Under the Department of Public Health, services are provided to all of Los Angeles County’s residents. Public health programs include:

* Environmental health: operates restaurant rating system and grading systems for apartments and rental homes; inspects sewage treatment and water plants; enforces state and local environmental laws

* Communicable disease control and prevention

* Alcohol and drug abuse programs

* Bioterrorism prevention

* Epidemiology

* AIDS prevention

* Immunizations

* Family planning

* Nutrition

* Cancer Treatment

Director Dr. Jonathan Fielding, has been awarded the UCLA Medal, the university’s highest honor on April 16, 2009, for his work as an innovator, leader and public health visionary. He is also a professor at the UCLA School of Public Health.

Adapted from the Wikipedia article Los Angeles County Department of Health Services, under the G. N. U. Free Documentation License. Please also see http://en.wikipedia.org/wiki

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Australia and New Zealand

Australia and New Zealand use a nutritional information panel of the following format:

Other items are included as appropriate, and the units may be varied as appropriate.

Canada

In Canada, a standardized “Nutrition Facts” label was introduced as part of regulations passed in 2003, and became mandatory for most prepackaged food products on December 12, 2005. (Smaller businesses were given until December 12, 2007 to make the information available.)[http://www.hc-sc.gc.ca/fn-an/label-etiquet/nutrition/index_e.html].

Canadian regulation tightly controls the manner in which the nutrition fact table (NFT) data is laid out. There is a wide variety of possible formats for use on a given food package. A selection hierarchy is used to select among the many formats (28 main formats, and 2-7 subformats for each). This results in standard (vertical) formats being considered for use before horizontal and linear formats. The selection hierarchy also allows the NFT to occupy no more than 15% of the physical package’s available display area (ADS), but never to be smaller than a format that would be
Adapted from the Wikipedia article Nutrition facts label, under the G. N. U. Free Documentation License. Please also see http://en.wikipedia.org/wiki

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Child Nutrition Act (CNA) is a United States federal law signed on October 11, 1966 by President Lyndon B. Johnson. The Act was created as a result of the “years of cumulative successful experience under the National School Lunch Program to help meet the nutritional needs of children.” The National School Lunch Program feeds 30.5 million children per day (as of 2007). NSLP was operated in over 101,000 public and nonprofit private schools in 2007 (AmberWaves). The Special Milk Program, functioning since 1954, was extended to June 30, 1970 and incorporated into the act. The act also provided Federal funding assistance towards non-food purchases for school equipment.

The act established the School Breakfast Program, a federally assisted meal program that provides low-cost or free breakfasts to children in public and non-profit schools as well as child care institutions. During the signing of the act, the president remarked that “good food is essential to good learning.”

Adapted from the Wikipedia article Child Nutrition Act, under the G. N. U. Free Documentation License. Please also see http://en.wikipedia.org/wiki

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Applied Computer Science

*Applied Computer Science (Bachelor of Science/Master of Science)

*Business Informatics (Bachelor of Science)

*Media Informatics (Computer Graphics and Human-Computer Interaction – Bachelor of Science)

*Electronic Business (Master of Science)

Business Administration

*Business Administration (Bachelor of Arts)

*Industrial Engineering (Bachelor of Engineering) → ”Cooperation with Electrical Engineering & Information Technology”

*International Management (Master of Business Administration)

Electrical Engineering & Information Technology

*Electrical Engineering & Information Technology (Bachelor of Engineering/Master of Engineering)

*Process Engineering (Bachelor of Engineering) → ”Cooperation with Food Technology”

*Industrial Engineering (Bachelor of Engineering) → ”Cooperation with Business Administration”

*Systems Design & Production Management (Master of Engineering)

Food Technology

*Food Technology (Bachelor of Science)

*Process Engineering (Bachelor of Engineering) → ”Cooperation with Electrical Engineering & Information Technology”

*Food Processing (Master of Science)

Nursing & Health Sciences

*Health Sciences (Bachelor of Science)

*Nursing (Bachelor of Science)

