Canadian Systems Research Articles

From Participant to Partner: Applying Indigenous Understandings of Treaties to Canada’s Environmental Impact Assessment Processes

The following seeks to explore solutions forward amid increasing pressure to improve the quality of Indigenous involvement within environmental assessments (EAs). This paper describes the historical entanglements of resource development, colonialism, and limited recognition of Indigenous interests within EAs currently. It deconstructs the implications of the following: extractive methodologies habitually used within EAs; distinctions between Canadian and Indigenous legal systems; cultural variances in perceptions of power structures; and noticeable systemic issues within EA processes. Drawing from Indigenous understandings of treaties, this article brings forth some key considerations necessary to establishing meaningful Indigenous involvement during EAs. It positions treaties as a powerful, practical orientation towards envisioning a framework that utilizes practices which foster genuine collaboration and dialogue amongst all parties involved. To this end, this article contends with the importance of addressing gaps in quality of Indigenous involvement during EAs, particularly as calls for reconciliation and sustainable environmental decision-making continue.

Therapists to Therapy Assistants: Experiences of Internationally Educated Physiotherapists and Occupational Therapists.

Background: In Canada, internationally educated physiotherapists (IEPTs) and occupational therapists (IEOTs) may work as occupational/physical therapy assistants (OTAs/PTAs) while pursuing Canadian licensure. This experience presents personal and professional opportunities and challenges. Purpose: We explored a) the barriers and facilitators experienced by IEPTs and IEOTs working as OTAs/PTAs while pursuing licensure in Canada and b) how might their professional identity changes during this period. Methods: In this cross-sectional qualitative study, we sampled IEPTs and IEOTs working as assistants using online focus groups. Reflexive thematic analysis of data was used to generate themes. Findings: Fourteen IEPTs or IEOTs participated reporting barriers including financial impacts while working as an OTA/PTA, discrimination, and challenges completing licensing exams. Facilitators while working as OTA/PTAs included social support, acculturation with Canadian systems, and career opportunities. Changes to professional identity encompassed accepting a new identity, reclaiming their old identity, or having a strong sense of identity within a healthcare profession. Participants advocated for bridging programs and modifications for examination processes for IEPTs and IEOTs to improve their experiences while pursuing licensure in Canada. Conclusion: Increased advocacy is needed to address the current experiences of IEPTs and IEOTs working as OTA/PTAs after migration.

HPR54 Policy Approaches to the Regulation and Reimbursement of Pediatric Medicines: Comparing Canadian, European, and UK Health Systems

HPR54 Policy Approaches to the Regulation and Reimbursement of Pediatric Medicines: Comparing Canadian, European, and UK Health Systems

Sexual and gender minority relevant policies in Canadian and United States organ and tissue donation and transplantation systems: An opportunity to improve equity and safety

Current policies in organ and tissue donation and transplantation (OTDT) systems in Canada and the United States unnecessarily restrict access to donation for sexual and gender minorities (SGMs) and pose safety risks to transplant recipients. We compare SGM-relevant policies between the Canadian and United States systems. Policy domains include the risk assessment of living and deceased organ and tissue donors, physical examination considerations, viral testing recommendations, and informed consent and communication. Identified gaps between current evidence and existing OTDT policies along with differences in SGM-relevant policies between systems, represent an opportunity for improvement. Specific recommendations for OTDT system policy revisions to achieve these goals include the development of behavior-based, gender-neutral risk assessment criteria, a reduction in current SGM no-sexual contact period requirements pending development of inclusive criteria, and destigmatization of sexual contact with people living with human immunodeficiency virus. OTDT systems should avoid rectal examinations to screen for evidence of receptive anal sex without consent and mandate routine nucleic acid amplification test screening for all donors. Transplant recipients must receive enhanced risk-to-benefit discussions regarding decisions to accept or decline an offer of an organ classified as increased risk. These recommendations will expand the donor pool, enhance equity for SGM people, and improve safety and outcomes for transplant recipients.

