speaker Biographies
Professor Benedict D. Michael, MBChB, FRCP, PhD
MRC Clinician Scientist
Professor Benedict Michael is an MRC Clinician Scientist, Consultant Neurologist and Director of the Infection Neuroscience Lab at the University of Liverpool. He and his team work across the translational spectrum from basic in vitro and in vivo models of brain infection, to investigating the role of bio-sample and neuroimaging markers of disease, and identification of immunomodulatory targets to improve patient outcomes from neurological infection.
He works closely with policy makers, including his commissioned WHO Clinical Exchange Platform, the WHO Disasters and Emergency Committee, NICE, DHSC, and the Academy of Medical Sciences.
He has received several awards for this work, including the Royal College Of Physicians Linacre Lectureship, the British Medical Association Vera Down Award, and the Leverage Award.
His work is supported by grant income of £4.3m as PI ad £17m as co-I through the MRC, UKRI, NIHR, AMS, MRF, and WHO.
He and his team led the UK’s response to neurological consequences of COVID-19 through the COVID Clinical Neurosciences Study and are now working to better understand the nature and underlying neurobiology of longer term sequelae.
Abstract
The science of encephalitis
For all the human suffering wrought by COVID-19, this represents a first opportunity to better understand the impact of pandemic viral infection outside of the brain on neurological inflammation and injury. Advancing our understanding is critical to develop strategies for recovery and has implications not just for the next pandemic but potentially also seasonal viral threats. This lecture will explore what we have learnt from COVID-19, what work is needed, and where we go in the future in light of this.
Sally Archer
Speech & Language Therapist and Acute Lead
Guy’s & St Thomas’ NHS Foundation Trust, UK
Dr Sally Archer is a Consultant Speech and Language Therapist (SLT) with over 20 years clinical experience and has held the post of acute team lead at St Thomas’ hospital in London since 2009. Dr Archer holds both clinical and operational responsibilities and is the lead for quality improvement, audit and research activities within the SLT department across Guy’s and St Thomas’ NHS Trust. Completing her PhD at Kings College London in 2014, Dr Archer is well published and has presented her work widely at international conferences. She has won prizes throughout her career, including a Trust prize for Innovation for development of an online swallowing awareness training package and most recently a Royal College of Speech and Language Therapists “Giving Voice” award for raising awareness of SLT and patient needs. Her research interests are dysphagia assessment and rehabilitation and she was a supervisor on the multi-disciplinary quality improvement FORWARD project at GSTT, aiming to improve care for people eating and drinking with acknowledged risks of deterioration. She is passionate about individualised dysphagia management, the fantastic SLT team she works in, her family and good food.
Naomi Soar
Speech & Language Therapist
Guy’s & St Thomas’ NHS Foundation Trust, UK
Naomi qualified as an SLT from University College London in 2008 and has worked for Guy’s & St Thomas’ NHS trust (GSTT), both in acute and the community for the past 13 years, with a specialist interest in ageing and health. Naomi was the lead on the multi-disciplinary quality improvement FORWARD project at GSTT, working to develop a trust-wide initiative to improve care for people eating and drinking with acknowledged risks of deterioration. This was the winner of the Royal College of Physicians Excellence in Patient Care Awards in 2020.
Abstract
Dysphagia and delirium – The Catch 22
Delirium is associated with difficulties swallowing (dysphagia)
and poor nutrition and hydration, both as a cause and a consequence. A challenging clinical question is frequently
faced: if patients are struggling to eat and drink due to their delirium, how
will their delirium improve? However, the management of dysphagia with delirium
is not outlined in NICE guidelines leaving best practice open to
interpretation. This talk will consider
different approaches to the management of this complex and multifactorial
interrelationship. It will outline specific issues in looking after the acutely
unwell inpatient as well as the individual living with delirium and chronic
dysphagia at home, weighing up risks, benefits and burdens at each moment of
care. The role of the Speech and Language Therapist will be highlighted as part
of a multi-professional team providing individualised patient-centred care that
is both flexible and responsive.
