The INSPIRE Market Stall

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					            Summer 2009                                    Volume 18 Issue 2

        The INSPIRE Market Stall

          It is amazing what lengths people will go just to get to the INSPIRE Stall

                           But clearly no one is at all impressed!

    28th April 2009 must go down as one of the driest days for an INSPIRE
Market Stall. Even so the stall is on the north side of the Guildhall and does not
get to see the sun until the afternoon, so it could have been warmer!
    With many thanks to everyone who donated all manner of goodies, whether
they be books, crockery, glassware or a coffee machine, they all helped to
raise over £450. Thank you also goes Phillippa Bell, Sue Clayton, Julie Esnouf,
Mo Morgan and of course Heather and Rose who persuaded the public to part
with their cash.
                       What’s Happening?
                       New Applications for Review

Effect of functional electrical stimulation-assisted rowing on
cardiorespiratory function in persons with spinal cord injury

    People with spinal cord injury (SCI) are at an increased risk of the diseases
of inactivity (cardiovascular disease, diabetes, osteoporosis and obesity)
compared with their able bodied counterparts. In addition, some of the
physiological consequences of SCI (e.g. impaired bladder, bowel and sexual
function) result in a reduced quality of life. Improvements in cardiorespiratory
fitness are related to a reduced incidence of the diseases of inactivity and an
enhanced quality of life in people with SCI. To improve cardiorespiratory fitness
an appropriate exercise training programme is required. Such a programme
needs to place the cardiorespiratory system under sufficient stress to stimulate
adaptation. Neither upper body exercise nor functional electrical stimulation
(FES)-assisted cycling appear to provide sufficient physiologic stress to bring
about significant improvements in cardiorespiratory fitness.

    Hybrid functional electrical stimulation (FES)-assisted exercise systems,
which recruit the paralysed lower limbs simultaneous with the voluntary action
of the arms, significantly increase the cardiorespiratory demand of exercise.
FES-rowing has been shown to elicit a greater acute cardiorespiratory
response than any other type of exercise in people with SCI. It is possible,
therefore, that people with SCI may derive significant cardiorespiratory benefits
from a programme of FES-rowing training.

   Studies that have investigated the cardiorespiratory benefits of FES rowing
have focused on gross measures of aerobic capacity. Although important,
these studies have not examined the effect of FES-rowing upon the
physiological systems that underpin changes in cardiorespiratory fitness.
Cardiac, vascular and respiratory structure and function may all change in
response to a structured programme of FES-rowing. Therefore, the purpose of
the present study is to determine how the physiologic systems underpinning
cardiorespiratory fitness and quality of life adapt in response to a programme
of FES-rowing. Such information may ultimately provide a basis for using FES-
rowing training as an additional therapeutic measure in people with SCI.

    The Potential Therapeutic Benefit Of Cortical Repetitive
    Transcranial Magnetic Stimulation on Pelvic Sphincter
    “Guarding Reflex” Function To Promote Continence In
         Incomplete Spinal Cord Injury: A Pilot Study

   Bladder and bowel problems                 Stanmore, together with Imperial
continue to be the most troublesome           College and University College
aspects of everyday life for people           London, has been investigating the
with paraplegia.     Indeed, recent           integrity and function of any
surveys have shown that above all             elements of the spinal pathways
the many other medical conditions in          controlling bladder and bowel
spinal cord injury, the need to               sphincters that have survived in
continue targeting recovery of                people with incomplete spinal cord
bladder, bowel and sexual functions           injuries. When compared to people
are uppermost in patients’ own                without an injury we have found, not
desires; this is despite the                  unex pec te d l y, th at v ol unt ar y
considerable progress achieved to             sphincter contractions are weak,
manage them over the past 60                  variable and poorly sustained.
years. There are a number of                  Interestingly, when we stimulate
treatments to alleviate the                   these residual spinal pathways with a
bothersome symptoms of urinary and            single non-invasive m agnetic
faecal incontinence including drugs,          stimulation pulse to the correct part
medical devices and surgery, but              of the brain we can momentarily
none are completely satisfactory.             enhance reflexes that contract the
Furthermore, the so-called “cure” by          sphincters, but only to a much lower
nerve regeneration and repair, if it is       level as compared with people
possible, is now looking likely to            without a spinal injury. In neither
require many more years of                    group of people do we observe this
development. So it is timely to               enhancing effect lasting longer than
consider some alternative therapies           a few seconds at most. Clearly such
that might be achievable in the               brief interaction does not impact
shorter-term. One such new therapy            significantly on the plasticity of the
could involve tapping into the                brain or spinal cord and provides no
“plasticity” of surviving nervous             lasting functional benefits.
pathways in the spinal cord following             However, studies of limb muscles
an injury; pathways that normally             have shown that by giving bursts of
control voluntary contractions of the         repetitive magnetic transcranial
bladder and bowel sphincters that             stimulation (known as rTMS) to the
help to maintain continence and               brain, the voluntary pathways to
achieve voiding.                              muscles can be significantly
   Recently, our team, at the London          facilitated and the effects made to
Spinal Cord Injuries Centre at                                   (Continued on page 4)

