Things in the library 16 March...

Things to trust...
The YouGov poll of adults in Great Britain shows:
- 66% agree that it is harder than ever to find trustworthy information.
- 84% agree that they trust information more when it is given by a professional.
- 90% agree that it is important to educate people on how to find trustworthy information.
- Medical staff topped the list, with 74% of British adults saying they thought they would provide trustworthy information, followed by teachers and police officers (both at 49%), librarians (46%) and lawyers (39%). Bottom of the list were politicians, with 2% of respondents saying they thought they would provide trustworthy information. We can help you find reliable information via our 'Book a Librarian' service.

Things about NHS priorities...

This editorial in BMJ says the NHS must prioritise health of children and young people as our future health and prosperity depend on it. Children and young people are a quarter of our population but 100% of our future. Our moral obligation to promote children’s health is clear within UK law and in the UN Convention on the Rights of the Child. Furthermore, 94% of adult Britons believe children’s health should be a priority for the NHS. Despite this, the low priority that UK health systems give to children suggests we must marshal other arguments to convince policy makers. Children and young people aged 0-19 years are the workforce of the 2020s and the parents of the next generation. Their health will be one of the factors deciding whether the UK is prosperous after 2019. Countries that invest in child health reap impressive economic rewards, with each pound spent on children’s health returning over £10 to society over a lifetime. The converse is that poor health in childhood leads to reduced workforce participation and productivity and lowers national wealth

Things about coping under pressure...
The Royal College of Physicians’ (RCP’s) NHS reality check: Delivering care under pressure reports gives over 2,100 doctors and NHS teams, who are overwhelmed by rising levels of demand in hospitals, a voice on how their profession is coping. It returns to last year's key report and once again gives over 1,500 doctors working in the NHS the chance to discuss their experiences of delivering care in the UK health service. The key finding for the 2018 update was that conditions had got worse and NHS staff, who have benefited from some of the best medical education in the world, were not able to provide the standard of care they have been trained to deliver.


Things to come and join in...
Journal Club next week is on Tuesday 20th March at 13:00 to 14:00 in Clinical Skills centre F Floor Stephenson Wing. The article being discussed is 'Are three malaria tests necessary in children returning from the tropics with fever?' Please contact us if you would like a copy of the paper. Home made muffins provided.






Things historic...

This year is the 70th anniversary of the NHS. If you know of someone from Sheffield Children's Hospital whose groundbreaking research has led to a significant difference to the care of our patients ...whether 70 years ago or more recently... please let  Gill  know. We would like to find out more about them and their work.


Things warm and comforting...
Nothing like a good beef stew for a cold weekend like this one from Mary Berry





......
or if you want a vegetarian option...Butternut squash and root veg hotpot

Things in the library 9th March...

Things doubled up...
If you come up to the library to use our computers don't be surprised if you are seeing double. Thanks to a successful bid for funding from HEE we have been able to provide two screens for each of the NHS computers. If you have worked with two screens you will know how useful it is to have, for example, a spreadsheet open on one and a Word document on another at the same time. If you are not sure how to do this please ask any of the library staff for help.

Things about mental health...
The CQC report their findings of their independent review of the system of services that support children and young people’s mental health. Are we listening? full report and summary are available here. 
Their recommendations are:

• The Secretary of State for Health and Social Care should make sure there is joint action across government to make children and young people’s mental health a national priority, working with ministers in health, social care, education, housing and local government
• Local organisations must work together to deliver a clear ‘local offer’ of the care and support available to children and young people
• Government, employers and schools should make sure that everyone that works, volunteers or cares for children and young people are trained to encourage good mental health and offer basic mental health support
• Ofsted should look at what schools are doing to support children and young people’s mental health when they inspect

Things to attend...

Two ScHARR courses in Sheffield.

Experiential Research Approaches (ERA): Qualitative Methods using Observation, Description and Interpretation  2 day course - Thursday 28th - Friday 29th June 2018 Early Bird Booking rate closes 29th April 2018. Standard Booking closes 13th June 2018.

Cluster Randomised Trials Design and Analysis 1 day course - Wednesday 4th July 2018 Early Bird Booking rate closes 6th May 2018. Standard Booking closes 20th June 2018.


