The Evolution of Free Trade in the Americas: NAFTA Case Studies

This conference includes contributions from Claudio Grossman, Dean Louis Perret, Alberto van Klaveren, Jose Luis Soberanes, James Holbein, Ken Roberts, William Miner, Bryan Elwood Salido, Eduardo Santos, Sergio Lopez-Ayllon, Javier Medina, Robert Herzstein, Andres Solimano, Enrique Gelbard, Al Lewis, Jonathan Doh, John F. Blakney, Hugo Concha Cantu, Jorge Rosenblut, Peter Dohlman, Raul Urteaga Trani, Dean Luis Riveros, and Dr. Pierre-Marc Johnson

Federalism and Health Care in Canada: A Troubled Romance?

Canadian federalism fragments health system governance Although the Constitution has been interpreted as providing shared jurisdiction over health generally with respect to health care specifically the courts have interpreted the Constitution as giving direct jurisdiction to the provinces The Federal role in health care is therefore indirect but nevertheless potentially powerful For example the Federal government has used its spending powers to establish the Canada Health Act CHA which commits funding to provinces on condition they provide firstdollar public coverage of hospital and physician services However in recent times as federal contributions have declined the CHA has been weakly enforced Further the failure to broaden the CHA to include prescription drugs dentistry and other important aspects of health care have contributed to Canada\u27s abysmal record on aboriginal health and its increasingly poor rankings in international comparisons Progress requires enforcement of an adequately funded CHA national pharmacare and concerted action on aboriginal health It requires bolder federal action and a panCanadian approach to governance in which federalism again becomes a laboratory of experimentation including on health human resource planning drug utilization and safety health emergency readiness health technology assessment electronic health information systems and systemlevel quality assuranc

Evaluating quality of obstetric care in low-resource settings: Building on the literature to design tailor-made evaluation instruments - an illustration in Burkina Faso

<p>Abstract</p> <p>Background</p> <p>There are many instruments available freely for evaluating obstetric care quality in low-resource settings. However, this profusion can be confusing; moreover, evaluation instruments need to be adapted to local issues. In this article, we present tools we developed to guide the choice of instruments and describe how we used them in Burkina Faso to facilitate the participative development of a locally adapted instrument.</p> <p>Methods</p> <p>Based on a literature review, we developed two tools: a conceptual framework and an analysis grid of existing evaluation instruments. Subsequently, we facilitated several sessions with evaluation stakeholders in Burkina Faso. They used the tools to develop a locally adapted evaluation instrument that was subsequently tested in six healthcare facilities.</p> <p>Results</p> <p>Three outputs emerged from this process:</p> <p>1) A comprehensive conceptual framework for the quality of obstetric care, each component of which is a potential criterion for evaluation.</p> <p>2) A grid analyzing 37 instruments for evaluating the quality of obstetric care in low-resource settings. We highlight their key characteristics and describe how the grid can be used to prepare a new evaluation.</p> <p>3) An evaluation instrument adapted to Burkina Faso. We describe the experience of the Burkinabé stakeholders in developing this instrument using the conceptual framework and the analysis grid, while taking into account local realities.</p> <p>Conclusions</p> <p>This experience demonstrates how drawing upon existing instruments can inspire and rationalize the process of developing a new, tailor-made instrument. Two tools that came out of this experience can be useful to other teams: a conceptual framework for the quality of obstetric care and an analysis grid of existing evaluation instruments. These provide an easily accessible synthesis of the literature and are useful in integrating it with the context-specific knowledge of local actors, resulting in evaluation instruments that have both scientific and local legitimacy.</p

Reconceptualizing conservation

Early definitions of conservation focused largely on the end goals of protection or restoration of nature, and the various disciplinary domains that contribute to these ends. Conservation science and practice has evolved beyond being focused on just issues of scarcity and biodiversity decline. To better recognize the inherent links between human behaviour and conservation, “success” in conservation is now being defined in terms that include human rights and needs. We also know that who engages in conservation, and how, dictates the likelihood that conservation science will be embraced and applied to yield conservation gains. Here we present ideas for reconceptualizing conservation. We emphasize the HOW in an attempt to reorient and repurpose the term in ways that better reflect what contemporary conservation is or might aspire to be. To do so, we developed an acrostic using the letters in the term “CONSERVATION” with each serving as an adjective where C = co-produced, O = open, N = nimble, S = solutions-oriented, E = empowering, R = relational, V = values-based, A = actionable, T = transdisciplinary, I = inclusive, O = optimistic, and N = nurturing. For each adjective, we briefly describe our reasoning for its selection and describe how it contributes to our vision of conservation. By reconceptualizing conservation we have the potential to center how we do conservation in ways that are more likely to result in outcomes that benefit biodiversity while also being just, equitable, inclusive, and respectful of diverse rights holders, knowledge holders, and other actors. We hope that this acrostic will be widely adopted in training to help the next generation of conservation researchers and practitioners keep in mind what it will take to make their contributions effective and salient

Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic