Decadal changes in biomass and distribution of key fisheries species on Newfoundland's Grand Banks

Canadian fisheries management has embraced the precautionary approach and the incorporation of ecosystem information into decision-making processes. Accurate estimation of fish stock biomass is crucial for ensuring sustainable exploitation of marine resources. Spatio-temporal models can provide improved indices of biomass as they capture spatial and temporal correlations in data and can account for environmental factors influencing biomass distributions. In this study, we developed a spatio-temporal generalized additive model (st-GAM) to investigate the relationships between bottom temperature, depth, and the biomass of three key fished species on The Grand Banks: snow crab (Chionoecetes opilio), yellowtail flounder (Limanda ferruginea), and Atlantic cod (Gadus morhua). Our findings revealed changes in the centre of gravity of Atlantic cod that could be related to a northern shift of the species within the Grand Banks or to a faster recovery of the 2J3KL stock. Atlantic cod also displayed hyperaggregation behaviour with the species showing a continuous distribution over the Grand Banks when biomass is high. These findings suggest a joint stock assessment between the 2J3KL and 3NO stocks would be advisable. However, barriers may need to be addressed to achieve collaboration between the two distinct regulatory bodies (i.e., DFO and NAFO) in charge of managing the stocks. Snow crab and yellowtail flounder centres of gravity have remained relatively constant over time. We also estimated novel indices of biomass, informed by environmental factors. Our study represents a step towards ecosystem-based fisheries management for the highly dynamic Grand Banks.

Perceptions of Magnetic Resonance Imaging During Pregnancy: A Newfoundland and Labrador Perspective

OBJECTIVES

This study aimed to identify enablers and barriers to participation in MRI for clinical indications and scientific research, and to determine the perceptions of MRI performed during pregnancy.

METHODS

We conducted a survey of 156 pregnant people in Newfoundland and Labrador including sociodemographic information, obstetrical history, MRI history, and willingness to participate in an MRI. Categorical variables were analyzed using a Fisher exact test and open-ended questions were analyzed using thematic analysis.

RESULTS

In total, 80% of participants reported willingness to receive an MRI while pregnant for clinical indications compared to 24% for research. Only 10% reported prior knowledge about MRI during pregnancy and most participants (94%) wanted additional information from their physician before feeling comfortable with the procedure. Participants who knew someone with complications during pregnancy were more likely to be willing to participate in an MRI for research (uncorrected P < 0.05). Participants' positive perceptions towards MRI during pregnancy for clinical indications were that it was a necessary and useful procedure, while the negative perceptions identified MRI as unsafe. For research MRI, participants' positive perceptions included that it would add to the advancement of knowledge and the negative perceptions were that it was an unnecessary and risky procedure.

CONCLUSIONS

Strategies are needed to improve patient knowledge about the benefits and safety of MRI during pregnancy. The present study suggests recruitment for research should incorporate education on safety concerns and relative risk, personal stories about the benefits of MRI in diagnosing pregnancy complications and should highlight the contribution to advancing scientific knowledge.

Changes in Medical Cannabis Use After Recreational Cannabis Legalization in Canada

Background: As part of its recreational cannabis legalization in October 2018, Canada imposed an excise tax of 10% (or $1 a gram, whichever is higher) on both recreational and medical cannabis. There is little evidence to inform the ongoing debate on whether the legalization had adverse impacts on medical cannabis use. Methods: We used an interrupted time series design and data on medical cannabis shipments (i.e., mail-order deliveries of cannabis from a licensed producer to a patient authorized to obtain medical cannabis) in Canada between quarter 1 of 2014 and quarter 1 of 2020. We examined changes in medical cannabis shipments after Canada's recreational cannabis legalization both across Canada and for each province. As this study used publicly available, province-level aggregate data, ethics approval was not required. Results: Recreational cannabis legalization was associated with significant reductions in medical cannabis use in 7 out of 10 Canadian provinces. Compared with the counterfactual estimated from prelegalization trends, the reduction in quarter 1 of 2020 varied from 500 shipments per 100,000 population (95% CI=312-688 shipments per 100,000 population) or 32% (95% CI=22-43%) in Newfoundland and Labrador to 3,778 shipments per 100,000 population (95% CI=2,972-4,585 shipments per 100,000 population) or 74% (95% CI=68-79%) in Alberta. At the national level, the number of medical cannabis shipments decreased by 823 per 100,000 population (95% CI=725-921 shipments per 100,000 population) or 48% (95% CI=45-52%). Conclusions: Recreational cannabis legalization was associated with reductions in medical cannabis use. Our findings call for policy attention to address possible adverse impacts of recreational cannabis legalization on medical cannabis users.

Co-roosting relationships are consistent across years in a bat maternity group

Long-lived, group living animals have the potential to form multiyear relationships. In some temperate bat species, maternity groups break apart and rejoin both daily, as females depart to forage and select day roosts to use, and annually, as bats leave for and return from hibernation. Here, we investigated whether bats have persistent social preferences by testing whether relationships between dyads in a focal year could be predicted by previous years. We also hypothesized that experience influences social preferences and predicted that an individual's age would influence its network position, while familiarity with bats of the same cohort would drive persistent social preferences. We quantified roost co-occurrence in little brown myotis (Myotis lucifugus) in Salmonier Nature Park, Newfoundland, Canada both within and among years. We found that roost co-occurrence patterns of previous years still had predictive value even when accounting for potential roost fidelity. However, we found no evidence that cohort familiarity or age explained any of the variation. Overall, we found long-term patterns of association in this temperate bat species that suggest levels of social complexity akin to other large mammal species.

The distribution of subarctic and boreal deep-sea demersal fish assemblages across environmental gradients of the northwest Atlantic

The oceanography of the Labrador Sea is well studied because of its globally important deep-water convection that oxygenates the deep ocean and drives climate-regulating ocean currents. However, little is known about the fish communities that inhabit this area, particularly beyond the depths accessible to standard research surveys and commercial fishing activities. We used baited longline surveys to characterize important components of demersal fish communities across a depth gradient of 200-3000 m and compared these data to a similar dataset collected c. 1200 km to the south in the Flemish Cap Region. We found demersal fish communities in the Labrador Sea to be similar to those of the Flemish Cap Region despite unique oceanography and lower primary productivity in the Labrador Sea. Moreover, both areas had high abundance, biomass, and species richness at intermediate depths that suggests factors beyond depth drive community structure in the deep ocean. These data are important for identifying high-value areas for potential protective measures in the northwest Atlantic and provide necessary data with which to assess potential environmental impacts of extractive industries that are expanding north and to deeper waters.

Shallow subtidal marine benthic communities of Nachvak Fjord, Nunatsiavut, Labrador: A glimpse into species composition and drivers of their distribution

Marine fjords along the northern Labrador coast of Arctic Canada are influenced by freshwater, nutrients, and sediment inputs from ice fields and rivers. These ecosystems, further shaped by both Atlantic and Arctic water masses, are important habitats for fishes, marine mammals, seabirds, and marine invertebrates and are vital to the Labrador Inuit who have long depended on these areas for sustenance. Despite their ecological and socio-cultural importance, these marine ecosystems remain largely understudied. Here we conducted the first quantitative underwater scuba surveys, down to 12 m, of the nearshore marine ecology of Nachvak Fjord, which is surrounded by Torngat Mountains National Park located in Nunatsiavut, the Indigenous lands claim region of northeastern Canada. Our goal was to provide the Nunatsiavut Government with a baseline of the composition and environmental influences on the subtidal community in this isolated region as they work towards the creation of an Indigenous-led National Marine Conservation Area that includes Nachvak Fjord. We identified four major benthic habitat types: (1) boulders (2) rocks with sediment, (3) sediment with rocks, and (4) unconsolidated sediments, including sand, gravel, and cobble. Biogenic cover (e.g., kelp, coralline algae, and sediment) explained much of the variability in megabenthic invertebrate community structure. The kelp species Alaria esculenta, Saccharina latissima, and Laminaria solidungula dominated the boulder habitat outside of the fjord covering 35%, 13%, and 11% of the sea floor, respectively. In contrast, the middle and inner portions of the fjord were devoid of kelp and dominated by encrusting coralline algae. More diverse megabenthic invertebrate assemblages were detected within the fjord compared to the periphery. Fish assemblages were depauperate overall with the shorthorn sculpin, Myoxocephalus scorpius, and the Greenland cod, Gadus ogac, dominating total fish biomass contributing 64% and 30%, respectively. Understanding the composition and environmental influences within this fjord ecosystem not only contributes towards the protection of this ecological and culturally important region but serves as a baseline in a rapidly changing climatic region.

