Eastern Canadian Provinces Research Articles

Geographical Disparities in Lung Cancer in Canada: A Review.

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

Lived Experiences of Fatherhood After Infertility

ObjectiveTo explore the lived experiences of fathers in the perinatal period after infertility. DesignA descriptive, phenomenological study. SettingResearcher’s private office and participants’ homes in an Eastern Canadian province. ParticipantsEight fathers who met the eligibility criteria. MethodsWe recruited a purposive sample of eight participants and held one-on-one interviews in person, by telephone, and via virtual platforms. We analyzed the verbatim transcripts of the audiotaped interviews using Colaizzi’s phenomenological data analysis method. ResultsWe uncovered seven themes that described the lived experiences of participants: The Journey: A Long Winding Road, Roles and Responsibilities: Supporter and Protector, Support: The Often-Forgotten Parent, Challenges and Hurdles: Bumps on the Road, So Many Feelings: The Rollercoaster, Coping: Living on the Road, and Reflection: An Unforgotten Journey. Participants shared their experiences of the perinatal period after infertility as long journeys and described how bumps along the road marked these journeys. The journeys were essential parts of their lives that they continued to remember years later. ConclusionThe perinatal experience after infertility is an important and remembered time for fathers. It is essential to involve and support them in the perinatal process to facilitate positive experiences and overall family health, especially after infertility. There is an ongoing need to conduct research with fathers and to develop evidence-based programming and resources to assist them in the perinatal period after infertility.

Assessing the Cumulative Impacts of Forest Management on Forest Age Structure Development and Woodland Caribou Habitat in Boreal Landscapes: A Case Study from Two Canadian Provinces

The Canadian boreal forest biome has been subjected to a long history of management for wood production. Here, we examined the cumulative impacts of logging on older forests in terms of area, distribution and patch configuration in the managed forest zones of the Eastern Canadian provinces of Ontario and Quebec. We also examined the consequences of these cumulative impacts on a once widely distributed and now threatened species, the woodland caribou (Rangifer tarandus caribou). The cumulative area of recently logged forest (since ~1976) was 14,024,619 ha, with 8,210,617 ha in Quebec and 5,814,002 ha in Ontario. The total area of older forests was 21,249,341 ha, with 11,840,474 ha in Quebec and 9,408,867 ha in Ontario. Patch statistics revealed that there were 1,085,822 older forests with core patches < 0.25 ha and an additional 603,052 < 1.0 ha. There were 52 > 10,00–50,000 ha and 8 < 50,000 ha. Older forest patches (critical caribou habitat) in the 21 local population ranges totalled 6,103,534 ha, distributed among ~387,102 patches with 362,933 < 10 ha and 14 > 50,000 ha. The median percentage of local population ranges that was disturbed was 53.5%, with Charlevoix having the maximum (90.3%) and Basse Côte-Nord the least (34.9%). Woodland caribou local population ranges with disturbed suitable habitats >35% are considered unable to support self-sustaining populations. We found that for the 21 caribou local population ranges examined, 3 were at very high risk (>75% area disturbed), 16 at high risk (>45 ≤ 75% area disturbed), and 2 at low risk (≤35% area disturbed). Major changes are needed in boreal forest management in Ontario and Quebec for it to be ecologically sustainable, including a greater emphasis on protection and restoration for older forests, and to lower the risks for caribou populations.

Transitioning from paediatric to adult healthcare: Exploring the practices and experiences of care providers.

Complex paediatric health conditions are increasingly associated with survival into adulthood resulting in more youth with complex care needs (CCN) transitioning from paediatric to adult healthcare. Current transition practices, when present, are disorganized, resulting in health status deterioration and complications due to unmet needs. The aim of this qualitative descriptive study is to develop a broader understanding of the current transition practices and experiences, as well as recommendations of care providers who support youth with CCN in the transition from paediatric to adult healthcare. Fifteen care providers from two Eastern Canadian provinces were interviewed using a semi-structured interview guide. The data collected were analyzed using inductive thematic analysis following the six phases outlined by Braun and Clarke (2006). The findings from this research demonstrate (1) a shortage of care providers, (2) inconsistent timing for transition initiation, and (3) lack of available community resources and services. Participant recommendations include (1) a designated transition coordinator; (2) transition policy implementation; (3) improved collaboration between and across care teams; and (4) the integration of virtual care to facilitate the transition process. The results of this study can potentially improve transition practices and policies and guide future research in this area.

