Amara Nwosu

MBCHB MRCP PhD


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Podcasts can help global discussion of palliative care

The following article has been reproduced from the University of Liverpool website:

A new study conducted by the Marie Curie Palliative Care Institute Liverpool (MCPCIL) shows the positive impact and reach podcasts can have on palliative care globally.

MCPCIL was formed in 2004 and is a partnership between the University of Liverpool, the Royal Liverpool and Broadgreen University Hospitals NHS Trust and the national charity Marie Curie, and is based with the University’s Institute of Translational Medicine.

Podcasts (downloadable online digital audio files) have the potential to facilitate communication about palliative care with researchers, policymakers and the public. Some podcasts about palliative care are available; however, this is not reflected in the academic literature.

Worldwide

The study, led by Dr Amara Nwosu, Academic Clinical Lecturer in Palliative Medicine, involved the development a podcast about palliative care, research and innovation according to internationally agreed quality indicators for medical education podcasts. Additionally, the study includes an analysis of the listenership over a 14 month period to demonstrate the reach and potential impact of the podcast.

The podcasts,were published on SoundCloud and promoted via social media. Overall 20 podcasts were developed which were listened to 3036 times (an average of 217 monthly plays) and listened to in 68 different countries. They were most popular in English-speaking areas, of which the USA, UK and Canada were most common.

The study, published in the British Medical Journal of Supportive & Palliative Care, highlights the potential usefulness for medical organisations to develop podcasts for specific purposes, such as education, lecture capture and research dissemination.

New opportunities

Dr Amara Nwosu, Academic Clinical Lecturer in Palliative Medicine, said: “Technology is increasingly being integrated into medicine to support new opportunities for the delivery of clinical practice, education and research. A palliative care podcast is a method to facilitate palliative care discussion with global audience. Podcasts offer the potential to develop educational content and promote research dissemination.

“Future work should focus on content development, quality metrics and impact analysis, as this form of digital communication is likely to increase and engage wider society.”

The full study, entitled ‘The use of podcast technology to facilitate education, communication and dissemination in palliative care: the development of the AmiPal podcast’, can be foundhere.

A podcast summary of the paper can also be found here.


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AmiPal podcast – Use of podcasts to facilitate education, communication and dissemination in palliative care – episode 22

This episode of AmiPal is about the development of this podcast. I’ll discuss my paper which was recently published in BMJ Supportive and Palliative Care:

Use of podcast technology to facilitate education, communication and dissemination in palliative care: the development of the AmiPal podcast.
spcare.bmj.com/content/early/201…bab6-eab94e775c39

Edison Research. The podcast consumer 2015. Website of Edison Research 2015.www.edisonresearch.com/the-podcast-consumer-2015/.

Davidson L. How Serial shook up the podcasting industry. Website of the Telegraph 2015.www.telegraph.co.uk/finance/newsbys…g-industry.html.

Sinclair C. Palliative Care Podcasts. Website of Pallimed 2015.
www.pallimed.org/2015/05/palliati…re-podcasts.html.

Lin M, Thoma B, Trueger NS et al. Quality indicators for blogs and podcasts used in medical education: modified Delphi consensus recommendations by an international cohort of health professions educators. Postgraduate Medical Journal 2015;91(1080):546-50.
pmj.bmj.com/content/91/1080/546.long

Adam Lella. Number of Mobile-Only Internet Users Now Exceeds Desktop-Only in the U.S. (April 2015)
www.comscore.com/Insights/Blog/Nu…-Only-in-the-U.S

Tommy Helgevold. Build a radio in less than 1 minute
www.youtube.com/watch?v=3Zzmi_Kno4w

AmiPal – SoundCloud: @mypal
AmiPal – Stitcher: www.stitcher.com/podcast/mypal-te…-palliative-care
AmiPal – TuneIn: tunein.com/radio/AmiPal-Palliative-Care-p837382/
AmiPal – Acast: www.acast.com/amipal

Audacity® is free, open source, cross-platform software for recording and editing sounds
www.audacityteam.org/

Copyright Dr Amara Nwosu, AmiPal Media 2016.
www.amaranwosu.com
twitter.com/amaranwosu

Music by Bensound
www.bensound.com/royalty-free-music


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Improving the approach to end of life care

The following article is reproduced from the University of Liverpool Website:

Improving the approach to end of life care

In a UK first, researchers from the Marie Curie Palliative Care Institute Liverpool, based at the University of Liverpool, have utilised a novel assessment tool to help monitor the hydration levels of a critically ill patient with POEMS syndrome to improve care.

