Weekly update
Back to backs at the weekend: 30 miles Saturday, 30 miles Sunday
Cold
Windy
Very very wet
Very miserable
100k Audax to look forward to next weekend!
Posts
NICU GRADUATE: Silvana Quinn Smith
7 years ago
Sunday 28 February 2010
Monday 22 February 2010
Help Wanted - Update
A while ago I posted about a couple of studies looking for help from parents of prems (and we all know how to determine if that's you!)
I have now been contacted again by Wendy Moncur at the University of Aberdeen who is running a study looking into communication of baby updates with friends and family:
What is this survey about?
When a baby is unwell in hospital, the right kind of support from close friends and family can reduce parents’ stress levels. We are developing a news system which allows parents to send personalised updates about a baby to their friends and relatives automatically by email or text message, to encourage friends and relatives to give support to the parents.
To get it right, we need the views of mums and dads like you. We want to know the kinds of messages that you think are most suitable to give to different people.
The study can be accessed here: http://www.abdn.ac.uk/websurveys/nicu/
Thank you!
I have now been contacted again by Wendy Moncur at the University of Aberdeen who is running a study looking into communication of baby updates with friends and family:
What is this survey about?
When a baby is unwell in hospital, the right kind of support from close friends and family can reduce parents’ stress levels. We are developing a news system which allows parents to send personalised updates about a baby to their friends and relatives automatically by email or text message, to encourage friends and relatives to give support to the parents.
To get it right, we need the views of mums and dads like you. We want to know the kinds of messages that you think are most suitable to give to different people.
The study can be accessed here: http://www.abdn.ac.uk/websurveys/nicu/
Thank you!
Sunday 21 February 2010
When will Spring spring?!
[Image from DailyMail.co.uk]
If it's not snowing in Paris in June I'm not sure I'll cope! Sitting in the warm now, I am glad I made the trip; it's another 55 miles closer to Paris and I learnt something about both cold (freezer bags can help protect the feet from the cold - shame I only tried it at around 40 miles) and nutrition (pretzels and licorice - not together- work nicely, and I should have eaten something at 1.5 hours, 2.5 hours and 3.5 hours). It's also not been a bad week overall - over 100 miles in training, nearly £300 sponsorship including my first commercial sponsor and surely we must be close to spring springing!
Nigel's Training Lore #6.
Actually, real food (pretzels, licorice, bagels, cereal bars) may work just as well as energy bars and gels.
Saturday 20 February 2010
Transfers
At the end of October, I wrote a brief entry about the Bliss Baby Charter, and said I'd return to it at a later date. Well just over 3 months after that, I guess this is a 'later date'!
For me, one of the burning issues in neonatal care is transfers, which is covered in Charter 3: Babies receive the nationally recommended level of specialist care in the nearest specialist unit to the baby's family home.
Within this, the charter requires trained specialist staff in multidisciplinary teams, near to home and operating consistently across a network. This isn't really too much to ask for is it? After all, it is pretty much what adults would also expect when they have a need for specialist medical care.
It is remarkable however, how often these objectives are not met. In particular, the provision of care 'near to home' is difficult for people to receive. There are many reasons why people are transferred, some quite legitimate, for example, transfers to a hospital that can provide higher levels of care, care for very premature babies or provide surgery.
Where things start to become unacceptable though is where it is purely a capacity issue and babies are transferred often many many miles from home simply because there is no cot closer to home. In a recent poll on the Bliss website (admittedly, this wasn't a scientifically rigorous study), nearly 20% of respondents were transferred between 50 and 100 miles, with more than 10% transferred over 100 miles. Some babies were transferred 140 milesor more, in one case 146 miles from Aberdeen to Glasgow, for a stay of 25 weeks! Even shorter transfers however can be traumatic, when it means a transfer further from home. Clearly the care of the preemie is paramount, and so where medical need dictates, transfers are fine. In other cases though, they risk:
Finally, what must be the most stressful type of transfer is the multiple transfer, either being passed from pillar to post (and often back to the same post or another one!) or where multiple births are split up and sent their separate ways, often with mums still in-patients in hospital #1.
Clearly there are instances when transfers are absolutely necessary and all parents who are able to bring their baby home are enormously grateful, regardless of the distances travelled. But it would be good if transfers could be better planned, along the lines of the Bliss guidelines. Notably:
For me, one of the burning issues in neonatal care is transfers, which is covered in Charter 3: Babies receive the nationally recommended level of specialist care in the nearest specialist unit to the baby's family home.
Within this, the charter requires trained specialist staff in multidisciplinary teams, near to home and operating consistently across a network. This isn't really too much to ask for is it? After all, it is pretty much what adults would also expect when they have a need for specialist medical care.
It is remarkable however, how often these objectives are not met. In particular, the provision of care 'near to home' is difficult for people to receive. There are many reasons why people are transferred, some quite legitimate, for example, transfers to a hospital that can provide higher levels of care, care for very premature babies or provide surgery.
