Advanced Clinical Nutrition: NUTR 476 - University of Alberta

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Advanced Clinical Nutrition: NUTR 476

Department of Agricultural, Food and Nutritional Science, University of Alberta

Winter 2014

Dr. Diana Mager PhD RD

Course Description

*3 (3-0-3). The principles of clinical nutrition and the role of diet in the treatment and management of chronic disease. Emphasis will be on case studies and application of principles of advanced clinical nutrition for development of individualized nutritional care plans for clients with chronic disease.

Prerequisite NUTR 468/302

B. Objectives

This course will provide the students the opportunity to acquire knowledge and apply knowledge:

1) The role of nutrition in the prevention and treatment of selected diseases, nutritional disorders and clinical conditions

2) Assess, discuss and resolve clinical nutrition management problems. This will include the integration of knowledge and skills acquired from previous course work (nutrition,

biochemistry, physiology and behavioral science).

3) The role of the clinical dietitian as a member of the health care team in the provision of nutritional care.

C. Format:

Lectures Mon: 12-12:50; Wed 12-13:50 Location: ECHA L1-140 Lab/seminar: 3 hours/week; Wed 2-5 pm Location: ECHA 2-430

D. Instructor (Office hours: W 11-12) Teaching Assistant(s)

Diana Mager PhD RD Sabina Valentine (SV) MSc RD candidate

2-021 Li Ka Shing Centre for Research [email protected]

Phone: 492-7687 Sarah Hewko RD PhD (candidate)

Email: [email protected] [email protected]

ECHA 2-420

Office Hours: Wed 5-6 until Feb 27 2013 By appointment/announcement March 1, 2

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Week: Tentative Lecture Schedule Lab

January 6-10 Enteral Nutrition: Adjunctive vs Treatment Reading 1-7

Case: Crohn’s Disease Lab: Enteral feeding/tube

Surgical vs Medical Therapy devices/feeding pump/

Product tasting: SV

DVD patient simulations:

Crohns and tube feeding

January 13-17 PN: How & when to order Readings: 7-14

Biochemical, Anthropometric and clinical Lab: Enteral calculation I

assessment TA: SV

Complications of PN: liver disease, sepsis, Overfeeding Case: Surgical Patient

January 20-24 Cancer/interpretation of blood work Lab: PN Cases, SV.

(slides 1-32 blood work) Readings 8, 9, 15-20 Trauma/Sepsis/ICU

January 27-31 Re-feeding Syndrome Readings: 21-24

Hypermetabolism: Burns Lab: Enteral/PN

Calculations, TA: SV Assignment 1 (20%) due Jan 29^th, 2014 in seminar

Feb 3-7 Transplantation Readings: 12, 25-27

Liver and small intestine Midterm/SV

Midterm exam Feb 5th, 2014 in seminar

Feb 10-14 Hypermetabolism: ARDS (Michelle Booth RD Readings 28-30 Hypermetabolism Pulmonary Disease Lab: TBA ICU: chylothorax

Wed Feb 12 Michelle Booth.

Feb 17-21 Reading Week- No classes scheduled

Feb 24-28 Renal Disease: Role of the kidney Readings 31-36 Chronic Renal Failure/Renal Insufficiency Lab: Renal Diets I

Dialysis TA: SH

March 3-7 Renal Disease II: Renal Transplantation Lab: Renal Diets II.

Cases: CRF/transplantation TA: SH

No lecture March 3, 2014 due to student union elections March 5: Dialysis Melanie Fougiere RD

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March 10-14 Pediatrics: Inborn Errors of Metabolism Readings 37-38

Case(s): PKU/Tyrosinemia/MSUD/ Lab: Metabolic Disorders galactosemia- March 12 Metabolics (2:30-4) RD TA: SH

March 17-21 Pediatric Nutrition Assessment Readings 39-41

Full term vs prematurity Lab: Pediatric Assessment

Use of PN vs Enteral DM

Failure to Thrive (FTT) DVD simulations

Assignment 2 Due Wed March 19, 2014 (20%) Guest speaker: 3:30

Case: Hypermetabolism Home NS Program.

