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The American eel (Anguilla rostrata) has long been regarded as a panmictic fish and has been confirmed as such in the northern part of its range. In this paper, we tested for the first time whether panmixia extends to the tropical range of the species. To do so, we first assembled a reference genome (975 Mbp, 19 chromosomes) combining long (PacBio and Nanopore and short (Illumina paired‐end) reads technologies to support both this study and future research. To test for population structure, we estimated genotype likelihoods from low‐coverage whole‐genome sequencing of 460 American eels, collected at 21 sampling sites (in seven geographic regions) ranging from Canada to Trinidad and Tobago. We estimated genetic distance between regions, performed ADMIXTURE‐like clustering analysis and multivariate analysis, and found no evidence of population structure, thus confirming that panmixia extends to the tropical range of the species. In addition, two genomic regions with putative inversions were observed, both geographically widespread and present at similar frequencies in all regions. We discuss the implications of lack of genetic population structure for the species. Our results are key for the future genomic research in the American eel and the implementation of conservation measures throughout its geographic range. Additionally, our results can be applied to fisheries management and aquaculture of the species. [ABSTRACT FROM AUTHOR]

During the past 30 years, research on policy analytical capacity's multidimensional nature and the evolution of policy advisory systems (PASs) has both increased knowledge of these processes and structures and opened new avenues of inquiry. While it is clear that changes in PASs in many countries have occurred ‐ featuring processes such as the increased externalisation and politicisation of policy advice ‐ studies of changes among the roles played by core policy professionals in advice provision have lagged. One aspect of this question concerns the nature and extent of changes in this 'forgotten fundamental' of advice systems related to how these professionals are arrayed within 'policy shops'—that is organisational units identified in the 1960s and 1970s as the main organisational home of policy professionals in government. Whether or not such shops have changed from the central‐integrated model identified in early studies and, if so, how, remain outstanding and foundational questions. Recent research in Canada has mapped the distribution of policy professionals at the central and provincial level and found more types of analysts and venues than in earlier eras— which range from the 'classical' integrated policy shops of the 1960s and 1970s which remain in central agencies and single‐purpose line departments to the much more 'distributed' patterns found in many departments dealing with multiple or complex controversial issues. Using Canadian data, this study outlines the development of these organisational types and their distribution in government and discusses the implications of these changes for better understanding the work, and needs, of core professionals in policy advice systems.. Points for practitioners: 'Policy professionals' or public employees specifically tasked with policy analysis in government are key players in policy advisory systems despite the addition of more external and internal actors in policy advice systems in recent years.How these advisors and analysts are organised in government, whether they work in clusters or small groups, and how they interact with other civil servants and policy‐makers are a key determinant of their activities and influence in policy‐making.In the policy sciences, work in the 1960s and 1970s established 'the policy shop', that is relatively small centrally located organisational units employing mainly policy analysts, as the main home of policy professionals in government. These units often enjoyed a monopoly in analysis and played a key role in policy‐making. However, research on these organisations has not kept up with changes in advisory relations within and outside of governments and the impact such changes have had on the influence and activities of core professionals.Recent work by the authors looking at the large Canadian province of Ontario has identified more than a single type of arrangement of analysts in the current era. This paper expands this analysis to both small and large jurisdictions in Canada, including the federal government, and develops two detailed case studies of the current organisation of policy professionals in smaller central agencies like Ministries of Justice as well as in larger omnibus Ministries of the Environment.The study finds a 'distributed' model of policy shops—in which multiple policy units exist throughout the agency—to be dominant in both cases and in all the governments examined and suggests this is now the new normal, replacing the dominance of the older more integrated central shop model. The predominance of the distributed model contributes to the fragmentation of policy advice already underway in government due to the growth in the number of external advisors such as consultants and think tanks, and internal ones such as political staffers. [ABSTRACT FROM AUTHOR]

