Issuu on Google+

AUTUMN 2010 | News from NHS Health Scotland, Scotland’s health improvement agency

GoodHealth

contents

2-5

the first word / SNAPSHOTS News and events round-up

6-7

social and digital media

Health goes digital – join the revolution

8-10

Active nation

Racing towards a healthier nation GLASGOW 2014 – a legacy for scotland

Building a Games legacy

11

hphs resource suite Support for clinical staff

12

I KNOW THIS MUCH Wilma Reid

NEXT


snapshots

st The firrd wo Welcome to the autumn edition of All In Good Health.

contact: email us visit our website call us

0131 536 5551

write to us

Peter Watson / Iain Radcliffe NHS Health Scotland, Woodburn House, Canaan Lane, Edinburgh EH10 4SG

NHS Health Scotland is the national resource for improving health and reducing health inequalities in Scotland. All In Good Health is published quarterly by NHS Health Scotland.

Editorial & design by: White Light Media www.whitelightmedia.co.uk © NHS Health Scotland. All rights reserved. Material contained in this publication may not be reproduced, in whole or in part, without prior permission of NHS Health Scotland (or other copyright owners). Whilst every effort is made to ensure that the information given herein is accurate, no legal responsibility is accepted for any errors, omissions or misleading statements.

All in GoodHealth

Autumn 2010

With the world’s attention focused on the recent Delhi Commonwealth Games, it’s a good time to look forward to Glasgow 2014, and how this high-profile international event can have a lasting impact on Scotland. Our cover feature, therefore, explains how NHS Health Scotland is working with partners in key national agencies to use the Games as a springboard to a healthier nation. Elsewhere, we take a look at the digital revolution and how the latest smart phone apps and social media can help us engage with audiences while also keeping us trim and fit. And Lorna Smith explains how a new series of peer-inspired Professional Profiles can support clinical staff in making health improvement interventions. We hope you find this issue useful and interesting, and are keen to hear your views and feedback, so please do get in touch and let us know what you think. Peter Watson (left) and Iain Radcliffe Editors

Good news for newborns New tests to detect two serious inherited conditions are being added to the routine NHS bloodspot screening programme for all newborn babies.   From 4 October 2010, the test – which is offered for babies at around five days of age across Scotland – will now also be able to check for MCADD and Sickle Cell Disorder.   MCADD, which affects about 1 in 10,000 babies in Scotland, prevents the body from metabolising fat properly, and Sickle Cell Disorder – affecting 1 in 2,500 babies

in the UK – causes misshapen red blood cells which hinder how oxygen is carried. Both conditions can cause serious illness and, in some cases, can be fatal. These new tests will enable early detection so that care and treatment can be given to manage the conditions.  

For details about changes to the newborn screening programme click here or contact your local Pregnancy and Newborn Screening Co-ordinator.

2 CONTENTS

PREVIOUS

NEXT


www.healthscotland.com

snapshots

New guide for quitters

September saw the launch of a new, up-to-date, evidence-based resource to assist health practitioners in Scotland help smokers kick the habit.   A joint collaboration between NHS Health Scotland and ASH Scotland, the Guide to Smoking Cessation in Scotland 2010 is a compendium of NICE recommendations, existing Scottish guidelines, and additional suggestions for good practice.   The resource is divided into two parts – ‘Helping Smokers To Stop’ is aimed at healthcare practitioners, while ‘Planning And Providing Specialist Smoking Cessation Services’ has been designed to assist providers and commissioners of intensive smoking cessation support. Both parts cover areas such as how to deliver interventions, pharmacotherapy, monitoring, and training. The guide also contains a brief interventions flowchart, containing suggested questions to help raise the issue of smoking with patients. 

Download the guide

Cervical screening on the list A new series of leaflets has been developed to encourage women across Scotland to pencil in a cervical screening test on their ‘to do’ list. The ‘Cervical Screening Test: Put It On Your List’ leaflets contain essential information to answer common questions about cervical cancer and the screening process. The universal leaflet will be sent to all women eligible for screening when they receive their invitation. There is also one available for those who are being invited for the first time, one for lesbian and bisexual women, and another to explain the screening results. The leaflets will also be available in healthcare and community settings, while printable PDF versions in English, Polish, Chinese and Urdu can be downloaded from the Health Scotland website.