Specialty Care and Counselling about Hereditary Cancer Risk Improves Adherence to Cancer Screening and Prevention in Newfoundland and Labrador Patients with BRCA1/2 Pathogenic Variants: A Population-Based Retrospective Cohort Study

Pathogenic variants (PVs) in BRCA1 and BRCA2 increase the lifetime risks of breast and ovarian cancer. Guidelines recommend breast screening (magnetic resonance imaging (MRI) and mammogram) or risk-reducing mastectomy (RRM) and salpingo-oophorectomy (RRSO). We sought to (1) characterize the population of BRCA1/2 PV carriers in Newfoundland and Labrador (NL), (2) evaluate risk-reducing interventions, and (3) identify factors influencing screening and prevention adherence. We conducted a retrospective study from a population-based provincial cohort of BRCA1/2 PV carriers. The eligibility criteria for risk-reducing interventions were defined for each case and patients were categorized based on their level of adherence with recommendations. Chi-squared and regression analyses were used to determine which factors influenced uptake and level of adherence. A total of 276 BRCA1/2 PV carriers were identified; 156 living NL biological females composed the study population. Unaffected females were younger at testing than those with a cancer diagnosis (44.4 years versus 51.7 years; p = 0.002). Categorized by eligibility, 61.0%, 61.6%, 39.0%, and 75.7% of patients underwent MRI, mammogram, RRM, and RRSO, respectively. Individuals with breast cancer were more likely to have RRM (64.7% versus 35.3%; p < 0.001), and those who attended a specialty hereditary cancer clinic were more likely to be adherent to recommendations (73.2% versus 13.4%; p < 0.001) and to undergo RRSO (84.1% versus 15.9%; p < 0.001). Nearly 40% of the female BRCA1/2 PV carriers were not receiving breast surveillance according to evidence-based recommendations. Cancer risk reduction and uptake of breast imaging and prophylactic surgeries are significantly higher in patients who receive dedicated specialty care. Organized hereditary cancer prevention programs will be a valuable component of Canadian healthcare systems and have the potential to reduce the burden of disease countrywide.

Environmental and temporal patterns in bioturbation in the Cambrian-Ordovician of Western Newfoundland

The early Paleozoic emergence of bioturbating (sediment-dwelling and -mixing) animals has long been assumed to have led to substantial changes in marine biogeochemistry, seafloor ecology, and the preservation potential of both sedimentary and fossil archives. However, the timing of the rise of bioturbation and environmental patterns in its expansion have long been subjects of debate-resolution of which has been hampered, in part, by a paucity of high-resolution bioturbation data or of systematic investigations of facies trends in lower Paleozoic bioturbation. To address these issues, we conducted an integrated sedimentological and ichnological characterization of the Cambrian-Ordovician Port au Port succession and Cow Head Group of western Newfoundland, encompassing over 350 meters of stratigraphy logged at the centimeter to decimeter scale. We find that, across a wide range of marine facies, bioturbation does not on average exceed moderate intensities-corroborating observations from other lower Paleozoic successions indicating that the early Paleozoic development of bioturbation was a protracted process. Moreover, bioturbation intensities in the Port au Port succession and Cow Head Group are commonly characterized by considerable variability at even fine scales of stratigraphic resolution and changes in bioturbation intensity correlate strongly with variability in sedimentary facies. We observe that facies recording nearshore depositional environments and carbonate-rich lithologies are each characterized by the highest intensities of both burrowing and sediment mixing. These data highlight the need for a high-resolution and facies-specific approach to reconstructing the evolutionary history of bioturbation and suggest that average levels of bioturbation, although relatively low throughout this interval, increased notably earlier in nearshore marine settings.

Sex differences in suicide mortality in Newfoundland and Labrador: An observational study with medical examiner data from 1997 to 2016

BACKGROUND

Globally, the suicide rate is two times higher for males than for females. Previous studies in Newfoundland and Labrador did not examine age-specific rates by sex. The objectives of this study were to determine suicide rates by sex and age group and to compare the demographic and clinical characteristics of males and females who died by suicide.

DATA AND METHODS

This observational study analyzed a routinely collected dataset based on all medical examiner-determined suicide deaths among people aged 10 years and older in Newfoundland and Labrador, Canada, between 1997 and 2016. Age-standardized and age-specific suicide rates and rate ratios were calculated based on the number of deaths during the period, and descriptive statistics were used to compare demographic and clinical characteristics between males and females.

RESULTS

The age-standardized suicide rate was 4.6 times higher among males than females and was higher for males in most age groups. Rates were highest in the young adult age groups for males (20 to 24 years) and females (35 to 39 years). Males who died by suicide were more likely to be from a rural community and to have died by firearm; females were more likely to die by self-poisoning and to have had a mental illness or substance use history.

INTERPRETATION

The results are broadly consistent with previous research, though this is the first study to report age-specific suicide rates among females across the life course in Newfoundland and Labrador. The results underscore the need to design public health and clinical interventions that account for sex differences in suicide risks.

Descriptive epidemiology of variants of infectious salmon anaemia virus in four Atlantic salmon farms in Newfoundland and Labrador, Canada

An incursion of infectious salmon anaemia virus (ISAV) was detected in 2020 in southern Newfoundland, Canada. This resulted in an outbreak affecting four marine farms stocking Atlantic salmon (Salmo salar L.) vaccinated against ISAV. This study provides the first description of epidemiologic characteristics of an ISAV outbreak in 2020 and 2021, and detected ISAV variants at the population level. Fish kidneys were screened for ISAV by real-time RT-PCR and non-negative samples were submitted for genotyping and further diagnostic testing. Nine distinct ISAV variants were identified: five European and three North American (NA) HPRΔ ISAV, and one NA-HPR0 ISAV variant. A notable finding was the concurrent detection of both an HPR0 and an HPRΔ ISAV variant in one individual fish. In two farms, both European and NA variants were simultaneously detected, while in the other two farms either NA or European variants were identified, but not both together. Generally, mortality increases followed rises in ISAV prevalence and cycle threshold values on RT-PCR decreased with time. Epidemiologic descriptions of ISAV outbreaks in Atlantic Canada contributes to the understanding of local disease dynamics and identification of changes thereof. Such insights are essential for the strengthening of disease management plans.

Vested Contracting to Improve Patient Care and Promote Innovation within a Newfoundland and Labrador Regional Health Authority

Eastern Health (EH) is the most populous of four Regional Health Authorities in Newfoundland and Labrador. In 2017, EH realized the potential impact that healthcare innovation could have on improving patient care, its outcomes as well as provincial economic development. This paper describes EH's innovation journey with "vested contracting," a relatively rare approach in Canada, for its procurement of management services for support activities, such as housekeeping, laundry, patient/resident food services, retail food services and portering. Through individual interviews with EH executives, directors and the successful vendor, this paper describes the system changes needed to accommodate "vested contracting," the burden associated with learning and changing the procurement process and lessons learned.

Polybrominated Diphenyl Ethers (PBDEs) in Marine Fish and Dietary Exposure in Newfoundland

Presence of PBDEs tested in 127 liver samples from Atlantic Cod (Gadus morhua) and Turbot (Scophthalmus Maximus) and 80 adult participants from two rural Newfoundland communities. Seafood consumption was measured through a validated seafood consumption questionnaire. PBDEs (-28, -47, -99, -156, and -209) were found in all fish liver samples, and PBB-153 and PBDEs-28, -47, -99, -100, -153 were identified as the most prominent congeners from the participants' serum samples. Cod was the most frequently consumed species in the seafood consumption survey. PBB-153 was higher amongst older (> 50 years age) participants (p < 0.0001), however, no PBDE congeners were significantly different by age. PBB-153 (p = 0.001), PBDE-153 (p = 0.006), and ₅PBDE (p = 0.008) levels were significantly higher in males. The study shows that the marine ecosystem around Newfoundland has been contaminated by PBDEs, and that rural coastal residents are potentially exposed to these contaminants through local seafood consumption.