This paper explores how politicians respond to the public salience of policy issues when determining which topics to publicly address. Using new data and state-of-the-art methodology, our study provides a fresh perspective on this fundamental question. We focus on a multi-party parliamentary system, specifically the Canadian House of Commons, with a specific emphasis on the issue of climate change. To assess the attention given by political parties to various policy issues, we analyze transcripts from the Question Period spanning from April 2006 to June 2021. To gauge the public's level of concern for these issues, we incorporate data obtained from Google Trends. Employing an instrumental variable estimation strategy, our study causally estimates the extent to which the public salience of climate change influences elite attention. Our findings reveal that the public salience of climate change significantly influences the attention given to this issue by parties, albeit with noticeable partisan variations. Moreover, our research highlights the effectiveness of the Question Period in compelling the government to address challenging or potentially embarrassing issues. Lastly, we uncover evidence suggesting that the Liberal Party of Canada successfully increased the public salience of climate change during its tenure in government. [ABSTRACT FROM AUTHOR]

This paper examines how policymakers interpret and deploy cultural economy approaches within municipal economic development strategies and cultural plans. Focusing on the 33 largest municipalities in Ontario, Canada, we conduct a keyword analysis of 63 municipal planning documents, supplemented with key informant interviews with economic development and cultural planning staff. Our analysis reveals that the use of cultural economy approaches in economic development and cultural plans varies depending upon city size, municipal governance structure and municipal organizational structure. However, despite the widespread use of cultural economy ideas in planning documents, we conclude that its uptake in municipal policymaking fails to reflect its professional and scholarly popularity. [ABSTRACT FROM AUTHOR]

In Canada, municipalities are involved in an increasing number of policy areas, but they remain largely absent from the nation's system of intergovernmental relations. Municipal representatives do not attend First Ministers' meetings that gather the Prime Minister and heads of each province and territory. They are also largely excluded from intergovernmental councils or committees focused on specific policy areas. Nor do they participate in the negotiation of most intergovernmental agreements. This paper explores how Canada's intergovernmental infrastructure could be reformed to include municipalities. It does so through an analysis of how other countries have made space for municipalities in their intergovernmental processes. After drawing five lessons from international experience, the paper concludes with four approaches to reforming intergovernmental relations in Canada: (1) ensure municipalities have the capacity, voice and structures to participate effectively in intergovernmental relations; (2) increase municipal involvement in provincial policy-making, including potentially through co-governed intergovernmental councils; (3) as far as possible, eliminate unfunded mandates (ie responsibilities devolved without adequate funding to discharge them) through, for example, provincial legislation or provincial-municipal intergovernmental agreements that require consultation on the fiscal impacts of draft legislation or regulation on municipalities; (4) strengthen trilateral (national/provincial/municipal) relations, including through location-specific or policy-specific agreements, and trilateral intergovernmental councils. [ABSTRACT FROM AUTHOR]

The COVID‐19 pandemic has challenged nations states across the world. They have implemented lockdown and social distancing and with the development of vaccines have gone to great lengths to build herd immunity for their populations. As place managers, local government has played a variety of roles supporting central government edicts related to social distancing and supporting local businesses impacted by lockdowns. The research reported here comparing the role local government has played in Australia, Canada, Italy, and New Zealand shows that they have at different times and for different issues been policy takers from central government, policy shapers, and policy makers adapting national strategies. Local government plays an important complementary role with central governments in both unitary and federal systems of government. The paper contributes to the literature on multi‐level governance, place‐based decision‐making, and disaster and emergency management by offering a framework for analysing municipal roles in crises management both in their relationship with higher layers of government and in their acting as locally placed organisations. Points for practitioners: Cross‐national study: Australia, Canada, Italy, and New Zealand.Examination of local government responses to COVID‐19 pandemic as policy makers, takers, or shapers.Comparison of federal and unitary states. [ABSTRACT FROM AUTHOR]

