Winter 2006 - University of Alberta

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1 Advanced Clinical Nutrition: NUTR 476

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

Winter 2018

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; Wednesdays 12-1:50 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 MSc RD Stephany Adame Perez MSc (cand) 2-021 Li Ka Shing Centre for Research [email protected]

Phone: 492-7687 Christy O’Donnell RD [email protected] [email protected]

Office hours to be held (course instructor) TA: Office Hours Monday 1-2.

2-021D in Clinical Research Unit Location: TBA Li Ka Shing Centre for Research

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2

Week: Tentative Lecture Schedule Lab

January 8-12 Enteral Nutrition: Adjunctive vs Treatment Readings 1-5

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

Surgical vs Medical Therapy devices/feeding pump/

Product tasting: SA

DVD patient simulations:

Enteral Calculation I

January 15-19 PN: How & when to order Readings: 6-10

Biochemical, Anthropometric and clinical Lab: PN calculations I

assessment TA: DRM

Complications of PN: liver disease, sepsis,

January 22-26 Cancer DRM, Refeeding Syndrome Lab work: CO

EN Calculations 2: SAP Readings 11-14

January 29-Feb1 ICU/Trauma and Burns Readings: 15-19 Lab: Enteral/PN II

Calculations: DRM

Feb 5-9 Hypermetabolism: ARDS/Pulmonary Disease Readings: 20-26 /Transplantation Review: DRM

Liver and small intestine

Assignment 1 (20%) due Feb 7, 2018 in seminar

Feb 12-16 ICU: chylothorax Readings: 27 Midterm: Feb 14, 2018-CO and DRM

Feb 19-22 Reading Week- No classes scheduled

Feb 26-Mar 2 Renal Disease: Role of the kidney Readings 28-31 Chronic Renal Failure/Renal Insufficiency Lab: Renal Diets I

Dialysis TA: DRM

Mar 5-9 Renal Disease II: Renal Transplantation Lab: Renal Diets II.

Cases: CRF/transplantation TA: CO

No lecture March 5th due to student union elections March 7: Dialysis Laura White RD

March 12-16 Pediatrics: Inborn Errors of Metabolism Readings 32-34 Case(s): PKU/Tyrosinemia/MSUD/ Lab: Metabolic

Galactosemia Disorders: S. St James

RD: DRM

March 14, 2018 (2:30-4) March 19-23 Pediatric Nutrition Assessment Readings 35-39

Full term vs prematurity Lab: Pediatric Assessment

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3

Use of PN vs Enteral DRM and CO

Failure to Thrive (FTT) DVD simulations

Case: Hypermetabolism Guest speaker: 3:30-5:00

Assignment 2 Due Wed March 21, 2018(20%) Home NS Program/pt visit.

March 26-30 TBA –Pediatric Clinical Cases & Lab Assessment CO Wed: 2-5

April 2-6 Developmental Disabilities Reading: 40-44

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

Dysphagia, Assessment

Gastroesophageal reflux disease (GERD) RD/SLP

Case: GERD and Dysphagia; IHEP Stanley Home Care No class Mon April 2; Easter Monday DVD Simulations:

TA: CO

April 9-13 Food Allergies & Hypersensitivities. Reading: 45-47 IgEvs non IgE mediated intolerances TA: DRM/CO

Case: Milk/Protein Soy Allergies with NCP SLP/RD: Dysphagia

Geriatrics (Last day of classes April 13, 2018)

E. Evaluation Date

Mid-term Exam: 25% February 14, 2018

Term Assignments*: 40% 2 assignments (20% and 20%) due Feb 14, March 21, 2018

Final Exam: 35% April 18, 2018

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.

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4 F. Summary Table 1 ICPEP for NUTR 476 (ADVANCED CLINICAL NUTRITION)*

*Dietitians of Canada and Alliance of Canadian Regulatory Bodies. 2013. The Integrated Competencies for Dietetic Education and Practice. This document is available at the Partnership for Dietetic Education and Practice Website at http://www.pdep.ca or Dietitians of Canada Website at http://www.dietitians.ca/About-Us/What-We-Do/Accreditation.aspx

ICDEP Foundational Knowledge Content

Area

Leve l

Instruction & Assessment Practice within limits of

professional knowledge & skills (1.04A)

Use of systematic approach to decision making (1.06G) Ensure appropriate and secure documentation (1.10F)

 Practice in a Regulated health professional (16B)

 Reflective Practice (16D)

 Appropriate Documentation Practices (16J)

2-3 Case based seminar with members of interdisciplinary health care team (RD, RN, SLP).

3.01: Assess Nutrition related risks and needs

3.01: A-H, J, M, Q-T, W-Y, AA, BB, DD, EE, GG, HH.

 Anatomy & Physiology (1A,C)

 Biochemistry (2D)

 Human Nutrition Across the Lifespan (8A-H)

 Inter-professional Collaboration (9A-D)

 Nutrition Assessment (12A-F)

 Nutrition Care Process and Medical Nutrition Therapy (13A- H)

 Pharmacology (14A-E)

3 Instruction:

 Case based seminars/lectures with interdisciplinary health care team in various clinical populations (in- patient and ambulatory).

 DVD case simulations/you tube.

 Direct Patient interactions (Home EN/Metabolics)

Assessment: Use of simulated medical charts (includes admissions/discharges and

ambulatory care) for Assignments.

Case based tests/exams.

3.02 Develop Nutrition Care Plans

3.02: C,E,G, I-M, O,W, CC,GG,HH

 Anatomy & Physiology (1A,C)

 Biochemistry (2D)

 Human Nutrition Across the Lifespan (8A-H)

 Pharmacology (14A-E)

3 Instruction:

 Case based seminars/lectures with interdisciplinary health care team in various clinical populations (in- patient and ambulatory).

 DVD case simulations/you tube.

 Direct Patient interactions (Home EN/Metabolics)

 Assessment: Use of simulated medical charts (includes admissions/discharges and

ambulatory care) for Assignments.

Case based tests/exams.

3.03 Manage Implementation of Nutrition Care Plans 3.03: A,B

3  As above.

 Nutrition Care Process in Charting (electronic health records).

3.04: Evaluate and monitor nutrition care plan as appropriate

3.04C

3  As above.

 Nutrition Care Process in charting.

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5 G. 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. If assignments are more than 10 calendar days late, then a grade of zero will be assigned. 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. Students must bring photo id with them to pick up their assignments outside of regularly scheduled classes.

Only hard copies of assignments will be accepted. No faxed or email assignments. The assignments must be tightly stapled. Assignments with clips and loose papers will be NOT be accepted. Assignments that are illegible will NOT be marked. Font size for typed assignments must be adhered to as specified in the assignment.

H. 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. Material from these seminars/labs WILL be included in the assignments/mid-terms/exams. The student is responsible to attend all of these seminars and all the material covered. Guest speakers in the seminar are NOT to be approached directly outside of the class times unless otherwise specified by the course instructor. Students should bring calculators to both lecture and labs as hands-on calculations will be done by students.

I. Student Marking requests regarding information about individual student grading will NOT be provided by email/telephone to students. This includes requests regarding final exam marks. 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.

J. Missed Mid-terms or Final Exam.

Students who are absent from mid-term exams due to illness only will NOT be provided with

alternative times to write the mid-term. Instead, the weight of the midterm will be added to the overall final exam (this will now be worth 60% of the entire grade for the course). No accommodation will be made for travel or outside commitments (other than illness) for missed midterms and a grade of zero will be assigned should the student miss the midterm for these reasons. All students must be approved through Academic and Student Programs in the Faculty of Agricultural, Life and Environmental Sciences to defer a final exam to the subsequent term. The timing of this exam will be contingent upon the Instructor and the availability of all of the students to write the exam in the subsequent semester. ONLY ONE TIME SLOT to write a deferred exam will be provided. Students are encouraged to contract the instructor in the first week of the subsequent semester regarding the scheduling of the deferred exam. Requests for remarking of illegible midterms or assignments will not be done.

K. 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.

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6 L. 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.

M. 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.

N. Reference Materials Required Readings*

Week 1: Nutrition Support: Enteral

1. Miller KR, McClave SA, Kiraly LN, Martingale RB, Benns MV. A tutorial on enteral access in adult patients in the hospitalized setting. JPEN: 2014:38(3):282-295.

http://pen.sagepub.com/content/38/3/282.full.pdf+html

2. Boullata J.I. et al. ASPEN Safe Practices for Enteral Nutrition Therapy. JPEN 2017:41:15-103.

Read pages 28-44; 62-67; 85-96.

http://journals.sagepub.com/doi/full/10.1177/0148607116673053

3. 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.

http://ncp.sagepub.com.login.ezproxy.library.ualberta.ca/content/25/1/16.full

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

http://journals.sagepub.com/doi/pdf/10.1177/0148607113488799

Competency #: Communication & Collaboration: 2.01e, 2.06 b, d, e, Nutrition Care: 3.01a-e, g-o, q- u, x-z, dd-hh, Nutrition Care Plans 3.02a-n, s-x, Implementation of Nutrition Care Plans 3.03 a, c, d, Evaluation and Modification of Care Plans: 3.04b-c.

Foundational Knowledge IC: IC 1A-C, 11A-B, 14A,E-G, 15C-H, 16A-K.

Week 2: Nutrition Support: PN

6. 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

7. Mundi MS, Nystrom EM, Hurley DL and McMahon MM. Management of Parenteral Nutrition in Hospitalized Adult Patients. Tutorial. Journal of Parenteral and Enteral Nutrition 2017:41(4):

535-549. http://journals.sagepub.com/doi/pdf/10.1177/0148607116667060

8. McMashon M.M, Nystronm E, Braunschweigh C, Compher, C and the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N); Board of Directors; ASPEN Clinical Guidelines:

Nutrition Support of Adult Patients with Hyperglycemia. JPEN 2013:37(1):23-36 (selected pages as per lecture). http://journals.sagepub.com/doi/pdf/10.1177/0148607112452001

9. McClave SA, DiBaise J.k. Mullen G, Martindate R.G. ACG Clinical Guideline: Nutrition

Therapy in the Adult Hospitalized Patient. Am J Gastroenterol 2016; 111:315–334;

http://www.nature.com/ajg/journal/v111/n3/pdf/ajg201628a.pdf (selected pages as per lectures).

10. 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

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7 Competency #: Communication & Collaboration: 2.01e, 2.06 b, d, e, Nutrition Care: 3.01a-e, g-o, q- u, x-z, dd-hh, Nutrition Care Plans 3.02a--x, Implementation of Nutrition Care Plans 3.03 a, c, d, Evaluation and Modification of Care Plans: 3.04b-c.

Foundational Knowledge IC: 1A-C, 2A,E, 11A-C, 14A-C, 15C-H,16A-E,16J-K, 17A-D.

Week 3: Cancer, Refeeding Syndrome, How to interpret blood work

11. 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.

12. Rousseau A , Losser M , Ichai C, Berger M.M. ESPEN endorsed guidelines: Nutritional therapy in burns. Clin Nutr 2013:32:497-502. http://ac.els-cdn.com/S0261561413000769/1-s2.0-

S0261561413000769-main.pdf?_tid=eaba647e-c30d-11e6-b048-

00000aab0f6c&acdnat=1481837702_8a7fa3d2b9068bfb3415e0d84b1762cd

13. Alessandro Lavianoa , Gianluca Di Lazzaro Giraldi A, and Angela Koverechb. Does nutrition support have a role in managing cancer cachexia? Curr Opin Support Pall Care 2016:10(4):288- 292.

