151 Main St. S.

, Box 1181,
Seaforth, ON, N0K 1W0,
519-600-5195

August 2015 Edition

THE OPEN GATE

Gateways Summer Students
Julia Huber, shown on left, has just completed her undergraduate degree in
the Honours Bachelor of Science in Nutrition and Dietetics at the University
of Western Ontario. She will be pursuing her Masters of Applied Nutrition at
the University of Guelph in the fall to achieve her goal of becoming a
Registered Dietitian. Julia grew up in Goderich, Ontario and hopes to return
to Huron County when her designation is received to help the community
where she grew up and to repay those who helped her gain nutrition
experience as a student. Throughout her employment at Gateway, Julia
has worked to create a food product
targeted at managing the current chronic
diseases that are of high prevalence in the
Huron, Perth, Grey, and Bruce counties.
Katrina Merner, shown on right, is from
Bayfield, Ontario and has recently completed her Honours Bachelor of Health
Science with a Minor in Life Science degree from University of Ottawa. Katrina
hopes to attain a future career in the health care field within a rural community,
and has considered career options in rural medicine and nursing. This
summer Katrina worked in partnership with Gateway Centre of Excellence in
Rural Health, School of Pharmacy at University of Waterloo and Huron
Community Family Health Team, under the direction of Dr. Feng Chang, the
Chair of Rural Pharmacy. Katrinas
research focused on safe, effective and efficient prescription opioid use.
Alanna Roy, shown on left, a recent graduate from Western University
with an Honours Specialization in Kinesiology, is hoping to pursue a
Masters of Science in Physical Therapy or a Medical Degree. During
her employment at Gateway, Alanna worked with Research Chair Jay
McFarlan on his project called Grand Sparks. The project consisted of a
5-day summer camp in July aimed at tracking the fitness levels of
grandparents and their grandchildren. The project also aimed to spark
participants interest in becoming more active by experiencing unique
activities at the camp, such as weightlifting, canoeing and adventure
hiking.

Funding Announcement
Prescription drug abuse is a significant public health and safety concern that can have devastating
effects on individuals, families and entire communities. It was reported in an Ontario survey in 2013, that one
in eight youth are using a prescription opioid drugs for non-medical purposes. On May 15th, at the Prescribing
Practices Forum in Hamilton, Ontario, the Minister of Health Rona Ambrose announced the Governments
commitment to fighting prescription drug abuse. Health Canada, under the Anti-Drug Strategy Initiative, will
be providing funding of $720, 330 (2015-2017) to the University of Waterloo, School of Pharmacy for an interdisciplinary initiative to reduce prescription opioid misuse. This involves the development and implementation
of a collaborative, web- based education program to target physicians, pharmacists, students and trainees
that will focus on applying evidence-based opioid management guidelines. Two of Gateways Board Members, Dr. Feng Chang, Chair of Rural Pharmacy and Dr. Agnes Kluz, Chair of Rural Senior Wellness, along
with their team will lead this project.

151 Main St. S., Box 1181,

Seaforth, ON, N0K 1W0,
519-600-5195

August 2015 Ediition

Hometown Heroes: Raise a Little Health 2015

On Thursday July 23rd, 2015, Gateway Centre of Excellence in Rural Health, the Alexandra Marine and
General Hospital and the Goderich-Huron YMCA hosted the 2nd annual Hometown Heroes Raise a Little Health
charity hockey game at the Maitland-Recreation Centre located in Goderich. The hockey game featured local NHL
players, including Boyd Devereaux, Ryan OReilly, Cal OReilly, and Dave McLlwain; local doctors, including Dr.
Paul Gill and Dr. Dan Noel; and, local Huron-Bruce M.P. Ben Lobb. The event was a great success this year as we
were able to raise over $50,000, while all attendees thoroughly enjoyed themselves! The funds raised were split
evenly between the Alexandra Marine & General Hospital, Gateway Centre of Excellence in Rural Health and the
Goderich-Huron YMCAs Strong Kids Foundation. The money will be used to help these local organizations
improve the health of our community.

