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Working better together

A group of researchers at the Northern Ontario School of Medicine is studying the dynamics of concussion management in interprofessional team settings.

The team is lead by co-investigators Dr. Tara Baldisera, a family physician and associate professor of clinical sciences at NOSM; Dr. Jairus Quesnele, a clinical chiropractic specialist and associate professor at NOSM; and, Shannon Kenrick-Rochon, a nurse practitioner, professor of nursing at Cambrian College and Laurentian University and a lecturer at NOSM. It also includes Dr. Sylvain Grenier, Professor of Human Kinetics and Michelle Laurence, Laboratory Technologist and Registered Kinesiologist, both faculty in the School of Human Kinetics at Laurentian University, and Matthew Baker, a research assistant and student at Laurentian University.

Concussions affect many systems of the body. For that reason, an interprofessional approach is widely considered best practice, and is the recommended standard of care of the Ontario Neurotrauma Foundation and Concussion Ontario.

The team is exploring how factors like communication and collective competencies of an interprofessional health-care team can affect a patient’s recovery.

Over the past two years, the team has been following both male and female athletes from multiple varsity teams at Laurentian University, tracking and treating their concussions. They are looking specifically at the effectiveness of interprofessional concussion management teams in diagnosing and treating injuries from both return-to-play and return-to-learn perspectives by measuring recovery rates and progression to post-concussion syndrome, according to Baldisera.

Though their research is still ongoing, they have already seen some promising preliminary results, says Quesnele.

“We’re seeing the athletes return-to-play sooner overall, and seeing fewer protracted or long-lasting cases in our second year of follow-up versus our first-year of follow up,” he says. “We’re currently trying to figure out why that is, but our initial thoughts are that as we become more proficient and more collaborative in our approach, it’s translating into better recovery rates for some of our athletes.”

Quesnele also credits expanding the team in the second year of tracking, as well as more formalized communication with the university’s accessibility office and the athletes themselves for the positive results.

“We were able to add key members to the team, which allowed us to develop tailored treatment strategies, giving us a better approach for targeting these concussion deficits more effectively,” he says.

The cohesiveness of the team itself and the rapport they have developed may also have an effect on the progress the athletes make, according to the researchers.

They have added patient satisfaction as an evaluation tool in their research to better understand the effect of an interprofessional concussion management team in this context, says Baldisera.

“We’re looking at both the internal team dynamics and how we operate within our community setting,” she says. “What both makes us a better team and helps enhance patient-centred care?”

With the help of two Dean’s Summer Medical Student award recipients, Eve Boissoneault and Emily Aleska, the team has also been able to explore how sex differences can factor into recovery rates, as well as other elements of the recovery process.

Whichever elements of the team dynamic are found to affect the results of an interprofessional concussion management strategy, the ultimate goal is to be able to provide patients with the best care possible, says Baldisera.

“Not every patient needs every health-care provider that can treat concussion to be involved in their care,” she says. “We want our team to operate in a way that allows patients to get the specific care they need.”

Read more stories like this one in the latest edition of The Scope.

Electric vehicle donationsupports NOSM researchers

The Northern Ontario School of Medicine (NOSM) recently installed an electric vehicle (EV) charging station. The EV station, generously donated by Bruce Power, has been installed outside NOSM’s medical school building at Laurentian University in Sudbury. This initiative is part of Bruce Power’s $5 million investment in funding to establish and support the Bruce Power Centre for Health, Environment and Radiation at the Northern Ontario School of Medicine.

Also located outside NOSM is the new Bruce Power Electric Research Vehicle, which is used by researchers and graduate students at the medical school. This completely emission-free electric vehicle is an environmentally sustainable way to travel to research sites and helps promote a healthier North.

Research projects utilizing this new electric vehicle are led by Dr. Doug Boreham, the Bruce Power Chair in Radiation and Health at NOSM and Division Head, Medical Sciences. Notably, researchers use the EV to travel to SNOLAB, where Boreham currently has one of his research projects established.

Researching Effects of the Presence and Absence of Ionizing Radiation (REPAIR) is a project located two kilometres (6,800 feet) deep underground within the world-class SNOLAB research facility at Vale’s Creighton mine. “This project studies the effects of the absence of natural background radiation in biological model systems,” says Boreham. “This work helps in understanding the mechanisms of diseases such as cancer in the context of radiation, as well as the fundamental importance of the background radiation we are all exposed to naturally on a daily basis.”

The provision of a clean energy vehicle and charging station provides a step toward more environmentally friendly transportation in Northern Ontario. Electric vehicles produce 90 per cent less carbon dioxide emissions than fossil fuel cars, leading to fewer environmental pollutants, which have a negative impact on health. The charging station at NOSM’s medical school building in Sudbury will allow faculty, staff, and students who park at the School to charge their electric vehicles.

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Improving food systems to meet the needs of Northern Ontarians

How can we improve our food and agricultural systems to better meet the needs of all people?

Michaela Bohunicky, a graduate of the Northern Ontario Dietetic Internship Program (NODIP) at NOSM, will be exploring this question when she starts a Master of Health Sciences at Lakehead University this fall. Bohunicky will be working with Dr. Charles Levkoe, a Canada Research Chair in Sustainable Food Systems.

Before coming to NOSM, Bohunicky attended the University of Manitoba, where she was part of a team of researchers exploring food sovereignty—the idea that all people have the right to healthy and culturally appropriate food produced using ecologically sound and sustainable methods, and the right to define their own food and agricultural systems.

“Studying food sovereignty and becoming involved in research really opened my eyes to the ways in which social, political and environmental determinants affect nutrition and health, and answered so many of my questions about why people are food insecure and why health inequities exist,” she says.

After completing NODIP in 2017, she took a job as a Food System Planner with Nishnawbe Aski Nation (NAN), supporting existing projects that work towards achieving food self-determination. This experience, combined with her NODIP placements with the First Nations and Inuit Health Branch in Ottawa and Roots to Harvest in Thunder Bay, played a key role in her motivation to continue learning about Indigenous food system issues through her Masters research.

Bohunicky says she wants to specifically explore how improving Indigenous and settler relationships can produce better food policy at a local, regional, national or even international level.

“I’ve been really, really lucky to get to see little bits and pieces of how food can be used as a tool for reclamation and resurgence,” she says. “I’d really like to explore through my research how I and other settlers can best make space for, and support that.”

She also recently became involved in Critical Dietetics, a movement of registered dietitians exploring issues of gender, race, class, ability, size, and creative expression, all in relation to food and dietetics.

“I see Critical Dietetics as a way to broaden our practice by exploring areas that we may have missed in our training, yet are so relevant to our work,” she says. “Dietitians have a unique area of expertise, and bring an important piece of the puzzle, but we can learn so much and really stretch our boundaries by engaging in interdisciplinary, community-based research.”

Her broadening understanding of the social, political and environmental context she practices in has been and will continue to be at the forefront of her research, she says.

“My experiences over the last few years have made me realize how important it is for Canadian registered dietitians to understand the colonial context of the food systems we’re working in, and that we’re working to change.”

 

Read more stories like this one in the latest edition of The Scope.

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