Where things start to become unacceptable though is where it is purely a capacity issue and babies are transferred often many many miles from home simply because there is no cot closer to home. In a recent poll on the Bliss website (admittedly, this wasn't a scientifically rigorous study), nearly 20% of respondents were transferred between 50 and 100 miles, with more than 10% transferred over 100 miles. Some babies were transferred 140 milesor more, in one case 146 miles from Aberdeen to Glasgow, for a stay of 25 weeks! Even shorter transfers however can be traumatic, when it means a transfer further from home. Clearly the care of the preemie is paramount, and so where medical need dictates, transfers are fine. In other cases though, they risk:
- Stress and other impact on the baby during transfer and change of surroundings
- Transfer to a hospital where medical staff do not know the baby and its history as well
- Less frequent visits by parents due to extra distance and less time at the cot-side
- Less frequent visits by siblings
- Less frequent visits by other friends and family
- Stress to parents due to extra travel, unfamiliarity, less time with baby
- Increased time that parents and other children are apart during visits to visit the preemie
- Increased travel for already exhausted parents
- Increased travel costs
- Increased food costs, or poorer nutrition
- Reduced opportunity to establish breastfeeding
- Frustration with medical staff who don't know the background of the baby
- The risk of subsequent out patient treatment being either at the same far flung hospital, split amongst several hospitals or simply lost 'between the cracks'
- A new unit to become familiar with, and a change of routine
Finally, what must be the most stressful type of transfer is the multiple transfer, either being passed from pillar to post (and often back to the same post or another one!) or where multiple births are split up and sent their separate ways, often with mums still in-patients in hospital #1.
Clearly there are instances when transfers are absolutely necessary and all parents who are able to bring their baby home are enormously grateful, regardless of the distances travelled. But it would be good if transfers could be better planned, along the lines of the Bliss guidelines. Notably:
- Better communication with parents about the reasons for a transfer
- Transfers only when absolutely necessary for medical reasons
- Recognition that within family centred care, the parents and siblings should also be considered in addition to the non-medical impact on the baby (ie stress)
- Better communication with parents about the new hospital - car parking, visiting hours, NICU protocol (should you bring your own nappies, is there somewhere for valuables, when are ward rounds etc)
- Recognition that whilst networks are a good idea in general, there are instance where people living on the boundaries will be transferred to a hospital further from home even if transferred back into their own network (ok, I sneaked that in from personal experience, but we can't be the only ones that happened to)
Wednesday 17 February 2010
First Commercial Sponsor!!
I have my first commercial sponsor! I spent the weekend writing letters to local companies explaining what I was doing and asking for sponsorship. I was reasonably selective about the companies I approached. I wanted to at least have heard of them, and ideally to have used their services in the past, the more the better really as I think it's important that this isn't just take take take. So, imagine my delight when the first company to respond was the best curry house in Saffron Walden, The Mogul! I frequent this reasonably regularly either for takeaways or nights out with the boys (good evening to CT United FC and the BBCC!!) and they already do a lot for local charity and local sports teams so it's great that they were happy to support me. They have also suggested I go back with a bucket on a Friday night to collect donations from the customers.
Many thanks to all at The Mogul, and I'll see you with CT United on Friday week!
Many thanks to all at The Mogul, and I'll see you with CT United on Friday week!
Saturday 13 February 2010
A landmark!
In the grand scheme of things, it's only just over half the distance of the furthest ride we'll be doing on C2P. Today however, was somewhat of a landmark in that I did 50 miles for the first time. Actually, I had to divert because a road was closed, so it was more like 57 miles. Quite a nice route in rural Essex, Dunmow, Hatfield Heath, back up through Harlow and Stortford before a diversion around Stansted and on home. My legs feel pretty shot, but it has been a great week's training, with around 110 miles covered.
I set off today in cold but dry and bright conditions, experienced sleet and came back under grey skies. Overall the weather wasn't as bad as it has been - perhaps nicer weather is just around the corner..?
Nigel's Training Lore #5.
Not all gels and bars are born the same.Try them in training so you don't find out you don't like them/they don't agree with you during your real event!
[I tried a new brand today and suffice to say they were horrible! I'll be sticking to the ones I know in future!]
I set off today in cold but dry and bright conditions, experienced sleet and came back under grey skies. Overall the weather wasn't as bad as it has been - perhaps nicer weather is just around the corner..?
Nigel's Training Lore #5.
Not all gels and bars are born the same.Try them in training so you don't find out you don't like them/they don't agree with you during your real event!
[I tried a new brand today and suffice to say they were horrible! I'll be sticking to the ones I know in future!]
Tuesday 9 February 2010
Cake a Difference
You may be aware that this week is Cake a Difference week. Each year Bliss does some fundraising around Valentines Day, normally 'Kiss for Bliss'. This year, it is Cake a Difference. I write this as my last batch of cakes are cooling prior to being iced up and sold at work tomorrow, all proceeds to Bliss, via my cycle fund.