Characterizing observed surface wind speed in the Hudson Bay and Labrador regions of Canada from an aviation perspective

Wind speed analysis is important for informing airport operation and safety. Many communities in the Hudson Bay and Labrador regions (Canada) are remote communities that rely heavily on aircraft for passenger and freight movement. Historical trends in average daily wind speed and maximum daily wind speed from 1971 to 2010 were examined to identify patterns of change and determine how these changes may influence aviation in six northern communities across Hudson Bay and Labrador in Canada. Significant increases in average wind speed and maximum wind speed were found for some of the months and seasons of the year for the Hudson Bay region, along with a significant decrease in those variables for the Labrador communities. Average wind speeds at multiple locations are approaching the threshold (18.5 km/h or 10 knots) when take-off and landing would be restricted to one direction. The results of this study agree with previous research that examined historical patterns for wind speed in these regions but calls into question climate change impact assessments that suggest wind speeds will continue to increase under future climatic conditions for this study area. Future research is needed to further analyse shifts in prevailing wind directions and changes in the frequency of extreme wind conditions, to better understand the potential impacts of projected climate change on this climatic variable and the implications these changes may have on applied sectors, such as aviation.

The Economic Impact of Healthcare Innovation Activity on the Newfoundland and Labrador Economy in 2019 and 2020

Eastern Health (EH), the most populous region of the four Newfoundland and Labrador (NL) Regional Health Authorities, has been advancing innovation to improve patient care, health outcomes and provincial economic development. This paper describes how EH engaged with the provincial Department of Finance to estimate the direct, indirect and induced economic impacts on provincial gross domestic product, employment and employment income from innovation-related activities. The modelling demonstrated significant economic benefits in both 2019 and 2020. There was a large increase in 2020 due to pandemic-related personal protective equipment manufacturing opportunities. The number of well-paying jobs created also increased. Local healthcare innovation was stimulated by EH's Living Lab, Health Innovation Team and increased coordination between vendor partners, Memorial University, the NL Centre for Health Information and government funding agencies.

Annual plastic ingestion and isotopic niche patterns of two sympatric gull species at Newfoundland, Canada

Ingestion of plastic pollution by pelagic seabirds is well-documented globally, but increasingly, researchers are investigating plastic ingestion in generalist predators and scavengers like gulls. We studied the gut contents of two sympatric gull species, American herring gulls (Larus smithsoniansus) and great black-backed gulls (L. marinus), collected year-round as part of "kill-to-scare" measures at the regional sanitary landfill in St. John's, Newfoundland and Labrador, Canada, to compare ingested anthropogenic debris, trophic position and diet breadth through the year. Although great black-backed gulls fed at a higher trophic level, frequency of occurrence of plastic ingestion was similar to American herring gulls, and varied little through the year. Diet breadth (isotopic niche size) was similar between species, but American herring gulls fed at a lower trophic level during winter, perhaps indicating a change in their reliance on anthropogenic food subsidies throughout their annual cycle.

Incursions of sea lamprey, Petromyzon marinus, and striped bass, Morone saxatilis, in Labrador waters: Episodic events or evidence of a northward range expansion?

We describe observations of sea lamprey (Petromyzon marinus) and striped bass (Morone saxatilis) incursions into Labrador, Canada. While P. marinus have been periodically observed in similar latitudes, their numbers have conspicuously increased in estuarine environments in 2020. In contrast, M. saxatilis were not observed from Labrador until 2017 but appear to be declining after the initial surge in abundance that peaked in 2018. It remains unclear whether spawning populations of either species exist. Given the potential to negatively affect species of commercial and cultural importance through predation, follow-up surveys are warranted.

Different individual-level responses of great black-backed gulls (Larus marinus) to shifting local prey availability

To grow, survive and reproduce under anthropogenic-induced changes, individuals must respond quickly and favourably to the surrounding environment. A species that feeds on a wide variety of prey types (i.e. generalist diet) may be comprised of generalist individuals, specialist individuals that feed on different prey types, or a combination of the two. If individuals within a population respond differently to an environmental change, population-level responses may not be detectable. By tracking foraging movements of great black-backed gulls (Larus marinus), a generalist species, we compared group-level and individual-level responses to an increase in prey biomass (capelin; Mallotus villosus) during the breeding season in coastal Newfoundland, Canada. As hypothesized, shifts in prey availability resulted in significantly different individual responses in foraging behaviour and space use, which was not detectable when data from individuals were combined. Some individuals maintained similar foraging areas, foraging trip characteristics (e.g., trip length, duration) and habitat use with increased capelin availability, while others shifted foraging areas and habitats resulting in either increased or decreased trip characteristics. We show that individual specialization can be non-contextual in some gulls, whereby these individuals continuously use the same feeding strategy despite significant change in prey availability conditions. Findings also indicate high response diversity among individuals to shifting prey conditions that a population- or group-level study would not have detected, emphasizing the importance of examining individual-level strategies for future diet and foraging studies on generalist species.

Diesel and Crude Oil Biodegradation by Cold-Adapted Microbial Communities in the Labrador Sea

Oil spills in the subarctic marine environment off the coast of Labrador, Canada, are increasingly likely due to potential oil production and increases in ship traffic in the region. To understand the microbiome response and how nutrient biostimulation promotes biodegradation of oil spills in this cold marine setting, marine sediment microcosms amended with diesel or crude oil were incubated at in situ temperature (4°C) for several weeks. Sequencing of 16S rRNA genes following these spill simulations revealed decreased microbial diversity and enrichment of putative hydrocarbonoclastic bacteria that differed depending on the petroleum product. Metagenomic sequencing revealed that the genus Paraperlucidibaca harbors previously unrecognized capabilities for alkane biodegradation, which were also observed in Cycloclasticus. Genomic and amplicon sequencing together suggest that Oleispira and Thalassolituus degraded alkanes from diesel, while Zhongshania and the novel PGZG01 lineage contributed to crude oil alkane biodegradation. Greater losses in PAHs from crude oil than from diesel were consistent with Marinobacter, Pseudomonas_D, and Amphritea genomes exhibiting aromatic hydrocarbon biodegradation potential. Biostimulation with nitrogen and phosphorus (4.67 mM NH4Cl and 1.47 mM KH2PO4) was effective at enhancing n-alkane and PAH degradation following low-concentration (0.1% [vol/vol]) diesel and crude oil amendments, while at higher concentrations (1% [vol/vol]) only n-alkanes in diesel were consumed, suggesting toxicity induced by compounds in unrefined crude oil. Biostimulation allowed for a more rapid shift in the microbial community in response to petroleum amendments, more than doubling the rates of CO2 increase during the first few weeks of incubation. IMPORTANCE Increases in transportation of diesel and crude oil in the Labrador Sea will pose a significant threat to remote benthic and shoreline environments, where coastal communities and wildlife are particularly vulnerable to oil spill contaminants. Whereas marine microbiology has not been incorporated into environmental assessments in the Labrador Sea, there is a growing demand for microbial biodiversity evaluations given the pronounced impact of climate change in this region. Benthic microbial communities are important to consider given that a fraction of spilled oil typically sinks such that its biodegradation occurs at the seafloor, where novel taxa with previously unrecognized potential to degrade hydrocarbons were discovered in this work. Understanding how cold-adapted microbiomes catalyze hydrocarbon degradation at low in situ temperature is crucial in the Labrador Sea, which remains relatively cold throughout the year.

