System Entrapment: Dehumanization While Help-Seeking for Suicidality in Women Who Have Experienced Intimate Partner Violence.

Attention to power imbalances when seeking help for suicidality after having been controlled within intimate partner violence (IPV) is crucial in improving health care delivery. Well documented in the literature is the correlation between suicidality and IPV and that help-seeking for each is difficult; however, a gap exists when both intersect. The process of women's help-seeking is explored in this feminist grounded theory and photovoice multiple qualitative method study. Analysis of interviews with 32 women from New Brunswick, Canada, and photovoice meetings with seven women revealed a basic psycho-social problem. System Entrapment or being dehumanized while seeking help for suicidality occurred as a result of perceived invalidation from health care providers' lack of empathy. Further harm while providing services to women feeling suicidal can be prevented with a shift from an individualist model toward a trauma and violence informed approach. Understanding the contextual factors influencing women's suicidality may reduce victim blaming.

Examining Collaborative Processes for Climate Change Adaptation in New Brunswick, Canada.

Collaboration is a proposed strategy to address super wicked environmental problems, such as climate change. Yet, understanding how it works for climate change adaptation is nascent. This research aims to advance the understanding of this by a cross-case analysis of three cases in New Brunswick, Canada. We sought to illuminate the inner workings of multiparty collaboration in the context of community climate change adaptation; identify important qualities of the process and outcomes from it, and probe their relationships; and, explore how they come about in practice. A questionnaire was sent to individuals involved in cases and key informant interviews were conducted. Results reveal case-specific variations, but more importantly, common qualities and outcomes across the cases. They offer key insight into elements which may be important in collaborative settings. These are informative for influencing the uptake of collaborative strategies in climate change adaptation and offer the opportunity to better understand their functional effectiveness.

An Assessment of Sub-Meter Scale Spatial Variability of Arcellinida (Testate Lobose Amoebae) Assemblages in a Temperate Lake: Implications for Limnological Studies.

Arcellinida (testate lobose amoebae), a group of benthic protists, were examined from 46 sediment-water interface samples collected from oligotrophic Oromocto Lake, New Brunswick, Canada. To assess (1) assemblage homogeneity at a sub-meter spatial scale and (2) the necessity for collecting samples from multiple stations during intra-lake surveys; multiple samples were collected from three stations (quadrats 1, 2, and 3) across the north basin of Oromocto Lake, with quadrat 1 (n = 16) being the furthest to the west, quadrat 2 (n = 15) situated closer to the center of the basin, and quadrat 3 (n = 15) positioned 300 m south of the mouth of Dead Brook, an inlet stream. Results from cluster analysis and non-metric multidimensional scaling (NMDS) analysis identified two major Arcellinida assemblages, A1 and A2, the latter containing two sub-assemblages (A2a and A2b). Redundancy analysis and variance partitioning results indicated that seven statistically significant environmental variables (K, S, Sb, Ti, Zn, Fe, and Mn) explained 41.5% of the total variation in the Arcellinida distribution. Iron, Ti and K, indicators of detrital runoff, had the greatest influence on assemblage variance. The results of this study reveal that closely spaced samples (~ 10 cm) in an open-water setting are comprised of homogenous arcellinidan assemblages, indicating that replicate sampling is not required. The results, however, must be tempered with respect to the various water properties and physical characteristics that comprise individual lakes as collection of several samples may likely be necessary when sampling multiple sites of a lake basin characterized by varying water depths (e.g., littoral zone vs. open water), or lakes impacted by geogenic or anthropogenic stressors (e.g., eutrophication, or industrial contamination).

California Serogroup Virus Infection Associated with Encephalitis and Cognitive Decline, Canada, 2015.

California serogroup (CSG) viruses, such as Jamestown Canyon and snowshoe hare viruses, are mosquitoborne pathogens that cause febrile illness and neurologic disease. Human exposures have been described across Canada, but infections are likely underdiagnosed. We describe a case of neuroinvasive illness in a New Brunswick, Canada, patient infected with a CSG virus.

Case definition for clinical and subclinical bacterial kidney disease (BKD) in Atlantic Salmon (Salmo salar L.) in New Brunswick, Canada.