*Nursing management (Bachelor of Science)

*Physical Therapy (Bachelor of Science/Master of Science)

*Pedagogy in Health Care Industry (Master of Arts)

*Public Health (Master of Science)

*Public Health Nutrition (Master of Science) → ”Cooperation with Oecotrophologie”

Nutritional Science

*Nutritional Science (Bachelor of Science)

*International Food Business & Consumer Studies (Master of Science)

*Public Health Nutrition (Master of Science) → ”Cooperation with Nursing & Health Sciences”

Social & Cultural Science

*Social Laws (Bachelor of Laws)

*Social Sciences (Bachelor of Arts)

*Intercultural Communication & European Studies (Master of Arts)

Social Work

*Social Work (Bachelor of Arts/Master of Arts)

Adapted from the Wikipedia article Fulda University of Applied Sciences, under the G. N. U. Free Documentation License. Please also see http://en.wikipedia.org/wiki

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Childbirth is an inherently dangerous and risky activity, subject to many complications. The “natural” mortality rate of childbirth—where nothing is done to avert maternal death—has been estimated as being between approximately 1500 deaths per 100,000 births. (See main article: neonatal death, maternal death). Modern medicine has greatly alleviated the risk of childbirth. In modern Western countries, such as the United States or Sweden, the current maternal mortality rate is around 10 deaths per 100,000 births.

Birthing complications may be maternal or fetal, and long term or short term.

Labor complications

The second stage of labor may be delayed or lengthy due to:

* malpresentation (breech birth (i.e. buttocks or feet first), face, brow, or other)

* failure of descent of the fetal head through the pelvic brim or the interspinous diameter

* poor uterine contraction strength

* active phase arrest

* cephalo-pelvic disproportion (CPD)

* shoulder dystocia

Secondary changes may be observed: swelling of the tissues, maternal exhaustion, fetal heart rate abnormalities. Left untreated, severe complications include death of mother and/or baby, and genitovaginal fistula. These are commonly seen in Third World countries where births are often unattended or attended by poorly trained community members.

Maternal complications

Vaginal birth injury with visible tears or episiotomies are common. Internal tissue tearing as well as nerve damage to the pelvic structures lead in a proportion of women to problems with prolapse, incontinence of stool or urine and sexual dysfunction. Fifteen percent of women become incontinent, to some degree, of stool or urine after normal delivery, this number rising considerably after these women reach menopause. Vaginal birth injury is a necessary, but not sufficient, cause of all non hysterectomy related prolapse in later life. Risk factors for significant vaginal birth injury include:

* A baby weighing more than 9 pounds.

* The use of forceps or vacuum for delivery. These markers are more likely to be signals for other abnormalities as forceps or vacuum are not used in normal deliveries.

* The need to repair large tears after delivery.

Pelvic girdle pain. Hormones and enzymes work together to produce ligamentous relaxation and widening of the symphysis pubis during the last trimester of pregnancy. Most girdle pain occurs before birthing, and is known as diastasis of the pubic symphysis. Predisposing factors for girdle pain include maternal obesity.

Infection remains a major cause of maternal mortality and morbidity in the developing world. The work of Ignaz Semmelweis was seminal in the pathophysiology and treatment of puerperal fever and saved many lives.

Hemorrhage, or heavy blood loss, is still the leading cause of death of birthing mothers in the world today, especially in the developing world. Heavy blood loss leads to hypovolemic shock, insufficient perfusion of vital organs and death if not rapidly treated. Blood transfusion may be life saving. Rare sequelae include Hypopituitarism Sheehan’s syndrome.

The maternal mortality rate (MMR) varies from 9 per 100,000 live births in the US and Europe to 900 per 100,000 live births in Sub-Saharan Africa. Every year, more than half a million women die in pregnancy or childbirth.

Fetal complications=

Mechanical fetal injury

Risk factors for fetal birth injury include fetal macrosomia (big baby), maternal obesity, the need for instrumental delivery, and an inexperienced attendant. Specific situations that can contribute to birth injury include breech presentation and shoulder dystocia. Most fetal birth injuries resolve without long term harm, but brachial plexus injury may lead to Erb’s palsy or Klumpke’s paralysis.

