Geographical Disparities in Lung Cancer in Canada: A Review.

PURPOSE OF REVIEW: The eastern provinces of Canada exhibit a heightened prevalence and mortality rate of lung cancer compared to their western counterparts. While established risk factors for lung cancer exist in Canada, there remains ambiguity regarding the underlying provincial and territorial trends. This review aims to identify and analyze potential contributors to healthcare inequality, guiding policymakers towards a strategic and sustainable approach at the provincial level. RECENT FINDINGS: Existing studies emphasize the significant roles played by socio-economic and environmental factors in influencing lung cancer disparities across Canadian provinces. However, a noticeable research gap persists, particularly in systematically examining the factors that amplify geographical disparities in lung cancer incidence and mortality rates within Canada. This review underscores the disparities in lung cancer prevalence and mortality rates between eastern and western Canadian provinces. While socio-economic and environmental factors have been identified as influential, there is an evident need for further research to comprehensively understand and address the underlying contributors to these geographical discrepancies.

The Stirling County Study: a case study of interdisciplinarity and its effects on the history of psychiatric epidemiology.

Epidemiology of mental disorders emerged in the post-1945 era at the intersections of different areas of knowledge. Given its ambitions, the Stirling County Study provides an instructive case study. It is also a good example of how the epidemiology applied methodological skills from social sciences. This paper aims, first, to reconstruct one of the first episodes in the development of psychiatric epidemiology. Its second purpose is to provide a detailed description of interdisciplinarity at work, and to examine its effects. After explaining some of the major features of the Stirling County Study, I emphasize the links between some of the first results, particularly regarding young people as a population at risk, and the job market after the Great Depression.

Yeast communities before and after spontaneous fermentation of wine grapes: a case study from Nova Scotia.

Wine fermentations are generally completed by the domestic yeast Saccharomyces cerevisiae, but many indigenous vineyard yeasts also influence wine flavour and aroma. Despite the flourishing wine industry in Nova Scotia, there has yet to be any systematic evaluation of these yeasts in Atlantic Canada. The yeast communities of pressed L'Acadie blanc grapes sampled from an organic vineyard in the Annapolis Valley in 2018 and 2019 were characterized before and after spontaneous fermentation by both Illumina and PacBio sequencing, to address and compare potential platform biases. Chemical and sensory evaluations were also conducted. Basidiomycete yeasts, including Vishniacozyma carnescens, Filobasidium globisporum, and Curvibasidium cygneicollum, dominated pre-fermentation diversity. Species of Saccharomyces made up ∼0.04% of sequences prior to fermentation, but 85%-100% after fermentation, with some replicates dominated by S. cerevisiae and some by S. uvarum. PacBio sequencing detected high proportions of Hanseniaspora uvarum, while Illumina sequencing did not. A better understanding of Nova Scotia vineyard yeast communities will allow local wine makers to make better use of non-traditional yeasts and spontaneous fermentations to produce high-quality wines unique to the region.

The Cost of a Nutritious Diet for Households Including People Living with HIV/AIDS in Nova Scotia: Findings and Lessons Learned by FoodNOW 2020 to 2022.

Purpose: FoodNOW (Food to eNhance Our Wellness) engaged in assessment of simulated households that include a person living with HIV/AIDS (PLWHA) in Nova Scotia to determine if a basic nutritious diet is affordable.Methods: We used supermarket websites to cost food and beverage items listed in the National Nutritious Food Basket (NNFB) for simulated households, each with a PLWHA. Food costing methodologies were co-developed and adapted with community members in response to barriers presented by the COVID-19 pandemic.Results: We found that simulated households, each with one PLWHA, that had a potential deficit after monthly expenses were a household of four on Income Assistance (-$1,058.70), a lone mother with two children on Income Assistance (-$973.65), a lone man on Income Assistance (-$677.40), and a household of four with one minimum-wage earner (-$383.45).Conclusions: Nova Scotia households with a PLWHA living on Income Assistance or with a minimum-wage earner cannot reasonably afford a nutritious diet in addition to basic household expenses. Using these food costing data can allow dietitians to efficiently inform government action and policy change to improve the health and wellness of individuals and families.

Lyme Disease, Anaplasmosis, and Babesiosis, Atlantic Canada.

