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Canadian Association of Cardiac Rehabilitation 20th Annual Meeting and Symposium Palais des congrès, Montreal, QC. Royal College and AACVPR CEC credits pending! Theme: Cardiac Rehabilitation from Policy to Patient Revised Program as of June 18, 2010 Thursday, October 21 18:30 PUBLIC FORUM - Café Scientifique: The Sodium Reduction Debate Co-hosts: CACR and Concordia University Friday, October 22 08:30 - 17:00 CACR ANNUAL BOARD OF DIRECTORS MEETING 19:00 – 21:00 Workshop: Advanced Motivational Interviewing Techniques Kim Lavoie Saturday, October 23 07:30 - 09:30 KELLOGG’S BREAKFAST EVENT Conference Opening Remarks - CACR President Nutrition Symposium – Nutritional challenges facing the aging boomer Paul Oh, CACR President, Toronto Rehabilitation Institute Jennifer Sygo, Cleveland Clinic Canada Presentation Summary This presentation will describe the development of the typical range of co-morbidities as a man and woman age from 45 to 75 and illustrate the importance of diet and nutrition to treat or prevent these common conditions. We will watch two boomers age, focusing on six main physiological/disease systems: musculoskeletal, digestive, endocrine, cancer, cardiovascular, neurological and other vascular conditions. Key evidence from recent clinical trials will be used to provide recommendations around top foods and nutrients that improve health and risk factors or prevent disease; guidance around foods to limit or avoid will also be provided. Objectives of Session 1. review the common health conditions affecting the “boomer” 2. provide evidence based recommendations around the impact of food and nutrition on six ket disease/physiological systems affected by ageing Dr. Paul Oh is the Medical Director of the Cardiac Rehab and Secondary Prevention Program at the Toronto Rehabilitation Institute where he has been very closely involved with program development, education, research and strategic planning for the program and hospital. He is an Assistant Professor in the Divisions of Clinical Pharmacology and Physiatry, Department of Medicine, University of Toronto and the current President of the CACR. 09:30 - 10:00 Posters, Displays and CACR Showcase Posters, Displays, Showcase area open Saturday 09:30 - 16:30; Sunday 09:30 - 13:00 Posters 1. What do Non-Rehab Cardiac Sciences Health Professionals Perceive of and know about Cardiac Rehab? - Lorraine J Avery 2. Patients Knowledge about Coronary Heart Disease: Comparison between Cardiac Rehabilitation Programs in Brazil and Canada - Gabriela Lima de Melo Ghisi 3. The English Validation of The Coronary Artery Disease Education Questionnaire: Cade-Q - Gabriela Lima de Melo Ghisi CACR 20th Annual Meeting and Symposium October 22 – 24, 2010 4. Screening for Obstructive Sleep Apnea in Patients in Phase II Cardiac Rehabilitation - A Preliminary Study - Philippe Blanc 5. Effect of the WII Sport Boxing Video Game on Heart Rate in Cardiac Patient - Philippe Blanc 6. The Importance of Physical Activity Measurement in Cardiac Rehabilitation - Chris Blanchard 7. Community Socioeconomic Status, Urban Sprawl, and the Perceived Environment's Relationship to Physical Activity during Home-Based Cardiac Rehabilitation - Chris Blanchard 8. The Role of Social Cognitive Variables during Hospitalization in Predicting Future Attendance in Cardiac Rehabilitation Programs - Suzanne Ferrier 9. Aboriginal Peoples with Cardiovascular Disease Receive the Greatest Benefits from Exercise Training - Heather Foulds 10. The Impact of Pre-Morbid and Post-Morbid Depression Onset on Mortality and Morbidity among Coronary Artery Disease Patients: A Meta-Analysis - Yvonne Leung 11. The Relationship between Body Image and Physical Activity in People Attending Cardiac Rehabilitation - Kathryn Lightfoot 12. Adherence to a Cardiac Rehabilitation Home Program Model of Care - a Comparison to a Traditional Program - Kerseri Naidoo 13. Is Social Integration Associated with Exercise Involvement in Coronary Heart Disease Patients? - Sandra Peláez 14. A Pilot Study of the Relationship between Dog Ownership and Physical Activity during Cardiac Rehabilitation - Mark Petter 15. Reliable Change Indices to Assess Progress of Individual Cardiac Rehabilitation Patients. II. Stress Testing: Exercise Capacity - Dr. Peter L. Prior 16. Women's Cardiac Rehabilitation Program Model Preferences: A Pilot Study - Cassandra