Advance consent could address many of the limitations traditional consenting methods pose to participation in acute stroke trials. We conducted a series of five focus groups with people with lived experience of stroke. Using an inductive thematic approach, two themes were developed: factors in favour of, and against, advance consent. Participants supported the idea of advance consent and highlighted trust, transparent communication and sufficient time as major factors that would positively affect their decision to provide advance consent. The results will be used to finalise a model of advance consent suitable for testing the feasibility in stroke prevention clinics.

Large-scale geological structures have controlled the long-term development of the bed and thus the flow of the West Antarctic Ice Sheet (WAIS). However, complete ice cover has obscured the age and exact positions of faults and geological boundaries beneath Thwaites Glacier and Pine Island Glacier, two major WAIS outlets in the Amundsen Sea sector. Here, we characterize the only rock outcrop between these two glaciers, which was exposed by the retreat of slow-flowing coastal ice in the early 2010s to form the new Sif Island. The island comprises granite, zircon U-Pb dated to ~177–174 Ma and characterized by initial ɛNd, 87Sr/86Sr and ɛHf isotope compositions of -2.3, 0.7061 and -1.3, respectively. These characteristics resemble Thurston Island/Antarctic Peninsula crustal block rocks, strongly suggesting that the Sif Island granite belongs to this province and placing the crustal block's boundary with the Marie Byrd Land province under Thwaites Glacier or its eastern shear margin. Low-temperature thermochronological data reveal that the granite underwent rapid cooling following emplacement, rapidly cooled again at ~100–90 Ma and then remained close to the Earth's surface until present. These data help date vertical displacement across the major tectonic structure beneath Pine Island Glacier to the Late Cretaceous.

Dietary education is a core component of cardiac rehabilitation (CR). It is unknown how or what dietary education is delivered across the UK. We aimed to characterise practitioners who deliver dietary education in UK CR and determine the format and content of the education sessions. A fifty-four-item survey was approved by the British Association for Cardiovascular Prevention and Rehabilitation (BACPR) committee and circulated between July and October 2021 via two emails to the BACPR mailing list and on social media. Practitioners providing dietary education within CR programmes were eligible to respond. Survey questions encompassed: practitioner job title and qualifications, resources, and the format, content and individual tailoring of diet education. Forty-nine different centres responded. Nurses (65·1 %) and dietitians (55·3 %) frequently provided dietary education. Practitioners had no nutrition-related qualifications in 46·9 % of services. Most services used credible resources to support their education, and 24·5 % used BACPR core competencies. CR programmes were mostly community based (40·8 %), lasting 8 weeks (range: 2–25) and included two (range: 1–7) diet sessions. Dietary history was assessed at the start (79·6 %) and followed up (83·7 %) by most centres; barriers to completing assessment were insufficient time, staffing or other priorities. Services mainly focused on the Mediterranean diet while topics such as malnutrition and protein intake were lower priority topics. Service improvement should focus on increasing qualifications of practitioners, standardisation of dietary assessment and improvement in protein and malnutrition screening and assessment.

Advance consent could allow individuals at high risk of stroke to provide consent before they might become eligible for enrollment in acute stroke trials. This survey explores the acceptability of this novel technique to Canadian Research Ethics Board (REB) chairs that review acute stroke trials. Responses from 15 REB chairs showed that majority of respondents expressed comfort approving studies that adopt advance consent. There was no clear preference for advance consent over deferral of consent, although respondents expressed significant concern with broad rather than trial-specific advance consent. These findings shed light on the acceptability of advance consent to Canadian ethics regulators.

Advance consent presents a potential solution to the challenge of obtaining informed consent for participation in acute stroke trials. Clinicians in stroke prevention clinics are uniquely positioned to identify and seek consent from potential stroke trial participants. To assess the acceptability of advance consent to Canadian stroke clinic physicians, we performed an online survey. We obtained 58 respondents (response rate 35%): the vast majority (82%) expressed comfort with obtaining advance consent and 92% felt that doing so would not be a significant disruption to clinic workflow. These results support further study of advance consent for acute stroke trials.

This study is an evaluation of the use of two health status measures for monitoring the outcome of acute psychiatric treatment. The measures are the Sickness Impact Profile (SIP) and the Classification of Illness States (CIS). The SIP is a measure of the impact of sickness on patients' daily activities and behaviour. The CIS was initially developed to measure ‘morbidity states’ after hospital treatment and can be used to generate the ‘Rosser Index’, both of which have been shown to be valid and reliable measures (Rosser, 1988).