Things about obesity...
Children who eat takeaways once or more each week have more body fat and higher low-density lipoprotein (LDL) “bad” cholesterol levels than those who never or hardly ever eat them. Their diets were also higher in fat and lower in protein and calcium. This cross-sectional study looked in depth at eating habits and risk markers for coronary heart disease, obesity and diabetes in 2,529 children in England. Though this type of study can only show an association between takeaways and risk markers, it is one of the first of its type, and the results do give cause for concern. Increasing numbers of people are eating takeaways in the UK. Local authorities and healthcare professionals are well placed to encourage parents and children to choose healthier foods, in line with current national guidance.

Things about abuse...
Getting help to overcome abuse A quick guide for young people receiving support published by NICE is available online. This guide has been written by young people who have experienced abuse or neglect. 15 young people from around the country were supported by AVA to help develop the NICE guideline on child abuse and neglect. They did this by talking about their experiences of seeking help and support, including sharing the challenges they faced as well as what worked well. When the guideline was finished, they wanted to write a quick guide to help other young people find out what support they are entitled to.

Things about child health...
The government has published the Child Health profiles for 2018 which provide an overview of child health and wellbeing for each local authority in England. Those working in local government and health services can use the profiles as a tool to help:

• understand the needs of their communities
• improve the health and wellbeing of children and young people
• reduce health inequalities

Things new in the library...

Quite a few new books hitting the shelves of the library this week. If you want to be notified when books matching your subject interests are bought please let us know. If you have suggestions for books or e-books you think we should have then get in touch. if you want to see the latest books then check this link on our catalogue.  If a book is 'processing' but not yet available it can be reserved for you.

Things to read...

Next months Reading Group will be on Wed 4th April so pop the date in your diaries the book to read is 'The Pianist' by Wladyslaw Szpilman. The powerful and bestselling memoir of a young Jewish pianist who survived the war in Warsaw against all odds.

and things to eat...
How about some Polish sausage and red cabbage - this dish could be a main or a side dish.  Rosemary braised red cabbage with kabanos takes long slow cooking but is really easy to prepare.

Things in the library 2 March...

Things snowy...
We have remained open throughout the bad weather and have had several waifs and strays working here if they can't get to their normal workplace. We sell hot drinks and biscuits and provide a spectacular view across the snowy rooftops of Sheffield.

Things to discuss...
Reading group next week on Wednesday 7th March 17:15 in the library. Drinks and nibbles and discussing a book about Eyam.
Come and join us.

Things about statistics...
We are often asked for help with statistics (which we are unable to do) but we have just bought a new book 'Statistics at square two' which is a companion to 'Statistics at square one'. This book aims to help you to evaluate the many statistical methods in current use and is aimed at all those who need to understand statistics in clinical research papers and apply them in their own research.

Things about the NHS...
The King's Fund has published results and trends from the British Social Attitudes survey which  has asked members of the public about their views on, and feelings towards, the NHS and health and care issues generally. The latest survey was carried out between July and October 2017 and asked a nationally representative sample of 3,004 adults in England, Scotland and Wales about their satisfaction with the NHS overall, and 1,002 people about their satisfaction with individual NHS and social care services. They conclude that :
"looking at the 2017 data through that long-view lens reminds us that overall NHS satisfaction levels remain higher than they were in the 1990s and early-to-mid-2000s. Nevertheless, the statistically significant fall in satisfaction (and rise in dissatisfaction) in 2017 took net satisfaction to its lowest level since 2007. With an increase over the last few years in the proportion of survey respondents reporting lack of funding as a reason for their dissatisfaction, it seems the public is increasingly aware of the reality of funding pressures that the NHS has experienced over the last seven years. With equally small increases in funding planned over the next few years and NHS performance on key headline measures worsening, it is hard to see the public’s satisfaction with the NHS improving in the near future."

Things about kiwis...
A recent article in European Journal of Nutrition reviews the nutritional and health attributes of kiwifruit. The review includes a brief history of green and gold varieties of kiwifruit from an ornamental curiosity from China in the 19th century to a crop of international economic importance in the 21st century; comparative data on their nutritional composition, particularly the high and distinctive amount of vitamin C; and an update on the latest available scientific evidence from well-designed and executed human studies on the multiple beneficial physiological effects.
Of particular interest are the digestive benefits for healthy individuals as well as for those with constipation and other gastrointestinal disorders, including symptoms of irritable bowel syndrome. The mechanisms of action behind the gastrointestinal effects, such as changes in faecal (stool) consistency, decrease in transit time and reduction of abdominal discomfort, relate to the water retention capacity of kiwifruit fibre, favourable changes in the human colonic microbial community and primary metabolites, as well as the naturally present proteolytic enzyme actinidin, which aids protein digestion both in the stomach and the small intestine. The effects of kiwifruit on metabolic markers of cardiovascular disease and diabetes are also investigated, including studies on glucose and insulin balance, bodyweight maintenance and energy homeostasis.

