Magister Legum - LLM / In recent years the issue of medical parole has become a controversial issue in South Africa. Prior to 2012, at which juncture the law governing the release of inmates on grounds of terminal illness was amended, there were cases where the public deemed the law inadequate and susceptible to political interference.1 There can therefore be little doubt that an amendment to the law was opportune to ensure that the release of inmates was based on legitimate medical reasons.

ABSTRACT BACKGROUND: Arthritis is increasingly becoming a public health concern as it is the leading cause of disability. Glucosamine and chondroitin, which are alternative dietary supplements, are commonly marketed for persons with joint pain. The purpose of this study is to examine if self-reported 12-month and past 30-day use of glucosamine and/or chondroitin among persons with any arthritis, unspecified arthritis, and rheumatoid arthritis is associated with reports of past 12-month improved health and reports of past 30-day joint pain, aching, and stiffness, respectively. METHODS: The 2012 National Health Interview Survey (NHIS), a nationally representative cross-sectional household interview survey, was used for this study. The adult sample consisted of 34,525. Subgroup analyses were conducted on 7,654 respondents with any arthritis, 6,016 with unspecified arthritis, and 898 with rheumatoid arthritis. The independent variables were defined as the use of glucosamine only, chondroitin only, or glucosamine and chondroitin one or more times in the past 12 months and past 30 days. The dependent variables were defined as self-reported past 12 month improved health and past 30 day joint pain, aching, and stiffness. Descriptive, bivariate, and multivariate analyses were conducted using SAS 9.4 accounting for the complex survey design, computing missing values as missing completely at random for variance estimation. All multivariate logistic regression models included sociodemographics, use of other observed alternative therapies, and other chronic conditions. RESULTS: Approximately 21.8% of U.S adults had any arthritis, 17.0% had unspecified arthritis and 2.5% had rheumatoid arthritis. Among persons with any arthritis, approximately 3.7% used glucosamine, 0.4% used chondroitin, and 3.4% used both glucosamine and chondroitin within the past 12 months while approximately 5.1% used glucosamine, 0.6% used chondroitin, and 0.4% used both glucosamine and chondroitin within the past 30 days. Among persons with unspecified arthritis, approximately 3.7% used glucosamine, 0.5% used chondroitin, and 3.8% used both glucosamine and chondroitin within the past 12 months while 5.5% used glucosamine, 0.5% used chondroitin, and 0.4% used both glucosamine and chondroitin within the past 30 days. Among persons with rheumatoid arthritis, approximately 2.4% used glucosamine, 0.3% used chondroitin, and 2.1% used both glucosamine and chondroitin within the past 12 months while approximately 2.9% used glucosamine, 0.7% used chondroitin, and 0.5% used both glucosamine and chondroitin within the past 30 days. Women used more of all supplements (past 12 months and past 30 days) except past 12 month use of chondroitin among persons with any arthritis. Persons 56 to 70 years old had the highest proportion of past 12 month and 30 day supplement use among persons with unspecified arthritis. After adjusting for sex, age, race, BMI, poverty level, other health conditions, and other CAM therapies (acupuncture, energy, mind-body, and chiropractic/osteopathic therapies), the use of chondroitin only (adjusted OR= 0.6; p= <0.01) and the use of both glucosamine and chondroitin (adjusted OR= 5.7; p= <0.01) during the past 30 days was associated with self-reported past 30 day joint pain, aching, and stiffness among persons with any arthritis. After adjusting for age, BMI, poverty level, region, other health conditions, and other CAM therapies (acupuncture, energy, mind-body, and chiropractic/osteopathic therapies), the use of chondroitin only was also associated with past 30 day joint pain, aching, and stiffness among persons with unspecified arthritis (adjusted OR= 0.5; p= 0.02). CONCLUSION: Chondroitin alone was associated reports of past 30 day joint pain, aching, and stiffness among persons with any arthritis and unspecified arthritis highlighting a potential effective role and use for this supplement. In addition, the use of both glucosamine and chondroitin were associated with reports of past 30 day joint pain, aching, and stiffness among persons with any arthritis. Marketing may play a role in these relationships and should be further examined.

Cancer is a global risk for human wellness and health. Dietary habits could profoundly affect the risk of certain cancer, such as colorectal cancer (CRC) (Platz, 2000). CRC has listed the third leading cancer among male and female in the United States (Stewart, 2014). Surprisingly, the consumption of dietary fiber has an inverse correlation with the mortality of CRC (Song, 2018). However, most Americans do not consume enough dietary fiber to meet the recommended level of dietary fiber intake (Clemens, 2012; Lee-Kwan, 2017). Hence, it is reasonable to increase the nutrient density, i.e., dietary fiber, of current food model. Xylo-oligosaccharides (XOS), an emerging prebiotics, showed multiple advantages over fructo-oligosaccharides (FOS) and inulin. For example, Hsu et al. (2004) reported XOS are more effective than FOS on increasing Bifidobacterium level in rat cecum (Hsu, 2004). It is also suggested that dietary fiber and phenolic compounds have synergistic effect on promoting gut health (Uehara, 2001; Matsukawa, 2009). Therefore, the application of XOS into a polyphenol-dense food vehicle (strawberry puree) could be a viable way to promote gastrointestinal health and help reduce CRC risk. First, the effect of xylo-oligosaccharides (XOS) incorporation on the quality attributes of strawberry puree was investigated. Rheological properties, color and physicochemical characteristics and composition such as water activity, pH, and total soluble solids, were investigated to determine the maximum XOS content that can be incorporated into the strawberry pure without significantly altering the original properties of samples. Based on the collected data, adding xylo-oligosaccharides greater than 7.5% w/w will significantly change the quality attributes of the strawberry puree including its rheological characteristics, color profile, water activity, and total soluble solids. The addition of XOS at 2.5% and 5% w/w did not significantly alter overall quality attributes of strawberry puree. Second, the effects of heat treatment (HTST, 75℃, 15s and UHT, 121℃, 2s) and storage condition (storage time: 1, 15, and 36 days; storage temperature: 4℃ and 55℃) on the quality attributes of xylo-oligosaccharides enhanced strawberry puree was studied (texture, color water activity, total soluble solids, and pH). In addition, the physicochemical (total phenolic, tannin, flavonoids contents, and antioxidant activity) evolution was studied. A 9-point Hedonic test was conducted to evaluate the sensory properties (overall, texture, color, appearance, sweetness, aroma, flavor) of purees (with and without XOS, 5%w/w) under different thermal treatments. Briefly, all nutritional attributes were retained better under cold storage (4 ℃) as compared to high-temperature storage (55 ℃). The result revealed that thermal treatment and high storage temperature showed an inverse correlation with puree consistency. As for chemical analysis, intense thermal treatment (UHT) caused the most degradation in TPC, TFC and tannin level. However, such treatments (UHT) helped significantly increase the measurable antioxidant level. For other physicochemical properties, processing methods (HTST / UHT) and high storage temperature exhibited more significance in changing the color profiles of the specimen than XOS incorporation. Overall, the addition of XOS up to 5% w/w could increase nutritional value of strawberry puree as well as consumer preference without significantly compromising quality attributes. Based on instrumental and sensory analysis, HTST treated strawberry puree with XOS incorporation (5% w/w) meet the standard of sensorial attributes of fresh puree with improved shelf-life stability and fiber concentration.