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A possible explanation for such ways of responding to the patient may be that the health workers, in their articulation of patient-centredness, draw on a repertoire of social conduct that involves an effort to level out, or tacitly deny, hierarchic structures, and that this becomes more pronounced in cross-cultural encounters. Patient-centredness and empowerment are results of long ongoing processes in Western countries, based on ideals of equality and individual freedom. The results from this study indicate that these approaches may pose intricate dilemmas for the health workers in their cross-cultural encounters, and need further attention.

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SummaryThis paper reports the results from a longitudinal study on iron status and diet among Norwegian and immigrant children living in the same residential area. This was the second part of the study and the children were two years old.All mothers with a normal pregnancy and delivery were invited to participate, and 80 of 95 eligible, accepted. Iron status analyses were carried out for 78 healthy children; 37 Norwegians and 4 1 immigrants (20 of Turkish origin).More immigrant children had depleted iron stores, compared to Norwegians. The median values for haemoglobin (Hb), mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH), serum ferritin (SF), transferrin saturation (TfS), free erythrocyte protoporphyrin (FEP) and transferrin receptor (TfR) were all within normal ranges. The differences between immigrants and Norwegians were significant except for Hb and SF. There was a rise in MCV and TfS and a decline in TfR among both Norwegian and immigrant children from one to two years, and a decline in SF among the Norwegians.The Norwegian children had a higher intake of soft drinks, dark bread and different iron-rich bread spreads than the immigrants, who had a higher intake of orange juice, and a more frequent use of citrus fruits than the Norwegians.Milk intake was negatively related -and consumption frequency of brown whey cheese was positively related -to iron . stores indicated by SF values above or below 15 pg/L.The results suggest that differences in food intake may explain the lower iron status in immigrants compared to Norwegians. More attention should be directed to children's diet and iron status in the second and probably third years of life.