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On Saturday 17th October, 16,000 people marched to protest against the new junior doctor contracts in London for the second time. The feeling at the protest was one of overwhelming solidarity, as people marched with placards of varying degrees of humour. Purposely misspelled placards reading “junior doctors make mistaks” were a popular choice, while many groups gathered under large banners identifying their hospital, offering 30% off.
The centenary of the Great War has led to a renewed interest in military matters, and throughout history, war has often been the setting for medical innovation with major advances in the treatment of burns, trauma, and sepsis emanating from medical experience in the battlefield. X-rays, which were discovered in 1895 by Roentgen, soon found a role in military conflict. The first use of X-rays in a military setting was during the Italo-Abyssinian war in 1896.
Nurses play a huge role in hospitals, clinics, and various care facilities throughout the world. However, there are widespread misconceptions about what responsibilities nurses have. Nurses are saving lives and making a difference every day in health care with little recognition from the media or the world at large. Test your knowledge and see how much you really know about what exactly goes into the job of being a nurse.
World Anaesthesia Day commemorates the first successful demonstration of ether anaesthesia at the Massachusetts General Hospital on 16 October 1846. This was one of the most significant events in medical history, enabling patients to undergo surgical treatments without the associated pain of an operation. To celebrate this important day, we are highlighting a selection of British Journal of Anaesthesia podcasts so you can learn more about anaesthesia practices today.
Fifth National Audit Project on Accidental Awareness during General Anaesthesia
Accidental awareness during general anaesthesia (AAGA) is a rare but feared complication of anaesthesia. Studying such rare occurrences is technically challenging but following in the tradition of previous national audit projects, the results of the fifth national audit project have now been published receiving attention from both the academic and national press. In this BJA podcast Professor Jaideep Pandit (NAP5 Lead) summarises the results and main findings from another impressive and potentially practice changing national anaesthetic audit. Professor Pandit highlights areas of AAGA risk in anaesthetic practice, discusses some of the factors (both technical and human) that lead to accidental awareness, and describes the review panels findings and recommendations to minimise the chances of AAGA. October 2014 || Volume 113 – Issue 4 || 36 Minutes
Pre-hospital Anaesthesia
Emergency airway management in trauma patients is a complex and somewhat contentious issue, with opinions varying on both the timing and delivery of interventions. London’s Air Ambulance is a service specialising in the care of the severely injured trauma patient at the scene of an accident, and has produced one of the largest data sets focusing on pre-hospital rapid sequence induction. Professor David Lockey, a consultant with London’s Air Ambulance, talks to the BJA about LAA’s approach to advanced airway management, which patients benefit from pre-hospital anaesthesia and the evolution of RSI algorithms. Professor Lockey goes on to discuss induction agents, describes how to achieve a 100% success rate for surgical airways and why too much choice can be a bad thing, as he gives us an insight into the exciting world of pre-hospital emergency care. August 2014 || Volume 113 – Issue 2 || 35 Minutes
Fluid responsiveness: an evolution in our understanding
Fluid therapy is a central tenet of both anaesthetic and intensive care practice, and has been a solid performer in the medical armamentarium for over 150 years. However, mounting evidence from both surgical and medical populations is starting to demonstrate that we may be doing more harm than good by infusing solutions of varying tonicity and pH into the arms of our patients. As anaesthetists we arguably monitor our patient’s response to fluid-based interventions more closely than most, but in emergency departments and on intensive care units this monitoring me be unavailable or misleading. For this podcast Dr Paul Marik, Professor and Division Chief of Pulmonary Critical Care at Eastern Virginia Medical Center delivers a masterclass on the physiology of fluid optimisation, tells us which monitors to believe and importantly under which circumstances, and reviews some of the current literature and thinking on fluid responsiveness. April 2014 || Volume 112 – Issue 4 || 43 Minutes
Post-operative Cognitive Decline
Post-operative cognitive decline (POCD) has been detected in some studies in up to 50% patients undergoing major surgery. With an ageing population and an increasing number of elective surgeries, POCD may represent a major public health problem. However POCD research is complex and difficult to perform, and the current literature may not tell the full story. Dr Rob Sanders from the Wellcome Department of Imaging Neuroscience at UCL talks to us about the methodological limitations of previous studies and the important concept of a cognitive trajectory. In addition, Dr Sanders discusses the risk factors and role of inflammation in causing brain injury, and reveals the possibility that certain patients may in fact undergo post-operative cognitive improvement (POCI). March 2014 || Volume 112 – Issue 3 || 20 Minutes
Needle Phobia – A Psychological Perspective
For anaesthetists, intravenous cannulation is the gateway procedure to an increasingly complex and risky array of manoeuvres, and as such becomes more a reflex arc than a planned motor act. For some patients however, that initial feeling of needle penetrating epidermis, dermis and then vessel wall is a dreaded event, and the cause of more anxiety than the surgery itself. Needle phobia can be a deeply debilitating disease causing patients not to seek help even under the most dire circumstances. Dr Kate Jenkins, a hospital clinical psychologist describes both the psychology and physiology of needle phobia, what we as anaesthetists need to be aware of, and how we can better serve out patients for whom ‘just a small scratch’ may be their biggest fear. July 2014 || Volume 113 – Issue 1 || 32 Minutes
Can you imagine a world without colour, where all you see is black, white or the shades of grey in between? As a self-confessed colour junkie such a world would sap my energies and leave my life (perhaps ironically), somewhat blue.
