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Learn how Queen's is planning for our safe return to campus.

Research Prominence

Principal Deane unveils university’s strategic framework

Queen’s convenes working groups to advance operational priorities.

Queen's Strategic Framework written on a blue banner, Mitchell Hall photograph in the background.
Newly established working groups will work over the coming months to define goals in support the Strategic Framework.

Following a comprehensive, year-long consultation with the campus community led by Principal and Vice-Chancellor Patrick Deane, the university’s Board of Trustees has approved Queen’s new strategic framework. Developed out of consultations with faculty, staff, students, alumni, and stakeholders in Canada and abroad, the new strategy defines the mission, vision and values of Queen’s and identifies six strategic goals aimed at positioning Queen’s as a university committed to societal impact and positive change.

“More than a year ago, I began a comprehensive consultation process to better understand who we are as a university and why we are,” says Principal Deane, who met with several thousand Queen’s community stakeholders as part of The Conversation. “From that frank, thoughtful, and at times unflinchingly critical process emerged the components of a positive, forward-looking strategy for our institution – one that will make explicit that Queen’s is a university for the future.”

Principal Deane has established six working groups to advance the strategy in its next stage of implementation. Each working group corresponds with one of six strategic goals articulated in the framework, which include aiming to increase the university’s research impact; advancing the student learning experience; growing the interdependence between research and teaching; strengthening the university’s global engagement; deepening the university’s relationship with the local, regional, and national communities; and improving Queen’s organizational culture.

“Queen’s new strategy leads with an important vision statement that declares we are a community,” says Principal Deane. “In that spirit, I very much look forward to convening the working groups and, with their assistance, identifying ways by which we can realize our fullest potential as an institution.”

Each working group is led by a faculty champion and includes additional representatives from faculty, university senate, staff, and students. Chairs include Parvin Mousavi, Erik Knutsen, Ram Murty, Sandra den Otter, and Elaine Power. Ellie Sadinsky, a staff member, will co-chair the working group on organizational culture with a faculty member. The working groups will meet over June and July and are tasked with developing two or three operational priorities to align with the strategic goals. The groups will engage the community through public consultation and online feedback before finalizing their goals, which are to be presented to a steering committee, chaired by Principal Deane, in early August.

The steering committee – comprised of the chairs of the working groups, the senior leadership team, and the deans – will then combine the operational priorities into a plan to enable implementation of the new strategy in the early fall. Central to the realization of the strategy will be the university’s recent commitment to advancing the United Nations’ Sustainable Development Goals; a commitment for which Queen’s was recently recognized as a national and global leader.

Learn more about the working groups, their composition, and mandates.

Unique technology gives humans a leg up on walking

An exoskeleton designed by Queen's Engineering researchers that improves walking efficiency is the subject of a new study featured in the leading academic journal Science.

The science of walking is taking its next big step with the aid of a unique exoskeleton that allows users to walk further while using less energy. Developed by a multidisciplinary team from the Queen's Faculty of Engineering and Applied Science, the backpack-mounted prototype removes energy during a specific phase of the gait cycle, lessening the metabolic cost of walking. Details of the device's development and evaluation were published today in Science—one of the world's foremost academic journals.

Unlike existing exoskeleton technologies that either add energy or transfer it from one phase of the gait cycle to another, this new device assists users by removing energy which helps the knee muscles during a critical moment—called the terminal swing phase.

“Removing energy from a person's legs during walking may sound counterintuitive, like applying the brake in a moving car,” says Michael Shepertycky, a recent PhD graduate and lead author of the study, “but our muscles naturally remove energy while we walk, and our device helps them to do so.”

The team envisages the technology—which weighs just over half a kilogram—enabling hikers to walk longer distances or helping nurses be less tired after a long shift on their feet.

“Improving walking and running economy has been an important topic of research for the past two decades, due to its scientific and practical implications,” says Qingguo Li, Associate Professor of Mechanical and Materials Engineering and co-author of the study. “Walking is a delicate and highly optimized process, which makes it difficult to use exoskeletons to improve walking efficiency.”

In addition to assisting the user, the device converts the removed energy into electricity that can be used to power the device's control system and other portable devices. This energy harvesting capability could be particularly useful for individuals travelling on foot in remote locations, allowing them to charge cellular phones or GPS devices. Yan-Fei Liu, Professor of Electrical and Computer Engineering and co-author of the study, led the development of the device's power electronics.

The team's interdisciplinary approach included elements of walking biomechanics, physiology, human-machine interactions, and design innovation. Much of this research was conducted in the Human Mobility Research Centre, a Queen's/Kingston Health Sciences Centre facility equipped with world-class gait analysis technology.

“For the first time, we have demonstrated that removing energy can increase walking efficiency,” says Dr. Shepertycky. “This is a significant advancement in the field of exoskeleton development, and one with the potential to change the way that we approach gait assistance. The publication of this work in one of the most prestigious scientific journals highlights the research expertise and excellent facilities at Queen's, as well as the world-class multidisciplinary education that I received here.”

Learn more about the exoskeleton project on the Science website.

Advancing international research collaborations

CIMVHR will be participating in NATO’s Science for Peace and Security (SPS) Programme to expand research supporting the successful transition and reintegration of military service personnel to civilian life.

Master Corporal Tina Fahie, a member of the Military Police Unit deployed on Operation IMPACT, poses for a photo on September 25, 2020. Credit: Sailor Third Class Melissa Gonzalez
Master Corporal Tina Fahie, a member of the Military Police Unit deployed on Operation IMPACT. (Credit: Sailor Third Class Melissa Gonzalez).