Download leaflet

New Chief Executive Gerald McLaughlin NHS Health Scotland is pleased to welcome Gerald McLaughlin, who took up the post of Chief Executive on 6 September. Originally graduating in social sciences, Gerry worked for 20 years as a local authority social work manager, and has also worked as Glasgow’s principal child protection officer, Assistant Director of the Royal National Institute for the Blind, Scotland, and as a Director of the British Red Cross. For six years, until September 2010, he was also a non-executive member of the Board of NHS Greater Glasgow and Clyde.

3 All in GoodHealth

Autumn 2010

CONTENTS

PREVIOUS

NEXT


www.healthscotland.com

snapshots

Use our free advertising service

‘Suicide.

Do you commission external researchers? Are you a health improvement researcher looking to increase your working partnerships?

Don’t hide it. Talk about it. Choose Life, the national strategy and action plan for suicide prevention in Scotland, kicked off the latest phase of its ‘Suicide. Don’t hide it. Talk about it.’ campaign on 6th September. Running throughout the month, the campaign included a number of activities to raise public awareness about suicide and mental health. More specifically, the campaign aims to encourage anyone experiencing suicidal thoughts to talk to someone they trust about their feelings, or call Breathing Space or Samaritans. Once more the campaign generated significant media coverage – including articles in The Big Issue Scotland, Holyrood Magazine and The Sun newspaper. It also earned extensive local media coverage, promoting the campaign’s ‘talking’ message and showing what was being done in local areas to raise awareness of suicide and its prevention. A variety of events were held across Scotland to mark the campaign. In Edinburgh, the programme included a free screening of The father of my children, a film which raises issues

All in GoodHealth

Autumn 2010

“the campaign generated significant media coverage – including articles in The Big Issue Scotland, Holyrood Magazine and The Sun”

around suicide, at the city’s Filmhouse cinema. Commenting on the week, Sandra de Munoz, Choose Life Co-ordinator for Edinburgh, said: “Suicide Prevention Week went very well, with a good mixture of events getting key messages about suicide prevention out to a large number of the public. We met some inspirational people, and people have emailed me to say how good they thought the film was – it’s really encouraging to know that they engaged with the events.” Separately, Choose Life is currently working on a film project with Glasgow North-East CHCP, particularly Positive Mental Attitudes, a mental health awareness programme in

NHS Health Scotland is providing a free advertising service for new health improvement research and evaluation contract opportunities.

the east of Glasgow. Being made in close collaboration with the target audience, the film will encourage young people to ask for help if they are having a difficult time, or offer help to a friend if they need someone to talk to. With the growth of social networks as communication channels of choice for young people, social media platforms will be used to engage with both the local young people and a wider target audience (see feature on social media and health education on p6).

Contributor

The service, which can be found on the External Research Contracts page of the NHS Health Scotland website, not only enables Health Scotland employees to post new research contract notices on behalf of partner organisations, but also notifies approved research contractors of new contract opportunities. For more information, please see the NHS Health Scotland website, email Rebecca Sludden or call 0141 354 2976.

“Working with partners in local areas means we can link local interventions to national campaigns, and jointly take forward new ways of communicating with people.”

Laura Blair, Communications Manager

4 CONTENTS

PREVIOUS

NEXT


www.healthscotland.com

snapshots

Award-winning communicators

see me stop the stigma

An NHS Health Scotland website designed to raise awareness about HIV has taken top honours at a prestigious awards ceremony HIV-wakeup.org.uk – which was developed in partnership with the wider NHS, Scottish Government, and local authority and voluntary sector partners – took the prize for Best Website at the prestigious Association of Healthcare Communications and Marketing Awards. The site was developed as part of the ‘HIV Wake Up’ campaign, which aims to provide information for men who have sex with men

(MSM) on HIV, risk behaviour, HIV testing and additional support on prevention and protection. The campaign itself received a Highly Commended award for Best Partnership Working. The site includes a complete service search for HIV-related services dedicated to MSM and interactive tools to check HIV risk behaviours.

EPP Directorate reshuffle NHS Health Scotland has pledged its support to help tackle the stigma of mental illness. See Me is Scotland’s national campaign to fight discrimination related to mental health conditions. Launched in 2002, and funded by the Scottish Government, it aims to change public attitudes and behaviour towards people who experience mental health issues. NHS Health Scotland CEO Gerry McLaughlin formally signed up to the See Me Pledge on 7 October, committing the organisation to support the campaign’s goals.

All in GoodHealth

Autumn 2010

Following a recent restructure of NHS Health Scotland’s Equality, People and Performance Directorate, three new programmes will form the core basis of the directorate’s work with boards. These are: • Working with our partners to continue to deliver improvements and efficiencies in services, driven by Scottish Governments national strategies • Providing a hub for sharing knowledge and practical support for boards to deliver frontline services to make an impact in reducing health inequalities • Ensuring our networks meet the challenges that face boards regarding the equalities agenda

The revised structure has a stronger focus on improving patient outcomes and the quality of care. It is effective as of 1st October. Cath Denholm, the Director of Equality, People and Performance, comments: “The NHS in Scotland is unique in having this important national resource that all boards can draw upon and work with to improve the quality and efficiency of their care, aiming to ensure that services meet the needs of everyone, every time.”

5 CONTENTS

PREVIOUS

NEXT


www.healthscotland.com

digital media

The digital

revo u ion From exercise tips on YouTube to online support forums, digital media offers huge potential for helping people who want to improve their health and wellbeing

F

or a self-confessed running ‘newbie’, NHS Health Scotland Communications Officer Amanda Moore admits that pledging to take part in a 5K run, as part of the Healthy Working Lives programme, was no breeze. “It can be quite daunting if it’s something that you haven’t done before,” she says. “I think maintaining motivation is definitely one issue that people trying to make a positive change in their lifestyles can have.” To help make her training regime more manageable, Amanda turned to coolrunning.com – a site that uses a variety of social media to inform, reassure and motivate people who want to take up or improve their running. As a recent convert to the sport, Amanda was able to find a wealth of support and training

All in GoodHealth

Autumn 2010

ideas within the ‘Couch to 5K’ programme. In addition to a central site that offers advice, tailored training programmes and user forums, Cool Running followers can download smartphone apps that time their runs, podcasts that contain training advice and pep talks, and a Facebook page with regular tips filtering through on news feeds. “The great thing about ‘Couch to 5K’ is that it breaks everything down into little stages, so the final goal doesn’t feel like an insurmountable challenge,” Amanda explains. “You can also share tips and get feedback from other people who are at a similar level. I’ve even got a running ‘twin’ in Toronto, and we follow the programme together, encouraging each other.”

Connecting and supporting Cool Running is a good example of how social media can be exploited to support and motivate people in making healthy lifestyle choices, by creating online ‘communities’. “Social media facilitates another way of engaging people, enabling motivational messages to be shared instantly and recorded,” comments Samantha Fiander, Senior Communications Manager at NHS Health Scotland. “It uses digital technology to mirror and support what we know about how people relate and communicate to each other when they are looking to adopt healthier lifestyles. Social media can become that ‘virtual’ weight loss club or enable your loved one to keep cheering you on to meet your goal.”

6

CONTENTS

PREVIOUS

NEXT


www.healthscotland.com

digital media It’s a winning formula that can be seen in a range of other health improvement social media initiatives. These include Tobacco Free Florida’s Qwitter site, which connects smokers who want to quit to the Twitter social network, allowing them to note their cravings and thoughts, and receive encouragement and support from friends and family. ‘Twit2Fit’ is another micro-blogging social media site where members can inspire and help each other improve their health and wellbeing. This interactivity is one important factor in the success of social media. Another is accessibility – and this is where digital communications can be so powerful.

YouTube shows how useful video content can be, offering seemingly endless examples of video content on everything from yoga classes, to how to cook more nutritious meals – all available free-of-charge, at the touch of a (mouse) button. Smart phone applications (‘apps’) are another, enabling users to download simple web-based

“social media facilitates another way of engaging people, enabling motivational messages to be shared instantly”

programmes that can be accessed free-of-charge and on the move. The NHS Quit Smoking app – which provides daily tips, calculates the money smokers have saved by not buying cigarettes, and provides links to local smoking cessation services – is one example. Another is the iBreastCheck app, devised by Breakthrough Breast Cancer, which includes video and photo content to show the kinds of changes in their breasts that women should be alert to, an interactive quiz for users to assess their own risk of breast cancer, and optional reminders prompting women to check their breasts.