Thus when two new books came to my attention both titled ‘The Colour Thief’ I was very intrigued; not only did they look like their subject matter would appeal to me, it was funny and surprising to see two books, from different authors/illustrators/publishers with the same title.
In The Colour Thief by Gabriel Alborozo an alien looks longingly across space to planet earth, full of colours and brightness. He believes such a beautiful place must be full of joy, and so sets off to bring some of that happiness back to his home planet.
With just a few magic words the alien is able to suck up first all the reds, then the blues and the greens and before long planet earth is looking very grey and sad. But what of the alien? Can he really be happy when he sees the glumness he has caused?
Alborozo’s story about kindness, desire and what makes us joyous and content is full of appeal. There are lots of themes which can be explored; from the beauty around us which we might take for granted (requiring an outsider to alert us to us), to whether or not we can be happy if we’ve caused others distress, this book could be used to open up lots of discussion.
Click to see larger image
Although the alien’s actions could be frightening, this is mitigated by his cute appearance, just one of the book’s charms. I also think kids will love the apparent omnipotence of the alien: He wants something, and at his command he gets it, just like that, and this identification with the alien makes the story more interesting and unusual. The artwork is fun and energetic, seemingly filled with rainbow coloured confetti. I can easily imagine a wonderful animation of this story.
The Colour Thief by Andrew Fusek Peters and Polly Peters, illustrated by Karin Littlewood is a very different sort of story. It draws on the authors’ own experience of parental depression, exploring from a child’s perspective what it can feel like to watch a parent withdraw as they suffer from this illness.
Father and son lead a comforting life “full of colour”, but when depression clouds the father’s mind he withdraws, and all the colours around the family seem to disappear. The child worries that he might somehow be the cause of this loss, but he is repeatedly reassured it is not his fault and gradually, with patience and love, colours start to seep back into the father’s life and he returns to his family.
Mental health is difficult to talk about when you’re 40, let alone when you are four, but this lyrical and moving book provides a thoughtful, gentle, and unsentimental way into introducing (and if desired, discussing) depression. If you were looking for “when a book might help” to reassure a child in a specific situation, I would wholeheartedly recommend this; it is honest, compassionate and soothing.
However, I definitely wouldn’t keep this book ONLY for those times when you find a child in a similar circumstances to those described in the book. It is far too lovely to be kept out of more general circulation. For a start, the language is very special; it’s perhaps no surprise when you discover that one of the author’s has more than 70 poetry books to his name. If you were looking for meaningful, tender use of figurative language, for example in a literacy lesson, this book provides some fabulous, examples.
Click to see larger image.
And then there are the illustrations. Karin Littlewood has long been one of my favourite illustrators for her use of colour, her graceful compositions, her quiet kindness in her images. And in The Colour Thief there are many examples of all these qualities. I particularly like her use of perspective first to embody the claustrophobia and fear one can feel with depression, with bare tree branches leaning in onto the page, or street lamps lowering overhead, and then finally the open, sky-facing view as parent and child reunite as they walk together again when colour returns.
*******************
Particularly inspired by the imagery in Alborozo’s The Colour Thief we made a trip to a DIY store to pick up a load of paint chips.
Wow. My kids went crazy in the paint section: Who knew paint chips could be just so much fun? They spent over an hour collecting to their hearts’ desire. A surprising, free and fun afternoon!
Once home we snipped up the paint chips to separate each colour. The colour names caused lots of merriment, and sparked lots of equally outlandish ideas for new colour names, such as Beetlejuice red, Patio grey, Spiderweb silver and Prawn Cocktail Pink.
