Primary Contact Spring 2016

Spring 2016

Reaching beyond borders Highlights from the Research Symposium In conversation with Kim Humphreys Outreach Abroad

A publication from the Canadian Memorial Chiropractic College for alumni, members and friends

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From the Chair CMCC has been a hub of scholarly and social activity to begin the year; some of the highlights have included CMCC’s Research Symposium, held on February 27 and 28.

To adjust or not to adjust: Chiropractic Management of Lumbar Disc Protrusion/ Disc Herniation was a sold out event, during which speakers from across Canada, the US and Europe shared their experience of this controversial topic. For those of you who were unable to join us, the Symposium will be made available online through CE. Please watch for its availability.

The Board of Governors was proud to celebrate the Class of 2016 during our annual reception while we gathered for our semi-annual meeting in April. This year’s event, “An Evening Affair,” included the presentation of the Graduation Citizenship Awards. Congratulations to our soon to be colleagues, who are already demonstrating commendable leadership and patient care skills. I look forward to reading about many of you in the coming issues of Primary Contact.

Following on the heels of our meeting was our popular Backs in Motion Run/Walk in support of chiropractic education, research and patient care. This year CMCC celebrated its 33rd event; and as in past years, the CMCC Board has been working diligently to meet its fundraising goals.

If you haven’t yet donated, please consider a donation through the Board at cmcc.ca/dgryfe. To those of you who have contributed to CMCC through this event, either this year or in years gone by, I speak for the entire Board in thanking you for your generosity.

If golfing is more your style, I invite chiropractors in Ontario and British Columbia to join us in our annual BackSwing golf tournaments. BC BackSwing took place May 17 this year, while Ontario BackSwing takes place September 15. To find out how to register for the Ontario event, please see the ad on the back cover of this issue.

While I am looking forward to an even greater number of golf tournaments across the country, I am excited about CMCC’s expansion into softball with Bat Crackers, CMCC’s inaugural softball tournament to be held Sunday, August 28 at Milliken Mills Park in Markham. I hope that many of you in the GTA will be able to join us.

There’s so much to enjoy as a member of CMCC, please keep in touch and stay involved.

To contact any member of the Board, please email board@cmcc.ca.

Spring 2016

Volume 53, Issue 2

02 From the President 04 CMCC News 06 In the Community 08 The Dr. Rick Mozell and Family Anatomy Department

10 Graduating Class of Toronto Chiropractic College 1920

12 Tribute night honours Drs. Jay Triano and Marion McGregor

14 In conversation with Dr. Kim Humphreys

18 Chiropractic management of lumbar disc protrusion/herniation

20 Practice OpportUnity 2016 21 Outreach Abroad 22 Passage 23 In Memoriam 25 NDI ranked as one of the most influential publications within cervical spine research

26 Backs in Motion 2016 27 Donations

From the President Research is creating new knowledge.

Neil Armstrong

David Wickes, DC, MA

This issue of Primary Contact looks at ways that CMCC has reached out and touched the lives of many persons around the globe. In February, we paid tribute to two of our senior CMCC scientists, Drs. Triano and McGregor, who have sadly decided to retire. An article in this edition of PC looks at how dozens of friends and colleagues attended a dinner in their honour to reflect upon the impact their research has had on our profession, not just in Canada, but across the world. This event was part of the highly successful biennial CMCC Research Symposium.

Our students continue to demonstrate their commitment to the profession and to society. The annual Students’ Council charity gala provided a superb blend of Gatsby-inspired fun and fundraising to support the Arthritis Society.

These are the chiropractors of the future and they continue to do us proud.

Students and faculty traveled again this year to the Dominican Republic to provide chiropractic care. Our Outreach Abroad program provided care at temporary clinics to over 1,000 patients in 12 days this April and we plan to have an even bigger presence in the future. You are sure to enjoy the photos of the trip, taken by one of the participating students.

The group visited a number of rural locations, often working through language barriers and without electricity, but not without rewards.

At this year’s annual North American chiropractic educational conference held by the Association of Chiropractic Colleges (ACC), CMCC had a significant presence.

Roughly two dozen papers,

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Go green You can reduce your carbon footprint and read Primary Contact in a digital format (PDF) instead of receiving a paper copy.

Email us at communications@cmcc.ca and we’ll make the switch for you.

workshops and posters were presented by our faculty. Some of our students who were involved in faculty research projects were also present. CMCC again won a larger number of awards for scientific papers than any other chiropractic institution. The 2017 conference will be held in Washington, DC, and will be a monumental undertaking for the profession, combining the ACC educational conference, the World Federation of Chiropractic Congress, and the American Chiropractic Association’s National Chiropractic Leadership Conference. CMCC will again be well represented at that conference.

Not only does CMCC touch the lives of so many around the world, we are also very fortunate to have many people reach out to CMCC to help us meet our mission. In this edition, we look at how a major contribution to

CMCC by the Mozell Family almost 10 years ago boosted our Capital Campaign and helped us create a sophisticated anatomy teaching laboratory.

Almost every day I find myself writing notes of thanks to donors who thoughtfully support CMCC. All of us received an education that was supported by the gifts and sacrifices of those coming before us, and for that we are eternally grateful.

With this issue The 2017-18 Admission Brochure has been mailed to CMCC members along with this issue of Primary Contact. It invites potential students of chiropractic to consider CMCC as their choice for professional education. Please share it with individuals who show interest in pursuing an education in chiropractic. If you would like additional copies, please contact admissions@cmcc.ca or call us toll free at 1 800 463 2923.

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CMCC News ACC RAC honours The Association of Chiropractic Colleges (ACC) and Research Agenda Conference (RAC) was held March 17 through 19 in Orlando, Florida. ACC, the scientific/educational portion of the conference emphasizes educational structure and teaching while RAC focusses on the development of scientific knowledge and skills through workshops and platform sessions.

The 2016 conference theme was best practices, developing quality chiropractic education, research, and clinical care to promote best outcomes. As has become a tradition, CMCC faculty and students contributed significantly to the success of the conference. This year CMCC representatives made 16 scientific research submissions and hosted three workshops.