Prof (Dr) Mani Santhana Krishnan, FRCPsych
Chair of the Old Age Psychiatry Faculty @RCPsych
Consultant in Old Age Psychiatry
Specialty Clinical Director, TEWV NHS FT
Associate Dean & Regional Delirium Lead, Health Education England, UK
Dr Krishnan continues to do full time clinical role as community Old Age Psychiatrist. He has interests in raising the profile of Old Age Psychiatry and has worked on Dementia, Delirium and Depression.
Dr Krishnan has been on the journey of raising delirium awareness since 2014 in his region and globally he contributed to making a social movement using the powers of social media and networking. He started the hashtag #icanpreventDELIRIUM.
His educational video on delirium on YouTube has had over 120K views.
Awards:
He received the inspirational leader of the year award in 2017 from Northeast Leadership Academy.
He was awarded Psychiatric Communicator of the year 2017 by the Royal College of Psychiatrists In 2016 and 2018 his team won the Psychiatry team of the year.
In 2021 he was the shortlisted for the psychiatrist of the year. He won the Innovation Champion award at the Bright ideas in health award ceremony for his remote ECG work during Pandemic.
Abstract
Public Education
How can we educate people better about delirium?
In the session I will share our Delirium Journey from the Northeast of England (Health Education England NE) where we have been working on raising awareness, knowledge and Skills in Delirium detection and management.
We will share our experience in regional, national and global initiative to educate health and social care colleagues, patients and carers.
Will share various resources that can be used in your clinical area to educate on delirium.
Babar Khan
Floyd and Reba Professor of Medicine and Respiratory Diseases
Indiana University School of Medicine, Indianapolis, IN, USA
Abstract
Levelling the Playing Field - Improving Delirium Care when there is a language and culture mismatch
Dr. Ali Mazaheri
Associate Professor in Psychology
University of Birmingham, UK
Ali completed his B.Sc and M.Sc degrees in Neuroscience at the University of Toronto, Canada. He earned his PhD at the Donders Institute for Cognitive Neuroimaging in Nijmegen, The Netherlands. After completing a post-doctoral fellowship at the University of California, Davis, Ali was appointed as an Assistant Professor in the Department of Psychiatry at the AMC-University of Amsterdam. He joined the School of Psychology at the University of Birmingham in 2015. Ali's research concentrates on understanding the environmental and neurobiological factors predisposing individuals to cognitive decline.
Abstract
What is the role of EEG in real world clinical practice across the age spectrum?
The ongoing EEG contains rhythmic activity produced by various generators in the brain. These rhythms have been shown in previous work to capture the functional architecture of the brain at rest as well as during cognition. In the current talk, I will present findings from both typical as well as clinical populations that specific characteristics of brain rhythms at rest can be used to gauge pain sensitivity. In addition, I will present evidence that task-related modulation of brain rhythms can reveal the impact of low-grade inflammation on cognitive function without overt behavioural symptoms. I will discuss the implications of these findings and possible future direction regarding both basic science and translational endeavours.
Justin Carey
Worcestershire Acute Hospitals Trust
Justin Carey is a consultant in geriatric and general internal medicine, with a sub-specialist interest in interface geriatrics. He is passionate about supporting older people to live as autonomously and fully as possible within the limits of their co-morbidities, and designing and delivering care that is responsive to their individual needs and preferences.
Abstract
This session discusses the systemic challenges and human factors that make it so difficult to ‘level the playing field’ of delirium assessment and care, while suggesting a possible future role for technology in mitigating these factors and closing the inequality gap due to language barriers.
Katie Gabriel
Royal Preston Hospital
Katie studied a BSc in Occupational Therapy at the University of Cumbria and graduated in 2018.
She has worked in a variety of settings including mental health, learning disabilities, trauma and orthopaedics, medicine and community. After a trial secondment, Katie successfully developed the Major Trauma Occupational Therapy role within Royal Preston hospital and this has been her main post for the past 2 years.
