Increasing demands for the natural resources of British Columbia coastal forests have led to conflicts between resource users. In addition recent demand for intangible "non-economic" resources, such as outdoor recreation is creating added pressure upon the wildland resource base. The British Columbia Forest Service, although restricted to some extent by a narrowly-worded "wood production" statute, has attempted to resolve forest resource conflicts by administrative action such as the development of new contract provisions and logging guidelines. These alternatives can be effectively enforced against Crown licensees due to Crown control of most timber resources, but they are largely ineffective for the regulation of private timberland operations. Although private lands are not extensive, their harvest is substantial and they comprise a significant acreage in the rich coastal forest areas. The common law offers several potential causes of action which might be employed by the Forest Service to regulate logging operations on private timberlands, particularly with respect to impact upon fishery resources in coastal forest streams. The Forest Act could also be interpreted to authorize regulation of private logging operations. Litigation, whether civil or criminal, however, is not an optimum method of environmental management. It is expensive, time-consuming, extremely technical and remedies are generally post facto in character. / Law, Peter A. Allard School of / Graduate

This study examines the leading businessmen in Vancouver, British Columbia, from 1886 to 1914. Its purpose is to define the economic and social character of the top portion of the business community in early Vancouver, and to explore the process by .which this community was formed. The identities of businessmen associated with 'important' businesses operating in the city were determined at two different four-year points, from 1890 to 1893 and 1910 to 1913 to allow for an analysis of changes within the leadership group. A comprehensive examination of all businesses in Vancouver during the two periods in question was first undertaken before the 'relatively large' or 'important' businesses in Vancouver, and the businessmen associated with them, were identified. To facilitate a more Intensive analysis of the 66 and 276 'business leaders' chosen during the two periods, businessmen who had headed the few largest companies in the city were categorized into another, more select group called the 'business elite'. An additional sub-group of business leaders who had lived in Vancouver from 1910 to 1914 and had achieved a position of high social status in the city was defined as the 'social upper class'. The development of Vancouver's business community was closely linked to the changing character of the two principal economic systems which operated in coastal British Columbia between 1886 and 1914. While the C.P.R. was initially responsible for the emergence of Vancouver as a city in the 1880's, and while the C.P.R. was by far the most powerful business institution in the Terminal City during the decade after 1886, early Vancouver business leaders retained many ties with the maritime economic system, centered in Victoria, which remained predominant in coastal British Columbia into the late 1890's. Vancouver became a regional metropolitan centre, and its wholesalers and lumbermen finally emerged as the two most influential business groups in the city, only when the coastal region of the province became fully integrated, a decade after the arrival of the G.P.R., into a transcontinental system centered in eastern Canada. The continentalization of the provincial economy was matched by the Canadianization of Vancouver's business leadership at the turn of the century. Vancouver's leading businessmen were a distinctly regional business group. They had few ties with the business establishment of eastern Canada, either on the boards of national corporations or in the business and social clubs of the eastern elite. Most city ^enterprises operated within British Columbia alone, though lumber companies and several wholesale firms marketed products on the prairies. This regionalism found expression in particular in the structure of business in Vancouver, and in the types of economic activity that preoccupied city businessmen. Vancouver-centered businesses were small by national standards, and exhibited a simple form of internal organization based on the dominant proprietorship of one man, group of partners or family; this was the case despite the fact that most 'important' local businesses had been incorporated into limited liability companies by 1914. The individual entrepreneur owning his own company, rather than the finance capitalist or career bureaucrat, was still the most prominent type of business leader in Vancouver before the War. Particularly indicative of the regional character of business activity in Vancouver was the preoccupation of these entrepreneurs with speculation in, or the development of urban land and hinterland resources. National business trends had begun to influence the structure of business and the nature of business leadership in Vancouver by 1914, however. The consolidation of many small into a few large companies and the consequent internal bureaucratization of businesses was taking place in the resource industries of the province before the War; local companies were giving way to the branch offices of eastern-centered national corporations; and local representatives of national companies with major operations in Vancouver did tend to exert more influence in the city than did the average head of a local company. The social characteristics of Vancouver's top businessmen were less distinctive than their occupational concerns. More British than the city as a whole in the 1890's Vancouver's business leaders had by 1914 become more Canadian; in both periods the business community was solidly Anglo-Saxon and Protestant. Business leaders' backgrounds conformed generally to a pattern now familiar in the historical