March 24-28 Developmental Disabilities Reading: 41

Energy Metabolism: Hypo-vs- Hypermetabolism Lab: Dysphagia Clinical

Dysphagia, Assessment

Gastroesophageal reflux disease (GERD) RD/SLP

Case: GERD and Dysphagia; IHEP Stanley Home Care Wed March 26^th, 2014: Klara RD DVD simulations

March31-April4 TBA TBA

No classes on April 2, 2014

April 7-11 Food Allergies & Hypersensitivities. Reading: 42-43 IgEvs non IgE mediated intolerances TBA

Case: Milk/Protein Soy Allergies with NCP Geriatrics

E. Evaluation Date

Mid-term Exam: 25% February 5, 2013

Term Assignments: 40% 2 assignments (20% and 20%).

Final Exam: 35% April 14, 2014

Note: Final exam will be cumulative. The University grading system will be applied dependent upon the distribution of the final grades in the class and then absolute values will be attributed to the letter designations.

F. Late assignments will be accepted, however a deduction of 10% per day late will be made. For example if an assignment is due on a Monday at 4:00 pm, and it is received any time after that, up until 4:00 pm the following day, 10% will be deducted from total mark. If it is late a second day, an additional 10% will be deducted and so on. If an assignment is worth 30% of the years work (or 30 marks) then a 10% deduction is minus 3 marks. Electronic submissions of assignments WILL NOT be permitted. Students may NOT pick up other students assignments/tests and may only pick up the assignments during regularly scheduled office hours or in class when they are distributed.

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G. The lab section of the course may include the need for supplemental lecture material from course instructor Dr. Diana Mager. Some lab will be conducted by Dr. Mager, the rest guest speakers or the TA. The lab will include hands-on experiential learning, videos, calculations and cased based

learning in addition to didactic approaches.

H. Student Marking requests regarding information about individual student grading will NOT be provided by email to students. Students may address any questions regarding tests/assignments results in regularly scheduled office hours with instructor. Tests/assignments will not be remarked. Only addition errors of total grade will be corrected. Assignments/mid-term will be returned in class/lab and/or may be picked up in regularly scheduled office hours of the instructor, unless otherwise specified.

I. Emails will be responded to within 24-72 hrs (not including weekends or statutory holidays). Use the question forum in Moodle as another way to ask questions and to see what new information has been highlighted.

J. Students who are late for class will be expected to enter the classroom quietly and to sit at the back of the class to avoid disrupting the class. While we encourage interactive group activities and class discussion at specific points in the lecture/lab, disruptive noise (such as talking) during non-group activities while instructor/TA/guest speakers are teaching, will not be tolerated.

K. Past evaluative material: Representative course evaluation materials from previous years will be posted on Moodle approximately one week before the mid-term and one week before the final exam.

L. Reference Materials

Required Readings*

1. McClave S, Neff R. Care and long term maintenance of percutaneous endoscopic gastrostomy tubes. JPEN 2006;30:S27.

http://pen.sagepub.com.login.ezproxy.library.ualberta.ca/content/30/1_suppl/S27.full 2. Soscia J, Freedman J. A guide to the management of common gastrostomy and

gastrojejunostomy problems. Paediatr Child Health 2011: Vol 16(5):281-287

3. Bankhead R et al. ASPEN Enteral nutrition practice recommendations. JPEN 2009. Pages 131- 158; 162-167.

http://pen.sagepub.com.login.ezproxy.library.ualberta.ca/content/33/2/122.full.pdf+html 4. Chen, Y and Peterson SJ. Enteral Formulas: Which one is right for your adult patient. Nutr Clin

Prac 2009; 24; 344

http://ncp.sagepub.com.login.ezproxy.library.ualberta.ca/content/24/3/344.full

5. Andrew Ukleja, Kevin L. Freeman, Karen Gilbert, Marty Kochevar, Michael D. Kraft, Mary K.

Russell, Melanie H. Shuster. Standards for Nutrition support: adult hospitalized patients. Nutr Clin Pract 2010 25:403-414.

6. Andrew Ukleja. Altered GI Motility in Critically Ill Patients: Current Understanding of Pathophysiology, Clinical Impact and Diagnostic Approach. Nutr Clin Pract 2010 25: 16-25.

7. Jensen G.L. Hsiao PY. Wheeler D. Adult Nutrition Assessment Tutorial. JPEN 2012; 36:267- 274. http://pen.sagepub.com.login.ezproxy.library.ualberta.ca/content/36/3/267.full.pdf+html 8. Shenkin A, Biochemical Monitoring of Nutrition Support. Ann Clin Biochem 2006;269-272.

