Things in the library 25 August...

Things newly published...
The Lancet has just launched a new journal 'The Lancet Child & Adolescent Health' you can keep abreast of the articles by signing up for their email alerts or you can sign up for our Paediatric medicine e-prompt service which will include this journal along with others that we monitor. We have e-prompts on many specialist subjects and anyone can sign up to receive them.




Things about obesity...

The Department of Health has announced £5 million of funding for a new obesity policy research unit at University College London. One year on from the launch of the childhood obesity plan, the National Institute for Health Research (NIHR) Obesity Policy Research Unit has been set up to provide resource for long term research into childhood obesity. It will give independent advice to policy makers and analysts, and develop understanding on the causes of childhood obesity, looking at social inequalities, the early years of childhood, and marketing to children and families. It will also help to evaluate action that has been taken so far, to make sure the plan works for those who need it most. In addition, the government tasked Public Health England (PHE) to look at why children are eating too many calories.

Things about allergy growth and nutrition...
A letter in pediatric Allergy and Immunology discusses 'Striking the balance between primary prevention of allergic disease and optimal infant growth and nutrition. '
The timing of introduction of solids and/or complementary feeds continues to be an area of intense interest with respect to allergy prevention and general optimal infant nutrition. There is recent evidence from RCTs and a meta-analysis, that the earlier introduction of peanut (between 4 and 11 months) and egg (between 4 and 6 months), in infants at higher risk of allergic disease, may be beneficial. However, concerns have been raised over the impact this may have on duration of breastfeeding, nutrition and growth, when a high protein and calorie-containing food, such as egg or peanut, is introduced. Duration of breast feeding appears to have little impact on development of allergic disease, but is important for protection against overweight and obesity, diabetes and childhood infections (particularly in resource poor settings). Read the full letter here

Things about mental health...
The Royal Colleges of GPs (RCGP), Paediatrics and Child Health (RCPCH), and Psychiatrists (RCPsych) have committed to five shared principles that they hope will lead to tangible actions to improve the care and support of children and young people (CYP) with mental health problems.
Following the development of the joint principles, the three Colleges have committed to a number of ongoing actions. These include ensuring the highest quality training and standards in CYP mental health; supporting the development of evidence based models of care that are focused on integration of care; and calling for greater investment and resources to be focused on developing services in CYP friendly settings that promote early intervention and resilience.

Things about patient flow...
Technology to track beds, equipment, staff and patients through a hospital has been used in the USA for years, with positive effect, and now there is growing interest in employing it in the NHS. Sophie Castle-Clarke (Nuffield Trust) joined a group of NHS leaders to look at how this technology has made a difference to flow and operational management in two different health care organisations in Florida. The results are impressive, although significant transformation is needed to realise the benefits.

Things about tobacco...
Several Member States in the WHO European Region are moving towards becoming tobacco-free: a smoking prevalence of 5% or less. Emphasis, in particular, is on protecting younger generations from smoking initiation and other tobacco-related harm. Protecting children from tobacco in the Region is essential, not only because smoking initiation is a key component of an important public health crisis, but also because Member States are responsible for supporting various children’s rights. This report highlights ongoing and emerging tobacco-related issues that affect children in the Region and examines the regulatory frameworks, commitments and other tools that Member States should use to protect children from tobacco. This also includes more novel approaches that could – and should – be used to pave the way towards a tobacco-free European Region.

Things about brisk walking...
You will have heard in the news this week about the added health benefits of a 10 min brisk walk...this was an update in 'Everybody active, every day: a framework to embed physical activity into daily life' first published in 2014. You can read all the evidence and associated documents from links on this page 


Things gluten-free...

(C) Gill Kaye 2017

We had our annual big family reunion picnic last Sunday at the lovely Charlecote Park (equidistant between Tunbridge Wells, Marlborough, Grantham, Stafford and Sheffield...the relations who live in Warwick had the quickest journey!). As one of my food contributions I made a sun-dried tomato 'bread' which was much appreciated by everyone - not just those GF.

Things in the library 18 August...

Things about epilepsy...
A review published this month 'The Immune System in Pediatric Seizures and Epilepsies' aims  to present current knowledge of the role of immunity in relation to seizures, with a particular emphasis on clinical data available in childhood. More specifically, various autoantibodies involved in autoimmune encephalitis and epilepsy and general pathophysiological hypotheses on the role of immunity in seizure genesis are discussed, specific epilepsy syndromes in which autoimmune components have been studied are summarized, workup recommendations and therapeutic options are suggested, and finally, open questions and future needs are presented. The full text of this article is available to you via your NHS OpenAthens login (if you don't have an login register here for free).