In July 2021, a PCR-confirmed case of locally acquired Babesia microti infection was reported in Atlantic Canada. Clinical features were consistent with babesiosis and resolved after treatment. In a region where Lyme disease and anaplasmosis are endemic, the occurrence of babesiosis emphasizes the need to enhance surveillance of tickborne infections.

An Examination of Melanoma Detection and Characteristics at a Nova Scotia Tertiary Care Centre, From 2015-2019.

BACKGROUND: Melanoma is one of the most common cancers in Canada,1 with the highest incidence in Nova Scotia (NS). OBJECTIVES: To describe the demographics, lesion characteristics, and diagnostic accuracy of suspected melanomas excised at the largest center in NS. METHODS: The dermatopathology database was interrogated for cases of possible melanoma from 2015 through 2019. Age, gender, site of lesion, pathologic diagnosis, Breslow depth, and equivocal pathology were assessed. RESULTS: 984 lesions had a clinical diagnosis of possible melanoma, identifying 301 melanomas. Of these, 142 (47%) were melanoma in situ (MIS) which in females occurred mostly on the extremities, while in males the head predominated. For invasive melanoma (IM), the extremities remained predominant for women, while the back was most common in men. Lower extremity lesions were more likely to be invasive and female patients were more likely to present with them at a younger age compared to males. The pathology was challenging for 23.94% of MIS, and 16.18% of IM. A mean of 3.1 lesions were excised for every melanoma identified. CONCLUSIONS: Early diagnosis of melanoma is challenging clinically and pathologically. Our melanoma detection rate was 31%, with an increasing trend in the proportion of MIS, and decreasing trend in the proportion of IM over the years. Almost 50% of melanomas were detected in early stages, supporting positive outcomes. Melanomas were more common on extremities in females and the back in males. Melanomas on the lower limbs were more likely to be invasive regardless of gender.

Supplemental diagnosis of Gyrodactylus nebulosus Kritsky and Mizelle, 1968 (Monogenea) on 0+ age Ameiurus nebulosus (Siluriformes) considered for commercial grow-out in Southwestern Nova Scotia, Canada.

Gyrodactylus nebulosus Kritsky and Mizelle, 1968 is reported for the first time from brown bullhead Ameiurus nebulosus (Siluriformes; Ictaluridae) in Nova Scotia. The study results from a screening of parasites with the potential to disrupt commercial rearing of wild-caught young-of-the-year (YOY) brown bullhead. Infected YOY were collected July 30, 2018 and estimated to be 3 weeks old. Eight of 10 fish were infected. Mean intensity was 3.1 ± 3.5 with a range of 1-10. The parasite occurred all over the body surface, but particularly on the ventral regions of the head including the base of the maxillary barbels. Diagnostically important features of the anchors, ventral bar/shield, marginal hooks, and male copulatory organ are described. A partial sequence of the 18S rRNA gene (432 bp) is included and represents the first confirmed molecular data for this species. Molecular analysis revealed a high similarity (99.3%) to a Gyrodactylus sp. reported from the same host, A. nebulosus, in Ontario and the next closest similarity (96.9%) to Gyrodactylus fairporti Van Cleave, 1921 from Ameiurus melas in Wisconsin. The report extends the known distribution of G. nebulosus from North Dakota, Iowa, and Ontario to Nova Scotia. The study concludes that any commercial venture to harvest local YOY brown bullhead from the wild for intense grow-out in captivity should include appropriate quarantine and therapeutic treatments for G. nebulosus as part of the operation.

Mothering at the Intersection of Marginality: Exploring Breastfeeding Beliefs and Practices Among Women From Nova Scotia, Canada Who Identify as Overweight, Low Income, and Food Insecure.

Breastfeeding is represented to support healthy body weight and food security. However, breastfeeding may be negatively impacted by high maternal body weight and income-related food insecurity. Guided by feminist poststructural methodology, this study explored breastfeeding beliefs and practices among women from Nova Scotia, Canada, identifying as income-related food insecure and overweight. Participants who were pregnant for the first time and intending to breastfeed participated in three interviews: prenatal (n = 8), first month postpartum (n = 6), and 3 months postpartum (n = 6). Employing discourse analyses, we found that participants' experiences aligned with dominant discursive representations of these health issues, informed through normative understandings of what it means to mother. However, some participants resisted and reframed what constitutes good mothering to identify with maternal subjectivities that were context specific. The findings have implications for understanding how discourses shape maternal identities and their effects for breastfeeding and other health-related practices.

