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Raising a child with learning and developmental disabilities in a low-income setting is challenged by inadequate resources, limited support and poverty. The impacts on caregivers include fatigue, distress and isolation. The purpose of this paper is to report on a programme (2008-2021) that was set up in Kilifi County, Kenya to investigate and address these difficulties.

The programme used mixed methods through a series of interconnected studies, starting with a situation analysis, followed by a home-based intervention where the caregiver served as agent for change using augmentative and alternative communication (AAC) methods. This was followed by two community-based inclusive development initiatives: disability awareness training to community groups and empowering self-help groups for caregivers of children growing up with disabilities.

The situation analysis revealed scarce support services for caregivers and children with learning and developmental disabilities, with report of limited resources, inadequate coverage and poor professional practice. A home-based, AAC intervention was associated with improved caregiver well-being, significant positive changes to caregiver perceptions of the child’s communication and some expansion to the child’ social activities. However, questions around sustainability persisted. Disability awareness training led by persons with lived experience of disability showed positive changes to the views, values and attitudes of established community groups. Caregiver participation in self-help groups was associated with their greater personal agency, perceptions of increased social support and reduced severity of child’s disability.

The programme narrative demonstrates a rationalised and evidence-based process for community-based inclusive development that is low cost, culturally acceptable, with potential for sustainability.

Few will complain that 1974 has not been an eventful year; in a number of significant respects, it has made history. Local Government and National Health Services reorganizations are such events. This is indeed the day of the extra‐large authority, massive monoliths for central administration, metropolitan conurbations for regional control, district councils corresponding to the large authorities of other days; and in a sense, it is not local government any more. As in other fields, the “big batallions” acquire greater collective power than the total sum of the smaller units, can wield it more effectively, even ruthlessly, but rarely appearing to take into account the masses of little people, the quiet people, who cannot make themselves heard. As expected, new names of authorities are replacing the old; new titles for departments and officers, ambitious and high‐sounding; a little grandiose for the tongues of ordinary folk. Another history‐making event of 1974, in the nature of a departmental transfer but highly significant for the course of future events as far as work in the field is concerned, was handing over of the personal health services—health of expectant mothers, babies, children, domiciliary midwifery, the school health services and their mainly medical and nursing personnel—from local health authorities to the newly created area health authorities. The public health departments over fifty years and more had created them, built them up into the highly efficient services they are. If anything can be learned from the past, new authorities are always more expensive than those they replace; they spend freely and are lavish with their accommodation and furnishings. In their first few months of existence, the new bodies have proved they are no exception. News of their meetings and activities in many areas is now scanty; even local newspapers which usually thrive on Council news—or quarrels—seem to have been caught on the wrong foot, especially in the small towns now merged into larger units. The public are relatively uninformed, but this doubtless will soon be rectified.