Things about NEC...
A recent article 'Reducing Incidence of Necrotizing Enterocolitis' reports the following key points.

• Own mother’s milk (OMM) is associated with reduced odds of necrotizing enterocolitis (NEC) in observational studies, and quality improvement (QI) efforts to increase OMM have been successful at decreasing NEC.
• Donor milk (DM) has also been associated with NEC reduction when OMM is unavailable, although DM has not been associated with other health benefits as seen with OMM feedings in preterm infants.
• Institution of standardized feeding guidelines has been associated with reduced NEC rates, although the optimal rates of advancement and fortification are uncertain. Prolonged periods of nothing by mouth are associated with increased rates and severity of NEC and thus enteral feedings should be instituted soon after birth.
• Acid antagonists and prolonged empiric antibiotics in the setting of negative cultures are associated with increased odds of NEC, and both should be minimized or avoided if possible.
• Probiotics have been associated with reduced NEC in some, but not all, studies. Meta-analyses demonstrate reduction in NEC. At present, however, there remains controversy about probiotics due to concerns regarding quality and reliability of available products.
• Anemia and blood transfusions have been linked to NEC. Controversy remains regarding these relationships and best practices regarding enteral feeding during blood transfusions.

Things about dairy intake and blood pressure...
An article published in Journal of American Heart Association has looked at the relationship between dairy intake and blood pressure in black and white children and adolescents enrolled in a weight management program.
What Is New?

• We observed racial differences for the effects of dairy intake on systolic blood pressure (BP) in a cohort of children and teens enrolled in a weight management program.
• Greater intakes of dairy were associated with lower systolic BP in white but not black children and teens, suggesting that greater dairy intake alone is not beneficial for all races regarding systolic BP.

What Are the Clinical Implications?

• Nutrition professionals should assess the quality of the overall dietary pattern, as opposed to single nutrients, when providing recommendations to lower BP in the overweight and obese childhood and adolescent population.
• Nutrition and medical professionals must consider non-nutrition factors contributing to childhood hypertension and other cardiovascular disease risk factors, as current dietary recommendations appear to have differential outcomes across races in this cohort of children and teens.
• To prevent or manage high BP in children and teens, nutrition and medical professionals should use a strong evidence base and work collaboratively to design patient‐focused nutrition interventions taking into account age, sex, and race.

Things coming soon...
Going Public: International Art Collectors in Sheffield continues at the Graves Gallery this autumn with one of the UK’s finest private collections of modern and contemporary art.

Bridget Riley, Red Overture, 2012 © Bridget Riley, 2017

Reflecting a passion for photography, minimalism and geometric abstraction, Jack Kirkland’s personal collection brings together work by some of the most important artists of the past 75 years.
This new exhibition showcases personally selected highlights from the collection, including painting, sculpture, works on paper and photography by Carl Andre, Donald Judd, Josef Albers, Anni Albers, Bridget Riley, Lewis Baltz and more.
Saturday 2 September 2017 - Saturday 2 December 2017

Things about health outcomes...
The Local Government Association has published  a report 'Partnership approaches to improving health outcomes for young people' - the case studies in this report showcase different approaches to supporting the health of young people. Whilst the approach and focus of the work in local areas varies, each case study provides an opportunity to reflect on what made the initiative a success and how we might use this learning in our own areas.



Things to bake...
One of my favourite food bloggers is Clotildel and her blog is called 'Chocolate & Zucchini' it occurs to me that any gardeners out there may be looking at a glut of courgettes (zucchini) at the moment and need inspiration on how to use them...so here is a cake to come to your rescue 'Chocolate and zucchini cake'

Things in the library 11 August...

Things about case reviews...
If you want to access old safeguarding case reviews then you may be interested to know that the NSPCC and the Association of Independent LSCB Chairs have worked together to create the national case review repository to make it easier to access and share learning at a local, regional and national level. If you click on one of the titles listed you will see a summary of the case and a link to the full report.

and also...
Brighton & Hove Local Safeguarding Children Board (LSCB) has published the report of the serious case review (SCR) into the deaths of two brothers W’ and ‘X,’ in Syria in 2014 when they were aged 17 and 18. The siblings received services from local agencies in the Brighton & Hove area before leaving the UK. The SCR evaluates multi-agency responses to vulnerable young people at risk of exploitation through radicalisation. Key issues identified include: safeguarding adolescents involved in risky behaviour and intervening with families who have suffered long-standing trauma and whose previous experience of intervention was not perceived positively.

