Introduction to the special section: The development of infant mental health home visiting in Michigan state government.

This issue of the Infant Mental Health Journal presents the first papers from a tripartite evaluation study of state-sponsored infant mental health home visiting program in Michigan, United States. This series of studies has been led by Kate Rosenblum PhD and Maria Muzik MD, Department of Psychiatry, the University of Michigan and faculty from the Michigan Collaborative for Infant Mental Health Research for the State of Michigan, Department of Health and Human Services, Mental Health Services for Children, to fulfill the requirements of state legislation (State of Michigan Act No. 291, Public Acts of 2013) that required that all home visiting programs meet certain requirements to be established as an evidence-based practice. In this introduction, we provide a historical context for the delivery of infant mental health home visiting through the community mental health system in the state of Michigan.

The Michigan infant mental health home visiting model.

Selma Fraiberg's pioneering work with infants, toddlers, and families over 40 years ago led to the development of a field in which professionals from multiple disciplines learned to work with or on behalf of infants, very young children, their parents, and the relationships that bind them together. The intent was to promote social and emotional health through enhancing the security of early developing parent-child relationships in the first years of life (Fraiberg, 2018). Called infant mental health (IMH), practitioners from fields of health, education, social work, psychology, human development, nursing, pediatrics, and psychiatry specialize in supporting the optimal development of infants and the developing relationship between infants and their caregivers. When a baby is born into optimal circumstances, to parents free of undue economic and psychological stressors and who are emotionally ready to provide care and nurturing for an infant's needs, an IMH approach may be offered as promotion or prevention, with the goal of supporting new parent(s) in developing confidence in their capacity to understand and meet the needs of the tiny human they are coming to know and care for. However, when parental history is fraught with abandonment, loss, abuse or neglect, or the current environment is replete with economic insecurity, threats to survival due to interpersonal or community violence, social isolation, mental illness, or substance abuse, the work of the IMH therapist may require intervention or intensive treatment and becomes more psychotherapeutic in nature. The underlying therapeutic goal is to create a context in which the baby develops within the environment of a parent's nurturing care without the psychological impingement that parental history of trauma or loss or current stressors such as isolation, poverty, or the birth of a child with special needs, can incur.

'[Her] hostess is anxious to have her back when she is cured': The impact of the evacuation of children on wartime local services, England, 1939-1945.

World War II had a profound, but uneven, impact on the delivery of services designed to support the bodies and minds of English children. This article, which is based on a study of a rural local authority located in North-West England, explores the influence of World War II on children's welfare services. Drawing on detailed case files relating to individual children and reports published by local and national policy makers, the article advances three related arguments which together nuance existing understandings of the conflict and its longer-term consequences. First, the article argues that many of the problems associated with evacuees were already familiar to medical and social work professionals. This awareness has important consequences for how we conceptualise the wartime proposals that attracted policy makers' attention. Second, the article shows that the arrival of evacuees into reception areas initially resulted in an expansion of children's services. A fuller understanding of Britain's welfare state, however, must acknowledge that local authorities continued to wield significant influence over the delivery of specialist services once the conflict ended. As a result, the priorities of local officials could lead to the needs of looked after children being overlooked despite wartime improvements to children's services. Finally, the article argues that amidst the totality of World War II, the British state remained unwilling to intrude on the rights of parents to influence the care of their children. Closer examination of the implementation of evacuation and the experiences of individuals reveals that important tensions existed between the state appointed experts and the civilians they were tasked with supporting.

[The Regional Features of Development of the System of Children Health Care in the Kabardino-Balkaria in XX Century].

The development of health care of children in the Kabardino-Balkaria in XX century at all its stages is associated with the development of system of protection children health in Russia. To combat children mortality and to protect children health, preventive and social hygienic direction was developed. Under the leadership of local health care authorities, a network of children medical institutions was re-established in Kabarda and pediatricians began to work. However, these institutions did not supply needed medical care of children. The health of the children population during the war (1941-1945) was supported jointly by the health care authorities and other state departments and structures of the Republic. Children health care was characterized by increasing of burden of medical institutions and the holding of emergency activities under leadership of the Children's Sector and the Council for Treatment and Prevention of Children. The most difficult for health care in the Kabardino-Balkaria were the post-war years. Due to lack of funding, only in 1959-1965 children's departments began to be organized in hospitals. The preventive activities among children of early age, especially among adolescents (vaccination, anti-tuberculosis and anti-obesity measures, organization of children sanatoriums) became more active. The dynamics of development of children health in the 1960s - 1980s had a pronounced extensive character with on-going increasing of number of beds and medical personnel. At the same time, the structure of infant mortality and morbidity demonstrated presence of shortcomings in work that blocked improving of indicators of children health. The infant mortality decreased slowly in the last decade of XX century. The foundations of modern children health service were organized. New children health care institutions were put into operation and the bed fund was restructured. However, the deterioration of social economic situation in the country and the region had a negative impact on the state of children health. At the turn of the century, the system of protecting children health in the Kabardino-Balkaria required more active medical and public events of medical, social and organizational nature with the identification of the tasks of highest priority.

