Health promotion through Neighborhood Health Centers: a tribute to George Rosen on the 20 anniversary of his death

George Rosen was not only one of the most noted medical historians in the United States, but also a pioneer in the scientific and practical establishment of public health. He promoted the socio-historical foundation of public health and emphasized the ambivalent role of the government between the creation of healthy living conditions and the control of individuals. Rosen was one of the first to point out the consequences of approaching social medicine exclusively from the perspective of modern bacteriology. The article shows that Rosen located elements of a democratic and holistic health system in his analysis of the Neighborhood Health Centers of the early 20th century. At the same time he assessed the reasons for the demise of these efforts with the expansion of the medical-industrial complex after World War II. According to Rosen this development was mainly due to the lack of a solid financial plan that was feasible for the entire country. Until today the integration of medical care, social security and psychosocial counseling has not been re-established in this kind of community-oriented form. The Neighborhood Health Centers were mainly characterized by a democratic integration of the population to be served, by their intercultural approach and by the cooperation of people from a variety of professional backgrounds. They were thus an example of a cooperative, community-based health promotion in residential areas with a high degree of social problems. The aspects of integrative programs, proximity to residential areas and the participation of the population present key elements that could also prove significant for the future development of health promotion in today's health system. Reading George Rosen's work creates an awareness for the central questions concerning the definition of the 'New Public Health'.Key words: George Rosen; health promotion; Neighborhood Health Centers      

Life after death: A child's reaction to the death of a parent

The death of a parent is a traumatic event for a child. This paper will correlate children's ideas about death with various developmental stages. In addition, it will provide suggestions from experts about how adults can help children go through the painful grieving process. Mental health professionals who work with children will find practical suggestions on helping children cope with the experience of losing a parent to death.     

A child's rights to his own parents: a look at two value systems

Christians and humanists accept an evolutionary world view and respect those fundamental relations underlying evolutionary development. Both value systems should be able to discuss seriously the risks of altering one of the most fundamental of all relations: that of child to parent.     

Premature mortality in France: relative importance of the main causes of death according to the number of years of life lost

The importance of major causes of deaths in France have been studied for 1972 and 1982, using years of potential life lost before age 65 and in relation to life expectancy. These indicators of premature mortality have been compared to death rates. Unintentional injuries and malignant neoplasms are the two main causes of mortality before age 65. There is an important excess mortality for males, particularly for unintentional injuries. Total premature mortality declined between 1972 and 1982, but cancer mortality for males and suicide and chronic bronchitis mortality for both sexes have increased. Cardiac mortality decreased only for females.     

Return to work after two years of total disability: A case report

Background: Little is specifically written regarding the details of clinical interventions with workers with chronic spinal pain. Specifically, the individual thought process behind the management of an injured worker is not often discussed except in clinical conferences or discussions with other clinicians. It is well known that once an injured worker is disabled from work for 2 years, successful return is unlikely. We thought it would be informative to illustrate the clinical approach we took with this case because of the history of long term pain and disability. Methods: This paper describes the conservative management of a patient who was disabled from work for 2 years, using an integrated approach including chiropractic manipulation, pain education, restricted duty and clear communications among all parties involved. Results: After 15 weeks, the patient returned to her previous occupation as a nurse, first part time, and subsequently full time. Conclusion: This report is provided to illustrate a systematic approach diagnosis and treatment to assist this injured workers return to work. This case illustrates that even after 2 years successful return to work can be achieved.     

Nutritional risk among Brazilian children 2 to 6 years old: A multicenter study

ObjectiveTo estimate the nutritional risk in children 2 to 6 y old.MethodsThe sample consisted of 3058 children enrolled in public and private schools in nine Brazilian cities. The assessment of nutrient intake was based on 1-d data combining direct individual weighing of foods and a food diary. A second evaluation of food consumption was conducted in a subsample to estimate the usual intake.ResultsThere was low prevalence of inadequate intake of vitamin B6 (<0.001%), riboflavin (<0.001%), niacin (<0.001%), thiamin (<0.001%), folate (<0.001%), phosphorus (<0.1%), magnesium (<0.1%), iron (<0.5%), copper (<0.001%), zinc (<0.5%), and selenium (<0.001%). However, 22% of children younger than 4 y and 5% of children older than 4 y consumed fiber quantities larger than the adequate intake. Approximately 30% of the sample consumed more saturated fat than recommended. The prevalence of inadequate vitamin E intake ranged from 15% to 29%. More than 90% of the children had an inadequate vitamin D intake. In children older than 4 y, the prevalence of inadequate calcium intake was approximately 45%. Sodium intake was higher than the upper intake level in 90% of children younger than 4 y and 73% of children older than 4 y.ConclusionsThe prevalence of inadequate dietary intake was low for most nutrients. However, fiber, calcium, and vitamin D and E intakes were lower than recommended. Moreover, children consumed large amounts of sodium and saturated fat.     

Picky eating during childhood: A longitudinal study to age 11 years

Picky eating is a common disorder during childhood often causing considerable parental anxiety. This study examined the incidence, point prevalence, persistence and characteristics of picky eating in a prospective study of 120 children and their parents followed from 2 to 11 years. At any given age between 13% and 22% of the children were reported to be picky eaters. Incidence declined over time whereas point prevalence increased indicating that picky eating is often a chronic problem with 40% having a duration of more than 2 years. Those with longer duration differed from those with short duration having more strong likes and dislikes of food and not accepting new foods. Parents of picky eaters were more likely to report that their children consumed a limited variety of foods, required food prepared in specific ways, expressed stronger likes and dislikes for food, and threw tantrums when denied foods. They were also more likely to report struggles over feeding, preparing special meals, and commenting on their child's eating. Hence, picky eating is a prevalent concern of parents and may remain so through childhood. It appears to be a relatively stable trait reflecting an individual eating style. However no significant effects on growth were observed.