2016 March AHPA Newsbrief
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3 Pearls from a Rheumatology Dietician at 2016 CRA Annual Meeting
ORA Educational Grants
ACPAC Program 2016-2017
ORA Conference – Save the date
Upcoming Courses and Conferences
Recent Articles and Online Resources
3 Pearls from a Rheumatology Dietician at 2016 CRA Annual Meeting
Dr. David Borenstein shared an insightful article on the-rheumatologist.org that It Takes All Kinds of health professionals to achieve positive outcomes for rheum patients, but there was a missing member of his dream team, the Rheumatology Dietitian. Although the article was posted in 2011, up to this date, just two Dietitians have joined the Arthritis Health Professionals Association in both the US and Canada, me being one of them in each association.
The first step was to understand the role of each member of the Rheumatology team, so I was fortunate to attend my first Canadian Rheumatology Association (CRA) Annual Conference and Arthritis Health Professions Association (AHPA) Pre-Course at Lake Louise in Calgary thanks to a travel bursary granted by AHPA. The careful organization of the event and the fantastic venue made it one of the best experiences I ever had as a health professional and it validated my passion for pursuing a career as a Rheumatology Dietitian “The Arthritis Dietitian”. Here are just a few highlights from #CRA2016.
1. Rheumatologists are the happiest subspecialists in the medical field! This statement took me by surprise until a Med student assured me that her main reason for becoming a Rheumatologist was to remain happy and to form long-term relationships with her patients. Who can blame her? Rheumatologists are in fact the most fun doctors to be around.
2. AHPA members warmly welcomed me as the first Dietitian joining the Board of Directors for the term of 2016-2018. I can’t wait to start working with this excellent group of professionals who share my passion for improving the care of arthritis patients.
3. Dr. James Maas and his talk on Sleep Deprivation hit a nerve. He clearly explained how a good night sleep can prevent fatigue and adverse health outcomes. Golden rules:
• Meet your sleep requirements every night (adults = 7.5 hours)
• Establish a regular sleep/wake schedule
• Get continuous sleep
• Avoid nicotine, alcohol or caffeinated drinks after noon
• Stay away from electronic devices before going to bed
I can write many more pearls of this exceptional event, but it is time to pace myself and get some rest. I am looking forward to working with the happiest doctors in North America and the outstanding health professionals that make arthritis patients (including me) live healthier and more meaningful lives.
Written by Cristina Montoya, AHPA Member at large, on February 28th, 2016
ORA Educational Grants
Dear Members,The Ontario Rheumatology Association Development and Education (ORADE) Committee is pleased to offer education grants again this year! We are looking for 2 ORA members and 1 AHP who can advocate for us at EULAR 2016 in London, or the ACR/ARHP 2016 Annual Meeting in Washington, DC.
The candidates who travelled last year to EULAR in Rome and the ACR/ARHP Annual Meeting in San Francisco produced excellent reports and thoroughly enjoyed the experience! We are excited to work with new candidates in 2016! More information is available on the ontariorheum.ca website, including Application Forms, Deliverables, and Funding Guidelines
Reminder: Deadline for Applications is April 16, 2016!
ACPAC Program 2016-2017
The Advanced Clinician Practitioner in Arthritis Care (ACPAC) Program is pleased to announce that applications for the 2016-2017 program are now open. Offered through the Office of Continuing Professional Development at the University of Toronto, ACPAC is an award-winning clinical-academic program that prepares experienced Physiotherapists, Occupational Therapists, and Nurses from across Canada for extended practice roles, including the diagnosis and management of patients with arthritis. ACPAC graduates have been recognized at the local, provincial, national, and international level for providing:
• Improved access to quality arthritis care
• Reduced clinic wait times and improved triage for arthritis patients
• Enhanced continuum of care for arthritis patients
The program runs from October 2016 to June 2017. Deadline to apply is Friday May 20, 2016 at 5pm ET. For more information contact email@example.com or visit http://acpacprogram.ca/about-the-program/register/
ORA Conference May 27-29, 2016 – SAVE THE DATE
The ORA conference and AGM will be held in Muskoka on May 27-29, 2016. As in previous years, AHPA members in Ontario will be able to register for and attend the full conference. Funding will be available to support 5 AHPA members who have abstracts accepted for presentation (registration and accommodation costs). Details will follow once the registration site is open. Please note: there will not be a workshop specific to allied health professionals on the Friday nor will there be travel bursaries awarded this year.