Moving and shaking One app that very successfully exploits the benefits of smart phone mobility is the British Heart Foundation’s Recipe Finder. Introduced in June 2010, the app allows users to access a databank of recipes, which can be searched either by cuisine or nutritional benefits. “We knew that there were a lot of recipe books out there, but we wanted something that was run by dieticians and was also designed with specific heart conditions in mind – such as high cholesterol, high blood pressure and diabetes,” explains Corinne Pritchard, the British Heart Foundation’s Digital Media Officer.

“Our thinking was to offer a more portable version of our online database – because a recipe isn’t just a recipe, it’s the whole experience that includes choosing that recipe and shopping for ingredients. And because people don’t only think about what to have for dinner when they happen to be in front of a computer, the app allows them to access that information anywhere,” Corinne explains. “If you’re on your lunch break at work, or out and about, then if it’s there on your phone and easier to use.” The recipe finder has been rated as one of Apple’s top iphone apps, and has received very positive feedback from users. “One thing that has proved very popular is a feature whereby you can shake your phone and the app will generate a random recipe,” Corinne says. “People can sometimes get paralysed by choice, so having one picked out of the air like that proved really useful.” So does she see digital media playing a key part in the future of health improvement? “It was an experiment to begin with, but we feel it’s been really successful, and we’re now certainly making a real concerted effort to go in that direction,” Corinne confirms. “Because social and digital media are so accessible, we can reach large numbers of people very quickly and get our message across in a fun, useful and effective way. And the benefits of are potentially huge.”

7 All in GoodHealth

Autumn 2010

CONTENTS

PREVIOUS

NEXT


www.healthscotland.com

ACTIVE NATION

Forging a legacy of health

With Glasgow set to welcome the Commonwealth Games in 2014, we look at how the arrival of some of the world’s greatest athletes can help Scotland boost its fitness

W

ith published figures suggesting that only 37% of adults currently enjoy the recommended level of half an hour’s moderate physical activity at least five times a week, it’s clear that many people struggle to find either the time or motivation to build physical activity into their lives. Yet as Glasgow prepares itself for the Commonwealth Games, a new programme is aiming to make sure that the elite international sports event will not only see Scottish athletes

sweeping to gold, but will also give a much needed boost to the nation’s longterm health prospects. ‘Active’ is one of four strands within the Scottish Government’s ‘On Your Marks’ Games legacy plan and includes the Active Nation public engagement programme. A strategy developed through partnership with key national agencies and voluntary organisations, its aim is to use the 2014 Games as a catalyst to inspire people to enjoy more active lifestyles. It’s about raising awareness of the benefits of being physically active, and giving people ideas of how they can incorporate more physical activity into their lives.

Of course, promoting active lifestyles is nothing new – Scotland already has a national physical activity strategy, Let’s Make Scotland More Active, which is a 20-year plan and sets national targets to achieve 50% of all adults and 80% of all children meeting the minimum recommended levels of physical activity by 2022. NHS Health Scotland is one of the key delivery organisations for this national strategy – examples of relevant work include leadership of the Physical Activity & Health Alliance (www.paha.org.uk), development of an Active Scotland database and support for a broad range

8 All in GoodHealth

Autumn 2010

CONTENTS

PREVIOUS

NEXT


www.healthscotland.com

active nation

of targeted government-funded initiatives (Paths to Health, Girls on the Move, Fit for Girls, Free to Dance). However, by placing sport in the cultural and media spotlight and igniting the public imagination, Glasgow 2014 represents a unique opportunity to raise the profile of, and add impetus to, the work already being undertaken, as Maureen Kidd, Health Improvement Manager at NHS Health Scotland, explains. “Since 2003, and the introduction of the ‘Let’s Make Scotland More Active’ strategy, NHS Health Scotland has been helping to implement a whole range of initiatives across Scotland that are all about getting more people more active more often. Active Nation is not taking us in a new direction,” Maureen says. “Instead, staging the 2014 Games will play a huge part in helping accelerate progress. It will do this by building on what is already there, joining

Contributor “This is the best opportunity we have ever had in getting more people more active more often”

