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Objective: To examine dynamic changes of ischial blood perfusion during sacral nerve root stimulation against surface functional electrical stimulation (FES). Methods: Fourteen adults with suprasacral complete spinal cord injury were recruited. The gluteal maximus was activated by surface FES or stimulating sacral nerve roots by functional magnetic stimulation (FMS) or a sacral anterior root stimulator implant (SARS). Ischial skin index of haemoglobin (IHB) and oxygenation (IOX) was measured. Results: Skin blood perfusion was significantly higher during FMS than the baseline (IHB 1.05±0.21 before vs. 1.08±0.02 during stimulation, P=0.03; IOX 0.18 ± 0.21 before vs. 0.46 ± 0.30, P=0.01 during stimulation, n=6). Similarly, when using the SARS implant, we also observed that blood perfusion significantly increased (IHB 1.01 ± 0.02 before vs. 1.07 ±0.02 during stimulation, P=0.003; IOX 0.79±0.81 before vs. 2.2±1.21 during stimulation, P=0.03, n=6). However, there was no significant change of blood perfusion during surface FES. Among 4 participants who completed both the FMS and FES studies, the magnitude of increase in both parameters was significantly higher during FMS. Conclusion: This study demonstrates that using SARS implant is more efficient to activate gluteal muscles and confer better benefit on blood perfusion than applying traditional FES in SCI population.

Aim: To report the findings from an evaluation of the impact of the Compassion in Practice Vision & Strategy (CiPVS) (National Health Service England (NHSE), 2012) on nursing, midwifery and care staff.\ud \ud Background: The CiPVS was a programme of work to highlight the importance of compassionate care following the Francis Report in 2013 into the deficits in care in an NHS hospital trust. It was launched by NHS England in 2012 at a time when fiscal cuts were introduced by the Department of Health in England. \ud \ud Design and setting: Mixed methods. \ud \ud Results: Inferential statistics were used to test whether there were significant differences between staff at different levels of seniority with regard to awareness and involvement in CiPVS and their attitudes to it. Awareness and involvement of staff in CiPVS was high amongst middle and senior management but limited at ward level. Staff were not involved in CiPVS due to a lack of awareness. Ward level staff who were aware and involved perceived a lack of support and communication from senior leadership to deliver CiPVS.\ud \ud Discussion: Results reveal professional anger, distress and resistance to CiPVS and a view of the programme as a top down initiative which did not sufficiently recognise structural constraints on nurses’ ability to deliver compassionate care. We discuss the implications of our findings for global nursing. \ud \ud Conclusion: Participants emphasised that compassion for patients is only sustainable where there is compassion for staff and many participants felt that they were not being treated with compassion.\ud \ud Relevance for practice: NHSE should strongly affirm that nurses and midwives in general provide compassionate care. Trust leadership should provide support for ward level staff who deliver compassionate care in difficult circumstances.

Aim: To quantitatively analyse the effect of ES on PrU healing compared with standard wound care (SWC) and/or sham stimulation.\ud \ud Method: Review was limited to peer-reviewed studies published in English from 1970 to May 2014. Studies included randomized controlled trials (RCTs) and non-RCTs. Methodological quality was assessed using established instruments. Pooled analyses were performed to calculate mean difference (MD) for continuous data, odds ratio (OR) for dichotomous data. \ud \ud Results / Discussion: Eight prospective controlled studies were reviewed, five studies were RCTs, and three studies were non-RCTs. Pooled analyses of eight trials showed ES significantly improved daily healing rate (MD 0.89, 95% CI 0.23-1.55, p=0.008) with significant heterogeneity. Pulsed current ES significantly improved daily healing rates compared with constant direct current (DC) or alternating current (AC) in two trials (MD 1.50, 95% CI 0.62, 2.39, p=0.0009, I2=81%). Pooled analysis of two trials showed significant higher numbers of ulcer healed (OR 2.95, 95% CI 1.69–5.17, p=0.0002, I2=0%) with ES treatment. There was a trend towards less number of ulcer worsened with ES treatment (OR 0.38, 95% CI 0.12–1.24, p=0.11, I2=18%).intervals (CI).\ud \ud Conclusion: ES can significantly enhance PrU healing in SCI according to limited level I evidence. Pulsed current ES may confer better benefit on PrU healing than DC or AC. Electrodes placed on wound bed maybe superior to those applied on the intact skin.

Patellofemoral pain syndrome (PFPS) is the most common type of knee pain. It is estimated that PFPS accounts for 25-30% of all knee pathologies. The condition can be very painful and the symptoms can take a long time to settle if it is not effectively treated. There is general consensus that effective treatment strategies are based on a thorough understanding of pathological changes of PFPS. This mini review briefly review biomechanical aspect of pathophysiology and current treatment strategies of PFPS available in the literature, in particular focused on muscle tightness in PFPS and provides an insight in stretching techniques for future alternative physiotherapy.

Project Summary\ud \ud Middlesex University is funded by HENCEL to undertake the following project: “Scoping the Role of the Nurse Consultant”. The project aims to provide HENCEL with a detailed review of progress of nursing research and development (R&D) being delivered through the Nurse and Midwife Consultant role across North Central and East London. This interim report covers the period from December 1st 2013 to 31st March 2014. \ud \ud The report considers progress of phase one and phase two.