Bacterial kidney disease (BKD) is considered an important cause of loss in salmon aquaculture in Atlantic Canada. Causative agent of BKD is the Gram-positive bacteria Renibacterium salmoninarum. Infected salmon are often asymptomatic (subclinical infection), and the disease is considered chronic. One of the challenges in quantifying information from farm production and health records is the application of a standardized case definition. Case definitions for farm-level and cage-level clinical and subclinical BKD were developed using retrospective longitudinal data from aquaculture practices in New Brunswick, Canada, combining (i) industry records of weekly production data including mortalities, (ii) field observations for BKD using reports of veterinarians and/or fish health technicians, (iii) diagnostic submissions and test results and (iv) treatments used to control BKD. Case definitions were evaluated using veterinarians' expert judgements as reference standard. Eighty-nine and 66% of sites and fish groups, respectively, were associated with BKD at least once. For BKD present (subclinical or clinical), sensitivity and specificity of the case definition were 75-100% varying between event, fish group, site cycle and level (site pen). For clinical BKD, sensitivities were 29-64% and specificities 91-100%. Industry data can be used to develop sensitive case definitions.

Neurotoxic non-protein amino acids in commercially harvested Lobsters (Homarus americanus H. Milne-Edwards).

Cyanobacteria produce neurotoxic non-protein amino acids (NPAAs) that accumulate in ecosystems and food webs. American lobsters (Homarus americanus H. Milne-Edwards) are one of the most valuable seafood industries in Canada with exports valued at > $2 billion. Two previous studies have assessed the occurrence of ß-N-methylamino-L-alanine (BMAA) in a small number of lobster tissues but a complete study has not previously been undertaken. We measured NPAAs in eyeballs, brain, legs, claws, tails, and eggs of 4 lobsters per year for the 2021 and 2022 harvests. Our study included 4 male and 4 female lobsters. We detected BMAA and its isomers, N-(2-aminoethyl)glycine (AEG), 2,4-diaminobutyric acid (DAB) and ß-aminomethyl-L-alanine (BAMA) by a fully validated reverse phase chromatography-tandem mass spectrometry method. We quantified BMAA, DAB, AEG and BAMA in all of the lobster tissues. Our quantification data varied by individual lobster, sex and collection year. Significantly more BMAA was quantified in lobsters harvested in 2021 than 2022. Interestingly, more BAMA was quantified in lobsters harvested in 2022 than 2021. Monitoring of lobster harvests for cyanobacterial neurotoxins when harmful algal bloom events occur could mitigate risks to human health.

Historical pesticide applications for the treatment of eastern spruce budworm infestations in New Brunswick.

Pesticides have been used in Canada since 1945 as part of large-scale aerial spray applications to control insect pests on forested lands. Some of the pesticides used historically were efficacious, nonselective, persistent, and have led to serious impacts on the environment. A well known, and extensively documented example is the large-scale aerial spray programs in New Brunswick, Canada. From 1952 to 1993, 97% of the 6.2 million ha of the forested lands of New Brunswick were treated with at least one application of one insecticide, the majority of which were applied to control outbreaks of eastern spruce budworm (Choristoneura fumiferana). The most well known insecticide was dichlorodiphenyltrichloroethane (DDT), applied from 1952 to 1968, which still persists in treated soils and adjacent water bodies, and caused the individual and cumulative ecosystem effects that can still be measured today. The insecticides that replaced DDT were nonpersistent and unlikely to be found today. However, during the years of application some of the insecticides were likely to have impacted local ecosystems to some degree. To aid future studies on the efficacy and environmental impact of these insecticides we created a digital spatial data set of known pesticide application in New Brunswick forestry from 1952 to 1993. The data set includes active ingredient, formulation, application rate, tank mix, aircraft type, and other ancillary information. The current version of the data is available on the New Brunswick Department of Natural Resources and Energy Development, GIS Open Data Page and in the supplemental material. Use of the data set for academic and educational purposes is encouraged, provided that both this data paper and the data source are properly cited; the Government of New Brunswick should be acknowledged as the data source (Open Government License http://www.snb.ca/e/2000/data-E.html).