We talked about shades and intensity of colours, and sorted our chips into three piles: Strong, bright colours, off-white colours, and middling colours. I then put a long strip of contact paper on the kitchen table, sticky side up, and the kids started making a mosaic with the chips, starting with the brightest colours in the middle, fading to the palest around the edge.
Apart for the soothing puzzle-like quality of this activity, the kids have loved using the end result as a computer keyboard, pressing the colours they want things to change to. I also think it makes for a rather lovely bit of art, now up in their bedroom.
Whilst making our colour mosaic we listened to:
My favourite ever, ever song about colours…. Kristin Andreassen – Crayola Doesn’t Make A Color For Your Eyes
Colors by Kira Willey. This song would go really well with ‘My Many Colored Days’ by Dr. Seuss.
Roy G Biv by They Might Be Giants
Other activities which might go well with either version of ‘The Colour Thief’ include:
The paint chips are such a great resource. I always keep some in my art and craft box, there are so many activities that you can use them for.
You’ve got me thinking about books with the same titles now, will see if I can come up with any more for your list
Choxbox said, on 10/14/2014 3:54:00 AM
Lovely artwork Zoe
Brigitte said, on 10/14/2014 2:08:00 PM
Fascinating topic and I’m so glad somebody thought of describing depression as the Colour thief! I couldn’t think of a better way to describe this condition especially to children.
Looking at the wonderful Dutch book I remembered Goethe’s Colour Theory and the poet’s remarkable activity in the field. I’d love to have a chat with him about the connection between poems and colour theory. Of course Newton would be invited too!
Major trauma impacts on the lives of young and old alike. Most of us know or are aware of somebody who has suffered serious injury. In the United Kingdom over five-thousand people die from trauma each year. It is the most common cause of death in people under forty. Many of the fifteen-thousand people who survive major trauma suffer life-changing injuries and some will never fully recover and require life-long care. Globally it is estimated that injuries are responsible for sixteen-thousand deaths per day together with a large burden of people left with permanent disability. These sombre statistics are driving a revolution in trauma care.
A key aspect of the changes in trauma management in the United Kingdom and around the world is the organisation of networks to provide trauma care. People who have been seriously hurt, for example in a road traffic accident, may have suffered a head injury, injuries to the heart and lungs, abdominal trauma, broken limbs, and serious loss of skin and muscle. The care of these injuries may require specialist surgery including neurosurgery, cardiothoracic surgery, general (abdominal and pelvic) surgery, orthopaedic surgery, and plastic surgery. These must be supported by high quality anaesthetic, intensive care, radiological services and laboratory services. Few hospitals are able to provide all of the services in one location. It therefore makes sense for the most seriously injured patients to be transported not to the nearest hospital but to the hospital best equipped to provide the care that they need. Many trauma services around the world now operate on this principle and from 2010 these arrangements have been established in England. Hospitals are designated to one of three tiers: major trauma centres, trauma units, and local emergency hospitals. The most seriously injured patients are triaged to bypass trauma units and local emergency hospitals and are transported directly to major trauma centres. While this is a new system and some major trauma centres in England have only “gone live” in the past two years, it has already had an impact on trauma outcomes, with monitoring by the Trauma Audit and Research Network (TARN) indicating a 19% improvement in survival after major trauma in England.
Not only have there been advances in the organisation of trauma services, but there have also been advances in the immediate clinical management of trauma. In many cases it is appropriate to undertake “early definitive surgery/early total care” – that is, definitive repair of long bone fractures within twenty-four hours of injury. However, patients who have suffered major trauma often have severe physiological and biochemical derangements by the time they arrive at hospital. The concepts of damage control surgery and damage control resuscitation have emerged for the management of these patients. In this approach resuscitation and surgery are directed towards stopping haemorrhage, performing essential life-saving surgery, and stabilising and correcting the patient’s physiological state. This may require periods of surgery followed by intervals for the administration of blood and clotting factors and time for physiological recovery before further surgery is undertaken. The decision as to whether to undertake early definitive care or to institute a damage control strategy can be complex and is made by senior clinicians working together to formulate an overview of the state of the patient.
Modern radiology and clinical imaging has helped to revolutionise modern trauma management. There is increasing evidence to suggest that early CT scanning may improve outcome in the most unstable patients by identifying life-threatening injuries and directing treatment. When a source of bleeding is identified it may be treated surgically, but in many cases interventional radiology with the placement of glue or metal coils into blood vessels to stop the bleeding offers an alternative and less invasive solution.
