Donate Now!
Gallery

Out of the Classroom and Into the Kitchen

Leave a comment

A new initiative at the Northern Ontario School of Medicine is taking medical students from the classroom to the kitchen. During the 2017-18 academic year, optional Culinary Medicine Labs were offered to undergraduate medical students with an interest in learning more about nutrition.

“Research shows that the greatest predictor of patient nutrition counselling by physicians is the physician’s own perceptions of nutrition and eating habits,” says Lee Rysdale, Registered Dietitian (RD), Associate Professor in the Clinical Sciences Division and Practice Education Research and Evaluation Lead in the Health Sciences and Interprofessional Education Unit at NOSM. “By supporting medical students and teaching these skills early on, we can foster healthy lifestyle habits which can be translated into physician practice and ultimately increase patient awareness of nutrition and healthy eating,” she says.

Some Canadian medical schools have implemented voluntary or brief amounts of nutrition education into the undergraduate curriculum but there are currently no nutrition-related curriculum guidelines or pertinent objectives in the Medical Council of Canada licensing exam, according to Rysdale. “Diet is the number one risk factor for chronic diseases and plays a huge role in the prevention and management of these diseases,” she says.

“The Culinary Medicine Labs are a way to educate our future health-care providers about food and nutrition so they’re able to competently and confidently approach and address these health issues,” she says. Rysdale organized the Culinary Medicine Labs with the help of fellow RD faculty and current interns with the Northern Ontario Dietetic Internship Program (NODIP) at NOSM. The four labs were held in teaching kitchens at local high schools in Sudbury and Thunder Bay. Each lab focused on a specific theme: fad diets, weight stigma, and nutrition and the art of eating. Registered dietitians and the dietetic interns presented a holistic approach to culinary medicine, and in each session the medical students were taught a combination of nutrition education, food skills and preparation, as well as counselling skills.

Students learned to appraise dietary patterns to determine whether they promote the “diet” mentality or flexible, individualized eating; to compare and contrast weight-focused versus weight neutral approaches to care; and to understand how food can help with the prevention and management of chronic conditions. “Food and nutrition and diet are all part of lifestyle, and if physicians don’t understand these lifestyle factors that influence chronic diseases, they can only help their patients to a certain extent,” says Nicole Selman, one of NOSM’s dietetic interns who assisted with the labs. Another purpose of the labs was to educate medical students about the roles of registered dietitians.

“Not only do we want to improve their nutrition competence, we also want them to better understand the roles of registered dietitians in health care, as well as who to refer a patient to when it comes to nutrition and health,” says Rysdale. By bringing together medical students and dietetic interns, the labs also present an opportunity for interprofessional learning between two groups here at NOSM. “It can be somewhat intimidating at first, because they’re medical students, but it was a great opportunity for us to show that while we both have our own unique skill set, we do a better job for patients if we work together as a team,” says Selman.

Read more stories like this in the latest issue of Northern Passages.

Homepage News, News

New study from Dr. Ulanova

Leave a comment

 

Indigenous populations have stronger immunity to a serious bacterial infection than non-Indigenous populations, regardless of whether they live in an area where the infection is common or uncommon, according to a study published online today in PLOS ONE.

Haemophilus influenzae type A (Hia) is a bacterial infection that can lead to serious illnesses including pneumonia, meningitis, sepsis and epiglottitis, all of which can result in permanent disability or death.

The study compared naturally-acquired immunity to Hia infection in Indigenous adults living in Ojibwa First Nations communities in Northwestern Ontario to that of non-Indigenous people living in Northwestern Ontario and across the country, as well as Indigenous adults living in Ojibwa First Nations communities in Southern Ontario.

The researchers examined serum bactericidal antibodies—antibodies occurring naturally in the blood that kill bacteria—in 110 Indigenous and 76 non-Indigenous adults. Of the 186 people studied, bactericidal antibodies against Hia were detected at higher rates in Indigenous compared to non-Indigenous adults: 80 per cent of Indigenous adults in Northwestern Ontario and 96 per cent of Indigenous adults in Southern Ontario had these antibodies, compared to only 64 per cent of non-Indigenous Canadian adults from across the country.

Northwestern Ontario has one of the highest rates of invasive Hia infections in Canada, second only to Nunavut, according to Dr. Marina Ulanova, a faculty member in the Medical Sciences division at the Northern Ontario School of Medicine (NOSM) and lead author of the study published today.

The infection occurs most commonly in young children, the elderly and adults with chronic diseases or other health issues that affect their immune system, according to the authors, and is more common in Indigenous versus non-Indigenous populations.