Inequity in insurance coverage for prescription drugs in New Brunswick, Canada.

OBJECTIVES: To describe the extent to which New Brunswick residents reported having drug insurance coverage supplementary to Canadian Medicare; to examine associations between socioeconomic and demographic characteristics, health status, language identity, and having reported such coverage; and to document any changes in coverage associated with the introduction of the New Brunswick Drug Plan in 2014. METHODS: We used repeated cross-sectional data for New Brunswick from eight cycles of the Canadian Community Health Survey from 2007 to 2017 and undertook logistic regression analysis. RESULTS: We found statistically significant, substantial and policy-relevant socioeconomic differences in the reporting of prescription drug insurance coverage among those 25-64 years and those ≥ 65 years of age, and an increasing reliance on private drug insurance over time. We found that individuals in the second decile of household income were particularly vulnerable to reporting neither public nor private drug coverage. The introduction of the New Brunswick Drug Plan in 2014 does not appear to have led to increased public drug coverage; however, from 2014, the decreasing trend in public drug coverage appears to have ceased. Those who reported lower health status usually had lower odds of reporting private drug coverage but higher odds of reporting public drug coverage. Driven by differences in private coverage, we found that relative to anglophones, francophones were less likely to report any drug coverage. CONCLUSION: Our findings emphasize the shortcomings of drug insurance systems such as that introduced in New Brunswick and substantiate calls for a universal drug program. New Brunswick's increasing reliance on private drug insurance is of concern and warrants additional research.

RéSUMé: OBJECTIFS: Décrire la mesure dans laquelle les résidents du Nouveau-Brunswick ont déclaré avoir une couverture d'assurance médicaments supplémentaire au régime public d'assurance maladie canadien; examiner les associations entre les caractéristiques socioéconomiques et démographiques, l'état de santé, l'identité linguistique et avoir déclaré une telle couverture; et documenter tout changement de couverture associé à l'introduction du Régime médicaments du Nouveau-Brunswick en 2014. MéTHODES: Nous avons utilisé des données transversales répétées du Nouveau-Brunswick de huit cycles de l'Enquête sur la santé dans les collectivités canadiennes de 2007 à 2017 et avons entrepris une analyse de régression logistique. RéSULTATS: Nous avons constaté des différences socioéconomiques statistiquement significatives, substantielles et pertinentes en matière de politiques dans la déclaration de la couverture d'assurance médicaments chez les 25 à 64 ans et les 65 ans et plus, et une dépendance croissante à l'égard de l'assurance médicaments privée au fil du temps. Nous avons constaté que les personnes appartenant au deuxième décile du revenu du ménage étaient particulièrement vulnérables au fait de ne pas avoir déclaré d'assurance médicaments publique ou privée. La mise en place du Régime médicaments du Nouveau-Brunswick en 2014 ne semble pas avoir entraîné une augmentation de la couverture publique des médicaments; cependant, à partir de 2014, la tendance à la baisse de la couverture publique des médicaments semble avoir cessé. Ceux qui ont déclaré un état de santé inférieur avaient généralement une cote exprimant la probabilité plus faible de déclarer une assurance médicaments privée, mais plus élevée de déclarer une couverture publique des médicaments. En raison des différences de couverture privée, nous avons trouvé que, par rapport aux anglophones, les francophones étaient moins susceptibles de déclarer une couverture pour les médicaments. CONCLUSION: Nos résultats mettent en évidence les lacunes des systèmes d'assurance médicaments comme celui mis en place au Nouveau-Brunswick et justifient les appels en faveur d'un programme universel de médicaments. La dépendance croissante du Nouveau-Brunswick à l'égard de l'assurance médicaments privée est préoccupante et justifie des recherches supplémentaires.

Identification of cannabinoids in post-mortem blood samples from the province of New Brunswick before and after recreational cannabis legalization.

