This page contains all of the course materials you need to support you once you have attended Session Four of the North Bristol NHS Trust Mindfulness course.

Course materials

Session 4 recordings to practice at home:

This week we suggest you continue alternating what you do each day: aim to do a movement practice of your choice (see week 3) one day and the “sitting” breath awareness practice the other.  Remember you can do this in sitting, lying or standing. It can be worth experimenting with how you do it.

25 minute “Sitting” practice – can be done in lying or standing as well as sitting:

https://soundcloud.com/fiona-mckechnie108681984/sitting-practice-25-mins/s-DgF59SMNVHe

We suggest you also practice a 3 step pause or breathing space, regularly and also when you feel you need it:

https://soundcloud.com/fiona-mckechnie108681984/3-minute-pause/s-T9yMnZ8Cq2d

You can click on the links below to download the written materials which support the course. We have made each handout available as a Word document or a pdf. The Word document is likely to be more useful if you want to write comments on your own handout and store them on your own computer.

This page contains all of the course materials you need to support you once you have attended Session Three of the North Bristol NHS Trust Mindfulness course.

Course materials

Session 3 recordings to practice at home:

A typical mindfulness course yoga-based movement practice. Do listen to this and make sure you are happy with it before going ahead: https://soundcloud.com/mindful-health/sets/mindful-yoga-with-taravajara

Fiona has made a lying sequence that is less strenuous: 

Mindful walking can also be an option: https://www.bangor.ac.uk/mindfulness/audio/cd1/04Track04.mp3

There is also a video Pete has made to guide you through some mindful movements:

Workbooks and handouts

You can click on the links to download the written materials which support the course. We have made each one available as a Word document or a pdf as we know that some people prefer one or another. The Word document is likely to be more useful if you want to write comments on your own copy and store them on your own computer.

Workbooks outline the practice and other activities for the week and have the option of recording and reflecting on what you are learning (you will need to use this one).

Handouts explain more about the background theory (this one is optional).

This page contains all of the course materials you need to support you once you have attended Session Two of the North Bristol NHS Trust Mindfulness course. Each week of the course has it's own page where  you will find the specific practice recordings for that week plus some additional written and sometimes video information.

Course materials

Session 2 recordings to practice at home:

15 minute body scan: https://soundcloud.com/fiona-mckechnie108681984/15-min-body-scan-fiona-wright/s-OcfX3

30 minute body scan: https://soundcloud.com/fiona-mckechnie108681984/half-hour-body-scan-fiona-wright/s-1NJPz

Landing/anchoring 10 minutes: https://soundcloud.com/fiona-mckechnie108681984/arrivallanding-practice-10-mins/s-hW1hz8wClD4
 

Workbooks and handouts

You can click on the links to download the written materials which support the course. We have made each one available as a Word document or a pdf as we know that some people prefer one or another. The Word document is likely to be more useful if you want to write comments on your own copy and store them on your own computer.

Workbooks outline the practice and other activities for the week and have the option of recording and reflecting on what you are learning (you will need to use this one).

Handouts explain more about the background theory (this one is optional).

Updated on 20/10/21

Key factors which are known to affect performance of the screening tests.

Working in conjunction with midwives and other health professionals we aim to reduce the number of 'avoidable repeats' as far as possible. Patient safety is our utmost concern, and if we request a repeat sample, it is to ensure we get the correct result, on the right baby, so each baby who has one of the diseases we screen for, can access appropriate treatment in a timely manner.

Avoidable repeats: Key factors known to affect performance of the screening tests.

1. Problems arising before sample collection:

• Baby too young (e.g. day 4)
• Expired card
• Details missing or inaccurate:
  • No NHS number / Date of birth / Date of sample

TIP: Ask the parents to check the card (if necessary make amendments to the label and/or card).

2. Problems arising during sample collection:

• Insufficient - blood spots too small
• Insufficient - Inappropriate application of blood e.g. not soaked through, applied both sides or multi-spotted.
• Compression of sample
• Contamination of sample (e.g. with faeces).

TIPS:

You can ask for the baby to be held in a different position to make it easier for you to take a good quality sample.
Prick the heel and wait for the blood to flow.

Fill each circle on the card with a single drop of blood - check the blood has soaked through to the back of the card.