The role of farmer networks in supporting adaptive capacity: Opening the door for innovation and transformation in the Northeastern United States

This article explores the role of farmer networks in building the adaptive capacity of small and diversified farmers in the Northeastern United States. Previous research suggests that farmers’ networks are the backbone of practical agricultural knowledge systems in the United States, serving as a critical venue where growers exchange and negotiate new ideas. Drawing upon empirical evidence from a regional survey on climate resilience and a series of focus groups conducted in collaboration with 9 farmer organizations from Pennsylvania to Eastern Canadian provinces, this article examines how the emergence of new ideas and agroecological innovations are influenced by geography, network affiliation, and perceived agency. First, we use regression analysis to identify factors that influence the use of no-till on diversified vegetable and berry farms, which is an emerging innovation in this community. Our analysis shows that geography may not be a significant driver of adoption among the population we sampled, which contrasts with previous research on explanatory factors, yet affiliation with certain farmer networks was significant in predicting the use or intended use of the practice. This quantitative analysis is complemented by qualitative data from a series of focus groups in which farmers identify the characteristics of certain networks which support them in addressing new challenges. Farmers identified that networks support them in learning about new ideas, accessing resources, and engaging in creative problem-solving, through facilitation of spaces for exchange with peers and experts and being responsive to their emerging needs.

The Prevalence and Predictors of Compassion Satisfaction, Burnout and Secondary Traumatic Stress in Registered Nurses in an Eastern Canadian Province: A Cross-Sectional Study.

The quality of Registered Nurses' worklife is impacting nurses' mental health, and the standard of care received by clients. Contributing factors to nurses' stress are the trauma of continuous caring for those in great suffering, and adverse working conditions. i) to explore the prevalence of work-related stress in a provincial sample of Registered Nurses; ii) to compare the levels of compassion satisfaction, burnout and secondary traumatic stress reported by nurses in hospital, community, non-direct care settings, and, iii) to identify factors that predict levels of nursing work stress. A descriptive, predictive study with a self-report survey containing demographic questions and the Professional Quality of Life Scale was emailed to over 3,300 Registered Nurses. The scale measured the prevalence of three worklife indicators, compassion satisfaction, burnout and secondary traumatic stress. Multiple linear regression identified factors that predicted the levels of the three indicators. A subgroup analysis explored the quality of worklife based on three practice environments. Nurses (n = 661) reported moderate compassion satisfaction, burnout, and secondary traumatic stress. The strongest predictor, satisfaction with one's current job, predicted high compassion satisfaction and lower burnout and secondary stress. The subgroup analysis identified hospital nurses as having the most work-related stress and the lowest level of compassion satisfaction. Innovative, collaborative action can transform nurses' practice environments. Organizational support is essential to bring about needed improvements.

“We Knew No One Else Had Our Back except Us”: Recommendations for Creating an Accountability Care Framework with Sex Workers in Eastern Canada

The authors report findings from a 15-month project that focused on the experiences of sex workers who live and work in an Eastern Canadian province. As part of a larger multi-phased study, 15 adults who identified as women, transgender, or non-binary, and received money or goods for sexual services, participated in photo-elicitation interviews. Drawing on a critical framing analysis, findings indicated supports—as identified and experienced by sex workers—encompassed three categories of care: self, community, and collective. These categories are described, with a particular focus on the latter two. Continuing with the care-based framework, recommendations to structure interventions draw on the role of accountability care in identifying how best to operationalize policies that promote health, well-being, and dignity of Canadian sex workers. The paper begins with a brief overview of the Canadian context and the role of supports. It follows with a discussion on the materials and methods and the results. It concludes with recommendations, limitations, and future considerations.

Public interest in unexpected genomic findings: a survey study identifying aspects of sequencing attitudes that influence preferences.

