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Polycyclic aromatic compounds (PACs) in Canadian air and deposition were examined at the national scale for the first time in over twenty-five years. Air concentrations spanned four orders of magnitude, and were highest near industrial emitters and lowest in the Arctic. Declines in unsubstituted PAHs were observed at locations close to industrial facilities that had reduced emissions, but trends elsewhere were modest or negligible. Retene concentrations are increasing at several locations. Ambient concentrations of benzo[a]pyrene exceeded Ontario's health-based guideline in many urban/industrial areas. The estimated toxicity of the ambient PAC mixture increased by up to a factor of six when including compounds beyond the US EPA PAHs. Knowledge of PAC deposition is limited to the Laurentian Great Lakes and Athabasca Oil Sands regions. The atmosphere remained a net source of PAHs to the Great Lakes, though atmospheric inputs were decreasing with halving times of 26-30 years. Chemical transport modelling substantially overestimated wet deposition, but model performance is unknown for dry deposition. Sources from Asia, Europe and North America contributed to Arctic and Sub-Arctic concentrations, whereas transboundary or long-range transport have not been assessed outside Canada's north. Climate-related impacts from re-emission and forest fires were implicated in maintaining air concentrations in the high Arctic that were not consistent with global emissions reductions. Industrial emission decreases were substantial at the national scale, but their influence on the environment was limited to areas near relevant facilities. When examined through the lens of ambient levels at the local scale, evidence suggested that contributions from residential wood combustion and motor vehicles were smaller and larger, respectively, than those reported in national inventories. Future work aimed at characterizing PACs beyond the EPA PAHs, improving measurement coverage, elucidating deposition phenomena, and refining estimates of source contributions would assist in reducing remaining knowledge gaps about PACs in Canada., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Crown Copyright © 2020. Published by Elsevier Ltd. All rights reserved.)

Use of elemental mercury (Hg 0 ) to enhance placer gold recovery is an effective method dating back centuries, but is associated with significant atmospheric Hg 0 losses. This method was widely used in the Canadian Klondike region during most of the 20th century when the mining industry experienced rapid growth. While the health risks associated with Hg 0 pollution are now well understood, few studies have assessed the environmental legacy of Hg 0 use in the Klondike. We used an annually resolved Picea glauca tree-ring Hg record (1864-2015) to reconstruct and evaluate changes in local atmospheric Hg 0 concentrations associated with gold production at the Bear Creek mining camp. Major temporal trends in the record are consistent with the scale of Bear Creek operations and are distinct from background trends at an unimpacted control site. Tree-ring Hg concentration increased most rapidly from 1923 to 1930, a period when several major mining operations were consolidated at Bear Creek. The highest Hg concentrations, ∼2.5× greater than pre-mining era, occurred in the 1930s, coinciding with maximum gold production at this site. Post-World War II economic factors adversely affected the industry, causing declining tree-ring Hg concentrations from 1939 to 1966. Closure of the Bear Creek camp in 1966 coincided with the strongest tree-ring Hg decline, although a return to background levels did not occur until the 1990s, likely due to re-emission of legacy Hg 0 from contaminated soils. Finally, a robust increase was observed over the last decade, similar to other tree-ring Hg records in N.W. Canada, which is linked to rising Hg 0 emissions in Asia. The Bear Creek tree-ring Hg record provides a unique opportunity to study the impact of Klondike gold mining on the local environment at annual resolution and demonstrates great potential to use Picea tree rings to study past changes in atmospheric Hg 0 from local and global emissions. MAIN FINDINGS: A 151-year long, annually resolved tree-ring Hg record was developed at a historic Klondike gold-mining site to investigate the influence of mining-related Hg 0 emissions on the local atmosphere and environment. Compared to a control site, the tree-ring Hg record documents highly elevated atmospheric Hg 0 concentrations during the period mining activities were ongoing at this site., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