literature on business elites at the turn of the century in both the United States and Canada. Leading businessmen in Vancouver, like business elites elsewhere, were a privileged group, coming from backgrounds of much greater economic and social advantage than the population as a whole. While economic mobility was slightly higher among the top businessmen in Vancouver before 1914 than among the elites at the national level, the career patterns of Vancouver business leaders was not characterized by dramatic 'rags-to-riches' mobility. In addition, status mobility did not conform exactly to economic mobility in Vancouver. While becoming a member of the city's economic elite did ease the way to inclusion into Vancouver's emerging 'social upper class' before 1914, the business leaders who were accepted into the inner circles of Vancouver 'society' were even more likely than successful businessmen to have come from privileged economic and social backgrounds. / Arts, Faculty of / History, Department of / Graduate

The provision of health care and preventive services that has evolved in Canada was based on the concept of equality. Within any one province all but a few selected groups pay equal prepaid insurance premiums or tax and are given the same benefit; payment of the provider for services rendered. The concept of Distributive Justice suggests that those with special needs should receive special services but selective provision of care or services may give rise to feelings of Relative Deprivation in non-recipients. For a health service to be equitable and perceived as "fair" there must be maximal distributive justice and minimal relative deprivation. During a research project in the Kitimat-Stikine Regional District during the summer of 19 75, it was found that northern British Columbians viewed their health services as unfair. They believed they subsidized the care and services used by southern British Columbia residents. This study investigates the factors in the health service system which affect the utilization and provision of health services and compares the utilization of hospital services of the Kitimat-Stikine Regional District with three other regional districts; Cowichan Valley, North Okanagan and East Kootenay and with British Columbia as a whole province. The comparative regional districts were chosen on the basis of demography, lifestyle, industrial, ethnic and geographic similarities and differences. Statistical tools used were Frequency Distribution, Simple and Multiple Regression. Determinants of access to care are discussed; the perception of illness, convenience costs, financial costs, availability of manpower, programmes and facilities, social and geographic isolation. An examination is made of the distribution of power in the health system and the use that is made of it by political decision makers, government administrators and planners, professional organizations, educators and pressure groups. The health services in the Kitimat-Stikine Regional District are described with emphasis given to missing programmes. The regional district has a high facilities-population ratio and a low manpower-population ratio. The expectations of the residents of northern British Columbia for provision of health care are presented, noting a concentration of expectation on access to acute health care. The planner's expectations, arising from elements in the health system are delineated. Manpower, facility and hospital utilization data were obtained for the four regional districts and the province. The hospital utilization data, separations by disease of residents from hospitals within and without their domiciliary regional district are subjected to statistical testing to determine whether access to care is reduced in the remote regional districts. The data are adjusted for the age and sex composition of the populations of each region-.and the province. There is no indication from the examination of hospital utilization data that the barriers to access to care that exist are effective in reducing the access gained. In each of the four regional districts, the numbers of separations are higher than expected based on the age and sex composition of the populations. A breakdown of the data on the 186 diseases into disease grouping indicates that hospital utilization is significantly high in some regions for particular groups of diseases. The results indicate a need to examine lifestyle and environmental factors in the four regional districts that may be influencing hospital use for these diseases. There are implications for policy formulation and for health planning activities. There is a need for regional districts to broaden their area of concern to include health services other than hospitals, to control environmental health hazards of industries, agencies and homes within their boundaries and to educate the residents about their personal responsibility for their health status, the special needs of some groups of people, the services required to meet those needs and why some services cannot be offered locally but require referral outside the regional district. The health system which has developed, based on the concept of equality does not provide northerners with a perception of equity or fairness. There is a need to obtain innovative services to meet special needs and to ensure the people excluded from the extra benefit are aware of the special needs of those for whom it is provided. Services which provide a high degree of distributive justice and minimize relative deprivation would result in an equitable and unequal service that could be perceived as fair by all. / Medicine, Faculty of / Population and Public Health (SPPH), School of / Graduate