Katie currently chairs the Lancashire and South Cumbria Major Trauma AHP forum, which focuses on improving pathways between the Major Trauma Centre and the Trauma Units within our area.
She describes herself as an Occupational Therapy geek and am passionate about promoting the role of our profession.
When not at work, Katie enjoys spending time with family, walking her Labrador and dancing.
Rebecca Chubb
Deputy Clinical Director Community Directorate
Honorary Clinical Lecturer
Locum Consultant: Mental Health Liaison Team
North Staffordshire Combined Healthcare NHS Trust
Dr Becky Chubb knew from medical school that she wanted to work with the elderly but only accidentally stumbled into psychiatry. She now works as a psychiatrist in liaison psychiatry and older adult psychiatry combining both loves. She is also deputy clinical director at North Staffordshire Combined Healthcare NHS Trust and was previously clinical lead of older adult services.
Becky is passionate about getting staff to care about delirium, increasing empathy for our patients and making it everyone’s business. She does this by championing innovative education. She has written and co-produced a virtual reality film where instead of observing the patient, the wearer becomes the patient. She also uses simple games such as a spot the delirium difference game to raise awareness on clinical wards. Becky enjoys sharing her projects and resources via twitter and as a psychiatrist is endlessly fascinated by the experiences people report as part of their delirium.
Hannah Dawe
Occupational Therapist - Neurosciences Team Lead
Queen Elizabeth Hospital Birmingham
Hannah was born and raised locally in Sutton Coldfield, Birmingham.
She studied a BSc in Occupational Therapy at Bournemouth University and graduated in 2016. Hannah has worked at the Queen Elizabeth Hospital Birmingham for the last 7 years and has a background in acute Neurosciences, Trauma, Medicine, Stroke, Burns and Plastics. Hannah is currently one of three team lead Occupational Therapists in Neurosciences with her main clinical areas of interest focussing on Traumatic Brain Injury, acute management of post traumatic amnesia and rehabilitation.
Hannah facilitates a development group for staff members to enhance their non-clinical practice and career progression which is rewarding to witness and she supports a Trust Therapies delirium group. This group are working towards a quality improvement project to implement delirium pathways across the Trust and are actively rolling out a training programme across therapies.
She is passionate about her profession and an advocate for Occupational Therapy. Hannah promotes their role across social media, through training and education within Trust and externally through going into schools to encourage the next generation of Occupational Therapists.
Outside of work Hannah enjoys spending time with her family, eating cake and being at one with nature!
Hannah Reilly
Senior Occupational Therapist - Team Lead
Hannah graduated from the University of East Anglia in 2010 with a BSc In Occupational Therapy and went on to complete an MSc in Advanced Occupational Therapy at the University of Plymouth in 2021.
Hannah has worked in a variety of acute clinical settings consisting of elderly care rehabilitation, Neurosciences, Elective and Trauma and Orthopaedics. Since 2015 Hannah has been the Occupational Therapy Team Lead for Trauma and Orthopaedics at the Queen Elizabeth Hospital in Birmingham. Hannah's main clinical duties are assessing and rehabilitating a range of orthopaedic conditions from single limb injuries to major trauma rehabilitation.
Hannah is passionate about research and Occupational Therapy in particular within orthopaedics and delirium. Her MSc dissertation aimed to establish Occupational Therapists perceptions of their role in delirium management. She is currently involved in a therapy specific quality improvement project aiming to implement delirium pathways across the hospital. Hannah is passionate about teaching and raising the profile of Occupational Therapy leading her to do guest lecturing on dementia and Delirium at BCU.
In her free time Hannah enjoys spending her time with her young family and their dog or exploring new places.