In recent times, there has been increase in climate change protest across the globe. However, whether decrease in emissions is connected with climate change protest or not is yet to be documented in the literature. Consequently, the aim of this study is to fill this gap by examining ex-post detection of how climate change protests and its interconnectedness with CO2 emissions. Using the Bai and Perron (1998) structural break test, we estimate the number of breaks as well as the date of such structural breaks in CO2 emissions series for 41 countries. Our aim is to match the date of the climate change protests to those of the structural breaks. We observe that climate change protests are fairly consistent with the dates of breaks in Europe and Asia, but not in BRICS economies or US, Canada and other countries. Therefore, this method allows us to solve a gap in the energy industry related to the modelling and correct allocation of positive shocks in CO2 emissions to climate change protests., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Background: Despite the rising burden of chronic respiratory diseases, global data for lung function are not available. We investigated global variation in lung function in healthy populations by region to establish whether regional factors contribute to lung function., Methods: In an international, community-based prospective study, we enrolled individuals from communities in 17 countries between Jan 1, 2005, and Dec 31, 2009 (except for in Karnataka, India, where enrolment began on Jan 1, 2003). Trained local staff obtained data from participants with interview-based questionnaires, measured weight and height, and recorded forced expiratory volume in 1 s (FEV₁) and forced vital capacity (FVC). We analysed data from participants 130-190 cm tall and aged 34-80 years who had a 5 pack-year smoking history or less, who were not affected by specified disorders and were not pregnant, and for whom we had at least two FEV₁ and FVC measurements that did not vary by more than 200 mL. We divided the countries into seven socioeconomic and geographical regions: south Asia (India, Bangladesh, and Pakistan), east Asia (China), southeast Asia (Malaysia), sub-Saharan Africa (South Africa and Zimbabwe), South America (Argentina, Brazil, Colombia, and Chile), the Middle East (Iran, United Arab Emirates, and Turkey), and North America or Europe (Canada, Sweden, and Poland). Data were analysed with non-linear regression to model height, age, sex, and region., Findings: 153,996 individuals were enrolled from 628 communities. Data from 38,517 asymptomatic, healthy non-smokers (25,614 women; 12,903 men) were analysed. For all regions, lung function increased with height non-linearly, decreased with age, and was proportionately higher in men than women. The quantitative effect of height, age, and sex on lung function differed by region. Compared with North America or Europe, FEV1 adjusted for height, age, and sex was 31·3% (95% CI 30·8-31·8%) lower in south Asia, 24·2% (23·5-24·9%) lower in southeast Asia, 12·8% (12·4-13·4%) lower in east Asia, 20·9% (19·9-22·0%) lower in sub-Saharan Africa, 5·7% (5·1-6·4%) lower in South America, and 11·2% (10·6-11·8%) lower in the Middle East. We recorded similar but larger differences in FVC. The differences were not accounted for by variation in weight, urban versus rural location, and education level between regions., Interpretation: Lung function differs substantially between regions of the world. These large differences are not explained by factors investigated in this study; the contribution of socioeconomic, genetic, and environmental factors and their interactions with lung function and lung health need further clarification., Funding: Full funding sources listed at end of the paper (see Acknowledgments)., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Background: Over the past two decades, there is increasing emphasis being placed upon providing family-centred care (FCC) in paediatric oncology settings. However, there is a lack of knowledge of FCC in paediatric oncology from the perspectives of immigrant parents. The purpose of this paper is to describe Chinese and South Asian immigrant parents' experiences of FCC in paediatric oncology settings in Canada., Methods: This study adopted a constructivist grounded theory approach. Fifty first generation Chinese and South Asian parents of children with cancer who were at least 6 months post-diagnosis were recruited from six Canadian paediatric oncology centres. Interviews were conducted in English, Cantonese, Mandarin, Urdu, Punjabi or Hindi, and transcribed into English. Analysis involved line-by-line, focused and theoretical coding, and the use of the constant comparison method., Results: Findings indicated that overall parents were highly satisfied with the care and services they received, and their experiences were reflective of the key elements of FCC. However, there were some areas of concern identified by participants: parents not perceiving themselves as a member of the medical team; inconsistency in the quality and co-ordination of services among healthcare providers; disrespectful and mechanical manner of a few healthcare providers; and parents' discomfort with healthcare providers communicating sensitive health-related information directly with their child., Conclusions: In order to successfully provide family-centred services to immigrant parents of children with cancer, better communication of the elements of FCC between healthcare staff and families is needed to negotiate a clear role for the parents as partners of the healthcare team. Moreover, a better understanding of how family relationships are structured in immigrant families will assist healthcare providers to balance the best interests of the child with that of the family as a unit., (© 2011 Blackwell Publishing Ltd.)

