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The COVID-19 pandemic highlighted the challenges that go into effective policymaking. Facing a public health crisis of epic proportion, government bodies across the world sought to manage the spread of infectious disease and healthcare-system overwhelm in the face of historic economic instability and social unrest. Recognizing that COVID-19 debates and research are still actively ongoing, this paper aims to objectively compare COVID-19 responses from countries across the world that exhibit similar economic and political models to Canada, identify notable failures, successes, and key takeaways to inform future-state pandemic preparedness.

Emergency departments (EDs) are an important source of care for people with mental health (MH) concerns. It can be challenging to treat MH in EDs, and there is little research capturing both patient and provider perspectives of these experiences. We sought to summarize the evidence on ED care experiences for people with MH concerns in North America, from both patient and provider perspectives. Medline and EMBASE were searched using PRISMA guidelines to identify primary studies. Two reviewers conducted a qualitative assessment of included papers and inductive thematic analysis to identify common emerging themes from patient and provider perspectives. Seventeen papers were included. Thematic analysis revealed barriers and facilitators to optimal ED care, which were organized into three themes each with sub-themes: (1) interpersonal factors, including communication, patient–staff interactions, and attitudes and behaviours; (2) environmental factors, including accommodations, wait times, and restraint use; and (3) system-level factors, including discharge planning, resources and policies, and knowledge and expertise. People with MH concerns and ED healthcare providers (HCPs) share converging perspectives on improving ED connections with community resources and diverging perspectives on the interplay between system-level and interpersonal factors. Examining both perspectives simultaneously can inform improvements in ED care for people with MH concerns. [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]

The pan-Canadian Oncology Drug Review (pCODR) makes recommendations to Canada's provinces and territories (except Quebec) to guide their cancer drug funding decisions. The objective of this paper is to explore, using an economic perspective and the pCODR as an example, the challenges associated with striving to simultaneously achieve the goals of maximizing health benefits with available resources and improving access to a more consistent standard of care across Canada. The first challenge concerns how to interpret the goals in order to determine how resources should be allocated to achieve each goal. The second challenge relates to whether, if pursued simultaneously, both goals can be achieved to the same extent that each goal could have been achieved alone with the same available resources. Regarding the first challenge, we illustrate that, due to a lack of definitional clarity, it is difficult to determine exactly how resources should be allocated in order to achieve the goal of improving access to amore consistent standard of care across Canada. Regarding the second challenge, we illustrate that choosing to strive for both of the pCODR goals simultaneously will likely be associated with tradeoffs in the extent to which one or both goals can be achieved (relative to what could have been achieved for each goal alone with the same available resources). We suggest that, if the pCODR and the provincial drug plan decision-makers it supports want to strive for both goals simultaneously, they must prioritize the goals and explicitly identify the tradeoffs associated with the prioritization. This will ensure that the consequences of striving to simultaneously achieve both goals are explicit, transparent, and predictable for provincial drug plan decision-makers, physicians, patients, caregivers, and society as a whole. [ABSTRACT FROM AUTHOR]

As populations continue to grow older, efforts to support the process of aging well are important goals. Various synonyms are used to cover aging well, such as active aging. The World Health Organization published in 2002 the report Active Ageing: A Policy Framework that according to the call for papers, has brought active ageing to the forefront of international public health awareness. The 2010 Toronto Charter for Physical Activity: A Global Call for Action was singled out in the call for papers as a key document promoting physical activity one goal of the 2002 WHO active aging policy framework. Media are to report to the public topics of importance to them. We investigated the newspaper coverage of aging well and synonymous terms such as active aging through the lens of the 2002 WHO active aging policy framework and the 2010 Toronto Charter for Physical Activity. As sources we used the following newspapers: China Daily, The Star (Malaysia), two UK newspapers (The Guardian, The Times), a database of 300 Canadian newspapers (Canadian Newsstand) and a US newspaper (The New York Times). The study generated data answering the following four research questions: (1) how often are the 2002 WHO active aging policy framework and the 2010 Toronto Charter for Physical Activity mentioned; (2) how often is the topic of active aging and terms conveying similar content (aging well, healthy aging, natural aging and successful aging) discussed; (3) which of the issues flagged as important in the 2002 WHO active aging policy framework and the 2010 Toronto Charter for Physical Activity are covered in the newspaper coverage of active aging and synonymous terms; (4) which social groups were mentioned in the newspapers covered. The study found a total absence of mentioning of the two key documents and a low level of coverage of "active aging" and terms conveying similar content. It found further a lack of engagement with the issues raised in the two key documents and a low level of mentioning of socially disadvantages groups. We posit that reading the newspapers we covered will not expose the reader to the two key documents and the issues linked to aging well including the need to increase physical activity.