We describe public preferences for unexpected genomic findings and explore predictors of preferences using an online survey in an Eastern Canadian province. Items measuring attitudes toward features of unexpected findings and genomic sequencing concerns were entered in logistic regression models predicting interest in unexpected findings. Very high levels of interest were observed in unexpected findings for treatable disorders and carrier results, with lesser interest in unexpected findings for non-treatable disorders and unclassified variants. Respondents who endorsed items measuring features of patient control and choice over their genomic data and testing options were 3-5 times more likely to be very interested in receiving unexpected findings. Respondents with high genomic sequencing concerns were less interested in the return of any unexpected result. Self-reported history of a genetic condition was significantly related to interest in receiving most categories of unexpected genomic information, while prior use of direct-to-consumer testing was significantly related only to interest in the return of unexpected genomic findings for disorders not currently treatable. Findings highlight the need for specific elements of information and transparency regarding the return of unexpected findings and can inform the development of patient-centered materials and return of results policies.

Family-Focused Early Learning Programing: Access, Opportunities, and Issues in one Canadian Context

Family-focused early learning programs aim to assist parents in supporting their young children language and literacy development. This study examined program access and learning opportunities for diverse families across a wide range of community-based settings in one eastern Canadian province. As well, the study examined practitioners’ perspectives on issues related to program development and implementation. Primarily through surveys, practitioners provided data on more half of all community-based programs in the province. The findings of the study showed that most programs offered a form of parent and child focused drop-in play as the core of their programing. Few programs offered a more formalized parent-facilitator learning component as is sometimes found in other jurisdictions. The issues and challenges in programing identified by practitioners included attracting participants, maintaining funding and expanding program activities, and staff training to expand and enhance programing to meet the needs of families. These issues are discussed in light of current public policy and practice.

Exploring French Canadian high school students' interest in and perspectives of a career with older adults.

For the next 30years, population aging will impact many facets of our society. Of specific concern is future human resources in the aging sector and related health fields. Every year, high school students make decisions related to their future careers, but few express interests in a career in aging. The goal of this study was to explore high school students' interest in and perspectives of a career in the field of aging. The specific objectives of the study were to identify high school students' perspectives of older adults, explore their level of interest in an aging-related career and understand the reasons for their level of interest for a career in aging. In this qualitative descriptive study, 41 French-speaking students in Grades 10 and 11 from an eastern Canadian province participated in a total of five focus group discussions where an educational video complemented the semi-structured interviews. Content analysis produced four common themes: perspectives of aging and older adults, exposure to aging in school, reasons for disinterest and increasing awareness and interest. Results indicate a lack of aging content or intergenerational activities in schools, whereas students made suggestions for better integration of aging content in the school curriculum. Future research with school guidance counsellors or educators would be beneficial in understanding aging content integration and student exposure to aging. Study limitations are also presented.

Commentary on the impact of the COVID-19 pandemic on opioid use disorder treatment among Indigenous communities in the United States and Canada

This commentary focuses on how some Indigenous communities in the United States (U.S.) and Canada are addressing the opioid epidemic within the context of the COVID-19 pandemic, from the perspective of the co-authors as researchers, clinicians, and pharmacists working within or among Indigenous communities in three eastern Canadian provinces and two western U.S. states. The pandemic has likely exacerbated opioid use problems among Indigenous communities, especially for individuals with acute distress or comorbid mental illness, or who are in need of withdrawal management or residential services. In response to the pandemic, we discuss first how greater prescription flexibility has facilitated and even increased access to medications for opioid use disorder. Second, we describe how Indigenous-serving clinics have expanded telemedicine services, albeit not without some challenges. Third, we note challenges with restricted participation in traditional Indigenous healing practices that can be helpful for addiction recovery. Fourth, we mention providers' worries about the pandemic's impact on their patients' mental health and safety. We argue that certain treatment transformations may be helpful even after the pandemic is over, through enhancing access to community-grounded treatment, decreasing stigma, and promoting patient self-efficacy.

Accessing Local Tacit Knowledge as a Means of Knowledge Co-Production for Effective Wildlife Corridor Planning in the Chignecto Isthmus, Canada