INTRODUCTION: Since recreational legalization of cannabis in Canada in 2018, self-reported use in New Brunswick (NB) has increased from 15.1% to 20.3%, the largest increase of any province. Current literature on the impact of recreational cannabis legislation in other jurisdictions is conflicting, though retail availability has often been delayed on enactment. Given the immediate availability of cannabis in NB after legalization, we sought to establish the effect this had on post-mortem cannabinoid detection. Furthermore, we wanted to investigate the impact that age, sex, and manner of death had on cannabis use. We also established if there were any increases in commonly detected drugs over the study period. METHODS: A retrospective chart review was conducted on all adult Coroner's cases with toxicology analysis in NB between January 2014 and May 2020 (n = 3060). Differences in the proportion of cannabinoid-positive samples pre- versus post-legalization in the overall cohort as well as within each demographic parameter were assessed using chi-square tests. The effects of demographic parameters on cannabis presence were further assessed by logistic regression. Lastly, chi-square tests for trend were performed to identify increasing trends in cannabis detection, as well as cocaine, ethanol, opiates/opioids, benzodiazepines, and amphetamines over the study period. RESULTS: After controlling for age, sex, and manner of death, participants that died after recreational legalization had higher odds of having cannabis present post-mortem than those that died pre-legalization. In addition, demographic sub-analysis identified a greater proportion of cannabinoid-positive samples post-legalization in 25- to 44-year-olds and in deaths classified as either suicide or accidental compared to pre-legalization. We also observed a significant increase in the presence of cocaine and amphetamines in post-mortem samples over the study period. CONCLUSION: This study demonstrates that cannabis use has increased post-legalization in NB, particularly within young adults and those dying by suicide or accidental means. It also highlights the need for future research into the impact that legalization has on cannabis use in other jurisdictions.

Improving Administrative Outcomes in Physiotherapy by Adopting Open-Access Booking.

Purpose: Long wait times for physiotherapy are associated with poorer health trajectories for clients. Clients' experiences with physiotherapy services in Saint John were suboptimal; thus, this study explored making administrative changes to improve those experiences. All physiotherapy services adopted an administrative model called open-access booking (OAB), which blended elements of advanced access, triage, and centralized wait lists. Method: OAB was instituted in the first week of February 2017 and has been active since. The researcher accessed more than 20,000 anonymized case records spanning 5 years (February 2014-January 2019) and compared the 3-year pre-OAB phase with the 2-year OAB phase using interrupted time series analysis models. Results: OAB appeared to not be associated with changes in client volume, but it was associated with fewer "on-paper" clients, shorter wait times to first appointment, more consistent record keeping, a greater likelihood of being discharged after one appointment, and fewer appointments before discharge. There was less variability in these outcomes after the adoption of OAB, suggesting a more stable client experience with the physiotherapy system. Conclusions: OAB appears to be associated with improved administrative outcomes, but strict causality cannot be assessed. The results are promising but not conclusive.

Objectif : les longues listes d'attente en physiothérapie sont liées à de moins bonnes trajectoires de santé pour les clients. Les expériences des clients à l'égard des services de physiothérapie étaient suboptimales à Saint John, et les chercheurs ont exploré les changements administratifs à apporter pour les améliorer. Tous les services de physiothérapie ont adopté un modèle administratif du nom de «livres en libre accès¼ (LLA), qui mêle des éléments d'accès avancé, de triage et de listes d'attente centralisées. Méthodologie : le modèle de LLA a été adopté la première semaine de février 2017 et se poursuit depuis. Les chercheurs ont accédé à plus de 20000 dossiers de cas anonymisés sur cinq ans (de février 2014 à janvier 2019) et ont comparé la phase de trois ans précédant les LLA aux deux ans de LLA suivants au moyen de modèles d'analyse chronologique interrompus. Résultats : le modèle de LLA ne semblait pas modifier le volume de clientèle, mais réduisait le nombre de clients «sur papier¼ et la période d'attente avant le premier rendez-vous, assurait une tenue de dossier plus uniforme, accroissait la probabilité d'obtenir un congé après un rendez-vous et limitait le nombre de rendez-vous avant le congé. Ces résultats étaient moins variables après l'adoption des LLA, ce qui laisse supposer une expérience plus stable des clients en physiothérapie. Conclusion : les LLA semblent assurer de meilleurs résultats administratifs, sans qu'il soit possible d'établir une causalité rigoureuse. Les résultats sont prometteurs, mais non concluants.