Labrador Emergencies and St. Anthony Institutional Care: Medical Cases of Donald McI. Johnson for the Grenfell Association, 1928-29

In contemporaneous and retrospective publications, British physician Donald McI. Johnson wrote about medical cases in 1928-29 for the organization founded by Wilfred Grenfell in Newfoundland and Labrador. The availability of one physician's cases in published and institutional forms allows consideration of discursive representations of patients for general and clinical readers in the two decades of Johnson's writing. This study places these cases within the context of Johnson's medical background and his escape to rural practice in a remote locale, one that emphasized emergency operations in Labrador and hospital care in the organization's main hospital in St. Anthony. In this way, it broadens knowledge of medical care provided by visiting physicians and considers ways in which such physicians represented local patients in publications for the general reader. Although it determines that Johnson was unique, it indicates the value of the fuller study of publications by other physicians associated with the Grenfell organization.

Publishing and Paternalism in the Grenfell Mission: Wilfred Grenfell's Accounts of a Boy Patient and Doctor-Patient Relations in Northern Newfoundland and Labrador, 1900-14

In 1906 Dr. Wilfred Grenfell, founder and head of the Grenfell medical mission of northern Newfoundland and southeastern Labrador, published a short article in Putnam's Monthly about a nine-year-old boy named Clem Richards, who had shot himself in the knee while hunting seabirds. The boy's identity was disclosed in full, with Grenfell including his name and image as well as a detailed description of his living conditions. The "story" of the boy's injury and recovery became a favourite of Grenfell's, and it was modified and republished in a number of magazines and books between 1906 and 1923. This article explores the appeal that Richards' accident held for Grenfell and argues that his dramatic mid-winter rescue of the boy helped Grenfell promote his mission and construct a public image of himself that would appeal to American readers and donors. By comparing published accounts with Richards' medical case record, however, we also see how much Grenfell distorted the incident to heighten its drama and reader appeal. The article also considers how the mission's dominance over northern Newfoundland and southeastern Labrador enabled Grenfell to use Richards' name and image for mission publicity with no consideration of patient consent.

"If We Can Make a Cure of Him": Lyrical Grenfell in the St. Anthony Casebooks, 1906

Narrative-based physician records contain much more than observerless data and diagnoses. Indeed, a "case," the basic currency of medical communication, can be seen as a literary genre, much like a novel or a poem, and given close readings for author voice, tradition, and influences. In this article, I describe my initial encounter with Dr. Wilfred Grenfell's casebooks in a hospital basement in St. Anthony, Newfoundland and Labrador, and my subsequent engagement with them as both a physician and a poet. Adopting Bleakley and Marshall's definition of medical lyricism as the impulse that "draws our attention to delicacy, tenderness and the joyous, and to verve, desire, eroticism, the fecund, abundance and generation," I argue that Grenfell's approach to medicine in early 20^th-century Newfoundland and Labrador was both a product of his scientific training and his enculturation at the end of the Victorian period.

Introduction-Case by Case: Private and Public Representations of Patients in the Grenfell Mission in Newfoundland and Labrador in the Early 20th Century

This article provides context for three studies about early 20^th-century medical cases in the geographically distributed humanitarian aid organization founded by Wilfred Grenfell in pre-Confederation Newfoundland and Labrador. It situates these studies within historiographical and theoretical approaches to case histories and their publication by medical practitioners, the background for research on the clinical records of the Grenfell organization's main hospital, and the history behind specific case information for coastal patients. While the cases examined cohere through their organizational origin, the authors of these three studies reveal sometimes unexpected representations of the patient in text and illustration. In these ways, both this introductory article and the following three studies emphasize the enduring appeal of narrative approaches to case writing while also pointing to the evolving ethics of publishing medical reports for general readers and scholars. Together they invite renewed attention to the representation of medical cases in publications that increasingly are available globally in internet collections.

Temperature and place associations with Inuit mental health in the context of climate change

BACKGROUND

Climate change has important implications for mental health globally. Yet, few studies have quantified the magnitude and direction of associations between weather and mental health-related factors, or assessed the geographical distribution of associations, particularly in areas experiencing rapid climatic change. This study examined the associations between air temperature variables and mental health-related community clinic visits across Nunatsiavut, Labrador, Canada, and the place-specific attributes of these associations.

METHODS

Daily de-identified community clinic visit data were collected from the provincial electronic health recording system and linked to historical weather data (2012-2018). A multilevel, multivariable negative binomial regression model was fit to investigate associations between temperature variables and mental health-related community clinic visits across the region, adjusting for seasonality as a fixed effect and community as a random effect. A multivariable negative binomial model was then fit for each Nunatsiavut community, adjusting for seasonality.

RESULTS

Mental health-related visits contributed to 2.4% of all 228,104 visit types across the study period; this proportion ranged from 0.6% to 11.3% based on community and year. Regionally, the incidence rate of mental health-related community clinic visits was greater after two weeks of warm average (i.e. above -5ᵒC) temperatures compared to temperatures below -5ᵒC (IRR_-5≤5ᵒC = 1.47, 95% CI = 1.21-1.78; IRR_6≤15ᵒC = 2.24, 95% CI = 1.66-3.03; IRR_>15ᵒC = 1.73, 95% CI = 1.02-2.94), and the incidence rate of mental health-related clinic visits was lower when the number of consecutive days within -5 to 5ᵒC ranges (i.e. temperatures considered to be critical to land use) increased (IRR = 0.96; 95% CI = 0.94-0.99), adjusting for seasonal and community effects. Community-specific models, however, revealed that no two communities had the same association between meteorological conditions and the incidence rate of daily mental health-related visits.

DISCUSSION

Regionally, longer periods of warm temperatures may burden existing healthcare resources and shorter periods of temperatures critical to land use (i.e. -5 to 5ᵒC) may present enjoyable or opportunistic conditions to access community and land-based resources. The heterogeneity found in temperature and mental health-related clinic visits associations across Nunatsiavut communities demonstrates that place quantitatively matters in the context of Inuit mental health and climate change. This evidence underscores the importance of place-based approaches to health policy, planning, adaptation, and research related to climate change, particularly in circumpolar regions such as Nunatsiavut where the rate of warming is one of the fastest on the planet.

Rural family physician perspectives on communication with urban specialists: a qualitative study

OBJECTIVE

Communication is a key competency for medical education and comprehensive patient care. In rural environments, communication between rural family physicians and urban specialists is an essential pathway for clinical decision making. The aim of this study was to explore rural physicians' perspectives on communication with urban specialists during consultations and referrals.

SETTING

Newfoundland and Labrador, Canada.

PARTICIPANTS

This qualitative study involved semistructured, one-on-one interviews with rural family physicians (n=11) with varied career stages, geographical regions, and community sizes.

RESULTS

Four themes specific to communication in rural practice were identified. The themes included: (1) understanding the contexts of rural care; (2) geographical isolation and patient transfer; and (3) respectful discourse; and (4) overcoming communication challenges in referrals and consultations.

CONCLUSIONS

Communication between rural family physicians and urban specialists is a critical task in providing care for rural patients. Rural physicians see value in conveying unique aspects of rural clinical practice during communication with urban specialists, including context and the complexities of patient transfers.

Comparison of conventional and digital workflows for implant-supported screw-retained zirconia FPD bars: Fit and cement gap evaluation using SEM analysis

PURPOSE

To assess the fit and cement gap of fixed partial dentures supported by two implants made using conventional and digital workflows.

MATERIALS AND METHODS

Patients requiring fixed partial dentures supported by two implants were included in the study. Forty-eight zirconia fixed partial denture bars supported by two implants (AnyOne, MegaGen, Daegu, South Korea) were produced using a conventional (n = 24, group C) and digital (n = 24, group D) workflow. All implants had the same internal connection prosthetic platform. Silicone open tray impressions with splinted copings (group C) and digital impressions using a Trios 3 intraoral scanner (3Shape, Copenhagen, Denmark) (group D) were taken for each patient. The fit and cement gap were assessed by scanning electron microscopy on the verified master cast. The distance between reference points on the titanium base and implant analogue was measured with and without tightening the prosthetic screw. The difference in distance was calculated and represented the misfit (Dmisfit). The cement gap (Dcement) was measured as the shortest vertical distance from the inferior edge of the bar to the top edge of the titanium base.

RESULTS

The median Dmisfit values (interquartile range) differed significantly (P < 0.05) between the groups, with 59 (60) µm for group C and 78 (88) µm for group D. Fixed partial dentures fabricated using a digital workflow presented lower Dcement values (35 [26] µm) than the conventional group (38.9 [23] µm) (P < 0.05).