Abstract
Cognitive pathways for Traumatic Brain Injury and Delirium
During our session we will showcase our role as Occupational Therapists and discuss the cognitive pathways used for both traumatic brain injury (TBI) and delirium within the acute Neuro and acute Trauma setting. There is a robust and structured pathway for Patient’s who have sustained a traumatic brain injury both whilst in post-traumatic amnesia (PTA) and once they have emerged from this. They also receive appropriate follow-up on discharge from Hospital. The same does not apply for delirium management throughout the hospital. Delirium awareness and management is everyone’s responsibility, however there is no clear, structured or robust delirium pathway in place to ensure these patients receive optimal multi-disciplinary management as an inpatient. As well as this, these Patients are often neglected due to lack of or no follow-up on discharge. With this session we aim to highlight how there’s scope to learn from the PTA pathway and discuss the benefits and challenges of transferring this to Delirium care in the future.
Bjørn Erik Neerland, MD, PhD
Senior Consultant and Postdoctoral Research Fellow
Oslo University Hospital, Norway
Bjørn Erik Neerland is a specialist in internal medicine and geriatrics, working as a senior consultant at Oslo University hospital, Geriatric department. He is also a postdoctoral researcher in Oslo Delirium Research Group.
Clinically, he mainly sees acutely admitted geriatric in-patients and older patients with hip fractures.
His research focuses on delirium, from research on biomarkers and pathophysiological mechanisms, to randomized controlled trials with pharmacological (alpha-2-adrenoreceptor agonists) or non-pharmacological interventions (music therapy). He is project leader of a large nationwide ongoing RCT on pharmacological prevention of delirium (ALPHA2PREVENT), and of a recently funded project to investigate delirium as a risk factor for cognitive impairment and dementia in older people in a large, population-based study.
Bjørn Erik Neerland is a board member of the European Delirium Association (EDA), and a former student at the European Academy of Medicine of Ageing (EAMA) post-graduate course, where he also has been teaching about delirium several times. He has extensive experience from teaching about delirium to various healthcare professional groups.
Abstract
Safe pharmacological treatment of unsafe symptoms in older people with delirium
Whilst there is little robust evidence for the effectiveness of medications in treating distress and behavioural changes associated with delirium in older people, we still use them. Often there are few options available and although medication risks are well-known, clinicians also have a duty to keep people safe, alleviate distress and ensure safety.
We will start with a brief critical overview of what we know so far: key trials, whether clinically useful and relevant endpoints are used in these studies, the most used drug classes (including antipsychotics, benzodiazepines) and the evidence on benefits and harm.
We will present in more detail, two common delirium case scenarios 1) a patient with delirium who is described as aggressive, and 2) a patient who is anxious and experiencing psychotic symptoms.
We will use discussion and online interactive tools to explore some of these complex dilemmas, how the audience would manage these situations in real-life, the advantages and disadvantages of psychosocial versus pharmacological management and acknowledge the challenges and tensions around this in real-world l settings.
By the end of the session, we hope attendees will feel more confident in taking a rationale, patient centred and safe approach to prescribing in delirium.
Dr. Kiran Reddy, MBBChBAO, BSc, MSc, FCAI, FJFICMI, EDIC
Icat Clinical Research Fellow
Queen's University Belfast, UK
Kiran is a senior trainee in intensive care medicine and anaesthesia, a Welcome Trust funded clinical research fellow working at Queen’s University Belfast, and an executive member of the Irish Critical Care Clinical Trials Network. His research focuses on using translational, bioinformatic, and machine learning approaches to understand heterogeneity in critical care syndromes and leveraging these data to deliver stratified platform trials.
Abstract
ARDS and ALI - a journey from nomenclature, to phenotypes and treatment
Almost all large-scale trials of disease-modifying therapeutic agents in critical care have not shown benefit. Heterogeneity is a consistent feature of all critical illness syndromes. This may be the reason why trials in the past have not shown benefit. Prognostic and predictive enrichment strategies have been developed to separate responders from non-responders and better target treatments. Subphenotypes identified in acute respiratory distress syndrome (ARDS) are particularly interesting and will be detailed in this talk. We are now able to prospectively identify these subphenotypes, allowing them to be targeted with precision medicine approaches in a prospective trial. This talk will outline some of the evidence for ARDS subphenotypes, plans for trials in the near future, and will shed light on how similar concepts may be applied to delirium.