Racco 17. Development and Psychometric Evaluation of a Theory of Planned Behavior Physical Activity Questionnaire for Individuals at Risk for Coronary Heart Disease - Dana Riley 18. Exercise for Women with Heart Failure: Systematic Review - Sheila Rizza 19. The Quit Smoking Program (QSP): Design, Patient Characteristics and Outcomes - Debbie Aitken 20. Measuring Barriers to Cardiac Rehabilitation Use: Conceptual Overlap and Uniqueness in Three Scales - Shamila Shanmugasegaram 21. Development of the French Version of the Cardiac Rehabilitation Barriers Scale - Shamila Shanmugasegaram 10:00 - 11:00 18th ANNUAL TERRY KAVANAGH LECTURE Sponsored by Cardiac Health Foundation of Canada TBA 11:00 - 12:00 CONCURRENT ORAL SESSIONS (3) CACR Annual Scientific Oral Presentations (9) Group 1: Measurement Reliable Change Indices to Assess Progress of Individual Cardiac Rehabilitation Patients. I. Psychometrics: Anxiety, Depression & Quality of Life - Dr. Peter L. Prior Integrating Self-Determination Theory (SDT) and Self-Efficacy Theory (SET) into a Comprehensive Model to Predict Physical Activity in Cardiac Rehabilitation Participants - Shane Sweet Using a Heart-Rate Walking Speed Index to Report Truer Physiological Changes When using Walking Performance Tests in Cardiac Rehabilitation - John Buckley Group 2: CR Services Degree and Correlates of Heart Failure Clinic Use - Shannon Gravely-Witte Risk Assessment in ACS Patients with Early Discharge and Access to Rehabilitation (RADAR) Pilot Project - Tracy Downie Implementation of Automatic Referral to Cardiac Rehabilitation: Predictors of Participation - Amy Mark Group 3: CR Results Improvement in Exercise Performance through Cardiac Rehabilitation (CR): Comparison of Exclusively Centre-Based CR with a Centre-to Home-based Transition CR - Candi Flynn The Impact of Physical Activity on Major Adverse Cardiovascular Events (MACE) - Amanda Rossi Effects of Nordic Pole Walking on Functional Status in Patients with Moderate to Severe Heart Failure: A Randomized Controlled Trial - Marja-Leena Keast Graduate Scholarship Awards Awards sponsored by Cardiac Health Foundation of Canada Masters Level Improvement in Exercise Performance through Cardiac Rehabilitation (CR): Comparison of Exclusively Centre-Based CR With a Centre-To Home-Based Transition CR- Candi Flynn PhD Level Degree and Correlates of Heart Failure Clinic Use - Shannon Gravely-Witte The Impact of Pre-Morbid and Post-Morbid Depression Onset on Mortality and Morbidity Among Coronary Artery Disease Patients: a Meta-Analysis - Yvonne Leung The Impact of Physical Activity on Major Adverse Cardiovascular Events (MACE) - Amanda Rossi CACR 20th Annual Meeting and Symposium 12:00 - 13:30 Lunch (provided) CACR ANNUAL GENERAL MEETING 13:30 - 14:30 WORKSHOP SESSION 1 (choose one) October 22 – 24, 2010 1. Exercice et le diabète – Thierry Gaudet-Savard (French session) Presentation Summary The presentation diabetes and Exercise aims to show what are the factors that determined the blood glucose levels responses to a single bout of exercise depending on the medication and the nutritional status. Objectives of Session Summary of the guidelines for exercise prescription in diabetic patients. Review of the factors influencing blood glucose variation with exercise. Understand the blood glucose level response to different type of exercises and in different nutritional status. Use the monitoring of blood glucose level to alert the patient and the clinician to take appropriate action to prevent or detect hypoglycemia. Evaluate the appropriate moment to exercise depending on the glycemic response of the patient Learn principles for adjusting medication dosages to exercise Exercise in nonoptimal glycemic control Thierry Gaudet-Savard is a graduate of Laval University in Quebec. He received his bachelor’s degree in Kinesiology and his master degree studying exercise training in Type 2 diabetes. He is certified by the American College of Sports Medicine as a Clinical Exercise Specialist. and by the Canadian Society for Exercise Physiology as Exercise Physiologist. He works as a Kinesiologist with diabetic, cardiac and pulmonary individuals at the rehabilitation center of the Institut universitaire de cardiologie et de pneumologie de Québec. He is a lecturer for the Faculty of Medicine of Laval University. He is the author of articles on blood glucose level responses to exercise in diabetic