Pre-paid medical and hospital insurance in Canada has enabled many people to obtain medical services that they could not previously afford, but equal access to health care is not yet ensured for all segments of the population. . It has been suggested that health care resources, particularly manpower, tend to concentrate in urban centres, while rural and remote areas have inadequate resources. In testing the relationship between rurality and accessibility to primary health care, this thesis aims at enriching the knowledge base for mitigation decisions. Seven groups of primary health care personnel were examined: general practitioners, pharmacists, dentists, general surgeons, pediatricians, obstetricians and psychiatrists Nine study regions were ranked by rurality and accessibility. Rurality was measured by (1) proportion of rural population residing in the study region, and (2) distance of the study region to the nearest metropolitan centre. Accessibility was measured by (1) travel distance to the nearest health care personnel, and (2) the ratio of health care personnel to the regional population. Rurality was then correlated with accessibility. Rurality was also correlated with waiting time for an appointment with a general practitioner, and statistical tests for significant difference were performed to determine if waiting time varies with community size. The relationship between practice locations of general practitioners and their personal attributes was tested (1) by correlating rurality with place and year of graduation, and (2) by testing for significant difference in place and mean year of graduation among different community size groups. Significant difference tests were also performed to test the effect of the federal policy restricting physician immigration on the proportion of foreign physicians in rural areas. The result of the accessibility test supports the hypothesis that accessibility diminishes with rurality. It also suggests that serious maldistributions occur in primary care sub-specialty personnel, namely pediatricians, obstetricians and psychiatrists, and that there are intra-regional disparities as well as inter-regional disparities. General practitioners are the least inequitably distributed. The findings reveal that population dispersion and small settlements are the primary obstacles to achieving equal access. Results of the waiting time tests were inconclusive. There is no evidence to support a linear relationship between waiting time and rurality. Long waiting times appear to associate with both the most rural and the least rural regions. Statistical tests of waiting time by community size indicate high variability, prohibiting meaningful comparison of the means. The tests of personal attributes of general practitioners indicate that age (year of graduation) decreases with rurality, and increases with community size, and that the proportion of non-B.C. graduates increases with rurality, but is not affected by community size. Federal immigration restrictions have diminished the proportion of foreign physicians in rural communities, but not in urban or metropolitan centres. The concluding discussion of policy implications covers: (1) Manpower Planning with special emphasis on the roles of the government, the Colleges and the University, and the potentials of various policy options, and (2) Regionalization and its application in health manpower planning. / Applied Science, Faculty of / Community and Regional Planning (SCARP), School of / Graduate

Local area planning is an approach to city planning which has developed in Vancouver over the past five years, and a major unit in the administrative structure of the Vancouver City Planning Department. This thesis is concerned with the purposes of this approach as they have evolved, particularly with the interplay between the purposes actually served and the structure of the civic bureaucracy, and with the choices made by planners among conflicting demands. The methodology used has two elements, an historical analysis based chiefly on contemporary documents, and a sociological analysis of the role relationships of planners working in Area Planning based on interview data. The conclusions suggest that the original purposes for doing Area Planning are no longer being served by the existing organizational structure, and that there is an opportunity and a need for restructuring of the organization and restatement of the purposes if the objectives of Area Planning are to be attained. The Area Planning Division of the City Planning Department was established in 1974, in response to the public demand for participation in the planning process among other reasons. It has grown rapidly, to become the largest division in the Planning Department. A 1973 report suggested three basic reasons for introducing this new approach to planning in Vancouver. Planning is more effective if a strong centralized planning effort is coordinated with neighbourhood oriented planning at the local level. Local area planning brings the planning process closer to the people. Local area planning promotes planning with citizens on a cooperative basis, rather than confrontation responses to plans and proposals. The planner is seen as the central figure in the process. In addition to responding to policy directives and the informal support and guidance of others in the same situation, the position taken by a planner is shaped by compromises among the conflicting expectations and demands placed on the person in this position by those in a variety of related roles. Guidance, or the lack of it, through policy directives is researched through study of documents. The literature is also the basis for specifying three different models of the structure of the work situation in which the local area planner is the central element. These models identify by organizational position and interest the significant others in the planner's environment, but they do not indicate how the planner chooses among the inconsistent expectations and demands made by those involved in these role relationships. To develop the models further interviews were conducted with all of the planners in the Area Planning Division, their superiors to whom they are administratively responsible, representatives of other civic departments who are in frequent contact with Area Planning, some aldermen, and some citizens active in