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Introduction: Interprofessional collaborative care is the gold standard in maternity care and has been proposed as the best way to manage the impending maternity care crisis in Ontario. This thesis researched the benefits and barriers to interprofessional collaboration from the perspectives of obstetricians and midwives. The goal was to understand how obstetricians and midwives view collaborative practice, how the different professions perceive collaboration, and to explore the attitudes and perceptions regarding collaboration of clinicians practicing in each discipline. Methods: This study adopted a mixed methods design. A province-wide survey was distributed to actively practicing obstetricians and midwives in Ontario. Following completion of the survey, participants were invited to contribute further opinions and perceptions in semi-structured interviews, conducted using a grounded theory approach. Results: Quantitative and qualitative data revealed three key findings. First, when comparing the opinions of obstetricians and midwives, scope of practice was viewed as a contentious issue with fee structures and turf protection being contributory factors. Second, the definition of interprofessional collaboration, and its application to clinical practice, varied by profession, and was viewed as a barrier to effective communication between disciplines. Finally, philosophy of care, particularly surrounding the provision of homebirth and women-centered care, varied starkly across the disciplines. Conclusion: Members of each profession need to develop strategies to ensure mutual respect is given in cases of philosophical and scope differences, an essential component to successful implementation of collaborative initiatives. Governing bodies and professional associations of each discipline need to strive for mutual agreement on appropriate scope of practice to ensure buy-in from members of each profession. Thesis Master of Health Sciences (MSc) This thesis examines the perceptions of interprofessional collaboration from the perspectives of midwives and obstetricians, and contrasts how these perceptions vary by the profession. Data was collected in two ways: through an online survey and semi-structured interviews. Midwives and obstetricians were asked about their experiences with collaboration, their perspectives on the barriers to collaboration and thoughts about an improved system in Ontario to facilitate enhanced maternity care collaboration. The results demonstrate the key barriers to collaboration including contentious views on scope of practice, the definition and interpretation of interprofessional collaboration and varying philosophies of care. The changing landscape of maternity care in Ontario is imminent; family doctors who provide obstetrical care are on the decline, increasing the workload for obstetricians and midwives necessitating the need to eliminate barriers to achieve successful interprofessional collaboration.

Funder: LEGO Foundation, This systematic review and meta-analysis considered evidence of guided play compared to direct instruction or free play to support children’s learning and development. Interventions from 39 studies were reviewed (published 1977-2020); 17 were included in meta-analysis (N total = 3,893; M childage = 1 – 8 years; M girls 49.8%; M ethnicity; White 41%, African American/Black 28%, Hispanic 19%). Guided play had a greater positive effect than direct instruction on early maths skills (g = 0.24), shape knowledge (g = 0.63) and task switching (g = 0.40); and than free play on spatial vocabulary (g = 0.93). Differences were not identified for other key outcomes. Narrative synthesis highlighted heterogeneity in conceptualisation and implementation of guided play across studies., LEGO Foundation

Amidst the coronavirus disease 2019 (COVID‐19) pandemic, there is uncertainty regarding potential lasting impacts on children's health and educational outcomes. Play, a fundamental part of childhood, may be integral to children's health during crises. We undertook a rapid review of the impact of quarantine, isolation and other restrictive environments on play and whether play mitigates adverse effects of such restrictions. Fifteen peer‐reviewed studies were identified, spanning hospitals, juvenile and immigration detention and refugee camps. We found evidence of changes in children's access to play in crises and quarantine. These studies indicated how play might support children enduring isolation but lacked robust investigations of play as an intervention in mitigating impacts of restriction. Studies pertaining to children in isolation due to infectious disease outbreaks were notably absent. It is important that the potential effects of changes to such a crucial aspect of childhood are better understood to support children in this and future crises.