CONCLUSIONS

Both workflows produced different levels of fit and differently sized cement gaps when measured on the master casts using scanning electron microscopy. A cast-free digital workflow was associated with a smaller cement gap, but larger misfit was detected when measuring on the verified master cast.

Life-stage-dependent supergene haplotype frequencies and metapopulation neutral genetic patterns of Atlantic cod, Gadus morhua, from Canada's Northern cod stock region and adjacent areas

Among highly migratory fish species, nursery areas occupied by juveniles often differ from adult habitats. To better understand the spatial dynamics of Canada's Northern cod stock, juveniles caught off the east coast of Newfoundland and Labrador were compared to adults from the same region as well as individuals from other areas in Atlantic Canada using double-digest restriction site-associated DNA sequencing-derived single nucleotide polymorphisms. A reduced proportion of homozygotes with a chromosomal inversion located in linkage group 1 (LG1) was detected between juvenile and adult samples in the Northern cod stock region, potentially indicating age-dependent habitat use or ontogenetic selection for attributes associated with the many genes located in LG1. No selectively neutral genetic differences were found between samples from the Northern cod stock; nevertheless, significant differences were found between some of these samples and cod collected from St. Pierre Bank, Bay of Fundy, Browns Bank and the southern Scotian Shelf. Clustering analysis of variants at neutral loci provided evidence for three major genetic units: (a) the Newfoundland Atlantic Coast, (b) eastern and southern Gulf of St. Lawrence and Burgeo Bank and (c) the Bay of Fundy, Browns Bank and southern Scotian Shelf. Both adaptive and neutral population structure within the Northern cod stock should be considered by managers to promote demographic rebuilding of the stock.

Smart solutions for smart cities: Urban wetland mapping using very-high resolution satellite imagery and airborne LiDAR data in the City of St. John's, NL, Canada

Thanks to increasing urban development, it has become important for municipalities to understand how ecological processes function. In particular, urban wetlands are vital habitats for the people and the animals living amongst them. This is because wetlands provide great services, including water filtration, flood and drought mitigation, and recreational spaces. As such, several recent urban development plans are currently needed to monitor these invaluable ecosystems using time- and cost-efficient approaches. Accordingly, this study is designed to provide an initial response to the need of wetland mapping in the City of St. John's, Newfoundland and Labrador (NL), Canada. Specifically, we produce the first high-resolution wetland map of the City of St. John's using advanced machine learning algorithms, very high-resolution satellite imagery, and airborne LiDAR. An object-based random forest algorithm is applied to features extracted from WorldView-4, GeoEye-1, and LiDAR data to characterize five wetland classes, namely bog, fen, marsh, swamp, and open water, within an urban area. An overall accuracy of 91.12% is obtained for discriminating different wetland types and wetland surface water flow connectivity is also produced using LiDAR data. The resulting wetland classification map and the water surface flow map can help elucidate a greater understanding of the way in which wetlands are connected to the city's landscape and ultimately aid to improve wetland-related conservation and management decisions within the City of St. John's.

Isotopic Discrimination (δ15N, δ13C) in Captive and Wild Common Murres (Uria aalge) and Atlantic Puffins (Fratercula arctica)

Studying the diet of consumers using stable isotopes provides insight into the foraging ecology of individuals and species. To accurately reconstruct the integrated diet of animals using stable isotope values, we must quantify diet-tissue discrimination factors (DTDFs), or the way in which stable isotopes in prey are incorporated into the tissues of consumers. To quantify DTDFs, controlled experiments are needed, whereby consumers are fed a constant diet. However, relatively few controlled-diet studies have been conducted for seabirds. In this study, captive adult Atlantic puffins (Fratercula arctica) and common murres (Uria aalge) were fed a two-source diet of capelin (Mallotus villosus) and Atlantic silverside (Menidia menidia) to determine the DTDFs for the cellular component of blood and plasma for both δ¹⁵N and δ¹³C. The DTDFs for the cellular component (Δ¹⁵N: 2.80±0.28; Δ¹³C: 1.21±0.22) and plasma (Δ¹⁵N: 1.72±1.03; Δ¹³C: -0.18±0.56) of puffins were similar to those for the cellular component (Δ¹⁵N: 2.91±0.18; Δ¹³C: 1.09±0.23) and plasma (Δ¹⁵N: 2.18±0.77; Δ¹³C: -0.70±0.18) of murres. We reconstructed the diet of wild murres and puffins breeding on the northeastern coast of Newfoundland using previously published DTDFs and estimated DTDFs from our feeding experiment. Reconstructed dietary proportions supported a priori knowledge of diet, although outputs were sensitive to the DTDF used. Despite the similarity of our DTDFs for puffins and murres, along with the similarity of our DTDFs with those of other seabird species, our sensitivity analysis revealed considerable differences among resultant dietary contributions from mixing models, further highlighting the importance of using species- and tissue-specific DTDFs to enhance knowledge in the foraging ecology of seabirds using stable isotopes.

Marine pollution in fledged Leach's storm-petrels (Hydrobates leucorhous) from Baccalieu Island, Newfoundland and Labrador, Canada

The Leach's storm-petrel (Hydrobates leucorhous) is one of the most abundant and widely distributed marine birds in the North Atlantic but is under global population decline, possibly linked to marine pollution. We determined levels of ingested plastic and hepatic total mercury (THg) in recently fledged juveniles that stranded in Newfoundland and Labrador, Canada, and assessed the relationship to body condition, size and diet. Plastic prevalence was high (87.5%) but hepatic THg was relatively low (mean 486.7 ng/g dry weight) compared to other studies. Levels of neither pollutant were significantly related to body metrics of health. Our data confirm that plastic and mercury are pervasive in the western North Atlantic Ocean, prominent even in young birds.

Evaluating the impact of a champion on implementation of the Back Skills Training (BeST) programme in Canada: a mixed methods feasibility study protocol

INTRODUCTION

There is global recognition that low back pain (LBP) should be managed with a biopsychosocial approach. Previous implementation of this approach resulted in low uptake and highlighted the need for ongoing support. This study aims to explore the feasibility of (i) training and using a champion to support implementation, (ii) using a cluster randomised controlled trial (RCT), (iii) collecting patient reported outcome measures in a Canadian public healthcare setting and to identify contextual barriers to implementation.

METHODS

A pragmatic cluster RCT with embedded qualitative study with physiotherapists treating LBP in publicly funded physiotherapy departments in Newfoundland and Labrador, Canada. Participants will complete a previously developed online training course to equip them to deliver a biopsychosocial intervention for LBP. Clusters randomised to the intervention arm will receive additional support from a champion. A minimum champion training package has been developed based on known barriers in the literature. This includes strategies to target barriers relating to group-based scheduling issues, lack of managerial support, perceived patient factors such as addressing patient expectations for other types of treatments or selecting which patients might be best suited for this intervention, and anxiety about delivering something new. This package will be further codeveloped with study champions based on identified implementation barriers using the Behaviour Change Wheel. Clusters will be monitored for 6 months to assess champion and physiotherapist recruitment and retention, acceptability and implementation of the champion training, and the viability of conducting a cluster RCT in this setting. A purposive sample of physiotherapists will be interviewed from both arms.

ETHICS AND DISSEMINATION

This study was approved by Newfoundland and Labrador Health Research Ethics Authority in December 2018. Results will be disseminated to academic audiences through conferences and peer reviewed publications; to all study participants, their clinical leads, and patients with LBP.

TRIAL REGISTRATION NUMBER

ClinicalTrials.gov Identifier: NCT04377529; Memorial University of Newfoundland Protocol Record 20190025; Pre-results.