151 Main St. S., Box 1181,

Seaforth, ON, N0K 1W0,
519-600-5195

August 2015 Ediition

Grand Sparks

From July 13-17, Gateway Centre of Excellence in Rural Healths research chair of Rural Nutrition and Exercise,
Jay McFarlan, ran a very successful activity camp for grandparents and grandchildren called Grand Sparks. This
day camp was funded by the Senior Community Grant Program for $8000. Grand Sparks aimed to challenge
grandparents to interactive outdoor play and recreation with their grandchildren. Small local businesses and
individuals led sessions in adventure hiking, canoeing, biking, yoga, strength training, and other exciting activities.
Additionally, different local food businesses catered lunch for participants; some of the meals included grilled
chicken, delicious salads and gourmet sandwiches. By partaking in Grand Sparks, participants are also involved in
rural health research, the primary question being: What motivates people to get active and stay active? Gateway
will request follow-up surveys of all adult participants at 1-month and 4-months after Grand Sparks. All of the
grandparents were given a fitness tracker to help them keep track of their daily activity, as Gateway wishes to learn
if the very act of measuring activity will encourage the grandparents to move more frequently.

151 Main St. S., Box 1181,

Seaforth, ON, N0K 1W0,
519-600-5195

August 2015 Edition

Retiring Well: Considering the Costs of Good Health

Gateway has recently wrapped up the first phase of The Retiring Well: Considering the Costs of Good Health program funded
by Employment and Social Development Canadas New Horizons for Seniors Program. Retiring Well is a community-based education
program that aims to raise awareness about the health-related costs associated with aging. Additionally, this program offers participants
valuable strategies for helping them better prepare for retirement. The Retiring Well program specifically targets seniors living in rural
Southwestern Ontario, as these individuals are known to face unique health challenges, including higher incidences of chronic disease,
reduced access to care, and lower incomes.
The Retiring Well program has been delivered 20 times, in 17 different communities, spanning 4 counties (Huron, Perth, Bruce,
and Lambton). With audience sizes ranging from approximately 10 to 75, a total of 487 individuals have participated in the Retiring Well
program, which far exceeded the expected participation rate. In addition, the feedback received on the Retiring Well program has been
overwhelmingly positive. The participants acknowledged that the program was helpful, the information package was useful and that
they would recommend the program to their friends. Most of the participants agreed that they learned something new from the Retiring
Well program. Gateway is thrilled with the community participation, engagement and networks formed. Gateway would like to thank our
community partners for their generosity in providing space for the events and their help with the organization of community events. We
would also like to thank the University of Waterloo, School of Pharmacy for leading this initiative. We are currently working on new
funding opportunities to continue moving forward with the program.