local area planning programmes in their own neighbourhoods. It is clear from the data that the rapid expansion of the Area Planning Division has not corresponded to a parallel expansion of area planning services. The major factor contributing to an increase in staff size is administration of two federal programs, NIP (Neighbourhood Improvement Program) and RRAP (Residential Rehabilitation Assistance Program). RRAP is clearly an implementation program rather than planning, and NIP differs in significant ways from the local area planning ideal. The second major factor in the growth of the Area Planning Division is the development of an "in-house" group of planners working within City Hall using a planning approach which has little in common with the Area Planning concept. The growth of the division and diffusion of its activities seem to have negated the spirit which characterized the intent and early implementation of Area Planning. In addition to the loss of its initial motivation, Area Planning is now at a critical point in time because of the cancellation of future NIP programs and changes in the RRAP approach by the federal government. A restructuring or replacement of the Area Planning Division will be required to establish again a local planning approach as a part of more effective and democratic governance of the city. / Applied Science, Faculty of / Community and Regional Planning (SCARP), School of / Graduate

With the onset of the depression in 1929 the Province of British Columbia found itself almost immediately in economic difficulties. As a province dependent to a very great extent on exports of raw and semi-processed products it faced by the winter of 1930 mounting unemployment, with which it was ill-prepared to cope, and declining revenues. The efforts of the Conservative government in power to meet the situation by attempting to implement the policy of a balanced budget were unsuccessful and by 1932 the province was facing a severe financial crisis. In the ensuing failure of morale the Conservatives allowed representatives of the business community, chiefly concentrated in Vancouver, to inspect the activities of all government departments and make recommendations which would help to improve the condition of the provincial treasury. The resultant Kidd Report, as it became known, threw education into high relief and in the subsequent election it became an important issue. The controversy over education brought out a number of issues which had been the cause of debate and dissension since the turn of the century. The question of the best means of financing the schools was the most pressing and.obvious one. Every economic recession in the past had highlighted this problem as schools under such circumstances usually suffered from inadequate local revenues and reduced government grants. In addition the problem was generally exacerbated by an increasing school population. But other questions disturbed educations: what subjects should be taught in schools, what emphasis should be given to traditional academic subjects and what to the more practically oriented ones, what structure of schools was the best, what was the function of public education, and most fundamentally, what was the philosophy of education which should be adopted in the changed and changing world of the twentieth century? Until very recently it has generally been stated by historians and educators writing about education that the changes which were proposed and implemented during the decade of the thirties were the product of a genuinely humanitarian impulse, a desire to make education more democratic and egalitarian, and dedicated to the cultivation of the worth of each individual child. However, the developments in the field of education which occurred under the Liberal administration cast serious doubts on this interpretation. The Liberal victory in the fall of 1933 brought to power in British Columbia a party which under the leadership of T. Dufferin Pattullo was, at least in stated social and economic policy, considerably to the left of the federal Liberal party, but nevertheless strongly committed to the preservation of the capitalist system. Pattullo appointed as Minister of Education G.M. Weir, head of the Department of Education at the University of British Columbia and coauthor of the Putman-Weir Survey, an exhaustive survey of education in the province written in 1925. He was widely known as a progressive educator, one who was in favour of the innovations of the "new education". Such innovations were not new to British Columbia but the reasons for their adoption during the first two decades of the century suggest primarily a desire for the production of a socially and vocationally efficient citizenry, a theme which is also basic to the Putman-Vfeir Survey. Similarly through the years from 1933 to 1940 the sane motivation seems apparent in the words and actions of those educators most responsible for educational change. Both the King Report on School Finance in British Columbia written in 1935 and the extensive curriculum revisions of elementary, junior and senior secondary schools undertaken in 1935, 1936 and 1937 give ample evidence of this. In addition there appears during these years an overriding concern with the preservation of the state. Fearful that the democratic state as they understood it had been placed in jeopardy by an unbridled individualism, educators in British Columbia sought to make the schools primarily the vehicle for what they tented the socializing of the student. In effect this amounted to conditioning him to retain those values which were deemed vital for the state's survival, and to reject those which seemed to act as a barrier to necessary social and economic change. / Education, Faculty of / Graduate

