Amara Nwosu

MBCHB MRCP PhD


Leave a comment

Investigation and management of iron deficiency anaemia in a specialist palliative care setting and the role of intravenous iron: a descriptive analysis of hospice data

Anaemia is common in hospice populations and associated with significant symptom burden. Guidelines recommend investigating for and treating iron deficiency (ID), but there is little evidence of this practice in palliative care populations. Our paper (published in AMRC Open Research) describes the results of investigations for and subsequent management of ID in Marie Curie Hospice Liverpool.

Our data demonstrates that iron deficiency is common and can be safely treated with intravenous iron replacement, within current guidelines, in a hospice setting. Further research should define the optimum use of this approach in palliative care patients.

More information can be found here:

Steele T, Bonwick H, Nwosu AC and Chapman L. Investigation and management of iron deficiency anaemia in a specialist palliative care setting and the role of intravenous iron: a descriptive analysis of hospice data [version 1; peer review: awaiting peer review]. AMRC Open Res 2021, 3:6 (https://doi.org/10.12688/amrcopenres.12963.1)

Medical photo created by rawpixel.com – www.freepik.com


Leave a comment

Evaluating the use of video communication technology in a hospital specialist palliative care team during the COVID-19 pandemic

Healthcare professionals’ use of video communication technology has increased during the novel coronavirus disease (COVID-19) pandemic, due to infection control restrictions. Currently there is little published data about the experiences of specialist palliative care teams who are using technology to communicate during the COVID-19 pandemic. The aim of this evaluation (published in AMRC Open Research) was to describe the experience of a UK based hospital specialist palliative care team, who were using video communication technology to support care during the COVID-19 pandemic.

Video communication technology has the potential to improve specialist palliative care delivery; however, it is essential that healthcare organisations address the existing barriers to using this technology, to ensure that these systems work meaningfully to improve palliative care for those who are most vulnerable beyond the COVID-19 pandemic.

More information can be found here:

Crosby B, Hanchanale S, Stanley S and Nwosu AC. Evaluating the use of video communication technology in a hospital specialist palliative care team during the COVID-19 pandemic [version 1; peer review: awaiting peer review]. AMRC Open Res 2021, 3:5 (https://doi.org/10.12688/amrcopenres.12969.1)

Abstract vector created by vectorjuice – www.freepik.com


Leave a comment

The use of advance consent to enable hydration assessments, for research, at the end of life

As the need for palliative care increases, it is essential for research opportunities to be offered to patients with palliative care needs to ensure patients can receive evidence-based treatments and services to improve care. Although it is recognised that palliative, and in particular end of life, research can be both methodically and ethically challenging it is important to note that palliative patients are keen to be involved with research.
Over the past three years, patients in Marie Curie Hospice Liverpool have been recruited to a research study evaluating hydration, where advance consent methodology is used to facilitate participation at the end of life. In this study, participants provided ‘advanced consent’ to receive research assessments, in anticipation of the deterioration of their health and loss of the ability to provide consent to ongoing research participation. During this process, recruiting participants will nominate a consultee (who can be any family member, friend or healthcare professional), who is contacted by the researcher prior to completion of research assessments. Participants will generally choose a caregiver or friend to act as a personal consultee; however, there may be some instances where a healthcare professional is chosen.
In this, we share our experiences using advanced consent methodology and a healthcare professional acting as a consultee, to facilitate research assessments in a patient who was lacking capacity at the end of life.

More information can be found in our case report here:

Stanley S and Nwosu AC. Case Report: The use of advanced consent methodology and healthcare professional consultee to facilitate research participation in dying patients [version 1; peer review: awaiting peer review]. AMRC Open Res 2021, 3:3 (https://doi.org/10.12688/amrcopenres.12961.1)


Leave a comment

Robotic technology for palliative and supportive care: Strengths, weaknesses, opportunities and threats

How could robots help us at the end of life? Check out this open access article I published with some great co-authors.

https://journals.sagepub.com/doi/full/10.1177/0269216319857628

What is already known about the topic?

  • Medical robots have mainly been used to support surgical procedures and for a variety of assistive uses in dementia and elderly care.
  • There has been limited debate about the potential opportunities and risks of robotics in other areas of palliative, supportive and end-of-life care.

What this paper adds?

  • The potential opportunities of robotics in palliative, supportive and end-of-life care include a number of assistive, therapeutic, social and educational uses.
  • There is concern that robots will exacerbate healthcare inequalities, disrupt the workforce and reduce face-to-face human interaction.

Implications for practice, theory or policy

  • Future work should evaluate the health-related, economic, societal and ethical implications of using robotic technology in palliative, supportive and end-of-life care.
  • There is a need for collaborative research to establish use-cases and policy recommendations to guide the appropriate use of robots for people with serious illness.

CLICK below to access the artilce

Nwosu AC, Sturgeon B, McGlinchey T, Goodwin CDG, Behera A, Mason S, Stanley S, Payne TR. Robotic technology for palliative and supportive care: strengths, weaknesses, opportunities and threats. Palliative Medicine 2019.