Overall, CMCC received five awards for scientific research: Drs. Marion McGregor, Alexandra Neilsen, Chadwick Chung, Silvano Mior, Wayne Wakeland, and Mr. Mark Fillery for Chiropractic care in a system dynamics model for minimizing opioid abuse for chronic non-malignant pain patients.

Drs. Steven Lester, David Starmer, Gregor Ruhr, Dominic Giuliano,

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Brynne Stainsby, Natalie Labelle and Jay Triano for Differences in force development rate of HVLA based on computation method.

Drs. Spencer Bell, Jay Triano, Kevin D’Angelo, Greg Kawchuk and Samuel Howarth for Procedure selection and patient positioning influence spine kinematics during high-velocity low-amplitude spinal manipulation applied to the low back.

Drs. McGregor and Triano each received a lifetime achievement award in recognition of their years of work and research to advance the chiropractic profession.

Dr. Triano also received a Certificate of Appreciation from the Veterans Association for his work in chiropractic care and research and his commitment to the profession, as well as for the advancement of future generations of chiropractors.

Congratulations to all who participated in the annual conference and represented CMCC through their submissions and presentations.

Putting CMCC on the map On Tuesday, March 22, CMCC invited Google to capture some of the interior features of the building and in so doing, to help put CMCC, its educational and research programs, clinic and bookstore, on the map.

Once live, viewers of Google Streetview will have the opportunity to take a virtual tour inside key areas of the campus.

In selecting the initial areas featured on the tour, we chose laboratories, equipment and spaces that would illustrate the depth of the program and provide a snapshot of the facilities and clinic. To view the new Google Street View presence, “google” CMCC, 6100 Leslie Street and choose the Google Map option.

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Last on Jeopardy!

There will no longer be any Canadians answering Alex Trebek in the form of a question on Jeopardy!, for the foreseeable future, but who was the last contestant from the Great White North to appear on the hit trivia game show? That would be CMCC microbiology instructor Dr. Victor Ferreira.

Jeopardy! closed its doors to Canadian contestants after the Canadian government introduced anti-spam legislation on July 1, 2014. Producers from the hit trivia show felt they were unable to change the online tests potential contestants must fill out to meet the new Canadian regulations. Those who had qualified as a contestant prior to the change in legislation were still able to compete though, hence Ferreira’s appearance. The episode featuring Ferreira aired on Friday, March 11, 2016.

Students’ Council Great Gatsby Gala The 2016 CMCC Students’ Council gala featured a Great Gatsby theme and raised close to $5,000 for the Arthritis Society. According to Council Social Director Michelle Cruikshank, the theme was inspired by the elegant design of The Eglinton Grand where the benefit was held.

Students’ Council chose the Arthritis Society for its natural association to chiropractic and to help establish a bridge between the organization and the chiropractic profession.

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In the Community David Millar receives Governor General Award Congratulations to CMCC alumnus Dr. David Millar, a 2016 recipient of the Governor General’s Caring Canadian Award. For over 30 years, Millar has been an active volunteer at the community, provincial and national levels. He has served on several boards including those of Sask Sport, the Saskatchewan Arts Board, the Chiropractors' Association of Saskatchewan, Rowing Canada Aviron, the Saskatchewan Rowing Association, the Regina Rowing Club and the Canadian Mental Health Association. His dedication to working with others and supporting numerous beneficial causes is inspiring.

Millar (Class of ’76) currently practices at Avord Chiropractic in Regina alongside Drs. Steve White (Class of ’94) and Ryan Dubusschere (Class of ’03)

Harmony Miraliakbari, Top 40 under 40 in Kelowna, BC Congratulations to Dr. Harmony Miraliakbari, (Class of ’12), recently featured in the Kelowna Daily Courier as a Top 40 under 40 nominee. The paper profiles community members who are making an impact through business, innovation and community involvement.

Miraliakbari (who goes by Dr. Mir) has been in Kelowna since 2014 and owns Harmony Chiropractic Clinic Inc., a family wellness practice where Mir emphasizes with her patients the need to make health their number one priority, despite the competing demands of their lives.

Although Mir treats all ages, she has a special interest in paediatrics and working with pregnant women. She began taking courses through the International Chiropractic Pediatric Association after graduation to help gain knowledge and confidence in the area, and grew to love it. Her work with children extends to interacting with youth in her community and speaking to groups and young people about her own path through the educational system.

Originally a music student, Mir changed her career path to chiropractic after she sustained an injury in varsity X-Country for which she underwent treatment. Her running coach was also a chiropractor, so she had the opportunity to learn from him before deciding to switch her studies to chiropractic. She moved to Kelowna in 2014 after two years of practice in Toronto, and she hasn’t looked back.

Dr. David Miller with the Right Honourable David Johnston, Governor General

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says Wickens. "I was so impressed with this drugless profession which promotes ‘feel better, function higher’ that I decided that chiropractic was what I wanted to do, too. I had an honours BSc in physiology so returning to school was an easy fit. I would be retired now if I had stayed in the government but I cannot imagine ever totally retiring from chiropractic. I love making a difference in people’s lives and as a chiropractor I get to do that each and every day."

Dr. Harmony Mir

“Although I originally moved to Kelowna to be with family,” says Mir, “ I have found it to be the best choice, professionally. It has brought a balance to my life – a support system that allows me to focus on business and the great quality of life that Kelowna offers. I feel blessed to call it my home.”

Center in Perth, Ontario. She began her career in chiropractic following 10 years of employment with the Federal Government.

Her career change was inspired by the chiropractic treatment she received for daily headaches. “A colleague sent me to Dr. Jean Chagnon in Orleans, Ontario,”

Wickens operates a multidisciplinary practice with Dr. Elizabeth Carter (Class of ‘14). The Chiropractic Care & Longevity Center offers chiropractic, massage, fitness and nutrition consultation. As part of their 25th anniversary, the clinic plans to ‘give back’ to the local community and is planning a walk/run event on Saturday, October 1, 2016.

The event will raise money to support the Lanark County Alzheimer’s Society and the local Habitat for Humanity chapter.

Mir still finds time for music and the performance arts – both on a personal level and as a chiropractor who treats musicians and dancers.

She plays a number of instruments, and says it is not uncommon for patients in the waiting room to hear her singing.

