Quebec Naturopathic Physician Continuing Education

Hour 1

• Describe the general diagnostic criteria of Metabolic Syndrome and CVD.
• Demonstrate an understanding of the enhanced diagnostic criteria and the importance of investigating these potential earlier markers.
• Demystify the “Cholesterol and HDL hypothesis” and explain the compensation mechanisms of the body for this.
• Recognize the biometric and physical signs of the progressive nature of CVD, CHD and MetS.
• Investigate Lifestyle Modification Programs as the major intervention strategy for the reversal and stagnation of these comorbidities. 

• Describe the general dietary interventions of Metabolic Syndrome and CVD.
• Demonstrate an understanding of sodium/salt as it relates to CVD/HTN.
• Demystify the confusion of major supplements and foods as it relates to CVD/HTN. 
• Recognize the associations between insomnia and CVD, CHD and MetS.
• Investigate various peer reviewed studies and the outcomes of nutritional interventions.  

• Provide an understanding of the clinical applications of biochemical/metabolic evaluations to determine a patient’s hormonal status
• Explain the differences between various assessments of hormonal status
• Evaluate hormonal imbalances and disorders
• Evaluate nutrient needs in metabolic disorders Plan and monitor nutrient interventions to correct abnormalities found by the tests

• Describe the origin of mitochondria from an evolutionary perspective.
• Understand the critical role that the thyroid plays in metabolism and how this relates to healthy mitochondrial function.
• Explain how to test for mitochondrial function/dysfunction.
• Show how living in a thermos neutral modern society contributes to obesity.
• Recognize how antibiotics can damage mitochondria and how that can play a role in obesity.
• Give examples of toxins/drugs that can adversely affect mitochondria.

• Describe how common mitochondrial genetic problems are in the general population.
• Explain how mitochondria are needed to produce glutathione and why glutathione is needed for healthy mitochondria.
• Discover how oxidative stress can be both good and bad for the body.
• Discuss how mitochondrial dysfunction plays a key role in a variety of diseases ranging from Parkinson’s, Cancer, NASH, Alzheimer’s, Autism and Diabetes.
• Discover key ways to optimize mitochondrial function in patients.

• Describe the associations of micronutrient deficiencies as it relates mental health disorders.
• Demonstrate an understanding of major prescriptive medications and their negative influence on mental health disorders. 
• Explain the overlap of certain pathophysiological conditions and mental health disorders.
• Recognize the current lack of proper diagnosis of mental health disorder.

• Describe the associations of micronutrient and nutritional deficiencies as it relates mental health disorders.
• Demonstrate an understanding of the major biochemical pathways, their enzymes and nutritional elements as it relates to psychological issues.
• Explain the importance of fatty acids in mental health disorders.
• Recognize the current lack of proper nutritional interventions as it pertains to TBI, mTBI and PCS.

• Provide an understanding of the clinical applications of biochemical/metabolic evaluations to determine a patient’s status of nutrients, toxicants and cell regulators, and functional gastrointestinal status.
• Explain the differences between various assessments of element status
• Evaluate specific nutrient deficiency states
• Determine weaknesses in digestive, assimilative and intestinal microbiological status
• Plan and monitor nutrient interventions to correct abnormalities found by the tests

• Define and explain the difference between "calories in, calories out" versus the “carbohydrate-insulin model of obesity”. Discuss the causes of increased intestinal permeability in competitive athletes and identify strategies to combat the condition. Identify the energy intake athletes require by calculating their total energy expenditure.
• Recall the quality and function of macronutrients and their role in physical performance.
• Describe common micronutrient deficiencies seen in competitive athletes and identify strategies to prevent such occurrences.

• Summarize the physiological energy and macronutrient requirements of the sprint/power athlete and game-playing athlete. Identify supplement strategies to support the sprint/power athlete and game-playing athlete.
• Summarize the physiological energy and macronutrient requirements of the endurance athlete.
• Identify supplement strategies to support the endurance athlete.
• Outline an effective whole food diet to support competitive athletes.

• Describe the secondary metabolites in whole foods.
• Understand the role of phytochemicals.
• Demonstrate an understanding of how they interact with our cells.
• Explain how to preserve them during cooking.

• Recognize the challenges caused by ultra-processed foods
• Identify the compounds in the Brassicaceae family
• Explain the health benefits of sulforaphane
• Explain the importance of preserving secondary metabolites
• Recognize the benefits of the fungal kingdom

Hour 1

• Describe the characteristics and mechanisms of actions of essential oils.
• Explain several key controversies in aromatherapy and the implications.
• Generalize the safety and quality issues surrounding the clinical use of essential oils.
• Compare the various modes of applications of essential oils.
• Summarize the pharmacology and biotransformation of essential oils and its constituents.
• Recognize the potential interactions of essential oils with medications and nutraceuticals.

Hour 2 

• Generalize the various considerations for prescribing essential oils.
• Calculate equivalent dosages of essential oils using several different units of measurement.
• Apply the guidelines for appropriate prescribing the internal use of essential oils.
• Determine the proper application and dosage for various essential oils used for digestive health.
• Specify the usage and dose determination for essential oils for mental health.