During the year the appointments of 32 Public Analysts were approved. The number of samples of food analysed by Public Analysts during the year 1933 was 138, 171, a slight increase over the number reported in the previous year. 7,601 samples were reported as adulterated or not up to standard. The percentage adulterated or below standard was 5·5. In the two previous years the percentages were 5·1 and 4·6 respectively, the latter being the lowest recorded. There were 380 infringements of the Public Health (Preservatives, &c., in Food) Regulations, a considerable reduction as compared with the number reported in any previous year. In 138 instances the food contained preservatives prohibited by the regulations, e.g., boron preservative in cream, sausages, meat pies, rennet and other articles; sulphur dioxide in sweets, minced, potted and other meat, desiccated soup, pepper, vinegar and table jelly; formaldehyde in milk; salicylic acid in lime juice and non‐alcoholic wine; and benzoic acid in caviare. Preservative in excess of the permissible amount was reported in 81 instances, including samples of sausages, jam, dried fruit, orange and lemon squashes, lemon juice, and non‐alcoholic wine and beer, while a preservative powder labelled as containing 12 per cent. of sulphur dioxide contained more than that amount. In 160 samples the preservative would have been permissible if its presence had been declared on the label. The number of samples of milk analysed was 74,545, of which 5,760 (or 7·7 per cent.) were reported to be adulterated or not up to standard. Soma local authorities also arrange for the informal testing of samples by their officers, but particulars of these are not available. 1,068 “appeal to cow” samples, i.e., samples taken at the time of milking, were analysed and 380, or 35·6 per cent., were reported to be below the presumptive standard of the Sale of Milk Regulations, 1901. Excluding “appeal to cow” samples, the number analysed and the percentage adulterated or below standard were, respectively, 73,477 and 7·3. The vendor of a sample which was reported to be 23 per cent. deficient in milk fat and to be coloured with annatto was prosecuted and fined 3 guineas and 1 guinea costs. There were 8 other cases in which added colouring matter was reported, and in several instances the vendors were convicted and fined. The presence of visible dirt was reported in 8 samples and of formaldehyde in 6 samples. Another sample was found to contain 1·79 grains per gallon of sulphur dioxide. 24 samples of graded milk were stated to be deficient in milk fat, the amount of the deficiency in one case being as much as 48 per cent., and 20 samples of skimmed milk were reported as deficient in non‐fatty solids, one being stated to contain 79 per cent. of added water. 1,171 samples of condensed milk were analysed, of which 24 were reported against. 16 contained the equivalent of less milk than indicated on the label, 5 were deficient in milk solids, 2 were unsound and unfit for consumption, and 1 contained 125 parts per million of tin. The number of samples of dried milk analysed was 207, and 8 were reported against. Two were deficient in milk fat, 3 which were sold as full cream milk should have been sold as skimmed milk, 1 was unlabelled, 1 contained the equivalent of less milk than indicated on the label and the remaining sample was not dried milk within the meaning of the Public Health (Dried Milk) Regulations. The number of samples of cream reported upon was 2,171, and in 59 cases adverse reports were given. Eighteen contained boron preservative, 11 sold as cream were reconstituted or artificial cream, 9 were deficient in milk solids, and 3 were reported against because of the presence of fat not derived from milk. Fifteen samples, some of tinned cream, were deficient in milk fat. One sample of tinned cream labelled as “a highly concentrated and rich cream” contained only 24 per cent. of fat, and 2 samples of tinned sterilised cream labelled “Pure Rich English Clotted Cream” contained only 25 per cent. of fat. The Analyst stated that a “cream containing only this amount of fat can hardly be described as ‘rich,’ since ordinary fresh cream contains on an average about 50 per cent. of fat. Clotted cream is manufactured by a special process and usually contains about 60 per cent. of fat.” Out of 8,903 samples of butter reported upon, 83 were stated to be adulterated or below standard. 67 contained water in excess of the legal maximum of 16 per cent., the vendor of a sample containing 36·5 per cent. of water being prosecuted and fined £2. Three samples contained excess free fatty acid, 12 consisted wholly or partly of margarine, and the remaining sample contained boron preservative. 3,180 samples of margarine were analysed, and the number reported against was 16; 2 contained milk fat in excess of the legal maximum of 10 per cent., 1 sold in error consisted wholly of butter, 10 were found to contain water in excess of the legal maximum of 16 per cent., and 3 were unsatisfactory both on the latter ground and because of not being properly labelled. The number of samples of lard reported upon was 2,688, only 3 adversely. Two consisted wholly of substitute fat and the third contained cotton seed oil. 414 samples of suet were analysed; 38 samples, of which 33 were “shredded” suet, contained an excess of rice flour or other starch. Out of 578 samples of dripping, 7 were reported upon adversely, 2 as consisting entirely of hog fat, 4 as containing excess water or excess free fatty acid, and one as being rancid and unfit for human consumption. The number of samples examined was 1,392, 5 sold as “Cheshire Cheese” were deficient in fat, the deficiency in one case being 53 per cent., 6 samples wrapped in tinfoil contained excess tin amounting in one case to 7·2 grains per lb., and 3 sold as cream cheese were made from whole or separated milk. 273 samples of bread were analysed; 4 were affected with “ropiness,” and one sample, submitted for analysis by a private purchaser, was reported to contain powdered glass. Investigation failed, however, to discover the source of the adulterant. The number of samples of flour analysed was 1,370, of which only 2 were reported against. One contained about 2 per cent. of soap flakes, presumably due to accident, and one sample of self‐raising flour contained an excess of bicarbonate of soda. 1,773 samples were analysed and 124 or 7 per cent. were found to be adulterated or below standard, a considerable increase on the proportion reported against in any previous year. The majority of these were deficient in the fruit specified on the label or contained other fruit, 25 contained preservative in excess of the amount permitted, while 5 were deficient in fruit and also contained more than the permitted amount of preservative. One sample contained a considerable amount of fungus. Proceedings were successfully taken in several cases and penalties were imposed. The samples reported upon numbered 1,746, of which 135 were stated to be adulterated or below standard. 9S were deficient in acetic acid, and 34, described as malt or table vinegar, consisted wholly or partly of artificial vinegar. Three samples contained prohibited preservative. In a number of cases proceedings were successfully taken and penalties imposed. The vendor of a sample sold as malt vinegar, which was wholly artificial vinegar, was fined three guineas and one guinea costs, and a similar penalty was imposed on a vendor of artificial vinegar found to be 72 per cent. deficient in acetic acid. The number of samples of spirits analysed was 1,947, of which 132 were reported against because the spirit had been reduced more than 35 degrees under proof. Of the samples reported against 85 were whisky, 26 rum, 14 gin and 7 brandy. Out of 420 samples of beer, 3 were adversely reported upon, one as containing phenolic disinfectant, one as being a non‐alcoholic imitation, and the third as containing more than the permitted amount of preservative.