Rural Lung Health Nurse Practitioner Assessment

Chronic obstructive pulmonary disease (COPD) is a progressive, disabling disease that can have devastating effects on
patients, families, and the healthcare system. Ranked as the fourth leading cause of death in Canada, it currently affects more than
830,000 Canadians. True rates are higher than reported because COPD is underdiagnosed. While smoking is the leading cause of
COPD, accounting for 80-90% of cases, occupational exposures is the other leading risk factor, accounting for 10-20 % of cases.
Unfortunately, the risk associated with occupational exposures is underappreciated. This has implications for primary healthcare (PHC)
nurse practitioners since COPD is preventable and treatable. PHC nurse practitioners, who work in rural areas, can include
occupational lung health risk factors within their lung health assessments.
Studies show that farmers are at an increased risk for lung disease, as a result of occupational exposures. However, these
exposure are often under-recognized and difficult to assess since farmers generally do not seek health care until serious symptoms are
present. In two research studies conducted in Alberta, Saskatchewan, and Manitoba, poultry producers were found to have lower lung
function and more lung symptoms including chronic cough, increased phlegm production, wheeze, chest tightness, and shortness of
breath. The findings of this research link these symptoms to indoor air contaminants within poultry houses, such as gases, dust,
chemicals, and micro-organisms. Operations where hens are housed in cages are more hazardous to lung health because indoor
contaminants are smaller in size, and can penetrate deeper into the lungs. These health effects can be reduced through environmental
controls such as ventilation systems and wearing industry-approved masks. Thus, when evaluating lung health risks, PHC nurse
practitioners can include questions about farming type, processes, and use of personal protective equipment.
Once occupational risk factors are included in the rural lung health assessment, this evidence-based health information can
guide the PHC nurse practitioner toward best practice. Core components of this assessment should include a complete health history,
evaluating lung symptoms, and physical examination. The health history should assess lung risk factors, such as occupational
exposures and smoking history including prenatal or childhood exposure to second-hand smoke. Other risk factors to consider are
asthma, allergies, age, gender, and family history of lung disease, since they are all linked to an increased risk of COPD development.
Lung symptoms can be evaluated using the Canadian Lung Health Test, developed by the Canadian Lung Association.
The physical examination should include an assessment of the chest, noting
rate, rhythm, breathing patterns, and lung sounds. Height and weight should be
determined and body mass index calculated, since they can affect chest expansion
and effective breathing. Systemic effects of COPD should also be assessed. These
results, combined with the health history and the Canadian Lung Health Test, can
help PHC nurse practitioners determine which individual requires further testing.
Specifically, spirometry testing can be used to diagnose COPD. Findings from the
rural lung health assessment should be discussed confidentially with each farmer so
that interventions can be tailored to meet their needs.
By recognizing occupational lung health risk factors, and incorporating this
information in a rural lung health assessment, PHC nurse practitioners, who work in
rural areas, are in a position to detect early changes in lung health and improve lung
health outcomes. By integrating evidence-based knowledge into practice, PHC
nurse practitioners can work with farmers in reducing exposure to lung risks and
promote lung health in high risk populations such as poultry producers.

151 Main St. S., Box 1181,

Seaforth, ON, N0K 1W0,
519-600-5195

August 2015 Edition

Gateway in the Community

Estate Planning and Charitable Giving Event
On Thursday May 7th, 2015 at the Huron County Museum in
Goderich, The Gateway Centre of Excellence in Rural Health
attended an estate planning and charitable giving event. Dean
Whalen of Lighthouse Money Management hosted the wellorganized occasion. This informative and enlightening event had two
top quality speakers, Wilmot George of MacKenzie Financial, and
Lea Koiv of Manulife Financial. Mr. George educated attendees
about different vehicles in which one can donate to their charity of
choice, and Ms. Koiv spoke about donating to charitable
organizations through life insurance. Three local charitable groups,
The Alexandra Marine and General Hospital (AMGH) Foundation,
The Maitland Trail Association, and The Gateway Centre of
Excellence in Rural Health, were able to speak about their values
and goals, and how donated funds will be used within their non-profit
organization. Myles Murdock spoke on behalf of the AMGH
Foundation about the three focuses of current attention: womens
health, mental health, and the health of older adults; as well as the
expansion of the dialysis unit. Susanna Reid spoke on behalf of The
Maitland Trail Association about the construction of a new bridge and benches along the trails. On behalf of Gateway, Dan Stringer
spoke about the development of Gateway; the hiring of the summer students Alanna Roy, Julia Huber, and Katrina Merner; and the
respective research projects that are currently being undergone by the research chairs and summer students. Accountants, lawyers,
financial advisors, and the general public attended the event; and the enthusiasm and information provided in each presentation was
enjoyed by all attendees.