She says for her, “success is being happy and content. Go for happiness first, and then everything falls into alignment.”

Kathy Wickens celebrates 25 years Congratulations to Dr. Kathy Wickens (Class of ’91) who celebrates her 25 year practice anniversary this year. Wickens owns Chiropractic Care & Longevity

Staff at Chiropractic Care and Longevity Center. Back row left to right: Dr. Elizabeth Carter, Sarah Salisbury, Kaitlyn Ryan, Dr. Kathy Wickens Front row: Alanna Dyer and Ashley Finnigan

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The Dr. Rick Mozell and Family Anatomy Department John (Sam) and Bev Mozell of Calgary, AB, chose to contribute to CMCC’s building fund in 2006, soon after CMCC had moved into its new 6100 Leslie Street Campus location. Their generous $500,000 donation, received at a crucial time in the life of the building, enabled CMCC to devote considerable resources to ensuring students had the best equipment at their disposal. In providing this generous gift, the Mozells created a legacy for their son, Dr. Rick Mozell (Class of ’89), and family.

The Mozell family elected to have their donation recognized through CMCC’s state of the art anatomy laboratory – a facility created around the specific needs of studying the human body to provide a grounding in anatomy, an essential skill for chiropractors and other health care professionals to become competent diagnosticians. The Dr. Rick Mozell and Family Anatomy Department now houses a laboratory, an anatomy museum and a bone library in addition to a separate area for body preparation.

In short, the customized laboratory includes: • movable overhead lights • a video system and overhead screens for demonstration purposes • customized, movable stainless steel tables • an anatomy museum for the study of prosected specimens • a bone library • an embalming room These specifications were requested by the former Chair of the Anatomy Department, Dr. Peter Cauwenbergs upon the move of the laboratory from CMCC’s former address at 1900 Bayview Avenue. He considered the very practical considerations involving the transportation, preparation and display of cadavers.

Life before 6100 Leslie It all happened after Dr. Rick Mozell graduated with the Class of '89. Always interested in health care and life sciences, he remembers combing through medical

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Dr. Rick Mozell, with his wife Michelle, sons Cade and Dexton, and family dog Nazzy

textbooks as a kid, lifting the plastic film on medical illustrations to reveal the different layers of anatomy underneath.

“I remember I also had a great dentist. I was one of the few kids who didn’t mind going to the dentist and thought about pursuing dentistry. However, some years later, I hurt my neck and my parents took me to their chiropractor, Dr. Murray Bowman for treatment. As time went by and I learned more about health, the whole body approach really began to appeal to me.”

“It was Dr. Bowman, a graduate of Palmer College of Chiropractic, who encouraged my father to support CMCC as he did himself, and always said though he wasn’t a CMCC graduate, that if you lived in Canada, you had to support the education here, and I agree. The level of education at CMCC was and is fantastic. I will add that it’s so important that Canada stays strong within the profession and continues to graduate chiropractors.”

“I was always surprised at how well CMCC did at its Bayview location. It seemed so small, but the level of instruction was marvelous. The anatomy lab at Bayview held about 15 cadavers and I remember being taught anatomy by Mr. Roy Webb and Dr. John Duckworth, an MD who taught at the University of Toronto and then came to CMCC. He was a genius. I remember he used to ride to school on a scooter and was ambidextrous.“

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From Wild Rose country to the outback to Beautiful BC After graduation, Mozell worked a number of locums in Alberta before deciding to spend a short time in Australia, visiting his sister. “While I was there, I realized how well regarded chiropractic is in Australia.

A degree from CMCC is a golden ticket anywhere, so I decided to stay.”

“It was another CMCC connection, Dr. Ray Sherman (Class of ’60), who vouched for me in Australia.

Ray taught radiology at CMCC and used to spend the cold half of the Canadian year in Australia. He would entice a CMCC student to spend six months in Australia once he or she had graduated. Each time he was back at CMCC, he recruited for the following year. He was hilarious because the slides he showed us featured beautiful Australian women – presumably to entice the men in the class.”

Captivated by the weather and lifestyle, Mozell and his wife, Michelle, stayed in Australia six years before returning to Canada.

“We missed the seasons,” he says.

The family returned to Alberta but were attracted to BC — again by the weather and lifestyle — as well as an opportunity for their two sons, Dexton and Cade, to more easily pursue their love of hockey at a dedicated school.

He began looking for a practice in BC’s Okanagan Valley and was able to connect with Dr. Terry Brown (Class of ’80), who was getting ready to retire. They came to an agreement that included retaining an experienced staff of four. It’s a situation he feels very fortunate to have found.

minded. Medical people routinely recommend chiropractic. In Alberta, that was not the case and starting that sort of referral relationship was more difficult. Here, it’s a different approach.“ “On a personal note, if you like being outdoors, there is a huge incentive to stay healthy here,” he says. “We live in Penticton, which is sandwiched between two lakes with mountains in one of the remaining four corners. Everyone in my family is so happy about living here. It’s a very positive experience. Even the dog was different when we moved here!”

The family moved cautiously, but 'loved it,' he says, 'from the get go.'

“I enjoy life in BC very much and find the people very open

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Designing Graduating Class of the the lab Toronto Chiropractic College 1920 According to Dr. Peter Cauwenbergs, with the move to Leslie Street in 2004, the upgrades to the anatomy laboratory had already made CMCC’s department the envy of some of the other schools. The lighting he says, made a huge difference.

“In recreating the lab at the Leslie Street campus, we considered how best to receive the body donations.

We accommodated the process of receiving the bodies through automobile access into a special area of the lab,” says Cauwenbergs.

“We thought about how to move them (hydraulic lifts), the best types of tables (durable stainless steel with swiveling wheels for easy maneuvering) and had dental lights installed so we could focus on specific areas of the anatomy.

We also had an audiovisual system installed so that group demonstrations were possible.”

As Chair of Anatomy at the time, Cauwenbergs handled every aspect of the body donation process as well. “It was a very rewarding process to be a part of,” he says, “which often began with a phone call directly from the donor."

For their part, the donors each play an unparalleled part in the education of chiropractic students and student groups who come into the facility to work specifically in the Dr. Rick Mozell and Family Anatomy Department.

