A multi-center international study on the spinal cord independence measure, version IV: Rasch psychometric validation.

Context: The Spinal Cord Independence Measure is a comprehensive functional rating scale for individuals with spinal cord lesion (SCL).

Objective: To validate the scores of the three subscales of SCIM IV, the fourth version of SCIM, using advanced statistical methods.

Study Design: Multi-center cohort study.

Protocol for a living systematic review for the management of concussion in adults.

Introduction: Concussion/mild traumatic brain injury (mTBI) often presents initially with disabling symptoms that resolve, but for an unfortunate minority some of these symptoms may become prolonged. Although research into diagnosis and interventions for concussion is increasing, study quality overall remains low. A living systematic review that is updated as evidence becomes available is the ideal research activity to inform a living guideline targeting clinicians and patients.

Feasibility of an Interactive Coaching App to Enhance Post-concussion Outpatient Care.

To determine the feasibility of patients to use a web-based health app for management of post-concussion (mTBI) symptoms in an out-patient setting. Seven (7) patients who were referred to an outpatient specialist clinic (physiatry) with persisting symptoms following a concussion. Participants had to be 18 years of age or older and more than 3 months post injury.

How can we improve the experiences of patients and families who request medical assistance in dying? A multi-centre qualitative study.

Background: Medical assistance in dying has been available in Canada for 5 years, but it is unclear which practices contribute to high-quality care. We aimed to describe patient and family perspectives of quality of care for medical assistance in dying.

Methods: We conducted a multi-centre, qualitative descriptive study, including face to face or virtual one-hour interviews using a semi-structured guide.

Reliability Validity and Responsiveness of the Spinal Cord Independence Measure 4th Version in a Multicultural Setup.

Objective: To examine the fourth version of the Spinal Cord Independence Measure for reliability and validity.

Design: Partly blinded comparison with the criterion standard Spinal Cord Independence Measure III, and between examiners and examinations.

Setting: A multicultural cohort from 19 spinal cord injury units in 11 countries.

How We Can Improve the Quality of Care for Patients Requesting Medical Assistance in Dying: A Qualitative Study of Health Care Providers.

Context: Since Canada decriminalized medical assistance in dying (MAID) in 2015, clinicians and organizations have developed policies and protocols to implement assisted dying in clinical practice. Five years on, there is little consensus as to what constitutes high-quality care in MAID.

Objectives: To describe MAID clinicians' perspectives on quality of care in MAID, including challenges, successes, and clinical practice suggestions.

Impact of Palliative Care Consultations on Resource Utilization in the Final 48 to 72 Hours of Life at an Acute Care Hospital in Ontario, Canada.

A wealth of literature and economic analyses has shown that palliative care is associated with significant cost reductions compared to nonpalliative care. However, no one has assessed the impact of an inpatient palliative care consultation service on costs at the very end of life (48 to 72 hours before death). This retrospective cohort review of 100 inpatients at a large hospital in Ontario examines the effect of palliative care consultations on seven independent cost categories during this period: medical-imaging costs, physician costs, laboratory costs, pharmaceutical costs, other health professional costs, food services costs, and unit costs.

Documentation of capacity and identification of substitute decisionmakers in Ontario.

Documenting capacity assessments and identifying substitute decisionmakers (SDMs) in healthcare facilities is ethically required for optimal patient care. Lack of such documentation has the potential to generate confusion and contention among patients, their family members, and members of the healthcare team. An overview of our research at the Ottawa Hospital and issues that influence the consistency of documentation in the Canadian context are presented here, as well as ideas for the mitigation of these issues and ways to encourage better documentation.

Formal ventilation patient education for ALS predicts real-life choices.

Our objective was to evaluate a single-session, hands-on education programme on mechanical ventilation for ALS patients and caregivers in terms of knowledge, change in affect and to determine whether ventilator decisions made after the education sessions predict those made later in life. Questionnaires were administered to 26 patients and 26 caregivers on four separate occasions. The questionnaires assessed knowledge of ventilatory support, feedback on the nature of the education programme, as well as self-reported emotional well-being.

Mind the gap: the lack of common language in healthcare ethics.

Ethics consultation services provide support to staff, patients, and family members who find themselves in morally difficult situations in healthcare settings. Not unlike other clinical consultation services, ethics consultation activities should be well documented. Good documentation allows for evaluation of the consultation process and the ability to refer back to consults when needed, and provides data for future research in healthcare ethics (HCE).

Concordance in goal setting between patients with multiple sclerosis and their rehabilitation team.

Objective: To determine the concordance between patients with multiple sclerosis and their clinical team members on the identification of goals for an inpatient rehabilitation stay.

Design: Prospective cohort study of patients admitted for rehabilitation in an adult inpatient neurospinal unit at a Rehabilitation Centre in Ottawa, Canada. Twenty-seven patients (11 men and 16 women, mean age of 45.

Delay of supraspinatus repair by up to 12 weeks does not impair enthesis formation: a quantitative histologic study in rabbits.

The purpose of this study was to find out whether supraspinatus repair delayed by up to12 weeks affects the formation of a new enthesis when compared to an immediate repair. In 67 rabbits, the supraspinatus fibrocartilaginous enthesis of one shoulder was resected. The tendon was attached to the greater tuberosity either immediately, after a 6-week, or after a 12-week delay.

Clinical significance and predictors of treatment response to cognitive-behavior therapy for insomnia secondary to chronic pain.

We examined individual responses to cognitive-behavior therapy for insomnia in 51 persons with chronic pain to determine the rate of clinically significant change and to identify predictors of successful treatment response. Outcome measures consisted of the Pittsburgh Sleep Quality Index (PSQI) and diary measures of sleep latency and sleep continuity. Using reliable change indices, 57% of participants were statistically improved on the PSQI after 7 weeks of treatment, but only 18% were considered fully recovered from their sleep problems.