Short view on origins of paediatric health care in Prague.

The first charity for protection of orphans in Prague was opened in the 16th century by Italian living in Prague. The first outpatient department for sick children in Prague was opened by Johann Melitsch in 1790 in the Saint Lazare hospital in Charles Square. In the same hospital, the first paediatric department with 9 beds was opened by Eduard Kratzman in 1842. Relatively low mortality of hospitalized children that time must be explained. Sick infants were not admitted to hospitals but sent to the orphan institutes with mainly social care, therefore in middle of the 19th century the infant mortality in these establishments was extremely high, during some years nearly 100 %. The first hospital for children in Prague was built by Josef Löschner in Charles Square in 1853, where a number of distinguished paediatricians worked including Gottfried Ritter von Rittershain, who described dermatitis exfoliativa Ritter, Alois Epstein, who described Epsteins pearls by newborns, Adalbert Czerny, who studied glycogen and later became a head of Paediatric clinic in Berlin, Leopold Moll, who was an initiator of the care for mother and child and later became a head of Paediatric clinic in Vienna, Dusan Lambl, who described flagellate (nowadays Giardia lamblia) in the stool of children with diarrhoe, and Bohdan Neureutter, who after the splitting of the Charles-Ferdinand-University on the in German speaking and Czech speaking parts opened the Czech paediatric hospital at the corner of streets Benatska and Vinicna. Due to increasing requirement of paediatric beds in Prague, simultaneous constructions of two paediatric centres were started in Prague. The first, areal with four buildings for German paediatric clinic was opened in 1901, which still serve as the second largest paediatric department in Prague, of course with much lower number of beds than 100 years ago. The second one, the Czech paediatric Frantz Josef I. hospital was opened in 1902, but due to construction of the bridge across the Nusle valley was demolished in 1970 and it´s clinics were transferred to the hospital in Motol. Keywords: history of paediatric health care.

[Processes of attention to children and adolescents under 20 years in La Castañeda: evolution of the concept of childhood in psychiatry]. / Procesos de atención a menores de 20 años en La Castañeda: evolución del concepto de infancia en psiquiatría.

Today, there is evidence that shows that children and adolescents can experience developmental problems and psychiatric disorders. This was possible because of two main reasons, the evolution of the concept of infancy and the progress made in medical and psychiatric diagnostic classification. This manuscript offers a glance to early psychiatric attention in Mexico, particularly the care processes provided to 36 children and adolescents under twenty, admitted in the mental asylum La Castañeda, during the first half of the XX century. Admission causes, length of stay, diagnosis, treatment and discharge motives, are some of the aspects described in this study. Finally, it also reflects about the challenge it is for a child psychiatric hospital nowadays, with such a history, to become an innovative institution able to claim a place in the medical field in favor of those minors that can barely defend themselves.

Resumen: Existe evidencia de que los niños y adolescentes pueden presentar problemas del desarrollo y trastornos psiquiátricos. Lo anterior es consecuencia del concepto de infancia y del refinamiento de las clasificaciones diagnósticas médico-psiquiátricas. Este artículo ofrece una mirada sobre los procesos de atención psiquiátrica brindados a 36 niños y adolescentes admitidos en el Manicomio La Castañeda en la primera mitad del siglo XX. Motivo de ingreso, tiempo de estancia, diagnósticos establecidos, tratamiento y motivo de egreso son algunos de los aspectos que se describen. Finalmente, se reflexiona sobre la existencia de un hospital psiquiátrico infantil, que siendo testimonio del pasado, tiene al mismo tiempo el desafío de convertirse en una institución innovadora; sitio que en el ámbito de las especialidades médicas reclama la psiquiatría infantil a favor de los menores que difícilmente pueden abogar por sí mismos.

Child Rights and Clinical Bioethics: Historical Reflections on Modern Medicine and Ethics.

Why might pediatric bioethicists in the United States reject the U.N. Convention on the Rights of the Child (CRC) as a framework for resolving ethical issues? The essays in this issue present arguments and counterarguments regarding the usefulness of the CRC in various clinical and research cases. But underlying this debate are two historical factors that help explain the seeming paradox of pediatric bioethicists' arguing against child's rights. First, the profession of clinical bioethics emerged in the 1970s as one component of modern medicine's focus on improving health through the application of technologically sophisticated treatments. The everyday work of U.S. bioethicists thus usually involves emerging technologies or practices in clinical or laboratory settings; the articles of the CRC, in contrast, seem better suited to addressing broad policy issues that affect the social determinants of health. Second, U.S. child health policy veered away from a more communitarian approach in the early 20th century for reasons of demography that were reinforced by ideology and concerns about immigration. The divide between clinical medicine and public health in the United States, as well as the relatively meager social safety net, are not based on a failure to recognize the rights of children. Indeed, there is some historical evidence to suggest that "rights language" has hindered progress on child health and well-being in the United States. In today's political climate, efforts to ensure that governments pledge to treat children in accordance with their status as human beings (a child right's perspective) are less likely to improve child health than robust advocacy on behalf of children's unique needs, especially as novel models of health-care financing emerge.