(Continued from page 3)
persist for up to many hours or even days. We suggest that the potential for
extending these persistent effects to bladder and bowel sphincters may well be
the basis of a therapy, for example as an adjunct to proven rehabilitation
techniques, to improve continence in spinal cord injury. In a small preliminary
study on healthy volunteers we have already demonstrated the utility of rTMS
for enhancing sphincter reflex function. This application is now for funding a
pilot study to investigate, in a randomised scientifically controlled way, whether
similar effects can be demonstrated in persons with an incomplete spinal cord
injury. If we are successful in this endeavour then we would go on to develop a
more comprehensive study to investigate the impact of such important effects
on improving continence and voiding in spinal cord injury.

                                        The Editorial
                                 This Issue is always earlier than usual because
                                our priority is not only with our main fundraising
                                event of the year, the Polo, but also other
                                matters including a new event in which General
                                Sir Mike Jackson, one time head of the Army will
                                be in conversation with Kate Adie, one time BBC
                                Defence Correspondent.
                                 Please don’t think we have gone a little senile
                                but Nessie has included a little extra with her
                                recipes but for the youngest of our readers.
    You will have seen the new projects which are currently out for review with
both the User and Scientific Committees. There will be a meeting in June and
the recommendations will then be taken to the Board meeting in August. This
year is going to be a challenge as the recession is taking its toll and no matter
how good the science, these projects may not be supported if there is a lack of
    At the end of April, I was lucky enough to be invited to attend Professor
Nick Donaldson’s Inaugural Lecture at the University College London. His talk
was on the history of electrical stimulation and surprisingly he started in the
17th Century! I would have included a photograph but I am having difficulty
extracting one out of him so I included one of mine. It shows Nick at the helm
of his beloved Cornish Crabber on page 7.
    On pages 12-14, there is a survey on Pressure sores. Lyn Wilson asked if
she could write to you but I said that it would be cheaper for us if we put her
advertisement and questionnaire into the Newsletter. If you can and would like
to, please find the time to take part.
    With best wishes to you all.

                       Postcard from the Seaside
    Grandson Oliver is learning to swim at school and is convinced it will
happen any day soon. At five years of age and living in Bournemouth he
already likes what he sees of the bucket and spade environment and cannot
wait to enjoy the water beyond. Brother Samuel, four years younger and
learning to walk, has kind of thrown a spanner in Oliver’s work to become a full
time holidaymaker because Mum and Dad, with him to consider as well, know
just how crowded it gets on the beaches down here at this time of year. So,
cue Grandad, who thought he had found the solution and who, at the time of
writing this postcard, is in the midst of a maddening scramble for one of those
traditional summertime sights decorating the English coastline - the beach hut.

    It did not take me long to find out that the world of the beach hut, unlike that
of the beachcomber, is an expensive one to join, if only for a few hours a day,
although you can actually sleep in some if you are prepared to pay an even
steeper price and are, as far as I’m concerned, completely stupid. Of course,
Oliver doesn’t agree with me and neither do the inhabitants of around 300 huts
on Mudeford Sandbank, but, in my defence you would have to say that these
are more like chalets, having both bunk beds and living quarters for overnight

    It is all a far cry from the nineteenth century visit to the seaside when no trip
was complete without a dip in the sea from a weird contraption known as a
bathing machine. Naturally enough, by the 1890s it became more acceptable
for people to walk across the beach in their bathing costumes and purpose-
built day huts began to appear. Such was the new fashion for sunbathing by
the inter-War years that bathing machines soon became outdated and even
newer modern-looking blocks of beach huts or chalets were built near lidos,
with sun terraces a popular craze of the period.