Client experiences of expertise in midwifery care in New Brunswick, Canada.

OBJECTIVE: This study contextualizes client experiences of midwifery in New Brunswick within the broader literature on midwifery in Canada and contributes to understandings of how midwifery care fits into the landscape of reproductive healthcare in the province. DESIGN: Semi structured interviews with 32 clients and supportive others of the New Brunswick midwifery program were carried out in 2019 and 2020, and transcripts were analysed using general thematic analysis. SETTING: N New Brunswick, Canada PARTICIPANTS: Clients of midwifery care provided by the Fredericton Midwifery Centre, as well as their supportive others (partners and spouses, family members, friends) FINDINGS: Participants in this study reported a high degree of satisfaction with midwifery services and identified several approaches to practice that they felt contributed to high quality midwifery care. These include competence and expertise, time and access as abundance rather than scarcity, attention to the familial context, trauma informed care and attention to mental and emotional health, postpartum care, and supporting agency and autonomy. In short, participants' responses indicate that midwifery care in New Brunswick meets the criteria for respectful maternity care, as outlined by Shakibazadeh et al. (Shakibazadeh et al., 2018) and Butler et al. (Butler et al., 2020). Our findings are in line with research on midwifery care in other settings, although there is a significant emphasis on the medical expertise and training of midwives amongst our participants which is less evident in the scholarly literature. KEY CONCLUSIONS: In a province where reproductive health care has been systematically underfunded, clients celebrate the expertise and competence of midwives, challenging the narrative which constructs midwifery as 'traditional' care, and hospital-based obstetrics as expert care. Instead, midwives are recognized as highly specialized evidence-based practitioners, and this is particularly prized by clients in relation to processes of information sharing.

Jamestown Canyon and snowshoe hare virus seroprevalence in New Brunswick.

Background: Jamestown Canyon virus (JCV) and snowshoe hare virus (SSHV) are wide-ranging mosquito-borne arboviruses in the California serogroup viruses (CSGV) that are known to circulate in New Brunswick. Despite potential for debilitating central nervous system manifestations, the prevalence of human exposure to these viruses in New Brunswick is unknown. The goal of this study was to quantify rates of human exposure in New Brunswick to these neglected arboviruses. Methods: A retrospective, anonymized provincial serosurvey was performed using a stratified random sample of residual sera submitted between May 2015 and August 2016. To determine the seroprevalence of JCV and SSHV, competitive enzyme-linked immunosorbent assay-positive samples were confirmed positive using plaque-reduction neutralization testing (PRNT). Results: A total of 452 serum samples were screened. The seroprevalence of antibodies against CSGV was estimated to be 31.6% (95% CI 27.4% to 36.1%) with 143 positive samples. PRNT results indicated that most single virus exposures were due to JCV (38 of 143; 26.6%) rather than SSHV (3 of 143; 2.1%). The species of CSGV, to which the remaining 102 seropositive people were exposed, could not be precisely determined. Conclusions: The prevalence of human exposure to CSGV is high but comparable to rates observed in other Atlantic Canadian jurisdictions. Studies such as this provide important baseline epidemiological data regarding the risk of exposure to these neglected arboviruses. SSHV and JCV should be considered in the differential diagnosis for undiagnosed febrile and neuroinvasive illness during mosquito season, particularly when testing for common aetiologies is negative or inconclusive.