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Before the Dominion Council of Chiropractors worked to establish a national association for chiropractic in Canada (known today as the Canadian Chiropractic Association) which would support CMCC in its development and success, a number of smaller, independent chiropractic colleges were formed in Canada.

Although these were short lived, they helped establish a pioneering group of chiropractors in the country.

This photograph, provided by Dr. John McRae (Class of ’60), shows the 1920 Graduating Class of the

Toronto Chiropractic College and includes his father, Dr. Thomas McCrae and Dr. Harry Yates. Yates became a member of the Dominion Council and helped to found CMCC. Thomas McCrae’s history has been captured by his son, Dr. John MacRae and can be read online at: cmcc.ca/HistoryofThomasMcCraeDC. His interesting story begins in 1892 and moves through the 1950s, reflecting the changing backdrop of life as well as the challenges still recognizable today.

CMCC’s inaugural softball tournament fundraiser

Bat Crackers

Sunday, August 28, 2016

Media sponsor

Register at cmcc.ca/batcrackers Milliken Mills Park Markham, Ontario Adult recreational slo-pitch. Three games guaranteed.

Spectators welcome! Join us in the beer garden. Splash pad on site for kids.

Winner’s team (all players) receives tickets to a Boston Red Sox vs Toronto Blue Jays game!

Follow us on Twitter: @cmccnews #batcrackers #cmcc2016

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Tribute night honours Drs. Jay Triano and Marion McGregor

Over 100 friends and family members of Drs. Jay Triano and Marion McGregor gathered at the Sheraton Parkway Hotel on Saturday, February 27, to celebrate and congratulate the two research scientists on their many accomplishments and contributions. The impact that each has made on the chiropractic

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profession was clearly evident in the overwhelming support and sentiments expressed by those attending the tribute evening.

Memories from their family and professional life were depicted in a slide presentation and through thoughtful words from their sons, Rob and AJ. Many thanks to all who

participated and contributed to the McMorland Family Research Chair in Mechanobiology in their honour.

Congratulations are also due to both Drs. Triano and McGregor, who were honoured during ACC RAC, March 17 -19, when each were recognized for their years of service to the profession.

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In Conversation with Kim Humphreys Head of the University of Zurich Chiropractic Medicine Program Dr. Kim Humphreys (Class of ‘82), Head of the Chiropractic Medicine program at the University of Zurich and former Dean of Graduate Education and Research at CMCC, shared some of his groundbreaking research at CMCC’s Research Symposium February 27 and 28.

While on campus, he talked about what precipitated Switzerland’s first chiropractic program, his experiences developing it, and why the Swiss health education system has so much promise for patients.

A changing role for chiropractic in Switzerland Humphreys explained that in 2007, the Swiss government passed legislation recognizing that the field of medicine is made up of five health care professions: human medicine, veterinary

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medicine, dentistry, pharmacy and chiropractic medicine. The new Act required that Switzerland have a chiropractic program in one of the Swiss universities as well as a Professor of Chiropractic Medicine.

The University of Zurich’s faculty of medicine offered to host the program and professorship.

Previously, with no program in the country, those wishing to become chiropractors had to go abroad to selected evidence-based institutions to complete their chiropractic education before returning home, passing the Swiss federal exam and undertaking the mandatory two year postgraduate program. Many CMCC alumni will remember their Swiss classmates, who CMCC had welcomed until 2008, when the Swiss program began. The first class from the University of Zurich program graduated in 2014.

A different model “Our program in Zurich is completely integrated with the medical curriculum,” says Humphreys, “and the final qualification is known as the Master of Chiropractic Medicine (M Chiro Med). It is a six year program consisting of a three year Bachelor of Medicine (B Med) followed by an additional three years of study."

"All of our students must first be accepted into the medical school, from which they can then choose the chiropractic medicine pathway.

Each year, we accept 20 students from the medical program. During the first four years (the B Med plus the first year of the M Chiro Med), our students take the complete medical curriculum as well as one to three additional chiropractic subjects each year. This means our students actually have more courses and total

15 hours than their fellow medical students. At the end of Year 4 (M Chiro Med 1), our students must pass the final medical examinations which allows them to work in the hospitals in Year 6 as ‘Under assistants’ or UAs." "Years 5 and 6 (M Chiro Med 2 and 3) are focused on chiropractic.

Specifically, Year 5 rounds out chiropractic examination, diagnosis, treatment knowledge and skills whereas Year 6 focuses on chiropractic treatment and management. An important benefit of the undergraduate program is that the chiropractic students take the same classes as the other medical students and make friendships that help to educate and breakdown perceptional barriers."

"As UAs in Year 6, students spend five months in hospital rotations (orthopaedics, rheumatology, neurology, radiology, internal medicine) and six months in the chiropractic teaching clinic, treating and managing patients under expert chiropractic supervision. Each UA is required to provide 800 treatments and see 80 new patients. Many of the patients they see are difficult chronic pain patients and have been referred by the hospital."

"Time in the hospital is incredibly helpful and provides UAs with in-depth exposure to a variety of patient conditions, symptomatology, clinical workup and management.

As a musculoskeletal hospital, it is the perfect location for us.

Another important benefit is that it provides hospital MDs with exposure to chiropractic and that helps breakdown professional barriers."

"The students are enthusiastic, knowledgeable and kind and I am

often asked where we found them!

It’s very encouraging to hear the praise the UAs receive for the positive results they achieve particularly with the chronic patients."

"Once finished the 6 year program, students must then complete a two-year post-graduate residency program in a private practice with additional classes, assignments and exams. The residency program is accredited by the Swiss government under the same rules and regulations as medical residency programs. I believe the two-year residency is essential and that chiropractors should follow the same model as medical doctors."

"I think we are producing chiropractors with a high level of clinical knowledge, treatment and management skill. Fortunately, the scope of practice for chiropractic in Switzerland has expanded and supports these new graduates.

Swiss chiropractors have the same diagnosis rights as MDs and some prescribing rights covered by health insurers. I’ve heard from some chiropractors in North America who believe that the Swiss system is simply turning chiropractors into medical doctors, which is not the case. We work as chiropractors in an integrated and collaborative medical team, respected for our knowledge and skills. We do not provide more medical care as most of our patients have already had this from other practitioners.