14. Hukmann MB, August DA. Perioperative Nutrition Support in Cancer Patients. Nutrition in Clinical Practice 2012: 27(5). 581-591.

http://journals.sagepub.com/doi/pdf/10.1177/0884533612455203

Week 4: ICU/Trauma

15. McClave et al, 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 2016 : 40(2): 159–211

(selected pages as per lecture)

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

16. 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 2014 Feb;29(1):29-43 (selected pages as per lecture).

17. Massanet P.L, Petit, L, Louart B, Corne P, Richart C, Preiser JC. Nutrition Rehabilitation in the ICU. ASPEN Tutorial: JPEN 2015; 391-400.

19. Berger M. M and Olivier Pantet. Nutrition in Burn Injury; any recent changes? Curr Opin Clin Care 2016:11(4):285-290.

Competency #: Communication & Collaboration: 2.01e, 2.06 b, d, e, Nutrition Care: 3.01a-e, g-o, q- u, x-z, dd-hh, Nutrition Care Plans 3.02a--x, Implementation of Nutrition Care Plans 3.03 a, c, d, Evaluation and Modification of Care Plans: 3.04b-c.

Foundational Knowledge IC: 1A-C,2A-B,E, 11A-C, 14A-G, 15C0H, 16A-F, J-K, 17A-E.

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8 Week 5: Nutrition Support in Intestinal and Liver Failure/Burns/Pulmonary Disease

20. 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

21. Wales, PW, Allen, N, Worthington P, George D, Compher C, the American Society for Parenteral and Enteral Nutrition and Dan Teitelbaum. ASPEN Clinical Guidelines: Support of Pediatric Patients with Intestinal Failure at Risk of Parenteral Nutrition-Associated Liver Disease. JPEN 2014: 538-557. http://journals.sagepub.com/doi/pdf/10.1177/0148607114527772

22. Klek, S et al. Management of acute intestinal failure: A position paper from the European Society for Clinical Nutrition and Metabolism (ESPEN) Special Interest Group: Clinical Nutrition

35(2016):1200-1218.

http://www.espen.info/wp/wordpress/wp-content/uploads/2013/06/burns.pdf

24. Berger M. M and Olivier Pantet. Nutrition in Burn Injury; any recent changes? Curr Opin Clin Care 2016:11(4):285-290.

25. 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

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

Foundational Knowledge IC: 1A-C, 2A-B, 11A-C, 14A-G, 15C-H, 16A-F, J,K. 17A-C.

Week 6: Nutrition Support: Chylothorax Midterm

27. Sriram K, Nutrition Support in adults with chyle leaks. Nutrition 2016:32:281-286.

http://ac.els-cdn.com/S0899900715003378/1-s2.0-S0899900715003378- main.pdf?_tid=eb3d83e2-c315-11e6-8de8-

00000aacb360&acdnat=1481841139_d886e75b5bca63b13ca45bdc7f8240c4

Foundational Knowledge IC: 1A-C, 11A-C, 14A, E-G, 15C-H, 16F-K, 17A-C.

Week 7: Feb 20-28, 2017. READING WEEK (no classes).

Weeks 8 & 9: Nutrition Support in the Renal Patient

28. 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

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9 29. Steiber, A. Chronic Kidney Disease: Considerations for Nutrition Interventions. JPEN 2014:418-

426.http://pen.sagepub.com/content/38/4/418.full.pdf+html

30. Ayers P & Dixon C. Simple Acid-Base Tutorial. JPEN: 2012:36:18-23.

http://pen.sagepub.com/content/36/1/18.full.pdf+html

31. Mager DR, Jackson S.T, Hoffman M, Jindal K, Senior PA. Vitamin D3 Supplementation and Quality of life in adults with diabetes and chronic kidney disease: an RCT. Clin Nutr 2016:

advance on line June 1, 2016.

http://www.sciencedirect.com/science/article/pii/S026156141630108X

Foundational Knowledge IC: 1A-C, 2B-C, E, 11A-C, 14A-C, E-G, 15C-H, 16A-K, 17A-C.