The federal Juvenile Delinquents Act of 1908 confirmed and expanded upon an inferior civil status for Canadian children and young people. Using the vehicle of a special children's court designed to protect its clientele with such innovations as private hearings and informal evidence, legislators denied the benefit of traditional legal protections to children. The rationale for these changes was the assumption that wayward children were incontrovertibly criminalized by contact with the regular court system and with adult offenders. Proponents of the new juvenile court system believed that a paternalistic probation officer who kept a close watch on the child and its family would provide an effective alternative to the cycle whereby juvenile offenders became irreversibly committed adult offenders. This thesis examines the day-to-day operations of the Vancouver Juvenile Court, one of the pioneer Canadian children's courts, with a view to testing some of these premises. Files were compiled on all juvenile males who came before the court during its first five years of operation. A computer analysis was made of the cases to determine how different variables, such as the child's home situation and who initiated his initial contact with the court affected handling of the cases. It was found that the Vancouver Court did not function as its promoters had intended. Children were still frequently picked up by police and held in regular police cells for varying lengths of time. They were subjected, further, to frequent and lengthy periods of detention in the Court's Detention Home. Instead of being the subjects of an exhaustive examination by a fatherly judge, their cases were decided, occasionally over the telephone and usually after only the most cursory consideration, by a police magistrate after his other duties were completed. Almost all male offenders who came into contact with the Court were formally charged. Of these, fewer than half were brought back for a subsequent offence. Most of those who did return to Court on one or more new charges were brought in for either the same or lesser orders of offences than their first charges. Many repeating offenders were brought forward on charges arising directly out of the settlements of their first cases. The Juvenile Court thus may have either succeeded in breaking the presumed cycle whereby boys arrested on a single charge went on to commit more frequent and more serious offences, or it may have actually inflated the numbers of offenders by causing the arrest of boys whose minor misbehaviours might otherwise have been overlooked. The Court's influence went beyond the power it held over its wards. Families, friends, teachers and employers of the boys were also brought under the control or influence of the probation officer as part of his efforts to control their environments. In a larger sense, the entire community was affected by Court campaigns for new bylaws to control children's activities. The Juvenile Court served a social function by enforcing a standard period of dependency for all children without regard to their personal and/or their parents' wishes in the matter. The lengthier childhood had always existed in law, but Court enforcement and elucidation of the issue made it a matter of wider practice as well. The Juvenile Court also functioned as an economic institution in that it controlled both the occupations of its wards and the regularity with which those occupations were practiced. It played a similar role for parents who came under its power. The evidence suggests that in both its social and its economics functions, the Court was acting in full compliance with the wishes of the general community. / Arts, Faculty of / History, Department of / Graduate

Past migration studies have tended to concentrate on either, the characteristics of migrants, the correlates that 'explain' migration flows, or the monetary gains which accrue to migrants but, despite a growing interest in the field of Social Impact Assessment, there has been little empirical analysis of the relative performance of migrants and non-migrants in areas experiencing economic expansion. The few relevant case studies which have been done examine historically stagnant areas that have managed to attract a new economic activity. They generally compare a single aspect of migrant/non-migrant performance (usually income) and use data that has limited information on important socio-economic variables. Hence, the available information on the relative performance of migrants and non-migrants is sparse and fragmentary. The thesis improves the level of understanding of the outcomes and implications of in-migration. It achieves this by comparing not only the relative mean wage incomes but also the demands for social services and the occupational distributions/unemployment rates of migrants who entered B.C. between 1966-1971 with those of longer term provincial residents (indigenes). The analysis uses bivariate tables to examine data derived from a one per cent sample of the 1971 provincial population, the whole sample is used in the study of the dependency ratios while the male household head subgroup was selected for the examination of the relative income and employment performance of migrants and non-migrants. The analysis can be divided into two main streams. First, the examination of areas in which some previous work had been done. In this stream the analysis revealed that higher incomes among younger in-migrants, which have been found in previous studies and which are evident in the data examined in the thesis, cease to exist when level of education is held constant. Indigenes were found to have mean wage incomes that were predominantly higher than or equal to those of comparable in-migrants. while inter-national in-migrants had incomes that were substantially below those of indigenes and interprovincial in-migrants. At the same time it was found that the indigenous population had a lower proportion of its population employed in service related industries than in-migrants. This is the reverse of the situation in historically stagnant areas attracting new activities. In addition, with the exception of international migrants, the migrant flow did not consistently have a larger proportion of its population in high skill occupations than indigenes. Once again, this result is in contrast to previous findings. The second group of findings is in areas where previous work is minimal or non-existent. I In these areas, in-migrants were found: to have a lower ratio of dependents per income earner than the indigenous population, to be employed in a broad range of occupations rather than concentrated in a few, and to import a large amount of human capital acquired in other jurisdictions. Yet the unemployment rate of the indigenous male household head population was found to be approximately three per cent. The findings lead to three general conclusions relating to in-migration to B.C. during the 1966-1971 period: 1. in terms of the factors studied, in-migration over the period was beneficial to the province. 