In the beginning, there was general paediatrics .

In this article, we address how general paediatrics has evolved and adapted to change over the past 50 years and speculate on its future directions. We compare the state of general paediatrics with that of general adult medicine. We argue that general paediatrics must continue to have a strong role both in paediatric teaching hospitals and the community.

Negotiating relationships of power in a maternal and child health centre: the experience of WHO nurse Margaret Campbell Jackson in Iran, 1954-1956.

From November 1954 to November 1956, Canadian nurse Margaret Campbell Jackson was employed by the World Health Organization (WHO) and was stationed in Tehran, Iran, where she participated in the establishment of a Maternal and Child Health (MCH) Centre. The objective of the project, known as Iran 10, was twofold: to set up a health service for mothers and children and to initiate a field training program for Iranian physicians, nurses, and other health care providers. Drawing on 180 letters Jackson wrote to her family in Canada from Iran, this article analyzes the MCH Centre as a contact zone and considers the relationships Jackson developed with staff affiliated with the project. The Centre became a space of cross-cultural encounters, where locally and foreign-trained Iranian staff and expatriates mingled and shared working relationships. I argue that authority was negotiated and contested through interactions and associations that were often unequal and framed by notions of progress, modernization, race, and health. Personality also played an important role.

The creation of the federal MCH Extramural Research Program, 1950-1969: lessons for today.

On April 9, 1912, the law establishing the Children's Bureau was signed by President William Howard Taft. The original mission of the Children's Bureau was to "investigate and report … upon all matters pertaining to the welfare of children and child life among all classes of our people." This paper focuses on the transitional years from roughly 1950 to 1969, when the Children's Bureau's investigative mandate was transformed from a set of intramural activities that viewed maternal and child health research as part of a larger effort cutting across investigative, programmatic, and policy goals, and across different domains of the child's life, to an extramural research program focused specifically on maternal and child health. Discussion focuses on the mission of the Maternal and Child Health (MCH) Research Program, housed now within the Maternal and Child Health Bureau (MCHB), Health Resources and Services Administration (HRSA), of the U.S. Department of Health and Human Services.

A radical proposition: the brief but exceptional history of the Seattle school clinic, 1914-21.

This article examines the history of the Seattle school clinic (1914-21) and the efforts of public school administrators to institutionalize a full-service medical program for poor and working class children. At its height, thirty-six volunteer physicians and thirteen partially paid dentists organized within nine departments performed a range of diagnostic and "corrective" surgical procedures, including tonsillectomies, circumcisions, and eye surgeries. These practices were not funded by other public school systems across the United States, almost all of which delineated between prevention and treatment services. This article explains the exceptional nature of the clinic, examines the institutional tensions instigated by the expression of medical authority within the schools, and considers how clinic technologies influenced state-school-child relations.

Julie Kamblijambi-Kep--PhD candidate at RMIT University, Australia.

Julie Kamblijambi-Kep has come a long way from her childhood in the village of Wingi in Papua New Guinea's East Sepik Province. This article explores the support Julie's family provided for her education, her subsequent training as a nurse and her work around the country, including as the coordinator of the maternal health program at the University of Goroka. The article's exploration of various challenges, including the death of Julie's husband and her need to work while raising five children, make it a useful reference point for women in Papua New Guinea, especially those who are committed to helping others by working in the field of maternal and child health.

NAVIGATING the future through the past: the enduring historical legacy of federal children's health programs in the United States.

The United States excels at treating the most complex medical conditions, but our low-ranking health statistics (relative to other countries) do not match our high-end health care spending. One way to understand this paradox is to examine the history of federal children's health programs. In the 1800s, children's health advocates confronted social determinants of health to reduce infant mortality. Over the past 100 years, however, physicians have increasingly focused on individual doctor-patient encounters; public health professionals, meanwhile, have maintained a population health perspective but struggled with the politics of addressing root causes of disease. Political history and historical demography help explain some salient differences with European nations that date to the founding of federal children's health programs in the early 20th century. More recently, federal programs for children with intellectual disability illustrate technical advances in medicine, shifting children's health epidemiology, and the politics of public health policy.

Organization of the "Marine Colony" for children with tuberculosis in Rijeka (Croatia): entanglement between medicine and politics.

Tuberculosis was a major public health concern in the beginning of the 20th century. Since medications were not available at the time, therapy in general was based on health education, healing effects of climate, nutrition and rest. The Marine Colony was founded in 1924 in Rijeka, a city with turbulent political history, by the Antitubercular Consortium which was part of a planned program for the fight against tuberculosis on a national level in the whole of Italy. The Colony in Rijeka, Croatia specialised in care of children with clinical tuberculosis or under greater risk of developing disease. This article gives an overview of the medical treatment provided for children in Colony, as well as pointing out the political-agenda at that period.