1992 and the Consumer

This paper summarises the journey so far towards the ‘single market’. Consumers may expect to benefit from increased choice and cheaper prices but the possibility that quality, as judged by % of characterising ingredient, will be lowered, is a cause for concern. The consumer will have to rely increasingly on labels, assuming that the label information is adequate. Quantitative ingredient information is desirable but provides technical difficulties for manufacturers. A voluntary ‘quality mark’ scheme could be a satisfactory replacement for compositional standards but would have to be carefully controlled by independent assessors. The abolition of frontier controls creates a dilemma between the desire to have free trade within the community and the need to give a high priority to public health.     

The prevention of tobacco-related disease

The key components of a strategy to prevent tobacco–related disease are outlined. These measures aim to increase the cessation of tobacco use and reduce its uptake. Components are wide–ranging, including a taxation policy, a ban on advertising and promotion, a comprehensive health promotion programme including advice from primary health care professionals and the development of campaigning skills, particularly by the medical profession. The prevention of tobacco–related disease has moved into the domain of campaigners and lobbyists at political, economic and international levels. The key target is countering the activities, especially the unethical trade practices, of the wealthy and powerful tobacco industry.     

Energy Intake and Glycemia in Lactating Women with Type 1 Diabetes

Objective To describe glycemia and insulin administration in lactating women with type 1 diabetes and compare their energy intake, lactation onset, and postpartum weight to lactating women without diabetes.Design A prospective observational study conducted at 2, 3, 6, 14, 42, and 84 days postpartum. Insulin dosage and glucose levels after fasting and at 80 and 110 minutes after eating (by measuring capillary blood glucose concentrations and glycated hemoglobin [HbA_1c] values) are described for women with type 1 diabetes. Dietary intake, weight, and lactation onset for women with type 1 diabetes are compared with those without the disease.Subjects/setting Fourteen lactating women with type 1 diabetes and 25 women without diabetes (control subjects) were recruited from private obstetrician offices and high-risk prenatal clinics at 3 major medical centers.Statistical analyses A repeated-measures 2-factor analysis of variance was used to determine group, time, and interaction effects between women with type 1 diabetes and the control group at 2, 3, 7, 14, 42, and 84 days postpartum.Results Seven women with type 1 diabetes breast-fed through 84 days postpartum, although they perceived later onset of milk and had fasting and postprandial hyperglycemia. Their HbA_1c levels increased by 20%, confirming relative hyperglycemia. After adjustment for prepregnancy weight, women with type 1 diabetes consumed 7 kcal fewer per kilogram per day than control subjects. Average insulin dose was returned to prepregnancy levels of 45.3±3.6 U/d (least square means±standard error of the mean) by 1 week.Application Achieving desired metabolic control during the establishment of lactation is difficult. A better understanding of energy and insulin needs and their relationship to lactation in women with type 1 diabetes is needed. J Am Diet Assoc. 1998; 98: 642–648.     

Propranolol Induced Electrical and Mechanical Alternans in Orthodromic Reciprocating Tachycardia

During an electrophysiological study in a patient with a concealed accessory connection, there was no evidence of eiectrical or mechanical alfernans during tachycardia until propranolol was adminislered, but both forms of alternans developed with tachycardia of a slower rate following propranolol. Echocardiographic. arterial pressure, and electrocardiographic data obtained prior to and following propranolol administration are presented.     

Harm reduction: roads less travelled to the Holy Grail

In recent years, a number of countries have embraced harm reduction as their principal philosophical stance and policy platform on alcohol and other drug-related problems. Harm reduction, while argued by some as not being a new concept, has dramatically changed the overall orientation of many health and human service approaches. We argue that as a result many important considerations have been overlooked. This paper explores the merits of harm reduction and examines the limitations and potential pitfalls that may exist in its application in the real world. For instance, where do we position non-drug-use? Such questions are raised in light of the impression perpetuated by some leading practitioners in this field that harm reduction is a global panacea for alcohol and drug problems. Without exploring all possible paths, progress toward our holy grail of minimising the harms and maximising the potential benefits of drug use will be hampered. An integrated model is discussed, which we believe provides an opportunity for wider acceptance and ownership by alcohol and drug stakeholders, politicians and the community.     

Prison misconduct among mentally retarded inmates

This article examines prison misconduct of inmates who tested as mentally retarded, borderline intellectual functioning, and intellectually normal. The sample is drawn from a cohort of inmates released from the New York State correctional system. Misconduct is measured by examining official documents and is divided into two types: non-violent and violent incidents. Analysis of variance suggests that the mentally retarded had significantly higher reported mean annual rates of involvement in both non-violent and violent incidents. However, results of multiple regression analysis indicate that, when controlling for the effects of several social and criminal history factors, IQ score has a significant effect on the violent, but not the non-violent, incident rate. Age and employment status at time of arrest have the strongest influence on an inmate’s disciplinary incident rate, while IQ score has the smallest influence of the variables examined in this study.