Go on, you know you want to!
[UPDATE: £50 raised. Thanks all!]
Go on, you know you want to!
[UPDATE: £50 raised. Thanks all!]
Monday 8 February 2010
Prevention and cause
Recent news reports stories have reported on both the causes and prevention of prematurity.
Firstly, the causes. The causes of prematurity are not well understood with multiple factors thought responsible. For example this paper suggested infection, vascular disease, maternal BMI, cervical length and previous history of premature births could all be risk factors. Equally, another paper recently reported no evidence for the efficacy of antibiotics as preventatives for premature birth. As reported by the BBC news, and a host of other news sources, however, recent work has strengthened the case for infection playing a vital role in prematurity. Following on from research undertaken by Imperial College London last year which found a link between a protein that causes inflammation in response to infection and prematurity, a group at the National Institute of Health in the US has now linked a particular gene to the story too. After studying the genes of woman and babies in Chile, the researchers have identified genes that are found in proportionately higher numbers in women and babies experiencing premature birth. The genes are linked to inflammation as a result of infection and from a evolutionary point of view are thought to be involved in life preservation (particularly from the point of view of the mother) when infection is present. The next step is to now develop tests to identify the presence of the gene (or protein) in order to pre-empt the inset of premature birth. Further down the line, perhaps even intervention to prevent the inflammatory response could lead to reduction in the likelihood of premature birth.
Closer to coming to fruition as a preventative approach, maybe, researchers at Yale have also recently reported that the use of progesterone can reduce the likelihood of premature birth.Working on the hypothesis that many premature births are a result of premature rupture of the foetal membranes, the researchers have determined that progestrone is able to reduce the rupture and thus potentially could reduce premature birth. Whilst still being explored in the lab, this is nevertheless an interesting piece of research.
Another recent report on work also funded by the NIH reported that Vitamin D could help to reduce the occurence of premature births. The study investigated the rate of early births between a high vitamin D dose group and a control group taking more like the current recommended dose of vitamin D. Premature births in the high vitamin D group were less than half that of the control group.
Please note: This blog does not suggest all expectant mothers should rush out and consume large quantities of vitamin D - please see your doctor!
Firstly, the causes. The causes of prematurity are not well understood with multiple factors thought responsible. For example this paper suggested infection, vascular disease, maternal BMI, cervical length and previous history of premature births could all be risk factors. Equally, another paper recently reported no evidence for the efficacy of antibiotics as preventatives for premature birth. As reported by the BBC news, and a host of other news sources, however, recent work has strengthened the case for infection playing a vital role in prematurity. Following on from research undertaken by Imperial College London last year which found a link between a protein that causes inflammation in response to infection and prematurity, a group at the National Institute of Health in the US has now linked a particular gene to the story too. After studying the genes of woman and babies in Chile, the researchers have identified genes that are found in proportionately higher numbers in women and babies experiencing premature birth. The genes are linked to inflammation as a result of infection and from a evolutionary point of view are thought to be involved in life preservation (particularly from the point of view of the mother) when infection is present. The next step is to now develop tests to identify the presence of the gene (or protein) in order to pre-empt the inset of premature birth. Further down the line, perhaps even intervention to prevent the inflammatory response could lead to reduction in the likelihood of premature birth.
Closer to coming to fruition as a preventative approach, maybe, researchers at Yale have also recently reported that the use of progesterone can reduce the likelihood of premature birth.Working on the hypothesis that many premature births are a result of premature rupture of the foetal membranes, the researchers have determined that progestrone is able to reduce the rupture and thus potentially could reduce premature birth. Whilst still being explored in the lab, this is nevertheless an interesting piece of research.
Another recent report on work also funded by the NIH reported that Vitamin D could help to reduce the occurence of premature births. The study investigated the rate of early births between a high vitamin D dose group and a control group taking more like the current recommended dose of vitamin D. Premature births in the high vitamin D group were less than half that of the control group.
Please note: This blog does not suggest all expectant mothers should rush out and consume large quantities of vitamin D - please see your doctor!
Sunday 7 February 2010
A good week
Despite being the US again this week I managed to get some pretty good training in. I managed a twenty miler on Tuesday before I went, a few miles on the treadmill to get the flight out of my legs on Wednesday night (about 1am GMT!) and 12 miles on a LifeCycle on Thursday morning.
This was then the first week of back to back rides on Saturday-Sunday, with 22 miles on Saturday followed by 34 on Sunday. Being away in Derby for the weekend allowed a change of scenery, with a circular route out to the town where I went to school on Saturday and an out and back into Derbyshire on Sunday.
We reach a milestone this coming weekend, with a 50 miler planned..!
This was then the first week of back to back rides on Saturday-Sunday, with 22 miles on Saturday followed by 34 on Sunday. Being away in Derby for the weekend allowed a change of scenery, with a circular route out to the town where I went to school on Saturday and an out and back into Derbyshire on Sunday.
We reach a milestone this coming weekend, with a 50 miler planned..!
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