Amara Nwosu

MBCHB FRCP PhD CF SFHEA


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Funding for the development of the digital palliative care media – Marie Curie Palliative Care Institute Liverpool (MCPCIL)

The Marie Curie Palliative Care Institute Liverpool (MCPCIL) has recently been awarded a £1,750 grant from the Friends of the University of Liverpool to develop audio-visual palliative care content. This will hopefully lead to the development of vodcasts and podcasts which will provide a wide audience information about palliative care and the work of MCPCIL.

For more information about the work of the Marie Curie Palliative Liverpool please click here:
Dr Amara Nwosu’s wesbite:
Twitter:
The Friends of the University of Liverpool:


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HIV/AIDs pain – Life Before Death video

The Ebola outbreak has caused people to focus on issues that affect some of the world’s poorest countries. Palliative care has particular challenges in these areas which differ greatly than those in the West. This video was developed by Life Before Death in 2011 and sobering reminder about the HIV/AIDs and the pain that many patients experience.


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Social media and palliative medicine: a retrospective 2-year analysis of global twitter data to evaluate the use of technology to communicate about issues at the end of life

ARTICLE FROM E-HOSPICE UK

http://www.ehospice.com/uk/ArticleView/tabid/10697/ArticleId/12212/language/en-GB/View.aspx

We are living in a digital age and the speed of advancement of technology is, at times, staggering. One technological phenomenon which continues to grow is social media. For example, Twitter (a social media micro-blogging service) has, since its creation in 2006, amassed 271 million monthly active users (who send approximately 500 million tweets per day).

Social media platforms enable their users to connect with others to facilitate discussion on topics of shared interest. This is notable with palliative care professionals who, over time, have established an increasing online presence.

Social media can be used to engage a specific audience, in order to obtain feedback and to communicate information to users. Social media analytical tools can be used to analyse tweets, in order to capture data, predict behaviour of users, analyse sentiment, identify influential people and create targeted advertising campaigns.

Although popular with many businesses, this technology is less commonly used by healthcare and academic organisations. Consequently, there is the potential to use these applications to gain a greater understanding about the use of social media in palliative care.

The aim of our study was to determine the frequency, sentiment and trend of Twitter ‘tweets’ containing palliative care related hashtags (for example, #palliative) and/or phrases sent by users over a two-year period. TopsyPro, a social media analytics tool, was used to conduct the analysis. TopsyPro provides several metrics about tweets, such as the volume, frequency, the overall tone (sentiment) and change in use over time (acceleration). In total, 13 palliative search terms were identified and analysed.

Our analysis revealed that over a two year period (2011 – 2013) the discussion of palliative care on Twitter was frequent (683,500 tweets) and increasing (a rise of 62.3% over the two years). We found that the majority of tweets were positive about the palliative care, demonstrated by a sentiment score of 89% (meaning that 89% of tweets were more positive than all other tweets sent on Twitter during this period). The analysis also demonstrated an increase of activity of several search terms in July 2013, which coincided with the release of the final report of the Independent review of the Liverpool Care of the Dying Pathway in that summer.

Overall this study demonstrates that a lot of discussion about palliative care is taking place on Twitter, and the majority of this is positive. Consequently, social media presents a novel opportunity for engagement and ongoing dialogue with public and professional groups about palliative care.

References

Nwosu AC, Debattista M, Rooney C, Mason S. Social media and palliative medicine: a retrospective two-year analysis of global Twitter data to evaluate the use of technology to communicate about issues at the end-of-life. BMJ Support Palliat Care 2014; Sep 2. pii: bmjspcare-2014-000701. doi: 10.1136/bmjspcare-2014-000701. [Epub ahead of print] http://spcare.bmj.com/content/early/2014/09/02/bmjspcare-2014-000701


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Slow down!

Christmas day: Up early; Christmas presents opened; nappies changed; chicken pox still problematic; hospice visited – nurses appreciative; Christmas day church service – very nice; one turkey (and another turkey); Queen’s speech; tired 3 year old; curious 6 month old; tired 30-something’s.

Boxing day: The beach; The M6; gammon; motorised trains; pink champagne; the Bible TV series; exhaustion.

Today: Picture hanging; birthday party planning; watch fixing; shopping; cleaning; bathing; Charlie Brooker; whiskey.


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Earlier GMC registration for junior doctors – shape of training report

shape of training logo

The independent review of postgraduate training (the shape of training review) for doctors in the UK was completed in the past 2 months and suggested a host of recommendations. This includes a greater emphasis on creating ‘generalists’ through a broad based training program, with few of these progressing on to be specialists. On paper, the proposals look at the reverse of modernising medical careers, which came in less than a decade earlier. The proposed change to award a CST (certificate of specialty training) as opposed to CCT (certificate of completion of specialist training), has led to fears that this may result in a sub-consultant grade that those with CST have to progress through before they can reach consultant appointments.

An item buried in the report is the move of full GMC registration to the end of medical school. Currently this sits after the foundation 1 (FY1) year. On paper, this change may seem innocuous; however, it potentially may lead to several issues. Firstly, it will put greater pressure on medical schools to ensure their graduates are fit to practice independently. Second, it will increase competition for FY1 posts from other countries, as now doctors who were previously ineligible from applying for FY1 posts (currently reserved for doctors with provisional registrations) will be eligible to apply; a move which may cause UK graduates (who already face over-subscription for foundation posts) to be unemployed. Thirdly, it also makes it easier for UK doctors to leave the UK immediately after medical school. Finally, it may cause legal ramifications for graduate entry medical schools who current provide 4 year courses (but under EU law are required to provide a five year course, with the FY1 being used as proxy for the final year, leading to full GMC registration). A move to earlier registration may mean that these medical schools may need to consider adding an extra year to the training (thus negating benefit of the  graduate entry course) or even consider closure.