Transitioning out of service is a major turning point in the lives of military personnel. While many have successful experiences, a significant amount face challenging obstacles. In understanding the factors that contribute to a failed military-to-civilian transition (MCT) most of the research has focused on men, leaving a gap in addressing the unique needs of women, particularly around mental health.

NATO (North Atlantic Treaty Organization) has recognized the importance of supporting women’s successful MCT as a high-level priority within its member and partner nations. This focus has led to a collaboration with the Queen’s-based Canadian Institute for Military and Veteran Health Research (CIMVHR), a leader in MCT research over the past decade, through NATO’s Science for Peace and Security (SPS) Programme. Joined by the Women’s Information Consultative Centre (WICC), researchers, veterans, and policy leaders will participate in a series of consultations and a workshop throughout the year with the purpose of applying a gender lens to MCT research. Focusing on the experiences of women from Ukraine, Canada, and the United States, the goal is to convene leading experts from these countries to translate existing research to policy opportunities and define priorities for new research to advance successful MCT for women.

A launch event marking the start of the collaboration happened on May 19 and reflected the significance and strategic importance of this issue for NATO and the participating lead countries. Representatives delivering remarks included David van Weel, Assistant Secretary General for Emerging Security Challenges at NATO, Ambassador Jacqueline O’Neill, Canada’s Ambassador for Women, Peace, and Security, and Dr. Kateryna Levchenko, Vice-Chair of Gender Equality Commission of Council of Europe and Government Commissioner for Gender Equality Policy of Ukraine.

“Many of our institutions have long thought that being ‘gender neutral’ or ‘gender blind’ was the fair thing to do, and that in fact treating everyone the same was a way of demonstrating respect and fairness,” says Ambassador O’Neill. “Notably, security forces have long prided themselves on treating everyone the same, and this extended to their supports for the eventual military to civilian transition. But the same treatment often does not result in the same outcomes; people have different experiences and different needs. This research will bring needed attention to the range of needs of diverse women veterans and enable governments to better support women through this critical milestone in their careers and lives.”

  • Ambassador Jacqueline O’Neill, Canada’s Ambassador for Women, Peace, and Security delivered a welcome address from Canada at the recent NATO SPS Advanced Research Workshop launching the collaboration.
    Ambassador Jacqueline O’Neill, Canada’s Ambassador for Women, Peace, and Security delivered a welcome address from Canada at the recent NATO SPS Advanced Research Workshop launching the collaboration.
  • Dr. David Pedlar of the Canadian Institute for Military and Veteran Health Research (CIMVHR) and Ms. Olena Suslova of the Women's Information Consultative Centre (WICC) are co-directors of the NATO SPS Advanced Research Project.
    Dr. David Pedlar of the Canadian Institute for Military and Veteran Health Research (CIMVHR) and Ms. Olena Suslova of the Women's Information Consultative Centre (WICC) are co-directors of the NATO SPS Advanced Research Project.
  • Attendees of the NATO SPS Advanced Research Workshop included representatives from NATO, government, and participating research institutions, including Principal Patrick Deane and Vice-Principal (Research) Kimberly Woodhouse.
    Attendees of the NATO SPS Advanced Research Workshop included representatives from NATO, government, and participating research institutions, including Principal Patrick Deane and Vice-Principal (Research) Kimberly Woodhouse.

CIMVHR’s participation in the SPS Programme lays a foundation for significant development and application in MCT research. Contributing to NATO’s core goals for more than six decades, the SPS Programme is one of the largest and most important partnership programmes addressing 21st-century security challenges bringing together member and partner nations for high impact. At this stage in MCT research, it is already understood that women can experience unique challenges with their mental health, specifically post-traumatic stress disorder (PTSD), employment and income, sense of purpose, and reintegration into civilian society and workplace culture in their transition from military service. Furthering this research within the common transition domains of study, such as health, finances, social integration, life skills, housing, and physical, cultural, and social environments, will not only improve the experiences of women but also reveal the support needed specific to sex and gender for successful MCT for all military personnel.

“Working together through the SPS Programme will hopefully serve as a catalyst to not only significantly advance MCT research but lead to further efforts to support NATO’s strategic objectives,” says David Pedlar, Scientific Director, CIMVHR. “This research will also help meet the needs of the Canadian Armed Forces and provide support to Canada’s military service personnel to ensure a continued sense of purpose and good well-being for them and their families when they transition to civilians. Transition is the key point to get that right.”

Over the course of the year, CIMVHR and WICC will facilitate consultations, an advanced research workshop, and develop a report advancing the subject matter area and identifying immediate knowledge for practice. A potential outcome by 2022 will be the establishment of collaborations or linkages amongst the participating nations on several NATO multi-year projects with the goal of advancing science and progress for women.

For more information about CIMVHR, a hub of 46 Canadian universities, including founders Queen’s University and the Royal Military College, and 14 Global Affiliates with a network of researchers from across Canada, visit their website.

Why we need to seriously reconsider COVID-19 vaccination passports

Vaccine passports may soon be required for travelling amid the COVID-19 pandemic. Like biometrics, they’ll likely become a permanent part of our daily lives — and there’s barely been any debate about them.
Vaccine passports may soon be required for travelling amid the COVID-19 pandemic. Like biometrics, they’ll likely become a permanent part of our daily lives — and there’s barely been any debate about them. (Unsplash / Artur Tumasjan)

In 2003, Canada’s immigration and citizenship minister, Denis Coderre, declared that “the biometrics train has left the station,” making reference to new technologies like facial recognition and retina scans.