Historique : Le virus de Jamestown Canyon (VJC) et le virus du lièvre d'Amérique (VLA) sont des arbovirus à grande portée transmis par des moustiques des virus du sérogroupe Californie (VSGC) qui circulent au Nouveau-Brunswick (NB). Malgré le risque de manifestations débilitantes du système nerveux central, on ne connaît pas la prévalence d'exposition humaine à ces virus au NB. La présente étude visait à quantifier le taux d'exposition humaine à ces arbovirus négligés au NB. Méthodologie : Les chercheurs ont réalisé une enquête sérologique rétrospective provinciale anonymisée au moyen d'un échantillon randomisé stratifié de sérum résiduel soumis entre mai 2015 et août 2016 au dépistage systématique. Ils ont stratifié le processus de sélection selon l'âge, le sexe et la zone de santé régionale afin de garantir un échantillonnage proportionné. Pour déterminer la séroprévalence du VJC et du VLA, ils ont confirmé la positivité des résultats d'échantillons positifs au test ELISA au moyen de tests de séroneutralisation par réduction des plaques (TSRP). Résultats : Au total, 452 échantillons de sérum ont fait l'objet d'un dépistage. Au NB, la séroprévalence des anticorps anti-VSGC était évaluée à 31,6 % (IC à 95 %, 27,4 % à 36,1 %), pour 143 échantillons positifs. Selon les résultats du TSRP, la plupart des expositions à un seul virus étaient causées par le VJC (38 cas sur 143, 26,6 %) plutôt qu'au VLA (trois cas sur 143, 2,1 %). Les espèces de VSGC, auxquelles les 102 autres personnes séropositives ont été exposées, n'ont pas pu être établies avec précision. Conclusions : La prévalence d'exposition humaine au VSGC est élevée, mais comparable aux taux observés dans d'autres régions des provinces de l'Atlantique. Des études comme celle-ci fournissent des données épidémiologiques de référence importantes à l'égard du risque d'exposition humaine à ces arbovirus négligés. Il faut tenir compte du VLA et du VJC dans le diagnostic différentiel de maladie fébrile et neuro-invasive pendant la saison des moustiques, notamment lorsque les tests pour dépister d'autres étiologies courantes sont négatifs ou non concluants.

Evaluation of the impact of the Healthy Start/Départ Santé intervention on improving menu planning practices and improving the congruence between planned menus and actual food served in Saskatchewan childcare centres.

The objective of this study was to evaluate the impact of the Healthy Start/Départ Santé (HS/DS) intervention program on improving menu planning practices and improving the congruence between planned menus and actual food served in licensed childcare centres in Saskatchewan. Overall, 39 licensed childcare centres in the province of Saskatchewan, Canada, were selected through a cluster randomized control trial to evaluate the impact of the HS/DS intervention. The pre and post intervention food menus of these centres were analyzed and compared to the Saskatchewan Childcare Nutrition Guidelines (SCNG). The food and beverages served at lunch were observed and digitally recorded using digital plate-waste measures. The congruence between the planned menus and the actual food served was assessed. Descriptive analyses and non-parametric tests were performed to determine the impact of the intervention. The results of this study indicated that there was no significant difference between the groups regarding the distribution and proportion of centres that adhered to the SCNG. The centres that received the intervention demonstrated significant improvements in adherence to their written menus, with the proportions of match between the items that served and listed (p-value = 0.029), and additional items served (p-value = 0.014). Within each group, intervention and usual practice, there were significant differences in centres that met the foods to limit guideline among the usual practice centres (p-value = 0.035). Findings from this study indicated that the HS/DS intervention had a positive impact on improving the adherence of the participating centres to the centres' planned menus. HS/DS trial registration number: NCT02375490.

An age-independent hospital record-based frailty score correlates with adverse outcomes after heart surgery and increased health care costs.

Background: Globally, an increasing number of vulnerable or frail patients are undergoing cardiac surgery. However, large-scale frailty data are often limited by the need for time-consuming frailty assessments. This study aimed to (1) create a retrospective registry-based frailty score (FS), (2) determine its effect on outcomes and age, and (3) health care costs. Methods: Retrospective data were obtained from the New Brunswick Heart Centre registry for all cardiac surgery patients between 2012 and 2017. A 20-point FS was created using available binary risk variables. The primary outcomes of interest most relevant to vulnerable patients were prolonged hospitalization, failure to be discharged home, and hospitalization bed cost. Composite outcome of prolonged hospitalization (>8 days) and/or non-home discharge were analyzed using multivariate analysis. Results: A total of 3463 patients (mean age, 66 ± 10 years) were included in the final analysis. Tercile-based FSs were: low (0-4; n = 856), medium (5-7; n = 1709), high (≥8; n = 898). In unadjusted data, frail patients were older with more comorbidities. High FS patients had greater risks of prolonged hospitalization (median 7 vs 5 days; P < .001), lower home-discharge rates (51% vs 83%; P < .001), higher 30-day readmission rates (18% vs 10%; P < .001), and increased 30-day mortality rates (≤0.7% [low], >0.7% to ≤1.2% [medium], and >1.2% to 4.8% [high]; P < .001). After statistical adjustment, the FS was an independent predictor of composite outcome (odds ratio, 1.3: 95% CI, 1.26-1.35), and increased hospital bed costs. Conclusions: A registry-based FS can be used to identify vulnerable or frail patients undergoing cardiac surgery and was associated with poor outcomes independent of age. This highlights that although frailty defined by increased vulnerability is often associated with older age, it is not a surrogate for aging, thereby having important implications in reducing health system costs and efforts to provide streamlined care to the most vulnerable.