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http://acb.rsmjournals.com.login.ezproxy.library.ualberta.ca/cgi/reprint/43/4/269

9. Gidden, F, Shenkin A. Laboratory Support of the Clinical Nutrition Service. Clin Chem Lab Med 2000;38(8): 693-714.

10. Kirby D.F, Corrigan M.L., Speerhas R.A, and Emery D.M. 2012: Home Parenteral Nutrition Tutorial. Journal of Parenteral and Enteral Nutrition 2012: Vol 36(6): 632-644.

http://pen.sagepub.com.login.ezproxy.library.ualberta.ca/c/content/36/6.toc

11. Seida J.C, Mager D.R, Hartling L, Vandermeer B, Turner J.M. Parenteral -3 fatty acid lipid emulsions for children with intestinal failure and other conditions: A systematic review. JPEN 2013: 37:44-55.

http://pen.sagepub.com.login.ezproxy.library.ualberta.ca/c/content/37/1/44.full.pdf

12. Tillman E. M. Review and Clinical Update on Parenteral Nutrition-Associated Liver Disease.

Nutr Clin Prac 2013: 28: 30-39.

13. Kumpf, VJ. Parenteral Nutrition-Associated Liver Disease in Adult and pediatric patients.

Nutrition in Clinical Practice 2006;21:279-290.

14. Stephen Marc Stout and M. Petrea Cober. Metabolic Effects of Cyclic Parenteral Nutrition Infusion in Adults and Children Nutr Clin Pract 2010 25: 277-281.

15. Esper DH, Harb WA. The cancer cachexia syndrome: a review of metabolic and clinical manifestations. Nutr Clin Practice 2005;20:369-376.

16. Raykher A, et al. Enteral Nutrition Support of Head and Neck Cancer Patients. Nutr Clin Prac 2007;22:68-73.

17. Todd SR, Kozar RA, Moore FA. Nutrition Support in adult trauma patients. Nutr in Clin Practice 2006;21:421-429.

18. Boitano M. Hypocaloric feeding of the critically ill. Nutr in Clin Practice 2006;21:617-622.

19. Frankenfield D. Energy expenditure and protein requirements after trauma injury. Nutr Clin Practice 2006;21:430-437.

20. Stephen A. McClave, Robert G. Martindale, Vincent W. Vanek, Mary McCarthy, Pamela Roberts, Beth Taylor, Juan B. Ochoa, Lena Napolitano, Gail Cresci, the A.S.P.E.N. Board of Directors and the American College of Critical Care Guidelines for the Provision and

Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient:: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) JPEN J Parenter Enteral Nutr 2009; 33; 277 (selected pages as per lecture)

http://pen.sagepub.com.login.ezproxy.library.ualberta.ca/content/33/3/277.full

21. Stanga Z, Brunner A, Leuenberger M, Grimble RF, Shenkin A, Allison SP, Lobo DN. Nutrition in Clinical Practice-the refeeding syndrome: illustrative cases and guidelines for prevention and treatment. Eur J Clin Nutr 2008: 62:687-694.

http://web.ebscohost.com.login.ezproxy.library.ualberta.ca/ehost/pdfviewer/pdfviewer?sid=2b25 5713-f3bd-4957-8809-998704dd7144%40sessionmgr14&vid=2&hid=15

22. Kraft MD, Btaiche I, Sacks GS. Review of the re-feeding syndrome. Nutr Clin Practice 2005;20:625-633.

23. Lee JO. Benjamin D, Herndon, DN. Nutrition Support strategies for severely burned patients.

Nutr Clin Practice 2005;20:325-330.

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24. Prelack, K, Dylewski, M, Sheridan RL. Practical guidelines for nutritional management of burn injury and recovery. J Burns 2006;2391

25. Weimann A, Braga M, et al. ESPEN Guidelines on Enteral Nutrition: Surgery including organ transplantation. Clin Nutr 2006;25:224-244.