Coderre’s statement demonstrated the perceived inevitability, along with the innocent embrace, of new biometric technologies.

It’s eerily similar to contemporary statements about vaccine passports. And, much like the rollout of biometrics, the solutions promised by these technologies outweigh the public’s appetite for debate. So what’s changed in the past 20 years, and why should we care?

Proposed vaccine passports are moving forward with little scrutiny due to their promise to solve many travel-related challenges during and after the COVID-19 pandemic. The emergence of biometrics and surveillance in post-9/11 border security tells a similar story.

Currently, vaccine passports are presented as a relatively simple technological solution to our current travel woes. However, like biometrics, vaccine passports will likely become permanent parts of our daily lives. That means meaningful public debate and discussion about their merits and problems is essential.

‘Function creep’

There is growing scholarly trepidation with “function creep” — the way technologies are gradually used for much more than their originally intended purposes.

These concerns dovetail with related fears about the rapid erosion of privacy. They should not be ignored, nor should they be considered trade-offs for political promises of safer and more efficient travel. Regardless of how effective vaccine passports may be, concerns about their use demand public conversation.

Intensified security at borders and in airports was believed to be a necessary evil of the post-9/11 world. Biometrics and surveillance provided a “sorting” function that improved travellers’ experiences. They promised to streamline interactions with reinforced border security. This positive dividend overlooked the wider social sorting functions of these technologies.

Largely ignored was the way travellers and populations were categorized along lines of race, gender and class. Similarly, in the face of nationwide lockdowns, the promise of a return to safe and efficient travel quiets criticism.

Personal privacy

Such technologies also challenge how we negotiate personal privacy. They contribute to enhanced law enforcement powers, and are increasingly presented as acceptable trade-offs for rediscovered mobility.

The pandemic, together with related government responses, have exposed the inequities in our society.

As a result, we should be troubled by the open embrace of vaccine passports. The lessons of the past two decades of surveillance in society have shown us that identification technologies such as biometrics have consequences that go well beyond their intended use.

A person holds a phone that says COVID-19 Digital Immune Passport.
Vaccine passports will probably live on our smartphones. (Wuestenigel/Flickr, CC BY-SA)

Contemporary vaccine passports will bear little resemblance to the handwritten vaccination cards of the past. Instead, they will likely reside on our smartphones.

Responsibility rests with us

That means the responsibility for them rests squarely with the citizen. Decidedly different than the responses to security challenges after 9/11, vaccine passports are not products of large transnational corporations.

Instead, regular citizens with programming skills who engage in “participatory democracy” on GitHub, an internet platform that hosts software development through volunteer programming, are proposing solutions. In the months following the first media mentions of vaccine passports, more than 40 related projects were launched on GitHub.

The majority of them are apps that use a smartphone’s algorithms to collect sensitive data such as name, date of birth, vaccine brand, dosage and mailing addresses. As one volunteer programmer writes: “I decided to stop enduring the effects of the pandemic and start to act.”

A trend is emerging: programming-savvy citizens who code for corporations by day now do so for public safety by night. The political significance of this cannot be understated.

The next generation of entrepreneurs are technologically savvy. These citizen-programmers imagine a future where safety, mobility, freedom and the dream of the return to pre-pandemic normalcy may intersect. But this intersection will be on the smartphone.

Post 9/11 consequences

The consequences of biometrics and surveillance rolled out in response to the security challenges of the post-9/11 world had widespread consequences. Similarly, leveraging smartphones as the vehicle for vaccine passports will be fraught with rights and civil liberties violations.

Research over the past two decades into surveillance is clear — it threatens individual freedoms and amplifies social differences. Social sorting technologies like biometrics not only verify that “you are who you say you are,” they also assess risk and categorize each of us in the process.

Proposed to solve problems related to enhancing secure and efficient travel, the consequences of vaccine passports are much broader. Surveillance and biometrics assign worth and opportunity. They also assign differential access to goods, services and places.

Vaccine passports provide the opportunity to add health data to our mobile personal data devices. While the promise of improved pandemic travel will likely be kept, there will also be a series of policy challenges, privacy concerns and troubling consequences of social sorting.

Real debate is needed

The absence of meaningful debate about turning to consumer technology as a vehicle for vaccine passports is serious. In the early 2000s, questioning the reliance on biometrics and surveillance was often regarded as suspicious, speculative and even anti-modern.

Today, public criticism and deliberation about vaccine passports is also overlooked and even discredited. Concerns over vaccine passports are sometimes conflated with anti-mask and anti-vaccination sentiments.

Safe and efficient travel is the coveted prize. However, failure to have fulsome public conversations about the long-term societal impact of vaccine passports will leave our privacy and civil liberties exposed.The Conversation

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Tommy Cooke, SSHRC Postdoctoral Researcher, Digital Privacy, Queen's University and Benjamin Muller, Associate Professor in Political Science and Sociology, Western University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

The Conversation is seeking new academic contributors. Researchers wishing to write articles should contact Melinda Knox, Associate Director, Research Profile and Initiatives, at knoxm@queensu.ca.

Queen’s health researcher receives inaugural Canadian Cancer Society Lifetime Contribution Prize

Joseph Pater, founding Director of the Canadian Cancer Trials Group, is recognized for a lifetime of work in cancer research.

[Photo of Joseph Pater]
Professor Emeritus Joseph Pater (Community Health and Epidemiology) is the recipient of the Canadian Cancer Society Lifetime Contribution Prize.