Rather, we deliver the best possible chiropractic care within a team setting. The referring MDs are often amazed at what we can do and grateful they have such a good referral option for their patients.

This is what it is all about, working as a team to improve patient care.

Nothing else matters."

"It is disappointing for me to see the wasted energy and effort spent on debating the ‘subluxation complex’ and ‘adjustment’ in North America.

Instead, we should focus on how to improve the health and life of patients. I have learned very quickly here that the focus is squarely on the patient and what can we do as a team to improve quality of life. The focus is not chiropractic. No single practitioner has all of the answers, including us!"

Research is king The University of Zurich is one of the leading research universities in Europe and research is the priority.

However, when Humphreys began the program in 2008, he was on his own as the only employee of the new program, with few resources to draw upon. He started with clinical outcome studies to investigate three important and relevant questions for patients and practitioners: 1. Do chiropractic patients improve with chiropractic care?

2. In what ways do they improve?

3. For how long do they remain improved?

“It would have taken a long time to do randomized clinical trials and

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16 we needed results earlier rather than later. With an increasing call for large database studies and comparative-effectiveness studies we had a valid rationale,” says Humphreys. “The best thing I did was enlist the help of my wife, chiropractor and radiologist Dr. Cynthia (Cindy) Peterson,” (Western States ’84).

“The next step was to enlist the help of the chiropractic profession in Switzerland to recruit patients for the studies. Chirosuisse, Switzerland’s chiropractic association, helped us to connect with chiropractic practices who recruited patients for our studies.

They remained in the practices to be treated by their regular chiropractors and we hired trained research assistants from the university hospital, who held independent interviews with over 2,500 patients for follow up outcome data."

"The outcome studies were focused on low back pain with and without leg pain; neck pain with and without arm pain; symptomatic lumbar disc herniation and symptomatic cervical disc herniation."

"Later on, comparative effectiveness studies comparing medical to chiropractic treatments were added.

We were able to group them, so we have data on outcomes for upper back pain, lower back pain, neck pain, pregnancy, dizziness. To date we have published 10 outcome studies with and have more pending."

According to Humphreys, not only do they have data on relative experienced efficacy, but they also have identified the point at which the patients began to experience positive treatment effects.

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Collaborative opportunities A close working relationship with ETH Zurich, the country’s technical university (ranked 9th among the best universities worldwide), has opened the doors to other research questions such as the brain’s response to mechanical stimuli (manual palpation of the spine, spinal manipulation), how the brain changes as back pain moves from acute to subacute to chronic and also its response to psychosocial factors such as fear of movement and the anticipation of pain.

Working with colleagues at ETH, Humphreys has been able to use a functional MRI to measure brain activation. “We can already see that both premotor activity and proprioception are diminished in patients with chronic back pain, which makes sense if you think about the way patients with chronic pain move. Now that we have these neural markers, we can monitor patients to see what happens to the brain in cases where patients go from acute to chronic pain.”

“Additionally, we can use these markers as well as patterns of neural connectivity to measure effects of spinal manipulation on the brain and hopefully identify the improvement process. At present we have investigated the application of manual mechanical pressure on the spine and the areas of the brain that are activated. The next step is to look at spinal manipulation, mobilization and other possible therapies. We also have some ideas about new adjunct therapies or rehabilitative exercises that may help to speed up or enhance the recovery process. The next few years will be busy but we see a bright future and ever increasing collaborations locally and internationally."

Cynthia Peterson Curriculum Director, University of Zurich Chiropractic Medicine Program Dr. Cynthia (Cindy) Peterson’s initial role at the University of Zurich was as a researcher in the radiology department and in supervising medical students doing their masters and doctoral research projects in radiology.

Following that, she took on the role of overseeing the initial research for the Department of Chiropractic Medicine and taught the diagnostic imaging classes. She also headed the two year postgraduate residency program in 2008, and led it through its initial accreditation process with the Swiss government. With the challenges in both creating the program and developing the research, what had initially been a part time commitment at the University of Zurich had grown substantially.

Now that the Chiropractic Medicine Program has gone through a complete cycle, there is an increased need for supervisors for the masters and doctoral research programs and Peterson has returned to her role at the University of Zurich.

“There is no doubt that the challenges faced in starting a new program within a major university which requires high levels of research productivity was extremely stressful,” says Peterson, “particularly considering the language barriers, but the opportunities and rewards are beyond comprehension! Having worked in chiropractic education for 30 years and at a total of four different chiropractic colleges, I can honestly say that the University of Zurich model is in the best interest of the patient, which in the end should be what is in the best interest of the profession.”

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Dr. Humphreys and Dr. Peterson presented at CMCC’s 2016 Symposium, a recording of which will be available at ce.cmcc.ca Watch for it this summer.

Take CE with you this summer… to your backyard and beyond.

Distance learning is just a click away. ce.cmcc.ca For inquiries, please contact: ce@cmcc.ca 416 482 2340 ext 191

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Dr. Cynthia (Cindy) Peterson’s lecture

CMCC Research Symposium: Chiropractic management of lumbar disc protrusion/herniation CMCC’s 2016 Research Symposium brought together researchers from the University of Zurich and specialists from Canada and the United States to discuss the latest findings and investigations regarding lumber disc protrusion/ herniation. “We had a really good mix of researchers and clinicians in our international cast,” says Dr. Marion McGregor, Acting Dean, Graduate Education and Research Programs. “It really helped everyone in attendance look at the issue from a number of different angles.”

Dr. Kim Humphreys (Class of ‘82), who developed the chiropractic program within the Faculty of Medicine at the University of Zurich, spoke about ground breaking clinical outcomes and comparative effectiveness research undertaken

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with back and neck pain patient populations in Switzerland.