Inclusion and equity in education: Current policy reform in Nova Scotia, Canada.

This article aims to explore the context of inclusive education policy in Canada, and to highlight the particular case of inclusive education policy reform in the province of Nova Scotia. As with most other provinces and territories, inclusive education policy in Nova Scotia has broadened to include a lens of equity, with a focus on not only students with special education needs, but all students - particularly those most often marginalized by and within Canadian school systems. The article reflects on the first phase of the developmental evaluation process which took place prior to full implementation of the policy. Four interconnected key themes emerge: 1) the shifting roles and identities for educators and specialized staff; 2) the changing roles of classroom teachers; 3) the importance of support to ensure effective universal and differentiated classroom practices; and 4) the professional learning of school staff. Although situated within the Nova Scotian and the national Canadian context, the discussion and implications can readily be applied to international systems engaged in developing and implementing broad inclusive education policy.

High Seroprevalence of Jamestown Canyon Virus among Deer and Humans, Nova Scotia, Canada.

Using residual serum samples from Nova Scotia, Canada, we found that 87.8% of tested deer and an estimated 20.6% of the human population were infected with Jamestown Canyon virus. Human seropositivity reached 48.2% in 1 region. This virus may be an underrecognized cause of disease in Nova Scotia.

Improving pathways to primary health care among LGBTQ populations and health care providers: key findings from Nova Scotia, Canada.

BACKGROUND: This study explores the perceived barriers to primary health care as identified among a sample of Lesbian, Gay, Bisexual, Transgender, and Queer (LGBTQ) identified individuals and health care providers in Nova Scotia, Canada. These findings, based on a province-wide anonymous online survey, suggest that additional efforts are needed to improve pathways to primary health among LGBTQ populations and in deepening our understanding of how to advance the unique primary health needs of these populations. METHODS: Data were collected from the LGBTQ community through an online, closed-ended anonymous survey. Inclusion criteria for participation were self-identifying as LGBTQ, offering primary health care to LGBTQ patients, being able to understand English, being 16 years of age or older, and having lived in Nova Scotia for at least one year. A total of 283 LGBTQ respondents completed the online survey which included sociodemographic questions, perceptions of respondents' health status, and their primary health care experiences. In addition, a total of 109 health care providers completed the survey based on their experiences providing care in Nova Scotia, and in particular, their experiences and perceptions regarding LGBTQ access to primary health care and physician-patient interactions. RESULTS: Our results indicate that, in several key areas, the primary health care needs of LGBTQ populations in Nova Scotia are not being met and this may in turn contribute to their poor health outcomes across the life course. CONCLUSION: A framework of intersectionality and health equity was used to interpret and analyze the survey data. The key findings indicate the need to continue improving pathways to primary health care among LGBTQ populations, specifically in relation to additional training and related supports for health care providers who work with these populations.

[Autoimmune diseases in dogs and their impact for breeding programs with special reference of the Nova Scotia Duck Tolling Retriever]. / Autoimmunkrankheiten und deren Bedeutung in der Hundezucht am Beispiel des Nova Scotia Duck Tolling Retriever.

INTRODUCTION: Autoimmune diseases are of considerable importance in dog breeding. An increased risk of diseases with genetic predisposition is present especially in breeds with a limited genetic diversity. Strict breeding regulations and a high degree of self responsibility of the breeders are essential to prevent these diseases. There are only a few DNA tests available for detecting carriers of genes predisposing for autoimmune diseases. In this review, we describe the special situation in the Nova Scotia Duck Tolling Retriever, who has a special predisposition for Systemic Lupus Erythematosus (SLE) and for Immune-mediated Rheumatoid Disease (IMRD), as well as for Steroid-Responsive Meningitis Arteritis (SRMA) and Juvenile Addison's Disease (JADD). In addition a short overview on the pathogenesis of autoimmune disease is presented.