Leave a comment

MyPal Podcast: Undergraduate medical education in palliative care – interview with Dr Daniel Monnery – episode 10

I interview Dr Daniel Monnery (Speciality trainee registrar in Palliative Medicine in the Mersey Deanery) to discuss a variety of topics including: postgraduate training in palliative medicine, medical handover, undergraduate medical education and its relevance to palliative care.

Student in library

Copyright Dr Amara Nwosu, KingAmi media 2014. www.amaranwosu.com

Music by ‘Year of the Fiery Horse’ (YOTFH). Soundcloud link: @year-of-the-fiery-horse


Leave a comment

Peer Led Learning In Palliative Care #8

Dr Amara Nwosu discusses his paper about peer-led learning as a mechanism to facilitate palliative care education in medical undergraduates.

Nwosu A, Mason S, Roberts A, Hugel H. Does peer-led education have a role in teaching medical students about palliative care? The evaluation of an examination question-writing task. The Clinical Teacher 2013;10(3):151-4
http://www.ncbi.nlm.nih.gov/pubmed/23656675

Peer learning pic

Copyright Dr Amara Nwosu, KingAmi media 2014. http://www.amaranwosu.com

Music by ‘Year of the Fiery Horse’ (YOTFH). Soundcloud link: https://soundcloud.com/year-of-the-fiery-horse


Leave a comment

MyPal podcast: Integrated Clinical Academic Training #3

I discuss my recent appointment to his Academic Clinical Lecturer (ACL) position in Palliative Care at the University of Liverpool. I then provide a brief overview of the Integrated Clinical Academic Training (ICAT)pathway in the UK which started in 2007.

Copyright Amara Nwosu
www.amaranwosu.com

Music by Year of the Fiery Horse
https://soundcloud.com/year-of-the-fiery-horse
References:

Nwosu AC. Integrated clinical academic training: an exciting new dawn for academic palliative medicine. Journal of Palliative Medicine 2012;15:507-8. (link to full article)
https://docs.google.com/file/d/0B4-vyPlJKkMgZVFwVGtVS2hVN2s/edit


Leave a comment

MyPal podcast: Research and innovation in palliative care (episode 2). Now available on Soundcloud and iTunes

In the second episode of MyPal I the importance of research and innovation in palliative care. Catch it on SoundCloud. It’s also now available on iTunes!

iTunes link:
https://itunes.apple.com/gb/podcast/mypal-palliative-care/id955964346?mt=2

Copyright Amara Nwosu
www.amaranwosu.com

Music by Year of the Fiery Horse
@year-of-the-fiery-horse

————————————————————————————————-

References:

World Health Organization definition of palliative care:
www.who.int/cancer/palliative/definition/en/

Research in palliative care: can hospices afford not to be involved? (Payne et al. Lancaster University)

www.lancaster.ac.uk/shm/research/io…esearch-hth.pdf

Research into end-of-life cancer care—investment is needed. Sleeman et al
www.thelancet.com/journals/lancet/…60230-X/fulltext

Patients want to be involved in end-of-life care research. Nwosu et al (BMJ spcare subscription needed)
spcare.bmj.com/content/3/4/457.extract


Leave a comment

The new MyPal podcast: technology, innovation and palliative care. Episode 1 now available.

This is the first episode of an exciting new project that I’m undertaking. This podcast blends discussion of technology, innovation, health, palliative care and research. This first episode provides an overview of the project and outlines what you can expect in the coming weeks.

MyPal is a podcast about technology, innovation and research relevant to Palliative Care. Come and join the conversation about these issues in a way you just might like.

Copyright Dr Amara Nwosu, KingAmi media 2014.www.amaranwosu.com

Original music is performed by ‘Year of the Fiery Horse’ (YOTFH). Soundcloud link: @year-of-the-fiery-horse


Leave a comment

Nanotechnology to diagnose and monitor cancer – can palliative care benefit? The Google X project

Google have entered into the health research arena. They aim to use technology to diagnose cancer early. I believe is exciting and should cause us to question how technology could be used in palliative care.

Computer science has arguably overtaken medicine as the newest academic discipline. Modern applications like the iPhone (only developed in 2007) have irreversibly changed the way we interact with technology on a daily basis. However, it is not common to hear about medics collaborating with computer scientists or undertaking computer science courses or research. This is in contrast with  other academic disciplines such as natural sciences, social sciences and psychology.

The ‘Google X’ project aims to avoid unnecessary deaths. In terms of cancer Google propose a diagnostic ‘smart pill’ that can be swallowed by an individual which. The pull would contain magnetised nanoparticles that would be released into the blood when swallowed. These particles would travel round the body looking for biomarkers, only to return (by action of their magnets) to a wearable device on the wrist to download the results. In addition to cancer Google indicate that other markers (such as sodium) could be monitored.

Google’s aim to reduce unnecessary deaths is admirable; however, should we also be asking how we can use computer science and concepts like nanotechnology to improve palliative care? Or, conversely, should high tech, high cost interventions be avoided at the end of life? This is interesting food for thought. What is certain is that technology and innovation will continue and the role this has in palliative care needs to be considered.

http://news.sciencemag.org/biology/2014/07/google-x-sets-out-define-healthy-human

http://online.wsj.com/articles/google-to-collect-data-to-define-healthy-human-1406246214