Aims: In 2014, in response to evidence that Canada's tobacco use would lead, inexorably, to substantial morbidity and mortality for the foreseeable future, a group of experts convened to consider the development of a "Tobacco Endgame" for Canada. The "Tobacco Endgame" defines a time frame in which to eliminate structural, political, and social dynamics that sustain tobacco use, leading to improved population health. Strategies: A series of Background Papers describing possible measures that could contribute to the creation of a comprehensive endgame strategy for Canada was prepared in advance of the National Tobacco Endgame Summit hosted at Queen's University in 2016. At the summit, agreement was reached to work together to achieve <5% tobacco use by 2035 (<5 by '35). A report of the proceedings was shared widely. Achievements: Progress since 2016 has been mixed. The Summit report was followed by a national forum convened by Health Canada in March 2017, and in 2018, the Canadian Government adopted "<5 × '35" tobacco use target in a renewed Canadian tobacco reduction strategy. Tobacco use has declined in the last 5 years, but at a rate slower than that which will be needed to achieve the <5 by '35 goal. There remain > 5 million smokers in Canada, signaling that smoking-related diseases will continue to be an enormous health burden. Furthermore, the landscape of new products (e-cigarettes and cannabis) has created additional risks and opportunities. Future directions: A bold, reinvigorated tobacco control strategy is needed that significantly advances ongoing policy developments, including full implementation of the key demand-reduction policies of the WHO Framework Convention on Tobacco Control. Formidable, new disruptive policies and regulations will be needed to achieve Canada's Endgame goal. [ABSTRACT FROM AUTHOR]

Background: In this paper we assess the quality of six deliberative stakeholder consultations regarding the implementation of a precision diagnostic for life-threatening pediatric brain tumors. Decision makers who base policy recommendations on the outputs of consultative exercises can presuppose that all deliberants are well informed of the policy issue, that participation in the deliberative process was fair, and that overcoming implementation barriers will necessarily result in practice change. Additional evidence is therefore needed to substantiate the informational quality of the deliberation, measure the equality of participation and study the effects on stakeholder reasoning to appropriately guide uptake of proposed recommendation(s). Methods: Using the DeVries framework for assessing the deliberative quality, we analyzed data from 44 post-consultation evaluation surveys completed by pediatric oncology and palliative care teams at two tertiary pediatric healthcare centers in Canada. We also conducted turn-taking and word-contribution analyses from the text transcriptions of each deliberation to assess equality of participation using descriptive statistics. Results: Deliberants agreed the quality of the deliberative process was fair (median ratings ranging from 9–10 out of 10) and the opportunities to receive expert information and discuss with others about the implementation of a new LDT were helpful (9.5 out of 10). While the session improved understanding of the implementation barriers and opportunities, it had marginal effects on deliberants' reasoning about whether LDTs would change their own clinical practice (3–10 out of 10). Participation was proportionate in at least four of the six deliberations, where no deliberant took more than 20% of total turns and contributed equal to, or less than 20% of total words. Conclusion: The quality assessment we performed demonstrates high informational value and perceived fairness of two deliberative stakeholder consultations involving pediatric palliative care and oncology teams in Canada. Quality assessments can reveal how the process of deliberation unfolds, whether deliberative outputs are the result of equitable participation among deliberants and what, if any, stakeholder voices may be missing. Such assessments should be routinely reported as a condition of methodological rigor and trustworthiness of deliberative stakeholder engagement research. [ABSTRACT FROM AUTHOR]

Background Generic drugs have been seen as a potentially powerful way to alleviate the financial burden on patients and health care systems. Two strategies for achieving rational prices of generic drugs are tiered pricing framework and pooled purchasing power. We compare the pan-Canadian Tiered Pricing Framework (TPF) and the Chinese National Volume-Based Procurement (NVBP) as comparators to explore the similarities and differences between the two mechanisms and summarise lessons for other jurisdictions. Methods This comparative study applies Donabedian's structure-process-outcome framework to systematically analyse the macro contexts, procedures, and long- and short-term results of each pricing mechanism, and the interactions between them. Results Structure: TPF is an upstream initiative aimed at lowering the prices of generic drugs and increasing coverage and price consistency. NVBP is a downstream national initiative prioritised for reducing drug prices to achieve value-based purchasing. Process: By associating the number of manufacturers with price cuts, TPF leaves the choice to manufacturers to decide if they want to enter a specific market. In contrast, the Chinese government determines NVBP list and has the authority to choose manufacturer(s) with the lowest price(s). TPF provides clear price information to potential suppliers with unclear order quantity. The NVBP drug price is determined by tendering, while procurement volume is clear and massive. Outcome: The effectiveness of TPF and NVBP is similar, with both achieving a 53% price cut. Both TPF and NVBP experienced efficiency improvement since their establishment, with 98 and 86 drugs priced per year. By comparing 60 drugs covered by both programmes, the NVBP price is 57% of that of the TPF counterpart on average (1.1 to 301.6%), by purchase power parity. Conclusions The tiered pricing scheme is feasible in regions with a stable and mature pharmaceutical market, typically seen in high-income countries, while tendering is more workable in low- and middle-income countries where the pharmaceutical market is weak and unstable. Experience in the two countries shows that a coordinated pricing mechanism involves many piecemeal interactive problems, which a sophisticated system with a robust long-range plan may address better. [ABSTRACT FROM AUTHOR]