Hydration in critically ill patients is important and the accurate assessment of their fluid status can be challenging. For example, many people with advanced cancer may have less desire to drink as their condition worsens and we understand little of the effects of this both physiologically and clinically.

Currently, there is a lack of evidence to guide health professionals’ management of (de)hydration of critically ill patients and current methods for monitoring hydration status can be invasive. In addition, current methods can provide a flawed measurement of hydration as they provide no information about extravascular or intracellular fluid status.

Feasibility and validity

The study, which took place in the Royal Liverpool University Hospital in collaboration withProfessor Andrew Pettitt, aimed to use bioelectrical impedance vector analysis (BIVA) to assist in guiding the care of a symptomatic patient with POEMS syndrome. Bioelectrical impedance vector analysis is a simple, safe, bedside method to measure body water content.

POEMS syndrome is an extremely rare multisystem disorder. POEMS stands for (P)olyneuropathy, disease affecting many nerves; (O)rganomegaly, abnormal enlargement of an organ; (E)ndocrinopathy, disease affecting certain hormone-producing glands that help to regulate sexual function, and certain metabolic functions; (M)onoclonal gammopathy or M proteins; and (S)kin abnormalities. The exact cause of POEMS syndrome is not known.

The researchers examined and evaluated the response of a 52-year-old female patient with POEMS syndrome to diuretic therapy. This therapy helps rid the body of salt (sodium) and water. Diuretics work by making the kidneys put more sodium into the urine. The sodium, in turn, takes water with it from the blood.

The patient was observed repeatedly over a period of a month and data was gathered as part of the assessment. The results of the study have been published in the British Medical Journal (BMJ) Supportive & Palliative Care.

Overcoming limitations

Dr Amara Nwosu, said: “This is the first study to use BIVA to evaluate hydration in POEMS syndrome. Furthermore, the evaluation of long term change in hydration in POEMS syndrome using BIVA, following intervention with diuretics, is novel.

“The advantage of BIVA is that it allows information to be obtained simultaneously about changes in tissue hydration or soft tissue mass, independent of regression equations, or body weight. This allows for accurate interpretation of BIVA readings even if patients are at extremes of weight or volume distribution.

Professor John Ellershaw, Director of the Marie Curie Palliative Care Institute Liverpool, said: “This case report highlights the potential to use BIVA to monitor hydration states over time in response to interventions. More research is needed to determine the potential of BIVA to improve the evaluation and management of hydration states in advanced cancer and chronic disease.”

The Marie Curie Palliative Care Institute Liverpool is a partnership between the University of Liverpool, the Royal Liverpool and Broadgreen University Hospitals NHS Trust and Marie Curie Cancer Care. The Institute aims to make a real and sustained difference to care at the end of life from bedside to policy through service innovation and improvement, research and development and knowledge transfer to inform clinical excellence.

The full paper, entitled ‘Longitudinal bioimpedance assessments to evaluate hydration in POEMS syndrome. BMJ Supportive and Palliative Care‘, can be found here.


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AmiPal podcast – Assessing hydration in POEMS syndrome using bioimpedance analysis – episode 21

In this episode I provide an overview of the use of bioimpedance analysis to assess hydration over time in a patient with POEMS syndrome. This was published in the BMJ Supportive and Palliative Care journal and can be found through the link provided below.

Nwosu AC, Morris L, Mayland C, Mason S, Pettitt A, Ellershaw J.