Joseph Pater, Professor Emeritus at Queen’s University, is the recipient of the Canadian Cancer Society Lifetime Contribution Prize, a new honour from the Canadian Cancer Society (CCS). The award recognizes an esteemed Canadian investigator whose contributions, vision, and leadership have enhanced the Canadian cancer research landscape to significantly benefit the lives of people with cancer.

For over 45 years, Dr. Pater has been devoted to advancing clinical trial research aimed at improving the lives of cancer patients and to educating, training, and mentoring the next generation of students, fellows, and young investigators. Under his guidance, the Canadian Cancer Trials Group (CCTG) at Queen’s University has become one of the most well-respected cancer clinical trials networks in the world, producing results that have accelerated the development of new treatments and established new standards of care worldwide.

“I am thrilled and humbled to be named the first recipient of the Canadian Cancer Society’s Lifetime Contribution Prize,” says Dr. Pater. “I am pleased that the selection committee has recognized my very collaborative contribution to establishing a network of Canadian research leadership who support the vital endeavour of finding the best treatments to reduce cancer morbidity and mortality, which is CCTG’s ongoing mission.”

Sometimes referred to as the “father” of cancer clinical trials research in Canada, Dr. Pater completed his medical training and accepted appointments in the Department of Medicine and, later, Oncology at Queen’s during a time when medical oncology was still in its infancy. In the early 1970s, Canadian oncologists began running cancer clinical trials with the support of the National Cancer Institute of Canada’s (NCIC) Epidemiology Unit. In 1980, NCIC established a formal collaborative research network, the NCIC Clinical Trials Group (now CCTG) and Dr. Pater was appointed as the inaugural director. Over the next 27 years, his leadership transformed the CCTG from a small national program at Queen’s to the largest collaborative cancer clinical trials network in Canada. The team became the first Canadian research network with a developmental drug program, allowing them to lead new investigational drug trials that directly led to new cancer drug approvals worldwide.

2021 Canada Gairdner Wightman Award
Recently, another Queen's researcher was recognized for their leadership in advancing cancer clinical trials research in Canada. Elizabeth Eisenhauer was presented with the 2021 Canada Gairdner Wightman Award for her dedication to transforming the fields of cancer clinical trials and cancer drug delivery. She has also held national and international leadership roles, including as the lead of the Investigational New Drug Program (IND) of the Canadian Cancer Trials Group.

Dr. Pater has played an active role in the development, execution, and analysis of over 500 multi-centre Canadian and international cancer trials involving more than 85,000 patients around the world. His 240 publications span the areas of hematology, oncology, statistical methods, cost effectiveness, and quality of life, and have been cited over 24,000 times for their insights on new drug and therapy development and patient-centered outcome measures.

"Dr. Pater created the most impactful cancer clinical research program in Canada, in terms of generating research results that directly led to benefits for patients with cancer," says Janet Dancey, CCTG Director. "He is one of the most important individuals in Canadian cancer research, having built a collaborative network that has defined new standards of practice, improved patient outcomes, and that is recognized globally as a centre for excellence."

As a Queen’s professor and mentor, Dr. Pater also acted as head of the Department of Community Health and Epidemiology, taught clinical trials courses to dozens of cohorts of students, and supervised numerous graduate students and fellows, many of whom have become emerging leaders in their own right.

After retiring from the CCTG, Dr. Pater served a three-year term as Vice-President of Clinical and Translational Research at Cancer Care Ontario, during which time he helped develop a new research chairs program and facilitated planning for provincial investments in cancer research. He has sat on numerous research advisory boards and selection committees in Ontario, Canada, and around the globe.

For his countless accomplishments, Dr. Pater has received multiple awards and accolades, including the Canadian Cancer Society’s Award of Excellence in Medicine and Health (2001), National Cancer Institute of Canada’s Diamond Jubilee Award (2007) and the Canadian Cancer Research Alliance’s Award for Outstanding Achievements in Cancer Research (2015).

"We’re pleased to introduce the Lifetime Contribution Prize this year, which provide an opportunity to honour extraordinary Canadian researchers in a new way," says Stuart Edmonds, Executive Vice-President, Research & Advocacy, Canadian Cancer Society. "The work of Dr. Pater has had, and will continue to have, a tremendous impact on cancer research in Canada and on the lives of people affected by cancer."

For more information on the Canadian Cancer Society Lifetime Achievement Award, please visit the website.

Powerful recognition for research

Queen’s researcher Praveen Jain receives the prestigious IEEE Medal in Power Engineering – the highest international award in the field of electrical power.

Praveen Jain, Canada Research Chair in Power Electronics and Director of the Queen’s Centre for Energy and Power Electronics Research (ePOWER), has been awarded the 2021 IEEE Medal in Power Engineering for contributions to the theory and practice of high-frequency power-conversion systems. He is only the third Canadian to receive this medal in the history of the IEEE.

[Photo of Praveen Jain and his IEEE medal]
Dr. Praveen Jain (Electrical and Computer Engineering)

IEEE medals are the highest honours given by the Institute of Electrical and Electronics Engineers (IEEE), the world’s largest association of technical professionals. The IEEE Medal in Power Engineering recognizes researchers who have made outstanding contributions to the technology associated with the generation, transmission, distribution, application, and utilization of electric power for the betterment of society. It is given to one out of approximately 50,000 IEEE members working in research related to electrical power every year.  

"This medal symbolizes 40 years of my life’s work in the practical applications of power engineering," says Dr. Jain. "I am indebted to Queen’s University for providing me a world class platform to realize my dream. I dedicate this medal to my students and collaborators who have contributed enormously to my success."