Accessible housing is an urgent issue for countries experiencing rapid population aging. For over 20 years the United Kingdom's (UK) building code (Part M) and Lifetime Homes Standard have been researched as leading practices to increase accessible housing stock and allow older adults to stay in their communities. This review compiles key stakeholder groups' perspectives on these regulatory tools. Five main themes and 'lessons learned' were derived to anticipate potential challenges and inform proactive response for planners and policy makers in Canada and other countries when developing their own accessible housing regulation. [ABSTRACT FROM AUTHOR]

Canada and Australia, two liberal welfare states whose market-based ECEC systems consistently rank poorly on international measures, embraced similar short-term childcare policy responses to the onset of the COVID-19 pandemic: widespread closures, reduced capacity of centers, establishment of publicly funded emergency childcare programs for essential workers, and short-term wage subsidies for essential workers (sometimes including educators). Rooted in a feminist political economy (FPE) theoretical framework and using a what-is-the-problem-represented-to-be (WPR) methodological approach, this article explores the extent to which the first and second "waves" of the COVID-19 pandemic policy responses in Canada and Australia framed childcare as a concern about gendered, reproductive labor within political representations of the policy problems to be solved. [ABSTRACT FROM AUTHOR]

• Immigrant youth are integrating successfully into Canada. • Immigrant youth face systematic and interpersonal discrimination. • More focus is needed on immigrants' cultural and social contributions. • Current research and policy often promote assimilation. • Inclusion and multiculturalism are required for integration. Although there is substantial research examining adult perspectives of immigration and integration, there is notably less data on youth attitudes and experiences. When youth are surveyed, a preliminary review of the existing literature reveals that non-immigrant voices are very rarely included. This systematic literature review (a) identifies the major themes and summarizes the findings of existing research; (b) determines gaps in the existing literature and; (c) proposes recommendations for future integration research, policy, and interventions. Ultimately, this paper finds that integration policy and research in Canada tends to focus on the changes required by immigrant youth but rarely discuss the cultural adaptation and inclusion required by settled Canadians. A paradigm shift in research, settlement practice, and policy is necessary to better reflect the bi-directional cultural exchange and the mutual responsibilities of integration. [ABSTRACT FROM AUTHOR]

Background: The value of a life is regularly monetised by government departments for informing resource allocation. Guidance documents indicate how economic evaluation should be conducted, often specifying precise values for different impacts. However, we find different values of life and health are used in analyses by departments within the same government despite commonality in desired outcomes. This creates potential inconsistencies in considering trade-offs within a broader public sector spending budget. We provide evidence to better inform the political process and to raise important issues in assessing the value of public expenditure across different sectors. Methods: Our document analysis identifies thresholds, explicitly or implicitly, as observed in government-related publications in the following public sectors: health, social care, transport, and environment. We include both demand-side and supply-side thresholds, understood as societies' and governments' willingness to pay for health gains. We look at key countries that introduced formal economic evaluation processes early on and have impacted other countries' policy development: Australia, Canada, Japan, New Zealand, the Netherlands, and the United Kingdom. We also present a framework to consider how governments allocate resources across different public services. Results: Our analysis supports that identifying and describing the Value of a Life from disparate public sector activities in a manner that facilitates comparison is theoretically meaningful. The optimal allocation of resources across sectors depends on the relative position of benefits across different attributes, weighted by the social value that society puts on them. The value of a Quality-Adjusted Life Year is generally used as a demand-side threshold by Departments of transport and environment. It exceeds those used in health, often by a large enough proportion to be a multiple thereof. Decisions made across departments are generally based on an unspecified rationing rule. Conclusions: Comparing government expenditure across different public sector departments, in terms of the value of each department outcome, is not only possible but also desirable. It is essential for an optimal resource allocation to identify the relevant social attributes and to quantify the value of these attributes for each department. [ABSTRACT FROM AUTHOR]