Longitudinal bioimpedance assessments to evaluate hydration in POEMS syndrome. BMJ Supportive and Palliative Care doi:10.1136/bmjspcare-2015-000991
spcare.bmj.com/content/early/201…-2015-000991.full

Nwosu AC, Mayland CR, Mason S, Khodabukus AF, Varro A, Ellershaw JE. Hydration in advanced cancer: can bioelectrical impedance analysis improve the evidence base? A systematic review of the literature. Journal of Pain and Symptom Management 2013; 46(3):433-446.e6
www.jpsmjournal.com/article/S0885-3…0499-X/abstract

Researchgate link: www.researchgate.net/publication/23…the_Literature

Nwosu AC, Mayland CR, Mason SR, Varro A, Ellershaw JE. Patients want to be involved in end-of-life care research. BMJ Support Palliat Care 2013, Dec;3(4):45.
spcare.bmj.com/content/early/201…13-000537.extract

Copyright Dr Amara Nwosu, AmiPal Media 2016.
www.amaranwosu.com
twitter.com/amaranwosu

Music by Bensound
www.bensound.com/royalty-free-music

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AmiPal podcast: A comparison between studies: research, audit and service evaluation – episode 20

In this episode I will provide an overview between the differences between research, audit and service evaluation. This is important to distinguish as research studies require ethical approval before they commence, whereas the other project types do not.

Is your project research, evaluation or audit? (Avon Primary Care Research Collaborative website)
www.apcrc.nhs.uk/governance/is_it_research.htm

NRES Defining Research leaflet.
www.hra.nhs.uk/documents/2013/09…ning-research.pdf

Copyright Dr Amara Nwosu, AmiPal Media 2016. www.amaranwosu.com

Music by Purple Planet
www.purple-planet.com


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AmiPal Podcast: Renal Medicine and Palliative Care – Interview with Dr Hannah Sammut – episode 19

In this episode of AmiPal I talk with Dr Hannah Sammut (Renal Physician and Royal College of Physicians post-CCT fellow in Palliative Medicine) about the importance of palliative medicine and palliative care.

 

The prevalence of symptoms in end-stage renal disease: a systematic review. Murtagh FE et al. Adv Chronic Kidney Dis. 2007 Jan;14(1):82-99.
www.ncbi.nlm.nih.gov/pubmed/17200048

 

Is maximum conservative management an equivalent treatment option to dialysis for elderly patients with significant comorbid disease?Carson RC et al.Clin J Am Soc Nephrol. 2009 Oct;4(10):1611-9. doi: 10.2215/CJN.00510109
www.ncbi.nlm.nih.gov/pubmed/19808244

 

AmiPal and it’s content is copyright of Dr Amara Nwosu, KingAmi Media 2016. www.amaranwosu.com

Music by Bensound
www.bensound.com/royalty-free-music


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AmiPal Podcast: Virtual reality and palliative care – episode 18

In this episode of MyPal I discuss the potential uses of virtual reality (VR) in healthcare and what this may mean for palliative care.

 

Beyond gaming: virtual reality in healthcare. Claire Bower. BMJ Blogs 2014.
blogs.bmj.com/bmj-journals-devel…ity-in-healthcare/

What can Oculus Rift do for healthcare?Mike Miliard. HealthcareIT news 2014.
www.healthcareitnews.com/news/what-ca…o-healthcare

The future of pain relief? Dutch burns unit trialling new virtual reality computer system that distracts patients from the agony of their wounds. Paul Donnelly, Daily Mail 9th Aug 2014.
www.dailymail.co.uk/sciencetech/art…ony-wounds.html

IS VR CHANGING HEALTHCARE?
weareformation.com/is-vr-changing-healthcare/

A Survey of Health-Related Activities on Second Life. Leslie Beard et al. J Med Internet Res. 2009 Apr-Jun; 11(2): e17.
www.ncbi.nlm.nih.gov/pmc/articles/PMC2762804/

Virtual reality for the palliative care of cancer. Oyama 1997
www.ncbi.nlm.nih.gov/pubmed/10175345

Copyright Dr Amara Nwosu, KingAmi Media 2016. www.amaranwosu.com

Music by Purple Planet
www.purple-planet.com

Photo by Jordi Boixareu
www.flickr.com/photos/jobopa/166…ycL-49wC8u-4HYWqe