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Using research to change practice needs clinical leaders who are supported by the organization and have the skills to implement research evidence, manage uncertainty and build trust with a range of other professionals.

No abstract

The Waterlow scale is the most widely used risk assessment scale in the UK and Ireland, even though there is no evidence to suggest it is more effective than the other most commonly used scales.

Peripheral neuropathy is common with both aging and disease. This sensory loss can impair the ability to feel trauma or forces during gait increasing the risk of falling, tissue damage, foot ulceration and amputation. We hypothesized that we could improve peripheral tactile sensation in the entire plantar aspect of the foot by applying subsensory electrical noise stimulation to the sensory nerve supplying this area.We applied imperceptible levels of electrical stochastic noise stimulation to a region of the tibial nerve above the ankle. Vibrotactile perception improved in both young and older individuals despite age related neuropathy in the older group. Both groups improved ~16% despite differences in baseline levels. All sites tested showed improvement, indicating that all sensory neurons on the plantar aspect of the foot and travelling down the tibial nerve were affected to a comparable degree.These are the first data to demonstrate that modulation of axon properties with applied electrical noise can improve neural transmission and perception of tactile stimuli. We suggest that the improvement in perception is due to changes in neural synchrony, a hypothesis that is supported by a developed computational model. Currently there are no treatment options for loss of sensory function and this work may have significant implications in the development of treatment models for neurodegenerative conditions.