AMGH Leadership Council and Gateway`s Collaboration Meeting

On Friday May 29, 2015 at the Parkhouse Restaurant in Goderich, Ontario, The Gateway Centre of Excellence in Rural Health
(Gateway) met with the Alexandra Marine and General Hospital (AMGH) Leadership Council to discuss possible collaboration
opportunities. On behalf of Gateway, Dan Stringer and Gwen Devereaux started off this productive meeting with an introduction of
Gateways goals and mission, the research chairs, existing collaborations and past research projects. One of Gateways summer
research assistants, Alanna Roy, then presented on future research collaboration opportunities between AMGH and Gateway in
regards to womens health, mental health and the health of older adults. Julia Huber, another summer research assistant, discussed
her collaboration with Everspring Farms in the development of three food products targeted towards specific chronic diseases, and
introduced the idea of a clinical study using these products at AMGH. The final summer research assistant, Katrina Merner, offered
collaboration with AMGH in regards to the opioid misuse project, Retiring Well, Peer Mentorship and a quality of medication use study.
Jay McFarlan, Research Chair of Nutrition and Exercise, discussed Grand Sparks, a week-long program promoting physical activity
and nutrition in grandparents and grandchildren that he will be running in July. Sheila Schuehlein introduced health coaching and the
expansion of the Retiring Well and Peer Mentorship program in AMGH. Finally, Rose Marie Dolinar talked about her research project
investigating COPD in rural chicken
farmers and seeking access to a
spirometer lab in the hospital.
Following Gateways presentations,
both teams split into groups and
had a walking meeting discussing
questions revolving around future
collaboration opportunities between
the two organizations. Both
Gateway and AMGH Leadership
Council were able to leave this
productive meeting feeling informed
and excited about the future
partnership with one another.

151 Main St. S., Box 1181,

Seaforth, ON, N0K 1W0,
519-600-5195

August 2015 Edition

Updates on Gateway`s Chairs

Dr. Wayne Caldwell`s Research Day
Gateway attended Dr. Wayne Caldwells (Research
Chair of Healthy Sustainable Communities) annual Research
Advisory Committee Meeting on June 12th, 2015 at the
University of Guelph. Dr. Caldwell and his PhD and Masters
students presented their research projects that are currently
ongoing and recently completed. The projects were all
surrounding Rural Economic Development, but were further
subdivided into 3 themes: Planning for Agriculture, Planning
for Healthy Communities, and Planning for Rural Resilience
and Local Economic Development. This was a productive
meeting for Dr. Caldwell as he was able to raise awareness of
his research, as well as receive input on the projects from
attendees, which consisted of municipal planners, OMAFRA
representatives and research organization representatives.
Dr. Wayne Caldwell, has also released 2 new books
this month. The first, Better Decisions, Together is a
facilitation guide for community engagement. This book
explains the need for citizen engagement, how conflict can be
harnessed as a positive force for change, provides facilitation
strategies proven to work at the community level, and gives
practical suggestions for engaging the community. Visit this
link for more information on the book: http://
www.waynecaldwell.ca/Books/betterdecisions.html. Dr.
Caldwells second book, Planning for Rural Resilience
addresses strategies for coping with climate change and the
energy future. This book addresses questions about change,
the ability to adapt in rural regions, and provides case studies
about town rebuilding. For more information about the book,
see: http://www.waynecaldwell.ca/Books/ruralresilience.html.

Dr. Craig Hudson`s Recent Published Study

Gateways Chair of Rural Mental Health, Dr. Craig Hudson, has recently published a clinical study in Hindawis Parkinsons
Disease Journal. The study involved 16 participants with Parkinsons disease who were studied over the course of 6 weeks.
Participants received a low dose of haloperidol, a medication known to increase sensitivity of dopamine receptors in animals, in
conjunction with their regular levodopa medication. The SPES/SCOPA scale, which assesses motor impairments and disabilities in
Parkinsons disease, was used as a method of measurement. Hudsons study found the SPES/SCOPA scores to decrease after
just 1 week of low dose haloperidol treatment, suggesting that haloperidol increases sensitivity of dopamine receptors in humans.
This is beneficial as the levodopa medication used in the management of Parkinsons Disease can have negative side effects. By
introducing haloperidol as a Parkinsons Disease treatment option, levodopa may be able to be decreased, and therefore decrease
the negative side effects. To read Craig Hudsons full article, visit this link: http://www.gatewayruralhealth.ca/parkinsonrsquosdisease-low-dose-haloperidol-increases-dopamine-receptor-sensitivity-and-clinical-response.html.

Visit www.gatewayruralhealth.com to keep updated on what is happening at Gateway!