The evolution of the trauma team is at the core of modern trauma management. Advances in resuscitation, surgery, and imaging have undoubtedly moved trauma care forward. However, the care of the unstable, seriously injured patient is a major challenge. Transporting someone who is suffering serious bleeding to and from the CT scanner requires excellent teamwork; parallel working so that several tasks are carried out at the same time requires coordination and leadership; making the decision between damage control and definitive surgery requires effective joint decision-making. The emergence of modern trauma care has been matched by the development of the modern trauma team and of specialists dedicated to the care of seriously injured patients. It is to this, above all, that the increasing numbers of survivors from serious trauma owe their lives.
Dr Simon Howell is on the Board of the British Journal of Anaesthesia (BJA) and is the Editor of this year’s Postgraduate Educational Issue: Advances in Trauma Care. This issue contains a series of reviews that give an overview of the revolution in trauma care. The reviews expand on a number of presentations that were given at a two-day meeting on trauma care organised by the Royal College of Anaesthetists in the Spring of 2014. They visit aspects of the trauma patient’s journey from the moment of injury to care in the field, on to triage, and arrival in a trauma centre finally to resuscitation and surgical care.
Founded in 1923, one year after the first anaesthetic journal was published by the International Anaesthesia Research Society, the British Journal of Anaesthesia remains the oldest and largest independent journal of anaesthesia. It became the Journal of The College of Anaesthetists in 1990. The College was granted a Royal Charter in 1992. Since April 2013, the BJA has also been the official Journal of the College of Anaesthetists of Ireland and members of both colleges now have online and print access. Although there are links between BJA and both colleges, the Journal retains editorial independence.
So the old adage goes. For generations medical educators have uttered this exhortation, based on a perceived increase in the incidence of medical and surgical errors and complications occurring at this time of year, owing to the influx of new medical graduates (interns) into residency programs at teaching hospitals. This phenomenon is known as the “July effect.”
The existence of a July effect is highly plausible. In late June and early July of each year, all interns and residents (physicians in training beyond the internship) are at their most inexperienced. Interns—newly minted MDs fresh out of medical school—have nascent clinical skills. Most interns also have to learn how a new hospital system operates since most of them enter residency programs at hospitals other than the ones they trained at as medical students. At the same time the previous year’s interns and residents take a step up on the training ladder, assuming new duties and responsibilities. Every trainee is in a position of new and increased responsibilities. The widespread concern that these circumstances lead to mistakes is understandable.
Yet, despite considerable consternation, evidence that there is a July effect is surprisingly hard to come by. Numerous studies of medical and surgical trainees have demonstrated no increase in errors or complications in July compared with other times of the year. Many commentators have declared the July effect a myth, or at least highly exaggerated. A few studies have shown the existence of a July effect, but only a slight one—for instance, on the sickest group of heart patients, where even a slight, seemingly inconsequential mistake can have grave consequences. Even here, however, the magnitude of the effect does not appear large, and the studies are highly flawed. Certainly, there is no reason for individuals to avoid seeking medical care in July should they become ill.
That the July effect is so difficult to demonstrate is a tribute to our country’s system of graduate medical education. Every house officer (the generic term for intern and resident) is supervised in his or her work by someone more experienced, even if only a year or two farther along. Faculty members commonly provide more intense supervision in July than at other times of the year. Recent changes in residency training, such as shortening the work hours of house officers and providing them more help with chores, may also help make residency training safer for patients—in July, and throughout the year.
Uncertainty is intrinsic to medical practice. Medical and surgical care, no matter how skillfully executed, inevitably involves risks. It would not be surprising if a small July effect at teaching hospitals does occur, particularly in certain subgroups of critically ill or vulnerable patients, given that house officers are the least experienced. However, the fact that this effect, if present, is small and difficult to measure provides testimony to the strength of graduate medical education in the United States. Indeed, the quality of care at teaching hospitals has consistently been shown to be better than at hospitals without interns and residents. Patients may be assured that their interests will be served at teaching hospitals—in July, and throughout the year.
Kenneth M. Ludmerer is Professor of Medicine and the Mabel Dorn Reeder Distinguished Professor of the History of Medicine at the Washington University School of Medicine. He is the author of Let Me Heal: The Opportunity to Preserve Excellence in American Medicine, Time to Heal: American Medical Education from the Turn of the Century to the Era of Managed Care, and Learning to Heal: The Development of American Medical Education.
