Amara Nwosu

MBCHB MRCP PhD


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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


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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


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Implantable cardioverter defibrillator (ICD) deactivation in palliative care – a case involving best interest decisions for someone lacking capacity at the end of life

The use of implantable cardioverter-defibrillators (ICD) has increased due to benefits of preventing death from cardiac arrhythmia. However, the increasing use of ICDs has created new challenges for how to proactively manage deactivation of these devices in people who are dying, especially for those who lack capacity to make decisions about their care. The aim of this case report is to discuss the challenges of planning for deactivation of an ICD for a patient who lacked capacity at the end of life.


In this case report (published on AMRC Open Research) we describe the challenges of managing ICD deactivation in a dying patient with fluctuating capacity who had previously expressed a wish for the ICD to remain active. Although it is preferable to use advance care planning (ACP), to provide care in-line with patient-identified care preferences, we demonstrate how a best interest process can be used to make decisions about ICD deactivation at the end of life.

More information can be found in our case report here:

https://amrcopenresearch.org/articles/3-4


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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


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MyPal Podcast: What makes a good Case Based Discussion (CBD)? Interview with Dr Laura Chapman & Dr Daniel Monnery

In this episode of MyPal I interview Dr Laura Chapman (Palliative Medicine Consultant and Training Programme Director for Palliative Medicine in Health Education North West- Mersey) and Dr Daniel Monney (Specility Trainee in Palliative Medicine) about the Eportfolios’ Case Based Discussion (CBD) supervised learning events (SLEs). We discuss practical tips for educational supervisors to help conduct these SLEs.

Copyright Dr Amara Nwosu, KingAmi Media 2015.

www.amaranwosu.com

Music by Bensound

www.bensound.com/royalty-free-music


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MyPal podcast: Social media and palliative care – Episode 15

In this episode I discuss social media and palliative medicine. I focus on my recent blog that was published on the EAPC website about my study about the use of Twitter to evaluate communication about palliative care on social media.

‘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’ by Nwosu AC, Debattista M, Rooney C, et al published in BMJ supportive & palliative care2015;5(2):207-12.
spcare.bmj.com/content/5/2/207

EAPC Blog – Social media and palliative medicine: An opportunity for community and professional engagement
eapcnet.wordpress.com/2015/08/17/soc…al-engagement/

EAPC Blog: With great power comes great responsibility: Using Facebook to explain palliative care – Dr Leeroy William
eapcnet.wordpress.com/2015/08/12/wit…lliative-care/

Palliative Medicine Teaching – Facebook and Twitter
www.facebook.com/PallMedEd
twitter.com/PallMedEd

E-Hospice: Discussion of palliative care on Twitter is largely positive, and increasing – Dr A Nwosu
www.ehospice.com/uk/Default/tabid…ArticleId/12212/

E-Hospice: Harnessing social media to enhance hospice care
www.ehospice.com/uk/Default/tabid…ArticleId/11617/

E-Hospice: Social media and palliative care
www.ehospice.com/uk/Default/tabid…ArticleId/10009/

Symplur and the Heathcare Hashtag project – Dr Mark Taubert
blogs.bmj.com/spcare/2015/08/16/…pcare_blog_sidetab

Palliative social media – Mark Taubert et al
spcare.bmj.com/content/4/1/13.ab…943e-bce5b3763321

Why don’t end-of-life conversations go viral? A review of videos on YouTube. Imogen Mitchell et al
spcare.bmj.com/content/early/201…be1a-bcbfa3a40024

Copyright Dr Amara Nwosu, KingAmi Media 2015.
www.amaranwosu.com

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


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MyPal Podcast: Bioelectrical impedance to assess hydration in advanced cancer (overview) – Twycross prize – episode 11

I provide an overview of my PhD research “The use of bioelectrical impedance vector analysis (BIVA) to assess hydration in patients with advanced cancer in a specialist palliative care inpatient unit”. This study won the 2014 Twycross Research prize of the Association of Palliative Medicine.

National Cancer Research Institute (NCRI) Conference prize winning abstract presented in 2014:
conference.ncri.org.uk/abstracts/201…cts/A222.html

Information about Early Career Researcher Award of the European Association of Palliative Care (EAPC)
www.eapc-2015.org/Early_Researcher_Award.html

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

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, KingAmi media 2014.www.amaranwosu.com

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