Tuesday, 24 February 2015

New publication on Autism by Roger Watson

Roger Watson has co-authored:
Roger Watson

Stewart, ME; Carrie A; Baron-Cohen, S; Watson, R (2015) Investigating the Structure of the Autism-Spectrum Quotient Using Mokken Scaling Psychological Assessment doi: 10.1037/pas0000058

Roger ways of the article: 'It is good, once again, to be able to demonstrate the value of Mokken scaling this time applied to broad spectrum autism.  The method applied here has provided further insight into the condition,  It is also good to publish in such a high impact APA journal along with such distinguished company.'

Monday, 23 February 2015

Hull colleague elected as Chair of Lead Midwives for Education (LME) -UK Executive

Nicky Clark, Deputy Head of Department of Midwifery and Child Health has been elected Chair of LME 
Nicky Clark

According to the Nursing and Midwifery website:

Role of the LME
LMEs are based at and employed by the educational institutes providing pre-registration midwifery education. They are experienced practising midwife teachers leading on development, delivery and management of midwifery education programmes.
LMEs play a key role in informing the NMC on whether student midwives are of good character, health and are competent to undertake the role of a midwife at the end of their training.
LMEs are part of the NMC quality assurance process for ensuring high standards in midwifery education programmes.

Wednesday, 11 February 2015

New publication by Helen Sissons

Helen Sissons has published:

Sissons H (2015) Vaccination uptake in pregnant women Practice Nursing 26:2, 84-87

Tuesday, 3 February 2015

Uganda blog 4 February 2015 Entry 6

Devine Mercy Orphanage, Mbarara (Jayne Fleming & Nicola Froud)

During the afternoon our time was spent with the children of the Devine Mercy orphanage. Sharing the many gifts acquired through our fundraising and donations.

As we entered we were quickly surrounded by many children of all ages all desperate to be acknowledged, all vying for our attention and affection. We were quite overwhelmed to begin with and struggled to juggle the many children in our arms all at one time.
The children were overjoyed with gifts we gave them one girl asking if it was Xmas. Although the conditions were not ideal and not having appropriate clothing the children seemed happy and did not appear to be undernourished.
While we were there all the girls gave us a show singing and dancing bringing tears to our eyes it was a joy to watch. Babies as young as three month were among the 80+ children in the orphanage with only five staff attempting to keep some kind of order.
The children enjoyed the time we spent there all posing for a photo opportunity and playing with our gifts. With promises to return the following day we were thanked, cheered and waved off by many happy children.

Uganda blog 4 February 2015 Entry 5

Day 6 Physiotherapy/Rehabilitation (Jayne Fleming & Nicola Froud)

Today we spent time in the physiotherapy outpatients clinic. We were immediately struck by the level of standards within the small unit. Screens were provided for privacy and there seemed to be an extensive range of equipment. Although the equipment seemed dated it was more than adequate to assist the physiotherapist to do her job. The unit was clean and well maintained with a locked filing cabinet and hand washing facilities which were used between each patient.

We were amused to see that most patients treatments included heating the affected areas with hot water bottles for a length of time before massage or exercise. The staff were very sensitive to their patients needs showing dignity and respect which were often lacking on other wards due to understaffing and lack of facilities. Although Learning Disability is barely recognised in Uganda it was encouraging to see a planned physiotherapy session for neuro development clinic...sadly our time at Mbarara Hospital has now come to an end and will be an experience we will never forget. We thank the staff and patients for allowing us the whistle stop tour of a developing countries healthcare system. Let's hope our journey home is a little less eventful than our journey here.

Uganda blog 4 February 2015 Entry 3

Day 5 Medical Ward (Jayne Fleming & Nicola Froud)

Our time on the medical ward was brief but encouraging. We saw the ward run with limited resources to manage contagious diseases such as Tetanus, HIV and Tuberculosis. The staff were bright and positive and adopted high standards of infection control in an attempt to reduce cross contamination including isolation rooms. The wards are very hot and overcrowded with patients over spilling in makeshift beds on the grass outside.

From the medical ward we decided to go to the private wards located on the hospitals brand new building to compare conditions. To our surprise the wards were a far cry from the ones we had observed previously. The wards resembled our own wards back in the UK with private rooms, up-to date equipment and a high standard of cleanliness. The staff were bright and cheerful and acknowledged the conditions there were much better than the main hospital wards. This brings to light the problem many people face in many different countries who do not have the luxury of NHS funded healthcare. In reality it seems that regardless of which country you may live whether it be developing or developed wealth will buy you a better standard of healthcare.

Next and final stop Physiotherapy/Rehabilitation...

Uganda blog 4 February 2015 Entry 2

Day 12 Physiotherapy (Alice and Sophie))

Today we spent the day with physiotherapy. We arrived at 8am to find that the physiotherapist did not start until 9.30 am so we decided to go to a nurses' meeting. We found this very empowering and inspirational as the modern matron discussed nurses being the backbone of medicine and that it was the era of assertiveness, hand hygiene, infection control and standing up for nurses views regardless of hierarchical traditions. However there was a lot of opposition to this as they felt cleaning was a demotion and if they stood up to doctors they would be ridiculed. The modern matron was all for research into infection control, emphasising the need to change and greater nurse involvement.

After the meeting we ventured to the private ward which was like entering another world, within metres from the general wards. Patients had privacy and dignity, with windows covered and curtains around every bed. There was locked cupboards by each bed and a sink in each room. There was a lot less patients and in general better facilities with Infection Control at it's best. We could not believe that this was the same hospital and it was a stark reminder of just how little people have in the main hospital with the cost being only £9 a night. 