Dr. Cynthia Peterson is a professor and researcher with the Department of Radiology, Orthopaedic University Hospital Balgrist; and professor in the Chiropractic Medicine Program, Faculty of Medicine, University of Zürich. She lectured on modic changes as seen on MRI scans and their relationship to low back pain. She shared the research done at the University of Zurich chiropractic medicine and radiology departments on how modic changes influence outcomes from various treatments, including spinal manipulation. Additionally, she provided consultation on the myriad of MRIs provided by all symposium speakers. She also spoke on the differences in practice between

Canada and Switzerland, noting that in Switzerland they were in the enviable position of having direct access to MRI. The research team of Drs. Leeman (’07), Peterson, Humphreys, Schmid (’04) and Anklin(’80) shared their studies and success of the High Velocity Low Amplitude adjustment used often by Anklin, Leeman and Schmid to treat patients with disc herniation.

Dr. Cesar Hincapié (Class of ’03), who recently completed his PhD in epidemiology at the Dalla Lana School of Public Health, University of Toronto, weighed in with his doctoral dissertation work, which advances knowledge of the risk for acute lumbar disc herniation following chiropractic care.

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Dr. Michael Hisey

Hincapié shared and discussed insights gained from synthesizing the evidence on the incidence and determinants of lumbar disc herniation with radiculopathy in adults, determining clinicians’ (chiropractors, family physicians and spine surgeons) beliefs about the risk for acute lumbar disc herniation associated with chiropractic spinal manipulation treatment, and investigating associations between both chiropractic and primary medical care, and acute lumbar disc herniation with early surgical intervention in a populationbased epidemiologic study using administrative health data from Ontario, Canada.

Dr. Dean Wright (Class of’89), the Executive Claims Officer of the Canadian Chiropractic Protective Association, serves on the Canadian Clinical Practice Guidelines Task Force. He discussed the treatment from the perspective of chiropractic protection in North America while Dr. Mark Erwin (Class of ’84), staff scientist at the University of Toronto Division of Orthopaedic Surgery and associate professor at

Dr. Dean Wright

Dr. Serafin Leeman

CMCC, shared his expertise with regard to the biology of the disc and outlined what chiropractors should know about it to facilitate clinical decision-making.

Dr. Michael Hisey provided a surgeon’s perspective. Hisey is an orthopaedic surgeon at the Texas Back Institute and handles cases when conservative treatment fails.

Dr. Pierre Côté (Class of ’89) is the Canada Research Chair in Disability Prevention and Rehabilitation, in the Faculty of Health Sciences at the University of Ontario Institute of Technology. He is also the Director of the UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation. Côté presented his research regarding disc herniation injuries sustained under medical and chiropractic care.

Dr. Cesar Hincapié

If you missed this novel and controversial weekend filled with clinically meaningful information, or wish to review it, you have the opportunity to watch it online through CMCC CE this summer.

Please check ce.cmcc.ca for availability.

Dr. Mark Erwin

SPRING 2016

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CMCC President Dr. David Wickes with Drs. Hillary Allen, Sarah Simison, Ayla Azad, and Scott Wilson

Practice OpportUnity 2016 On Wednesday, February 17, students and chiropractors came together for Practice OpportUnity ’16. A discussion panel, keynote speaker, lunch and learn session and trade show provided students with ideas and tips for their future.

Keynote speaker Dr. Luke Boudreau (Class of ’99), spoke about the challenges of starting practice while the Ontario Chiropractic Association’s Practice Realities Panel with Drs. Hillary Allen (Class of ’04), Sarah Simison (Class of ‘10) and Scott Wilson (’94) shared their diverse practice experiences.

New this year, President Dr. David Wickes conducted a lunch and learn on the physical influences of

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vascular flow. Wickes demonstrated how various factors can impact blood flow, with both intended and unintended results. Bringing out a Doppler ultrasound to use on a volunteer from the crowd, allowed those in attendance to hear the volunteers’ arterial and venous blood flow and their changes with exposure to a variety of external factors.

The tradeshow brought together 34 vendors and 25 chiropractor exhibitors, demonstrating business products and showcasing practice opportunities for new graduates.

A special thank you to the sponsors of Practice OpportUnity ‘16: Gold: Ontario Chiropractic Association Silver: Canadian Chiropractic Association, CIBC Commercial Banking, The Co-operators, The Orthotic Group Bronze: Footmaxx, Omax3 Professional Strength, RBC Royal Bank, Ultimate Glucosamine Food Sponsor: Canadian Chiropractic Protective Association Thanks to all those who helped to make this annual event a success.

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Outreach Abroad: Dominican Republic Thirteen interns treated over 1,000 patients in 12 days, at a variety of locations across the Dominican Republic as part of CMCC’s fifth independent chiropractic Outreach Abroad, April 4 to 18. Enjoy these photos taken from Moca and the surrounding area, capturing the unforgettable days these interns shared during the outreach.

The 2016 Outreach Abroad team was: • • • • • • • • • • • • •

Ida Aghigh Sarah Batley Sara Brand Rosanna Cheng Alexandra Dennis Patricia Farrell Aditi Ganesh Sara Ho Shenaigh Newman Jennifer Pratt Karlie Sikura Ian Vana Sina Yeganeh

Drs. Les Wiltshire and Patricia Tavares were supervising clinicians.

Look forward to more details of their journey in the September issue of Primary Contact.

SPRING 2016

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Passage Dr. Lindsay Rowe

It is with sadness that we announce the passing of Dr. Lindsay Rowe, esteemed former faculty member and widely respected chiropractic radiologist, most recently serving as Associate Professor of Diagnostic Radiology for the University of Newcastle in Newcastle, Australia and Adjunct Professor for the School of Chiropractic at Murdoch University in Perth, Australia.

Dr. Rowe was a chiropractor, medical doctor, internationally renowned chiropractic radiologist as well as an author and educator.

A graduate in 1979 of the Royal Melbourne Institute of Technology in Australia, Chiropractic Program, he subsequently entered private practice and completed postgraduate specialty training in chiropractic radiology earning his Diplomate. He is known for the book, Essentials of Skeletal Radiology, of which he is co-author.

Rowe joined CMCC faculty as Chair of the Department of Radiology in

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1982, a position he held until 1984 before moving to Northwestern College of Chiropractic in Minneapolis, Minnesota, and then eventually returning home where he chose to pursue a medical degree at the University of Newcastle.

He finished his hospital residency program in general and emergency medicine and surgery, after which he became senior registrar and Fellow in Diagnostic and Interventional Radiology in Newcastle. He later joined the radiology staff at the Center for Diagnostic Imaging (CDI) with locations worldwide.