INTRODUCTION: Les maladies auto-immunes ont une signification de plus en plus importante et croissante dans l'élevage de chiens. Les races spéciales avec une base d'élevage étroite et une diversité génétique associée limitée sont prédisposées. Un élevage responsable, visant à exclure des animaux particulièrement prédisposés, permet de contrôler la recrudescence des maladies auto-immunes chez les chiens de race. Actuellement, des tests ADN individuels sont proposés, permettant d'identifier les porteurs de gènes. Cette revue systématique décrit la prédisposition particulière du Retriever de la Nouvelle-Écosse pour le lupus érythémateux disséminé et le rhumatisme à médiation immunitaire, la méningite-artérite sensible aux stéroïdes et le syndrome juvénile d'Addison. Mais avant cela, la pathogenèse des maaladies auto-immunes est présentée resp. récapitulée.

Fungal endophytes of wild and hybrid Vitis leaves and their potential for vineyard biocontrol.

Plants are colonized by diverse assemblages of fungal endophytes that have potential as biocontrol agents for a variety of crops, including grapevine. Although the diversity of symbionts can be very high in wild plants, the fungal endophytes of wild Vitis plants have not yet been investigated. We surveyed the fungal endophytes of 6 wild populations of Vitis riparia, as well as a cold-tolerant, hybrid grapevine in 5 vineyards (1 certified organic), using 454 pyrosequencing. We detected between 43 and 235 operational taxonomic units per sample, with the highest richness and diversity in the wild, the lowest in conventional vineyards, and intermediate levels in the organic vineyard. Wild plants supported a range of taxa not seen in the conventional vineyards, and vineyards were dominated by relatively few taxa. We also isolated fungi from the wild plants and tested them for their ability to inhibit pathogens of grapevine. Several wild isolates (e.g., Ramularia spp.) were strongly inhibitory to grapevine pathogens. We show that wild Vitis supports a distinct and highly diverse community of fungal endophytes and may represent a rich repository of potential vineyard biocontrol agents.

'Not everyone can be a Gandhi': South Asian-trained doctors immigrating to Canada, c. 1961-1971.

OBJECTIVES: This paper will explore the social history of the transnational migration of foreign-trained doctors to western countries in the post-WWII era, by examining, as a case study, South Asian-trained doctors who were first licensed in the Canadian province of Nova Scotia between 1961 and 1971. DESIGN: This article draws on both quantitative and qualitative primary sources. First, we analyzed the 1966 and 1971 copies of the Canadian Medical Directories (CMD), the annual compendium of all licensed practitioners in the country (over 20,000 practitioners). These CMD entries were supplemented by the annual returns of 'intended occupation' (those designated as 'physician' or 'surgeon') of landed immigrants to Canada, as compiled by the federal Department of Manpower and Immigration. Secondly, we analyzed testimony of 26 oral histories and narrative accounts of foreign-trained doctors being compiled as part of an ongoing multiyear program of research on the immigration of foreign-trained doctors to Canada. We have interviewed 14 doctors who, at one point in their career, practiced in Nova Scotia, 8 of whom were South Asian-trained medical practitioners. These oral interviews provide personal reflections on the process of professional and social acculturation that occurred as these foreign doctors settled in Canada. RESULTS: The results of this paper indicate that the social history of the immigration of South Asian-trained doctors to Canada in the 1960s must be seen within a larger and more complicated pattern of the international migration of health care professionals. Indeed, the demand for foreign-trained doctors in Britain was in part a reflection of the out-migration of British-born doctors who were leaving the National Health Service for Canada, the USA, and Australia. And the demand in Canada for doctors was itself a reaction to the drift of a certain number of Canadian-trained doctors for advanced training in the USA. CONCLUSIONS: In this way, this article sheds important historical perspectives on the globalization of health human resources and the complicated, multiple migrations that continue to animate international health human resources today.

Characterization of colloidal arsenic at two abandoned gold mine sites in Nova Scotia, Canada, using asymmetric flow-field flow fractionation-inductively coupled plasma mass spectrometry.

Asymmetric flow-field flow fractionation-inductively-coupled plasma-mass spectrometry was used to determine whether colloidal arsenic (As) exists in soil pore water and soil extract samples at two arsenic-contaminated abandoned gold mines (Montague and Goldenville, Nova Scotia). Colloidal arsenic was found in 12 out of the 80 collected samples (=15%), and was primarily associated with iron (Fe) in the encountered colloids. The molar Fe/As ratios indicate that the colloids in some samples appeared to be discrete iron-arsenic minerals, whereas in other samples, they were more consistent with As-rich iron (oxy)hydroxides. Up to three discrete size fractions of colloidal As were encountered in the samples, with mean colloid diameters between 6 and 14nm. The pore water samples only contained one size fraction of As-bearing colloids (around 6nm diameter), while larger As-bearing colloids were only encountered in soil extracts.

