Child and adolescent depression.

For much of the 20th century, major depression was viewed as a malady to which children were not susceptible. In recent years, this view has given way to an understanding that child and adolescent depression not only exist, but constitute an insidious and major public health problem. Depressive symptoms in children can be subtle and varied. The diagnosis in adolescents often is complicated by behavioral manifestations associated with hormonal changes. Both the etiology and the treatment of child and adolescent depression remain controversial. However, recent developments in pharmacotherapy appear promising. Primary prevention may not always be efficacious, but evidence suggests secondary prevention can reduce significantly future psychosocial problems.

Selected health and behavioral effects related to the use of caffeine.

This paper reviews the research literature concerning health and selected behavioral effects of caffeine. Epidemiological and laboratory findings are reviewed to determine the health risks associated with both acute and chronic caffeine exposure. Common sources of caffeine, its properties, and physiological effects are considered. The relationships between caffeine and various health conditions are examined including caffeine's association with heart disease, cancer, and benign breast disease. Caffeine's possible contribution to enhanced exercise performance is discussed along with a brief overview of caffeine's effects on mental and emotional health. Over 100 references cited in this review were part of a more extensive literature base obtained from several on-line services including MEDLINE and LEXIS/NEXIS medical data bases. Other sources of relevant literature included manual searches of research journals and the use of selected references from appropriate articles. The relationship between caffeine consumption and various illnesses such as cardiovascular disease and cancer remains equivocal. Prudence might dictate that pregnant women and chronically ill individuals exercise restraint in their use of caffeine, although research suggests relatively low or nonexistent levels of risk associated with moderate caffeine consumption.

School drug education programming: in search of a new direction.

School drug abuse prevention programs represent an enormous educational resource. Recent perceptions of an epidemic of drug abuse among the nation's youth have fueled the escalation in expenditures for drug prevention programming. An important question that needs to be addressed concerns whether broad ranging drug education efforts directed at all public and private school students are efficient and effective uses of available resources? After a brief survey of the evolution of drug education programming in the U.S., this article examines recent longitudinal research regarding the antecedents of drug abuse among young people. Based on this research, suggestions are made for a new approach to drug education programs which would direct intensive interventions at the minority of youth who are identifiable in early childhood as particularly susceptible to problems with drug abuse.

Health risks associated with residential exposure to extremely low frequency electromagnetic radiation.

Extremely low frequency electromagnetic radiation has received considerable attention recently as a possible threat to the health of persons living near high tension electric power lines, distribution substations, and even in close proximity to common household electric appliances. Results of epidemiological and laboratory research are examined to assess risks associated with magnetic fields generated by extremely low frequency electromagnetic sources. Health risks associated with such fields include a wide variety of ills ranging from disruption of normal circadian rhythms to childhood cancers. Risk assessment has been particularly difficult to determine in light of an ostensible lack of a dose-response relationship. Current media sensation fueled in part by an equivocal position adopted by the United States Environmental Protection Agency has contributed to the controversy. Recommendations for prudent avoidance of possible dangers are presented along with policy implications concerning health risks associated with magnetic fields.

An assessment of cancer education offerings in medical school, dental school, and health education curricula in New York and California.

This survey identified the extent of courses in cancer control through prevention in medical, dental, and health education curricula. A questionnaire was sent to all medical, dental, and health education academic programs in New York and California. With a return rate of 81%, it was determined that health education programs more frequently offered courses in cancer control through prevention than medical and dental programs. The majority of all academic programs studied that did not currently offer such a course reported it was unlikely such a course would be offered during the next 2 years. Primary reasons for this included an already crowded curriculum and lack of resources. Recommendations are offered to support health professionals in taking a more active role as cancer educators emphasizing primary prevention and early detection techniques.

First, do no harm.

Returning to the concept presented at the beginning of this paper, in an era when for many people the quality and longevity of life have never been better, why are there increasing levels of dissatisfaction with life? According to Thomas (1974), "there is something fundamentally, radically unhealthy about all this. We do not seem to be seeking more exuberance in living as much as staving off failure, putting off dying. We have lost all confidence in the human body. The new consensus is that we are badly designed, intrinsically fallible, vulnerable to a host of hostile influences. We live in danger of falling apart at any moment and are therefore always in need of surveillance and propping up." Certainly health educators cannot accept all the blame for this contemporary fad; however, they may contribute to the phenomenon by implicitly suggesting that people are entitled to some idealized level of health and wellness which includes halcyon days immune from the pain and ravages of life in the real world.2+ Henry David Thoreau offered a perceptive view of how life should be experienced when he wrote: "I did not wish to live what was not life, living is so dear; nor did I wish to practice resignation, unless it was quite necessary.(ABSTRACT TRUNCATED AT 250 WORDS)

Alcohol abuse among Native Americans.

Native Americans have experienced substantial problems with alcohol since its introduction to their culture by early European settlers. Epidemiological data indicate that elevated morbidity and mortality attributable to alcohol abuse among this population remain at epidemic levels. Adolescent drinking patterns and family and peer influences on alcohol use are examined. A multifactorial etiology is indicated in the origin of Native American alcohol abuse. Some scholars have ascribed this problem to historical factors such as the introduction of alcohol to Native Americans by aberrant role models, while other researchers subscribe to various physiological theories which support the "firewater myth" suggesting that Native Americans may be genetically predisposed to crave ever increasing doses of alcohol during a rapid loss of control of their senses. The physiological theories generally suggest significant differences in alcohol absorption and metabolism rates between Native Americans and caucasians. A wide variety of social factors appear to be implicated in Native American drinking problems. Cultural and social orientations, socioeconomic conditions, "stake theory," failure to develop social sanctions regulating drunken deportment, passive-aggressive syndromes, and emotional repression contribute to Native American alcohol abuse. Treatment regimes for Native American alcoholics are examined briefly. Nativistic movements, conversion to evangelistic regions, therapies grounded in the medical model, and Native American group-oriented efforts have demonstrated varying degrees of success. Clearly, prevention would be preferable to the frustration of attempting to change the highly addictive behavior patterns characteristic of alcoholism. Suggestions for health education interventions are presented including an example of one effort currently being implemented.

Self-esteem, health locus of control, and health attitudes among Native American children.

Self-esteem and health locus of control have been postulated as predictors of attitudes and behaviors related to child health. The association among these variables has not been assessed adequately among Native American children. This study measured the relationship among self-esteem, health locus of control, and health attitudes of Native American fourth, fifth, and sixth grade students. A statistically significant relationship was found between self-esteem and positive attitudes toward health. Self-esteem was a modest predictor of health attitudes and health behavioral intentions among Navajo and Pueblo children.

The Ramah Navajo Child-to-Child Program.

The international CHILD-to-child program, conceptualized by Dr. David Morley of the University of London, is based on the concept that children in developing nations act as caregivers, teachers, and health workers in their families and communities. The critical component in the program is the ability and willingness of children to become actively involved as care givers. CHILD-to-child is an action-oriented approach that draws upon a vast reservoir of similar programs that have been successful in over forty developing countries of the Third World. Similarities between the Ramah Navajo Community in New Mexico and many Third World nations served as a stimulus in the initiation and development of this project. The Ramah Navajo CHILD-to-child Health Education Project involved the development of a school health education curriculum that supported Native American children in a community-based effort to improve the quality of health care and the standard of living for their families. With funding from the U.S. Department of Education as a national demonstration project, a needs assessment was conducted and a seven-unit curriculum was developed.