Inclusive knowledge systems that engage local perspectives and social and natural sciences are difficult to generate and infuse into decision-making processes but are critical for conservation planning. This paper explores local tacit knowledge application to identify wildlife locations, movement patterns and heightened opportunities and barriers for connectivity conservation planning in a critical linkage area known as the Chignecto Isthmus in the eastern Canadian provinces of Nova Scotia and New Brunswick. Thirty-four local hunters, loggers, farmers and others with strong tacit knowledge of wildlife and the land participated in individual interviews and group workshops, both of which engaged participatory mapping. Individuals’ data were digitised, analysed and compiled into thematic series of maps, which were refined through participatory, consensus-based workshops. Locations of key populations and movement patterns for several species were delineated, predominantly for terrestrial mammals and migratory birds. When comparing local tacit-knowledge-based maps with those derived from formal-natural-science models, key differences and strong overlap were apparent. Local participants provided rich explanatory and complementary data. Their engagement in the process fostered knowledge transfer within the group and increased confidence in their experiential knowledge and its value for decision making. Benefits derived from our study for conservation planning in the region include enhanced spatial data on key locations of wildlife populations and movement pathways and local insights into wildlife changes over time. Identified contributing factors primarily relate to habitat degradation and fragmentation from human activities (i.e., land use and cover changes caused by roads and forestry practices), thereby supporting the need for conservation measures. The generated knowledge is important for consideration in local planning initiatives; it addresses gaps in existing formal-science data and validates or ground truths the outputs of existing computer-based models of wildlife habitat and movement pathways within the context of the complex social-ecological systems of the place and local people. Critically, awareness of the need for conservation and the value of the participants’ shared knowledge has been enhanced, with potential influence in fostering local engagement in wildlife conservation and other planning initiatives. Consistent with other studies, engagement of local people and their tacit knowledge was found to (i) provide important insights, knowledge translation, and dissemination to complement formal, natural science, (ii) help build a more inclusive knowledge system grounded in the people and place, and (iii) lend support to conservation action for connectivity planning and human-wildlife co-existence. More broadly, our methods demonstrate an effective approach for representing differences and consensus among participants’ spatial indications of wildlife and habitat as a means of co-producing knowledge in participatory mapping for conservation planning.

Public engagement with genomic medicine: a summary of town hall discussions.

Engaging with the public for their input about genomic medicine is critical before it is implemented into routine healthcare practice. In order to inform discussion and planning for the introduction of genome sequencing into clinical care in an Eastern Canadian province, we implemented a program of public engagement activities. Here, we report a qualitative summary of two town hall discussions utilizing a hybrid information-consultation approach with 20 residents of the province of Newfoundland and Labrador, Canada. Discussion revealed largely positive attitudes towards genomic medicine; however, critical reflection around informed consent models, the return of sequencing findings, and access to qualified healthcare professionals revealed numerous public concerns. Public support will be important to realize the potential benefits of genomics and precision medicine to health outcomes. Our findings highlight public concerns that must be addressed in educational and informed consent documents related to sequencing. Town hall attendees endorsed ongoing public education and awareness-building initiatives which could help foster transparency and trust as genomics is integrated into healthcare systems.

Public interest in whole genome sequencing and information needs: an online survey study.

Aim: To survey the general public about whole genome sequencing interest, including pharmacogenomic testing, and to identify information important for sequencing decisions. Patients & methods: An online survey of 901 members of the general public in an eastern Canadian province. Results: Interest in whole genome sequencing, including pharmacogenomic testing, was high with few differences among demographic variables. Issues identified as very important to sequencing decisions included familial implications of testing, whether treatment was available for conditions tested and knowing who could access genomic information. Most respondents would value support when interpreting sequencing results. Conclusion: Findings reveal the kind of information and support users of sequencing services would value and could inform the implementation of sequencing into care in ways that accord with public preferences and needs.

Genetic diversity of strawberry mild yellow edge virus from eastern Canada.

Strawberry mild yellow edge virus (SMYEV) is a member of the genus Potexvirus, family Alphaflexiviridae. It is one of the most common pathogenic viruses infecting cultivated strawberries worldwide. In this study, we investigated the genetic diversity of SMYEV in strawberry fields that were severely affected by strawberry decline disease in the eastern Canadian provinces of New Brunswick, Nova Scotia, Prince Edward Island and Quebec. A total of 134 SMYEV coat protein (CP) gene sequences, representing 85 nucleic acid haplotypes, were identified in 56 field samples. A highly divergent SMYEV population was found in all four provinces, but there was little genetic differentiation among the populations, and moreover, the Canadian SMYEV isolates formed a unique dissimilar, genetically divergent population group when compared to those reported in other countries. Phylogenetic analysis revealed three new SMYEV subclades that consisted mainly of Canadian variants and were composed of 76 sequence haplotypes (76/85, 88%). Mixed infections by different SMYEV variants were observed in 38 samples (38/56, 68%). Evolutionary analysis suggested that the SMYEV strains in eastern Canada possibly originated outside of Canada but adapted to conditions in the region through genetic mutations.