Healthcare is both the largest (17 + percent) and the most rapidly growing (three plus times the consumer product index (measure of inflation) and half a percent of gross domestic product each year) segment of the US economy. The purpose of this paper is to focus on outcome successes that illustrate application of a previously reported health equation. The health equation allows an organized and more transparent assessment of healthcare outcomes.

The approach includes “end use/least cost” techniques that identifies healthful care as a big unmet need (BUN) and equally attractive business opportunity in identifying health promotion that improves outcome at lower net costs.

Opportunity exists to reduce costs while also reducing adverse events, healthcare morbidity and morality. Transparency is essential to find what works more effectively to yield desired outcomes. Metrics and measures, particularly more precise tools to assess true outcome in promoting health or managing ill health, are given priority as they allow quantified and, often econometric, outcome opportunities in the midst of current uncertainties.

This paper is for consumers and businesses, managers and administrators, professionals and allied health professionals. The successes described herein illustrate fundamental opportunities driving change and innovation within healthcare and in our society.

Attention is called to opportunity areas that can fund out of savings the transition from the authors' current “sickness care” system to a healthful care, proactive prevention approach to delivering care. Novel application of transparency and end use/least cost can help guide choices to achieve healthier outcomes.

In a recent reference to changes brought about by the local government reorganisation of 1974, we criticised some of the names given to the new areas. Some of these name changes have made difficulties for those who follow from afar the doings of local authorities, as well as raising the ire of local people. Local names, however, are not the only casualty. The creation of new and larger governmental organisations rarely, if ever, results in economy and as anticipated, it was not long before the new local authorities were being directed to embrace financial stringency and all that it incurs. One such other casualty has been the loss of so many of the annual reports of local authority departments, very few now arriving at BFJ offices. In every case, the reason has been the same—severe restrictions on spending. Not that this was not necessary in many fields, but in respect of annual reports, we are convinced it was false economy. For so many of the reports, it was our pleasure to review them in the pages of BFJ. A prominent Labour politician was once heard to refer to them as “hard and dry reports for hard and dry officials”. It all depends probably on what you are looking for in them. Statistics there must be but most enforcement officers and public analysts, endeavour to keep these to the minimum, the general impression being that these are “dry”. If you are looking for trends, for comparison of the year under review with preceding years and then for comparing the results reported in one part of the country with another, where the population, eating habits, consumer reactions may be different, the tables of statistics are highly important.