    Being a bit of a boring old researcher by nature, I’ve also found out that the
beach hut reached its heyday by the 1950s and from that decade to this,
through good times and bad, dedicated fans kept ‘hut life’ going until a present
day resurgence, which has been fuelled by a fair amount of recent media
interest. Adding to all this publicity down in Dorset are the Boscombe ‘beach
pods’, said to be the most innovative beach huts in the UK, that are going up at
this very moment in front of Europe’s first artificial surf reef. We haven’t told
Oliver about this development, as we are not as stupid as we either look, or
imagine the sleep-overers to be. Quite frankly, he needs to swim, before his
brother walks, and maybe then they can both run down to the beach from one
of these historic newfangled things!                        Alan Dommett (C6/7)

            A Letter from America
     Gloom: This week, our old TV
declared itself unable to provide us
with a clear spectrum of on-screen
colours.      To be more exact,
programmes which showed
previously presentable ladies and
gentlemen now presented said L &
Gs accompanied by hideously red
auras which made them look like
murder victims! Now, does one feel
happy that (a) the opportunity to
purchase a flat- screen-all singing -
all dancing monster electronic marvel                     The “Beast”
has finally arrived or (b) to                colour!) and I humbly and hastily
acknowledge that a prudent man               approved of her choice.
would settle for some device                     Operational Considerations: Now
somewhat more modest and                     that “beast” has been installed in our
considerably less expensive?                 house and coupled up to a Blue Ray
     Strategy: My game plan now              DVD player, a VCR, a radio and a
involved innocently waltzing Julie           cable programming box which
into the nearest purveyor of all sizes       enables us to record any channels
and shapes of tele-visual delights           we wish. Said box provides so many
and then hurriedly leading her to the        features I am a little stunned by it all
biggest and most elaborate TV which          particularly as I still have to reduce
was currently (and luckily) showing a        our four remote controls to one all-
romantic nature scene involving cute         purpose device. I have not yet got
little animals! Nothing better to tug        around to reading all the contents of
not only at the heartstrings but also        a user’s handbook which is provided
the family purse strings!                    on a DVD disc. I should probably
     Tactics: Of course, I knew at           wait until my seven year old
once that this first mammoth TV was          granddaughter comes next month –
definitely an overkill but would prove       she will shake her head and patiently
to be a great vehicle leading us to          say “Grandpa let me do this for you”
smaller, but none the less splendid              Great News: I was delighted to
neighbouring devices. Julie was duly         see in the last newsletter that John
impressed by a particular Flat-screen        Aves received formal recognition for
High Definition TV (Wow, I thought,          his many contributions in those areas
here comes 47 inches of glorious                                 (Continued on page 7)

(Continued from page 6)
that all of you are well aware of –
great guy, great family!
     More somewhat great news: Our
son, Simon, much to our delight,
recently telephoned us from
Baghdad. He is in Iraq for a full year.
If the internet news is correct he will
miss having his Brit counterparts to
chat with and will also lose the
chance to polish up his English
accent! Meanwhile, Si’s wife and
three daughters are in Texas and,
not surprisingly, can’t wait to
welcome the Colonel home.
     AU REVOIR: Best wishes to you
all - keep safe      Jack & Julie G.               We couldn’t resist this picture!

      Play Dough Recipe
   A brilliant recipe which lasts for
weeks and is much softer than

    1 cup flour
    ½ cup salt
    1 cup water
    2 teaspoons cream of tartar               Nick Donaldson at the helm of his beloved
    1 tablespoon cooking oil                             Cornish Crabber

    Heat water until it reaches
boiling point – add cream of tartar,
flour and salt.                                  Polo 11th July
    Stir well.                                Jockeys & Eventers
    Take off heat, add colouring and
cooking oil.                                     Polo Match &
    Keep in an airtight container or
wrapped in cling film and it should                  Lunch
keep for weeks!                               reply form & details
                                                on the last page

                A Couple of Recipes
                                 Nessie Owen

                           AND HOLLANDAISE
Serves 8
A very elegant starter which can be prepared in advance and arranged on
the plate just before your guests arrive.