Upcoming Courses and Conferences
Reconciling Biomechanics with Pain Science
Date: April 2-3, 2016
Location: Body Mechanics london785 Wonderland Road South London, ON
This course helps the therapist to integrate the pain science and biopsychosocial model of pain with traditional but modified biomechanical approaches. The course simplifies many of those biomechanical techniques and distills the most relevant and important aspects of those techniques for pain resolution and injury management. An emphasis is placed on exercise prescription for injury management and simple educational and interviewing strategies to start addressing the psychosocial aspects that influence both pain and performance. Therapists will learn strategies to introduce pain education into every encounter with their patient. A pain education workbook can be downloaded at greglehman.ca. Find out more!
Diagnostic Imaging of the Upper Extremity: Application to Physiotherapy Practice
Date: April 2, 2016
Location: Sunnybrook" HSC Holland Orthopaedic and Arthritic Site - 43 Wellesley St E, 8th Floor Conference Room, Toronto, ON M4Y 1H1
Aquatic Therapy for the Orthopedic Patient: Evidence-Based Practice
Date: April 16, 2016
Location: Royal Victoria Regional Health Centre. 201 Georgian Drive, Barrie ON
Nordic Pole Walking Instructors Certification Course
Date: April 23, 2016? Location: InsideOut Physiotherapy & Wellness Group, 1240 Bay St., Suite 502, Toronto, ON, M5R 2A7
Principles of Assessment and Management of Pain in the Older Adult
Date: Sunday, May 29, 2016
Time: 8:30 am – 4:30 pm
Location: Victoria Convention Centre, Sidney Room
Eligibility: Physiotherapists, Other Health Professionals
Speaker: Eric Thériault
Upon completion of this workshop participants will be able to:
1. Describe factors impacting pain perception and how these can affect acute pain or contribute to persistent pain syndromes.
2. Identify the consequences of under recognized and unmanaged pain in older adults.
3. Demonstrate and apply aspects of assessment unique to successful evaluation of pain in older adults.
4. Recognize pathophysiologic changes of aging which complicate management of pain in older adults.
5. Develop multi-modal strategies for management of common pain disorders in older adults.
Clinical Practice Skills for Inflammatory Arthritis
The Arthritis Society is committed to educating healthcare professionals in the most up to date arthritis best practices. This long-established professional development program, which has evolved over 37 years, focuses on inflammatory and osteoarthritis. The program is a blend of online, didactic and hands-on learning, delivered over a 4 day period. Although this program was designed for Physiotherapists and Occupational Therapists, its content is applicable and mandatory for Nurses interested in enrolling in the Advanced Clinician Practitioner in Arthritis Care (ACPAC) program.
Date: May 4-7, 2016
Location: Four Points by Sheraton, 1150 Wellington Rd S., London, Ontario, Canada.
The program emphasizes best practice assessment and management techniques as applied to the most common types of inflammatory arthritis. Upon completion of the program, the participant will have the skills to effectively recognize and report on the health status of clients with inflammatory and osteoarthritis and to formulate an appropriate management plan.
CBT Immersion - Cognitive Behaviour Therapy
All health care professionals address behaviour change in their clinical practice. This course is a unique, condensed course on the principles of CBT training to be used within the scope of non-mental health practitioners to help facilitate behaviour change in their patients. This course is offered in partnership between Wilfrid Laurier University Faculty of Social Work Professional Development and Qualia Counselling Services Inc.
Dates: Jan. 29, 30, 31 2016 & Nov. 4, 5, 6, 2016 (Course duration is over 2 weekends)
Hours: 9:30 a.m. to 5 p.m.