Epidemiology of Lyme Disease, Nova Scotia, Canada, 2002-2013.

Ixodes scapularis ticks, which transmit Borrelia burgdorferi, the causative agent of Lyme disease (LD), are endemic to at least 6 regions of Nova Scotia, Canada. To assess the epidemiology and prevalence of LD in Nova Scotia, we analyzed data from 329 persons with LD reported in Nova Scotia during 2002-2013. Most patients reported symptoms of early localized infection with rash (89.7%), influenza-like illness (69.6%), or both; clinician-diagnosed erythema migrans was documented for 53.2%. In a separate serosurvey, of 1,855 serum samples screened for antibodies to B. burgdorferi, 2 were borderline positive (both with an indeterminate IgG on Western blot), resulting in an estimated seroprevalence of 0.14% (95% CI 0.02%-0.51%). Although LD incidence in Nova Scotia has risen sharply since 2002 and is the highest in Canada (16/100,000 population in 2013), the estimated number of residents with evidence of infection is low, and risk is localized to currently identified LD-endemic regions.

2023 Wildfires in Canada: Living in Wildfire Regions in Alberta and Nova Scotia Doubled the Odds for Residents to Experience Likely Generalized Anxiety Disorder Symptoms.

Background: Wildfires have become increasingly prevalent in various regions, resulting in substantial environmental and psychological consequences that have garnered increasing attention. Objective: This study aims to examine the prevalence of likely Generalized Anxiety Disorder (GAD) and explore the determinants of likely GAD during the wildfires in Alberta and Nova Scotia. Methods: Data were collected online through a cross-sectional survey from 14 May-23 June 2023. Alberta and Nova Scotia participants self-subscribed to the program by texting 'HopeAB' or 'HopeNS' to a short code, respectively. The GAD-7-validated tool was used to collect information on likely GAD. Results: This study included 298 respondents while one hundred and twelve respondents lived in a region of Alberta/Nova Scotia affected by the wildfires (37.7%). The prevalence of likely GAD among the respondents was 41.9%. Respondents who lived in a region of Alberta/Nova Scotia recently impacted by the wildfires were twice as likely to experience GAD symptoms (OR = 2.4; 95% C.I. 1.3-4.3). Conclusions: The study's identification of a statistically significant relationship between residing in a wildfire-impacted region and likely GAD shows the association between environmental and psychological well-being. However, the relatively small sample size and self-reported assessment of GAD symptoms may limit the generalizability of the findings. Further research involving a larger sample size delving into potential predictors could facilitate strategies for mitigating the mental health consequences of natural disasters.

Mitigating Psychological Problems Associated with the 2023 Wildfires in Alberta and Nova Scotia: Six-Week Outcomes from the Text4Hope Program.