Week 10: Nutrition Support in Inborn Errors of Metabolism.

32. Camp K.M, Lloyd-Puryear MA, Huntington K.L. Nutritional Treatment for Inborn Errors of Metabolism: Indications, Regulations and Availability of Medical Foods and Dietary

Supplements using PKU as an example. Mol Genet Metab 2012: 107(1-2): 3-9.

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

34. Frazier D.M, Allegeier C, Homer C, Marriage BJ, Ogata B, Rohr, Splett PL, Strernbridge A, Singh R. Nutrition management guideline for MSUD: An evidence-and consensus-based approach. Mol Gen & Metab 2014:112:210-217.

Competency # Communication & Collaboration: 2.01e, 2.06 b, d, e, Nutrition Care: 3.01a-e, g-o, q-u, x-z, dd-hh, Nutrition Care Plans 3.02a--x, Implementation of Nutrition Care Plans 3.03 a, c, d,

Evaluation and Modification of Care Plans: 3.04b-c.

Week 11: TBA

Week 12: Nutrition Support in Pediatrics

(Growth curves to be provided on Course Moodle site).

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

36. Corkins K.G, Teague E.E. Pediatric Nutrition Assessment: Anthropometrics to Zinc, Nutrition in Clinical Practice 2016:advance on line Dec 2. DOI: 10.1177/0884533616679639.

http://journals.sagepub.com.login.ezproxy.library.ualberta.ca/doi/pdf/10.1177/088453361667963 9

37. Kelly Green Corkins, Nutrition-Focused Physical Examination in Pediatric Patients. Nutr in Clin Practice 2015: 30(2):203-209. http://journals.sagepub.com/doi/pdf/10.1177/0884533615572654 38. Nutrition for Healthy Term Infants - Statement of the Joint Working Group: Canadian Paediatric

Society, Dietitians of Canada and Health Canada http://www.hc-sc.gc.ca/fn-an/nutrition/infant- nourisson/recom/index-eng.php

39. Critch J. Nutrition for healthy term infants: 6-24 months : An overviewPaediatr Child Health 2014;19(10):547-49. http://www.cps.ca/en/documents/position/nutrition-healthy-term-infants-6- to-24-months

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10 Foundational Knowledge: IC; 10A-B, 15A-H, 16A-K.

Week 13; Nutrition Support in Children and Adults with Neurological Impairment &

Dypsphagia

40. 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 2016 (4^nd Edition).

41. Edwards S, Davis AM, Mousa H, Bruce A, Lyman B, Cocjin J, Dean K, et al. Caring for the tube fed children; a review of management, tube weaning and emotional considerations. JPEN 2015:

DOI: 10.1177/0148607115577449

http://pen.sagepub.com/content/early/2015/03/13/0148607115577449.full.pdf+html

42. Edwards, S, McGrath Davis A, Ernst L, Sitzmann B, Bruce A, Keeler D, Almadhoun O, Mousa H, Hyman P. Interdisciplinary strategies for treating oral aversions in children. JPEN 2015;8990- 909.

43. Wilmskoeffer MS, Herbert MS, Bonitha HS. Factors Associated With Gastrostomy Tube Removal in Patients With Dysphagia After Stroke: A Review of the Literature . Nutr Clin Prac 2016: Advance on line August 2016 DOI: 10.1177/0884533616661012

44. Defining the role of the Dietitian in Dyshphagia Management and Treatment: Can J Diet Pract &

Res 2015: 76(2):100-103. http://www.dietitians.ca/Downloads/Public/Dysphagia-Role-Paper- 2015.aspx

Competency #: Communication & Collaboration: 2.01e, 2.06 b, d, e,

Nutrition Care: 3.01a-v, x-hh, Nutrition Care Plans: 3.02a-c, e-w, Implementation of Care Plan:

3.0a, c, d; Evaluation/Modification of Nutrition Care Plan: 3.04b, c.