                              24 quails eggs
                    8 large slices of smoked salmon
                          1 jar of salmon caviar
                              Dill to garnish
                       3lb potatoes
                 1 ½ tablespoons olive oil
                  1 ½ oz unsalted butter
                      salt and pepper
                  3 tablespoons wine vinegar
                         6 peppercorns
                            1 bay leaf
                         Blade of mace
                           2 egg yolks
                        110g/4oz butter
                           Lemon juice

   Parboil the potatoes for 10 minutes and allow to cool in their skins. Peel
and grate with a coarse grater. (the potatoes are easier to grate if they have
been chilled)
   Use a 9 inch/23cm heavy, non-stick frying pan and heat up the oil and
butter. When the oil is very hot spread the potato evenly into the pan. Turn
down the heat and cook for 10 minutes, until golden brown on each side. If the
pan seems rather dry, add more butter and oil.
For the quails eggs
   Put the quail’s eggs in boiling water for 3 minutes exactly. Refresh
immediately in cold water to stop them over cooking. Peel the eggs.

For a speedy Hollandaise
        If a liquidizer or food processor is available, a speedy hollandaise can
        be made. Reduce the flavoured vinegar and strain it, hot, onto the egg
        yolks while the machine is running. Then add the butter (just warm
        and melted, not in cold pieces) in a thin steady stream.

To serve
Arrange the Rosti on the plate – either 1 large or 3 small per person
(uneven numbers)
Spoon some hollandaise on the Rosti. Arrange the waves of smoked
salmon on top with the quails eggs, salmon caviar and dill.

                             Chocolate Marquise
This very rich chocolate puding has a velvety texture and is delicious served
with summer berries. You can make this up to 2 days in advance and freeze
until required. I have taken this from Victoria Blashford Snell§s new book, The
Cooking Book = it is a good one for the freezer.

Makes 10-12 slices
                                900g (2lb) loaf tin
                             Freeze for up 3 months

                           400g (14oz) dark chocolate
                                175g (6oz) butter
                             175g (6oz) caster sugar
                       4 tbsp cocoa, plus extra for dusting
                                   6 egg yolks
                          500 ml (16fl oz) double cream
                              Raspberries, to serve
                              Blueberries, to serve
1 Line the loaf tin with cling film.Put the chocolate, butter, sugar, and cocoa in
a saucepan, and melt over a very low heat, stirring.
2 Put the egg yolks in a bowl and pour in the melted chocolate, stirring
constantly.In a separate bowl, whisk the cream until it just holds a trail. Fold
into the chocolate mixture until combined.
3 Pour into the prepared tin.

Chill in the refrigerator for 2 hours, or until set.Carefully turn out on to a plate,
and remove the cling film. Use a hot knife, cut into slices and serve with
raspberries,blueberries, and a sprinkling of cocoa.
Good with a big bowl of mixed berries, a fruit salad, or pouring cream.

     Acknowledgements & Notices
    In addition to thanking the Trusts, groups and individuals listed below, who
have donated £25 or more to INSPIRE, we would also like to thank other
members and friends, too numerous to list, who have supported us since our
last newsletter went out in March 2009. In addition many others donate once a
month and their annual total exceeds £25.

         ARL Wheatcroft                     Colin David & Family Charitable
           MC Leslie                                     Trust
        Smyle Events Ltd                           Prof N Donaldson
           A Tromans                       The Arnold Burton 1998 Charitable
            R Barrett                                    Trust
         JA Watt-Smith                                 ML Merritt
 George Skeates Benevolent Fund               The Company of Actuaries
        RJ & JP Vincent                          Charitable Trust Fund
          M Todhunter                               Mrs GS Holmes
    Chiddick Charitable Trust                  Thriplow Charitable Trust

                       In Memoriam
We have received donations in memory of
                             Trevor Parfrement
                             Adrian Hounsome

                   Allen Bearman of Trowbridge, 7th Jan 09
ON behalf of the Trustees and Members, our condolences go out to the family
and friends.

