The end (?) of CHN

I received the following message from Dietitians of Canada (DC) this morning. If you have used the Canadian Health Network (CHN) in the past, you know it is a very valuable, reliable resource for nutrition and health information. Please consider voicing your concern and expressing your support. The ways you can do this are outlined in the email.

Dear DC Member:

We have received considerable feedback from our members about the recent announcement of the federal government cutbacks to grants and contribution funding that will mean phasing out of the Canadian Health Network by March 2008. Many have expressed dismay and have asked how they can further voice their support for CHN and their concern regarding the loss of this valued and highly-used website.

Dietitians of Canada is providing feedback to the Public Health Agency of Canada to express our concern regarding the gaps that will be left in the absence of CHN. Our key messages focus on:

- how dietitians have been using the site and referring their clients to the site as a place to find trusted health information. CHN has been a valuable support for dietetic practice. CHN boasted approximately 400,000 unique users per month, over 5 million users a year; and profiled over 20,000 peer reviewed resources;

- CHN is cost effective drawing on the resources of 2100 contributing organizations who serve as affiliates and network contributors. The extensive CHN collaboration can help the government achieve its goal of a 20% increase in the proportion of Canadians who are physically active, eat healthy and are at healthy body weights. There is no other web site like it that profiles a wide range of Canadian content in both official languages. CHN helps reduce duplication of effort;

- the need for continued support of health promotion and integrated approaches to chronic disease prevention has never been more pressing with the rising costs of chronic disease;

- the need for resources that can be used to support and foster self-help for the public has never been higher, when the public is ready to take action on behalf of their own health needs and goals;

- the significant contribution that the non-government sector [ie. voluntary health organizations across Canada] makes to health promotion and disease prevention. The CHN supported networking amongst non-profit organizations and provided Canadians with a strong, positive profile of the work done for them by the voluntary, non-profit sector.

To voice your individual concerns please contact Dr. David Butler-Jones, the Chief Public Health Officer at the Public Health Agency at the following address:

Dr. David Butler-Jones
Chief Public Health Officer P
Public Health Agency of Canada
130 Colonnade Road
AL 6501H
Ottawa, Ontario K1A 0K9
Fax: 613-954-8529
Email: david_butler-jones@phac-aspc.gc.ca
Direct correspondence right on the website: http://www.phac-aspc.gc.ca/contact_cpho_e.html

In addition, you can consider the following options

- contact your local member of parliament in your federal riding, who you can find at http://canada.gc.ca/directories/direct_e.html#mp

- The Right Hon. Stephen J. Harper, Prime Minister, Office of the Prime Minister
80 Wellington St., Ottawa K1A 0A2
Fax: (613) 941-6900
E-Mail: Harper.S@parl.gc.ca
PM’s website: http://www.pm.gc.ca/

- The Hon. Tony Clement, Minister of Health Minister's Office - Health Canada
Brooke Claxton Building, Tunney's Pasture
Postal Locator: 0906C Ottawa, ON K1A 0K9
Fax: (613) 952-1154
E-mail: Minister_Ministre@hc-sc.gc.ca
Direct correspondence right on the website: http://www.hc-sc.gc.ca/ahc-asc/minist/health-sante/contact/index_e.html

- opposition party health critics.

Liberal: Robert Thibault (West Nova): Thibault.R@parl.gc.ca

NDP: Judy Wasylycia-Leis (Winnipeg North): wasylj@parl.gc.ca

Bloc: Christiane Gagnon (Quebec): gagnoc@parl.gc.ca

Green Party: Health Promotion critic Blake Poland: blake.poland@greenparty.ca

If you receive media requests for more information on DC’s response, please refer the requests to me at mswaisman@yahoo.com . .

Thank you all for your continued interest and support.

Mary Sue Waisman, MSc RD
Project Manager
CNH Healthy Eating Affiliate
Dietitians of Canada

I'm very disappointed about this decision to discontinue the CHN and will try to draft a letter before next Monday. Whatever I write, I will share here.