Network analyses using case-control data to describe and characterize the initial 2014 incursion of porcine epidemic diarrhea (PED) in Canadian swine herds

The overall objective of this study was to describe the contact structure and animal movement patterns of porcine epidemic diarrhea (PED) case herds and matched control herds during the initial incursion of PEDV in Canada, and to evaluate possible mechanisms of spread during this period. Possible mechanisms of spread included transmission through a common-source, herd-to-herd transmission, and transmission due to low biosecurity. Three hypotheses were evaluated by assessing: 1) whether feed supplier, semen supplier and/or animal transportation company networks contained a higher proportion of case herds compared to randomly permuted networks, 2) whether the proportion of case herds in the giant weak component differed from randomly permuted networks, and 3) whether external herd biosecurity, defined as the number of mean contacts with other herds in a one-mode network, was different between case and control herds. The study period for recruiting case and control herds was from January 22, 2014 to March 1, 2014, and a 30-day history of each participating site was collected using a questionnaire. The study included swine herds located in central and eastern Canadian provinces. Multiple two-mode networks with swine herds and service suppliers were constructed. This included feed suppliers, animal movement, animal transportation companies, semen suppliers and a complete network with all service providers.The complete network consisted of 145 nodes. There were a total of 765 edges in the complete network and majority were between feed suppliers and primary herds 29.8% (228/765). The proportion of case herds in the largest feed supplier network was higher than what was expected using randomly permuted networks, suggesting that the likely mechanism of spread during this phase was a common-source through the feed network. A single feed supplier (FS1) had the highest out-degree and outgoing contact chain indicating its importance in disease spread throughout the feed and complete networks. Network descriptive measures, as well as the results of the hypotheses testing indicate little significance in the roles of animal movement, animal transportation companies, and semen suppliers during the initial phase of the 2014 Canadian PED outbreak.

Infrared spectroscopy estimation methods for water-dissolved carbon and amino sugars in diverse Canadian agricultural soils

Infrared spectroscopy has the potential to rapidly analyse soil water-dissolved carbon and amino sugars. In this study, mid-infrared (MIR) and near-infrared (NIR) spectra collected from soil water extracts or from bulk soils were analysed with partial least squares regression (PLSr) to estimate the concentrations of water-dissolved carbon and amino sugars in diverse agricultural soils collected from five field sites in two western and two eastern Canadian provinces. The MIR-PLSr models developed from soil water extract spectra estimated hot-water (100 °C) dissolved carbon (HWDC) [R2 = 0.97–0.70, ratio of prediction to deviation (RPDp) = 6.13–1.83] well, but the MIR-PLSr models did not estimate cold-water (21 °C) dissolved carbon (CWDC) well (R2 = 0.82–0.50, RPDp = 2.35–1.42). The model estimates of HWDC at the multisite scale (all samples together) and for the two western Canada sites (R2 = 0.97–0.93, RPDp = 6.13–3.68) surpass the modal estimates for the three eastern Canadian sites (R2 = 0.81–0.70, RPDp = 2.28–1.83). The MIR- and NIR-PLSr models derived from bulk soil spectra both estimated HWDC well at the multisite scale (R2 = 0.91–0.88, RPDp = 3.32–2.90) and for the western Canada sites (R2 = 0.90–0.87, RPDp = 3.18–2.96). Models developed from hot-water extract spectra and bulk soil spectra resulted in poor estimates of soil amino sugars (R2 = 0.74–0.21, RPDp = 1.99–1.12), except for the approximate quantitative estimation of muramic acid by models based on soil spectra at the western and the multisite scale (R2 = 0.82–0.80, RPDp = 2.33–2.21). We concluded that MIR and NIR models at regional and multisite scales can be used as a tool to monitor HWDC but that additional research is required for estimating soil amino sugars.