                   THE INSPIRE FOUNDATION
                    INSPIRE - INtegrated SPInal REhabilitation.
                          Registered Charity No 296284

       To promote research into, and the development of, electronic, mechanical and medical aids
to assist the mobility and enablement of people suffering spinal cord paralysis and its associated
effects and to communicate the useful results of such research.
     Group Captain Keith Crosby MRAeS FBIM
     Mr Robert Key MP
     Mr Clive Pryke
     The Lord Vincent of Coleshill GBE KCB DSO
     Toyah Willcox
Mr Rob Barrett*, Major General Ralph Crossley CB CBE FBIM, Miss Michelle Howard LLB*, Mrs
Gillian Matthews MBE*, Mr David McCreath* (Chairman), Mr Anton Prantl*, Mr Jonathan Rudge
MSc* (Vice Chairman), Mr Tony Tromans FRCS, Mr Robert Tylor*
     Executive Director:     Mr Robert Morgan
     Technical Director:     Professor Ian Swain BSc PhD CEng MIEE MBES
     Honorary Treasurer:     Mr John Gisby
     Assistants to the Executive Director:   Mrs Rose Carnegy (Finance and Members)
                                             Mrs Heather Heier (Events and Publicity)

                              USER COMMITTEE MEMBERS
Mr Rob Barrett*, Mr Badg Champion*, Mr Tony Dickson*, Ms Michelle Howard LLB*, Mrs Gillian
Matthews MBE*, Mr Anton Prantl*, Mr Jonathan Rudge*, Mr Robert Tylor*

                           SCIENTIFIC COMMITTEE MEMBERS
Prof J Burridge; Dr P Chappell PhD; Dr M Coggrave PhD, MSc, SRN; Prof N Donaldson MA,
PhD, CEng, MIEE, MIPEM, MIFESS; Dr M Donovan-Hall PhD, MSc; Prof P Ellaway; Dr D Ewins;
Dr A Gall MB ChB, MRCP; Prof SC Lillicrap PhD, DSc, FInstP, CPhys; Prof DN Rushton MB
BChir, MRCP (UK), MD(Cantab), FRCP; Dr P Shakespeare; Prof I Swain BSc PhD CEng MIEE
MBES; Mr AM Tromans FRCS; Mr RI Tylor* (Lay member and User Committee’s representative);
Mr PAA Waring MSc* (Chairman)
* Denotes Spinal Cord Injured

    AUDITORS: Fletcher & Partners

    BANKERS: Royal Bank of Scotland, 14 Minster Street, Salisbury SP1 1TP
             Sort Code: 16-31-12, Account Name: The INSPIRE Foundation
             Account No: 10274311

    INSPIRE:     Spinal Treatment Centre, Salisbury District Hospital, SALISBURY, SP2 8BJ
                 Telephone: 01722-336262 Ext 2465; Fax: 01722-415230
                 E-mail:; Website:


                                              Clinical Trials Research Unit
                                                                     University of Leeds
                                                        Clinical Trials Research House
Tuesday, 21 April 2009                                                         LS2 9PH


     Re:      Patient forum for the Pressure Ulcer Research Programme.

I would like to invite you to join a small group of approximately six to 10
representatives, to provide support and input on an existing research
programme about pressure Ulcers (sores) and the development of new

The current research programme, started September 2008 and is a nationally
funded five year programme which has five studies relating to quality of life,
risk assessments and care issues for patients with pressure ulcers.

The role of the patient representative is to:

1.      To increase professional and researchers understanding of the
patients perspective regarding the research
2.      To advise on the information needs of patients/carers involved in the
3.      To support in the development, monitoring, and interpretation of the
4.      To help identify potential areas for future research and advise
professionals producing research proposals

Full support will be given to bring you up to date with the project; an initial
meeting will be arranged and this will be followed by an invite to attend:

1.         A steering Committee meeting once a year,
2.         Programme Management Group meetings 4 meetings per year.
3.         Read and comment on information sheets
4.         Read protocols as appropriate (3 in year one, 2 in year 3)

The nurses involved in the research at the Clinical Trials Unit will provide you
1.      All the research information as needed
2.      A nominated contact for support
3.      Relevant induction and training
4.      Contact details of other committee members
5.      Reasonable travel expenses (up to £15/day) and other expenses such
as carers cost or loss of earnings may be reimbursed.

