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Problems experienced by individuals in institutions tend to be hidden from the public gaze. This is so for inmates of prisons where regulations and bureaucratic structure conceal the daily life situation of prisoners from public view. Anonymity and concealment are enhanced by the widespread misperception of prisoners as an homogenous group. As a result, problems of vulnerable groups, such as people with disabilities, can be ignored. One such group is prisoners with impaired hearing. This descriptive study utilized a multidisciplinary approach to investigate the problems experienced by prisoners within the context of social control. Drawing from selected literature in health, sociology and criminology, the theoretical framework merges the labelling perspective [interactionism] with macro-level theories of social control. The study provides, for the first time, an examination of the percentage, degree and social import of hearing loss in federal prisoners in the Pacific Region of the Correctional Service of Canada. Through the use of survey, audiometric measurement, and interview techniques, an examination was undertaken of the presence and implications of partial hearing loss in inmates of federal penitentiaries in British Columbia. Interview subjects were identified through hearing testing of volunteers in eight federal penitentiaries. Data were gathered through interviews with prisoners with impaired hearing, a comparison group of prisoners with normal hearing, and a selection of custodians. Of 114 prisoners screened, 69% had some degree of impaired hearing, often previously unidentified. Custodians, 86% of the time, labelled behaviours characteristic of the hard of hearing as deviant, and often aggressive, behaviours. Prisoner accounts revealed that failure to test hearing at time of incarceration has harmful effects on performance in programmes and encounters with the justice system. A social activist approach is recommended, to address structural inequalities among prisoners and barriers for prisoners in general. This work indicates that lower-class, lower-status persons may be more susceptible to negative labelling. Prisoners with partial hearing loss, due to the often invisible nature of their condition, are particularly vulnerable to negative labelling. Study recommendations include: 1] Routine hearing screening of all prisoners at time of incarceration. 2] Education of custodians to understand behaviours and communication needs of persons with impaired hearing. 3] A partnership effort between correctional services, the disabled consumer group, and professionals, to improve the situation of prisoners who are hard of hearing.

Telehealth is defined by Jocelyne Picot as "the use of communications and information technology to deliver health and health care services and information over large and small distances" (Telehealth Industry 1). Current research in telehealth focuses on the evaluation of applications and projects, on the competitiveness of the telehealth industry, and on its role in international development. In contrast, this dissertation contextualizes telehealth in social history and theory. In so doing, it adopts an analytical, cultural studies approach rather than an empirical one. It also studies the extent of citizen involvement in current telehealth initiatives in Canada. More specifically, the dissertation examines whether the forms of involvement promoted by telehealth initiatives empower Canadian citizens. The examination is conducted through a five-step process. The first four steps involve an overview of the following: (1) histories of medical technology; (2) critiques of medical technology; (3) history and critique of the Canadian health care system; (4) critiques of information and communications technology and policy. The fifth step consists in mapping out the current state of telehealth development in Canada, including policy, applications and projects, as well as distinguishing the main roles of citizens in such initiatives. In closing, ways of achieving citizen empowerment through telehealth are suggested, whether it is found to be achieved in recent initiatives or not. Theoretical frameworks with the aim of positioning new technology in order that it may accomplish social change and citizen empowerment are put forward as an innovative means of evaluating current telehealth applications and projects in Canada.

Problems experienced by individuals in institutions tend to be hidden from the public gaze. This is so for inmates of prisons where regulations and bureaucratic structure conceal the daily life situation of prisoners from public view. Anonymity and concealment are enhanced by the widespread misperception of prisoners as an homogenous group. As a result, problems of vulnerable groups, such as people with disabilities, can be ignored. One such group is prisoners with impaired hearing. This descriptive study utilized a multidisciplinary approach to investigate the problems experienced by prisoners within the context of social control. Drawing from selected literature in health, sociology and criminology, the theoretical framework merges the labelling perspective [interactionism] with macro-level theories of social control. The study provides, for the first time, an examination of the percentage, degree and social import of hearing loss in federal prisoners in the Pacific Region of the Correctional Service of Canada. Through the use of survey, audiometric measurement, and interview techniques, an examination was undertaken of the presence and implications of partial hearing loss in inmates of federal penitentiaries in British Columbia. Interview subjects were identified through hearing testing of volunteers in eight federal penitentiaries. Data were gathered through interviews with prisoners with impaired hearing, a comparison group of prisoners with normal hearing, and a selection of custodians. Of 114 prisoners screened, 69% had some degree of impaired hearing, often previously unidentified. Custodians, 86% of the time, labelled behaviours characteristic of the hard of hearing as deviant, and often aggressive, behaviours. Prisoner accounts revealed that failure to test hearing at time of incarceration has harmful effects on performance in programmes and encounters with the justice system. A social activist approach is recommended, to address structural inequalities among prisoners and barriers for prisoners in general. This work indicates that lower-class, lower-status persons may be more susceptible to negative labelling. Prisoners with partial hearing loss, due to the often invisible nature of their condition, are particularly vulnerable to negative labelling. Study recommendations include: 1] Routine hearing screening of all prisoners at time of incarceration. 2] Education of custodians to understand behaviours and communication needs of persons with impaired hearing. 3] A partnership effort between correctional services, the disabled consumer group, and professionals, to improve the situation of prisoners who are hard of hearing. / Graduate and Postdoctoral Studies / Graduate

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Population aging in Canada is expected to result in a sharp increase in the use of health services by the aged. The purpose of this thesis, is to enhance the knowledge of the utilization of the health system by the elderly. For this, an analysis of the utilization of three health services was pursued, using data from two health surveys, and two general social surveys in a statistical examination; to describe age-use; identify the major determinants of utilization; and to discover the sources of change in use. The results show that the aged were the highest users of health services among all age groups. Use increased for some services, and decreased for others. Changes in how people were managed by the health system, and to a lesser extent a rise in disease prevalence, were the primary sources of variations in utilization. There was no conclusive evidence of the presence of supplier induced demand. Population aging was not a significant determinant of changes in health service use, but rather factors associated with the management of the elderly by the health system; this includes technological changes in medicine, and changes in treatment patterns.

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This thesis considers the rationalization of health care in Canada. It focuses on the conflicting roles modern physicians play in our system, acting as both patient advocate and social agent. It begins by tracing the origin of both of these duties. It then examines the ethical, professional, and legal issues which arise in the limited circumstances where front-line physicians must participate in the rationing of health care. It offers a framework for resolving the double agent dilemma and states five interlocking recommendations which are the building blocks of the resolution.