This article explores the little understood practice of school interior design and the manner in which school interiors give form to ideas about what the work of children and teachers could and should look like. Its focus is a perceived link between the concepts of school work made material in the design of new twenty‐first century learning environments and those expressed in the design of Modernist progressive schools such as Richard Neutra’s Corona Ave, Elementary School, California. The article’s impetus comes from current interest in the inter‐relationship between the design of physical learning environments and pedagogy reform as governments in Australia and internationally, work to transform teaching and learning practices through innovative school building and refurbishment projects. Government campaigns, for example the UK’s Schools for the Future Program and Australia’s Victorian Schools Plan, use a promotional rhetoric that calls for the final dismantling of the cellular classroom with its industrial model of work so that ‘different pedagogical approaches and the different ways that children learn [can] be represented in the design of new learning environments’, in buildings and interiors designed to support contemporary constructivist‐inspired pedagogies.

In both Norway and Sweden the law governing food hygiene is similar to that in Britain. Powers are vested in local authorities by one general Act couched in wide terms, and by more detailed regulations or byelaws drawn up as required. The degree of severity with which local authorities interpret the regulations varies, and in both countries the functions of central government in relation to food hygiene are mainly advisory. Outbreaks of food poisoning are rare. The various salmonella infections and the cattle diseases liable to infect food are well known, and the supervision in slaughterhouses and on farms is such that the organisms, if present, are identified. Salmonella out‐breaks due to infected imported dried eggs have also been traced. Yet such knowledge and careful supervision is common to other countries where notified outbreaks of food poisoning are comparatively numerous. Whether the relative absence of notified outbreaks in Norway and Sweden is entirely due to a higher standard of food hygiene, or to the prevailing custom of preparing food immediately before or even during a meal, is not clear. It is noticeable that in restaurants some time elapses between ordering a meal and receiving it, and that the food is always freshly prepared. In neither country are food handlers examined medically, except those in the milk trade, who are said to be examined every year. Some doubt exists about the value of this examination and the extent to which it is enforced, though in Stockholm enforcement would not be difficult as over 90 per cent of the milk supplied to that city is handled by one combine, controlled by the farmers' co‐operatives. In both countries all milk supplied in towns must be pasteurised, though bovine tuberculosis has been almost eliminated. Owing to a shortage of glass, milk is still sold “ loose ”, but it is hoped to introduce compulsory bottling in the near future. As the result of requests for more detailed instructions from Medical Officers of Health of small towns and country districts new regulations governing the sale of food have recently been drawn up. Restaurants, hotels and food shops must be licensed by local authorities; they are not licensed until they have been inspected and approved. The local authority can revoke a licence, but the proprietor of the establishment concerned has the right of appeal to the courts.

The importance of succession in family business is well documented and there is general agreement that successful succession represents a key factor in the success or otherwise of individual businesses owned and run by families. The importance of gender in family business succession is a much more recent topic, where initial work has focussed very much on the increasing tendency for women to take on the family business as a successor. Far less research, however, considers the scenario where a female leader passes on the business, whether that takes the form of family succession, a new leader from out with the family or indeed business sale. This dearth of research is not entirely surprising: whilst female leaders in a family business context are not new, their numbers have been relatively small and often mediated through the lens of co-preneurship with a male partner. As women increasingly succeed to and found family businesses however, the gender dimension within family business succession develops and the research response forms the basis for this chapter.

Describes a three‐track process for executive leadership development (TTL) intended to develop a cadre of strategic business leaders for the next decade. TTL consists of three simultaneous tracks of activity requiring as much as 18 months, during which participants also perform their regular jobs. It has three objectives, corresponding to the tracks of activity: the business track ‐ solves real‐life business problems thereby supporting the business while providing each individual participant with increased expertise in an area previously unknown to him or her; the leadership track ‐ enables participants to lead individuals, groups and organizations more effectively; and the personal track ‐ helps participants appreciate and more effectively utilize their innate personal skills, values, predispositions and traits. Examines results to date and shows that this leadership development process has already provided substantial returns to many individuals and organizations.