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.

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.

An account is given of the role of an attached social worker to a primary care team in the management of chronic neurotic illness in the community. The medico-social implications of the findings are discussed.

The definition and measurement of counsellor trainee competency is an issue that has received increased attention yet lacks quantitative study. This research evaluates item responses, scale reliability and intercorrelations, interrater agreement, and criterion-related validity of the Professional Performance Fitness Evaluation/Professional Counseling Performance Evaluation, a measure used by counsellor educators to evaluate professional fitness. The results identified several scale items that were insensitive to substandard skill levels and indicated that university and site supervisors' trainee ratings did not agree. Both site and university supervisors did identify a majority of students demonstrating substandard skills, and when the site and university supervisors' ratings were combined, the supervisors identified 79% of the noncompetent trainees.