Reducing the dimension of water quality parameters in source water: An assessment through multivariate analysis on the data from 441 supply systems

In this research, multivariate statistical analysis was performed on twenty water quality parameters (WQP) collected on tri-monthly basis (four times/year) from 441 drinking water sources in Newfoundland and Labrador (NL), Canada for 18 years (1999-2016). The WQP included alkalinity (Alk), color (Col), conductivity (Cond), hardness (Hard), pH, total dissolved solids (TDS), turbidity (Turb), bromide (Br), calcium (Ca), chloride (Cl), fluoride (F), potassium (K), sodium (Na), sulfate (SO₄), dissolved organic carbon (DOC), ammonia (NH₃), nitrate (NO₃), Kjeldahl nitrogen (N), total phosphorus (P) and magnesium (Mg). The assessment was conducted on surface water (SWS) and groundwater (GWS) sources separately. In SWS and GWS, number of samples analyzed for each WQP were in the ranges of 3434-6057 and 1915-1919 respectively. Averages of DOC and pH showed increasing trends (SWS: DOC = 0.0722 mg/L/year; pH = 0.0375 units/year; GWS: DOC = 0.0491 mg/L/year; pH = 0.0441 units/year) while the other WQP showed variable characteristics, which could increase treatment cost and deteriorate tap water quality. Strong correlations were observed for Ca-Hard (r = 0.97-0.98), TDS-Cond (r = 0.91-0.99) and Na-Cl (r = 0.87-0.96). In SWS, Alk had stronger correlations with Cond, Hard, pH, TDS, Ca and Mg (r = 0.62-0.94) than GWS (r = 0.56-0.63). Principal Component Analysis revealed separate clusters for DOC-Col, Na-Cl, TDS-Cond, Ca-Alk and Mg-Hard, indicating that these WQP moved together. In SWS and GWS, six principal components were significant (eigenvalue ≥ 1.0), and explained 74.8% and 72.9% of overall variances respectively. In Factor Analysis, six varifactors explained 73.4% and 70.5% of total variances in SWS and GWS respectively. For SWS and GWS, eleven and ten WQP, respectively explained these variances, indicating 45% and 50% data reduction respectively. The findings can assist in controlling water quality through monitoring reduced number of WQP, which is likely to minimize the monitoring cost.

Evaluating the use of synchrotron X-ray spectroscopy in investigating brominated flame retardants in indoor dust

Brominated flame retardants (BFRs) are commonly used in consumer products and they shed off these products and eventually build up in household dust. Polybrominated diphenyl ethers (PBDEs), in particular, are known endocrine-disrupting chemicals affecting various hormone syntheses. Portable X-ray fluorescence spectroscopy (XRF) is the most common non-destructive method in identifying BFRs in environmental samples. However, the method is insensitive to bromine speciation. Synchrotron-based XRF has been shown to have very low detection limits (< 1 μg/g) that is suitable for detecting BFRs and can be combined with X-ray absorption near-edge spectroscopy (XANES) to identify the bromine species present in the household dust. Twenty indoor dust samples were collected from rural homes in Newfoundland (Canada) to assess the use of synchrotron-based techniques to identify BFRs. Synchrotron-based XRF analysis identified bromine in all the samples, with concentrations ranging from 2-19 μg/g. XANES analysis identified organic-based bromine species in several samples that are likely BFRs based on the spectral line shape. The accuracy of using XANES to identify BFRs is highly dependent on the source and size of the dust samples. Therefore, for future research, it is important to take into account the sources of dust sample and to focus on fine dust particles.

Effect of aeration, iron and arsenic concentrations, and groundwater matrix on arsenic removal using laboratory sand filtration

Natural groundwater from the towns of Wabana and Freshwater and treated well water from the town of Wabana in Newfoundland and Labrador, Canada were tested separately and together in sand columns to study the removal of arsenic. The most ideal conditions for arsenic removal appeared to include an arsenic concentration of approximately 35 µg/L and lower, an Fe:As mass ratio in the order of 65 and lower, and aeration of the sand media. Active aeration by pumping air though the filter, passive aeration by scraping off top layers of sand and virtual aeration by diluting the strength of the water being treated, were employed and compared. For tests where groundwater from the towns of Wabana and Freshwater was combined, arsenic removal was optimized and other elements, in addition to iron, were also correlated with effluent arsenic. Further, for these same tests there was a gradual increase in effluent pH that could have been due to oxygen depletion or gradually more reducing conditions in the sand column. Where Ni, Mn and Zn were correlated with effluent arsenic it was concluded that the increase in pH increased heavy metal removal and arsenic release. In the test where the treated Wabana water made up a greater proportion of the mix than the Wabana groundwater, lithium was also correlated with arsenic.

Developing an Innu framework for health research: The canoe trip as a metaphor for a collaborative approach centered on valuing Indigenous knowledges

Indigenous communities increasingly assert their right to self-determination by requiring that participatory research approaches be used, valuing and prioritizing Indigenous knowledges, for the purpose of improving Indigenous health. While frameworks that focus on Indigenous knowledges are being developed, these must be adapted or developed by Indigenous communities because their knowledge is specific to place and inherent to their lived experience. No community-based participatory research (CBPR) framework for health research has been developed with the Labrador Innu. In addition, while the literature emphasizes the importance of relationship in research with Indigenous communities, the process of establishing relationships is underspecified. Within this context, we describe our experience in developing a CBPR framework for health research in a study that is community-initiated and fitting within Innu self-determination. We highlight the importance of paying attention to the theoretical roots of CBPR, arguing that this helps researchers focus on the centrality of Indigenous knowledges (in this case, Innu knowledge). This requires that non-Indigenous researchers question assumptions of universality regarding their own knowledge and see all knowledges as equitable. Such posture of humility allows non-Indigenous researchers to enter relational spaces that join researchers and Indigenous communities. Within these spaces, a true collaborative approach is enabled and Indigenous knowledges are uncovered and become foundational in the inquiry process. We illustrate these ideas by describing a model for opening relational spaces that include Indigenous and non-Indigenous researchers. We then present a framework that uses the metaphor of canoeing together to capture our CBPR approach for use in Innu health research. We outline the behaviors of non-Indigenous researchers to build and solidify relationships with Indigenous community researchers over time. This article is useful for non-Indigenous researchers interested in relational approaches to research with Indigenous communities, and for Indigenous leaders and researchers who seek community solutions through research.

Development of a drinking water quality index based on a participatory procedure using mixed multicriteria methods

The objective of this study is to propose and apply a novel approach to develop a drinking water quality index that enables water managers to routinely identify the vulnerabilities in a distribution system (DS) while taking into account the priorities of water managers and operators. Here, we propose an innovative approach based on the participation of eight researchers and water managers. The input from these participants was included through a combination of the Delphi and MACBETH (Measuring Attractiveness by a Categorical-Based Evaluation Technique) methods, which were applied to an index developed using fuzzy logic. The index was then validated by conducting sensitivity and comparative analyses on a database from field sampling campaigns conducted in various small municipal DSs in two Canadian provinces: Quebec and Newfoundland and Labrador. Finally, the drinking water quality index was applied to a database of the DS in Quebec City, Canada. Sensitivity and comparative analyses revealed that the developed index could allow for the characterization of water sample quality and could prove useful for prioritizing interventions in the DS. The index was also useful for representing the spatial variability of water quality, and provided nuanced information about water quality, especially when the water quality parameter values complied with guidelines and regulations. These results provide a transferable and integrated approach for developing customized drinking water quality indices. This study will help pave the way for water quality managers to better prevent episodes of possible water quality deterioration.

A qualitative study exploring the influence of clinic funding on the integration of family practice nurses in Newfoundland and Labrador

AIM

This study explores the contributions of family practice nurses in primary care across Newfoundland and Labrador funded by fee-for-service and alternate payment plans to examine the influence of funding arrangements on nursing roles/activities.

DESIGN

A qualitative descriptive design was employed.

METHODS

Semi-structured telephone interviews were conducted between March-July 2018 with physicians and Registered Nurses working in primary care settings in Newfoundland and Labrador. Interviews were transcribed verbatim, and a content analysis approach was used to identify recurring themes.

RESULTS

Clinic funding was instrumental in the integration of family practice nurses into primary care settings and influenced roles/activities. In fee-for-service practices, nurses work with physicians and focus on one-on-one patient care in office-based settings, whereas nurses in alternate payment plans practices work more independently, in a wider range of settings and with emphasis on both individual and group-based encounters. Compared with alternate payment plans practices, fee-for-service practices tend to be more restrictive due to physician billing requirements.