When we returned to physiotherapy we saw that hot water bottles were commonly used to treat back pain. Privacy and dignity was maintained throughout with curtains separating areas. We saw a massage called a Mackenzie and some arm exercises for post operative muscle weakness, this was very interesting to see. They hold a neurodevelopmental session on Wednesday for people with disabilities to attend; it is good that this was including however felt it may further exclude people from being included and accepted. 

Tomorrow we will spend some time on the medical ward which will mark the end of our enlightening, challenging and amazing hospital journey. 

Uganda blog 4 February 2015 Entry 1

Day 9 Sophie and Alice on a Paediatric ward

We spent some time on the high dependa=ency and critical care units, where we saw conditions such as malaria, cholera, aspiration pneumonia, meningitis, convulsions, malnutrition, cerebral palsy, leukaemia and many others. Again there was an overwhelming about of people with little regard for children and their families as at one point 15 medical students gathered around one bed to discuss a case. This would not be acceptable in the UK due to privacy and dignity. Due to lack of facilities there was only one thermometer between all the children; not being cleaned after each use. On the ward round a number of patients were being discharged, showing their treatment is effective. The doctor engaged well with the children talking to them and making them laugh. When discussing cerebral palsy the doctor stated that some people believe that burning the back of people with cerebral palsy will cure it. It seems people with a disability have trouble accessing mainstream healthcare services as they are often sent to rehabilitation units regardless of their medical need. There was a notable lack of resources such as suction machines which are readily available in the UK. We then went into the assessment room where we only stayed briefly. 

We then decided to go to the ICU and Emergency Room. We were surprised by some of the resources in ICU such as monitors and beds that were used in the UK. Staffing levels were very low with just one nurse responsible for 6 critically ill patients. We asked how she would manage if two people went into cardiac arrest and she said she would ring other wards for help. She showed us the crash trolley but she was aware that it probably wasn't fully stocked due to limited resources. 

On the Emergency Room we asked the doctor if it was okay for us to observe for a short time. We saw a patient with a gun shot wound on his leg and all he had was a piece of cardboard held together by a piece of string.  

Tomorrow we are visiting physiotherapy. 

New Faculty Ethics Committee members

The Faculty Ethics Committee has three new members:

Jackie Hutchinson

Peter Draper

Kate Bowers

Monday, 2 February 2015

Uganda blog 3 February 2015

Day 4 Labour Ward (Nicola and Jayne)

When we arrived we were welcomed and invited the morning meeting where many doctors and midwives gathered for a report from the previous 24hrs. There had been many births six of which had been caesarian section and also three stillbirths. The midwife told us they usually had between 10 and 20 births per day. The antenatal ward was fully occupied with woman also on floor. We were shown to the Labour Ward, where two ladies just delivered and another was in full labour.
Labour ward

The midwife informed us she was going to give the ward a thorough clean until the lady was ready to deliver. Sterilisation of instruments were carried out in two large buckets. The first contained a water and bleach solution the other, water from the tap. All used instruments were placed together in the first bucket, and everything washed with the same cloth before rinsing in the bucket of water then stacked on a table to dry. We had the the pleasure of witnessing two live births which were so different to what we are used to in the UK. The women laboured in silence with no pain relief or intervention just nature taking its natural course. The woman were so brave and made it look so easy.
Sterlisation with
limited resources

Once the placenta had been delivered they gathered up their babies before walking to the postnatal ward. Only women who had had a caesarian section were allowed a bed; everyone else was on a mattress on the floor on the ward or outside. When one woman left another arrived ready to start the birthing process again. It saddened us to hear the midwife tell of shortage of supplies. Supplies only delivered four times a year, yet the ward ran like clockwork despite the daily problems they faced.

Next stop Medical Ward...but before that we shall enjoy the sights and hidden treasures of Lake Mburo

Sunday, 1 February 2015

Uganda blog 1 February 2015 entry

Fiona writes: On Day 8 Alice and I were rotated to spend time on the maternity ward. We got permission to observe surgery today and to wear theatre scrubs and we were able to assist in the preparation of the anaesthetist from the U.S. The anaesthetist appeared quite frustrated by the lack of help and support available as there were only three  people in the room compared with up to 20 staff in the U.S for the kind of operation that was being performed. The staff appeared to lack knowledge about setting up for theatre; on a few occasions the anaesthetist became annoyed due to the lack of effective infection control measures.
Here we are in scrubs

Doors where left open during the surgery and other staff interrupted the surgeon multiple times with what seemed like irrelevant information. Mobile phones were answered and on charge in the room, jewellery was worn and what appeared to be scalpels appeared not to be sharp enough. No pre-op assessments are carried out if the family cannot afford them. A post operative room with equipment was available but not in use due to lack of staff to facilitate it so patients are left in the hallway until awake and someone  takes them to the ward.

We then proceeded to the maternity ward where we were showed around. There was yet again an overwhelming amount of people yet there was a lack of male presence with only one husband observed. Mandatory medication for pregnant women is provided free which includes folic acid, iron tablets, malaria tablets and what surprised us was they were also given worming tablets due to some women eating soil when ill. We were told abortions were illegal and were informed that there was a risk that someone could steal another woman's baby to sell it so mothers are told to keep an eye on their baby at all times. The labour ward consisted of three beds and women were only allowed in once they were 4 cm dilated. We were able to watch and assist with the birth of her child which was the most amazing experience we have had in Uganda so far.
And here we are again -
not in scrubs

Tomorrow we spend time on the paediatric ward.