Background: The growth of urban dwelling populations globally has led to rapid increases of research and policy initiatives addressing associations between the built environment and physical activity (PA). Given this rapid proliferation, it is important to identify priority areas and research questions for moving the field forward. The objective of this study was to identify and compare research priorities on the built environment and PA among researchers and knowledge users (e.g., policy makers, practitioners). Methods: Between September 2022 and April 2023, a three-round, modified Delphi survey was conducted among two independent panels of international researchers (n = 38) and knowledge users (n = 23) to identify similarities and differences in perceived research priorities on the built environment and PA and generate twin 'top 10' lists of the most important research needs. Results: From a broad range of self-identified issues, both panels ranked in common the most pressing research priorities including stronger study designs such as natural experiments, research that examines inequalities and inequities, establishing the cost effectiveness of interventions, safety and injuries related to engagement in active transportation (AT), and considerations for climate change and climate adaptation. Additional priorities identified by researchers included: implementation science, research that incorporates Indigenous perspectives, land-use policies, built environments that support active aging, and participatory research. Additional priorities identified by knowledge users included: built environments and PA among people living with disabilities and a need for national data on trip chaining, multi-modal travel, and non-work or school-related AT. Conclusions: Five common research priorities between the two groups emerged, including (1) to better understand causality, (2) interactions with the natural environment, (3) economic evaluations, (4) social disparities, and (5) preventable AT-related injuries. The findings may help set directions for future research, interdisciplinary and intersectoral collaborations, and funding opportunities. [ABSTRACT FROM AUTHOR]

This article analyses and compares disability policies for working-age individuals in Canada with a focus on the mode of policy provision and type of measure to determine the degree to which direct funding is used in this country. To consider policy diversity in this federal system, policies are compared using a mixed-methods approach. Using quantitative methods, federal, provincial and territorial policies are first compared using hierarchical cluster analysis. This provides evidence of three distinct clusters in Canada according to policy provision and measure type. In a second, qualitative analysis, the disability strategies of four provinces' (British Columbia, Ontario, Newfoundland and Labrador and Quebec) are compared, to determine over arching policy orientations. Findings indicate that policy provision in Canada largely favours money over services. Furthermore, most provinces emphasize either health or integration measures over substantive measures. Despite these commonalities, significant variation persists across Canada. This extends to poverty and disability reduction strategies with two of the four provinces having a broader orientation while the other two provinces focus specifically on employment as a means of social inclusion. The article concludes with a discussion on the state of employment policies for individuals with a disability in Canada. [ABSTRACT FROM AUTHOR]

• The Finnish Baby Box provides parents of newborns with a wide range of infant clothing and other basics. • The cardboard box in which the infant can sleep was emphasized by the media and commercial companies outside Finland. • The box preventing SIDS was advanced by private companies and the media. • This was less the case in Wales and Scotland, a result of their being governed by authorities with a "left" orientation. For over 80 years the Finnish state has provided expectant mothers with a cardboard box containing an extensive collection of clothing, bathing products for the baby, nappies, bedding and a small mattress. Numerous jurisdictions have implemented it in some form. We investigated through a critical case study methodology whether its translation into the liberal welfare states of Canada, UK, and USA experienced message distortion (the box as a means of preventing SIDS), commercialization, watering down of content; and separation from the complex of Finnish welfare state policies that support families with children. We find that only Scotland and Wales recognized the decommodification and equity roles played by the baby box. This study identified numerous barriers to building progressive public policy in Canada, UK, and USA: the structures and processes of the liberal welfare state, commercial interests that skew public policymaking and media logic that limits news reporting to the concrete and simple, eschewing complex analysis. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to explore 232 service providers' and policymakers' experiences of supporting children's well-being during the pandemic, across sectors, in 22 countries – including Kenya, the Philippines, South Africa, India, Scotland, Sweden, Canada and the USA, in the last quarter of 2020. Design/methodology/approach: A smartphone survey delivered via a custom-built app containing mostly open-ended questions was used. Respondents were recruited via professional networks, newsletters and social media. Qualitative content analysis was used. Findings: The findings reveal numerous system-level challenges to supporting children's well-being, particularly virus containment measures, resource deficiencies and inadequate governance and stakeholder coordination. Those challenges compounded preexisting inequalities and poorly affected the quality, effectiveness and reach of services. As a result, children's rights to an adequate standard of living; protection from violence; education; play; and right to be heard were impinged upon. Concurrently, the findings illustrate a range of adaptive and innovative practices in humanitarian and subsistence support; child protection; capacity-building; advocacy; digitalisation; and psychosocial and educational support. Respondents identified several priority areas – increasing service capacity and equity; expanding technology use; mobilising cross-sectoral partnerships; involving children in decision-making; and ensuring more effective child protection mechanisms. Practical implications: This study seeks to inform resilience-enabling policies and practices that foster equity, child and community empowerment and organisational resilience and innovation, particularly in anticipation of future crises. Originality/value: Using a novel approach to gather in-the-moment insights remotely, this study offers a unique international and multi-sectoral perspective, particularly from low- and middle-income countries. [ABSTRACT FROM AUTHOR]