Celiac Disease

Today at noon I listened to Mark Forsythe's BC Almanac interview with medical columnist Dr. Jane Haley who gave an excellent overview of Celiac Disease. I hope the interview will be archived and if it is, I will provide the link. Dr. Haley highly recommended this blog, Gluten-Free Girl, and after spending a few minutes exploring it -- and wanting to stay longer -- I would have add my own 5 star rating. Her new book also is getting rave reviews and I'm very tempted to add it to my library.

I have a few other priority tasks to complete today but I hope to write either an addendum or part 2 to this post in which I describe how I, as a clinical dietitian, might use the information on Ms. Ahern's site and in her book.

Also, I'm sure most Canadian dietitians and dietetics students are familiar with Shelly Case's expert writing and speaking on celiac disease, but in case you don't have link to her web site or book, I'm including it here: Gluten-Free Diet.

Home tube feeding challenges

I find it easiest to write from "I'm in the midst of it right now" experience so that's what I'm going to do today. As I mentioned, I have an intern with me this week and I've given her the challenge of simplifying our home tube feeding handouts for clients who either do not speak/understand English or have low literacy skills.

I hop to share our finished handouts on this blog, but in the meantime, here is the link to the home tube feeding resource we are using. From it we are selecting the most important information, simplifying the wording, and using pictures instead of words where possible.  

Tube Feeding at Home: a guidebook for patient, families and caregivers

Preceptoring & Mentoring

Example isn't another way to teach. It is the only way to teach.

- A. Einstein

This past week and next week, I have a dietetic intern in her Clinical 1 placement with me. This requires me to switch roles frequently throughout the day, examine questions, ideas and issues from different perspectives, and use different skills and knowledge as dietitian, allied health care team member, preceptor, mentor, learner myself, and most important, according to Einstein, exemplar.  So I thought this would be an excellent time to review the internship, preceptoring and mentoring resources I've accumulated in my files over the years, check out online resources, and then compare, pare down to the best, and share the results with you.

Here are several key resources I've looked at this week:

Dietitians of Canada (DC) has an extensive, up-to-date collection of mentoring and preceptoring resources on its members-only pages and PEN site.

Mentoring  (access requires DC membership)
Knowledge Pathway on Preceptoring & Mentoring (access requires PEN subscription)

The University of British Columbia (UBC) College of Health Disciplines has resources for preceptors and mentors.  I've looked at several of the web pages and they summarize much of the material covered in preceptorship workshops I've attended in past years.

Whatever your role in the learning process, I hope you find some useful information on these pages.

Tell me and I forget. Show me and I remember. Involve me and I understand.

- Anonymous Chinese Proverb

Critical Care Nutrition

Until earlier today, I didn't know about this valuable site -- it's Canadian, too -- for critical care dietitians and physicians. I discovered Critical Care Nutrition (CCN) by responding to a request to complete a survey.  I don't have a good excuse for my ignorance other than, from habit, I've always turned to A.S.P.E.N., and more recently, ESPEN for nutrition support practice guidelines.

Now that I've found CCN, I'll be adding the link to my Connotea library and sharing it here, with a brief introduction and description to guide your exploration of this site.

CCN's team consists of physicians and dietitians "dedicated to the improvement in nutrition therapies in intensive care units across the world." The site's resources include downloadable, adaptable:

• Evidence-based Canadian Clinical Practice Guidelines  in three formats: full-text Journal of Parenteral & Enteral Nutrition (JPEN) article (2003), protocol, and summary of recommendations.
• Tools & Training Kit (protocols, algorithms, flowcharts) consisting of (i) a Manual of Clinical Practice Guidelines for Nutrition Support in Mechanically-Ventilated, Adult Critically Ill Patients (ii) Glycemic Control for Adult Intensive Care Patients, (iii) Order Sets, and (iv) a Training Kit for an Interactive Workshop.

Another feature is a discussion forum, although its activity seems to be quite low at present.

CCN definitely is a site worth exploring if you are a dietitian looking after critically-ill patients.