Physical Medicine and Rehabilitation



Physical Medicine and Rehabilitation, also known as Physiatry, is the branch of medicine concerned with the comprehensive diagnosis, medical management and rehabilitation of people of all ages with neuromusculoskeletal disorders and associated disabilities.  Physiatrists work in a diverse range of subspecialty areas to help patients with a variety of impairments related to conditions such as stroke acquired brain injuries, spinal cord injuries, amputation, and various musculoskeletal disorders.  Physiatrists play a vital role in our health care system and as the Canadian population continues to age, the demand for their services will only continue to grow.

School of Medicine Building recognized with award

Published Wed Dec 17/14 2:00pm.

Queen’s recently received awards for two of its new buildings – the School of Medicine Building picked up an Award of Merit in the City of Kingston’s Livable City Design Awards while the Isabel Bader Centre for the Performing Arts was recognized by the Frontenac Heritage Foundation at the 2014 Heritage Conservation Awards.

The Livable City Design Award highlighted the way the School of Medicine Building creates an “effective transition between the Sydenham Heritage Conservation District and the university campus.” The jury also pointed to the preservation of two heritage buildings on Barrie Street that were incorporated into the new structure.

Designed by Diamond Schmitt Architects in Toronto and in concert with local architects Shoalts and Zaback Architects, it was built by local construction firm M. Sullivan and Son Limited and opened in fall 2011.

The beauty of the building is in the details, points out Yvonne Holland, Director of Campus Planning for Queen’s.

“The architects designed an accessibility elevator that they installed in between the old and the new,” she says. “You can’t even see it from the street but it’s wonderfully designed. A lot of the historic features were restored and reconstructed to match the original appearance. It really is a fabulous state-of-the-art, 21st century facility that also respects the fact that it is in a deeply-historic area of our city.”


Ms. Holland says that while the design of the building respects the historic nature of the area it also provides a high-tech and contemporary facility for students, faculty and researchers. She also points out that the use of natural lighting creates an open feel and at night, with plenty of activity going on, the building lights up the whole corner, particularly in winter. The end product is something to be proud of, she says.

“I think from a project management perspective, nothing short of a Herculean effort was exercised here to make this happen,” she says. “This is not a conventional facility. This is a medical facility with labs and new teaching spaces, respecting the pedagogy that has changed of late.”

To the southwest, along Front Street, is the university’s newest addition – the Isabel Bader Centre for the Performing Arts.

A visual splendour designed by internationally-renowned architecture firm Snohetta, the Isabel also combines cutting-edge design with the preservation of heritage. 

The award citation points to the conserving of limestone walls and multi-pane windows at the former Morton’s Brewery site.

“(Heritage) is a key element for us and for the city in which we are situated,” Ms. Holland says. “We have 88 historic facilities here, which is more per capita than anywhere else, so we absolutely respect that as part of the fabric of our city.”

Ms. Holland explains that the recently-completed Campus Master Plan took close to two years to complete and that these two buildings, and the awards they have now garnered, are a validation of the process.

“Hundreds of people were involved including the city and other key community stakeholders, so it wasn’t just an inward-looking process , it was very much an outward-looking process she says. “Both of these facilities support the plan. I just think they’re magnificent.”

Dr. Alberto Neder's research helps people breathe easier

Published Mon Dec 15/14 2:00pm.

Few of us would equate the household chore of vacuuming with quality of life. But for people with heart and lung disease, quality of life often comes down to having the breath, to carry out those simple, everyday tasks.

“There is a close relationship between your physical capacity and your quality of life,” says Alberto Neder, a Queen’s University respirologist and clinician scientist at the Kingston General Hospital Research Institute. “Shortness of breath has a huge impact on that quality of life.”

Born and educated in Brazil, Dr. Neder is a leading expert in exercise and respiratory physiology. He was recruited to Queen’s and the KGH Research Institute last year from the Federal University of Sao Paulo, where he was a full professor, head of the institution’s respiratory division, and founder of a rehabilitation centre for patients with chronic cardiac and lung disease.

Dr. Neder’s research focuses on the interactions of lungs, heart, blood and cells, with the goal of better understanding the mechanisms that cause the breathlessness associated with diseases such as Chronic Obstructive Pulmonary Disorder (COPD) and congestive heart failure. His long-term goal is to improve his patients’ quality of life.

“We are interrogating the complex biological system that is the human body. We’re not looking at just one specific system, we’re looking at all of them, and how they work in an integrated manner,” he says. “And the best way to investigate these systems is when they are under the stress of physical exercise. It gives us information we can’t get when the body is at rest.”

To do this he has established the Laboratory of Clinical Exercise Physiology at Kingston General Hospital, the world’s first centre devoted to the study of the combination of lung-heart disease. Patients take part in physical activities such as riding a stationary bicycle or walking on a treadmill, enabling Dr. Neder and his team to monitor and assess the complete oxygen pathway through the body, from oxygen intake and blood distribution to the work done by their respiratory muscles.

“By looking at all of these interactions we can discover what’s going on in terms of insufficient oxygen to the tissues, and how it’s linked to the sensation of shortness of breath and general fatigue.”

Dr. Neder’s research asks potentially game-changing questions about treatments for this difficult disease combination, and he is currently recruiting patients for at least three innovative studies.  

One study assesses smokers with apparently normal lung function. The research aims to show, for the first time, early signs of COPD damage or malfunction to small lung vessels that are not apparent in conventional breathing tests. Currently little is known or done for those with COPD in its early, potentially reversible stages; this research could help to identify new treatments for early-stage COPD.

Another study, into congestive heart failure, explores the use of nitric oxide to improve blood flow to muscles including the heart and brain. Dr. Neder has begun the first randomized control study delivering concentrated beetroot juice, a natural nutrient that is rich in nitric oxide, to heart failure patients. “It has been used to enhance athletic performance, and now there’s the potential to use it as a health product,” he says.

“It’s about the benefits of keeping moving,” says Dr. Neder. “It makes a lot of difference, especially when you get older.”

Implications of Implantable Cardioverter Defibrillators (ICDs) in Palliative Care Patient

Published Tue Dec 02/14 9:00am.
Presenter: Dr. Jaimi Heidman, Palliative Medicine PGY3

0800-0900
Friday December 5, 2014
36 Barrie Street

Objectives:

1. Examine important issues surrounding the use of ICDs in palliative care patients

2. Identify factors that influence decisions on ICD deactivation

3. Discuss an approach to discuss goals of care and patient wishes regarding continued ICD use vs deactivation

Flyer attached here.

Physician Hastened Death: Spiritual Considerations

Published Fri Nov 21/14 11:00am.
Presenter: Neil Elford

DMin, CASC Teaching Supervisor (PCE/CPE), Director for Spiritual Health, Mission and Ethics

0800-0900
Friday November 28, 2014
36 Barrie Street

Objectives:

  • Exploration of what influences spiritual considerations
  • Discussion about spiritual considerations in conversations with patients and their loved ones
  • Identifying spiritual distress in health care providers
  • Recommendations for clinical practice
Flyer attached.
Presentation slides attached here.

Resident Safety and Travel

Published Wed Nov 19/14 2:00pm.
As winter is approaching, residents are reminded that their personal safety and travel is covered in the Resident Health and Safety policy.  Section 5 of the policy covers safety and travel and includes the following points:

5.7 - A resident may elect not to attend their academic half-day, clinic, etc. if in his/her estimation, it would not be safe to travel because of weather.

5.7.1- The resident must inform the appropriate person as soon as possible of absences due to inclement weather.

The entire policy can be viewed online.

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