Extended producer responsibility’s effect on producers’ electronic waste management practices in Japan and Canada: drivers, barriers, and potential of the urban mine

Electronic waste is the fastest-growing domestic waste stream globally, continuously outstripping projections. With increasing ubiquity of complex computing, many non-renewables are contained in end-of-life electronics, creating a vast urban mine, potentially hazardous, depending on treatment. The aim of this study is to compare how Extended Producer Responsibility (EPR) policy is applied in two case countries, Japan and Canada, the practical implications of EPR policy design on producer operations, and how EPR affects electronic waste management improvements in each case. These cases share international obligations for electronic waste management but employ contrasting EPR policies. These policies are widespread in both cases, yet are not presided over by larger, regional obligations. Therefore, country-level interviews with electronic waste management stakeholders focusing on how EPR regulation affects producer practice were conducted. The physical application of EPR, as seen in Japan, drives design changes by producers intending to simplify downstream treatment, while financial responsibility in Canada, creates greater concern with cost-savings for producers, complicating end-of-life processing. EPR implementation, along with specific geographical factors, also create contrasting resource recovery results between countries. Regulation primarily drives EPR implementation in both countries, which is consistent with the literature. This study presents new drivers and barriers, namely pre-emptive legislation, and no incentive to improve, classifying the Japanese and Canadian systems as suffering from externalities on an insular system, and lack of harmonization, respectively. This research addresses a gap in comparative studies across regions of physical and financial EPR effects on producer practice.

How Canada can supply Europe with critical energy by creating a Trans‐Atlantic energy bridge

AbstractPublic policy decisions made over the past 10–15 years have significantly impacted the resiliency of Canadian and European energy systems. Rightly or wrongly, these decisions have included shifts away from coal and nuclear energy for electricity in favour of wind and solar, scuttling oil pipeline developments in all directions in Canada, how world governments responded to the pandemic, and increased reliance on Russian and US energy networks. The pandemic and subsequent Russian invasion of Ukraine have significantly tested the resiliency of these systems and caused major impacts on prices and everyday life. It has revealed weaknesses in Western energy security, and Europe is scrambling to adjust to sudden and drastic reductions in imports of Russian energy. In this perspective, I review the challenges to our energy systems. Then, I propose the creation of a Trans‐Atlantic energy bridge to Europe and highlight some technologies and strategies Canada can use to create it.

73 Parenting Experiences of Families of Refugee Background in the Greater Toronto Area: A Formative Study

Abstract Background As of date, the world is experiencing its highest levels of human displacement, with many families resettling in Canada. While there is an understanding that families of refugee background have complex, multigenerational mental health, and developmental needs, little is known about whether their parenting needs are met adequately in Canada after resettlement nor how COVID-19 related restrictions have further complicated their resettlement experience. Objectives To gather data about the facilitators and barriers that impact the parenting experience of families of refugee background in the Greater Toronto Area (GTA) in the context of their children’s unique developmental and resettlement needs. Design/Methods This was a qualitative, community-based participatory research study. All data was collected from August 2019 to July 2020. In-depth interviews (IDIs) were conducted with caregivers of refugee background and healthcare providers that work closely with this population. Data were recorded, transcribed, and coded by two independent coders and a peer-debriefing strategy was used to verify the coding approach. Results In total, 20 IDIs were conducted (7 caregivers, 13 care providers). Six key themes were identified: (1) Mental Health and Healthcare Access, (2) Language, (3) Navigating Canadian Systems, (4) Finances, (5) Cultural Dimensions of Caregiving, and (6) Advocacy and Agency. The caregivers and healthcare providers agreed that language is a migration barrier, housing and financial stability are challenging to obtain, and that families struggle to self-advocate. There was disagreement as to how families and healthcare providers viewed healthcare access: caregivers reported that they have good access, but the providers cited that there are still barriers, including health literacy and cultural differences. While caregivers believe they are well supported by the government, healthcare providers believe more funding and education on the families’ rights are necessary. Finally, although most caregivers describe Canada as welcoming, healthcare providers highlighted more incidences of misunderstandings and gaps within the system that may allow families to fall through the cracks. Conclusion Our study describes the unique facilitators and barriers to the resettlement, healthcare access, and lived experiences of families of refugee background raising children within the GTA.