Previous research by Ulanova’s team has found that Indigenous adults in Thunder Bay have a higher immunity against Hia compared with non-Indigenous people living there. She says the results of today’s study are surprising because Indigenous adults from both the Northwestern and Southern Ontario communities both had high rates of immunity, despite Hia infection being very uncommon in Southern Ontario.

“One of the ways you develop natural immunity to bacteria is through exposure,” she says. “So it makes sense that adults who live in an area where the infection is common have a higher immunity to it. But because Hia is not common in Southern Ontario, the higher rate of immunity in Indigenous populations living there suggests there are other factors at play here.”

While the study did not directly answer the question of why Indigenous adults have higher immunity to Hia than non-Indigenous adults, Ulanova says she thinks immunity may be influenced by changes to gene expression over time as the result of stress and intergenerational trauma.

“Indigenous populations have been exposed to a number of highly unfavorable environmental factors that could cause epigenetic changes in the body–changes in the expression of genes in charge of immune responses,” she says. “This may increase the production of natural antibodies, and could explain why healthy adults do not normally develop serious Hia infections despite the fact that Hia widely circulates in Indigenous communities in Northwestern Ontario.”

However, very young children or people with a weakened immune system as a result of aging or chronic diseases still experience very serious Hia infections at a higher rate in Indigenous versus non-Indigenous communities, says Ulanova, and this study emphasizes the need to further address the role of the social determinants of health in the formation of immune defenses as well as in susceptibility to infectious diseases.

Gallery

A decade of making a difference: City of Lakes Family Health Team celebrates 10th anniversary

Leave a comment

In 2008, the new City of Lakes Family Health Team (CoLFHT) clinic in Val Caron had its first patient walk through the doors. Ten years later, that patient is one of 20,000 who are served by the CoLFHT in one of four clinics in Sudbury, Val Caron, Walden and Chelmsford.

“Many of the patients we’ve rostered over the past ten years didn’t have a family physician, so we’ve been able to help close the gaps in access to primary care in the Greater Sudbury community,” says David Courtemanche, the Executive Director of the CoLFHT.

As the clinic celebrates its tenth anniversary this year, Courtemanche and the team at CoLFHT are reflecting on the milestone, and the impact the clinics have had on the community.

According to Courtemanche, of the approximately 125 family physicians in Sudbury, about 100 are located in the core of the city. Only 25 are located in surrounding areas, despite the fact that half the population of Sudbury lives there.

“Of those 25 physicians, 12 are part of our team,” he says. “People living in the outlying areas of Greater Sudbury now have better access to primary care because our clinics are where they live. We think that’s important.”

In Sudbury, as in many communities in Northern Ontario, recruiting and retaining physicians and other healthcare professionals was a challenge for decades. From the beginning, there was a desire among CoLFHT leadership to make the clinics teaching sites for NOSM as a solution to the shortage, says Courtemanche.

“Having students and residents come in from the Northern Ontario School of Medicine has really helped us increase our health workforce,” he says. In fact, the past seven new physicians hired by the CoLFHT have all been graduates of NOSM, according to Courtemanche.

“Many residents and students from the Northern Ontario School of Medicine find clinical placements with us,” he says. “The CoLFHT provides an attractive place for family physicians to establish a practice, particularly for new physicians who are drawn to team-based care.”

The CoLFHT was approved by the Ontario Ministry of Health and LongTerm Care in 2005 as part of the first wave of new family health teams in Ontario.

At that time, most family physicians in Ontario worked alone or in small practices. Family health teams were a new model of primary care organizations that would include an interdisciplinary team of family physicians, nurse practitioners, registered nurses, social workers, dietitians, and other professionals who would work together to provide primary health care for their community.

The CoLFHT is also a NOSM-designated clinical teaching site for health disciplines, with nurse practitioners, registered nurses and dietitians serving as preceptors for clinical learners.

And the interdisciplinary team is only one piece of the family health team puzzle. The CoLFHT offers afterhours clinics for patients with urgent concerns, as well as a variety of programs addressing priority health issues including geriatrics, diabetes, smoking cessation, mental health and addictions in which the patients have the opportunity to enroll.

“The establishment of multiple clinics delivering team-based care has redefined primary care in our community, and has helped to build a more sustainable local health-care infrastructure,” says Courtemanche. “The Northern Ontario School of Medicine has played a major role in that, and I believe it will continue to for the next ten years to come.”

NOSM University