Neonatal infection

Neonates are prone to infection in the first month of life. Some organisms such as S. agalactiae (Group B Streptococcus) or (GBS) are more prone to cause these occasionally fatal infections. Risk factors for GBS infection include:

* prematurity (birth prior to 37 weeks gestation)

* a sibling who has had a GBS infection

* prolonged labour or rupture of membranes

Untreated sexually transmitted infections are associated with congenital and perinatal infections in neonates, particularly in the areas where rates of infection remain high. The overall perinatal mortality rate associated with untreated syphilis, for example, approached 40%.

Neonatal death

Infant deaths (”neonatal deaths” from birth to 28 days, or ”perinatal deaths” if including fetal deaths at 28 weeks gestation and later) are around 1% in modernized countries.

The most important factors affecting mortality in childbirth are adequate nutrition and access to quality medical care (“access” is affected both by the cost of available care, and distance from health services). “Medical care” in this context does not refer specifically to treatment in hospitals, but simply routine prenatal care and the presence, at the birth, of an attendant with birthing skills.

A 1983-1989 study by the Texas Department of State Health Services highlighted the differences in neonatal mortality (NMR) between high risk and low risk pregnancies. NMR was 0.57% for doctor-attended high risk births, and 0.19% for low risk births attended by non-nurse midwives. Conversely, some studies demonstrate a higher perinatal mortality rate with assisted home births. Around 80% of pregnancies are low-risk. Factors that may make a birth high risk include prematurity, high blood pressure, gestational diabetes and a previous cesarean section.

Intrapartum asphyxia

Intrapartum asphyxia is the impairment of the delivery of oxygen to the brain and vital tissues during the progress of labour. This may exist in a pregnancy already impaired by maternal or fetal disease, or may rarely arise ”de novo” in labour. This can be termed ”fetal distress”, but this term may be emotive and misleading. True intrapartum asphyxia is not as common as previously believed, and is usually accompanied by multiple other symptoms during the immediate period after delivery. Monitoring might show up problems during birthing, but the interpretation and use of monitoring devices is complex and prone to misinterpretation. Intrapartum asphyxia can cause long-term impairment, particularly when this results in tissue damage through encephalopathy.

Adapted from the Wikipedia article Childbirth, under the G. N. U. Free Documentation License. Please also see http://en.wikipedia.org/wiki

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There are many social, environmental and physical causes of developmental disabilities, although for some a definitive cause may never be determined. Common factors causing developmental disabilities include:

* Brain injury or infection before, during or after birth.

* Growth or nutrition problems.

* Abnormalities of chromosomes and genes.

* Birth long before the expected birth date – also called extreme prematurity.

* Poor diet and health care.

* Drug misuse during pregnancy, including alcohol intake and smoking.

* Child abuse, which can severely affect a child’s socio-emotional development.

* An autism spectrum disorder.

Developmental disabilities affect between 1 and 2% of the population in most western countries, although many government sources acknowledge that statistics are flawed in this area. The worldwide proportion of people with developmental disabilities is believed to be approximately 1.4%. It is twice as common in males as in females, and some researchers have found that the prevalence of mild developmental disabilities is likely to be higher in areas of poverty and deprivation, and among people of certain ethnicities.

Adapted from the Wikipedia article Developmental disability, under the G. N. U. Free Documentation License. Please also see http://en.wikipedia.org/wiki

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Very low calorie diet (VLCD) is a diet with very or ”extremely” low calorie consumption per day. It is defined medically as a diet of 800 kilocalories per day or less. VLCDs are formulated, nutritionally complete, liquid meals containing 800 calories or less per day. VLCDs also contain the recommended daily requirements for vitamins, minerals, trace elements, fatty acids and protein. Carbohydrate may be entirely absent, or substituted for a portion of the protein; this choice has important metabolic effects. The VLCD products are usually a powder which is mixed with water or another low calorie liquid.