Maureen Kidd, Health Improvement Programme Manager

All in GoodHealth

Autumn 2010

“you need to create a sense of national celebration and encourage people to get involved locally in physical activity”

them together and adding the impetus and national pride which comes with hosting an event like the Commonwealth Games. In that sense, Active Nation serves as a unifying banner and collective call for action – one of those once-in-a generation opportunities to make a real difference to our health.” NHS Health Scotland has already played a key role in the development of the Active Nation strategy – which will be delivered in partnership with local authorities, health boards, sports bodies, businesses and others – with staff participating in the various governance bodies and working closely with the Scottish Government Active Nation team. Now, with Delhi having formally handed the baton to Glasgow, it really is a case of “Let the Games commence.” “There is research to indicate that to achieve a crossover from elite sport into the health of the wider public, you need to

9 CONTENTS

PREVIOUS

NEXT


www.healthscotland.com

active nation of influence, to encourage people to be more active. Whether it be putting up signage in hospitals, talking to the public about Active Nation events, directing people to the website, making sure that any land we have is being used to help and host events – we need to work together to use all our resources.” Collaboration and co-operation are, in fact, at the heart of delivering Active Nation, as Jacqueline Lynn of sportscotland, one of NHS Health Scotland’s key partners in the strategy, explains.

Participants will be encouraged to set as many goals as they like over a timescale that suits them” create a sense of national celebration and encourage people to get involved locally in physical activity,” Maureen explains.

the strategy and encourage public participation, and all details of these will be available on the website.

To help create this ‘festival factor’, the Scottish Government will lead on an Active Nation campaign. This will include a user-friendly website, www.ouractivenation.co.uk, where people can register personal goals for undertaking sports and physical activity challenges. Participants will be encouraged to set as many goals as they like over a timescale that suits them – with the emphasis firmly on fun, enjoyment and taking part. There will be a series of events, both local and high profile, to publicise

Stakeholder contributions will be crucial to the strategy’s success, as Maureen explains: “Active Nation is about raising awareness of the benefits of being active, and, very importantly, motivating people – that’s one of the key aims of the website,” she says.

All in GoodHealth

Autumn 2010

“For the strategy to work we need to get people to visit the site who wouldn’t normally do so – and that’s where stakeholder engagement is so important. We really need them to think about what they might do within their sphere

“Partnerships are vital in delivering a more active nation. For example, as part of its role in supporting Active Nation, sportscotland is working with local authorities and investing £1.5 million in community sport hubs. We have already made good progress and aim to deliver a significant number of these throughout Scotland,” she says. “This kind of partnership working is vital. Bringing together central government,

Contributor

local government, and the nation’s lead agencies for sports development and health promotion, is essential to drive home the Active Nation message and enable communities to engage with this great international event that we are hosting.” Ann Thomson, Scottish Government Active Nation Programme Manager, agrees: “NHS Health Scotland, sportscotland and the Scottish Government have worked together to shape the Active Nation programme, and that partnership has been essential in adding value to the strategy. “Now, if we are to reach out to all those who are currently inactive, and support them in becoming more active, we need to engage partners and stakeholders from across all of Scotland, share good practice and make the most of the resources we have.” “It’s a considerable and fairly ambitious shift in attitude that we want to achieve,” Maureen adds. “But the impact of a successful Active Nation programme will have real long-term benefits for Scotland’s health.”

Contributor “The Games legacy gives us a great opportunity to inspire and motivate Scottish people and communities to engage in sport and physical activity”

Jacqueline Lynn, Head of School and Community Sport, sportscotland

“We want to make sure that the biggest multisport event Scotland has ever hosted inspires people to change their lives for the better”

Ann Thomson, Active Nation Programme Manager, Scottish Government

10 CONTENTS

PREVIOUS

NEXT


www.healthscotland.com

hphs

Health improvement: raising the profile The Health Promoting Health Service aims to make sure that every healthcare contact is a health improvement opportunity. Lorna Smith explains how a new series of Professional Profiles will support acute sites in achieving this goal

T

he need to better engage clinical staff in the discussion of health improvement in acute settings has emerged as an important issue in implementing the aims of the Health Promoting Health Service, and the reduction of re-admissions and preventable diseases. With this in mind, a series of Professional Profiles has been developed. Based on the experience of staff from professions across the NHS workforce, the profiles are designed to encourage discussion between and across professions about their own role and the potential they have to provide health improvement support. Profiles are currently being developed for midwifery, physiotherapy, psychology, facilities management, occupational