individuals 2. The Qualified Exercise Professional and Cardiac Rehabilitation: Introducing CSEP’s Advanced Modules for Cardiac Rehabilitation – Darren Warburton Presentation Summary Dr. Warburton will address the important role of the Qualified Exercise Professional in clinical exercise rehabilitation. He will highlight how recent advancements in our knowledge have enhanced greatly current practices in clinical exercise rehabilitation. He will discuss the Canadian Society for Exercise Physiology (CSEP) and the steps that have been taken to enhance the training of CSEP-certified members for work with various clinical populations. He will in particular highlight the advanced modules that were created recently by CSEP (in collaboration with the CACR) for work in cardiac rehabilitation settings. Objectives of Session At the end of this session, participants will be able to: 1. Understand the certification, training and foundational knowledge required to be considered a Qualified Exercise Professional. 2. Outline how recent advancements in clinical exercise rehabilitation have been used to improve the training of graduates of exercise science programs. 3. Demonstrate a clear understanding of the new advanced modules that have been created by CSEP for Qualified Exercise Professionals working in cardiac rehabilitation settings. Dr. Darren Warburton is the co-Director of the Physical Activity and Chronic Disease Prevention Unit at the University of British Columbia (UBC). He is also the founder and director of the Cardiovascular Physiology and Rehabilitation Laboratory at UBC and was the director of the Sport Cardiology and Musculoskeletal Assessment Research Team (SMART 2010) for the 2010 Olympic and Paralympic Games. He is also co-director of the Physical Activity Support Line (www.physicalactivityline.com). Dr. Warburton is a Canadian Institutes of Health Research (CIHR) New Investigator. He is currently a national executive member of the Canadian Society for Exercise Physiology (CSEP) Health & Fitness Program and the Canadian Association of Cardiac Rehabilitation. His research spans the spectrum of elite athletic performance, childhood health, quality of life in the elderly, and the treatment of patients with chronic disease and/or disability (including individuals with heart disease, cancer, diabetes, and spinal cord injury). Dr. Warburton has an impressive publication record in leading peer-reviewed journals including over 70 articles in the last three years. His laboratory has also received considerable research support including funding from the CIHR, the MSFHR, the Natural Sciences and Engineering Research Council of Canada (NSERC), the Canadian Breast Cancer Research Alliance, the Canadian Diabetes Association, the Canada Foundation for Innovation, the Social Sciences and Humanities Research Council of Canada, the Public Health Agency of Canada, and the BC Ministry of Health. For further information on Dr. Warburton and his research program please visit www.healthandphysicalactivity.com. CACR 20th Annual Meeting and Symposium October 22 – 24, 2010 3. Starting a CR Program – Agnes Cartier, with Emilie Chan-Thim and Amanda Rizk Presentation Summary An interactive workshop outlining the steps required to create a community based cardiac rehabilitation program from inception to implementation. Objectives of Session To inspire the development of similar community initiatives. Agnes Cartier, director of the West Island Cardiac Wellness Program has been a social work practitioner in the Quebec health care system for more than twenty years. As a graduate of the McGill University School of Social Work, her focus has been predominately in hospital settings. Her clinical experience ranges from psychiatry, geriatrics, cardiology and hemodialysis and includes individual, group and community work. This rich experience provided a strong foundation to develop the Cardiac Education and Support Program, a project which began in 1999 to educate recently diagnosed cardiac patients and their families. With the support and ongoing guidance of the Lakeshore General cardiologists, this program evolved into the West Island Cardiac Wellness Program. Partnering with community and corporate sponsors Ms Cartier has been able to provide a comprehensive cardiac rehabilitation program without cost to the patient, making the program accessible for those who need it. The growing demand