Since coming to Queen’s in 2001, Jain has helped transform the way society understands electrical energy, advocating for its sustainable generation, distribution, and utilization and contributing to innovations in applications for space, telecommunications, computer, induction melting, and renewable energy industries. One of the first researchers to solve long-standing problems in induction melting power supply systems, Jain proposed inverter circuit configurations now applied worldwide by the induction heating industry. Jain’s new class of AC-to-DC converter topologies provided a breakthrough in the design of compact, lightweight, and efficient power supplies for high-frequency power distribution systems in space applications. He also led the development of constant frequency resonant converter topologies for high-density power supplies for telecommunications.

Jain’s innovative digital control techniques have also revolutionized the design of power converters in computer applications. The patented technology, adopted by most chip manufacturers, has been incorporated in the development of digital power controllers with ultra-fast dynamic response for computer microprocessors. Jain also developed new power converter topologies and control techniques for photovoltaic microinverters. Currently, he is leading a team of researchers from Queen’s, York University, Western University, and the University of Ottawa in the development of a prototype smart microgrid platform that will help meet greenhouse gas emission goals and other industry standards.

In his career so far, Dr. Jain has secured over $35 million in external research funding and his work has resulted in over 600 publications and over 100 patents. He has earned numerous awards and honours, including being named a Fellow of the Engineering Institute of Canada, the Canadian Academy of Engineering, the Royal Society of Canada, and the IEEE. He has also founded two companies, CHiL Semiconductor designing digital power control chips, and Sparq Systems developing solar microinverters.  

"For decades, Dr. Jain has worked to help industries around the world understand and meet their power needs in more cost-effective, environmentally friendly ways," says Kimberly Woodhouse, Vice-Principal (Research). "My sincere congratulations to him on this prestigious career honour."

Dr. Jain received the IEEE Medal in Power Engineering during a virtual award ceremony on May 13. For more information on the medal, visit the website.

Why Ontario had to transfer thousands of Toronto COVID-19 patients

The Conversation: The need to transfer 2,500 COVID-19 patients around Ontario, and bring in extra doctors from other provinces, exposes two fallacies about Canada’s health-care system.

An ambulance speeds along a city street
A Halton Region ambulance drives along a busy street. (Jonnica Hill/Unsplash)

You can learn a lot from a crisis. During Ontario’s COVID-19 pandemic, over 2,500 patients have required transfer from Toronto to receive life-saving care in other cities.

The ConversationThe egress of COVID-19 patients from Toronto began in mid-November 2020, when the Ontario government activated the GTA Hospital Incident Management System. Transfers peaked in April during the third wave of COVID-19.

At Kingston Health Sciences Centre (KHSC) we have received over 100 Toronto area patients with COVID-19, many on ventilators. They came by helicopter, ambulance and even by bus, unaccompanied by family.

Ontario even put out a national call for health-care workers to help out, and Newfoundland answered.

Why would Ontario need to transfer masses of critically ill patients with a highly infectious disease across the province, even resorting to involuntary transfers? Why would a metropolis like Toronto call on comparatively tiny Newfoundland for health-care workers? Is this simply the unavoidable consequences of a huge third wave of COVID-19?

In fact the root causes began long before the pandemic and originated with a flawed understanding of the capacity (physical and human) of our health-care system.

Two fallacies

I lead the department of medicine at Queen’s University and co-lead the medicine program at KHSC. In these roles I am responsible for hiring doctors and ensuring our medicine beds run efficiently. I have often been confronted by two fallacies relevant to the genesis of our current crisis:

  • Fallacy 1 — Ontario has enough hospital beds because medical care is largely conducted on an outpatient basis.
  • Fallacy 2 — Canada has more than enough health-care workers and doctors.

Both fallacies have been widely embraced by provincial and federal governments. Let’s examine the validity of these beliefs with the goal of designing a more resilient health-care system.

Fallacy 1: Number of hospital beds

It is popular in Canada to believe that the future of medicine is mostly in outpatient care and that hospital beds are obsolete. In reality, as medicine becomes more high-tech, admissions are shorter but more beds are needed to support procedures that improve the quality and duration of life.

We are now putting heart valves, hips, lenses and more into older Canadians, and performing lifesaving diagnostic and therapeutic interventions on people who 20 years ago would have been considered ineligible because they were too premature, too obese or too high-risk.

Canada’s bed shortage is particularly critical in academic health sciences centres that uniquely deliver advanced forms of care. Pre-pandemic Ontario was running at 96 per cent occupancy.

Our bed capacity was designed for troughs in demand, like summer, not for peaks, as occur each fall when influenza strikes. Every fall, as rates of infections like influenza rise, our emergency departments and medicine wards become congested and admitted patients must be accommodated in hallways. These are the consequences of inadequate numbers of in-patient beds. The COVID-19 pandemic simply made our tenuous reserve capacity more apparent.

Ontario has built new bed capacity for COVID-19, but had minimal reserve capacity pre-pandemic.

Ontario Health did three things to deal with COVID-19:

  1. Relocated 1,000 people from hospitals, including alternative level of care patients;

  2. Cancelled “elective procedures” and repurposed the resulting 6,849 beds for possible COVID-19 patients (necessary but dangerous to the health of the 99 per cent of Canadians that don’t have COVID-19; and

  3. Opened 2,500 new hospital beds.

The government views Ontario’s health-care system as “one resource.” That sounds good in principle, but moving patients on ventilators away from their families is a poor way to deliver care. In addition, most of Ontario’s COVID-19 capacity derives from deferring elective procedures, few of which are truly elective.

