National Health Service England 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.

This paper analyses the newly proposed United Kingdom (UK) psychiatric diagnosis of 'dangerous and severe personality disorder' ('DSPD'). The aim is to show how the category of 'DSPD' manifests aspects of Beck's analysis of the 'risk society' and poststructural 'governmentality' approaches to understanding the notion of risk. Concepts such as 'dangerousness', 'violence' and 'risk' are critically reviewed in relation to 'DSPD' and are found to be less than objective. The paper interrogates the political underpinnings of this newly proposed diagnosis and analyses pre-existing frameworks of potential utility for developing further understanding of dangerousness and violent behaviour. Key issues are critically discussed in relation to the concept of 'dangerousness' including the reliability of assessment tools, the socioeconomic status of those potentially diagnosed with DSPD and detention without committing any prior offence. The paper also discusses the potential for conflict between the proposed legislation, the UK Human Rights Act 1998, healthcare practice and the likelihood of divided professional loyalties. The paper argues that this newly proposed public health policy has a sociopolitical rather than psychiatric rationale for justifying psychiatric detention and, as such, is a psychiatric manifestation of the late modern culture of risk.

Local knowledge gained through participatory engagement and collaborative working within Uganda is relevant and useful for current and future UK-Ugandan higher education partnerships.

ObjectiveTo systematically review the effects of preoperative and postoperative resistance exercise training on the recovery of physical function in patients undergoing abdominal surgery for cancer.Data sourcesA systematic review of English articles using Medline, Physiotherapy Evidence Database, CINAHL and the Cochrane Library electronic databases was undertaken.Eligibility criteria for selecting studiesStudies were included if they used a randomised, quasi-randomised or controlled trial study design and compared the effects of a muscle-strengthening exercise intervention (±other therapy) with a comparative non-exercise group; involved adult participants (≥18 years) who had elected to undergo abdominal surgery for cancer; and used muscle strength, physical function, self-reported functional ability, range of motion and/or a performance-based test as an outcome measure.ResultsFollowing screening of titles and abstracts of the 588 publications retrieved from the initial search, 24 studies met the inclusion criteria and were accessed for review of the full-text version of the article, and 2 eligible studies met the inclusion criteria and were included in the review. One exercise programme was undertaken preoperatively and the other postoperatively, until discharge from hospital. The exercise interventions of the included studies were performed for five and eight sessions, respectively. There were no differences between groups in either study.ConclusionThe only two studies designed to determine whether preoperative or postoperative resistance muscle-strengthening exercise programmes improved or negatively affected physical function outcomes in patients undergoing abdominal surgery for cancer provide inconclusive results.

More reliable evidence is required. Clear and extensive guidelines are necessary to ensure high-quality care for patients with acute stroke to improve their quality of life, and reduce morbidity and mortality rates.