Professor Liz Sampson
Consultant Liaison Psychiatrist
Royal London Hospital with East London NHS Foundation Trust, UK
Liz is a consultant and joint clinical lead for Liaison Psychiatry at Barts and the Royal London Hospital with East London Foundation Mental Health Trust. She gained her MBChB at Birmingham University, completed her MD at the Dementia Research Centre, National Hospital for Neurology and Neurosurgery, Queen Square, London and has an MSc in Epidemiology from the London School of Hygiene and Tropical Medicine. Liz is an honorary professor in the Centre for Psychiatry and Mental Health, QMUL and the Division of Psychiatry, UCL. Her research focusses on dementia and delirium in acute hospital inpatients (epidemiology and health services research) and liaison psychiatry. She is the principal investigator for the NIHR/ESRC-funded Empowering Better End of Life Dementia Care (EMBED-Care) research programme. She is a member of Royal College of Psychiatrists' Faculty of Liaison Psychiatry Executive Committee and an elected member of the board of the European Delirium Association.
Abstract
Does delirium at the end of life provide insights into delirium earlier in the life course?
Delirium is common in older people and in those who are dying. This has driven rapid growth in research, knowledge and change in clinical practice. But much of this work has been siloed and focussed on particular older populations and settings. In this session I will use examples of what we know about delirium in older people; risk factors, precipitants, clinical presentation, detection, management and outcomes and consider how this could inform paediatric delirium research and care. I will take a life-course perspective and demonstrate the rich potential learning if we consider this continuum and move out of the comfort zones that separate our field.
Professor Bronagh Blackwood, PhD, RGN
Chair in Critical Care at the Wellcome-Wolfson Institute for Experimental Medicine, Queen’s University Belfast, Northern Ireland
Bronagh’s clinical research focuses on trials of practice change interventions to improve care for patients receiving mechanical ventilation related to weaning, sedation and delirium. She is a Content Editor for the Cochrane Emergency and Critical Care Group, an Associate Editor for Thorax and the Northern Ireland lead for Evidence Synthesis Ireland.
Abstract
Is paediatric delirium unique? How can it inform practice in adults?
In contrast to the considerable attention given to adult delirium, the domain of paediatric delirium has been notably understudied. Nonetheless, over the past decade, there has been increasing recognition of its clinical importance. The intricate nature of delirium in children presents us with a set of distinctive challenges due to their evolving neurocognitive development and varying language abilities: factors that can complicate the recognition and diagnosis of delirium. Within this presentation, I will outline the distinct landscape of pediatric delirium, including its causes, detection, associated risks, and impacts. Furthermore, I will explore how insights gleaned from paediatric delirium may inform our understanding and practice in adult delirium.
Dr Claire Anne Pryor, PhD, MSc, PGc, TCH, FHEA
Assistant Professor in Adult Nursing
Florence Nightingale Foundation Research & Leadership Scholar
University of Northumbria, UK
PhD. MSc. Advancing Healthcare Practice, PGC Advanced Practice (Clinical), PGC Teaching and Learning in Professional Practice, NMC Teacher (NMC/TCH), V300 Independent/Supplementary Prescriber, Fellow Higher Education Academy (FHEA) Registered Nurse Adult (RN).
Specialist editor and advisor of the National Non-medical prescribing bulletin.
Dr Claire Pryor is an Assistant Professor in adult nursing, working with allied health professions and nursing students at Northumbria University. Following a diverse nursing career spanning acute medical assessment units, critical care, and community intermediate care, Claire worked as a specialist older persons nurse/advanced nurse practitioner supporting physical health care in a mental health Trust.
Working in mental health services sparked an interest in delirium superimposed on dementia and the complexity around the conditions, care provision and understanding of the condition. This formed the basis of Claire’s PhD study exploring the mental health nurse experience of caring for people with DSD.
