Babes in Arms: An Application of The Australian Federal Child Care Model to Canada

This paper examines the feasibility of implementing the Australian model of federal childcare policy in Canada. A historical institutionalist approach is used to examine this feasibility by means of qualitative and comparative analyses. The distinct policy histories and current measures of both countries are outlined and studied through the course of this paper. Its research finds that, while Australia possesses some similarities in political structure to Canada, their distinct socio-political contexts make much of the former’s model inapplicable to the latter. Canadian federalism’s asymmetry and the political will of its federal units to defend powers conceded to them make it highly unlikely for the federal government to implement one of the most important aspects of the Australian model: a nationwide care standard for childcare facilities. While enacting this tenet of Australian policy is untenable, this paper recommends that federal authorities expand their existing monetary benefits for childcare and for both national and subnational governments to maintain existing agreements on childcare provision

Immediate results of percutaneous management of coarctation of the aorta: A 7-year single-centre experience.

Coarctation of the aorta (CoA) is often treated percutaneously. The aim of this study was to describe the immediate results of percutaneous management of native aortic coarctation (NaCoA) and recoarctation of the aorta (ReCoA) at our institution. We identified all patients with NaCoA or ReCoA who underwent percutaneous dilatation by either balloon angioplasty (BAP) or endovascular stent implantation (ESI) between 2011 and 2017. Success was defined as a residual peak-to-peak gradient (PPG) <20 mmHg or a ≥50% reduction in the gradient if the pre-intervention PPG was <20 mmHg. 63 patients (median age 6.8 years, interquartile range [IQR] 0.4-14.2) were identified. Among 11 patients with NaCoA, 7 underwent BAP and 4 had ESI, and among 52 patients with ReCoA, 42 underwent BAP and 10 had ESI. In patients with NaCoA, BAP was successful in 71%, with median PPG decreasing from 32 mmHg (IQR 25-46) to 17 mmHg (IQR 4-23) (p = .02), and ESI was successful in 100%, with median PPG decreasing from 20 mmHg (IQR 14.5-40) to 2 mmHg (IQR 0-6) (p < .01). In patients with ReCoA, BAP was successful in 69%, with median PPG decreasing from 20 mmHg (IQR 16-31.3) to 9 mmHg (IQR 0-14.3) (p < .001), and ESI was successful in 100%, with median PPG decreasing from 18 mmHg (IQR 11.5-22.8) to 0 mmHg (IQR 0-3.5) (p < .01). ESI was more successful than BAP (p = .01). There was only one complication. Percutaneous management of CoA is safe and effective in both NaCoA and ReCoA. Stent implantation is more effective than BAP