26. Jeejeeboy KN. Short bowel syndrome: a nutritional and medical approach. CMAJ 2002;166(10):1297-1302.

http://www.ncbi.nlm.nih.gov.login.ezproxy.library.ualberta.ca/pmc/articles/PMC111082/

27. Matarese L. Nutrition and Fluid Optimization for Patients with Short Bowel Syndrome. Journal of Parenter Enteral Nutr 2013: 37: 161-170.

http://pen.sagepub.com.login.ezproxy.library.ualberta/content/37/2/161.full.pdf

28. Anker, SD, John M et al., ESPEN guidelines on enteral nutrition: cardiology and pulmonology.

Clin Nutrition 2006; 25:311-318.

http://www.sciencedirect.com.login.ezproxy.library.ualberta.ca/science/article/pii/S02615614060 00379

29. Malone, A. M. Specialized enteral formulas in acute and chronic pulmonary disease. Nutr Clin Practice 2009:24:666-674.

30. Turner, KL, Moore FA, Martindate R. Nutrition Support for the Acute Lung Injury/Adult Respiratory Distress Syndrome Patient: A Review: Nutr Clin Prac 2011:Vol 26 (1):14-25.

http://ncp.sagepub.com.login.ezproxy.library.ualberta.ca/content/26/1/14 http://ncp.sagepub.com.login.ezproxy.library.ualberta.ca/content/22/1/68.full

31. Rhoda KM, Porter MJ, Quintini, C. Fluid and Electrolyte Management: Putting a Plan in Motion. JPEN 2011: Vol 35(6):675-685.

http://pen.sagepub.com.login.ezproxy.library.ualberta.ca/content/35/6/675.full.pdf+html

32. Kent PS. Integrating clinical nutrition practice guidelines in chronic kidney disease. Nutr in Clin Practice 2005;20:213-217.

33. Moore E. Celano J. Challenges of providing nutrition support in the outpatient dialysis setting.

Nutr in Clin Practice 2005;20:202-212.

34. Wooley JA, Btaiche I, Good KL. Metabolic and nutritional aspects of acute renal failure in critically ill patients requiring continuous renal replacement therapy. Nutr in Clin Practice 2005;20:176-191.

35. Legg, V. Complications of Chronic Kidney Disease: A close look at renal osteodystrophy, nutritional disturbances and inflammation. AJN 2005:105:40-49.

36. Phil Ayers and Laurie Warrington, Diagnosis and Treatment of Simple Acid-Base Disorders.

Nutr Clin Prac 2008:23:122-127.

37. Nenad Blau, Francjan J van Spronsen, Harvey L Levy Phenylketonuria. Lancet Vol 376 October 23, 2010 1417-1427.

38. Morton DJ, Strauss KA et al., Diagnosis and treatment of maple syrup disease; a study of 36 patients. Pediatrics 2002;109:999-1008.

http://web.ebscohost.com.login.ezproxy.library.ualberta.ca/ehost/pdfviewer/pdfviewer?hid=119

&sid=fc37ecd9-699b-4ff5-9bfd-f0147c40aa81%40sessionmgr113&vid=3

39. Nofal, A.A. Schwenk, F. Growth Failure in Children: A Symptom or a Disease? Nutrition in Clinical Practice 2013: 28:651-658.

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40. Axelrod D, Kazmerski K, Iyer K. Pediatric Enteral Nutrition. JPEN 2006;30:S1-S26.

http://pen.sagepub.com.login.ezproxy.library.ualberta.ca/content/30/1_suppl/S21.full

41. Johnson T, Sexton E. Managing children and adolescents on parenteral nutrition: challenges for the nutrition support team. Proceedings of Nutr Society 2006;65:217-221.

http://journals.cambridge.org.login.ezproxy.library.ualberta.ca/action/displayFulltext?type=1&pd ftype=1&fid=815180&jid=PNS&volumeId=65&issueId=&aid=815168

42. Mager D & Pencharz P.B. Nutritional Considerations in Children with Developmental Disabilities. In: An Introduction to Developmental Disabilities in Ontario. Editor Front Porch Publishing, Toronto, Baltimore: Paul H Brookes Publishing Inc. Ontario 2011 (3^nd Edition).

43. Mascharenas M.R et al. Outpatient nutrition management of the neurologically impaired child.

Nutr Clin Prac 2008:23: 597-607.

44. Crary Ma, Groher M.E. Reinstituting Oral Feeding in Tube-Fed Adult Patients With Dysphagia.

Nutr Clin Prac 2006;21:576-586.