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Image credit: Multiracial medical students wearing lab coats studying in classroom. Photo by goldenKB, iStockphoto.
President Barack Obama has proclaimed March 2014 as “American Red Cross Month,” following a tradition started by President Franklin D. Roosevelt in 1943. 2014 also marks the 100-year anniversary of the outbreak of the First World War in Europe. Although the United States would not officially enter the war until 1917, the American Red Cross (ARC) became deeply involved in the conflict from its earliest days. Throughout World War I and its aftermath, the ARC and its volunteers carried out a wide array of humanitarian activities, intended to alleviate the suffering of soldiers and civilians alike.
In honor of American Red Cross Month, and in commemoration of the First World War’s centennial, here’s a list of things you might not have known about the World War I era history of the American Red Cross:
(1) On 12 September 1914, just over a month after the First World War erupted in Europe, the American Red Cross sent its first relief ship to the continent. Christened the Red Cross, the ship carried units of physicians and nurses, surgical equipment, and hospital supplies to seven warring European nations. This medical aid reached soldiers on both sides of the conflict.
(2) After the United States entered World War I in April 1917, the ARC’s intervention in Europe expanded enormously. Over the next several years, the ARC’s leaders established humanitarian activities in roughly two-dozen countries in Europe and the Near East. The organization provided emergency food and medical relief on the battlefields and on the European home front, but ARC staff and volunteers also took on more constructive projects. They built hospitals, health clinics and dispensaries, libraries, playgrounds, and orphanages. They organized public health campaigns against diseases like typhus and tuberculosis. They took steps to reform sanitation in many countries and introduced nursing schools in several major cities. The ARC’s efforts for Europe, in other words, went well beyond immediate material relief to include long-term, comprehensive social welfare projects.
(3) During World War I, the American Red Cross experienced astronomical growth. On the eve of war, ARC membership hovered around 10,000 US citizens. By 1918, the last year of the war, roughly 22 million adults and 11 million children – approximately 1/3 of the total US population at that time – had joined the American Red Cross and contributed at least $1.00 to the organization.
(4) In 1917, the wartime leaders of the American Red Cross established an auxiliary body for US children—the Junior Red Cross (JRC). During the war, American Juniors put on plays and organized bazaars to raise money for the war effort, collected scrap metal and other essential war supplies, and helped produce over 371,500,000 relief articles for US and Allied soldiers and refugees, valued at nearly $94,000,000. After the war ended, postwar leaders transformed the JRC’s mission, moving away from relief efforts and towards international education initiatives. They established pen-pal programs for between US and European schoolchildren and published monthly magazines to teach US students about the culture, geography, and histories of other nations.
(5) As President of the United States, President Woodrow Wilson was also the President of the American Red Cross. Wilson proved to be a tireless promoter of the ARC. Through many speeches and press releases, he urged all US citizens to join the ARC, defining this as nothing less than a patriotic duty. Wilson also lent his face to ARC posters, magazine covers, and other forms of fundraising publicity. It was on 18 May 1918, perhaps, that Wilson made his commitment to the ARC most visible: on that day, he led a 70,000-person American Red Cross parade down Fifth Avenue in New York City. The visible support of Wilson and his administration played a critical role in defining the ARC as the United States’ leading humanitarian organization—a status that it continues to hold 100 years later.
Julia F. Irwin is an Assistant Professor of History at the University of South Florida. She specializes in the history of US relations with the 20th century world, with a particular focus on the role of humanitarianism in US foreign affairs. She is the author of Making the World Safe: The American Red Cross and a Nation’s Humanitarian Awakening. Her current research focuses on the history of US responses to global natural disasters.
The first time I increased a patient’s insulin dose I lay awake all night worrying that his blood sugar might fall too low. I was a house officer, and insulin was scary! The patient slept well and safely.
Diabetes is common, chronic and complicated. A recent nationwide audit of 12,191 people with diabetes in 206 English acute hospitals found that 15% of beds were occupied by people with diabetes. Worryingly, 37% of these patients experienced at least one error with their diabetes medications (the full results can be read here).
The National Patient Safety Agency (NPSA) has had over 16,000 reports of insulin incidents. In 2010 the NPSA issued an alert requiring action for all health care professionals to improve prescribing and administration of insulin, which was linked to a “Safe use of insulin” e-learning course.