During his career, Rowe was awarded chiropractor of the year honours, received a medal in pathology and in 1998, was awarded the Australian Presenter of the Year from the Chiropractors Association of Australia.

His personal interests included sailing, and according to Dr. Peter Rissis, he won a championship

as recently as one year ago. “His diminutive stature disguised an enormous heart,” says Rissis, “and he always gave 100 per cent in anything he did. He was always there for anyone who needed him and the profession has lost a true ‘giant’.”

Dr. Igor Steiman recalls first becoming acquainted with Lindsay, while he was part of CMCC faculty.

He recalls that "Lindsay was a popular and effective instructor, and that photos he took travelling across Canada graced CMCC’s walls. Despite his ongoing prowess and accomplishments, he remained humble," says Steiman. "His cheery demeanor and warm friendship will be missed by all those who were fortunate enough to know him. " Dr. Deborah Kopansky-Giles worked with Rowe through World Spine Care in Botswana, where he provided expert opinion of radiographs. She remembers him as “a wonderful colleague, mentor, brilliant radiologist, and philanthropist who

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In Memoriam

gave so much. What many of us also didn’t know was that when Dr. Rowe presented at international World Federation of Chiropractic congresses, he always funded his own way there and never accepted an honorarium to speak. As always, he was incredibly generous with his time, his energy and his wit. He always made us laugh!”

Rowe was known as a prolific presenter, ranging from large international congresses, to conventions, education programs and government delegations. He conducted imaging workshops and clinical meetings for chiropractors, general medical practitioners and medical specialists, osteopaths, physiotherapists, nurses and patient interest groups. His contribution will leave a lasting impression.

Dr. Rowe is survived by his wife Anne, and their two children, Ryan and Hannah.

E. Grant Armstrong (Class of '51)

Robert Jeffrey Cohen (Class of ’88)

Vincent Delmonte (Class of ‘85)

Ian Judge (Class of ’60)

Kenneth W. MacGillivray (Class of '51)

Stuart Rhem (Class of '61)

William Sykes (Class of '51)

CMCC is grateful to its supporters who have thought to include a donation to CMCC in recognition of the passing of their loved one.

Memorial cards are available through Donation Services at 416 482 2340 ext. 194.

SPRING 2016

Exclusive Membership Benefits catered to your practice, personal & educational needs • Group extended health and dental benefits; save over $1,000* • Free and discounted orthotics • Up to 40% savings on group auto and home insurance • Significant savings on Continuing Education, Supply Centre and Bookstore purchases and more!

With potential savings of $3,000 what are you waiting for?

Become a CMCC Member today: Contact Alumni Affairs 416 482 2340 ext. 146 or membership@cmcc.ca Learn more at cmcc.ca/membership *depending on your plan

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The NDI ranked number two among the most influential publications in cervical spine research The study authored by Drs. Howard Vernon and Silvano Mior published in the Journal of Manipulative and Physiological Therapeutics in 1991 entitled The Neck Disability Index: A Study of Reliability and Validity has been ranked number two of 100 papers deemed most influential to cervical spine research, according to a study recently published in the journal, Spine.

“The Neck Disability Index (NDI) came along when there was nothing in place to measure disability related to neck pain,” Vernon says.

He took some insight for the NDI from the Oswestry Disability Index (ODI), published in 1980, which focused on lower back pain in patients. He then shifted his focus towards the neck.

Vernon says the reason the NDI is so frequently cited is because it has been proven to be highly reliable and valid. Being a responsive instrument it also has the ability

to change as the patient’s level of disability increases or decreases.

This has made it so helpful in many hundreds of surgical and conservative care clinical trials. As well, it has been translated into over 30 languages, making its use truly global.

Vernon says the NDI did take a while to catch on, however. “Over the first 10 years it was quoted maybe once a year, ” he says. “It has been more commonly cited over the past 15 years, which reflects the increased usage of patient-reported outcomes in both research studies and clinical practices.” Patientreported outcomes (PRO) include questionnaires and interviews where the patients themselves indicate their level of pain or discomfort. Vernon also indicated that recent research has shown that the NDI is a powerful predictor of how a patient with neck pain will recover in the future, so, it is very useful in the prognosis of neck pain patients.

Dr. Claire Johnson, editor in chief of JMPT commented on the paper and the significance of its high ranking: “The NDI is well suited not only for daily clinical practice to measure the response to care, but has also contributed to research, since its scoring method can be used for statistical analysis.

According to the most recent study published in Spine, not only is the paper by Vernon and Mior on the list of most influential papers, but it is listed as number two out of 100, which is quite an accomplishment. At the time the NDI paper was published, only a handful of chiropractic-related research papers were available.

Thus, not only is the Vernon/Mior paper an important contribution to chiropractic research; it is now recognized as one of the most influential papers of all time for cervical spine research.”

SPRING 2016

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CMCC 33rd Annual

BACKS IN MOTION Spring rain did not dampen the enthusiasm of nearly 400 runners and walkers who came out for CMCC’s 33rd annual Backs in Motion 10 km Run and 5 km Run/Walk held May 1 near CMCC Campus.

Once again, CMCC welcomed Markham running group Sole Sisters who participated in the 5 km and 10 km runs and added to the fun.

We were also glad to see a couple of young runners out enjoying the day, one of whom was seven years old!

Congratulations to everyone who came out and made the day a success.

The fastest men in the 10 km race were Andrew Bolton (39:05), Jonathon Lloyd (40:24) and Mo Tumi (42:25). The fastest women were Elaine Lavallee (43:05), Shirley Lee (43:54) and Emma Mangialardi (44:50).

Our top three 5 km male runners were Brian Jaimes (17:42), Jake Smith (18:21) and Christian Simmons (18:59), while Dakota Poulter (21:02), Joyce Chiang (21:08) and Brittany Morris (21:10) were the top three female 5 km runners.

Several dogs joined the walk this year, though we suspect some were in it for the bagels. The youngest dog was Hazel, at just nine weeks old.

Thank you to all our sponsors volunteers, participants and donors.

