This thesis employs a post-anarchist influenced lens and develops a collective capacity framework in order to explore how the media consumption and production practices of the Chinese Canadian, Latin American, and Somali Canadian communities in Ottawa, Canada, can strengthen these communities’ ability to facilitate the process by which immigrants become community members and form a sense of belonging in Ottawa. The thesis explores both how ethno-cultural media can help newcomers to form a sense of belonging and become part of a local ethno-cultural community, as well as how such media can help members of minority ethno-cultural communities become part of the broader local community and to form a sense of belonging in Ottawa, and Canada more broadly. Throughout, the thesis identifies and explores the differences that emerge between the three communities in order to gain better insight into the potential benefits of ethno-cultural media. In order to explore and to answer these questions, the thesis employs quantitative and qualitative methods. It relies on analysis of secondary literature, raw data from the OMMI 2012 Survey, raw content coding of local Chinese and Spanish language media carried out as part of the Ottawa Multicultural Media Initiative, and primary research consisting of content coding of a Somali Canadian television program. The main contribution of this thesis lies in offering a new lens through which to assess the integrative potential of ethno-cultural media. Approaching the question from a bottom-up, relationship-centred perspective has yielded different findings than those generally reported in Canadian ethno-cultural media research. Although there were significant differences in terms of media use and media production between the three communities, the findings revealed that all three used ethno-cultural media in ways that had the potential to help them in the process of settling down and taking root in a new city, and of helping them to form a sense of belonging.

A single-item measure of self-rated mental health (SRMH) asks respondents to rate their mental health on a 5-point scale from ‘excellent’ to ‘poor’. SRMH is being used increasingly in research and on population health surveys. However, little is known about this item, as there are no literature reviews and few formal validation studies. The aim of this study is to understand what SRMH measures by conducting the first known systematic review of SRMH literature, followed by analysis of the Canadian Community Health Survey (CCHS 1.2). Results of the systematic review reveal SRMH has relationships with mental health scales, mental disorders, self-rated health, health problems, service utilization, and service satisfaction. Analysis of CCHS 1.2 data finds SRMH is associated with psychiatric diagnoses, distress, physical health, and sociodemographic characteristics. Both studies conclude SRMH is measuring mental health and more; however, there needs to be more research to understand the specifics of these relationships.

A single-item measure of self-rated mental health (SRMH) asks respondents to rate their mental health on a 5-point scale from ‘excellent’ to ‘poor’. SRMH is being used increasingly in research and on population health surveys. However, little is known about this item, as there are no literature reviews and few formal validation studies. The aim of this study is to understand what SRMH measures by conducting the first known systematic review of SRMH literature, followed by analysis of the Canadian Community Health Survey (CCHS 1.2). Results of the systematic review reveal SRMH has relationships with mental health scales, mental disorders, self-rated health, health problems, service utilization, and service satisfaction. Analysis of CCHS 1.2 data finds SRMH is associated with psychiatric diagnoses, distress, physical health, and sociodemographic characteristics. Both studies conclude SRMH is measuring mental health and more; however, there needs to be more research to understand the specifics of these relationships.

Introduction: The benefits of leisure-time physical activity on mental and physical health among older adults are well documented, but few studies have explored the association between depression and leisure-time physical activity within a theoretical framework. Objective: The purpose of the present study was to identify the association between depression and leisure-time physical activity among community-dwelling, Canadian adults aged 65 and older, using a modified version of the International Classification of Functioning, Disability and Health (ICF) framework. Method: The present study included a weighted sample of 3,785,145 community- dwelling, seniors aged 65 years or older who participated in the Canadian Community Health Survey (Cycle 2.1). Univariate and multiple logistic regressions were used to examine the cross-sectional association between depression-related disorders and leisure-time physical activity in the context of chronic physical conditions and psychosocial factors. Results: Older adults reporting depression-related disorders were less likely to participate in leisure-time physical activity after adjusting for relevant psychosocial factors (odds ratios (ORs) ranged from 0.76 to 0.79, p < 0.001). This association was partially mediated by activity limitations associated with depression-related disorders. Similar results were observed between chronic physical conditions and participation in leisure-time physical activity. Conclusion: Although the present study was unable to identify the temporal relationships among study variables, the results provide clinicians who care for older adults with depression and/or chronic physical diseases with potentially useful information on the benefits of physical activity. They also provide evidence in support of community-based exercise or leisure-time physical activity program for seniors who are physically inactive to prevent chronic mental or physical illnesses and reduced quality of life