I trained over 30 years ago. Are junior doctors more confident now? Apparently not. A study of 2149 junior doctors by George et al provides worrying evidence that UK trainees lack confidence in managing diabetes. Just 27% were fully confident in diagnosing diabetes, 55% in diagnosing and managing dangerous low glucose and 27% in managing intravenous insulin. Regarding management of diabetes, 24% of respondents would “not often, rarely or never” take the initiative to improve diabetes control. 43% would not adjust insulin in patients with poor glucose control.
Confidence is a combination of knowing what to do and believing you can do it. Experience helps. Also, we all need to know what we don’t know and when to ask for help. An unconfident doctor may make the patient anxious. Galen believed that in the 2nd Century: “Confidence and hope do more good than physic”.
Trainee doctors receive varying amounts of diabetes training and variable supervised experience of looking after people with diabetes. With too little training, trainees may rightly be worried about managing diabetes. Inadequate care of people with diabetes in hospital could worsen virtually every clinical outcome regardless of the main reason for admission. It also worsens patient experience. Diabetes is a common, potentially dangerous but eminently treatable condition. All units in all hospitals should have access to a specialist diabetes team. And trainee doctors should have training and support in diabetes management until they each feel confident in looking after people with diabetes under their care.
Ahhhh...summer when you're a teenager. I don't care if you lived in city or in country, chances are you were wandering the streets with a group of your friends getting into various amounts of trouble. You were free of adult constraints answering your parent's question of "Where are you going?" with the simple word "Out!"
This is the summer scene for sisters Claire and Natalie. Claire is soon heading off to university. She's ready to dump her boyfriend for an unknown future full of promise, and she cannot really wait to go off on her own. Natalie, on the other hand, is a bit anxious. She's never been without Claire, and cannot imagine going from sharing a room to seeing Claire occasionally. But Natalie is spending her summer like she always does. She's hanging out at the Ding-Dong where Audrey works with the rest of her friends. She's playing hideous games of "Would you rather..." with them, waiting for everyone to show. You know...how gross can it get? The rest of the night is spent pool hopping when the owners aren't around.
And then everything changes.
After the accident, Natalie doesn't know what to do. Is it wrong to go to work while your sister lays comotose in the hospital? Is it wrong to kiss a boy when your parents are so distraught that they can't even talk to you? Would you rather see your sister die, or be hooked to machines for the rest of her "life"?
Written in sparse prose, Marthe Jocelyn brings the reader into a family tragedy, and introduces some amazing teenage characters. Natalie's feelings are so raw, and her life with her friends is incredibly realistic. They are smart, and sharp, and genuinely care for one another. While this is a sad story, readers will find themselves hoping that Natalie can find her way and hoping that her family can keep it together. Would You is a perfect choice for the teens who have recently enjoyed Before I Die, by Jenny Downham
Again, in the interest of full disclosure, I do know Marthe Jocelyn, but rest assured, this book would not appear on my blog if I didn't think it was great!
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So the old adage goes. For generations medical educators have uttered this exhortation, based on a perceived increase in the incidence of medical and surgical errors and complications occurring at this time of year, owing to the influx of new medical graduates (interns) into residency programs at teaching hospitals. This phenomenon is known as the “July effect.”
In honor of American Red Cross Month, and in commemoration of the First World War’s centennial, here’s a list of things you might not have known about the World War I era history of the American Red Cross:
(4) In 1917, the wartime leaders of the American Red Cross established an auxiliary body for US children—the Junior Red Cross (JRC). During the war, American Juniors put on plays and organized bazaars to raise money for the war effort, collected scrap metal and other essential war supplies, and helped produce over 371,500,000 relief articles for US and Allied soldiers and refugees, valued at nearly $94,000,000. After the war ended, postwar leaders transformed the JRC’s mission, moving away from relief efforts and towards international education initiatives. They established pen-pal programs for between US and European schoolchildren and published monthly magazines to teach US students about the culture, geography, and histories of other nations.
The paint chips are such a great resource. I always keep some in my art and craft box, there are so many activities that you can use them for.
You’ve got me thinking about books with the same titles now, will see if I can come up with any more for your list
Lovely artwork Zoe
Fascinating topic and I’m so glad somebody thought of describing depression as the Colour thief! I couldn’t think of a better way to describe this condition especially to children.
Looking at the wonderful Dutch book I remembered Goethe’s Colour Theory and the poet’s remarkable activity in the field. I’d love to have a chat with him about the connection between poems and colour theory. Of course Newton would be invited too!