Location: Wilfrid Laurier University 130 King St. West, Toronto Cost: $1,599 after December 1, 2015 (textbooks, parking, lunch and accommodations not included) TO REGISTER: call 519-884-0710 ext. 5265 or online at www.wlu.ca/fswpd
2016 National Fall Prevention Conference
This Conference will bring together experts from across Canada and around the world to share the latest fall prevention programs, research and updates in fall and injury prevention among older adults. The conference is an exceptional learning and networking opportunity for those who work with older adults in all settings, including practitioners, researchers and policy makers in the field of seniors’ health and injury prevention.
Dates: May 16-17, 2016
Where: Calgary, AB
Host: Injury Prevention Care, University of Alberta, Alberta Health Services
Location: Coast Plaza & Conference Centre - Calgary, AB
Registration Link: http://watchyourstepcanada.com/registration/ Registration Coordinator: Karin Ivand Registration Coordinator Contact: 647-343-5034 / Karin@bayhousegroup.com
Assessment and Management of Rheumatic Diseases is a 4-day skills workshop for physical therapists, occupational therapists and nurses. Workshop details:
Date: April 11 – 14, 2016
Location: Mary Pack Arthritis Centre, Vancouver, British Columbia
Cost: $656.25 ($625 + $31.25 GST)
Key benefits of attending: * Update your knowledge of evidence-based care for three common forms of arthritis * Practice hands-on assessment skills with patient models * Learn from multidisciplinary instructors and case studies * Registration deadline is March 11, 2016 For more information and a copy of the workshop brochure visit http://mpap.vch.ca/resources-for-professionals/becoming-an-ace-member or contact firstname.lastname@example.org (mailto:email@example.com)
Bone Fit Workshops - Osteoporosis Canada
March 19-20, 2016
This evidence-informed exercise training workshop is designed for healthcare professionals & exercise practitioners to provide training on the most appropriate, safe & effective methods to prescribe & progress exercise for people with osteoporosis. Register for workshops at www.bonefit.ca
Recent Articles and Online Resources
Evolution of Patient Decision-Making Regarding Medical Treatment of Rheumatoid Arthritis
Mathews, A. L., Coleska, A., Burns, P. B. and Chung, K. C. (2016), Arthritis Care Res, 68: 318–324. doi: 10.1002/acr.22688
The migration of health care toward a consumer-driven system favors increased patient participation during the treatment decision-making process. Patient involvement in treatment decision discussions has been linked to increased treatment adherence and patient satisfaction. Previous studies have quantified decision-making styles of patients with rheumatoid arthritis (RA); however, none of them have considered the evolution of patient involvement after living with RA for many years. We conducted a qualitative study to determine the decision-making model used by long-term RA patients, and to describe the changes in their involvement over time.
Twenty participants were recruited from the ongoing Silicone Arthroplasty in Rheumatoid Arthritis study. Semistructured interviews were conducted and data were analyzed using grounded theory methodology.
Nineteen out of 20 participants recalled using the paternalistic decision-making (PDM) model immediately following their diagnosis. Fourteen of the 19 participants who initially used PDM evolved to shared decision-making (SDM). Participants attributed the change in involvement to the development of a trusting relationship with their physician, as well as to becoming educated about the disease.
When initially diagnosed with RA, patients may let their physician decide on the best treatment course. However, over time patients may evolve to exercise a more collaborative role. Physicians should understand that even within SDM, each patient can demonstrate a varied amount of autonomy. It is up to the physician to have a discussion with each patient to determine his or her desired level of involvement.
Toward Standardized Musculoskeletal Ultrasound in Pediatric Rheumatology: Normal Age-Related Ultrasound Findings Collado, P., Vojinovic, J., Nieto, J. C., Windschall, D., Magni-Manzoni, S., Bruyn, G. A. W., Iagnocco, A., D’agostino, M. A., Naredo, E. and on behalf of the Omeract Ultrasound Pediatric Group (2016), Arthritis Care Res, 68: 348–356. doi: 10.1002/acr.22670
The Outcome Measures in Rheumatology Ultrasound Task Force has recently started to work on the validation and standardization of musculoskeletal ultrasound (MSUS) examination in children in order to improve its applicability to joint examination.
