Some notes on the new paradigmatic environment of "natural remission" studies in alcohol research.

With the broad shift from the alcoholism paradigm to the new public health paradigm in "alcohol science" in general and alcohol epidemiology in particular, research on natural remission has grown in scientific interest. The phenomenon itself has moved from the status of a rare and anomalous occurrence (in the alcoholism paradigm's lens) toward the status of a conventional and expected outcome for "heavy" drinking. A broadening conception of the problem domain properly comprehended by alcohol studies has further highlighted the apparent ubiquity of change in drinking behavior. However, this widening orbit of problematization is not fully accounted for, we argue, by substantive developments in either the survey-research or the Ledermann-model sources of "alcohol science"'s paradigmatic transformation--and a dialectical source of the change is suggested. The new paradigmatic environment also harbors an important shift in the moral orientation of alcohol research--from the alcoholism paradigm's focus on the rescue and protection of the alcoholic to the public health paradigm's focus on the reduction of alcohol-related consequences for the public. The new paradigmatic environment poses new risks for natural remission researchers as well as the renewed challenge to focus research enterprises on the production of meaningful new knowledge.

Cirrhosis mortality and per capita consumption of distilled spirits, United States, 1949-1994: trend analysis.

OBJECTIVE: To describe, evaluate, and suggest interpretations for an observed aggregate-level relation between trends in mortality from cirrhosis and per capita consumption of distilled spirits in the United States. DESIGN: Trend analysis using data on US cirrhosis mortality and per capita alcohol consumption. RESULTS: There is a consistent long-term trend relation between mortality from cirrhosis and per capita consumption of distilled spirits in the United States from 1949 to 1994. Two instances of comparatively sharp drops in the consumption of spirits in the 1940s generated mixed results in predicting changes in cirrhosis mortality. CONCLUSIONS: An aggregate-level relation between trends in long-term cirrhosis mortality and the consumption of spirits falls considerably short of establishing a direct causal link between the two for individuals. Moreover, two sharp drops in the consumption of spirits generated only mixed results with respect to the short-term trend in cirrhosis. Nevertheless, the observed relation between the consumption of spirits and cirrhosis mortality merits further investigation.

Cirrhosis mortality and per capita consumption of distilled spirits, United States, 1949-94: trend analysis.

OBJECTIVE: To describe, evaluate, and suggest interpretations for an observed aggregate level relation between trends in mortality from cirrhosis and per capita consumption of distilled spirits in the United States. DESIGN: Trend analysis using data on US cirrhosis mortality and per capita alcohol consumption. RESULTS: There is a consistent long term trend relation between mortality from cirrhosis and per capita consumption of distilled spirits in the United States from 1949 to 1994. Two instances of comparatively sharp drops in the consumption of spirits earlier in the 1940s generated mixed results in predicting changes in cirrhosis mortality. CONCLUSIONS: An aggregate level relation between trends in long term cirrhosis mortality and the consumption of spirits falls considerably short of establishing a direct causal link between the two for individuals. Moreover, two sharp drops in the consumption of spirits generated only mixed results with respect to the short term trend in cirrhosis. Nevertheless, the observed relation between the consumption of spirits and cirrhosis mortality merits further investigation.

Atresia esofágica, análisis y seguimiento / Esophageal atresia: analysis and follow-up

Se presenta la evolución y seguimiento de 54 niños con atresia esofágica tratados en la Unidad de Recién Nacidos Patológicos del Hospital Luis Calvo Mackenna, analizando la muestra según la presencia (grupo A) o ausencia (grupo B) de fístula traqueoesofágica. Los niños con atresia esofágica y fístula traqueoesofágica (grupo A) se subdividen en: grupo A1, peso de nacimiento mayor a 1.500 g y sin malformaciones asociadas; grupo B, recién nacidos con atresia esofágica y sin fístula traqueoesofágica. El grupo A1 está formado por 28 recién nacidos con 100 por ciento de sobrevida. El promedio de hospitalización fue 20,7 días cuando la corrección quirúrgica se efectuó en un tiempo. En el seguimiento, los problemas más frecuentes fueron reflujo gastroesofágico (62,5 por ciento), estenosis esofágica (30,4 por ciento), incoordinación en la deglución (26 por ciento). El 36,3 por ciento está sano. El grupo A2 está formado por 21 recién nacidos con una mortalidad en el período neonatal de 33,3 por ciento y durante el primer año de vida de 57,1 por ciento. Las malformaciones asociadas más frecuentes fueron cardiológicas, anorrectal y urológicas. Siete niños están en seguimiento, tres sin patología. El grupo B está formado por cinco niños, dos con trisomía 21, uno con hidrocefalia y dos sin malformaciones asociadas. La solución de la atresia esofágica es larga y difícil. Se concluye que la mortalidad está dada por las malformaciones asociadas y la evolución posterior no está exenta de problemas

Norman Jolliffe, the Rockefeller Foundation, and the origins of the modern alcoholism movement.

Archival sources shed new light on and offer a fuller picture of the story of Norman Jolliffe's early, but finally unsuccessful, effort to interest the Rockefeller Foundation's Division of Medical Sciences in funding a comprehensive program of alcoholism research in the late 1930s. New documentation also casts doubt on Mark Keller's contention that the Research Council on Problems of Alcohol--the organizational flagship of the "new scientific approach" to alcohol-related problems in this period--emerged directly from Jolliffe's failed Rockefeller Foundation request.

The great controlled-drinking controversy.

This chapter reviews the controlled-drinking controversy. It presents cameo descriptions of the controversy's three major episodes--those occasioned by D. L. Davies' 1962 report, the 1976 publication of the first Rand Report, and the 1982 publication in Science of a paper by Pendery, Maltzman, and West--as well as a cameo for the long "interepisode" period between Davies' paper and the Rand Report. I argue that the controversy has emerged out of the failure of the "new scientific approach" to alcoholism, initiated a half century ago, to advance alcoholism treatment significantly beyond the point from which it began. Lack of progress, in turn, has generated tensions and reverberations along many of the normative dimensions that define scientific/treatment activity, both internally and in relation to the broader society. Some of the changing social and valuative forces at work in the controversy's history are examined.

The strange case of the Jellinek formula's sex ratio.

The historical development of the Jellinek formula is reviewed and it is concluded that the formula's male : female ratio of 5 : 1 or 6 : 1 is unjustified.