Introduction: The benefits of leisure-time physical activity on mental and physical health among older adults are well documented, but few studies have explored the association between depression and leisure-time physical activity within a theoretical framework. Objective: The purpose of the present study was to identify the association between depression and leisure-time physical activity among community-dwelling, Canadian adults aged 65 and older, using a modified version of the International Classification of Functioning, Disability and Health (ICF) framework. Method: The present study included a weighted sample of 3,785,145 community- dwelling, seniors aged 65 years or older who participated in the Canadian Community Health Survey (Cycle 2.1). Univariate and multiple logistic regressions were used to examine the cross-sectional association between depression-related disorders and leisure-time physical activity in the context of chronic physical conditions and psychosocial factors. Results: Older adults reporting depression-related disorders were less likely to participate in leisure-time physical activity after adjusting for relevant psychosocial factors (odds ratios (ORs) ranged from 0.76 to 0.79, p < 0.001). This association was partially mediated by activity limitations associated with depression-related disorders. Similar results were observed between chronic physical conditions and participation in leisure-time physical activity. Conclusion: Although the present study was unable to identify the temporal relationships among study variables, the results provide clinicians who care for older adults with depression and/or chronic physical diseases with potentially useful information on the benefits of physical activity. They also provide evidence in support of community-based exercise or leisure-time physical activity program for seniors who are physically inactive to prevent chronic mental or physical illnesses and reduced quality of life

Abstract The purpose of this study was to examine how parents of African descent understand the African-centered school concept as an alternative education to the mainstream public school in Toronto. While we cannot ignore the success stories of some Black students in the school system, the reality remains that the academic performance of some shows a downward trend. Hence, concerned educators and members of the African-Canadian community suggest the need for the establishment of a Black focused or African-centered school as an alternative to the mainstream public school. This will allow students to learn more effectively because they are culturally grounded and will be able to link issues of individual or group identities with what goes on at school. This qualitative research relied principally on in-depth interviews with twenty African-Canadian parents who have children in the mainstream public schools in Toronto. It assumes that parents are important stakeholders in their children’s education so their views on problems and the need for an alternative form of schooling have significant implications for the academic performance of Black youth. The data from my study and available literature make it evident that despite the introduction of African heritage and multicultural programs and anti-racist education, profound problems still exist for Black youth in the mainstream public schools. The findings indicate that out of twenty, a majority of seventeen African-Canadian parents support the establishment of African-centered schools as an alternative to the mainstream public school. All participants interviewed agree that discrimination, prejudice and stereotyping in mainstream public schools are major problems for their children. The parents’ narratives show that the establishment of an African-centered school as an alternative to the mainstream public school is a way to combat the discrimination and prejudice Black youth encounter at school. The parents believe Black focused schools should be a major preoccupation of educational personnel, school boards and policy makers. Finally the implications of establishing an African-centered school to address the needs of Black youth and directions for future research are discussed.

This thesis is an investigation of the self-reported health behaviour changes made by adults in the Canadian Community Health Survey 2007, categorized by BMI category. Descriptive analyses and forward stepwise regression were performed to determine variables associated with HBC. The final sample n = 111,449. Overall, 58% of individuals had made a HBC in the past year. Increased exercise was the most common HBC (29%), followed by improved eating habits (10%) and losing weight (7%). Only 51% experienced barriers to HBC; lack of will power was most commonly cited. Overweight and obese individuals were more likely to undertake HBC. In the regression model, opinion of own weight was the strongest predictor of HBC, followed by fruit and vegetable consumption, number of consultations with doctor, smoking status, and perceived health.