‘Don’t Even Think About Bringing That to School’: New Brunswick students’ understandings of ethnic diversity

Canada is a country with a long history of substantial ethnocultural diversity. Questions about the reasonable accommodation of immigrant groups, the preservation of official language minority rights, and the fostering of Aboriginal rights permeate political and social discourse in Canada. Effective citizenship requires people who understand the subtle differences between and among groups in Canada, and are able to wrestle intelligently and respectfully with difficult questions inherent in these issues. This article reports on a study designed to map the conceptions of ethnic diversity held by grade 6 students in the eastern Canadian province of New Brunswick with a particular focus on the three areas outlined above. Overall, students demonstrated quite superficial understandings of ethnic diversity being able to identify some practices and beliefs as ‘cultural’, but with little knowledge of specific cultural groups or practices or the role of language as a vehicle for cultural enhancement and preservation.

Canadian low-energy housing: National energy context, and a case study of a demonstration house with focus on its ground-source heat pump

This article first reviews the energy use in Canadian houses and the current energy-saving practices. Various low-energy house (building) concepts are discussed, and some research projects and initiatives completed in Canada over the last 10–15 years are then briefly outlined. Second, it describes the EcoTerra demonstration low-energy house and its innovative construction and HVAC system that integrates a reversible brine-to-air geothermal heat pump as a main heating and cooling system, electricity, and heat generation from a building integrated photovoltaic (PV)/thermal (BIPV/T) system, concrete floors and walls as passive and active solar energy storage means, and several heat recovery devices. The EcoTerra house was built in 2007 in the province of Québec (eastern Canada) under the Equilibrium Housing Pilot Demonstration Project, a national initiative lead by Canada Mortgage and Housing Corporation that brought the private and public sectors together to develop low-energy healthy homes. This article summarizes the overall energy performance of EcoTerra's main energy system as well as the 5-year design validation and energy performance of the ground-source heat pump with vertical, closed-loop ground-coupled heat exchanger. The results obtained show the annual electrical energy consumption of EcoTerra has been reduced on average by 57.9% compared to the average consumption of Québec's (eastern Canadian province) conventional houses heated with electrical baseboards. On the other hand, the ground-source heat pump (GSHP) has ran with relatively high heating and cooling performances while the ground thermal capacity has been well-balanced and fully recovered from one heating dominated season to another.

Better Beginnings: At Risk Moms; What Are We Missing?

Abstract BACKGROUND: Since 2005, the number of infants born to mothers using substances has increased 4-fold in an eastern Canadian province. These babies may be at risk of medical problems including a withdrawal syndrome called “neonatal abstinence syndrome”. Previous research has shown that mothers using substances may experience increased rates of domestic violence, mental illness and housing and food insecurity. Currently, these determinants of health are not routinely recorded on medical charts of pregnant women who are patients at the province’s largest maternity facility. OBJECTIVES: The primary goal of this study is to determine the prevalence of smoking, alcohol use, substance use, domestic violence and food/ housing insecurity in mothers delivering in an eastern Canadian province maternity hospital. DESIGN/METHODS: This is a quantitative study involving all postpar-tum women delivering at the major delivery facility in province over a two month period (N=150). Participants were asked to complete an online, anonymous survey about their food/housing situation, domestic violence and substance use before and during pregnancy, as well as sociodemo-graphic questions. RESULTS: Food and Housing Insecurity: The results of the study showed increased healthy eating behaviours during pregnancy; however the number of participants reliant on food banks remained at 4%. Our study found that while the majority of participants lived in a permanent residence, 2% of mothers used shelters or lived in a non-permanent residence. Mental health and Domestic Violence: While the majority of mother felt respected by their partner, family and friends, a significant amount reported feelings of isolation during pregnancy (12%). Women experiencing domestic violence stayed consistent before and during pregnancy at 2%. Smoking: Cigarette use in this population was slightly decreased from previous reports by the provincial perinatal program (12% vs. 14.9% reported) with rates of exposure to cigarette smoke much higher (24.7% vs. 6.4% reported). Alcohol use: Maternal reporting alcohol use during pregnancy was substantially increased from previous reports (13.3% vs. 0.9% reported). Those who reported consuming alcohol most frequently reported 1-2 drinks about 1-3 times per month. Substance Use: Currently, no reports within the province have captured the number of mothers using substances. This study shows approximately 5% of mothers using either marijuana, street/illicit drugs or methadone. Limitations: Mothers who did not speak English were excluded from the study. CONCLUSION: The findings of this research indicate that important determinants of health are not being adequately recorded in Provincial databases thus programs are lacking.