and success of the West Island Cardiac Wellness Program continues. Patients who participate in the program become healthier with the secondary effect of diminishing costs for the health care system. We now see "graduates” of the Cardiac Wellness Program giving back as volunteers and more importantly empowered to make improved lifestyle choices; significantly decreasing the risk of a second cardiac event 4. Return to Work – Christine Foisy, Laura Cupper Presentation Summary The presentation will focus on the practical aspects of assessing an individual’s capacity to return to work. Clinical Scenarios will be used to demonstrate the step by step process to ensure a thorough and holistic approach when making return to work recommendations for patients from all cardiac fitness levels. Objectives of Session After the presentation the attendee will better understand: Using stress test results and exercise performance for work prescription Calculating functional activity levels Considering emotional and cognitive status as well as environmental factors at the work-site Facilitating a safe return to work Theory into practice: Case scenarios Christine Foisy, BScOT(c), OTR is the Clinical Specialist in Occupational Therapy for the Northern Alberta Cardiac Rehabilitation Program and a Clinical Lecturer with the Department of Rehabilitation Medicine at the University of Alberta (U of A). She has a varied clinical and leadership background including community, long term, and acute care in the USA and Canada. She is the coauthor of the Return to Work chapter in the 3rd Edition of the Canadian Guidelines for Cardiac Rehabilitation and Cardiovascular Disease Prevention. Laura Cupper has been a vocational rehabilitation counsellor with the University of Ottawa Heart Institute Minto Prevention & Rehabilitation Centre since 1983. She has published in the area of vocational assessment and rehabilitation for cardiac rehabilitation clients. She served on the Board of Directors of the American Association of Cardiovascular and Pulmonary Rehabilitation and the Canadian Association of Cardiac Rehabilitation. 14:30 - 15:30 WORKSHOP SESSION 2 (choose one) 1. Managing Economics and Growth in CR Programs – Martin Juneau; Anil Nigam Doctor Nigam is a preventive cardiologist at the cardiovascular prevention center of the Montreal Heart Institute (Centre ÉPIC), and an Associate Professor of Medicine at the University of Montreal. He performed his medical school training at the University of Ottawa and completed his internal medicine residency at the University of Alberta followed by his cardiology fellowship at the University of Montreal. He completed a 2-year fellowship in preventive cardiology at the Montreal Heart Institute. He also received a Master’s degree in Biomedical Sciences from the University of Montreal and an NIH-funded Degree in Clinical Research from Mayo Clinic Rochester. Dr. Nigam is a clinician-scientist of the Quebec Health Research Fund. His research is funded by the Montreal Heart Institute Foundation, the CIHR and the Heart and Stroke Foundation of Quebec. His research interests include cardiovascular nutrition and exercise training in high-risk populations. 2. Débuter un programme de réadaptation cardiaque – Agnes Cartier (French session), with Emilie Chan-Thim and CACR 20th Annual Meeting and Symposium October 22 – 24, 2010 Amanda Rizk (as Session 1) 3. Managing Drug Interactions in Your Clients – Paul Oh Presentation Summary This presentation will illustrate examples of drug interactions associated with the complex pharmacotherapy that is typical of the contemporary cardiovascular patient. The basic pharmacokinetic principles of absorption, distribution, metabolism and elimination will be used as the framework to demonstrate common sites of interactions. The important role of the hepatic cytochrome P450 system will be highlighted with specific case examples of commonly used drugs such as statins, calcium channel blockers, antiplatelet and gastroprotective agents. Useful reference sources around drug actions and interactions will be discussed. Objectives of Session 1. review pharmacokinetic principles – what is the disposition of a medication once ingested? 