Category / Nursing & Midwifery

Dementia

Most of us know someone touched by dementia – a friend, relative or loved one.  As the average age of our population grows ever older, the chances are some of us will be affected.

As such dementia is emerging as a new strategic priority for BU, with investment from our HEIF funds to create the Bournemouth University Dementia Institute, or BUDI as the team like to call it.  The team is growing rapidly working on a range of funded dementia projects with more in the pipeline. Working with the Director of BUDI Anthea Innes, Lee-Ann Fenge, Sue Barker, Vanessa Healsip, Michele Board have recently completed a review of Higher Education Dementia Curriculums on behalf of the Higher Education Dementia Network.  Work that reflects Anthea’s previous experience leading masters and undergraduate programmes in Dementia Studies and the dementia focus of social work and nursing colleagues within the School of Health and Social Care.  A number of research and knowledge exchange projects are underway including:

  • An ongoing programme of work funded by Bournemouth Borough Council involves the BUDI team delivering a range of activities via two different programmes; a ‘cupcake club’ and a technology group.  The evaluation report isn’t due until February 2013 so a lot is happening over the autumn months.
  • A BU Research Development Grant enabled an early collaboration between the Schools of Tourism and Health and Social Care.  This project led by Anthea Innes (HSC) and Stephen Page (Tourism) is currently being written up for publication and dissemination.  It is the first study to conceptualise ‘Dementia Friendly Tourism’ as an area worth investigation to try and improve the leisure opportunities for those with dementia and their families; but the project will also produce recommendations to  help advise tourism and leisure providers to enhance their provision to promote inclusion of those with dementia.
  • An international study GRIID (Gateway Rural International Initiatives in Dementia), involving partners from Australia, Canada, India, Sweden and the UK is also in the writing up stages following a policy synthesis and survey of Alzheimer Disease International (www.adi.co.uk) members.
  • European work is on-going too, focused on Malta where Anthea has long established links working on improving the quality of care offered in Maltese hospital wards
  • A multi-site NIHR project has just commenced exploring site loss and dementia for people who continue to live at home.  This is a collaboration between the Universities of York, BU, Cambridge, Worcester and consumer organisations; the Housing and Dementia Research Consortium (HDRC); Pocklington Trust supported by the Alzheimer Society and the Macular Disease Society

But this is just the start with money being committed by many of large funding agencies this is a societal theme of the moment.  BU is part of a large FP7 grant application currently first reserve for funding, and BU is coordinating a multimillion ESRC grant application with 12 other institution due for submission this autumn.  Working locally is also very much on the agenda.  Staff in BUDI are working for example in partnership with commissioners and clinicians across Dorset to secure funding via the NHS South of England Dementia Challenge fund with BU as the evaluator for a number of innovative local projects proposed by those delivering dementia care every day.

BUDI launched 16 May 2012 just three months ago and the progress is impressive, but there is also a long way to go to achieve its objectives of making a real contribution to improving the lives of those with dementia and those who provide support whether they be family or paid clinicians and carers.  This is not just an initiative launched from HSC but a cross BU one and I am delighted to announce the secondment of Samuel Nyman (Psychology, DEC) to BUDI to strengthen its work force and continue his existing collaboration with Anthea which includes a match funded BU PhD Studentship with Anthea Innes and Marilyn Cash which is looking at the role of gaming technology to support older men with dementia in rural areas.  BUDI is looking for staff who wish to engage from across BU and is truly multidisciplinary in its approach and reach.  There may be other who are interested in similar secondments and I would encourage them to get in touch with Anthea.  DEC and Tourism are already involved with BUDI contributing staff and time but there is huge scope for others to get involved for example in the Media School.  Why not drop Anthea a line and get in touch?

Also starting in September is Patricia McParland as BUDI Project Manager or Engagement Consultant, a post-doc appointment is pending, PhD student Ben Hicks will start soon and we will be advertising for an Associate Director for BUDI soon.  BUDI has the full support of UET and is receiving strategic investment to make things happen quickly; dementia is of the moment as illustrated by the Prime Minister Dementia Challenge launched earlier this year and it’s for BU to cease this moment.  BUDI offers the opportunity to have a real impact, to make a difference in our society, to develop practice and research and to do it quickly.  Please get involved and get in touch with Anthea or myself directly.

 

BUCRU – Seminar presenting Breaking News!

 

BREAKING  NEWS…

We would like to invite you to an afternoon seminar by one of our Visiting Faculty, Professor Mike Wee, presenting some exciting new research findings to come out of a recently completed Research for Patient Benefit funded study comparing two methods of pain relief during labour (abstract and biography below).  This paper was just voted best paper of the conference at the Obstetric Anaesthetists Association Annual Conference in Liverpool and was featured recently in the Bournemouth Echo http://www.bournemouthecho.co.uk/news/9770928.Pain_relief_in_labour__study_at_Poole_hospital_makes_important_discovery/

The seminar is scheduled for Thursday 19th July 2-3pm in BG10 Bournemouth House (after the HSC end of term lunch and next door for your convenience).