A Transformer-Based Machine Learning Approach for Sustainable E-Waste Management: A Comparative Policy Analysis between the Swiss and Canadian Systems

Efficient e-waste management is crucial to successfully achieve sustainable urban growth universally. The upsurge in e-waste has resulted in countries, including Canada, adopting a wide array of policies associated with sustainable management. In this study, we conducted a mixed-method analysis of Canadian e-waste management policies to showcase the opportunities and limitations of the current system. We examine and compare the effectiveness of electronic waste management strategies in Canada and Switzerland using a comparative policy evaluation and by quantitatively measuring their efficiencies through two efficiency methods, namely a transformer-based, bidirectional, unsupervised machine learning model for natural language processing (NLP) and data envelopment analysis (DEA). Switzerland is utilized as a comparison case due to its robust legal framework that has been in place for proper management e-waste in order to enhance Canada’s electronic waste management system. The policy considerations presented in this study are directed toward urban planners, policy makers, and corporate strategists. These involve a mix of political, economic, social, and environmental planning tools concerning how to communicate and foster competent e-waste management in these countries. This is the first study to incorporate DEA and NLP-based BERT analysis to identify the most efficient policy deployment concerning e-waste management.

Institutional Determinants of Mining Projects in Canada and Sweden: Insights from the Prosperity and Kallak Cases.

Mining has proven to be a controversial form of resource development throughout the circumpolar north. This article compares two mining projects-the proposed Prosperity gold and copper mine in central British Columbia, Canada and the proposed Kallak iron ore mine in Norrbotten County in northern Sweden-that have endured long and protracted approval processes that have caused tensions and disputes between mining companies, Indigenous peoples, communities and state actors. In an effort understand the particular development paths taken by these two mining projects, this article examines the institutional determinants that structure relationships between industry, Indigenous communities and the state in Canada and Sweden. Using an historical institutionalist theoretical approach, the article focuses on the manner in which the structural features of the political systems and the environmental assessment and permitting processes in both countries have shaped the mine approval process. It also identifies particular critical junctures-important events and decisions that influenced the trajectory of the approval processes in profound and consequential ways. The article finds that institutional determinants, both historical and contemporary, have played a critical role in determining outcomes in both cases. In particular, it demonstrates the ways in which the structures of the Canadian and Swedish political systems have historically excluded Indigenous peoples from the decision-making process for resource development projects such as mines. It also shows how broader institutional contexts, as well as specific events and decisions, have complicated and politicized the mine approval processes, a situation that has heightened tensions on all sides.

Performing Turtle Island: Indigenous Theatre on the World Stage

Performing Turtle Island: Indigenous Theatre on the World Stage

Applicability of Entry to Practice Examinations for Optometry in Canada

High-stakes assessment for entry-to-practice is a critical component for the optometric profession's regulatory bodies in carrying out their duties to assure safe, effective, and ethical practice by their respective registrants. In 2019, the College of Optometrists of Ontario approved the acceptance of the United States (US) entry-to-practice examination for optometry, the National Board Examiners in Optometry (NBEO®), as an acceptable alternative assessment for the Canadian entry-to-practice examination, the Optometry Examining Board of Canada (OEBC). This decision was not unanimously supported in stakeholder feedback. In this paper, the development and structure of the two assessments are described. A global consensus framework is applied to identify the appropriateness of the assessments for Canada, and a similar change in entry-to-practice for nursing is examined for contextual correlates. Although intrinsically satisfactory for their respective jurisdictions, the NBEO® does not appear to satisfy the critical criteria of validity and acceptability for Ontario or, more broadly, Canada. Cultural and systemic differences between the Canadian and US health systems were also identified as additional barriers. Lastly, major future vulnerabilities for the profession lie in the availability of the entry-to-practice examination to all Canadians, Anglophone and Francophone.