Things about blockchain...
Do you know your Bitcoin from your Ethereum...and the possible implications for this technology for healthcare? If not this article from the Emerging Technology Group at NHS HEE may help you understand.

Things about health services for children...
A framework to support challenged children and young people’s health services achieve a good or outstanding CQC rating has been published. This framework supports and enables senior children and young people’s nurses to achieve good and outstanding care standards for children and young people’s health services. It integrates policy guidance with the most frequent reasons the Care Quality Commission (CQC) gives for rating children’s services as ‘requiring improvement’ or ‘inadequate’ as identified in our review of CQC reports.

Things about fish...
In Pediatric Allergy and Immunology a study by a group in Sweden suggested that toddlers who eat fish at least once a month  or live on a farm are less likely to develop hay fever in later childhood.
Eating fish once a month or more at age 12 months reduced the risk of allergic rhinitis at 12 years (0.70, 0.50-0.98) as did living on a farm with farm animals at four years (0.51, 0.32-0.84). Continuous farm living from age 4 to 12 seemed to drive the association. They concluded that Allergic rhinitis affected more than 20% of 12-year-olds, but was lower in children who ate fish at 12 months or grew up with farm animals.

Things about oral health...
A report on  the oral health survey of 5-year-olds in Yorkshire and the Humber in 2015, as part of the National Dental Epidemiology Programme for England, has been published. Yorkshire and The Humber remains the second worst region in the country for the proportion of five-year-olds with experience of tooth decay. However, the results show a continued decrease in the proportion of children with tooth decay (prevalence) and a decrease in severity of decay (the number of teeth with decay) at a regional level and at a local authority level for most areas. More five-year-old children have had teeth removed (extracted) due to tooth decay in the Yorkshire and The Humber than any other region in England.

Things to eat...
This is a fabulously easy dessert which I have made several times...and of course it features kiwi fruit.

Things in the library 23 Feb...

Things to do with the children...
Nature Detectives Event, Weston Park Museum Saturday 24th February 2018, 11-4pm
Come and meet some scientists and discover how they identify animals using DNA, bird calls, poo, tracks and other clues.
Have a go at becoming a nature detective yourself, get up close to the taxidermy collection, and find out more about real scientific projects such as how otters are tracked in Sheffield.

Things about behavioural and emotional disorders...
Behavioural and emotional disorders in childhood: A brief overview for paediatricians.
Childhood behaviour and emotional problems with their related disorders have significant negative impacts on the individual, the family and the society. They are commonly associated with poor academic, occupational, and psychosocial functioning. It is important for all healthcare professionals, especially the Paediatricians to be aware of the range of presentation, prevention and management of the common mental health problems in children and adolescents.

Things about probiotics...
European guidance on paediatric use of probiotics states that benefits are limited to several conditions and urges caution with specific vulnerable groups. The use of probiotics has been covered by many guidelines, position papers and evidence-based recommendations, but few have referred to specific patient groups or clinical indications. This European study summarises recommendations and scientifically credited guidelines on the use of probiotics for children and provides practice points. The panel found that specific probiotic strains were effective in preventing antibiotic associated and nosocomial diarrhoea, treating acute gastroenteritis and treating infantile colic in breast fed infants. However special caution is indicated for premature infants, immunocompromised and critically ill patients and those with central venous catheters, cardiac valvular disease and short-gut syndrome. We discuss the safety of using probiotics for paediatric patients and the quality of the products that are available and provide practice points based on our findings.

Things about activity...
Extended physical education in children aged 6-15 years was studied in this recent article, they conclude that  increasing weekly physical education over nine years was associated with improved academic achievement in boys.










Things to attend...
This King's Fund two-day Digital health and care congress ( 10 - 11 July 2018) provides an established forum for health and care professionals to come together and learn from successful adoptions and practical implementations of digital health and care.




Things for those who like maps and history...

I discovered this National Library of Scotland site during the week. You can look at old maps and current satellite images or maps side by side - and as you move or zoom on the current map the same thing happens in the split-screen on the old one, hours of fun!



Things to use up...
Any left-over dhal after an indian meal?  Try this recipe to perk them up and create an extra meal.

Things in the library 16 Feb...