SARS-CoV-2 Surveillance System in Canada: Longitudinal Trend Analysis.

BACKGROUND: The COVID-19 global pandemic has disrupted structures and communities across the globe. Numerous regions of the world have had varying responses in their attempts to contain the spread of the virus. Factors such as public health policies, governance, and sociopolitical climate have led to differential levels of success at controlling the spread of SARS-CoV-2. Ultimately, a more advanced surveillance metric for COVID-19 transmission is necessary to help government systems and national leaders understand which responses have been effective and gauge where outbreaks occur. OBJECTIVE: The goal of this study is to provide advanced COVID-19 surveillance metrics for Canada at the country, province, and territory level that account for shifts in the pandemic including speed, acceleration, jerk, and persistence. Enhanced surveillance identifies risks for explosive growth and regions that have controlled outbreaks successfully. METHODS: Using a longitudinal trend analysis study design, we extracted 62 days of COVID-19 data from Canadian public health registries for 13 provinces and territories. We used an empirical difference equation to measure the daily number of cases in Canada as a function of the prior number of cases, the level of testing, and weekly shift variables based on a dynamic panel model that was estimated using the generalized method of moments approach by implementing the Arellano-Bond estimator in R. RESULTS: We compare the week of February 7-13, 2021, with the week of February 14-20, 2021. Canada, as a whole, had a decrease in speed from 8.4 daily new cases per 100,000 population to 7.5 daily new cases per 100,000 population. The persistence of new cases during the week of February 14-20 reported 7.5 cases that are a result of COVID-19 transmissions 7 days earlier. The two most populous provinces of Ontario and Quebec both experienced decreases in speed from 7.9 and 11.5 daily new cases per 100,000 population for the week of February 7-13 to speeds of 6.9 and 9.3 for the week of February 14-20, respectively. Nunavut experienced a significant increase in speed during this time, from 3.3 daily new cases per 100,000 population to 10.9 daily new cases per 100,000 population. CONCLUSIONS: Canada excelled at COVID-19 control early on in the pandemic, especially during the first COVID-19 shutdown. The second wave at the end of 2020 resulted in a resurgence of the outbreak, which has since been controlled. Enhanced surveillance identifies outbreaks and where there is the potential for explosive growth, which informs proactive health policy.

Exploring the Availability of Emergency Contraception in New Brunswick Pharmacies: A Mystery-Client Telephone Study.

Although levonorgestrel-only emergency contraceptive pills (LNg-ECPs) have been available over the counter in Canada for more than a decade, barriers to access persist. We aimed to obtain information about the availability and cost of LNg-ECPs in New Brunswick. Using a mystery-client study design, we called all 207 non-specialty pharmacies in the province posing as a 17-year-old woman seeking something to prevent pregnancy after sex. We evaluated the information provided for accuracy and quality. The overwhelming majority of pharmacies (n = 180, 87%) had at least one brand of LNg-ECPs in stock; the price averaged CAD28.69 (USD21.65). Although the majority of pharmacy representatives provided accurate information about LNg-ECPs, a small number made incorrect statements about the timeframe for use, side effects, and mechanism of action. In nine interactions (4%) pharmacy representatives incorrectly indicated that a male partner could not obtain LNg-ECPs; none indicated that parental involvement was required to procure LNg-ECPs. None of the pharmacy representatives referenced any other modality of emergency contraception, including ulipristal acetate. Our findings suggest that LNg-ECPs are widely available and that most pharmacy representatives are providing accurate medical and regulatory information. However, supporting the continuing education of pharmacists and pharmacy staff, particularly around alternative modalities of emergency contraception, appears warranted.