Adapted from the Wikipedia article Very-low-calorie diet, under the G. N. U. Free Documentation License. Please also see http://en.wikipedia.org/wiki

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Proper nutrition is important after delivery to help the mother recover, and to provide enough food energy and nutrients for a woman to breastfeed her child. Women having serum ferritin
Adapted from the Wikipedia article Nutrition and pregnancy, under the G. N. U. Free Documentation License. Please also see http://en.wikipedia.org/wiki

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Healthy Black Family Project

The Healthy Black Family Project (HBFP) concentrates on several East End neighborhoods of Pittsburgh. This area, called the Health Empowerment Zone, has a high percentage of Black residents and of residents living below the federal poverty line. HBFP works with individuals and families, providing a variety of activities and services to help prevent diabetes and hypertension.

HBFP provides health coaches, lay health advocates, and nutritionists at no cost to help families alter their activity and diet to create and maintain a healthy lifestyle. They offer cooking classes, exercise classes, walking clubs, a smoking cessation program, as well as yoga, tai chi, and meditation classes, all designed to promote a healthy lifestyle and prevent disease.

In addition, HBFP provides genetic counseling to ascertain family health history and any risks that might be associated with it, as well as giving a health risk assessment to create a personal health analysis, and they help individuals learn practical ways to handle chronic disease.

Healthy Black Families Project also implements the “Small Steps, Big Rewards” campaign, inspired by the findings of a NIH sponsored study, HHS’ Diabetes Prevention Program (DDP) clinical trial. This study has shown that individuals with pre-diabetes (those whose blood glucose levels are higher than normal but not yet diabetic), can delay and possibly even prevent type 2 diabetes simply by making moderate changes in diet and exercise that enable them to lose five to seven percent of their body weight. Regular physical activity such as a brisk thirty minute walk five times per week, and modest weight loss could cut the risk of developing type 2 diabetes by more than half in pre-diabetic individuals. These lifestyle changes were shown to be especially successful in individuals over age 65. HBFP has every confidence that these methods will prove effective in Pittsburgh’s neighborhoods.

The Healthy Black Family Project provides the framework for all of these programs, and tracks the progress of the families and individuals who are involved. Approximately 6000 individuals have enrolled in the program.

“The overall goal of the Healthy Black Family Project,” said Dr. Angela Ford, associate director of the center, “is to close the gap in health status between blacks and whites through coordinated community mobilization that is culturally relevant and grounded in a public health approach.”

Take A Health Professional to the People

A serious gap or disparity in health outcomes and access to medical care continues to exist for racial or ethnic groups, despite the efforts of government, community leaders, and healthcare providers. The problem is complex and entrenched, involving policy barriers, as well as cultural, social, and economic issues, and therefore demands fresh, creative solutions.

Take a Health Professional to the People Day is just the sort of innovative solution needed to address this serious disparity problem. Part of the Health Advocates In Reach (HAIR) program, it sends doctors, nurse, pharmacists and health educators into the barber shops and beauty salons of underserved communities to deliver health screenings and health education in a familiar, comfortable environment. Stephen B. Thomas, PhD, the director of CMH explains, “Far too many African Americans have no ‘medical home’ to access health care services, so government programs that promote ‘taking a loved one to the doctor’ are not as effective for this community. Therefore, CMH created Take a Health Professional to the People Day. By focusing our efforts on a single day, we believe we can help generate a greater understanding of the importance of regular health screenings while at the same time reaching people who tend to have the least access to healthcare.”

The Center for Minority Health inaugurated “Take a Health Professional to the People Day in 2002, starting with just three barber shops and salons. The program now includes nine beauty salons and barber shops, and over one hundred health professionals, some of whom continue to work with the shops in an on-going effort to provide health and wellness activities there.