45. Garcia-Careaga M, Kerner JA. Gastrointestinal manifestations of food allergies in pediatric patients. Nut in Clin Practice 2005;20:526-535.

46. Volkert D, et al. ESPEN guidelines on enteral nutrition: geriatrics. Clin Nutrition 2006;25:330- 360.

*Note most readings are available through the U of A library electronic access via the following link. You can access this link through your University of Alberta ccid and password.

http://www.library.ualberta.ca/ejournals/search/index.cfm

Additional Readings (optional). These may or may not be available via your University of Alberta electronic journal links.

1. Fessler T.A, Trace Elements in Parenteral Nutrition: A practical guide for dosage and monitoring for adult patients. Nutr in Clinical Practice 2013: Vol 28(6): 722-729.

2. Kelly D.G., Tappenden K.A, Winkler M.F. Short bowel syndrome: highlights of patient

management, quality of life and survival. JPEN: 2013: 1-11. DOI: 10.1177/0148607113512678.

Advance on line Nov 2013.

3. Dhaliwal R, Cahil N, Lemieux M, Heyland D. The Canadian Critical Care Nutrition Guidelines in 2013. An update on Current Recommendations and Implementation Strategies. Nutr in Clinical Practice Advance on line Dec 2, 2013.

4. Corkins M.R. Griggs K.C, Groh-Wargo S, Han-Markey T.L. Helms R.A. Muir L.V, Szesycki E.E. Standards for Nutrition Support; Pediatric Hospitalized Patients. Nutrition in Clinical Practice 2013 Vol 28(2):263-276.

5. Chan, LN. Drug-Nutrient Interactions (Tutorial): JPEN; 2013 37(4):450-459.

6. Gura K. Is there still a role for peripheral total parenteral nutrition. Nutr Clin Prac 2009:709-717.

7. Nightingale, J, Woodward JM. Guidelines for management of patients with a short bowel. Gut 2006;55:1-12.

8. Malone A, Hamilton, C. The Academy of Nutrition and Dietetics/The American Society for Parenteral and Enteral Nutrition Concensus Malnutrition Characteristics: Application in Practice.

Nutr Clin Prac 2013, 28: 649-650.

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9. Promoting optimal monitoring of child growth in Canada: Using the WHO growth charts.

Collaborative Public Policy Statement: CPS, DC, College of Family Physicians of Canada, CHNC, BCC. 2013. www.dietiitans.ca

10. Nutrition for Healthy Term Infants - Statement of the Joint Working Group: Canadian Paediatric Society, Dietitians of Canada and Health Canada 2013.

http://www.hc-sc.gc.ca/fn-an/nutrition/infant-nourisson/recom/index-eng.php

11. Laubereau B, Brockow I, et al. Effect of breast feeding on the development of atopic dermatitis during the first 3 years of life-results from the Gini-Birth Cohort Study. J Pediat 2003;144:602- 607.

12. von Berg, A et al. Preventative effect of hydrolyzed infant formulas persists until age 6 years:

Long term results from the German Infant Nutritional Intervention (GINI) Study. J Allergy Clin Immunol 2008:121: 1442-1447.

13. Christie L, Hine J, Parker JG, Burks W. Food allergies in children affect nutrient intake and growth. J Am Diet Associ 2002; 102:1648-1651

14. Marshall WJ. Nutrition assessment: its role in nutrition support. J Clin Pathol 2008; 61:1083- 1088.

15. American Society for Parenteral and Enteral Nutrition: The Science and Practice of Nutrition Support-A Case Based Core Curriculum; 2006.

16. Modern Nutrition in Health and Disease, 10^th Edition. Lippincott Williams & Wilkins, 2010.

17. American Dietetic Association. Manual of Clinical Dietetics, 6^th Edition, Chicago: American Dietetic Association, 2000.

18. A.S.P.E.N. Ethics Position Paper Task Force, Albert Barrocas, Cynthia Geppert, Sharon M.

Durfee, Julie O'Sullivan Maillet Cheryl Monturo, Charles Mueller, Kathleen Stratton, Christina Valentine and A.S.P.E.N. Board of Directors Nutr Clin Pract 2010 25: 672

19. Ellinger S et al. Efficacy of vitamin supplementation in situations with wound healing disorders:

results from clinical intervention studies. Curr Opin Clin Nutr Metab Care 2009:12:588–595 20. Morag J. Andrew and Peter B. Sullivan Growth in Cerebral Palsy Nutr Clin Pract 2010 25: 357-

361.