Background Prostate cancer (PCa) is the most common non-skin cancer among men in Canada and other Western countries. Increased prevalence and higher cost of newer treatments have led to a significant rise in the economic burden of PCa. The objectives of the present study were to systematically review the literature on direct costs for the initial management of PCa, and to examine the methodologic considerations across studies. Methods Bibliographic databases were systematically searched for peer-reviewed articles in English. Studies were reviewed for methodologic considerations and mean direct cost of active surveillance or watchful waiting (AA/WW) and initial treatments. Direct cost was standardized to 2011 Canadian dollars. Results After a review of abstracts and full-text papers, seventeen articles met the eligibility criteria and were included in the review. Studies were published during 1992-2010. The studies reported on health care systems in the United States, France, the United Kingdom, German, Italy, and Spain. Our review identified a lack of methodologic consensus, leading to variation in direct costs between studies. Nevertheless, results indicate a significant direct cost of PCa treatments. Conclusions The existing literature lacks methodologically rigorous studies on the direct costs of PCa treatments specific to publicly funded health care systems. Additional studies are required to appreciate the direct costs of newer treatments and the impact of their adoption on the growing economic burden of PCa management. [ABSTRACT FROM AUTHOR]

This study analyzes the previous literature on the online safety of children and youth under "the 4Cs risk framework" concerning contact, content, conduct, and contract risks. It then conducts a comparative study of Australia, Canada, and the UK, comparing their institutions, governance, and government-led programs. Relevant research in Childhood Education Studies is insufficient both in quantity and quality. To minimize the four major online risks for children and youth in cyberspace, it is necessary to maintain a regulatory approach to the online exposure of children under the age of 13. Moreover, the global society should respond together to these online risks with "multi-level" policymaking under a "multi-stakeholder approach". At the international level, multilateral discussion within the OECD and under UN subsidiaries should continue to lead international cooperation. At the domestic level, a special agency in charge of online safety for children and youth should be established in each country, encompassing all relevant stakeholders, including educators and digital firms. At the school and family levels, both parents and teachers need to work together in facilitating digital literacy education, providing proper guidelines for the online activities of children and youth, and helping them to become more satisfied and productive users in the digital era. [ABSTRACT FROM AUTHOR]

(1) Background: Canada had a unique approach to COVID-19 vaccine policy making. The objective of this study was to understand the evolution of COVID-19 vaccination policies in Ontario, Canada, using the policy triangle framework. (2) Methods: We searched government websites and social media to identify COVID-19 vaccination policies in Ontario, Canada, which were posted between 1 October 2020, and 1 December 2021. We used the policy triangle framework to explore the policy actors, content, processes, and context. (3) Results: We reviewed 117 Canadian COVID-19 vaccine policy documents. Our review found that federal actors provided guidance, provincial actors made actionable policy, and community actors adapted policy to local contexts. The policy processes aimed to approve and distribute vaccines while continuously updating policies. The policy content focused on group prioritization and vaccine scarcity issues such as the delayed second dose and the mixed vaccine schedules. Finally, the policies were made in the context of changing vaccine science, global and national vaccine scarcity, and a growing awareness of the inequitable impacts of pandemics on specific communities. (4) Conclusions: We found that the triad of vaccine scarcity, evolving efficacy and safety data, and social inequities all contributed to the creation of vaccine policies that were difficult to efficiently communicate to the public. A lesson learned is that the need for dynamic policies must be balanced with the complexity of effective communication and on-the-ground delivery of care. [ABSTRACT FROM AUTHOR]

Background: This study examined self-reported physical activity (PA) participation, well-being, and perceived needs of Canadians with disabilities during the COVID-19 pandemic. In addition, we assessed physical and mental health and the extent to which pre-identified needs were being met or unmet. Methods: Two iterations of the COVID-19 Disability Survey were conducted during two pandemic timeframes: June–December 2020 (iteration 1, n = 599) and December 2020–September 2021 (iteration 2, n = 528). PA participation was assessed with the International Physical Activity Questionnaire. Physical and mental health were assessed with the PROMIS Global-10 questionnaire. A needs assessment was conducted on 11 needs pre-identified in partnership with community organizations. Results: Approximately 50% of respondents to both iterations reported that they did not do any moderate-vigorous intensity PA. While physical health was not different between timeframes, mental health was worse during iteration 2 than iteration 1 (p = 0.028). During both timeframes, access to recreation and leisure facilities was the greatest unmet need. Conclusion: These data highlight the low levels of PA and the perceived changes in PA, mental health, and recreational needs of Canadians with disabilities during the pandemic. The findings of the Survey were used to support policy change to remove barriers to PA participation for people with disabilities in Ontario. [ABSTRACT FROM AUTHOR]

This article identifies the potential sources of inequity in three stages of integrating cystic fibrosis personalized medicines into the Canadian healthcare system and proposes mitigating strategies: (1) clinical research and diagnostic testing; (2) regulatory oversight and market authorization; and (3) implementation into the healthcare system. There is concern that differential access will cast a dark shadow over personalized medicine by stratifying the care that groups of patients will receive—not only based on their genetic profiles, but also on the basis of their socioeconomic status. Furthermore, there is a need to re-evaluate regulatory and market approval mechanisms to accommodate the unique nature of personalized medicines. Physical and financial accessibility ought to be remedied before personalized medicines can be equitably delivered to patients. This article identifies the socio–ethical and legal challenges at each stage and recommends mitigating policy solutions. [ABSTRACT FROM AUTHOR]