• Analyze the concept of central pain processing and the consequences of dysfunction of descending inhibition.
• Associate FM with trauma and abuse, depression, anxiety, sleep disorder and pain processing disorders with emphasis on limbic system dysfunction, aberrant stress physiology, and ultimate failure of descending anti-nociception. 
• Assess the difference between regionalized somatic pain and true central allodynia
• Describe the accurate differential diagnosis of patients presenting with suspicion of FMS
• Identify common subsets of clinical disorders that may lead to an erroneous diagnosis of FMS (i.e., “pseudo” FMS)

• Describe and Identify the functional medicine approach to common pediatric problems
• Develop a comprehensive functional medicine assessment and treatment of common pediatric problems such as constipation, headaches and migraines, upper respiratory infections and otitis media, food sensitivities, allergies, asthma and atopy
• Examine the salient features of history, physical examination and laboratory testing to best implement functional medicine interventions to common pediatric problems
• Utilize a functional medicine approach to assess what each child may need to get or get rid of to treat each of these common pediatric problems 
• Summarize the literature supporting the use of functional medicine in pediatrics
• Recognize the four pillars of a functional medical approach to chronic pediatric illness – gastroenterologic, immunologic, metabolic and neurologic
• Classify and explain the importance of the genetic and genomic susceptibilities/predisposition and environmental triggers of chronic pediatric illnesses
• Utilize a functional medicine approach to assessing and treating chronic pediatric disease such as ADHD, Autism, Autoimmune Encephalitis, Anxiety, Allergy and Atopy
• Interpret the literature citations and develop protocols based on emerging evidence supporting a functional medicine approach to these chronic pediatric problems
• Appraise the assessment and management of the importance of the microbiome in immune tolerance, allergy and autoimmunity.

• Discuss the catecholamine pathway will be presented in an organized fashion with emphasis on real world applications. 
• Review clinical case studies. 
• Assess different genetic mutations within the catecholamine pathway . 
• Individualize treatment plans in practice. 
• Demonstrate a basic road map of the catecholamine pathway. 
• Use genetic parsing software and the tools attained form this course to highlight and modulate genes/SNPs of interest. 
• Derive natural therapeutic agents to modulate epigenetic expression. 
• Utilize basic nutrigenomic assessment and treatment knowledge in the catecholamine pathway.

• Define and explain the different terms that identify exercise intensity and their relationship to maximal oxygen uptake (VO2 max).
• Discuss the history of exercise physiology and how technology influenced research and ultimately, exercise guidelines.
• Differentiate the physiological responses to sprint interval training and to low-to-moderate intensity continuous training.
• Reconstruct a lay explanation to patients and/or clients of why sprint interval training is an extremely effective strategy for improving overall health and fitness.
• Summarize key research studies that support sprint interval training.

Hour 2

• Recognize additional research that supports sprint interval training.
• Identify key physiological benefits of sprint interval training.
• Recall important case study benefits.
• Outline effective overall strategies for implementing sprint interval training.
• Distinguish appropriate sprint interval exercises for differing populations.

Hour 1:

• Summarize the differences between genomics, genetics, and epigenetics
• Illustrate how genomics can affect risk and outcomes in auto-immune and inflammatory conditions
• Interpret relative function of genes based on presence of relevant SNPs
• Identify genes and SNPS involved in autoimmune disease and chronic inflammation
• Assess Dietary, Lifestyle and Herb/Nutrient recommendations based on genomics

 Hour 2:

• Apply nutritional genomics in autoimmune and inflammatory diseases
• Outline basic disease pathogenesis in autoimmune and inflammatory diseases
• Explain which genes and SNPs are relevant depending on the clinical scenario
• Assess other contributors to chronic inflammation and autoimmune disease

• Summarize the current state of legal status and research on fecal microbial transplants (FMT)
• Describe the state of research of FMT for irritable bowel syndrome
• Describe the state of research of FMT for hepatic encephalopathy
• Describe the state of research of FMT for antibiotic associated diarrhea/dysbiosis
• Describe the state of research of FMT for ulcerative colitis
• Describe the state of research of FMT for Clostridium difficile infection
• Describe the state of research of FMT for autism

• Define leaky gut
• Recall basic histology/molecular biology involved in leaky gut
• List conditions associated with leaky gut
• Compare diagnostic tools in the differential diagnosis of leaky gut
• Recite how the lactulose mannitol test works
• List therapeutic interventions for leaky gut

• Define Small Intestinal Bacterial Overgrowth (SIBO) 
• List common causes/ associations/risk factors of SIBO
• Recall the various estimates of SIBO prevalence
• Explain why SIBO prevalence estimates vary
• Describe the trajectory of SIBO research over the past decades

• Explain the limitations of using breath tests for the diagnosis of SIBO compared to other alternatives.
• Describe the specific issues with glucose-based breath tests for SIBO diagnosis.
• Describe the specific issues with lactulose-based breath tests for SIBO diagnosis.
• Critique the North American consensus document on breath testing for SIBO