The simple truth is we were never configured to deal with surges in admissions. We mistakenly focused on the symptoms of bed deficiency, like “hallway medicine” and emergency room wait times and failed to address the root cause: inadequate numbers of beds (in hospitals and long-term care facilities).

Several caveats about this bed-centric article are relevant. First, outpatient care is important and when it fails, unnecessary hospitalizations occur.

Second, inadequate long-term care facilities and home care services in the community exacerbate the bed shortage by causing inappropriate hospitalization of people awaiting alternate levels of care.

Third, don’t let the term “hospital bed shortage” mislead you to envision a shortage of mattresses and pillows; a “bed” is a surrogate for the capital and human resources required to provide care in that bed 24/7, 365 days a year.

Bar graph showing number of doctors trained per capita internationally.
Canada trains comparatively few doctors for its population. (OECD data)

Fallacy 2: Number of health-care workers

Canada has 86,092 active physicians (excluding trainees), 25 per cent of whom are international medical graduates. When recruiting academic physicians, I often struggle to find a Canadian-trained doctor and rely on our pool of international medical graduates. These doctors are often first-rate, but the fact we rely on other countries to train our doctors is not widely recognized.

Our dependence on international medical graduates does not reflect Canadians not wanting to become doctors. Queen’s University School of Medicine has 5,000 applicants for 100 seats and more Canadians are training abroad as physicians than in Canada. The Organization for Economic Co-operation and Development (OECD) tracks medical graduates per 100,000 inhabitants in member countries. Canada is near the bottom.

Our physician-to-population ratio is also low, ranking 29 out of 36 OECD nations. The reality is that doctors and other health-care workers are expensive. Canada’s universal health-care system has many advantages; however, a single-payer system means the provincial governments (the payers) see a whopping human resources bill every year and, in trying to control costs, are invested in keeping numbers of physicians (and hospital beds) in check.

COVID-19 has given us a master class in what is wrong with our health-care system. Admittedly, Canada’s post-pandemic to-do list is long and includes improving the care of seniors, providing affordable child care, fostering a domestic biotech industry, re-establishing a pandemic surveillance system and bolstering public health programs. We also need to legislate good employment practices, such as provision of paid sick days.

Additionally, we need to continue the funding for the new beds created to deal with the pandemic, using them flexibly to ensure we have surge capacity. We should also create an adequate supply of domestically trained health-care professionals.

It is clear what must be done. We must find the funds and will power to meet the post-pandemic moment with action.The Conversation

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Stephen L Archer, Professor, Head of Department of Medicine, Queen's University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

The Conversation is seeking new academic contributors. Researchers wishing to write articles should contact Melinda Knox, Associate Director, Research Profile and Initiatives, at knoxm@queensu.ca.

How a unicorn is helping Ontario’s public and Catholic schools welcome gender diversity

Queen’s researcher Lee Airton has created Gegi.ca, an online resource that helps students advocate for their gender expression and gender identity human rights.

Gegi.ca is a newly launched website that advocates for gender identity and gender expression
Gegi.ca is a newly launched website that advocates for gender identity and gender expression

Queen’s researcher Lee Airton, Assistant Professor of Gender and Sexuality Studies in Education, and Kyle Kirkup, Associate Professor in the Faculty of Law (Common Law Section) at the University of Ottawa, have launched an online resource that targets elementary and high school students and educators seeking more information about gender identity and gender expression human rights protections. With “Gegi” – a beautiful/handsome nonbinary unicorn – as their guide, K-12 students across Ontario can acquire information and tools to self-advocate within their school and school board.

The launch of the website aligns with Education Week and Catholic Education Week initiatives across Ontario.

Gegi.ca was created following a study by Dr. Airton and Dr. Kirkup of how Ontario school boards were responding to their new legal responsibilities to offer an environment free from two separate forms of discrimination: for who you are gender-wise (your gender identity), and how you let others know through things like your clothing, grooming, and behaviour (your gender expression). The resource aims to translate and mobilize findings from their recent Social Sciences and Humanities Research Council (SSHRC) Insight Development Grant (2018-2020), which identified that Canada is going through a gender human rights law revolution and that action was needed to directly address the incremental and uneven rate at which K-12 school structures and practices are changing in response.

“Gender expression and gender identity are still new concepts to many people, let alone new areas of legal responsibility for school staff. Gegi.ca is intended to fill this gap by supporting Ontario’s K-12 students and their loved ones is the kind of self-advocacy that changes schools for everyone,” says Dr. Airton.

Each Ontario school board (public and Catholic) will have two dedicated student and staff web pages on gegi.ca. These pages connect students and their loved ones or staff directly to relevant board policies and suggest what a Gegi visitor can do or whom to contact if their board has not yet updated its policies. Students are also invited to download and share information about their gender identity or gender expression human rights in relation to athletics, field trips, and washroom or changing room access directly with school staff or administration.

The site will also host a series of downloadable and accessible resources both in French and English. These resources contain the most up-to-date law- and research-informed guidance on the changes required to fulfill every school’s duty to create a learning environment free from discrimination on the basis of gender expression or gender identity.

 “Gegi.ca is a powerful resource for Ontario students and their families to ensure their gender identity and gender expression is protected and that students can thrive and grow in our schools,” says Rebecca Luce-Kapler, Dean, Faculty of Education.