As of the 2006 census, nearly one fifth of Canada's population was foreign-born. With such a sizeable and fast-growing immigrant population, research in immigrant health in Canada is increasingly important, including research on the smoking behaviours of Canada's immigrants. Research has shown that immigrants are significantly less likely to smoke than non-immigrants, yet differences by immigrant origins have yet to be fully explored. This paper explores smoking prevalence and cessation amongst immigrants in Canada disaggregated by country of birth. Additionally, it examines the impact of neighbourhood level effects on smoking cessation to determine if residential location has an impact on the likelihood of quitting. Results reveal important heterogeneities previously unseen in studies employing aggregate data. While immigrants in general were less likely to smoke than non-immigrants, and are also more likely to quit than non-immigrants, considerable variation exists between immigrant groups defined by origin region or country. Asian immigrants were the least likely to smoke but exhibited the greatest variation between countries of origin. Vietnamese men were found to be the most likely immigrant group to smoke and among the least likely to quit. While neighbourhood disadvantage was negatively associated with quitting smoking, it is not as important as individual socioeconomic characteristics in explaining variations in smoking cessation. The research illustrates the need for disaggregated data to account for the diversity of Canada's immigrant population., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

Background: Endoscopic hemostasis is commonly practiced during GI endoscopy practice. We hypothesized that, because the choice of endoscopic intervention is influenced by many factors, for example personal experience, prior training, guidelines, etc., there would be differences in practice patterns among different groups of endoscopists., Objective: To explore the potentially different practices for endoscopic hemostasis between the "East" (eight Asian countries) and the "West" (USA and Canada)., Design: Cross-sectional descriptive study (internet-based survey)., Study Subjects: We administered a questionnaire survey to American Society of Gastrointestinal Endoscopy (ASGE) and Korean Society of Gastroenterology (KSGE) members (see: http://www4.utsouthwestern.edu/inetdemo/endoscopy/hemostasis.html , or supplementary paper for review online)., Results: Eastern ASGE members (n = 112) were more likely to complete this survey than ASGE members in the West (n = 180): 15.1 vs. 5.0%, P < 0.001. Choice of hemostatic method, regardless of primary or recurrent bleeding, varied significantly among Eastern and Western endoscopists. For example, for treatment of a gastric ulcer with a visible vessel, a vast majority (70%) of Western endoscopists preferred pre-injection followed by thermocoagulation whereas responses from the East were more diverse, with endoclip application +/- pre-injection being the top choice (29%) (P < 0.001). Personal EGD volume and hospital bed numbers did not seem to be associated with hemostatic choices in either the East or the West., Conclusions: Endoscopic hemostasis practice patterns for upper GI tract bleeding differed among Eastern and Western endoscopists, suggesting fundamental differences in practice habit determinants.

The primary role of the extensive and complex modern food legislation is to protect the consumer. Providing a framework for industry and enabling free trade are secondary aims. In the EU the 2006 Regulation on nutrition and health claims made on foods was adopted in December 2006. This Regulation defines detailed lists of permitted claims with precise conditions, requires foods making claims to meet specific nutrient profiles and requires the submission of a dossier for approval of new health claims. Nutrient profiles and an initial list of existing health claims will not be agreed until January 2009 and January 2010 respectively. The uncertainty about profiles and the initial list of claims as well as the prescriptive nature of the Regulation will have a major impact, some negative but some positive, on food innovation. Worldwide legislation on nutrition and health claims continues to develop. The current paper also provides an outline of some other key pieces of European legislation that affect food innovation. However, currently, all this legislation remains in development and up-to-date information can be sought from the reference material provided.