Prolonged maternal investment in northern bottlenose whales alters our understanding of beaked whale reproductive life history

Nursing and weaning periods are poorly understood in cetaceans due to the difficulty of assessing underwater behaviour in the wild. However, the onset and completion of weaning are critical turning points for individual development and survival, with implications for a species' life history including reproductive potential. δ15N and δ13C deposited in odontocete teeth annuli provide a lifetime record of diet, offering an opportunity to investigate variation and trends in fundamental biology. While available reproductive parameters for beaked whales have largely been inferred from single records of stranded or hunted animals and extrapolated across species, here we examine the weaning strategy and nursing duration in northern bottlenose whales (Hyperoodon ampullatus) by measuring stable isotopes deposited in dentine growth layer groups (GLGs). Using a collection of H. ampullatus teeth taken from whales killed during the whaling era (N = 48) and from two stranded specimens, we compared ontogenetic variation of δ15N and δ13C found in annual GLGs across all individuals, by sex and by region. We detected age-based trends in both δ15N and δ13C that are consistent across regions and males and females, and indicate that nursing is prolonged and weaning does not conclude until whales are 3-4 years old, substantially later than previous estimates of 1 year. Incorporating a prolonged period of maternal care into H. ampullatus life history significantly reduces their reproductive potential, with broad implications for models of beaked whale life history, energetics and the species' recovery from whaling.

Fine spatial-scale variation in scavenger activity influences avian mortality assessments on a boreal island

Bird-window collisions are the second leading cause of human-related avian mortality for songbirds in Canada. Our ability to accurately estimate the number of fatalities caused by window collisions is affected by several biases, including the removal of carcasses by scavengers prior to those carcasses being detected during surveys. We investigated the role of scavenger behavior in modifying perceived carcass removal rate while describing habitat-specific differences for the scavengers present in a relatively scavenger-depauperate island ecosystem. We used motion activated cameras to monitor the fate of hatchling chicken carcasses placed at building (under both windows and windowless walls) and forest (open and closed canopy) sites in western Newfoundland, Canada. We recorded the identity of scavengers, timing of events, and frequency of repeat scavenging at sites. Using 2 treatments, we also assessed how scavenging varied with 2 levels of carcass availability (daily versus every third day). Scavenger activities differed substantially between forest and building sites. Only common ravens (Corvus corax) removed carcasses at building sites, with 25 of 26 removals occurring under windows. Burying beetles (Nicrophorus spp.) dominated scavenging at forest sites (14 of 18 removals), completely removing carcasses from sight in under 24 hours. Availability had no effect on removal rate. These findings suggest that ravens look for carcasses near building windows, where bird-window collision fatalities create predictable food sources, but that this learning preceded the study. Such behavior resulted in highly heterogeneous scavenging rates at fine spatial scales indicating the need for careful consideration of carcass and camera placement when monitoring scavenger activity. Our observations of burying beetle activity indicate that future studies investigating bird collision mortality near forested habitats and with infrequent surveys, should consider local invertebrate community composition during survey design. The high incidence of invertebrate scavenging may compensate for the reduced vertebrate scavenger community of insular Newfoundland.

Protocol for assessing the determinants of preoperative test-ordering behaviour for low-risk surgical procedures using a theoretically driven, qualitative design

INTRODUCTION

Current evidence suggests that preoperative tests such as chest X-rays, electrocardiograms and baseline laboratory studies may not be useful for healthy patients undergoing low-risk surgical procedures. Routine preoperative testing for healthy patients having low-risk surgery is not a scientifically sound practice. In this study, we will interview healthcare providers working at medical facilities where low-risk surgical procedures are carried out. This will allow us to gain insight into the determinants of preoperative testing behaviours for healthy patients undergoing low-risk surgeries and their barriers and enablers to guideline adherence.

METHODS AND ANALYSIS

We will use semistructured interviews with anaesthesiologists, surgeons and preadmission clinic nurses to assess the determinants of preoperative testing behaviours. The interview guide was designed around the Theoretical Domains Framework (TDF), developed specifically to determine the barriers and enablers to implementing evidence-based guidelines. Interviews will be audio-recorded, transcribed verbatim and coded according to the TDF. Key themes will be generated for each of the identified domains.

ETHICS AND DISSEMINATION

We have received ethics approval from the Health Research Ethics Board in Newfoundland and Labrador (HREB #2018.190) for this study. The results of this work will be disseminated through a peer-reviewed publication, presentation at a healthcare forum and plain-language infographic summaries. Additionally, deidentified data collected and analysed for this study will be available for review from the corresponding author on reasonable request.

The Ecology of Individual Differences Empirically Applied to Space-Use and Movement Tactics

Movement provides a link between individual behavioral ecology and the spatial and temporal variation in an individual's landscape. Individual variation in movement traits is an important axis of animal personality, particularly in the context of foraging ecology. We tested whether individual caribou (Rangifer tarandus) displayed plasticity in movement and space-use behavior across a gradient of resource aggregation. We quantified first-passage time and range-use ratio as proxies for movement-related foraging behavior and examined how these traits varied at the individual level across a foraging resource gradient. Our results suggest that individuals adjusted first-passage time but not range-use ratio to maximize access to high-quality foraging resources. First-passage time was repeatable, and intercepts for first-passage time and range-use ratio were negatively correlated. Individuals matched first-passage time but not range-use ratio to the expectations of our patch-use model that maximized access to foraging resources, a result that suggests that individuals acclimated their movement patterns to accommodate both intra- and interannual variation in foraging resources on the landscape. Collectively, we highlight repeatable movement and space-use tactics and provide insight into how individual plasticity in movement interacts with landscape processes to affect the distribution of behavioral phenotypes and potentially fitness and population dynamics.

Nitrous oxide fluxes of a boreal abandoned pasture do not significantly differ from an adjacent natural bog despite distinct environmental conditions

Land-use conversion of pristine boreal peatlands for agricultural purposes is an ongoing process and projected to become more intensive with rising population growth and increased demands for food production. However, agricultural use of peatlands affects the production and emission of nitrous oxide (N₂O), a very potent greenhouse gas currently gaining more attention in the global assessment of greenhouse gases. While the intensity of N₂O emissions depends on a range of environmental factors, including hydrological parameters, temperature and the availability of nitrogen in soils, key driving processes remain poorly understood. In order to understand the effects of land-use change on the peatland ecosystem, we quantified N₂O fluxes under different land-use in a comparative study between a natural bog and an adjacent abandoned pasture in Newfoundland, Canada. We conducted in situ gas flux measurements using the static chamber method over five growing seasons. In addition, we measured photosynthetic rates and environmental parameters, namely soil temperature and moisture, water table and concentrations of total nitrogen and dissolved organic carbon in pore waters. According to previous studies, we hypothesized higher N₂O emissions from the abandoned pasture due to drainage compared to the natural bog. However, despite significant differences of environmental parameters and photosynthetic rates, we found no significant difference of N₂O fluxes between the two sites. We argue that N₂O production at the abandoned pasture was inhibited due to exhaustion of plant-available nitrogen as a result of increased gross primary production compared to the natural bog. We conclude that the effect of drainage and fertilization on N₂O fluxes during the growing season was superposed by vegetation composition change effects at the abandoned pasture, leading to similar N₂O fluxes at both sites.

Investigation of the climatological impacts of agricultural management and abandonment on a boreal bog in western Newfoundland, Canada

We compared greenhouse gas (GHG) fluxes and albedo of a pristine boreal bog and an adjacent abandoned peatland pasture in western Newfoundland, Canada to estimate the magnitude of radiative forcing (RF) created by agricultural drainage and abandonment. Our results indicated that these anthropogenic activities induced a climate cooling effect (negative RF), with the magnitude of the RF caused by the albedo change comparable to that induced by altered GHGs. Although the albedo-induced RF was positive in winter and negative in summer, the summer effect dominated because of greater solar radiation received. The climate cooling effect of GHGs change was due to an increase in the carbon dioxide sink capacity and a reduction in methane emissions under lower water table levels following agricultural drainage and abandonment. Calculation of sustained-flux global warming/cooling potentials also supported this finding. Our results show that the overall increase in albedo resulting from agricultural drainage and abandonment contributes significantly to the negative RF, strengthening the cooling effect due to the changing GHG fluxes. Therefore, changes in albedo due to altered vegetation coverage and hydrology and GHG fluxes should be considered when assessing the climatic impacts from land-use change in northern peatland.