Background: In 2023, wildfires led to widespread destruction of property and displacement of residents in Alberta and Nova Scotia, Canada. Previous research suggests that wildfires increase the psychological burden of impacted communities, necessitating population-level interventions. Cognitive Behavioural Therapy (CBT)-based text message interventions, Text4HopeAB and Text4HopeNS, were launched in Alberta and Nova Scotia, respectively, during the 2023 wildfire season to support the mental health of impacted individuals. Objectives: The study examines the effectiveness of Text4HopeNS and Text4HopeAB in alleviating psychological symptoms and improving wellbeing among subscribers. Methods: The study involved longitudinal and naturalistic controlled trial designs. The longitudinal study comprised subscribers who completed program surveys at baseline and six weeks post-enrolment, while the naturalistic controlled study compared psychological symptoms in subscribers who had received daily supportive text messages for six weeks (intervention group) and new subscribers who had enrolled in the program during the same period but had not yet received any text messages (control group). The severity of low resilience, poor mental wellbeing, likely Major Depressive Disorder (MDD), likely Generalized Anxiety Disorder (GAD), likely Post-Traumatic Stress Disorder (PTSD), and suicidal ideation were measured on the Brief Resilience Scale (BRS), the World Health Organization-5 Wellbeing Index (WHO-5), Patient Health Questionnaire 9 (PHQ-9), Generalized Anxiety Disorder 7 (GAD-7) scale, PTSD Checklist-Civilian Version (PCL-C), and the ninth question on the PHQ-9, respectively. The paired and independent sample t-tests were employed in data analysis. Results: The results from the longitudinal study indicated a significant reduction in the mean scores on the PHQ-9 (-12.3%), GAD-7 (-14.8%), and the PCL-C (-5.8%), and an increase in the mean score on the WHO-5, but not on the BRS, from baseline to six weeks. In the naturalistic controlled study, the intervention group had a significantly lower mean score on the PHQ-9 (-30.1%), GAD-7 (-29.4%), PCL-C (-17.5%), and the ninth question on the PHQ-9 (-60.0%) which measures the intensity of suicidal ideation, and an increase in the mean score on the WHO-5 (+24.7%), but not on the BRS, from baseline to six weeks compared to the control group. Conclusions: The results of this study suggests that the Text4Hope program is an effective intervention for mitigating psychological symptoms in subscribers during wildfires. This CBT-based text messaging program can be adapted to provide effective support for individuals' mental health, especially in the context of traumatic events and adverse experiences such as those induced by climate change. Policymakers and mental health professionals should consider these findings when shaping strategies for future disaster response efforts, emphasizing the value of scalable and culturally sensitive mental health interventions.

Massive barnacle recruitment on the Gulf of St. Lawrence coast of Nova Scotia (Canada) in 2024 linked to increased sea surface temperature.

With the ongoing climate and oceanographic change, an increasing number of studies are reporting dramatic population losses caused by thermal extremes in intertidal habitats. Under moderate warming, however, populations can fare better in places where species normally experienced suboptimal temperatures. This article reports the massive recruitment of the barnacle Semibalanus balanoides on the Gulf of St. Lawrence coast of Nova Scotia (Canada) in 2024. As recruits appear mostly during May in this region, coastal sea surface temperature (SST) in April is critical for the ecological performance of larvae, as they are pelagic and live in the water column for weeks before intertidal settlement. Thus, a study that spanned 12 years (2005 to 2016) on this coast found that annual barnacle recruitment was positively correlated to April SST. In April 2024, coastal SST was 116% higher than for the same month averaged over those 12 years (4.1 vs. 1.9 °C). This SST spike was followed by an elevated recruitment that was 111% higher than the average for those 12 years (1,278 vs. 607 recruits dm-2). Overall for the studied years, the amount of variation in annual barnacle recruitment statistically explained by April SST was 51%. While the southern distribution limit of S. balanoides has moved northwards in recent decades due to lethal warming, our results support the notion of improving reproductive success with seawater warming on colder northern shores.

Enhancing surface drainage mapping in eastern Canada with deep learning applied to LiDAR-derived elevation data.

Agricultural dykelands in Nova Scotia rely heavily on a surface drainage technique called land forming, which is used to alter the topography of fields to improve drainage. The presence of land-formed fields provides useful information to better understand land utilization on these lands vulnerable to rising sea levels. Current field boundaries delineation and classification methods, such as manual digitalization and traditional segmentation techniques, are labour-intensive and often require manual and time-consuming parameter selection. In recent years, deep learning (DL) techniques, including convolutional neural networks and Mask R-CNN, have shown promising results in object recognition, image classification, and segmentation tasks. However, there is a gap in applying these techniques to detecting surface drainage patterns on agricultural fields. This paper develops and tests a Mask R-CNN model for detecting land-formed fields on agricultural dykelands using LiDAR-derived elevation data. Specifically, our approach focuses on identifying groups of pixels as cohesive objects within the imagery, a method that represents a significant advancement over pixel-by-pixel classification techniques. The DL model developed in this study demonstrated a strong overall performance, with a mean Average Precision (mAP) of 0.89 across Intersection over Union (IoU) thresholds from 0.5 to 0.95, indicating its effectiveness in detecting land-formed fields. Results also revealed that 53% of Nova Scotia's dykelands are being used for agricultural purposes and approximately 75% (6924 hectares) of these fields were land-formed. By applying deep learning techniques to LiDAR-derived elevation data, this study offers novel insights into surface drainage mapping, enhancing the capability for precise and efficient agricultural land management in regions vulnerable to environmental changes.