2. there are only a few subgroups of the indigenous population studied that did not perform as well as in-migrants in the expanding provincial economy. Furthermore, these groups include only a small per centage of the total indigenous population examined. 3. among male household heads there is no substantial support for the conventional wisdom that in-migrants fill a large number of jobs needed by the indigenous population. / Applied Science, Faculty of / Community and Regional Planning (SCARP), School of / Graduate

In the late nineteenth century, middle class Canadian reformers tried to use education to change the values and rhythms of working class, immigrant, and Indian children. They used boarding schools, however, only in the case of Indians. Educators expected boardingsschoolstto give them complete control over the environment of their pupils, thus making it possible to rear a generation of culturally and occupationally assimilated Indians. They did not expect their efforts to be blunted or reshaped by existing Indian rhythms. Because Indians were outnumbered, and because their culture was under attack from many directions, historians too have generally assumed that native rhythms had a negligible impact on residential education. Most accounts of the schools portray them as either assisting or victimizing a decimated and essentially helpless minority. This thesis uses Government reports, school records, correspondence, and oral accounts to investigate the way educators and Indians made attendance decisions. It shows that Indians played a vital role in deciding whether children went to residential school; which children went; at what ages they enrolled; how long they stayed; and how much contact they retained with their families and culture while in attendance. It clarifies some of the emotional, economic, and cultural needs which conditioned Indians' attendance decisions. By examining how existing native patterns of life modified a very determined campaign to control and alter Indian society, the thesis hopefully sheds light as well on the gradual, adaptive, and fluid process of "directed" cultural change. Residential schools were not simply an "imposed" social experience, but a mutual and changing relationship shaped by Indians as well as whites. / Arts, Faculty of / History, Department of / Graduate

A survey was conducted during the months of June and July 1976 at the Willow Chest Clinic in Vancouver, British Columbia, using a questionnaire designed to test tuberculosis patients' knowledge on the cause, course, treatment and prevention of tuberculosis, and their attitude towards the patient education process. The questionnaire was administered to 159 new active tuberculosis patients attending the Clinic for follow-up treatment. Approximately half of this population had been hospitalized at Pearson Hospital during their initial treatment phase, while the other half was treated at the Willow Chest Clinic since the diagnosis of the disease. A control population of 162 patients matched by age, sex, education and ethnic origin was selected from patients attending the Clinic for other respiratory diseases. The objective of the study was to compare hospital versus clinic education of tuberculosis patients in Vancouver, since the product and the process of patient education have an important impact on the treatment and control of tuberculosis. The tuberculosis patients knew more about the disease than the non-tuberculosis patients. The Hospitalized patients had consistently and significantly higher scores than the Control group. The Non-Hospitalized patients had statistically higher scores than the Control only in the area of knowledge of treatment of tuberculosis. The patients who had been hospitalized knew more about the disease than patients who were treated on an ambulatory basis since the diagnosis of the disease. Biases such as that resulting from the selection process of the Study and Control groups, the design and administration of the questionnaire could have contributed to the differences in the scores. Age, education and ethnic origin were found to have significant impact on the knowledge of the patients. However, these variables had been adjusted for in the final analysis of the scores. Since the hospital had provided more patient education opportunities than the clinic, the higher scores could be due to the patient education process. Patient education could have increased the knowledge of tuberculosis among the hospitalized patients. The importance of good communication in patient education was reiterated. That these different groups of patients, by virtue of their differences in age, education and ethnic origin, had their unique education needs was evident from the patients' response. Hence different means of communicating disease information in varying amounts would be necessary. The use of non-tuberculosis patients to estimate the level of knowledge of tuberculosis patients prior to their disease has not been completely satisfactory. It is recommended that future patient education programs have mechanisms for evaluation built into their design. This would allow a better assessment of the effectiveness of patient education. / Medicine, Faculty of / Population and Public Health (SPPH), School of / Graduate