Foundational Knowledge: IC; 10A-B, 15A-H, 16A-K.

Week 14: Nutrition Support in the Elderly/Food Allergies in Pediatrics.

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

46. Hanna J.S. Sarcopenia and critical illness: a deadly combination in the elderly. JPEN:2015:273- 281.

47. Fiocchi A, Dahdah A, Albarini B, Martelli A. Cow’s Milk Allergy in Children and Adults Chem Immunol Allergy. Basel, Karger, 2015, vol 101, pp 114–123 DOI: 10.1159/000375415

https://www.karger.com/Article/Pdf/375415

Foundational Knowledge: IC; 10A-B, 15A-H, 16A-K.

*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. This is the only way the above links will work.

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

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11 Additional Readings (optional). These may or may not be available via your University of

Alberta electronic journal links.

Nutrition Assessment

48. Malone A, Hamilton, C. The Academy of Nutrition and Dietetics/The American Society for Parenteral and Enteral Nutrition Consensus Malnutrition Characteristics: Application in Practice. Nutr Clin Prac 2013, 28: 649-650.

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

50. American Society for Parenteral and Enteral Nutrition: The Science and Practice of Nutrition Support-A Case Based Core Curriculum; 2012.

Parenteral Nutrition

51. Davila J, Konrad D. Metabolic complications of Home Parenteral Nutrition. Nutr Clin Pract 2017:32(6):753-768.

52. 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.

53. Shenkin A, Biochemical Monitoring of Nutrition Support. Ann Clin Biochem 2006;269-272.

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

55. Boullata JI, Gilbert K, Sacks G, et al. ASPEN Clinical Guidelines: Parenteral Nutrition, Ordering, Order Review, compounding, Labeling and Dispensing. JPEN 2014:344-377.

56. Choban, P, Dickerson R, Malone A, ASPEN Clinical Guidelines: Nutrition Support of the Hospitalized Adult Patients with Obesity: JPEN: 2013:37:714-744

Enteral Nutrition

57. Cotogni P, Enteral versus parenteral nutrition in cancer patients: evidences and controversies.

Ann Palliat Med 2016: 5(1):42-49.

58. Boullata JI, Gilbert K, Sacks G, et al. ASPEN Clinical Guidelines: Parenteral Nutrition, Ordering, Order Review, compounding, Labeling and Dispensing. JPEN 2014:344-377.

59. Chen, Y and Peterson SJ. Enteral Formulas: Which one is right for your adult patient. Nutr Clin Prac 2009; 24; 344

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

61. Forbes A et al. ESPEN guideline: Clinical nutrition in inflammatory bowel disease. Clin Nutr 36(2017):321-347.

Cancer and Refeeding Syndrome

62. ESPEN Clinical Guidelines for Patients with Cancer. Clin Nutr 2016:1-38.

http://dx.doi.org/10.1016/j.clnu.2016.07.015

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

64. Nelson G et al. . Implementation of Enhanced Recovery After Surgery (ERAS) Across a Provincial Healthcare System: The ERAS Alberta: Colorectal Surgery ExperienceWorld J Surg (2016) 40:1092–1103

Short Bowel & Transplantation

65. 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.

66. 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.

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68. 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.

69. 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

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

Pediatrics & Allergies

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Developmental Disabilities and Dysphagia

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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.

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 (online at www.governance.ualberta. ca) 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.”

Code of Student Behaviour

“All students at the University of Alberta are subject to the Code of Student Behaviour, as outlined at http://www.governance.ualberta.ca/en/CodesofConductandResidenceCommunityStandards/CodeofStu dentBehaviour.aspx.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) 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.”

Students should speak with the course instructor about any questions or concerns about the code.

Students should be particularly aware of the code as it pertains to internet and library research, use of previous class notes, reclamation plans of former students and interviews or discussions with others.

 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).