Abstract Increases in youth vaping rates and concerns of a new generation of nicotine addicts recently prompted an increase in the federal minimum legal purchase age (MLPA) for tobacco products, including e-cigarettes, to 21 years. This study presents the first regression discontinuity evidence on the effectiveness of e-cigarette MLPA laws. Using data on 12th graders from Monitoring the Future, we obtain robust evidence that federal and state age 18 MLPAs decreased underage e-cigarette use by 15–20 percent and frequent use by 20–40 percent. These findings suggest that the age 21 federal MLPA could meaningfully reduce e-cigarette use among 18- to 20-year-olds. [ABSTRACT FROM AUTHOR]

Pluralist societies face challenges developing diversity-related policies to integrate newcomers and facilitate harmonious relationships between ethnocultural minorities and majorities. The integration policies that governments implement have significant implications for intergroup relations in diverse societies. The current paper (i) discusses the characteristics of two integration policies, multiculturalism and interculturalism; (ii) examines how these integration policies have been studied within the psychological literature; and (iii) explores the policy implications of these concepts for intergroup relations research and psychosocial adaptation of immigrants. In addressing the above points, we have paid specific attention to multiculturalism in Canada and interculturalism in Europe and in Quebec, the French speaking region of Canada, which highlight the developing role pluralist integration strategies are playing in the social and policy debates surrounding integration, inclusion, and social cohesion. [ABSTRACT FROM AUTHOR]

Background: Despite well-documented increased demands and shortages of personal protective equipment (PPE) during previous disease outbreaks, health systems in Canada were poorly prepared to meet the need for PPE during the COVID-19 pandemic. In the primary care sector, PPE shortages impacted the delivery of health services and contributed to increased workload, fear, and anxiety among primary care providers. This study examines family physicians' (FPs) response to PPE shortages during the first year of the COVID-19 pandemic to inform future pandemic planning. Methods: As part of a multiple case study, we conducted semi-structured qualitative interviews with FPs across four regions in Canada. During the interviews, FPs were asked to describe the pandemic-related roles they performed over different stages of the pandemic, facilitators and barriers they experienced in performing these roles, and potential roles they could have filled. Interviews were transcribed and a thematic analysis approach was employed to identify recurring themes. For the current study, we examined themes related to PPE. Results: A total of 68 FPs were interviewed across the four regions. Four overarching themes were identified: 1) factors associated with good PPE access, 2) managing PPE shortages, 3) impact of PPE shortages on practice and providers, and 4) symbolism of PPE in primary care. There was a wide discrepancy in access to PPE both within and across regions, and integration with hospital or regional health authorities often resulted in better access than community-based practices. When PPE was limited, FPs described rationing and reusing these resources in an effort to conserve, which often resulted in anxiety and personal safety concerns. Many FPs expressed that PPE shortages had come to symbolize neglect and a lack of concern for the primary care sector in the pandemic response. Conclusions: During the COVID-19 pandemic response, hospital-centric plans and a lack of prioritization for primary care led to shortages of PPE for family physicians. This study highlights the need to consider primary care in PPE conservation and allocation strategies and to examine the influence of the underlying organization of primary care on PPE distribution during the pandemic. [ABSTRACT FROM AUTHOR]

