This paper argues for increased access to civil justice in Ontario for citizens who cannot privately afford it (“needy citizens,” defined as those unable to engage in meaningful civil legal action due to financial inability). Access to justice is defined as access to trained legal representation as well as access to knowledge about Ontario civil law. The paper first articulates the theoretical underpinnings necessitating access to justice for all citizens. The paper then explores 5 common areas of Ontarian civil law (tort, residential, family, small business, and standard contract law) regarding access to civil justice within these regimes, and discusses 3 potential ways to remedy Ontario’s civil access to justice gap. These reforms are increasing government funding, an increase in activity by the legal profession of Ontario, and finally limited deregulation of Ontario’s law licensing process. The first two reforms are rejected, while the third is recommended.

This paper argues for increased access to civil justice in Ontario for citizens who cannot privately afford it (“needy citizens,” defined as those unable to engage in meaningful civil legal action due to financial inability). Access to justice is defined as access to trained legal representation as well as access to knowledge about Ontario civil law. The paper first articulates the theoretical underpinnings necessitating access to justice for all citizens. The paper then explores 5 common areas of Ontarian civil law (tort, residential, family, small business, and standard contract law) regarding access to civil justice within these regimes, and discusses 3 potential ways to remedy Ontario’s civil access to justice gap. These reforms are increasing government funding, an increase in activity by the legal profession of Ontario, and finally limited deregulation of Ontario’s law licensing process. The first two reforms are rejected, while the third is recommended.

This inquiry examines the ruptures and continuities in local democratic practices in opposition and in government. I conducted research in seven rural municipalities in Chalatenango, El Salvador where leaders of oppositional community-based organizations entered municipal politics 15 years ago. This new generation of municipal officials established forums for citizen participation that incorporate patterns of citizenship learning and participation developed in oppositional civil society. The democratic outcomes of these municipal spaces for citizen engagement are mixed, however: they improved the quality of citizen participation in municipal governance, but circumscribed autonomous forms of citizen participation. The influence of partisan political and institutional state interests are the principal factors that account for this outcome. At the same time, civil society and local government in Chalatenango exist in a relationship of mutual influence. This suggests that efforts to foster democratic citizen participation should complement support to institutional innovation with efforts to strengthen civil society.

This inquiry examines the ruptures and continuities in local democratic practices in opposition and in government. I conducted research in seven rural municipalities in Chalatenango, El Salvador where leaders of oppositional community-based organizations entered municipal politics 15 years ago. This new generation of municipal officials established forums for citizen participation that incorporate patterns of citizenship learning and participation developed in oppositional civil society. The democratic outcomes of these municipal spaces for citizen engagement are mixed, however: they improved the quality of citizen participation in municipal governance, but circumscribed autonomous forms of citizen participation. The influence of partisan political and institutional state interests are the principal factors that account for this outcome. At the same time, civil society and local government in Chalatenango exist in a relationship of mutual influence. This suggests that efforts to foster democratic citizen participation should complement support to institutional innovation with efforts to strengthen civil society.

While accountability measures are designed and promoted to increase trust among members of society in Canada, this study finds that accountability practices actually reduce trust and flexibility among people. This dissertation interrogates the concept of accountability as value-free and in the public interest in Canada. Using institutional ethnography as an approach to research, this study traces how accountability as a concept is defined through a set of performances described in texts that trickle down from the federal to the municipal level in Ontario. In particular, I examine how residents’ groups providing social services with a small grant from an Ontario municipality are required to go to great lengths to perform accountability according to dominant texts. This study overlays a mapping of the textual organization of accountability with the theories of civility and governmentality to demonstrate how white, middle-class, neoliberal values pervade decision-making about the allocation of public funds. The data demonstrate that while government accountability measures are designed with elected officials and government workers in mind, the practice of accountability gets enforced through the least socially powerful members of society, defined through racialized, gendered, and class distinctions. I conclude that while changes to reporting mechanisms could render the lives of more residents visible, ultimately the dominant focus on rules rather than relationships in Canada undermines real trust, and thus is the most vital site for change.

While accountability measures are designed and promoted to increase trust among members of society in Canada, this study finds that accountability practices actually reduce trust and flexibility among people. This dissertation interrogates the concept of accountability as value-free and in the public interest in Canada. Using institutional ethnography as an approach to research, this study traces how accountability as a concept is defined through a set of performances described in texts that trickle down from the federal to the municipal level in Ontario. In particular, I examine how residents’ groups providing social services with a small grant from an Ontario municipality are required to go to great lengths to perform accountability according to dominant texts. This study overlays a mapping of the textual organization of accountability with the theories of civility and governmentality to demonstrate how white, middle-class, neoliberal values pervade decision-making about the allocation of public funds. The data demonstrate that while government accountability measures are designed with elected officials and government workers in mind, the practice of accountability gets enforced through the least socially powerful members of society, defined through racialized, gendered, and class distinctions. I conclude that while changes to reporting mechanisms could render the lives of more residents visible, ultimately the dominant focus on rules rather than relationships in Canada undermines real trust, and thus is the most vital site for change.