More things from NSPCC....
They have a section of their website devoted to their evaluation and research on what works to protect children from abuse and neglect. Split into sections: child abuse, looked after children, early years, families facing adversity, support for professionals.

Things about cerebral palsy...
Although it is estimated that half of all children with cerebral palsy also have comorbid intellectual disability, the domains of quality of life (QOL) important for these children are not well understood. The aim of this study was to identify important domains of QOL for these children and adolescents.
Results: The 11 domains identified as important to QOL were physical health, body comfort, behaviour and emotion, communication, predictability and routine, movement and physical activity, nature and outdoors, variety of activity, independence and autonomy, social connectedness, and access to services.

Things about health service use from infant to adult...
Late-preterm infants born at 34 to 36 weeks' gestation have increased risks of various health problems. Health service utilization (HSU) of late-preterm infants has not been systematically summarized before. this meta analysis aims to summarize the published literature on short- and long-term HSU by late-preterm infants versus term infants from infancy to adulthood after initial discharge from the hospital. It concludes that late-preterm infants had higher risks for all-cause admissions as well as for various cause-specific HSU during the neonatal period through adolescence.

Simple biscuits...
If you are stuck inside in this horrible weather and running short of things to do with the children then baking these simple biscuits is always a good stand-by...and then perhaps you could then have a mad-hatters tea party 

Things in the library 4th August...

Things new...
Blog going out a bit late today as I have been putting lots of lovely new books out on the shelves. See them here  . You can always make suggestions of new books that you think we should buy and if you have found a book particularly useful (or not) why not rate it on our catalogue and leave a comment for other users. You can also make suggestions of e-books you would like us to purchase by logging on to the e-book platform with your NHS Open Athens account

More new things...
Lots of new staff arriving this week - we look forward to helping you in any ways we can whilst you are here. If you need anything relating to information or organisation skills we are your people.

Things about juvenile mood disorders...
Suicide attempts are prevalent in association with major mood disorders, and risk is greater with bipolar disorder (BD) than major depressive disorder (MDD) in adults. There may be similar relationships in juvenile mood disorders, but the evidence has not been compiled systematically and quantitatively. Article published in JAA Child and Adolescent Psychiatry



Things about wellbeing...
Independent high quality evidence on what organisations – Governments, Charities, Businesses – can do to improve wellbeing is available here.

Things about undernourishment of children in England...
The Patients Association has issued a report suggesting that under-nutrition among children is not confined to the developing world, but is a problem in Britain today.
The project was undertaken by the Patients Association and funded by a non-restricted education grant from Abbott. A cross-section of health and care staff in four sites – Bradford, Cornwall, Tower Hamlets and Birmingham – were interviewed. Parents were also interviewed in Bradford and Cornwall. The findings reveal examples of positive efforts in working with children and families across agencies, particularly by public health teams, community and acute health staff; but many are overstretched and unable to meet demand for the types of information and guidance that people need. The report’s recommendations include:

• Awareness of under-nutrition should be raised among both professionals and the public
• New and existing training and guidance for professionals should include the identification and treatment of under-nutrition
• National guidance and a care pathway should be developed specifically for undernutrition.

Things improved...

New improved BNF and BNFC app has been launched.

The publishers of the British National Formulary (BNF) and British National Formulary for Children (BNFC) have released a new, faster, easier to use and access app. 

The new app has been purpose built for iOS and Android platforms. This has enabled an intuitive design and enhanced features around search, interactions checking and updating mechanisms. 

For the first time adult and child BNF content is available through a single app, providing ease of use and saving space on users’ devices.

The new app is fully portable and users don’t need to be connected to the internet to access it; this means the BNF and BNFC’s authoritative guidance is readily available at the point of care in a digital format to suit the needs of health and social care professionals.

Things to read...

We had an enjoyable time at Reading Group this week discussing our last book. The next meeting is at 17:15 on Wed 6th Sept and the book we will be discussing then is Lion: a long way home by Saroo Brierley. Do come and join us.

Things to attend...

Did you know Sheffield is hosting the Special Olympics between 7 - 12 August? Tickets are now on sale for the opening ceremony. We attended this in 1993 and it was great. However the previous night I had spent in Sheffield Children's where son number 1 was having a Lego brick he had inhaled removed....sigh.  PS If the junior doctor who was on duty when we first brought him in ...and didn't believe us......is now an esteemed consultant...do come and have a word...! 

Things to eat...

For the Reading Group this week I made some Buttermilk biscuits from the recipe in the book we were reading. The recipe below is similar and one I have made before...great with chowder.