Health-wellness resources on Canadian immigrant service provider organizations’ websites: A content, navigability, usability, and credibility analysis towards service & asset mapping

BackgroundImmigrant service provider organizations (SPOs) are often immigrants’ first point of contact to Canadian systems, such as job, education, health and social care, and housing. Prior research emphasizes the health literacy potential of websites as information infrastructures that can reduce information poverty and improve health outcomes. Yet, whether health-wellness resources are present on immigrant SPOs’ websites in a user-friendly manner remains unexplored. MethodsWe identified the presence of health-wellness resources on SPOs’ websites and analyzed those contents to understand their typology. We also ascertained the navigability, usability, and credibility of those websites regarding the health-wellness resources. ResultsAmong the 1453 SPO websites identified, only 289 (35.9%) had health-wellness information in their web-contents. Of the websites with health-wellness contents, “lifestyle and wellness resources” were present on 86.5% and “healthcare system resources” were present on 80.6% of the websites. Regarding “navigability”, zero to two mouse clicks were required to access health-wellness resources on 94.8% of the websites; however, more than one language option was very limited, available on less than a quarter of websites. ConclusionsAs immigrants continue to seek information online, immigrant SPOs’ websites hold value in increasing the health literacy and health-wellness of immigrants. This research assessed the current state of immigrant SPOs’ websites as information infrastructures and reveals areas for improvement. We recommend SPOs add resources for obtaining healthcare card, accessing primary care, sexual and reproductive, parenting, senior's health, mental wellbeing, and women's health information to their websites. We also recommend websites accommodate ethnic language option to improve navigability for immigrants.

Sentencing Youth in Canada: A Suitable Balanced Approach for Vietnam or Falling from Charybdis to Scylla?

Abstract This paper examines the sentencing regime that applies to the youth in Canada. The origins, history, evolution and challenges that faced this sentencing regime are reviewed. Its comparison with its Vietnamese counterpart allows the author to identify specific elements that could perhaps be improved in Vietnam not forgetting the many relevant differences that exist between the Canadian and Vietnamese criminal law systems. The author submits that the Canadian experience regarding youth sentencing should be considered as a good example for Vietnam.

Older Syrian Refugees’ Experiences of Language Barriers in Postmigration and (re)settlement Context in Canada.

This research explores older Syrian experiences of language barriers in Canada's post-migration and resettlement context. Guided by the ecosystemic model, the qualitative descriptive method was used to describe the experiences of six older adults (three women and three men, 55-year-old and over) living in the Greater Toronto-Hamilton Area. Results suggest the lack of English proficiency affects refugees' resettlement and, in particular, older adults at risk of abuse. Language barriers influence older adult refugees because it limits their ability to navigate the Canadian systems, exacerbate their dependency on adult children, increase social isolation, and decrease employment and income opportunities. Participants' commitment to learning English comes from their conviction that fluency has an essential role in shaping their experiences in Canada. Conclusions can help policymakers identify specific interventions to address language barriers among older adult Refugees.

American and Canadian Health System Overview

Scientists have written numerous papers studying different aspects of health systems in the world. Comparing health systems in the world is essential for policymakers to learn from each other to make healthcare services effective with better outcomes and decrease the cost of healthcare services. In the world, countries have different health systems. The difference in the health systems is a combination of components that are specific to each country based on the financial status of healthcare, workforce, and infrastructures. This paper will evaluate the contrast of Canadian and American health systems payment systems, timely access, and healthcare quality outcomes. Both countries are well-developed countries that have a health system with excellent infrastructure and effective healthcare services. However, the system operates differently in both countries. America does not have a universal healthcare plan and spends more money per capita compared to Canada. The United States has a lower rank than its peer, underperforms in maternal mortality, infant mortality, preventable deaths, and life expectancy. On the other hand, Canada has a universal healthcare plan for all Canadian residents and performs better in life expectancy, infant mortality, and maternal mortality. However, waiting for specialized care is longer than in the United States.

