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This chapter argues that the trouble with subgroup analyses is not in doing them, but rather in their interpretations. The fact that investigators do not report results of subgroup analyses does not mean that they were not done, as some would have you believe in regard to gender as a subgrouping variable. The belief that gender-by-treatment interactions are unrecognized because investigators do not look for them is usually false. Most journals have word and table limits. Authors are not likely to use their word and table budgets reporting subgroup analyses unless they think there is something to report. The best that can be expected is a sentence indicating that subgroup analyses were done for designated variables and that no differences were found.

In this chapter, an overview of the prevalence and health problems of childhood obesity in Singapore provides a backdrop to the discussion on the measures of prevention and intervention of childhood obesity in Singapore and the success and failures of these measures. While there is a lack of major publications on the prevention and management of childhood obesity in Singapore, the various reports and limited publications give us a glimpse into the strategies used, the effectiveness, flaws, and the ongoing programs to combat childhood obesity. In addition, the chapter provides new research data and clinical experience in the areas of childhood obesity and related issues such as eating disorders.

This introductory chapter illustrates the state of crime and punishment in Belfast. A major by-product of the political and civil conflict in Northern Ireland has been a lack of consensus among the population over who should police ordinary crime and how. This is clearly evidenced among the predominantly Nationalist and Republican inhabitants of West Belfast, who have consistently sought to prevent crime and punish offenders by employing a variety of informal strategies, rather than rely upon the police service. The most notorious of these informal approaches are shootings, beatings, and exclusions by Republican armed groups. The chapter then discusses the research methods and data behind the succeeding chapters.

Despite apparent similarities in the issues raised, informed consent in the research setting has evolved quite separately from informed consent to treatment. Consent to treatment is largely a creature of case law, with some subsequent statutory modification. Consent to research has been shaped by professional codes, statutes, and administrative regulations, with the courts playing a less important role. Systematic medical research, of course, is a newer phenomenon than medical treatment. The eighteenth century saw some of the first efforts to demonstrate the etiology of diseases. One was Lind’s controlled study of the effects of citrus juices in preventing scurvy (1). Pierre Louis’s classic study, in the 1820s, of the efficacy of bloodletting as a treatment for pneumonia demonstrated the potential of clinical investigation, but his medical colleagues were slow to follow his lead (2). By the turn of the century, the pace of experimentation with human subjects was quickening. The etiologies of beriberi and pellagra, for example, were discovered using human volunteers. In the early years of systematic medical investigation, only sporadic attention was paid to the circumstances under which research should be carried out, including the issue of consent. There are a few statements from leading physicians of the time, such as Paul Ehrlich and William Osier, endorsing the disclosure of information about the risks and benefits of experimental treatment. After a public scandal in Prussia in the 1890s, involving experimentation on unsuspecting patients who were inoculated with the spirochete that causes syphilis, the Prussian government required consent for any further research with human subjects (3). Shortly thereafter, Walter Reed, conducting his famous experiments in Cuba on yellow fever, developed a contract—very much like the modern consent form— for his volunteers to sign, which included a discussion of the risks they would be running (3). Public concern in Germany culminated in the 1931 promulgation of guidelines that required clear explanations of innovative or experimental treatments (4). Interestingly, this pre-war German code of ethics, which addressed human experimentation, was, in some ways, more extensive in its protections and principles than either the post-war Nuremberg Code or Helsinki Declaration (5).