Take your time - If the baby is not bleeding it may be necessary to prick the heel again. Do not squeeze.
 

3. Problems arising after sample collection:

• Sample contamination (e.g. with faeces)
• Water damage
• Arrival in laboratory >14 days after collection
• Analytical problem / Unsatisfactory analysis.

TIP: Samples sent by courier arrive in the lab more quickly.

Resources

• Improve blood spot quality e-learning
• Repeat blood spot samples: Information sheets for health professionals and parents/carers
• Avoidable repeat rate film

Unavoidable repeats

Occasionally, we will contact the midwife and ask for a repeat sample for one of the following reasons. In these cases, the original sample was collected correctly, but the results for one or more of the tests was borderline or inconclusive.

• Slightly raised TSH result - Repeat should be collected 7 -10 days after the initial sample.
• Inconclusive CF screen - Repeat should be collected between 21 - 24 days of age.

Other factors known to affect the reliability of the screening tests

• Thalassaemia trait is not excluded.
• The Sickle Cell Screen is only valid if baby not transfused.
• IRT is not always abnormal in CF patients with meconium ileus; therefore the screening result may be falsely normal.
• IRT is an unreliable indicator of CF in babies >8 weeks of age. Therefore the test will not be performed in samples collected in this age group.
• Some babies with MCADD, MSUD or IVA may become symptomatic in the first few days of life, before the screening test has been carried out. In this case the clinician looking after the baby should send clinical samples to their usual diagnostic laboratory. 
• CHT screening tests for raised TSH only; therefore if hypothyroidism occurs secondary to pituitary disease, the screening result may be falsely normal.
• Newborn bloodspot screening is only offered to babies up to 1 year of age. In older babies, other tests are available to doctors through clinical pathways for babies/children with suggestive symptoms.

This list is not exhaustive and it is important to remember that these tests are screening tests; no screening test is 100% reliable. Further information about the limitations of newborn screening tests can be found in the following laboratory handbooks:

• IMDs
• CHT
• CF
• SCD

Updated 23/04/2020

Reviewed on 20/10/21

Labelling the blood spot card

Points to remember:

• It is ESSENTIAL that the blood spot card is completed correctly with all the details of the baby whose blood is collected (including the NHS number). Samples received without an NHS number will not be processed.
• These details must be filled in BEFORE the heel prick is carried out, to make sure there is no chance of a mix-up.
• If there is an indication that any incorrect information may have been provided on a bloodspot card, you must inform the laboratory immediately.
• Do not assume that printed labels in the baby's child health record are accurate, it is important to check the details each time you use them.
• There is no need to indicate whether the baby is breastfeeding or bottle-feeding.

Information for parents

The NHS Newborn Blood Spot Test website includes information about each condition, FAQ's and links to further information.

The Screening Tests for You and Your Baby leaflet contains information about the blood spot screening test and the conditions it screens for. It is available in other languages.

Find out what happens to your baby's blood spot card.

Collecting the sample

A full guideline and quick reference guide are available here.

e-Learning for Healthcare has developed an e-learning module to support midwives and other sample takes in obtaining good quality newborn blood spot samples: https://www.e-lfh.org.uk/programmes/nhs-screening-programmes/

 of an acceptable quality sample, with correctly completed details. 

Transportation

The blood spots should be allowed to air-dry thoroughly, away from direct sunlight before placing in the transparent paper (Glassine) envelope provided (not plastic as this may cause the specimen to 'sweat') and sent, by first class post or courier on the day of collection, in a sturdy envelope.  If not possible, despatch within 24 hours of taking the sample. Despatch should not be delayed in order to batch cards together for postage.

We normally invite patients to attend the Introduction to Pain Management Meeting at Southmead or Cossham hospital. This would be a group meeting,  to provide you with enough information to make an informed choice about how to proceed with your Pain Management referral.

We are currently unable to offer groups because of the Covid-19 restrictions, so we have made this presentation available online. We would encourage you to listen to this in your own time and then contact us if you wish to proceed with your Pain Management referral by email or phone:

Email: painmanagementcentre@nbt.nhs.uk
Telephone: 0117 4147357

We will then be able to offer you an assessment appointment, at a mutually convenient time. At present, because of the Covid-19 restrictions we are offering telephone assessments.