Things to attend...
Inaugural Lecture - Can we explain 'medically unexplained' symptoms? Prof Chris Burton, Academic Unit of Primary Medical Care, University of Sheffield Followed by wine reception  Tuesday, 27 March 2018 from 18:00 to 19:30

Inaugural Lecture: Medical Education - The Journey
Prof Michelle Marshall, Academic Unit of Medical Education, University of Sheffield Followed by wine reception Monday 23 April 2018  18:00 to 19:30


Things for Teddy bears...
Teddy Bear Doctors are ready to welcome poorly teddies (or other stuffed friends) to Weston Park Museum 10am - 4pm, Saturday 17 February  to kick off the half term with some Teddy Bear Hospital fun!

Teddies will get a taste of what it's like to visit the GP or go to hospital, as well as learning about how to live a healthy and happy lifestyle. Activities including going in an "MRI" scanner, taking an x-ray, having Teddy bandaged and finding out what foods will keep Teddy healthy. This year try out the new 'virtual reality' activity to see inside the human body, and learn how to care for Teddy's emotional wellbeing at our new emotions station. Our student orthoptists and dentists will also be on hand to check Teddy's eyesight and give top tips on how to keep Teddy's teeth sparkly clean. Teddy Bear Hospital is a Sheffield Students' Union Society which aims to reduce the anxiety that children can experience when visiting the doctor or dentist, as well as promoting child health. This activity forms part of the Sheffield Volunteering programme. Free, no booking required   The session is aimed at children aged 3 - 8, but children of all ages are welcome  Children and teddies are asked to please bring an adult with them!

Things about healthy communities...
This King's Fund  article states: "The role of communities in improving health is receiving increasing, and long overdue, attention in health policy and practice. Stronger recognition of the role communities can play and greater involvement are needed if there is to be a successful move to population health systems. As part of this shift in focus, sustainability and transformation partnerships and integrated care systems need to take the role communities can play in improving and sustaining good health seriously." The article discusses topics such as health policy, examples of community involvement and commissioning. They provide a reading list for those who want to explore this topic further.


Things on Systematic Review and Meta-analysis...
The aim of this ScHARR three day course (Tues 17th - Thurs 19th April 2018) is to provide participants with an introduction to methods for conducting systematic reviews in health care. Sessions will be delivered by ScHARR staff experienced in systematic review methods and health technology assessment. The course will be interactive and practical, with delivery of sessions based on lectures and individual and small group practical exercises. No previous knowledge of systematic reviews or meta-analysis is assumed. £999 - Early Bird Rate for confirmed bookings received on or before midnight on Sunday, 18th February 2018 £1099 - Standard Rate for confirmed bookings received on or after Monday, 19th February 2018. A 20% discount will be offered for group bookings of 4 or more people. Please contact Karen Holden at scharr-scu@sheffield.ac.uk to book. NB: This discount cannot be applied at checkout or after a booking has taken place through the Online Store, all group bookings should go directly to Karen Holden at scharr-scu@sheffield.ac.uk.

Things on obesity...
An evaluation study has been published in  Public Health Research. Working with teachers, families and children,  the Healthy Lifestyles Programme (HeLP) was developed, which aimed to engage and support children and families to make healthy food and activity choices. This study is to understand whether or not HeLP can prevent children aged 9–10 years from becoming overweight or obese.
 The study involved  32 primary schools from Devon, half of which were randomly selected to receive the programme while the other half continued as usual. They measured children’s weight and height, waist circumference and percentage body fat; assessed how active they were; and used questionnaires to look at the types of food and drink they consumed. They also asked what they understood about a healthy lifestyle and how they felt about it.
The study began when the children were 9–10 years old, in Year 5, and HeLP was delivered in the spring and summer terms of Year 5 and in the autumn term of Year 6. Children had their final set of measurements taken when they were at secondary school (aged 11–12 years). They were able to follow up 94% of children for their final set of measurements, an exceptionally high follow-up rate; they think that this is because schools, children and families helped them design the trial.Despite HeLP’s success in engaging children, families and teachers, there was no difference in weight status between children who had received the programme and those who had not. There was no difference in the amount of physical activity children did or in the amount of time they spent not being active. They saw a positive difference in some snacking behaviours, with children who had taken part in HeLP eating fewer unhealthy snacks and having less unhealthy foods generally.
Given that the programme failed to achieve sufficient change in behaviour to prevent overweight or obesity, they think that new approaches are needed to support families and children in making healthy lifestyle choices.

Something to love and something to eat...

We have had our heart shaped biscuits in the library again this week as a reminder about our Book a Librarian service. This week we did some reference managing training at Ryegate - don't forget we can come to you and your team if you can't get to the library. If you want to make the biscuits you will find the simple recipe here.