If you agree to acting as a patient representative then I will contact you in to
arrange a convenient date to meet and discuss further.

I hope this covers all the information you need at present and would be grateful
if you would complete the attached indicating if you agree to be involved.

Thank you
Yours sincerely

Lyn Wilson
Tissue Viability Nurse Specialist
Programme Manager
Pressure Ulcer Programme

Please see over for the Response Form


 Patient forum for the Pressure Ulcer Research Programme
                       Response Form

Full Name: …………………………………………………………….

Postal address:…………………………………………………………

Post Code:     ……………………………….

Telephone Number: ……………………………………………………

E. Mail address: ………………………………………………………..

Yes I agree to act as a patient/carer representative for the
pressure ulcer study

No I cannot act as a patient/carer representative for the pressure
ulcer study

Please return to:
                          Lyn Wilson,
                     Programme Manager,
                 Clinical Trials Research Unit,
                      University of Leeds,
                Clinical Trials Research House,
                    71–75 Clarendon Road,
                             LS2 9PH

      The Chelsea Pensioners, guests of INSPIRE since 2006 meeting Prince William
                                 after the Rundle Cup

              Marquee                        The INSPIRE Charity Polo Day is unique
                                             and combines social polo with a fantastic
                Menu                         lunch to raise vital funds for an essential
                                            cause. Many of my clients have commented
       Fillet Steak with Salsa              on how wonderfully unexpected it is to meet
  Handmade Traditional Sausages              stars from the equestrian world including
 Roasted Mediterranean Vegetables              Richard Dunwoody, Richard Johnson,
            with couscous                       Lucinda Fredricks, Jonny Good and
      Chefs special coleslaw                     of course Zara Phillips in such an
            New Potatoes                       unassuming and relaxed environment.
             Green Salad                               Rick Stainton – Smyle
 Vegetarian Option Nut Roast with
       red onion marmalade                  Supporting the INSPIRE Polo Day is a most
     Fine wines & Soft Drinks               enjoyable way of helping this very deserving
                                              cause. Fun filled sporting events a great
             ~~~~~~~                        lunch and all in delightful surroundings and
Dark or White Chocolate Truffle Torte       very good company. It’s a great day out and
       Strawberries & Cream                   the publicity and the money that the day
        Coffee & Chocolates                  raises really does help the spinally injured
                                                  in all sorts of very positive ways.
             ~~~~~~                         Field Marshal The Lord Vincent of Coleshill
           Afternoon Tea                          Patron, The INSPIRE Foundation

                       Jockeys v Eventers Polo 11th July 2009
                                                         Response Form see overleaf

         INSPIRE Charity Polo Saturday 11th July 2009 at Tidworth
          Reply Form for Players and Guests Marquee & Car Park



Please change details above if they are incorrect.

I/we would like to purchase ……...Lunch tickets at £55 each
                                 INSPIRE members £50 each

 Lunch tickets include entrance for the day & car park, reception before
 the lunch with fine wines & soft drinks, Afternoon tea from 3.30 is also
I/we do not want lunch but would like to purchase …….. Car Park at £20 each
(£25.00 on the day).

I/we would like to sponsor:
       ………..Wheel chairs at £50 each
       ………...Pony (ies) at £100 each

I/we would like…….. Stand seats to watch the afternoon matches at £23 each
Stand seats are free for the INSPIRE Event

I/we are unable to attend but I/we would like to make a donation for
INSPIRE’s work. Please tick if you are a UK tax payer and would like this
donation to be treated as Gift Aid

                I/we enclose a cheque in the amount of £………...

Please make your cheque payable to INSPIRE and send to Robert Morgan, INSPIRE, Spinal
Treatment Centre, Salisbury District Hospital, SALISBURY, SP2 8BJ. Telephone: 01722-
336262 Ext 2465


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