Pain management information video 

This page contains all of the course materials you need to support you once you have attended Session One of the North Bristol NHS Trust Mindfulness course. Each week of the course has it's own page where  you will find the specific practice recordings for that week plus some additional written and sometimes video information. This course has been adapted for people who are living with fatigue and pain, and we are grateful for the time and care which our patients have offered to improve this course.

Course materials

Session 1 recordings to practice at home:

15 minute body scan: https://soundcloud.com/fiona-mckechnie108681984/15-min-body-scan-fiona-wright/s-OcfX3

30 minute body scan: https://soundcloud.com/fiona-mckechnie108681984/half-hour-body-scan-fiona-wright/s-1NJPz

Workbooks and handouts

You can click on the links to download the written materials which support the course. We have made each one available as a Word document or a pdf as we know that some people prefer one or another. The Word document is likely to be more useful if you want to write comments on your own copy and store them on your own computer.

Workbooks outline the practice and other activities for the week and have the option of recording and reflecting on what you are learning (you will need to use this one).

Handouts explain more about the background theory (this one is optional).

We have added several resources in sections below. Just click on each section and it will open up to show the different resources.

Understanding pain & self-management

Arthritis

Back Pain

Employment and pain management

Fibromyalgia

Therapeutic activity and exercise

Mindfulness-based approaches

Self-help books

We normally offer patients the opportunity to take part in a pair of meetings called the “Foundation Phase” seminars. This short course has a number of aims, including:

• clarifying the symptoms of ME/CFS
• exploring in depth some of the key ME/CFS self-management areas
• sharing coping strategies between patients coming to the seminars
• finding ways of reducing the impact of the condition

The seminars have been developed with a lot of patient involvement and feedback, and each seminar we run involves sharing knowledge and experience which patients have already developed.

We had to stop offering these seminars in March 2020 to reduce the risk of Covid-19 infection, so we have put together this short online course, so that people can still access the ideas from the Foundation Phase seminars.

The first seminar is split into two parts. The first part clarifies the symptoms, consequences and triggers. The second part looks at activity management, particularly as a way of managing post-exertional malaise.

The second seminar is split into two parts as well. The first part is a short introduction to the impact of stress and the role of stress management. The second part is longer and focusses on sleep management.

We have made the workbooks which support these seminars available as a written guide, which you can choose to read by selecting the "Foundation Phase written guide" from the left hand menu. There is also an example of an activity diary available, and some guidance about completing an activity diary, which you can read by choosing the "Bristol M.E. Service: Activity, Rest and Sleep Diary" from the left hand menu.

Foundation session 1 part 1 

Foundation session 1 part 2 

Foundation session 2 part 1 

Foundation session 2 part 2 

Canagliflozin, Dapagliflozin, Empagliflozin and Ertugliflozin are from a class of medication called sodium-glucose co-transporter 2 (SGLT2) inhibitors. Most people taking these medications will have type 2 diabetes but some may have type 1 diabetes. People taking these medications are at increased risk of Diabetic Ketoacidosis (DKA). This could happen even with normal blood glucose levels. DKA is rare in people with type 2 diabetes but it is a serious condition and could be life-threatening.

If you are taking any of these medications and feeling unwell we suggest you stop them till you are feeling better. It is important to keep well hydrated.

If you have symptoms suggestive of DKA (for example, excessive thirst, dehydration, vomiting, fast breathing, feeling drowsy, abdominal pains) we suggest that you stop taking these tablets, keep well hydrated, and follow the advice below:

• If you have type 2 diabetes and you do not have access to a blood ketone meter. Please follow advice from this link: TREND UK: Type 2 Diabetes and DKA.
• If you have type 2 diabetes and have access to a blood ketone meter, please measure your blood ketone level:
  • If ketone is normal (<0.6 mmol/L), please follow advice from this link: TREND UK: Type 2 diabetes: what to do when you are ill.
  • If ketone is raised (>0.6 mmol/L) then contact 111.
• If you have type 1 diabetes, please measure your blood ketone level and follow advice from this link: TREND UK: Type 1 diabetes: what to do when you are ill.
• If your symptoms are getting worse or you think you are developing DKA then call 111.