Background: Contextual factors may play an influential role in determining individual uptake of preventive health care services, especially among potentially vulnerable subpopulations. Using cervical cancer screening as a case study, this paper examines the multilevel factors associated with Pap testing in native-born and immigrant women., Methods: Cross-sectional multilevel logistic regression models were used to identify the individual- and neighbourhood-level characteristics that might explain differences in the lifetime uptake of Pap testing among immigrants and native-born women between the ages of 18 and 69 residing in the Montreal, Toronto and Vancouver Census Metropolitan Areas (CMAs). Individual-level data were drawn from the Canadian Community Health Survey (Cycle 2.1, 2003) and linked with census tract profile data from the Canadian Census (2001)., Results: Findings reveal significant between-neighbourhood variation in uptake. After controlling for age, marital status, access to a regular doctor and socio-economic status, a woman's immigrant status and cultural origin appear to be significantly associated with ever having had a Pap test. In particular, the uptake of cervical cancer screening is less common among recent immigrant women and women of Chinese, South Asian and other Asian backgrounds., Interpretation: There appear to be significant differences between neighbourhoods and CMAs in the uptake of Pap testing. Findings point to the role of cultural origin, which largely accounts for these differences. This indicates the need to promote greater information and awareness of public health services for cervical cancer screening, especially among recent immigrant women with such backgrounds.

We evaluated all articles published by different world regions in the top 50 biomedical journals in the database of the Journal Citation Reports-Institute for Scientific Information for the period between 1995 and 2002. The world was divided into 9 regions [United States of America (the U.S.), Western Europe, Japan, Canada, Asia, Oceania, Latin America, and the Caribbean, Eastern Europe, and Africa] based on a combination of geographic, economic and scientific criteria. The number of articles published by each region, the mean impact factor, and the product of the above two parameters were our main indicators. The above numbers were also adjusted for population size, gross national income per capita of each region, and other factors. Articles published from the U.S. made up about two-thirds of all scientific papers published in the top 50 biomedical journals between 1995 and 2002. Western Europe contributed approximately a quarter of the published papers while the remaining one-tenth of articles came from the rest of the world. Canada, however, ranked second when number of articles was adjusted for population size. The U.S. is by far the highest-ranking country/region in publications in the top 50 biomedical journals even after adjusting for population size, gross national product, and other factors. Canada and Western Europe share the second place while the rest of the world is far behind.

Background: An international comparison study of women's occupational health issues was carried out in 2000 for the Philippines, Thailand, Malaysia, Canada, Hong Kong and Singapore. The study was funded by the Canadian International Development Agency's Southeast Asia Gender Equity Program., Aim: The objective was to compare the issues, risk factors, social determinants, and challenges in women's occupational health, according to the status of economic development as defined by the World Bank., Method: Data were collected through 27 key informant interviews of high-ranking government officials and senior researchers, self-administered questionnaires on country or regional statistics and 16 courtesy calls., Results: Results indicated that women's occupational health problems common in these countries or regions included women's long hours of work (double workday), shift work and a caring role for family and friends. Problems reported in developing countries but not developed countries included poor access to training and protective equipment, and insufficient legislation to protect women's rights. Problems reported in developed countries but not in developing countries included obesity, smoking and not including women in health research., Conclusion: This paper provides insights into the changing environment in the workplace, such as increasing participation of women in the paid workforce and changes in gender differences due to the changing country economy, for improving women's occupational health.

Background: It is widely acknowledged that there is a global divide on health care and health research known as the 10/90 divide., Methods: A retrospective survey of articles published in the BMJ, Lancet, NEJM, Annals of Internal Medicine & JAMA in a calendar year to examine the contribution of the developing world to medical literature. We categorized countries into four regions: UK, USA, Other Euro-American countries (OEAC) and (RoW). OEAC were European countries other than the UK but including Australia, New Zealand and Canada. RoW comprised all other countries., Results: The average contribution of the RoW to the research literature in the five journals was 6.5%. In the two British journals 7.6% of the articles were from the RoW; in the three American journals 4.8% of articles were from RoW. The highest proportion of papers from the RoW was in the Lancet (12%). An analysis of the authorship of 151 articles from RoW showed that 104 (68.9%) involved authorship with developed countries in Europe or North America. There were 15 original papers in these journals with data from RoW but without any authors from RoW., Conclusions: There is a marked under-representation of countries in high-impact general medical journals. The ethical implications of this inequity and ways of reducing it are discussed.