21. Lochs, H, Dejon C. et al. ESPEN Guidelines on Enteral Nutrition : Gastroenterology. Clin Nutrition 2006;25:260-274.

22. Mitch WE, Maroni BJ. Factors causing malnutrition in patients with chronic uremia. Am J Kid Dis 1999:33:176-179.

23. Wooley JA, Btaiche I, Good KL. Metabolic and nutritional aspects of acute renal failure in critically ill patients requiring continuous renal replacement therapy. Nutr in Clin Practice 2005;20:176-191.

24. Rex O. Brown, Charlene Compher and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) Board of A.S.P.E.N. Clinical Guidelines : Nutrition Support in Adult Acute and Chronic Renal Failure JPEN J Parenter Enteral Nutr 2010 34: 366

25. Cichero J.A.Y, Steele, C, Duivestein J, Clave P, Chen J, Kayashita J, Dantas R, LEcko, C, Speyer R, Lam P, Murray J.M. The need for international terminology and definitions for texture-modified foods and thickened liquids used in dysphagia management: foundations of a global initiative. Curr Phys Med Rehabil Rep 2013: DOI: 1008/s40141-01300024-z.

26. Chernoff R. Tube feeding patients with dementia Nutr in Clin Practice 2006;21:142-146.

27. Alan H. Silverman Interdisciplinary Care for Feeding Problems in Children Nutr Clin Pract 2010 25: 160

28. Nutrition Care Process Update: Part 1 JADA; 2008;108(7):1113-1117.

29. Nutrition Care Process Update: Part 2 JADA; 2008;108(8):1287-1293

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M. Additional Information

1. Electronic Devices: Electronic devices during examinations are restricted. Only approved non- programmable calculators will be allowed. Please consult me regarding this issue PRIOR to any mid-term or final exam to avoid any problems with this during the exam. Programmable calculators are NOT allowed. Taping of lectures/lab-seminar cannot be done without prior permission of the TAs and the instructor. Permission must be obtained before each session. Calculators should be brought to all lectures and seminars as there are hands-on calculations that need to be performed.

2. Late assignment: Late assignments will be accepted, however a deduction of 10% per day late will be applied. For example, if an assignment is due on Monday at 4:00 pm, and it is received any time after that, up until 4 pm the next day, 10% will be deducted from the total mark. If it is late a second day, an additional 10% will be deducted and so on. If an assignment is worth 30% or 30 marks then a deduction of 10% is worth 3 marks. Only hard copies of assignments will be accepted. No faxed or email assignments. The assignments must be tightly stapled. No loose papers will be accepted.

3. Academic Integrity: Code of Student Behavior

“The University of Alberta is committed to the highest standards of academic integrity and honesty.

Students are expected to be familiar with these standards regarding academic honesty and to uphold the policies of the University in this respect. Students are particularly urged to familiarize themselves with the provisions of the Code of Student Behaviour (www.ualberta.ca/secretariat/appeals.htm) and avoid any behaviour which could potentially result in suspicions of cheating, plagiarism,

misrepresentation of facts and/or participation in an offence. Academic dishonesty is a serious offence and can result in suspension or expulsion from the University.” (GFC 2003)

Code of Student Behaviour

“All students at the University of Alberta are subject to the Code of Student Behaviour, as outlined at http://www.ualberta.ca/~unisecr/policy/sec30.html and on pages 652-672 on the 2005-2006 Calendar.

Please familiarize yourself with it and ensure that you do not participate in any inappropriate behavior as defined by the Code. Key components of the code include the following statements.

30.3.2(1) Plagiarism: No Student shall submit the words, ideas, images or data of another person as the Student’s own in any academic writing, essay, thesis, project, assignment, presentation or poster in a course or program of study.

30.3.2(2) c. No Student shall represent another’s substantial editorial or compositional assistance on an assignment as the Student’s own work.”

 Please speak to me if you have any questions or concerns about the Code, particularly as it pertains to team/group assignments, internet research using the same work as part of the assignments in more than one course, lab work and the definition of Plagiarism.

 Policy about course outlines can be found in section 23.4(2) of the University Calendar (GFC 29 Sept 2004).