Moving to the University in 2016, Claire’s educational practice centres on specialist nursing care for the older person including frailty, including the anatomy and physiology of ageing, delirium, and non-medical prescribing. Claire works closely with key stakeholders to ensure partnerships are maintained with clinical practice, the needs and wishes of the workforce, and strategic future planning of curricula. This work is cross cutting, including health and social care services, and for all levels of clinicians and workforce. Current workforce developments include supporting the Enhanced Care of Older People competency framework (EnCOP), devising a new Adult Social Care Specialist Practice Qualification (SPQ), and innovations in Delirium education across professions and levels of study.
Abstract
High tech/low tec and no tec options in contemporary practice
Delirium education is complex and multifaceted. Ensuring all health and social care professionals have a shared understanding of delirium is paramount for high quality delirium clinical practice.
This session aims to showcase a variety of educational strategies which can be used in all care settings, with all health and social care professionals. A variety of modalities will be presented including Hi-tec virtual reality, low tec options combining online supported learning and table top exercises, and no-tec options highlighting the positive element of surprise and a chance to meet Dylan the Squid.
During the session delirium educators will be on hand to answer any questions, give live demonstrations and support translation of bright ideas into practice.
PD dr re. hum. biol. Peter Nydahl, BScN, MScN
Nursing Researcher
University Hospital of Schleswig-Holstein, Kiel, Germany
PD Dr Peter Nydahl, nurse researcher from the University Hospital Schleswig-Holstein, Campus Kiel. He worked for 30 years in critical care and started his research about early mobilization and delirium 15 years ago, and identified a lot of results, facilitators and barriers. He is collaborating with other clinicians within Germany, Europe, and worldwide to improve the quality of care and lives of patients and their families.
Abstract
Early mobilisation in ITU - how to make it generalisable (including paediatrics)
Early mobilization has several advantages as reduced length of stay or days with mechanically ventilation, and is recommended to prevent and treat delirium, but this effect is not guaranteed. In a bundle, mobilization has good effects, but as a stand alone intervention, it has got limitations. How can we identify those patients with the best benefits, and how can mobilization be dosed for the best effects?
Lyndsey Dunn
Service Manager Community Flow, Delayed Discharge and Integrated Discharge Hubs
Fife Health and Social Care Partnership
Deputy Chair Nursing and Allied Health Professionals Council British Geriatric Society
Lyndsey has had the privilege to serve NHS for twenty years and began her journey as a Trainee Pharmacy Technician in 2002 before changing paths in 2014 to pursue a career in Nursing.
Since qualifying in 2016 Lyndsey has held the position of Frailty Nurse Specialist in Acute Medicine as part of the Health Improvement Scotland Frailty at the Front door Collaborative then progressed to surgical frailty as a POPS Specialist Nurse (Proactive Care Of Older People) within the surgical directorate.
Lyndsey’s passion for Improving the health and well-being of older adults has seen her take a specialist interest in early Identification and management of patients at risk of Delirium and person centred discharge planning, she works closely with Edinburgh Napier University delivering sessions for first year nursing students.
In 2021 Lyndsey took up the post of Lead Nurse for Quality Improvement and Standards and was elected as the Deputy Chair for Nursing and Allied Health professionals within the British Geriatric Society (BGS). She worked closely raising the profile around the Importance of person centred care planning in patients with altered state of cognition where she presented a quality improvement project at the Spring BGS Conference in Glasgow. The Abstract was displayed at The European Delirium Conference in 2022.
Lyndsey took up her Management post within Fife Health and Social care Partnership in February this year where she and her team work hard to provide high quality professional standards of care that aim to prevent unnecessary delay in hospital, facilitate prompt transfer of care and prevent unnecessary hospital admission in line with Scottish Government Initiative Discharge without Delay and Home first strategic priorities.
Despite an accelerated career since qualifying Lyndsey has had the privilege to work at all levels within the organisation. Her Journey and passion has always been delivering high-quality person centred care with a key role to influence and engage all levels of the organisation to drive and improve health care for older adults.