All in GoodHealth

Autumn 2010

therapy, nursing, speech and language therapy, medicine and podiatry. Each highlights the contributions made towards awareness raising, signposting and referral by each clinical discipline. Compiling staff views on their professional remit and feelings about health improvement has highlighted a number of issues, including staff confidence in the delivery of health improvement messages, the extent of health improvement in their formal education, clinical motivations for action, and their understanding of local pathways. A series of ‘How to’ guides is therefore also being developed to support frontline staff in acute settings by offering guidance on how to recognise health improvement opportunities; basic information on key topics such as smoking,

alcohol, physical activity and healthy eating; and tools for appropriate interventions. Together, it is hoped the Profiles and ‘How to’ guides will give clinical staff greater confidence, consolidate their existing knowledge and ultimately increase health improvement in acute settings. The HPHS Network and our clinical champions will be key players in facilitating discussion through the use of these profiles in their local NHS boards. Other areas of the HPHS action plan include working with NHS Education for Scotland on raising awareness of health improvement and inequalities with professional associations and colleges, developing health improvement examples for the 6 KSF core dimensions and a pilot service improvement scoping exercise for health improvement pathways. For more information about the HPHS Professional Profiles series, please e-mail Lorna Smith.

Contributor “Working with clinical staff who have an enthusiasm and drive for health improvement is an exciting project”

Lorna Smith, Health Improvement Programme Officer

Excerpts from the profiles... “Physiotherapists are well-placed, as experts in the field of physical activity, to promote being active and give advice that is both safe and relevant to the needs of their patients” Lynn Speed, Lead Adult Mental Health Physiotherapist, NHS Forth Valley “Pre-assessment is 6-9 weeks prior to surgery… and this assessment appointment is an ideal opportunity to engage with patients regarding smoking, alcohol, drug taking and weight loss… we are able to signpost people to the help available, but also provide a rationale as to why a change in behaviour will assist them in their recovery from surgery” Louise Bruce, Senior Charge Nurse (Pre-assessment), NHS Tayside “It is not just the foot or feet in front of us that needs attention. The process that leads to the development of diabetesrelated foot complications need to be considered… and this may be the first opportunity the person has had to discuss it” Nasrin Khosravi, Specialist Podiatrist (diabetes), NHS Lothian

11 CONTENTS

PREVIOUS

NEXT


www.healthscotland.com

I KNOW THIS MUCH 3. People really are the key for me What an absolute pleasure it is to work with smart, funny, friendly, hard working people! (And even the grumpy ones can be persuaded to go along with you at times!) I have had the privilege of having colleagues at all levels in NHS Health Scotland who go the extra mile for the job and for their fellow workers. And what a difference that makes when you have experienced the other side!

I know this much:

Wilma Reid

For Wilma Reid, Head of Learning and Workforce Development, it’s all about people, poise, prioritising… and punk

“I used to want everyone to like the things I love but I am much more ‘live and let live’ now and take pleasure from differences”

1. NHS Scotland is a great  organisation to work for I got my first training officer job in NHS Lothian and loved it. I later left the NHS for the university sector and I couldn’t wait to come back to it 15 years later! The sense that we are contributing to the greater good is very important to me and I have been encouraged to develop and progress in every NHS job I have had. Even now when we are tightening our belts I see people showing great commitment to doing a good job, and even managing to do things better. 2. It is good to be calm I have learned to do this more and more – maybe it’s an age thing, but I have seen how it works by observing two of my female bosses over the years. If you can stay calm, you will reassure those people who might be anxious and uncertain around about you – it’s like a soothing ripple effect – and you will also make better decisions. 

4. Get through the tough tasks one step at a time If I have a difficult job to do I tell myself it is only one, two or three hours out of the rest of my life. Although I’m generally a big picture person, breaking things down helps me succeed by forcing me to analyse and assess what is important and a ‘must do’. If you don’t achieve all the rest, then don’t stress about it. You will do better next time.   5. Contentment comes in many forms I have learned that not everyone likes what I do: listening to The Fall, Pixies and Ramones at full volume in the car; reading mounds of ‘heavy’ books on holiday; eating spicy Moroccan food and wine; jogging up Craiglockhart hill; talking, dancing and laughing for hours with my friends; watching my boy play sport on a frosty Saturday morning. I used to want everyone to like the things I love but I am much more ‘live and let live’ now and take pleasure from differences. However, I am reassured to know there are at least three more Fall fans in the building.

12 All in GoodHealth

Autumn 2010

CONTENTS

PREVIOUS


All In Good Health | Autumn 2010