A review of Canadian and international food safety systems: Issues and recommendations for the future.

In January 2019, the Safe Food for Canadians Act/Safe Food for Canadians regulations (heretofore identified as SFCR) came into force across Canada and brought a more streamlined process to food safety practice in Canada. Food trade and production processes have evolved rapidly in recent decades, as Canada imports and exports food products; therefore it is critically important to remain aware of the latest advances responding to a range of challenges and opportunities in the food safety value chain. Looking through the optics of the recent SFCR framework, this paper places the spotlight on leading domestic and international research and practices to help strengthen food safety policies of the future. By shedding some light on new research, we also draw attention to international developments that are noteworthy, and place those in context as to how new Canadian food safety policy and regulation can be further advanced. The paper will benchmark Canada through a review study of food safety best practices by juxtaposing (i) stated aspirations with, (ii) actual performance in leading Organization for Economic Cooperation and Development (OECD) jurisdictions.

Analyzing models of patient-centered care in Canada through a scoping review and environmental scan.

AimThe objective of this study was to identify and synthesize models of patient-centered care in Canada and compare them with the normative models described in the literature.Subject and methodsPatient-centered care has gained momentum in the twenty-first century as a component of quality care. During the Covid-19 pandemic, the crisis often shifts the focus to the disease rather than the patient. The multiplicity of Canadian systems, including the federal, provincial, and territorial contexts, made a good case to search for a variety of models. This study was conducted using a scoping review method supported by an environmental scan to identify patient-centered care models in Canada.ResultsThe study identified 19 patient-centered interventions across Canada. The interventions included bedside interventions, patient-engagement projects at the organizational level, and citizen advisory panels at the system level. The organizational model was the most common. The goals of interventions ranged from enhancing the patient’s experience of care to identifying ways to cut costs. In most organizational-level projects, there was a marked tendency to engage patients as members of quality improvement committees. Respecting patient dignity and autonomy in one-on-one clinical interactions was minimally addressed in the models.ConclusionHealth systems are not only technical, biomedical organizations but also socio-political institutions with goals of financial protection, the fair distribution of services and resources, and the meaningful inclusion of the citizens in the system, and thus patients need to be respected as individuals and as collectives within the healthcare system.

Impact of a Combined Philosophy and Mindfulness Intervention on Positive and Negative Indicators of Mental Health Among Pre-kindergarten Children: Results From a Pilot and Feasibility Study.

Background: Fostering greater resiliency to stress, optimal psychosocial development and promoting better mental health and well-being in youth is an important goal of the Canadian and American elementary school systems (1, 2). Recent research on mindfulness and philosophy for children (P4C) has yielded promising results regarding innovative interventions that may be implemented in elementary school settings to foster greater child resiliency and well-being (3–5).Goal: The goal of this feasibility study was to pilot a new intervention, which combines mindfulness meditation and P4C activities, with the goal of improving mental health in pre-kindergarten children, assessed with positive (i.e., social skills and adaptability) and negative (i.e., internalized symptoms, comprises depression, anxiety, inattention; and hyperactivity) indicators.Methods: A randomized cluster trial with a wait-list control group was employed to evaluate the impact of the combined MBI and P4C intervention on child mental health. Two classrooms of pre-kindergarten children (N = 38, mean age = 4.6 years old) took part in this study and were randomly allocated to the experimental or wait-list control conditions. Teachers completed pre- and post-intervention questionnaires.Results: ANCOVAs did not reveal a significant effect of condition on internalized symptoms, controlling for baseline levels. Sensitivity analyses indicated that for the whole sample, internalized symptom scores were statistically significantly lower at post-intervention, when compared to pre-intervention scores. No impact of group on levels of hyperactivity was found, however, sensitivity analyses indicated that for both the experimental and control groups, hyperactivity scores were statistically significantly lower at post-intervention, when compared to pre-intervention scores. Finally, no impact of group on levels of social skills and adaptability were found. Sensitivity analyses conducted using paired t-tests did not indicate statistically significant pre-to-post changes in scores for both variables.Conclusion: These preliminary results suggest that mindfulness and philosophy for children may not be the most effective intervention to foster short-term resiliency, well-being and better mental health in children. Yet, group differences were often small and past research suggested the effectiveness of this type of intervention. Further research considering the impact of moderators such as age or baseline levels of psychopathology, using longer time frames and comparing the effectiveness of this combined intervention with other types of school-based interventions with similar aims (such as, e.g., P4C or MBI alone) is warranted, to evaluate if mindfulness and P4C interventions have an added value compared to other types of interventions implemented in school settings.