Aims: To explore nurse practitioners' experiences of medication abortion implementation in Canada and to identify ways to further support the implementation of medication abortion by nurse practitioners in Canada. Design: A qualitative approach informed by feminist theory and integrated knowledge translation. Methods: Qualitative interviews with stakeholders and nurse practitioners between January 2020 and May 2021. Data were analysed using critical feminist theory. Results: Participants included 20 stakeholders, 16 nurse practitioner abortion providers, and seven nurse practitioners who did not provide abortions. We found that nurse practitioners conduct educational, communication and networking activities in the implementation of medication abortion in their communities. Nurse practitioners navigated resistance to abortion care in the health system from employers, colleagues and funders. Participants valued making abortion care more accessible to their patients and indicated that normalizing medication abortion in primary care was important to them. Conclusion: When trained in abortion care and supported by employers, nurse practitioners are leaders of abortion care in their communities and want to provide accessible, inclusive services to their patients. We recommend nursing curricula integrate abortion services in education, and that policymakers and health administrators partner with nurses, physicians, midwives, social workers and pharmacists, for comprehensive provincial/territorial sexual and reproductive health strategies for primary care. Impact The findings from this study may inform future policy, health administration and curriculum decisions related to reproductive health, and raise awareness about the crucial role of nurse practitioners in abortion care and contributions to reproductive health equity. Patient or Public Contribution: This study focused on provider experiences. In‐kind support was provided by Action Canada for Sexual Health & Rights, an organization that provides direct support and resources to the public and is committed to advocating on behalf of patients and the public seeking sexual and reproductive health services. [ABSTRACT FROM AUTHOR]

The authors comment on an article by W. Hall and colleagues on regulating delta-9-tetrahydrocannabinol (THC) content in cannabis products. Topics include policy options discussed by W. Hall and colleagues with a view to reduce cannabis-related harm, the introduction by Quebec and Uruguay of caps on THC levels for the products supplied through the legal market, and possible impact of accommodating different THC concentrations among different legal supply options.

When individuals evaluate policies, they consider both the policy's content and its endorsers. In this study, we investigate the conditions under which these sometimes competing factors guide preferences. In an effort to combat the spread of COVID-19, American President Trump and Canadian Prime Minister Trudeau bilaterally agreed to close their shared border to refugee claimants and asylum seekers. These ideologically opposed leaders endorsing a common policy allows us to test the influence of a well-known foreign neighbor on domestic policy evaluations. With a large cross-national survey experiment, we first find that Canadians and Americans follow ideological positions in evaluating the policy, with right-leaning respondents offering the most support. With an experiment, we reveal how both populations shift their views when told about their neighboring leader's endorsement. Our findings highlight ideologically motivated reasoning across an international border, with broad implications for understanding how individuals weigh a policy's content against its political cues. [ABSTRACT FROM AUTHOR]

Tourism trade associations play a critical, though little understood role in tourism policy development and implementation. As the direct conduit between industry and government, associations seek to develop a reciprocal arrangement with government departments, senior bureaucrats and elected officials with the goal of influencing policy to either benefits their members or minimise damage to them. This paper examines the role of tourism trade associations in government relations activities by analysing the roles played by different types of provincial associations in Canada. The study found that, depending on their size, associations liaised with more than 20 different government departments on a wide array of issues. However, their direct links are closest with tourism departments. [ABSTRACT FROM AUTHOR]

Nutrition guideline development is traditionally seen as a mechanism by which evidence is used to inform policy decisions. However, applying evidence in policy is a decidedly complex and politically embedded process, with no single universally agreed-upon body of evidence on which to base decisions, and multiple social concerns to address. Rather than simply calling for "evidence-based policy," an alternative is to look at the governing features of the evidence use system and reflect on what constitutes improved evidence use from a range of explicitly identified normative concerns. This study evaluated the use of evidence within the Canada Food Guide policy process by applying concepts of the "good governance of evidence" – an approach that incorporates multiple normative principles of scientific and democratic best practice to consider the structure and functioning of evidence advisory systems. The findings indicated that institutionalizing a process for evidence use grounded in democratic and scientific principles can improve evidence use in nutrition policy making. [ABSTRACT FROM AUTHOR]

