procurement management, information sharing, and quality and inventory management practices are driven by TQM practices. This tri-linkage helps to achieve the desired operational performance.

There are very limited studies that have considered both the areas together to achieve better operational performance. In pharmaceutical industry, both TQM and SCM are the critical areas for any organization to drive its growth.

There is growing statistical and research evidence to suggest that the prevalence of alcohol misuse is increasing among older adults in the UK. This has been an under‐recognised problem, but is now a source of increasing concern for health and social care providers. Older adults with mental health problems have increased vulnerability to problematic alcohol use, and this is likely to have a significant impact on older people's mental health services (OPMHS).

This paper discusses some of the problems facing OPMHS in relation to increasing alcohol misuse among services users.

There is also evidence that alcohol misuse in older adults is often poorly identified and untreated within health and social care services including OPMHS. Use of an alcohol‐screening tool as part of a health care assessment is an effective way to improve detection. This paper also reviews the use of alcohol screening tools in the detection of alcohol related illness among older adults with mental health problems and proposes a care pathway for the management of alcohol misuse in OPMHS.

Current evidence indicates that the prevalence of alcohol misuse among older adults is increasing and is likely to rise further due to the reasons discussed in this paper.

The mammoth proportions of Public Expenditure, its accountability, its control, must be one of the biggest problems any government has had to meet. Despite all its counselling to the public spenders, its massive efforts to scale down the spending, there is extremely little to show for it. The Departments and State Services have become so large, they have outgrown government control; they are in fact forms of government in themselves. When a body established with a definite role becomes so big and powerful, as many of the authorities in the country have become, they tend to resent any form of control over them. History has many such examples in one form or another. Where an ocean divides them, the subordinate power may seek a separate nationhood for itself, as the American colonies did a couple of centuries or more ago. They chose the right moment to rebel when the home government sought to pass on extra levy on the importation of tea, which the Colonists turned into a slogan “no taxation without representation”. The truth, however, was they had outgrown the mother country and saw themselves as a new nation in a new land immensely rich in natural resources, riches all theirs for the taking. Much of the old country understood their aspirations and in the final settlement, the British were more than generous to them.

The division between town and country in most areas of the world is marked and shows little evidence of any closer association, but in this country recent history with its wide economic changes has made the division less deep than in times past, but still within living memory. Time was when country folk were almost a distinct breed, living under conditions for the most part primitive.

The way of thought and vision and memory is that they often come upon you unexpectedly, presenting nothing new but usually with a clarity and emphasis that it all seems new. This will sometimes happen after a long period of indecision or when things are extremely difficult, as they have long been for the country, in most homes and among ordinary individuals. Watching one's life savings dwindle away, the nest‐egg laid down for security in an uncertain world, is a frightening process. This has happened to the nation, once the richest in the world, and ot its elderly people, most of them taught the habit of saving in early youth. We are also taught that what has been is past changing; the clock cannot be put back, and the largesse—much of it going to unprincipled spongers—distributed by a spendthrift Government as token relief is no answer, not even to present difficulties. The response can only come by a change of heart in those whose brutal selfishness have caused it all; and this may be a long time in coming. In the meantime, it is a useful exercise to consider our assets, to recognize those which must be protected at all costs and upon which, when sanity returns, the future depends.

In a Northern city, which claims to have more than 12,000 Commonwealth immigrants, mostly of Asian origin—Pakistanis and Indians, an increasing number of whom have been joined by their wives and families, there was instituted in 1965 a routine examination of their children before school entry, later extended to children of immigrant origin already in the schools. This examination extended to haemoglobin estimation, tuberculin‐testing and, equally important, examination of the stools for pathogens and parasitic ova. 419 entrants were examined in the first half of 1965 and 898 pupils. Parental co‐operation must have been excellent, as parents all agreed, without exception, to the special examination, although to some extent, there might have been considered legal authority in the current School Health Service (Medical Inspection) Regulations made under the Education Act, 1944. We are not aware of any report of intestinal pathogens, but helminth infestations were reported (Archer D. M., Bamford F. N., and Lees E., Helminth Infestations in Immigrant Children, 1965, Brit. Med. J., 2, 1517), from which it appears 18·6% carried five types of worm, of which the commonest was hookworm. It would be fair to assume that helminth infestation, indicating as it does, exposure to food infections, water‐borne disease and environment generally, is an index of gastro‐intestinal infection and the presence of pathogens, including the carrier state.

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.