• Implement the 2020 ACG Guidelines as it relates to breath testing for patients with IBS.
• Implement the 2020 ACG Guidelines as it relates to breath testing for patients taking PPIs.
• Discriminate between normal and abnormal ppm of H2S on a breath test.
• Contrast between the microbial diversity of the small intestine in those with and without SIBO.
• Identify the aberrant organism most associated with SIBO in the REIMAGINE study.
• Implement the 2020 ACG Guidelines as it relates to testing IBS patients for food sensitivities.
• Implement the 2020 ACG Guidelines as it relates to the use of low FODMAP diets in IBS patients.
• Select the Gut Directed Hypnotherapy regimen associated with the largest effect size.
• Explain the need for GRADE within the context of Guideline development.
• Critique a guideline using the AGREE-II criteria.
• Define the concepts of pre- and post-test probability.
• Calculate a post-test probability.

• Describe the role of GRADE in Guideline development
• Recall the recommendations of the ACG SIBO Guidelines
• Identify key concepts of SIBO as delineated by the authors
• Appraise the ACG Guidelines

• Recall the pathophysiology of the progression of Barrett’s esophagus to adenocarcinoma
• Implement the 2022 ACG guidelines on the use of PPIs for Barrett’s esophagus
• Evaluate the conclusions from the three competing meta-analyses on PPIs for Barrett’s
• Apply relative risk reduction calculations to the determination of the benefit of PPIs for Barrett’s

Hour 1

• Distinguish what gases are measured with Aire versus Aire2
• Judge the diagnostic agreement between Quintron and Aire devices in patients suspected of having SIBO
• Map the relationship between ‘fermentation scores’ and ppm
• Illustrate how you could use the Aire device to conduct formal SIBO breath tests

Hour 2

• Extrapolate hydrogen levels in the background of high methane
• Compare and contrast the pros and cons of using the Aire device
• Implement the clinician dashboard for breath testing
• Clarify why CO2 levels are not needed for Aire

• Recall the most common symptoms which H2S patients present with 
• Identify which H2S treatment interventions led to a statistically significant rate of adequate patient response 
• Evaluate an H2S SIBO case with a focus on severity and treatment history 
• Determine reasonable treatment options for an H2S SIBO case

• Examine the impact of sexual boundaries on the health care relationship
• Recognize the most common misconceptions about sexual boundaries
• Distinguish between sexual misconduct and sexual harassment
• Demonstrate the need for providing safety for patients
• Identify the inherent dangers of being in a power position

• Define sex abuse
• Identify the characteristics of an abused individual
• Appraise the effects of abuse on the health care relationship
• Create an individualized Patient Protection Protocol
• Develop office procedures and policies that will create a safe and comfortable environment for all patients

• Summarize the effect of exercise on wound healing in older adults
• Discuss the relationship between trunk muscle composition and functional capacity
• Assess the effects of high-intensity strength training on balance
• Describe a study that examines the reliability and validity of a new steadiness measure
• Assess the effect of an endurance exercise program on depression, anxiety and quality of life

• Summarize the concept of mitochondrial degeneration
• Discuss the free-radical mitochondrial theory of aging and the susceptibility of the brain to oxidative stress
• Assess the relationship between mitochondrial decay and age-related neurodegenerative diseases, such as Alzheimer's disease (AD) and Parkinson's disease (PD)
• Illustrate the array of mitochondrial nutrients and the various vitamins that may improve mitochondrial function

• Breakdown the biomechanical processes of spinal degeneration
• Explain the biochemical processes that occur in the geriatric population in 
• Differentiate between various diagnosis of structural and chemical conditions seen in geriatric patients
• Analyze the radiological findings and how they influence clinical decisions
• Explain Syndrome X and how it affects physiology
• Differentiate trauma and its late effects on the body

• This contains all courses with the educational objectives listed from Geriatrics 103 through 106

Hour 1

• Describe psychoneuroimmunology and its application to clinical diagnosis of geriatric patients
• Apply psychoneuroimmunology to activities of daily living

Hour 2

• Differentiate clinical approaches to managing psychoneuroimmunology
• Measure clinical treatment outcomes

Hour 3

• Relate what factors contribute to this field in the elderly patient
• Incorporate hormonal balancing with nutrition in clinical treatment plans for Chiropractic Patients

• Implement nutrients that promote spinal and joint function to obtain positive clinical outcomes
• Explain Ph., alkalinity and acidity as it impacts the physiology of the body in regards to healing
• Categorize toxins in the environment that create clinical presentations of  geriatric patients clinical care
• Utilize vitamins herbals and supplements to augment patients’ care
• Factor nutritional aspects of protein, fats and carbs into clinical treatment plans to improve healing
• Create treatment goals and nutritional plans

• Assess various treatment modalities
• Implement treatment protocols as found in the latest research
• Progress patients to incorporate wellness into their lifestyle
• Perform postural evaluations and discuss clinical significance to the patient
• Appropriately factor radiographic findings into diagnosis and clinical decision making of the geriatric patient
• Examine physical findings and set specific and measurable patient treatment goals