Culture determines the different ways that patients understand cancer, the ways they explain it, and their attitudes towards it. These factors affect the patient's emotional response to the disease and health behaviour in terms of prevention and treatment. In this paper we review the explanatory models for cancer in several cultural groups. These models range from metaphysical to interpersonal and physical. Cultural explanations of health and health behaviour could detract from social and economic factors that might be more important as determinants of these behaviours.

Approximately one-fourth of all cigarettes sold in the United States are mentholated. An understanding of the consequences, patterns, and correlates of menthol cigarette use can guide the development and implementation of strategies to reduce smoking prevalence and smoking-attributable morbidity and mortality. This paper summarizes the literature on the health effects of mentholated cigarettes and describes various patterns of use as indicated by consumption and survey data from the United States and other nations. The epidemiological literature on menthol cigarettes and cancer risk is inconclusive regarding whether these cigarettes confer a risk for cancer above that of nonmentholated varieties. Available data indicate that mentholated cigarettes are at least as dangerous as their nonmentholated counterparts. In addition, because mentholation improves the taste of cigarettes for a substantial segment of the smoking population and appears to mask disease symptoms, this additive may facilitate initiation or inhibit quitting. Menthol market share is high in the Philippines (60%), Cameroon (35%-40%), Hong Kong (26%), the United States (26%), and Singapore (22%). Newport has become the leading menthol brand in the United States. Surveys from four nations indicate that menthol use among adult smokers is more common among females than males. Among U.S. smokers, 68.9% of Blacks, 29.2% of Hispanics, and 22.4% of Whites reported smoking a mentholated variety. Research is needed to better explain factors that may influence menthol preference, such as marketing, risk perceptions, brand formulation, and taste preferences. Such research would guide the development of potentially more effective programs and policies.

"In Canada, the proportion of women among immigrants fluctuates around 50 percent, with a slight increase in recent years. Another important characteristic of immigration...is a radical change in the composition of origin of flows in the past three decades--European-dominated streams have been replaced by those originating mostly in Asia. This paper focuses on female Asian immigrants in Canada.... Major Asian source countries of female immigrants (Hong Kong, Philippines, India, China, Sri Lanka, Taiwan, Lebanon and Iran) give evidence to the growing importance of political push factors and sending countries' policies-facilitation factors as crucial determinants of international migration.", (excerpt)

"The present paper reviews Canadian immigration policy and assesses the current situation. An analysis of the 1994 immigration consultation process is presented which led to the new changes in immigration policy. Recent changes in the organizational structure of the Department of Citizenship and Immigration and its policy are evaluated. The implications of the new immigration policy are discussed, particularly as it relates to Asian immigration.", (excerpt)

Given the distinctive historical experiences, cultural features, and status positions of the diverse ethnic groups in Canadian society, we anticipate that these differences will influence the retirement behavior and conditions of their members. This paper examines the effects of ethnic group membership for immigrants to Canada on the timing of retirement and the sources and amounts of retirement income using data from the Public Use Sample of the 1981 Census of Canada. Separate but parallel analyses are conducted for men and women to take into account their distinctive labor force experiences. We find that membership in Asian, African, or Latin American ethnic groups is associated with both later retirement and a lower probability of receiving social insurance and private pension benefits, as well as appreciably lower income among elderly men. This is likely the result of changes in pension legislation in the 1960s and 1970s reducing benefits to recent immigrants.

As difined in the first part of these papers, the distribution of MS does not really correlate well with broad geoclimatic factors. Specifically there is little evidence for a direct correlation with latitude, and such correlations, to be meaningful, need to consider longitude as well. At latitude 40 degrees north, for example, MS is high frequency in America, medium in Europe, and low in Asia. Accordingly the world-wide distribution of MS is best regarded as comprising three bands or zones of high medium, and low risk or frequency as delineated here. All the high and medium regions are at present found in Europe or in areas colonized by Europeans. It seems likely then that MS originated in western Europe and has spread from there to the United States and Canada as well as to New Zealand and Australia. The disorder may well have "taken" also in South Africa and Hawaii, but at considerably lower levels. Further attention to the character and timing of the depresion of this disease may well provide clues vital to determining its cause.