New Coleoptera records from eastern Canada, with additions to the fauna of Manitoba, British Columbia, and Yukon Territory.

One-hundred-eleven new provincial and territorial Coleoptera records are reported from New Brunswick (64), Nova Scotia (20), Prince Edward Island (5), Quebec (14), Manitoba (3), British Columbia (3), and Yukon Territory (2) for the 26 following families: Carabidae, Dytiscidae, Histeridae, Staphylinidae, Scarabaeidae, Buprestidae, Eucnemidae, Elateridae, Cantharidae, Erotylidae, Monotomidae, Cryptophagidae, Passandridae (first record of this family from New Brunswick), Laemophloeidae, Nitidulidae, Anamorphidae, Coccinellidae, Latridiidae, Mordellidae, Tenebrionidae, Cerambycidae, Chrysomelidae, Anthribidae, Brentidae, Dryophthoridae, and Curculionidae. Among these are ten new Canadian records: Heterosternuta oppositus (Say, 1823) (Dytiscidae) (New Brunswick), Gyrophaena blatchleyi Seevers, 1951 (Staphylinidae) (Quebec), Acropteroxys lecontei Crotch, 1873 (Erotylidae) (Manitoba), Placonotus falinorum Thomas, 2011 (Laemophloeidae) (Quebec), Adelina pallida (Say, 1824) (Tenebrionidae) (Quebec), Poecilocera harrisii (J.L. LeConte, 1851) (Chrysomelidae) (New Brunswick), Plesiobaris albilata (LeConte, 1876) (Curculionidae) (Quebec, New Brunswick), Pseudopityophthorus asperulus (LeConte, 1868) (Curculionidae) (Nova Scotia), Hylurgops palliatus (Gyllenhal, 1813) (Curculionidae) (New Brunswick), and Heteroborips seriatus (Blandford, 1894) (Curculionidae) (Nova Scotia). Plesiobaris disjuncta Casey reported as new for Canada in New Brunswick and Quebec by Webster et al. (2012a) is actually P. albilata (LeConte) and thus P. disjuncta is removed from the faunal list of Canada. Eleven species from New Brunswick not previously reported in literature were found on the online platforms BugGuide.Net and iNaturalist and are reported in this publication. This highlights the importance of online platforms dedicated to recording wildlife observations and citizen science in detecting new species records. Data is also presented for seven species from Quebec and two species from New Brunswick reported by Bousquet et al. (2013) without any supporting information for their occurrence in these provinces. Among the species reported here, 32 are adventive.

A Multiple Streams Approach to Understanding the Issues and Challenges of Lyme Disease Management in Canada's Maritime Provinces.

This study examines potential challenges facing Lyme disease patients in Canada's Maritime provinces-New Brunswick, Nova Scotia, Prince Edward Island-and considers how issues could be addressed. Reviews of both the academic and grey literature are complemented by surveys targeting both medical professionals and decision makers in government. Combined, the literature reviews and surveys demonstrate that there is considerable debate surrounding the effectiveness of testing, treatment options, and the existence of chronic Lyme disease. As the focus on the Maritimes demonstrates, these debates often pit the medical community against patients and patient advocates and, thus far, governments have been unable to produce policy that entirely pleases either side. Moving forward, this study recommends the creation of a discussion forum via a federal Commission of inquiry to review best practise guidelines for Lyme disease. The key is to foster an unbiased probe of central issues surrounding treatment and diagnosis without alienating stakeholders. This course of action will not necessarily solve the issue of Lyme disease, but would foster a greater understanding through dialogue that includes and validates the experiences of stakeholders, which is something that is currently missing.

Checklist of the Coleoptera of New Brunswick, Canada.

All 3,062 species of Coleoptera from 92 families known to occur in New Brunswick, Canada, are recorded, along with their author(s) and year of publication using the most recent classification framework. Adventive and Holarctic species are indicated. There are 366 adventive species in the province, 12.0% of the total fauna.