This was a prospective multicenter study performed by 4 experts in pediatric MSUS, who independently collected representative images using predefined scanning procedures of 4 joints (knee, ankle, wrist, and second metacarpophalangeal joint) in different predefined age groups. Researchers were allowed to use their own settings (B-mode and Doppler) in order to get the best quality image and highest sensitivity for low blood flow. Images were evaluated for quality parameters and an atlas was created with the best images. An equipment comparative study was performed by a single examiner using 2 different types of machines.
Sixty-four healthy children were scanned. The quality of evaluated images, obtained by predefined scanning positions, was highly comparable among the examiners. The B-mode images clearly showed age-related variations of joint findings, while Doppler images showed the presence of blood flow, particularly within the epiphyseal cartilage of the children at a younger age. There was a high to good level of consistency between images obtained from the 2 different ultrasound machines.
The study shows a systematic method for ultrasound examination of children at different age groups. Additionally, a baseline collection of images was developed, showing blood vessels in the joints examined. The present study could provide a framework for ongoing MSUS studies as well as for clinical practice in pediatric rheumatology.
Association Between the Use of Oral Contraceptives and Patient-Reported Outcomes in an Early Arthritis Cohort
Albrecht, K., Callhoff, J., Buttgereit, F., Straub, R. H., Westhoff, G. and Zink, A. (2016), Arthritis Care Res, 68: 400–405. doi: 10.1002/acr.22667
To evaluate the association between exposure to oral contraceptives (OCs) and clinical outcomes in an early arthritis cohort.
Female patients with early inflammatory arthritis, ages 18–60 years, who were enrolled in an early arthritis cohort and had no exposure to hormone replacement were studied (n = 273). Associations between OC exposure (current/past/never) and disease activity, treatment, and patient-reported outcomes, including the Rheumatoid Arthritis Impact of Disease Score (RAID), the Rheumatoid Arthritis Disease Activity Index (RADAI), the Profile of Mood and Discomfort (PROFAD), and the Hannover Functional Assessment (FFbH), were studied over 2 years. Linear mixed models adjusted for age, body mass index, parity, smoking, and education were used.
Eighteen percent of patients had never used OCs, 63% had used OCs in the past, and 19% currently used OCs. After adjustment, the current/past OC use was associated with better RAID, PROFAD, RADAI, and FFbH scores at 12 months (P < 0.05 for all) compared to never use. Longitudinally over 2 years, the mean RAID scores were significantly better in women with current/past OC use (P < 0.001). Actual inflammatory markers were not associated with OC use. Glucocorticoids were used by a higher percentage of OC never users than by current/past users (P = 0.08), especially in patients with impaired function
For past as well as current use, OCs seem to moderate patient-reported outcomes in inflammatory arthritis. Protective effects may be induced via central nervous pathways rather than through the suppression of peripheral inflammation.
NSAIDs in axial spondyloarthritis: to be continued …?
G Varkas, F Van den Bosch .Ann Rheum Dis doi:10.1136/annrheumdis-2015-208194. Published Online First 26 February 2016 Read article here: https://www.readbyqxmd.com/read/26920998/nsaids-in-axial-spondyloarthritis-to-be-continued-â
Wellocracy is a website that provides impartial, easy-to-understand information on new personal “self-health” technologies like activity trackers, wireless devices and mobile apps. The site has sections on wearable activity devices, activity apps, sleep apps & devices, mood apps, food & calorie apps, heart health apps & devices, connected scales, and healthy habit apps. For example, the wearable activity devices page includes a comparison chart showing the difference in price, features, how the device is worn, how the device is powered, how data can be accessed, how data is uploaded, and how data is displayed. There are also information sheets on each wearable device as well as related articles, such as “Getting the most out of your new activity tracker” and “The method behind the magic: How trackers work”. Wellocracy is run by the Center for Connected Health at Partners HealthCare.
Next News Brief Deadline The deadline for the April Newsbrief will be March, 25th 2016. Please send any contributions to Julia Farquharson at Julia.firstname.lastname@example.org. We are particularly interested in notices of conferences or workshops, new resources for patients or health professionals and summaries of recent research/publications. We welcome contributions from members from all parts of the country.