We hope you can make it and look forward to seeing you then.

BUCRU

Website: http://microsites.bournemouth.ac.uk/bucru/

Administrator: +44 (0)1202 961939 / wardl@bournemouth.ac.uk

Title: The IDvIP Trial: A two-centre double blind randomised controlled trial comparing i.m. diamorphine and i.m. pethidine for labour analgesia

Research team and affiliations: MYK Wee, JP Tuckey,* P Thomas,† S Burnard,* D Jackson.

Poole Hospital NHS Foundation Trust, Poole, UK, *Royal United Hospital, Bath, UK, Bournemouth University Clinical Research Unit, Bournemouth, UK.

Abstract:

Background: Intramuscular pethidine, the commonest parenteral opioid analgesic used in obstetrics and more recently diamorphine usage has increased in the UK.  The maternal, fetal and neonatal side effects are well known for pethidine but there are no sufficiently powered large RCTs comparing pethidine with diamorphine. The aim of this trial is to address this.

Methods: After ethical approval, informed consent was obtained from 484 women randomised to receive either 7.5mg diamorphine i.m. or 150mg pethidine i.m. for labour analgesia. The sample size calculation derived from a small RCT giving 90% power (at the 5% significance level) is based upon the maternal primary outcome measure of pain relief at 60mins and the neonatal primary outcome measures of Apgar Score of <7 at 1min and neonatal resuscitation. Secondary outcome measures include verbal pain intensity at 60mins and over 3hrs post-analgesia, pain relief over first 3hrs, maternal oxygen saturation, sedation, nausea and vomiting and maternal satisfaction with analgesia. Fetal and neonatal secondary outcomes include CTG trace, meconium staining, UApH, UVpH, time of delivery to first breath, Apgar Score at 5mins, naloxone use, neonatal oxygen saturations, sedation and feeding behaviour for the first 2hrs after delivery.

Results: Reported using CONSORT guidelines. At 60mins post-administration and over a 3hr period, diamorphine is better at reducing pain scores than pethidine (p<0.001). There were no statistical differences between the two groups regarding Apgar Scores of <7 at 1min and the need for neonatal resuscitation.  The time between first dose administered and delivery is on average 82mins longer with the diamorphine group compared to pethidine (p<0.001). The vast majority of women experienced moderate to severe pain at all times. Women receiving diamorphine were more satisfied with their analgesia. There were no statistically significant differences in maternal sedation, nausea and vomiting or oxygen saturations over the 3hr period. There were no statistically significant differences in the fetal and neonatal outcomes including feeding behaviour between the two groups within 2hrs of birth but neonates in the pethidine group were more likely to be moderately or severely sedated at delivery.

Discussion: Intramuscular 7.5mg diamorphine gives significantly better analgesia than 150mg pethidine but prolongs delivery by approx. 82mins.  Women given diamorphine are more likely to be satisfied with their analgesia.  The mechanism for the prolongation of delivery time in the diamorphine group should be investigated further.

Acknowledgement: This research was funded by the NIHR Research for Patient Benefit Programme (PB-PG-0407-13170).

References

1. Tuckey JP, Prout RE, Wee MYK. Prescribing intramuscular opioids for labour analgesia in consultant-led maternity units: a survey of UK practice. International Journal of Obstetric Anesthesia 2008, 17(1):3-8.

2. Fairlie FM, Marshall L, Walker JJ et al. Intramuscular opioids for maternal pain relief for labour: a randomised controlled trial comparing pethidine with diamorphine. British  Journal of Obstetrics and Gynaecology 1999; 106(11): 1181 -1187.

Biography of speaker:

Michael Wee is a consultant anaesthetist from Poole Hospital and Royal Bournemouth Hospitals.  He has a special interest in obstetric anaesthesia and is the lead obstetric anaesthetist at Poole Hospital.  He is chair of the Research and Innovations Group at Poole Hospital and is a Board member of the Western Comprehensive Local Research Network.  He was awarded a visiting professorship at Bournemouth University in 2009.  He is a referee for several medical journals.  His research interests include patient information, safety in anaesthesia, maternal analgesia and simulation in epidural anaesthesia.  He is a co-supervisor of a PhD student at BU and chief investigator of the MObs study investigating early warning scores in obstetrics.

Research into public health and tourism strategies

Watch this excellent short video from BU’s Dr Heather Hartwell (School of Tourism and School of Health and Social Care) who describes unique research facilitating strategic direction for public health, in alignment with tourism strategies, aimed at creating conversation and collaboration

To see other BU videos on YouTube go to the BU YouTube page.

 

httpv://www.youtube.com/watch?v=Hv8DM9zKU1c