In 2007, CMH linked forces with the Mayo Clinic Urban Immersion Program for ‘Take a Health Professional to the People Day’. Eight Mayo staff members traveled to Pittsburgh to gain valuable experience in delivering health care in a non-traditional setting. Dr. Sherine Gabriel, director of Education Resources for the Mayo Clinic Center for Translational Science Activities (CTSA), states, “We created the Urban Immersion Program in collaboration with Dr. Stephen Thomas and the CMH to help our students, faculty, researchers and physicians learn and apply these innovative community outreach strategies here at Mayo Clinic.”

Health Disparity Working Groups

Health Disparity Working Groups are charged with planning and organizing health promotion activities that will be implemented during National Minority Health Month (NMHM), which occurs every April. Each group in this diverse collection, brought together from the academic community, health providers, health promotion and human service organizations, and community representatives, organizes health promotion events that focus on the seven health disparity priorities of CMH.

These NMHM community-based events and activities are deeply rooted in the history of the Black community. They are modeled on the Health Improvement Week, which under the leadership of Booker T. Washington evolved into the National Negro Health Movement, and was annually observed for 35 years. Local NMHM activities are planned to be of value and interest for the entire family – including health, mental health, and wellness screenings, as well as physical activity and entertainment that features the world famous Double Dutch Divas.

In addition to their responsibilities of planning for NMHM, the Working Groups are also valuable as an ideal forum where materials and ideas related to research studies and the EXPORT Health communication campaign can be field tested. Representing, as they do, a wide-base of constituents and organizations, they also provide a large network for disseminating valuable information to the community.

Healthy Class of 2010

The Healthy Class of 2010 is a multi-year campaign designed to prevent disease and to promote health among students in the Pittsburgh Public Schools. Initiated in the 2003-2004 academic year, targeting those students who entered sixth grade that year, the program has a twofold goal: 1) to enable staff to systematically engage every student who entered sixth grade in 2003 in “active living”; and 2) to increase students’ knowledge, attitudes and healthy choices regarding physical activity, nutrition, and a tobacco-free lifestyle. The program, which partners with the Pittsburgh Public School System and the Allegheny County Health Department, follows the student’s progress toward achieving these goals, tracking them over a seven-year period through the year 2010, when they graduate. The Center for Minority Health is working toward making the Class of 2010 the healthiest students ever to graduate from the Pittsburgh Public School System, to coincide with the deadline set for Healthy People 2010, the nation’s health promotion program.

This unique collaboration between the Center for Minority Health (CMH), Graduate School of Public Health at the University of Pittsburgh, and the Pittsburgh Public Schools, focuses on partnership building between school administrators, teachers, students and their families, and the public health community. This creates a unique opportunity to address community needs of eliminating health disparities by customizing relevant interventions to address student health issues.

Adapted from the Wikipedia article Center for Minority Health, under the G. N. U. Free Documentation License. Please also see http://en.wikipedia.org/wiki

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Center for Nutrition Policy and Promotion (CNPP) is an agency of the U.S. Department of Agriculture created on December 1, 1994, and is the focal point within the USDA where scientific research is linked with the nutritional needs of the American public.

The creation of the Center came at a time when the American public was becoming increasingly aware of the importance of diet, yet was receiving conflicting nutrition messages. The Center, therefore, serves as a touchstone where the public is assured that the nutrition guidance they receive is based on sound research and analysis.

The Center reports to the [http://www.fns.usda.gov/fncs/fncs.htm Office of the Under Secretary of Agriculture for Food, Nutrition, and Consumer Services]. The staff of the Center is composed primarily of nutritionists, nutrition scientists, dietitians, economists, and policy experts, all of whom were chosen for their expertise. Dr. Rajen Anand is the current Executive Director of the Center. The Deputy Director is Dr. Robert C. Post.

CNPP carries out its mission by (1) advancing and promoting food and nutrition guidance for all Americans; (2) assessing diet quality; and (3) advancing consumer, nutrition, and food economic knowledge.

Adapted from the Wikipedia article Center for Nutrition Policy and Promotion, under the G. N. U. Free Documentation License. Please also see http://en.wikipedia.org/wiki

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