ДЕРЖАВНЕ РЕГУЛЮВАННЯ ТА ПІДТРИМКА ОРГАНІЧНОГО СІЛЬСЬКОГОСПОДАРСЬКОГО ВИРОБНИЦТВА: ОГЛЯД ОСНОВНИХ ПОКАЗНИКІВ ТА ПОРІВНЯЛЬНИЙ АНАЛІЗ ДВОХ КРАЇН

The goal of organic agricultural production is to provide humanity with high-quality food without genetically modified organisms and to support the sustainability of society. It is noted that the many benefits of organic agriculture make us think about the prospects for the development of global agriculture as one of the key factors influencing the future of the next generations. n this article we outline the main stages of evolution in the organic farming sphere and emphasize the characteristics that are relevant to each stage; define the term “organic farming” specified for Canadian and Ukrainian legislative systems. This paper also highlights the main prerequisites for the need for state support for organic production in the world on the example of two big organic producers – Canada and Ukraine. Based on the main indicators of the current state and level of development in both countries, the need for government regulation, support, and stimulation are considered. The main approaches to the stimulation and development of organic production in Canada are considered in order to determine priorities for Ukraine. It is established that subsidies for organic agriculture in Canada at one time gave an extremely important impetus to the development of this area of agricultural production, which ultimately led to significant progress in environmental protection, climate change mitigation, health, development of rural areas, and consumer protection. Also, it gave a significant boost for the national farmers, so they could grow in the area and improve their farming activity using innovative technologies. The domestic experience of financial and organizational and legal support of the organic sphere at the state and regional levels for the formation of areas for improvement is analyzed. The necessity of not only direct financial state support, but also active educational, research, and organizational support together with representatives of the active community and business has been proved. It was recovered that the main problems of the development of organic farming in Ukraine and obstacles to the formation of green policy in the field of agriculture include the following: lack of state control and statistical reporting of production, circulation, and sale of organic production; - lack of developed infrastructure in the organic sector of the agricultural sector; - imperfection of the system of certification and labeling of organic products, inconsistency of these processes with European standards; - lack of state support programs for organic producers and an insufficient number of local support programs. The necessity of a systematic approach to the stimulation and development of the domestic organic sphere to ensure the sustainability of the agricultural sector of Ukraine is substantiated. It is established that the policy of organic support in our country is not yet characterized by a high level of system and consistency, but important initial steps have been taken in the areas of organizational, legal, and financial support of organic production.

Aging in a Digital Society: Exploring How Canadian and Australian Public Library Systems Program for Older Adults

ABSTRACT Amid global population aging and technological advancement, this article seeks to support public librarians in innovating programs for older adults. It compares how Canadian and Australian public libraries approach this task using environmental scans and thematic analyses within both countries. Findings reveal that Canadian and Australian librarians similarly seek to craft programs that target the informational interests of older adults, increase digital literacy, mitigate social isolation, and combat ageism by means of community engagement, strategic partnerships, and experimentation. Findings highlight similar approaches to overcoming programming challenges and differences in how they market older adult specific programs.