The Review of Economic Performance and Social Progress 2001: The Longest Decade: Canada in the 1990s

One of the most (if not the most) highly charged public debates in this country over the past decade has been about the role of economic imperatives in dismantling the foundations of the welfare state set out in the universalist model adopted in the post-war years. Ken Battle in his chapter is critical of the ongoing public discourse on this issue, which he considers as lacking both in substance and subtlety. He argues that this has led to a polarization of views and produced persistent mythologies which in his estimation have served to insulate government from effective criticism and prevented the occurrence of a truly needed, open and informed public debate on the present and future course of social policy. Battle describes the overall process of reform and developments in social policy in the last two decades as one of "relentless incrementalism" where cumulative, purposeful and patterned change has produced a substantial shift in the structure of the Canadian income security system. He concludes that on the whole the emerging post-welfare state will better serve Canada's evolving social, economic and political needs and sees little cause for continuing nostalgia over the fading universalist welfare state, which in his estimation never worked all that well.Social Policy, Income Support, Income Security, Economic Security, Welfare State, Welfare System, Social Safet Net, Welfare Policy, Social Security, Canada

Hyperoxemia and excess oxygen use in early acute respiratory distress syndrome : Insights from the LUNG SAFE study

Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Concerns exist regarding the prevalence and impact of unnecessary oxygen use in patients with acute respiratory distress syndrome (ARDS). We examined this issue in patients with ARDS enrolled in the Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study. Methods: In this secondary analysis of the LUNG SAFE study, we wished to determine the prevalence and the outcomes associated with hyperoxemia on day 1, sustained hyperoxemia, and excessive oxygen use in patients with early ARDS. Patients who fulfilled criteria of ARDS on day 1 and day 2 of acute hypoxemic respiratory failure were categorized based on the presence of hyperoxemia (PaO2 > 100 mmHg) on day 1, sustained (i.e., present on day 1 and day 2) hyperoxemia, or excessive oxygen use (FIO2 ≥ 0.60 during hyperoxemia). Results: Of 2005 patients that met the inclusion criteria, 131 (6.5%) were hypoxemic (PaO2 < 55 mmHg), 607 (30%) had hyperoxemia on day 1, and 250 (12%) had sustained hyperoxemia. Excess FIO2 use occurred in 400 (66%) out of 607 patients with hyperoxemia. Excess FIO2 use decreased from day 1 to day 2 of ARDS, with most hyperoxemic patients on day 2 receiving relatively low FIO2. Multivariate analyses found no independent relationship between day 1 hyperoxemia, sustained hyperoxemia, or excess FIO2 use and adverse clinical outcomes. Mortality was 42% in patients with excess FIO2 use, compared to 39% in a propensity-matched sample of normoxemic (PaO2 55-100 mmHg) patients (P = 0.47). Conclusions: Hyperoxemia and excess oxygen use are both prevalent in early ARDS but are most often non-sustained. No relationship was found between hyperoxemia or excessive oxygen use and patient outcome in this cohort. Trial registration: LUNG-SAFE is registered with ClinicalTrials.gov, NCT02010073publishersversionPeer reviewe

Sustaining Public Pensions in Canada: a Tale of Two Reforms

paper for the Hitotsubashi Spring Workshop on Pensions, National Center of Sciences, Tokyo, Japan, 19 April 2002科学研究費補助金（特定領域研究） = Grant-in-Aid for Scientific Research on Priority Areas44, [9] p