Doctor of Education / Department of Educational Leadership / Sarah Jane Fishback / Diversity is recognized by acknowledging individual differences. The term diversity can refer to an array of descriptors such as, race, religion, color, gender, national origin, disabilities, sexual orientation, age, level of education, geographic origin, economic status, family status, appearance/physical size and skill characteristics. Although there are multiple definitions of diversity, many include at least one or all of the attributes listed above. This qualitative study examined perceptions of classified employees regarding the level of diversity awareness among their workforce at a large Midwestern land grant university. The sample was purposefully selected from the population of classified support staff using both scores from Dahm’s (2006) Organizational Diversity Needs Analysis (ODNA) and responses to demographic questions. This survey was designed to measure diversity awareness in the workplace using the dimensions; cultural inclusion or exclusion, organizational inclusion or exclusion, workload, trust, sensitivity and affirmative action. Demographic information used to select the sample for this study included; age (Generation Y, Generation X and Baby Boomers), gender (male and female), and race and ethnicity (White and all others, for example: African American, Asian American, Hispanic and Native American). Semi-formal, one-on-one interviews were conducted with the participants by the researcher in this study. Additionally a theme emerged that expressed the “good old boy” system as being “alive and well”; differential treatment among staff who did not have the same or similar levels of education; positional power and situational occurrences whereby individuals who appeared different were treated unfairly or without respect by other staff, faculty or students at the university. Findings included a difference in perceptions about diversity awareness between Whites and non Whites. Whites fell into the following categories; 1) Many employees felt the current status of diversity awareness was sufficient, 2) an equal number of others felt that their needed to be an increase in diversity awareness initiatives among employees, 3) others felt as though diversity awareness was problematic or 4) the need did not exist for diversity awareness initiatives. Non White participants disagreed, all claimed to have been the victim of discriminatory behavior.

This thesis explores health technology innovation within indigenous enterprises in China, India, and Brazil. The main discussions are presented in five papers/manuscripts. The first is a case study of Brazil’s health biotechnology sector. It concludes that systemic tensions between the country’s public and private sectors may be detracting from its overall innovative success. The second paper gauges vaccine and medicinal innovation within enterprises in the stated countries by analyzing new technologies in their pipelines or on the market. It concludes that that a growing number of health enterprises in these countries are tackling more technologically challenging and costly innovations. The third paper explores how national institutions and industry globalization interact to shape commitments to new drug and vaccine innovations by enterprises in the three countries. It concludes that; a) the introduction of pharmaceutical product patent regimes has had a modest impact on entrepreneurial attempts to develop new technologies, b) key challenges that diminish patent incentives tend to be institutional in nature and, c) the increasingly globalized nature of health product innovation limits what countries can achieve independently. The fourth paper analyzes key issues and trends in health biotechnology firms’ transition to innovation in China, India, Brazil, and South Africa. It concludes that this transition often entails greater integration into the global system. The fifth paper ponders the implications for global health of the emerging market firms’ transition to innovation. It concludes that these enterprises have the potential to simultaneously address global health needs while exploiting global markets, provided support mechanisms are put in place to enable product development for the poorest market segments. This research suggests that to succeed in biopharmaceutical innovation, nations need to adjust scientifically, sectorally and globally all at the same time. Also, that national governments and the global health community need to enhance engagement of emerging market enterprises in related efforts.

Introduction: Facial lipoatrophy is a stigmatizing hallmark for HIV-positive status, and can lead to poor social functioning. Information gleaned from an economic evaluation of facial lipoatrophy treatments would inform policy decision making concerning potential public insurance coverage. Methods: A decision-analytic model was used to estimate the lifetime costs and Quality Adjusted Life Years (QALYs) gained from treatments using either poly-l-lactic or and polyalkylimide gel for HIV positive patients. Disease progression probabilities and utilities were derived from the literature. Costs were obtained from interviews with physicians and product distributors. Findings: Incremental costs per QALY were $66,409 CAD/$57,352 CAD for poly-l-lactic acid, and $48,715 CAD/$45,457 CAD for polyalkylimide gel® (Societal perspective/Ministry of Health perspective). Sensitivity analysis did not have a significant effect on the lower incremental costs per QALY reported for polyalkylimide gel. Conclusion: Our base-case analysis revealed that treatments using polyalkylimide gel offers lower ICUR than treatments using poly-l-lactic acid.

Introduction: Facial lipoatrophy is a stigmatizing hallmark for HIV-positive status, and can lead to poor social functioning. Information gleaned from an economic evaluation of facial lipoatrophy treatments would inform policy decision making concerning potential public insurance coverage. Methods: A decision-analytic model was used to estimate the lifetime costs and Quality Adjusted Life Years (QALYs) gained from treatments using either poly-l-lactic or and polyalkylimide gel for HIV positive patients. Disease progression probabilities and utilities were derived from the literature. Costs were obtained from interviews with physicians and product distributors. Findings: Incremental costs per QALY were $66,409 CAD/$57,352 CAD for poly-l-lactic acid, and $48,715 CAD/$45,457 CAD for polyalkylimide gel® (Societal perspective/Ministry of Health perspective). Sensitivity analysis did not have a significant effect on the lower incremental costs per QALY reported for polyalkylimide gel. Conclusion: Our base-case analysis revealed that treatments using polyalkylimide gel offers lower ICUR than treatments using poly-l-lactic acid.