{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T03:38:27Z","timestamp":1760240307976,"version":"build-2065373602"},"reference-count":63,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2019,4,30]],"date-time":"2019-04-30T00:00:00Z","timestamp":1556582400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004633","name":"Mount Allison University","doi-asserted-by":"publisher","award":["Summer Research Grant"],"award-info":[{"award-number":["Summer Research Grant"]}],"id":[{"id":"10.13039\/501100004633","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>This study examines potential challenges facing Lyme disease patients in Canada\u2019s Maritime provinces\u2014New Brunswick, Nova Scotia, Prince Edward Island\u2014and considers how issues could be addressed. Reviews of both the academic and grey literature are complemented by surveys targeting both medical professionals and decision makers in government. Combined, the literature reviews and surveys demonstrate that there is considerable debate surrounding the effectiveness of testing, treatment options, and the existence of chronic Lyme disease. As the focus on the Maritimes demonstrates, these debates often pit the medical community against patients and patient advocates and, thus far, governments have been unable to produce policy that entirely pleases either side. Moving forward, this study recommends the creation of a discussion forum via a federal Commission of inquiry to review best practise guidelines for Lyme disease. The key is to foster an unbiased probe of central issues surrounding treatment and diagnosis without alienating stakeholders. This course of action will not necessarily solve the issue of Lyme disease, but would foster a greater understanding through dialogue that includes and validates the experiences of stakeholders, which is something that is currently missing.<\/jats:p>","DOI":"10.3390\/ijerph16091531","type":"journal-article","created":{"date-parts":[[2019,4,30]],"date-time":"2019-04-30T08:51:44Z","timestamp":1556614304000},"page":"1531","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["A Multiple Streams Approach to Understanding the Issues and Challenges of Lyme Disease Management in Canada\u2019s Maritime Provinces"],"prefix":"10.3390","volume":"16","author":[{"given":"Mario","family":"Levesque","sequence":"first","affiliation":[{"name":"Department of Politics and International Relations, Mount Allison University, 144 Main St., Sackville, NB E4L 1A7, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew","family":"Klohn","sequence":"additional","affiliation":[{"name":"Department of Politics and International Relations, Mount Allison University, 144 Main St., Sackville, NB E4L 1A7, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2019,4,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1221","DOI":"10.1503\/cmaj.080148","article-title":"The emergence of Lyme disease in Canada","volume":"180","author":"Ogden","year":"2009","journal-title":"CMAJ"},{"key":"ref_2","unstructured":"Russell, N. 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