Gegi.ca targets both students and teachers, providing access to knowledge and skills that are typically only held by legal professionals. Skills fostered by gegi.ca’s resources include legal self-advocacy (i.e., correctly identifying governing laws, past legal precedents, policies and procedure; and maintaining written records and conducting correspondence), and identifying key actors and levers of power within their own school and school board. For school staff who face gender expression discrimination, gegi.ca’s board-specific pages connect to local school board policies and advocacy resources, as well as union policies. Lastly, teachers and school administrators who recognize the presence of gender expression or gender identity discrimination in their school can access gegi.ca’s collection of tip sheets and curated resources, all of which prompt proactive change. The Gegi.ca team will also share the resources with equity leads in Ontario’s school boards and work to engage all directors of education as part of the rollout.

For more information on gegi.ca, visit the website.

Caribbean food security during COVID-19 can only be ensured through debt relief

International border closures, which prompted the near-total shutdown of air and cruise travel to curb the spread of COVID-19, dealt a catastrophic blow to the Caribbean's tourism industry.

A woman shops in the produce section of a Caribbean grocery store
People visit fruit section of a grocery store on Guadeloupe, an island group in the southern Caribbean Sea. (Shutterstock)

The pandemic and global trade disruptions have highlighted the growing vulnerability of Caribbean states when it comes to importing food items. Annually, Caribbean states import food items valued at nearly US$5 billion for food security.

International border closures to curb the spread of COVID-19 meant restricted access to these imported food items which make up more than 80 per cent of the region’s food system.

A household survey commissioned by Caribbean governments in April 2020 to explore the impact of the pandemic on regional food security revealed that global border closures increased barriers to food security by augmenting food prices and decreasing income and employment levels. The survey data also revealed that more than half of all respondents experienced income or job loss.

The impact of international border closures on food security

Tourism supports a large percentage of economic activity in the Caribbean. International border closures, which prompted the near-total shutdown of air and cruise travel to curb the spread of COVID-19, dealt a catastrophic blow to the Caribbean’s tourism industry.

The decline in tourism led to decreased spending by tourists, hotel and associated tourism service closures and job losses for community members. Such outcomes translated to higher levels of indebtedness, unemployment and psychological stress, disproportionately affecting vulnerable populations throughout the Caribbean.

All of these factors made many residents anxious about their ability to ensure food security in the coming months, because without money they cannot afford to buy food.

Shopping centre
Pictured is the largest grocery store in San Jose De Ocoa, Dominican Republic. (Shutterstock)

The downward economic spiral

Downward growth spirals across vital economic sectors like tourism prompted Caribbean states to turn to international development institutions such as the World Bank and the International Monetary Funds (IMF) for emergency loans during the pandemic.

Alicia Bárcena, executive secretary of the Economic Commission for Latin America and the Caribbean, highlighted concerns back in April, 2020 about the emergency loans stating “borrowing is not the answer to confront this crisis. Caribbean countries need grant support fast. There is need for urgent intervention to ensure liquidity.”

According to Bárcena, Caribbean countries are spending between one per cent and four per cent of GDP to tackle the COVID-19 crisis. Growing external debt burdens to replace income and ensure social outcomes, like food security, worsened the Caribbean’s debt to GDP ratio, which averaged 68.5 per cent in 2019.

The growing debt problem

The rising debt burden facing Caribbean states is largely because most hotels and restaurants in the region’s tourism sector import bulk supplies of low-priced food items. The priority for cheap imported food for tourist consumption means that as much as 80 cents from every dollar generated in the Caribbean’s tourism sector leaves the region each year.

While the pandemic disrupted tourism growth, the extreme external debt levels facing Caribbean states are increasing. And governments are becoming more responsible for social outcomes like food security.

Over the past 12 months, the IMF provided more than US$1 billion to Caribbean countries.

Relative to annual foreign exchange earnings in a thriving island economy, US$1 billion in emergency loans seems immaterial. However, in just paying the interest on external debt accumulated on emergency loans offered by development institutions like the IMF, some Caribbean island states allocate up to 54 per cent of their annual budgets to external debt servicing.

Small islands, like the Bahamas are spending up to US$ 1 million each week on food assistance programs — all while increasing financial support on health spending for COVID tests, treatment, vaccinations, surveillance and protective equipment.

In shifting the responsibility for social welfare from people to the state, COVID-19 is worsening the growing external debt problem across small Caribbean states.

Shopping centre with cars
Coki Point Plaza, a shopping centre in St. Thomas, U.S. Virgin Islands. (Shutterstock)

Food security in the post-Covid-19 economy

In April 2020, Antigua and Barbuda’s Prime Minister, Gaston Browne, issued a call to international development institutes, like the IMF, for alternative development approaches, he said:

“The economic burden for our countries has been unsustainable because of the high levels of debt. We don’t have the capacity for printing money and our policy instruments are very limited. What is required at this point is some level of support from international financial institutions, such as the International Monetary Fund and the World Bank.”

Debt relief would improve Caribbean states response to global crises. Less debt means that governments can increase spending on social services that would improve economic conditions to ensure food security. It really is the only solution.

A post-pandemic recovery pathway to ensure Caribbean food security involves the IMF and other development entities recognizing the unsustainable debt situation across Caribbean island states and including the region in considerations extended to other developing countries for debt relief.The Conversation

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Kasmine Forbes, PhD Candidate, Department of Geography and Planning, Queen's University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

The Conversation is seeking new academic contributors. Researchers wishing to write articles should contact Melinda Knox, Associate Director, Research Profile and Initiatives, at knoxm@queensu.ca.