Unmet needs for assistive technologies (ATs) exist and the need for ATs is growing owing to demographic changes worldwide. Little comprehensive research has examined equity of access to ATs in Canada. Our study elucidates perspectives of policymakers and stakeholders on challenges and solutions for enhancing equitable access to ATs to advance policy discussions. We conducted a qualitative interview study with a purposive sample of policymakers and stakeholders. Stakeholders were from non-profit organisations; private insurance companies; ageing or technology industries; and advocacy, consumer, and support groups. We used thematic analysis to develop themes that summarised and facilitated data interpretation. We conducted 24 interviews involving 32 participants. We present three themes: (1) User experiences, detailing challenges experienced by AT system users; (2) System characteristics: Challenges and solutions, outlining governance, financial, and delivery arrangements that create challenges for accessing AT, as well as participants' proposed solutions; and (3) Shifts in models and principles, for approaches that may foster equitable access to ATs. We consolidate results into a set of valued qualities of a system that can enhance equitable AT access, and relate results to relevant national and international activities. This is the most comprehensive study of Canadian policymaker and stakeholder views on AT access to date. Identified challenges and solutions point to opportunities for policy action and to support work to create a national vision for AT access that strengthens the potential for ATs to enable daily activity participation, independence, and societal inclusion of seniors and people with disabilities. AT use supports daily activity participation, independence, and societal inclusion of seniors and people with disabilities. There is an urgent need to ensure that those who need ATs have access to them, considering the benefits of their use, current unmet needs for ATs, and the anticipated demand for ATs because of the ageing population and increased prevalence of chronic disease and disability. A comprehensive understanding of policymakers' and stakeholders' perspectives on challenges and potential solutions for enhancing equitable access to ATs is critical to support development of evidence- and values-informed policies. Understanding challenges and solutions identified by diverse policymakers and stakeholders can lead to national and local opportunities for policy action and support work to create a national vision for enhancing equitable access to AT. [ABSTRACT FROM AUTHOR]

Progress in reducing health inequalities through public policy action is difficult in nations identified as liberal welfare states. In Canada, as elsewhere, researchers and advocates provide governing authorities with empirical findings on the sources of health inequalities and document the lived experiences of those encountering these adverse health outcomes with the hope of provoking public policy action. However, critical analysis of the societal structures and processes that make improving the sources of health inequalities difficult—the quality and distribution of living and working conditions, that is the social determinants of health—identifies limitations in these approaches. Within this latter critical tradition, we consider—using household food insecurity in Canada as an illustration—how polemics and anger mobilization, usually absent in health inequalities research and advocacy—could force Canadian governing authorities to reduce health inequalities through public policy action. We explore the potential of using high valence terms such as structural violence, social death and social murder, which make explicit the adverse outcomes of health‐threatening public policy to force government action. We conclude by outlining the potential benefits and threats posed by polemics and anger mobilization as means of promoting health equity. [ABSTRACT FROM AUTHOR]

The concept of autonomy is essential in the practice and study of gerontology and in long-term care policies. For older adults with expanding care needs, scores from tightly specified assessment instruments, which aim to measure the autonomy of service users, usually determine access to social services. These instruments emphasise functional independence in the performance of activities of daily living. In an effort to broaden the understanding of autonomy into needs assessment practice, the province of Québec (Canada) added social and relational elements into the assessment tool. In the wake of these changes, this article studies the interaction between the use of assessment instruments and the extent to which they alter how older adults define their autonomy as service users. This matters since the conceptualisation of autonomy shapes the formulation of long-term care policy problems, influencing both the demand and supply of services and the types of services that ought to be prioritised by governments. Relying on focus groups, this study shows that the functional autonomy frame dominates problem definitions, while social/relational framings are marginal. This reflects the more authoritative weight of functional autonomy within the assessment tool and contributes to the biomedicalisation of aging. [ABSTRACT FROM AUTHOR]

This article focuses on Canada's liberal welfare state and the COVID-19 pandemic, offering an overview of some of the unequal health and social effects of the crisis. It argues that the policy response to the pandemic should be situated within a broader pattern of welfare restructuring and organization that serves to instrumentalize economic insecurity and extend labor discipline. Without making firm predictions about the future, we argue that this is likely to reproduce increasingly unequal patterns of welfare access, providing benefits to some constituents while disciplining vulnerable groups to facilitate competitive gains. [ABSTRACT FROM AUTHOR]