Things in the library 9th February...

Things parents want...
As a first step toward the development of an animated video and infographic to increase parents’ knowledge of pediatric urinary tract infections (UTIs), the authors of this report in  'Patient Education and Counseling' conducted a systematic review of their experiences and information needs. This highlighted:

• Reports of parents’ experiences and information needs about urinary tract infections are scarce.
• Parents desire information on prevention, diagnosis, treatment, and prognosis.
• Parents do not always trust healthcare providers as information sources.
• Care providers must communicate information that empowers educated care decisions.
• Knowledge translation efforts should be tailored to parents’ self-identified needs.

Things old and new about Vitamin D...

Hypovitaminosis D in childhood is a re-emerging public health problem in developed countries. New life style habits, current "epidemics" of obesity in children and adolescents worldwide, and other preventable risk factors may play a role in favouring the occurrence of vitamin D deficiency. In addition to skeletal consequences, hypovitaminosis D has been found to be involved in the development of serious health extra-skeletal problems in childhood, including atopy and autoimmunity. The increasing concerns about the global health impact of vitamin D deficiency make further research necessary to fill the gaps of knowledge in this field, and particularly to establish universally accepted "normal" serum 25(OH)D levels in the pediatric population, and to improve strategies for the screening, prevention and treatment of hypovitaminosis D. This review discusses the key points of hypovitaminosis D in childhood in the light of new knowledge, and highlights the limitations of current strategies to control this condition.

Things to love...

Make a Date with a Librarian.....let us help you get the information you want when you need it. Our "Book a Librarian" service enables you to reserve a 1:1 or group session with a member of staff.

Use the online form to book or email the library with your request. Support available on the following:

•  Literature search
•  Obtaining articles
•  e-promptXtra (current awareness)
•  Google searching
•  Using Microsoft Office
•  Using social media
•  Managing email
•  Managing references
•  Conference posters/graphics
•  Critical appraisal (group session)
•  Health information
•  Referencing

Things to discover...

Our next Reading Group is on Wednesday 7 March, 17:15 in the library.

We will be discussing Eyam: plague village by David Paul.

The story follows the local rector, the Revd William Mompesson, as he tries to support his parishioners and contain the plague which was inadvertently transported from London to Eyam in September 1665 on a consignment of cloth. Events are told from the perspectives of the rector, his wife Catherine, and the fictional character of Beth Hounsfeild, Catherine's cousin. Much of Eyam's population died as the village instated a "cordon sanitaire", isolating itself to prevent the disease from spreading.

Everyone welcome (whether you've read the book or not!) Come and join our informal discussion. Refreshments will be served.

Things to attend...

What will the NHS be facing on its 90th birthday? By Professor Chris Whitty - The 20th Sir Arthur Hall Memorial Lecture- 15 February  Book a place   18:00 The Students' Union Auditorium, The Students' Union, Western Bank, 

This year the NHS celebrates its 70th birthday. There have been significant changes in health and medicine in the UK over the last two decades, and in many areas of healthcare very substantial changes since the initial foundation of the NHS in 1948. These include major reductions in the impact of heart disease and stroke, large changes to infectious diseases and many improvements in the prevention and treatment of cancers. In some areas such as diabetes or antimicrobial resistance things are moving in the wrong direction. The demography of the UK has changed and is changing. Many of the trends have been remarkably stable so it is possible realistically to project forward 20 years in many areas of medicine and public health. This helps with planning research and policy. The 2018 Sir Arthur Hall lecture will consider where we have come from and where we are going over the next two decades in health and medicine.

Things to see (or do)...

If you have ever fancied having a go at pottery or painting/drawing you might like to check out the classes at The Art House in the City Centre (just off Division Street) - a charity runs these courses to support their work.   "We believe that participation in the arts and creative opportunities brings improved health outcomes and an increased sense of wellbeing for people as they learn new skills, develop their creativity and benefit from meeting up with other individuals with a similar interest. In particular our mission is to support and promote recovery, social inclusion the development of local artists from marginalised groups with a particular focus on working with people with mental health issues to enable them to overcome barriers and fulfil their potential."

They have an exhibition starting on 16th February 'All our brains' that brings together community groups, artists, students, health professionals and people with dementia in a cross-disciplinary creative exploration of dementia and its effect on people’s lives.

Things to eat...

I made this Pomegranate chicken with almond couscous one evening last week - very quick, healthy and easy ...everyone enjoyed it.