Silver sponsors: ObusForme, The Orthotic Group Bronze sponsors: Cofely Adelt GDF Suez, Deep Relief, Impact Cleaning Services, Metagenics, MuscleCare, Ultimate Glucosamine Friends of CMCC: Aramark, Arla, Canadian Tire Store 192, Running Free, Saucony, Springwall Sleep Products Media sponsor: Canadian Chiropractor

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Donations The donations listed here were received and processed between January 1, 2016 and April 31, 2016. We extend our sincere appreciation to those who have made gifts to CMCC. If you have a correction to this list or would like more information about making a donation, please call Donation Services at 416 482 2340 ext. 194.

Research Chair Mr. David Boldovitch Dr. Kenny K. S. Chan Dr. Kevin Charbonneau Dr. Darrell J. Dailey Dr. Scott Dunham Dr. Brad S. Ferguson Dr. Martin B. Gurvey Dr. Paul K. Ho Dr. Kim B. Humphreys Dr. Tyson Joseph Mrs. Kimberley Kelly Dr. Kevyn R. Kristmanson Dr. Kate MacAdam Dr. Silvano A. Mior Dr. Riaz Oozeer Dr. Michael W. Pernfuss Dr. Cindy Peterson Dr. David Piche Dr. Laurence G. Reynolds Dr. William S. Rogal Dr. Gordon F. Rust Dr. Ryan C. Scott Dr. Jeffrey R. Sheppard Dr. Igor Steiman Dr. Kathryn A. Stitt Dr. Cecile A. Thackeray Dr. Richard R. Thompson Dr. Tim Zafiris

The Co-operators Group Insurance The Estate of Gwendolyn Carleton The Estate of Dr. Alexander F. Taylor Awards and Scholarships Dr. Brian Ferguson & Dr. Celina White Dr. James P. Laws Dr. Jean A. Moss Dr. N. Scott C. Wilson Canadian Chiropractic Association CMCC Students' Council Ontario Chiropractic Association Royal College of Chiropractic Sports Sciences Canada York-Peel Chiropractic Society General Donations & Gifts in Kind Dr. Ron Brady Ms. Geraldine Chen Dr. Matthew Kim

Dr. Silvano A. Mior Dr. Ronald A. Oswald Dr. D. Keith Thomson Able Translations Ltd. Investors Group Financial Services Inc Sun Life Financial In Memoriam Donations Ms. Elizabeth Clark Ms. Susan Clarkson Dr. A. Ronald Elford Ms. Shareen Ewing Dr. David A. Gryfe Mr. John & Ms. Linda Harti Dr. E. Kitchener Hayman Mrs. Eileen Hugli Pierrette Janzen Dr. Sandra J. Malpass Ms. Michelle Mclean Mr. Mark Mendell Dr. Silvano A. Mior Dr. James D. Misner Dr. Michael F. Moreira Dr. Jean A. Moss Dr. Ronald A. Oswald Dr. Catherine Owens Britton Smith

Ms. Joan Speer Dr. Igor Steiman Dr. Catherine M. Straus Ms. Denise Valcour Ms. Jacqueline Wellman Dr. Kathy Wickens Dr. Robert M. & Mrs. Anne Wingfield Dr. Thomas S. Wright Chiropractors' Association of Saskatchewan CUPE LOCAL 4773 Burkom, LeBlanc & Wilcox Investment Team University of Waterloo Office of Development West & Varsalona Chiropractic Professional Corporation

SPRING 2016

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What if you could contribute to chiropractic education and research to improve the health of your community?

You can. CMCC and its facilities represent the future of chiropractic in Canada. From 252 Bloor to 1900 Bayview to 6100 Leslie, our potential has expanded to fill each new environment, exceeded only by our commitment to the profession and to patients.

Below are ways you can support CMCC: Awards and Scholarships

Hands on the FutureÂŽ

Body Donations Program

Lecture Hall Seat

Canadian Chiropractic Historical Association

McMorland Family Research Chair in Mechanobiology

CMCC Membership

Health Sciences Library

General Donations

Special Events

Gifts-in-Kind

Tributes and In Memoriams

Governors’ Club Membership

Receipts are issued in accordance with CRA regulations

To donate to one of these funds or discuss other interests you have please contact 416 482 2340 ext. 270

Winter 2016 Volume 53 / Issue 2 Primary Contact is published three times a year by the Division of Marketing and Communications at CMCC. Your opinions, comments, and input are important to us. Do you have suggestions for topics we can cover?

Phone: 416 482 2340 ext. 217 Fax: 416 482 3629 communications@cmcc.ca

Other frequently requested email addresses: admissions@cmcc.ca alumni@cmcc.ca board@cmcc.ca advancement@cmcc.ca membership@cmcc.ca president@cmcc.ca Executive Editor: Shannon Clark Contributing Editors/Writers: Mara Bartolucci Kavita Dogra Margaret McCallen Michael Radoslav Art Director: Puja Malhotra Photography: Jay Bowes Martin Levesque Ward Hails Karlie Sikura Chris Vassolos Brenda Yi istockphoto.com Director, Marketing and Communications: Mara Bartolucci Director, Alumni Affairs: David Coleman

CMCC does not necessarily endorse or approve advertisements published in Primary Contact. Opinions of individual authors do not necessarily reflect the views of CMCC administration.

Publications Mail Agreement Number: 40062432 Change of address and undeliverable copies should be sent to: CMCC Alumni Affairs Office 6100 Leslie Street, Toronto, ON M2H 3J1 cmcc.ca Twitter @cmccnews Facebook.com/cmccnews

Everything you're looking for all in one place at the CMCC Supply Centre & Bookstore, in store and online.

Visit our new online store at

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CMCC Supply Centre & Bookstore 6100 Leslie Street Toronto, Ontario, M2H 3J1 Toll Free: 1 800 268 8940 bookstore@cmcc.ca

CMCC’s golf tournament fundraiser

BackSwing ‘16 Ontario Thursday, September 15, 2016 Bayview Golf & Country Club, Thornhill cmcc.ca/BackSwing To register or for more information, visit us online or contact Special Events at events@cmcc.ca or 416 482 2340 ext. 200.

Silver Sponsors

Allan M. Freedman Barrister & Solicitor

Bronze Sponsors

Hole-in-one Sponsor $20,000 cash prize

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