2. highlight the role of the drug metabolism cytochrome P450 system as a particular site for many important drug interactions 3. describe accessible sources of drug information 4. Diabetes and Exercise – Thierry Gaudet-Savard (as Session 1) 15:30 - 16:30 Reception and Sharing Library – sponsored by PERFORM Centre, Concordia University New: CR programs are invited to bring a sample of patient resources developed in-house that could be shared with other programs and via CACR online Resource Library 18:30 ANNUAL BANQUET AND SOCIAL EVENING (ticket required) Auberge (Hotel) Saint- Gabriel, 426 St-Gabriel St., Old Montreal Join your colleagues for an evening of networking, fine Montreal cuisine and dance the night away to local entertainment. Max capacity - 130 Sunday, October 24 08:30 - 09:00 COFFEE SERVICE 09:00 – 10:00 PLENARY SESSION National Issues in Cardiac Rehabilitation: Wait Times and Issues in Accessing CR Release of April/10 CACR Wait Time survey results Sherry Grace, York University Presentation Summary The CACR has been partnering with the Canadian Cardiovascular Society to understand and improve access for cardiac patients across the continuum of care to cardiac rehabilitation. Earlier this year a survey was undertaken of all CR programs nationally, to investigate patient access, program capacity and wait times. Results will be presented, including average wait times by cardiac condition, wait list prioritization and factors affecting wait times. Objectives of Session Upon completion of this session, the participants will be able to: 1. To apply performance measures to their CR programs to assess wait times and compare them to established targets. 2. Appraise factors affecting CR wait times. 3. Consider approaches to improve access and wait times in Canada. Dr. Sherry L. Grace is an Associate Professor in the School of Kinesiology and Health Science at York University, a Scientist with the Women’s Health Program at the Toronto General Research Institute, Behavioural Sciences and Health Division, an Adjunct Scientist with the Toronto Rehabilitation Institute, and a Research Scientist in Chronic Disease Management at York Central Hospital. She is also appointed as an Assistant Professor in the University of Toronto’s Faculty of Medicine, in the Psychiatry, Health & Disease Program of the Department of Psychiatry, and is affiliated with Graduate Department of Rehabilitation Sciences, and Heart & Stroke / Richard Lewar Centre of Excellence in Cardiovascular Research. She holds a New Investigator Award from the Canadian Institutes of Health Research. Her research interests lie in the areas of cardiac psychology and health services utilization, specifically referral and continuity in CACR 20th Annual Meeting and Symposium October 22 – 24, 2010 secondary preventive services for women and men with heart disease. She has held grant funding totaling approximately $6 million, has published approximately 75 peer-reviewed papers, and has collaborated on government reports (e.g., Women’s Health Surveillance Report, Ontario Women’s Health Status Report), and clinical practice guidelines (e.g., Canadian Guidelines for Cardiac Rehabilitation and Cardiovascular Disease Prevention). She is an Editorial Board member with the Journal of Cardiopulmonary Rehabilitation and Prevention. She is a previous Board member of the Canadian Association of Cardiac Rehabilitation. She serves on the Cardiac Care Network of Ontario Chronic Disease Management working committee and Canadian Cardiac Rehabilitation Registry Research sub-committee. CACR CR Registry Regional Rollout Results Neville Suskin, Registry Scientific Director Presentation Summary Update of “pilot” phase of CCRR Objectives of Session 1. Review rationale and progress of CCRR 2. Describe national roll-out strategy Dr. Suskin is a cardiologist at London Health Sciences Centre and Medical Director of the Cardiac Rehabilitation and Secondary Prevention Program. Dr. Suskin has a Master’s degree in Epidemiology and Biostatistics from the University of Western Ontario where he is currently an Associate Professor of Medicine. Dr. Suskin has held or holds a number of peer-reviewed grants evaluating different aspects of cardiac rehabilitation, including those specifically evaluating referral strategies for women and TIA populations. Dr. Suskin is past president of CACR and is currently Scientific Director of the Canadian Cardiac Rehabilitation Registry and Associate Editor of the 3rd Edition of the Canadian CR Guidelines. 