Things in the library 2nd February...

Things long lost...

We had a package delivered to the library this week, on opening it we found a bound copy of Sheffield Children's Hospital Annual reports for 1930 - 1948. Accompanying the volume was a note of apology from a doctor who had been clearing out their office and found the volume which they think they have had for over 30 years. These make fascinating reading covering the war years and the time when W.R.S. Stephenson was Chairman of the Board of Management (after whom this building is named). From the Rules  & Regulations 1930
"Patients may present themselves for admission from 10.00 to 11.45 am - no one will be admitted after 11.45. No child may be visited until one month after admission excepting in the case of serious illness. The visiting day is Saturday from 2.15 to 3.15 pm."

Also in 1930 a new nurses home was opened (13 Broomfield Road) costing £2164 8s 11d and concern was raised about the 80% of medical beds being occupied by Rheumatic Children.

Cots were sponsored and paid for by numerous individuals and organisation eg in 1933 Messrs Cole Brothers Ltd maintained a cot annually to be known as the 'Uncle Jumbo Cot'.
On the 19th October the Countess of Fitzwilliam handed over to the hospital a 'Wireless Installation' subscribed for by readers of a local newspaper. [Note to our younger readers this was a radio]

There are regular reports from the Knitting Circle (making woolies for the patients) and the Linen League who sewed clothes, sheets and other items for the hospital. The interestingly named ultra-violet and massage departments had plenty of patients.

In 1947 the board decided to appoint a full-time paediatric surgeon for the first time; the average length of stay of an in-patient was 17 days and the average number of beds occupied daily was 158. They looked forward to being called upon to play a vital role in the forthcoming comprehensive National Health Service.

Things about tuberculosis...
A disease that would have been well known in the Children's Hospital of the past is still with us, the World Health Organisation aims to end the TB epidemic by 2035 this article discusses the recent trends and advances in childhood tuberculosis.


Things about the NHS...

The Kings Fund have published a report on how public attitudes have changed to the NHS during the last three decades. Conclusion: Through the BSA survey, the British public has shared its views on the NHS for the past 34 years, which covers almost half of the NHS’s 70-year history. Remarkably, despite substantial technological, economic and social change, the belief that the NHS should be available to all and free at the point of use has remained largely stable unlike views on welfare. In contrast, the public has also shown marked differences in their level of satisfaction with the NHS over the same period. As the NHS turns 70, they want to explore further why the public feels the way it does. Later this year, The King’s Fund will be carrying out a series of deliberative events with the public, to explore the relationship between the public and the NHS. They will be asking people what their expectations of the NHS are, where responsibility for health should lie and what is the implicit contract between users and the health service in terms of rights and responsibilities? They hope to find out more about the public’s current relationship with the NHS and feed into the debate about what it might (or should) look like in future.

Things about early nutrition...
Maternal prenatal nutrition and the child's nutrition in the first 2 years of life (1000 days) are crucial factors in a child’s neurodevelopment and lifelong mental health. Child and adult health risks, including obesity, hypertension, and diabetes, may be programmed by nutritional status during this period. Calories are essential for growth of both fetus and child but are not sufficient for normal brain development. Although all nutrients are necessary for brain growth, key nutrients that support neurodevelopment include protein; zinc; iron; choline; folate; iodine; vitamins A, D, B6, and B12; and long-chain polyunsaturated fatty acids. Failure to provide key nutrients during this critical period of brain development may result in lifelong deficits in brain function despite subsequent nutrient repletion. Read more about this in Advocacy for Improving Nutrition in the First 1000 Days To Support Childhood Development and Adult Health a policy statement from American Academy of Pediatrics.

Things about care leavers...
The Care Leavers Association (CLA) has published findings from a study into the health needs of care leavers. Recommendations from a survey of the health needs of 418 care leavers of all ages include: the health needs of looked after children and care leavers to be a distinct section in the Joint Strategic Needs; that a young person in care has a comprehensive health assessment at entry into care which is then monitored and updated on a regular basis; the commissioning of a range of mental health and wellbeing services that specifically support looked after children and care leavers.
The CLA has also produced a Commissioning Toolkit for care leavers to guide commissioners to better meet the needs of care leavers through the commission process, and a short guide, created by care leavers, on how to work with adolescent children in care and care leavers.

Things to keep you warm...
I love making soups in the winter and usually thrown in whatever I think will work. A soup based around butternut squash is always popular - you can add a sprinkle of cheese or some fried bacon bits on top just before serving or use creme fraiche or yogurt as in this recipe.