Ghana needs to rethink its small-scale mining strategy

The devolution of small-scale mining decisions to municipal and district assemblies working in collaboration with traditional authorities is key to saving the industry in Ghana.

Gold is key to the economic survival of millions of Ghanaians. Knut-Erik Helle/FlickrCC BY-NC

Ghana is among the top two gold producers in Africa. What has caught little attention, however, is the fact that more than 35 per cent of total gold output in Ghana comes from artisanal and small-scale miners. Artisanal and small-scale mining is estimated to support the livelihoods of some 4.5 million Ghanaians, about 12 per cent of the population. They account for more than 60 per cent of the country’s mining sector labour force.

Artisanal and small-scale mining is a low-tech, indigenous and often informal. It occurs in over 80 mineral-rich developing countries. Up to 100 million people globally work in this sector.

Artisanal and small-scale mining has a long history in Ghana. It was only in 1989, however, that government recognised its legitimacy through the Small-scale Mining Act (PNDCL 218), later integrated into the current Mining Act 703 (2006). The act provides a blueprint for its formalisation. It also reserves small-scale mining for Ghanaians. The law requires prospective local miners to apply for a licence to mine up to 25 acres of land in designated areas.

Government’s intention to formalise the sector has had very little success. More than 85 per cent of all small-scale mining operations in Ghana are carried out by unlicensed operators.

Due to the sector’s evolving nature, the distinction between artisanal and small-scale mining has become contentious and blurred. To avoid any complications, most scholars now use them interchangeably. Some use the level of sophistication employed to make a distinction. But in Ghana today one sees rudimentary tools (traditional artisanal mining) and modern tools (small-scale mining) being used on a single mining site.

Jackboot approach

Government’s response to illegal mining has been to use the military to raid small-scale miners. There is a long history to such a combative approach in Ghana. It dates as far back as the British colonial administration which enacted the Mercury Ordinance of 1933 to ban and criminalise native miners.

In 2013, the then president John Mahama formed the Inter-Ministerial Taskforce to “flush out” illegal miners, which led to many arrests and the expulsion of illegal Chinese miners. The use of force intensified under the current president, Nana Akufo-Addo, who vowed in 2017 to put his presidency on the line to fight illegal mining in Ghana. This culminated in the setting up of Operation Vanguard, the largest centralised military-police joint taskforce to combat illegal mining in Ghana.

The real problem, however, is government’s failure to implement its legislative framework for the formalisation of small-scale miners.

Barriers to formalisation

Government first introduced a framework for the formalisation of small-scale miners more than 30 years ago. But it has very little to show for it. Less than 15 per cent of small-scale mining operators have been able to acquire the requisite mining licences. Many don’t bother to apply due to the tedious and cumbersome nature of the regulatory process.

To gain a better understanding of why the formalisation process has not achieved much, an aspect of my PhD research sought to unearth local perspectives on the underlying conditions for the creation of these informal local mines. It examines how these underpin persistent informality.

There are two problems. The first is that the current formalisation blueprints fail to adapt to the conditions of the majority of local miners. The second is that the blueprints make it very difficult or too costly for small-scale miners to comply. They are therefore a disincentive to formalise.

Only a small segment of small-scale miners can raise the amount of money required to become formal operators. The costs include application fees as well as the money required for the preparation and processing of the application. Then there are costs for environmental permits, the hiring of surveyors and for the acquisition of business documents. A prospective small-scale mining licensee could spend at least US$4,000 to secure the requisite legal status.

When unofficial payments (bribes) are included, according to small-scale miners, the costs of getting a licence to mine 25 acres can balloon to as much as US$7,000. A burgeoning body of research has shown that artisanal and small-scale miners in Ghana are driven to mining by poverty.

The second challenge revolves around a centralised bureaucracy and lack of effective engagement with all stakeholders. Despite the administration of small-scale mining being decentralised into nine mining districts across the country, only the national head office can issue a small-scale mining licence. Key local stakeholders like municipal and district assemblies with better understanding of the complexities play no effective role in the licensing process.

Again, the creation of a centralised taskforce to address a localised problem runs parallel to existing local structures. This undermines effective policing, monitoring and accountability.

Finding solutions

President Akufo-Addo’s call for a dialogue on illegal mining in his January 2021 state of the nation address portends a potential shift.

To create the enabling policy environment for a blooming artisanal and small-scale mining industry that is environmentally sustainable and economically beneficial to the state and citizens, greater engagement with local actors is the path to chart.

The solution is the devolution of small-scale mining decisions to municipal and district assemblies working in collaboration with traditional authorities.

This will facilitate greater recognition and inclusion of local actors in the licensing process. It will also open dialogue with local miners since municipal and district assemblies are the local development agents. This will bring decision making processes closer to small-scale miners and enhance the effective policing and monitoring of the sector.

The reform of the licence regime for small-scale mining should be driven by the need to match the costs of formalisation with the complex socio-economic dynamics of the majority of operators. This is attainable when policy treats small-scale mining as a survivalist sector rather than a platform for wealth creation. Artisanal and small-scale mining has also suffered because of its portrayal by the media and public misrepresentation as a vehicle for “quick money”.The Conversation

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Richard Kwaku Kumah, PhD Candidate, School of Environmental Studies, Queen's University.

This article is republished from The Conversation under a Creative Commons license. Read the original article.

The Conversation is seeking new academic contributors. Researchers wishing to write articles should contact Melinda Knox, Associate Director, Research Profile and Initiatives, at knoxm@queensu.ca.

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