Occurrence of plastics ingested by Atlantic cod (Gadus morhua) destined for human consumption (Fogo Island, Newfoundland and Labrador)

In the province of Newfoundland and Labrador, fishing is a core occupation and also a source of marine plastic pollution. To look at this relationship, we examined 216 gastrointestinal tracts of Atlantic cod (Gadus morhua) caught by commercial fishers at Fogo Island, Newfoundland and Labrador, Canada. We found three tracts contained plastic for a frequency of occurrence of 1.4%. While this result is consistent with other cod sampled in the province, this study found two gastrointestinal tracts contained intact bait bags, used in commercial pots, and the third tract contained a polypropylene thread, likely originating from fishing rope. Our findings demonstrate the frequency of plastic ingestion in this region is low, but fishing-gear related plastics represent a key source of marine plastics in the region that should be addressed.

The INternet ThERapy for deprESsion Trial (INTEREST): protocol for a patient-preference, randomised controlled feasibility trial comparing iACT, iCBT and attention control among individuals with comorbid chronic pain and depression

INTRODUCTION

Approximately one-third of adults with chronic pain also report clinically relevant levels of depression. Internet-delivered psychological therapies such as Cognitive Behavioural Therapy (iCBT) and Acceptance and Commitment Therapy (iACT) have been developed to overcome barriers of access to services and ensure the timely delivery of care. The objective of this trial is to collect data on feasibility, acceptability and range of probable effect sizes for iCBT and iACT interventions tailored towards the treatment of depression and chronic pain using a randomised controlled patient-preference design.

METHODS AND ANALYSIS

Community dwelling adults with chronic non-cancer pain (CNCP) and major depression will be recruited from pain clinics and primary care providers in Newfoundland and Labrador, Canada. The study is a randomised controlled patient-preference trial. Eligible patients will be randomly assigned to a 'preference' or 'no-preference' arm during the first step of randomisation and to intervention or control in the second step of randomisation. Two interventions (ie, iCBT or iACT) will be evaluated relative to attention control. iCBT and iACT involve the completion of 7-weekly online modules augmented with one session of motivational enhancement and weekly therapy sessions. Primary outcomes include (1) feasibility and acceptability parameters and (2) change in symptoms of depression. Secondary outcomes include pain, physical function, emotional function and quality of life. We will recruit 60 participants and examine the range of effect sizes obtained from the trial but will not conduct significance testing as per recommendations for behavioural trial development.

ETHICS AND DISSEMINATION

Ethics was approved by the provincial Health Research Ethics Board. Dissemination of results will be published in a peer-reviewed academic journal and presented at scientific conferences.

TRIAL REGISTRATION NUMBER

NCT04009135.

Rural360: incubating socially accountable research in the Canadian North

People in Northern Newfoundland and Coastal Labrador (NNCL), Canada, face major challenges obtaining accessible and contextually-relevant healthcare. Rural360 is a socially accountable research incubator that provides funding for NNCL physicians to research solutions to these issues. NNCL graduates of the adjoined 6for6 research training program for rural physicians are invited to submit the research project they have conceptualised as part of that initiative as a letter of intent, and subsequently as a research proposal, to Rural360. These submissions are reviewed by relevant subject matter experts as part of the Rural360 adjudication process. This process is iterative and strives to guide and assist participants in refining their submission. The overarching objective of Rural360 is to collaborate with rural physicians to conduct, disseminate or otherwise catalyze unsupported community-based research in NNCL. In so doing, it is highly socially accountable, empowering participants to become change-makers who investigate contextually important health issues that emerge from NNCL communities.

Sexually selected traits are larger and more variable in male than female beach-spawning capelin, Mallotus villosus

We evaluated whether morphological traits in capelin, Mallotus villosus, that appear to be sexually selected (pectoral fin, pelvic fin, anal fin, lateral ridge) were larger and more variable in males than females compared with naturally selected morphological traits (eyes, dorsal fin). Photographs were obtained of 136 capelin captured at two spawning sites and standardised measurements were taken of six morphological traits. Males had larger traits than females for a given body size and this was most pronounced in the traits thought to be sexually selected. Body size explained much of the variation in female traits but less variation in male traits, suggesting alternative selection pressures are involved. We suggest that larger male body size aids in endurance rivalry and sexually dimorphic traits help males to remain in physical contact with females while spawning on the beach.

Piecing together the Inuit food security policy puzzle in Nunatsiavut, Labrador (Canada): protocol for a scoping review

INTRODUCTION

Inuit Nunangat is the Inuit homeland in Canada. It is comprised of four Inuit regions. Inuit residing in these areas experience greater social and economic inequities than the general Canadian population. Food security exemplifies this inequity and is a distinct determinant of Inuit health. Policy can play an integral role in health equity. However, demonstrating this role can be a complex task, especially when there are both national and regionally specific policies pertaining to each of the Inuit regions. This scoping review will focus on Nunatsiavut, located in northern Labrador. This region is situated within a complex policy space due to the national, provincial and regional governance structures, geographical location and the breadth of factors pertaining to food security. This scoping review aims to identify the range of policies pertaining to food security in Nunatsiavut and complete a directed content analysis to code each policy against the applicable dimension of food security.

METHODS AND ANALYSIS

The researchers will conduct a search strategy on the following four databases: MEDLINE (via Ovid), Embase (via Ovid), CINHAL and Scopus. A hand search of the relevant journals, conference abstracts and grey literature will be completed from April to October 2019. The following parameters will be extracted: a description of the policy, the organisation/institution that developed the policy, the definition of food security used or implied, and any stated intended targets or outcomes. The results will be compiled in a tabular form.

ETHICS AND DISSEMINATION

Ethics approval is not required as primary data will not be collected. The findings from this scoping review will be disseminated through peer-reviewed journals and public presentations. The results of this scoping review will be validated by a Nunatsiavut Government Advisory Group.

Low serum choline and high serum betaine levels are associated with favorable components of metabolic syndrome in Newfoundland population

BACKGROUND

We investigated the relationships between serum choline and betaine levels with metabolic syndrome-related indices in the general population of Newfoundland.

METHODS

1081 adults were selected from the CODING study. Serum choline and betaine levels were measured. Major confounding factors were controlled in all analyses.

RESULTS

Partial correlation and linear regression analysis showed that serum choline levels were positively associated with systolic blood pressure (r: 0.124), serum TG levels (r: 0.132) and negatively correlated with serum glucose levels (r: -0.121) in males (p < 0.01 for all). In females, serum choline levels were positively correlated with serum TG, TC and HDL levels (r: 0.104 to 0.148, p < 0.05 for all). Serum betaine levels were negatively associated with serum TG, TC, LDL and insulin levels, and with atherogenic index and HOMA-IR index in males (r: -0.081 to -0.179, p < 0.05 for all). In females, serum betaine levels were negatively associated with serum TG, hsCRP and insulin levels, and with HOMA-IR index (r: -0.092 to -0.213, p < 0.05 for all). Moreover, subjects with serum choline levels in the highest tertile showed highest serum TG levels and systolic blood pressure in males, and highest serum lipids levels in females. Subjects with the highest serum betaine levels had the lowest serum lipids levels, atherogenic index, IR severity in males, and the lowest serum TG and hsCRP levels, and IR severity in females.

CONCLUSION

Low serum choline and high serum betaine levels are associated with favorable components of metabolic syndrome in general adults.

Helicopter-borne NMR for detection of oil under sea-ice

Mobile nuclear magnetic resonance (NMR) operating in Earth's magnetic field is adapted to detect leaked or spilled oil trapped in or under sea ice without the need to place any personnel on the ice. A helicopter placed a 6-meter diameter NMR coil system weighing approximately 1000 kg on 92 cm-thick ice surrogate and detected the equivalent of 1 cm thick oil under the ice surrogate in 3-1/2 min.