10:00 - 10:30 CACR Showcase and Posters 10:30– 11:30 PLENARY SESSION The Global Perspective on Women and Heart Disease Louise Pilote, McGill University Objectives of Session To review sex differences in risk presentation, treatment and outcome of patients with ACS to explore novel aspects of coronary disease in women Dr. Louise Pilote is a Professor of Medicine at McGill University and the Director of the Division of General Internal Medicine at the McGill University Health Centre. She holds a James McGill Chair at McGill University and a research scholarship from the Fonds de Recherche en Santé du Quebec. She is a practicing Internist and Epidemiologist at the Montreal General Hospital. Dr. Pilote received her MDCM from McGill University. She then obtained an MPH from the Harvard School of Public Health and a PhD in Epidemiology at the University of California at Berkeley. Dr. Pilote's interests include cardiovascular epidemiology, outcomes research, and health services research. She is the PI for the GENESIS: an intercapacity enhancement team on gender and sex determinants of cardiovascular diseases funded by CIHR and the Heart and Stroke Foundation as well other studies related to access to care for patients with congestive heart failure, and pharmacoepidemiology studies of cardiac medications. She is also the lead investigator of the PRAXY (premature acute coronary syndrome in women and men) study, a large cohort study of patients with premature ACS. She has authored over 150 publications. She is a mother of 5 children. 11:30 - 12:30 PLENARY SESSION Exercise and Obesity John Buckley, President, British CR Association; Sponsored by Montreal Behavioural Medicine Centre Paul Poirier, Laval Hospital Presentation Summary We will cover the importance of exercise in weight loss and maintenance and talk about waist loss instead of weight loss. Assessment of adiposity will also be discussed. Objectives of Session To assess the impact of exercise on weight loss and weight maintenance. Paul Poirier is a graduate of Laval University. He received is bachelors degree in physical activity sciences and his masters degree in studying the role of exercise training in Type 2 diabetes. He obtained his MD in 1992 from Laval University where he completed specialty training in internal medicine and in cardiology, and a PhD in experimental medicine studying the role of exercise in diabetes. He pursued post-doctoral studies at the University of Colorado Health Sciences Centre in the Endocrine division under Dr Robert H. Eckel. He is an associate professor of the faculty of pharmacy. Board certified cardiologist, he was recruited for leadership of the cardiac prevention/rehab. program at l’Institut universitaire de cardiologie et de pneumologie de Québec. Dr Poirier has collaborated on a wide variety of basic science and clinical studies and clinical trials. Albeit his young career, Dr Poirier CACR 20th Annual Meeting and Symposium October 22 – 24, 2010 is an author or coauthor of more than 200 papers in peer reviewed journals, 200 abstracts, 25 chapter books and hundreds of presentations most of which are in the area of exercise, risk factors, obesity, diabetes and heart disease. He was the first author of the “American Heart Association Scientific Statement on the Pathogenesis and pathophysiology of obesity and its association with cardiovascular disease”. He is also past-chair of the Obesity Committee on the Council on Nutrition, Physical Activity and Metabolism of the AHA. He was part of the macrovascular subcommittee of the Canadian Diabetes Association for the Clinical Practice Guidelines for management of diabetes in Canada 2008. Dr Poirier has a long-term interest in exercise, obesity, diabetes and cardiomyopathy. 12:30 CACR CLOSING CEREMONY - WHAT HAVE WE LEARNED AND WHERE ARE WE GOING IN 2011? CACR President 12:30 - 14:00 Lunch, Poster Presentations and Exhibition (Palais des congrès) 14:00 – 16:00 CCC OPENING CEREMONY/HSFC LECTURE REGISTRATION IS NOW OPEN! (Be sure to register under CACR to ensure your registration fee goes directly to CACR using this link: http://cardiocongress.org/english/FeeTable_cacr.html) New: Conference Hotel accommodation is only available online and only after registering. See Conference web site for the hotel list. Other non-conference hotels can be booked by calling them directly. MEMBER EARLY BIRD REGISTRATION FEE: $320 until July 31 Early Bird Physician rate is $350. JOIN YOUR COLLEAGUES FOR THIS EXCEPTIONAL PROFESSIONAL DEVELOPMENT EVENT!