Physical Medicine and Rehabilitation Publications Copyright (c) 2013 Western University All rights reserved. http://ir.lib.uwo.ca/physmedpub Recent documents in Physical Medicine and Rehabilitation Publications en-us Sun, 27 Jan 2013 00:46:27 PST 3600 Study Protocol of the YOU CALL--WE CALL TRIAL: Impact of a Multimodal Support Intervention after a "Mild" Stroke http://ir.lib.uwo.ca/physmedpub/2 http://ir.lib.uwo.ca/physmedpub/2 Thu, 11 Mar 2010 15:36:32 PST BACKGROUND: More than 60% of new strokes each year are "mild" in severity and this proportion is expected to rise in the years to come. Within our current health care system those with "mild" stroke are typically discharged home within days, without further referral to health or rehabilitation services other than advice to see their family physician. Those with mild stroke often have limited access to support from health professionals with stroke-specific knowledge who would typically provide critical information on topics such as secondary stroke prevention, community reintegration, medication counselling and problem solving with regard to specific concerns that arise. Isolation and lack of knowledge may lead to a worsening of health problems including stroke recurrence and unnecessary and costly health care utilization.The purpose of this study is to assess the effectiveness, for individuals who experience a first "mild" stroke, of a sustainable, low cost, multimodal support intervention (comprising information, education and telephone support)--"WE CALL" compared to a passive intervention (providing the name and phone number of a resource person available if they feel the need to)--"YOU CALL", on two primary outcomes: unplanned-use of health services for negative events and quality of life.

METHOD/DESIGN: We will recruit 384 adults who meet inclusion criteria for a first mild stroke across six Canadian sites. Baseline measures will be taken within the first month after stroke onset. Participants will be stratified according to comorbidity level and randomised to one of two groups: YOU CALL or WE CALL. Both interventions will be offered over a six months period. Primary outcomes include unplanned use of heath services for negative event (frequency calendar) and quality of life (EQ-5D and Quality of Life Index). Secondary outcomes include participation level (LIFE-H), depression (Beck Depression Inventory II) and use of health services for health promotion or prevention (frequency calendar). Blind assessors will gather data at mid-intervention, end of intervention and one year follow up.

DISCUSSION: If effective, this multimodal intervention could be delivered in both urban and rural environments. For example, existing infrastructure such as regional stroke centers and existing secondary stroke prevention clinics, make this intervention, if effective, deliverable and sustainable.

TRIAL REGISTRATION: ISRCTN95662526.

]]> Annie Rochette et al. Clinical Education of Ethicists: The Role of a Clinical Ethics Fellowship http://ir.lib.uwo.ca/physmedpub/1 http://ir.lib.uwo.ca/physmedpub/1 Thu, 20 Aug 2009 16:00:47 PDT Background: Although clinical ethicists are becoming more prevalent in healthcare settings, their required training and education have not been clearly delineated. Most agree that training and education are important, but their nature and delivery remain topics of debate. One option is through completion of a clinical ethics fellowship.

Method: In this paper, the first four fellows to complete a newly developed fellowship program discuss their experiences. They describe the goals, structure, participants and activities of the fellowship. They identify key elements for succeeding as a clinical ethicist and sustaining a clinical ethics program. They critically reflect upon the challenges faced in the program.

Results: The one-year fellowship provided real-time clinical opportunities that helped them to develop the necessary knowledge and skills, gain insight into the role and scope of practice of clinical ethicists and hone valuable character traits.

Conclusion: The fellowship enabled each of the fellows to assume confidently and competently a position as a clinical ethicist upon completion.

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