As with anything, the devil will be in the detail. In the meantime, the British Medical Association (BMA) are monitoring the situation carefully through their representative committees.

Further information can be found here:

Shape of training

BMA response to shape of training 

#shapeoftraining


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Getting ready for Christmas; planning rest into a PhD…

This has been a crazy few days. London on Friday for a BMA academic committee meeting, followed  by a family packed weekend. In summary, two 6-foot Christmas trees have been hauled into the back of a small Renault Clio and put up in two different houses. Thirty or so Christmas cards written; various parcels posted; a church Christmas party has been enjoyed with friends, followed by a Christingle locally on our estate – very nice.

Something the PhD is teaching me about the importance of time management. The decision to allow time for rest and recuperation is essential to ensure that you have to complete your studies. Academia, medicine and work in general have insatiable appetites; if you don’t allow time between courses you’ll end up with bellyache.


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Shooting star

This weekend I was in a Huddersfield with family. We had decided to conduct fireworks this weekend as I was attending the BMA academic trainees conference the weekend before. My four month old child had taken an uncharacteristically long time to settle in the evening and was waking up several times, hourly, that night. At 3am I elected to take him downstairs to see whether he would settle there, and to also provide my wife with some much needed rest.

On navigating downstairs I made my way to the conservatory, which hosted a long sofa that I could lie down on. The conservatory provides excellent views of the Yorkshire dales which, despite the neighbouring M62 motorway, offer low levels of light pollution of the night sky. Consequently, I was rewarded with a wonderful panorama of the night sky, which the belt of Orion, Venus, Sirus all easily visible with the naked eye. Almost immediately I saw a beautiful shooting star; the first time I’d seen such a sight. I’ve grown up in cities where it is often difficult to see any stars at night – this was a real blessing. Theo promptly fell asleep in my arms, almost as if he was satisfied with the event. I sat on the couch for a few minutes to ponder what just happened, after which I took him back upstairs where he slept soundly until the morning.

The night sky is really beautiful. I’m convinced Theo wanted to see it and show me the shooting star. It was really lovely; I thank God and Theo for such a nice moment.


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Social Care Funding Changes: made simple to understand

Source: money.co.uk

In July 2011, economist Andrew Dilnot published his proposals on how to fund adult social care and make it both sustainable for the state and affordable for the elderly.

18 months later Health Secretary Jeremy Hunt has responded with the Government’s plans to revamp the care funding system in England.

We take a look at four changes to how social care for the elderly will be paid for – both privately and publicly – going forward:

1. £72,000 cap on how much individuals will pay

Around 10% of people currently end up paying over £100,000 in care costs as they grow old.

From April 2016, the amount you’ll have to pay for “standard-rate” care in England will be limited to £72,000 with the rest paid by the state. This was originally set to be capped at £75,000 and starting in 2017.

However, if your non-health costs exceed this standard-rate then you’ll likely need to make up the difference even after hitting the £72,000 cap.

Non-care costs such as food and accommodation aren’t included in the cap, and these ‘hotel’ costs can account for as much as £7,000 to £10,000 per year in today’s money, which you’ll need to pay on your own.

The Government’s cap almost doubles Dilnot’s preferred £35,000 figure, even after inflation is added; it means 16% of over-65s should face cheaper bills (compared to the 37% that would have been helped under Dilnot’s proposals).

2. How will you and I be able to pay for it?

It is hoped that setting a worst-case-scenario upper limit for how much you may need to pay will at the very least give you a target to plan for financially, against your future care needs.

The Government also hopes the cap will also encourage insurance companies and even pension providers to start providing for social care into their policies, although it has been disputed in some areas whether this will actually happen.

3. Means-testing threshold to rise from £23,250 to £123,000

Currently, elderly people who need to move into a residential care home are eligible for means-tested Government support if their total assets are worth £23,250 or less. £14,000 or less, and it’s free.

From April 2013, you will be able to claim some form of means-tested Government support for residential care up to a personal wealth threshold of £123,000. That figure is more or less in line with Dilnot’s proposals, taking into account inflation.

4. How will the Government fund its part?

The Government hopes to generate 80% of its expected £1bn annual spend on social care from extra National Insurance contributions which will start alongside the single-tier state pension in 2016.

The remaining 20% will be funded by freezing the existing Inheritance Tax threshold at £325,000 per person (£650,000 for couples) for an extra three years, until 2019.

5. What about Scotland, Wales & Northern Ireland?

Social care in Scotland

Currently, social (personal) care is available free to all pensioners living at home.

For elderly people living in residential care homes, the Scottish Government makes a flat rate contribution to your personal care or nursing costs, while ‘hotel’ or accommodation costs are means-tested.

However, at a current cost to the Scottish taxpayer of £500m per year there are concerns that Scotland too will face a social care funding gap as costs continue to grow.

Social care in Wales

There is currently a £50 per week cap on how much you’ll pay for care, provided you’re living at home and receiving non-residential services. However, there is no current cap on contributions toward residential care.

The Social Services and Well-being (Wales) Bill was introduced to the Welsh Assembly for consultation in January 2013; the effects of the changes made in England will be considered during its consultation prior to adopting or rejecting its measures.

Social care in Northern Ireland

Proposals for revamping social care in Northern Ireland were published in 2012, with consultation and review ongoing. Currently your personal assets are means-tested for Government support, similar to in England and Wales.

Read more: http://www.money.co.uk/article/1009567-social-care-changes-what-they-mean-for-you.htm#ixzz2Os863Xqj