Abstract The purpose of this study was to examine how parents of African descent understand the African-centered school concept as an alternative education to the mainstream public school in Toronto. While we cannot ignore the success stories of some Black students in the school system, the reality remains that the academic performance of some shows a downward trend. Hence, concerned educators and members of the African-Canadian community suggest the need for the establishment of a Black focused or African-centered school as an alternative to the mainstream public school. This will allow students to learn more effectively because they are culturally grounded and will be able to link issues of individual or group identities with what goes on at school. This qualitative research relied principally on in-depth interviews with twenty African-Canadian parents who have children in the mainstream public schools in Toronto. It assumes that parents are important stakeholders in their children’s education so their views on problems and the need for an alternative form of schooling have significant implications for the academic performance of Black youth. The data from my study and available literature make it evident that despite the introduction of African heritage and multicultural programs and anti-racist education, profound problems still exist for Black youth in the mainstream public schools. The findings indicate that out of twenty, a majority of seventeen African-Canadian parents support the establishment of African-centered schools as an alternative to the mainstream public school. All participants interviewed agree that discrimination, prejudice and stereotyping in mainstream public schools are major problems for their children. The parents’ narratives show that the establishment of an African-centered school as an alternative to the mainstream public school is a way to combat the discrimination and prejudice Black youth encounter at school. The parents believe Black focused schools should be a major preoccupation of educational personnel, school boards and policy makers. Finally the implications of establishing an African-centered school to address the needs of Black youth and directions for future research are discussed.

<p>Background</p> <p>Adults with cerebral palsy (CP) may have special health care considerations related to an increased prevalence of risk factors for chronic diseases. In particular, disability-related sedentary time may increase the risk of cardiovascular disease and the related major adverse cardiovascular events (MACE) in this population.</p> <p>Methods</p> <p>Part I: A systematic review of major databases, trial registries, and conference abstracts identified randomized trials and observational studies exploring the prevalence and evaluating the prevention of MACE and risk factors for MACE in adults with CP. Title and abstract, data extraction, and quality of reporting assessment were completed in duplicate.</p> <p>Part II: A secondary analysis of Canadian census data evaluated the crude and adjusted risk of stroke in adults with CP and compared the crude risk with other Canadian adults with spinal cord injury, acquired brain injury, and epilepsy. All risks were reported as an odds ratio (OR) with 95% confidence intervals.</p> <p>Results</p> <p>Part I: 2281 unique articles were screened to provide 10 cross-sectional studies. No studies evaluated any interventions for MACE or risk factors for MACE. The most common risk factor studied was obesity. Two studies showed an increased in death due to circulatory diseases.</p> <p>Part II: Crude risk of stroke to CP was OR=12.5 (12.2-12.9). Mediation effects or multicollinearity was not observed. The adjusted risk of stroke was OR=7.9 (1.8-34.2). Elevated crude risk of stroke was also noted in patients with acquired brain injury (OR=16.2 [16.0-16.5]), spinal cord injury (OR=6.1 [6.0-6.3]), and epilepsy (OR=6.2 [6.0-6.3]).</p> <p>Conclusions</p> <p>This thesis provides a preliminary overview of the risk of MACE in adults with CP and hypothesis generating evidence for further research in this population. A prospective cohort study is urgently needed assess the implications of these findings. Adults with CP should minimize exposure to modifiable risk factors as much as possible.</p> / Master of Science (MSc)

This dissertation examined health care utilization patterns across conventional health care (CHC), complementary and alternative medicine (CAM), and public health care (PHC) systems among Canadians aged fifty and older. I argued that utilization research is currently limited by a primary focus on discrete use of health care services, largely within the CHC system (i.e., medical doctors, specialists, hospitals). However substantial growth in use of CAM and PHC, particularly among late middle-age cohorts, suggests the need to widen the research lens from discretionary service use within health care systems to include medical pluralism or use across health care systems. To address the lack of research on medical pluralism and the need for a comprehensive overview of service use, I used two different strategies to create discrete patterns of service use and non-use. To frame the predictors of these patterns, a medical pluralism paradigm was proposed, which suggests that there are distinct social location and health characteristics that may explain use across health care systems. Five hypotheses were tested using data pooled from two cycles of the Canadian Community Health Survey (Cycles 2.1 [2003] and 3.1 [2005]) to create an overall sample (n=117,824). Results from the deductive (variable oriented) and inductive (person centred) strategies were compared. Differences in both the number and form of patterns are apparent. Across both strategies, the most common pattern is dual use of CHC (medical visits, specialist visits) and PHC (flu shots, sex-specific screening) but not CAM (chiropractors, other CAM providers). Consistent with the literature, women use more types of services overall than do men. The gender effect is significantly mediated by age: older men are less likely to use services across the three health care systems than older women. Strong evidence for a socioeconomic gradient in medical pluralism is also found. Higher levels of income and education increase the likelihood of using services across the three health care systems compared to low and middle levels of both income and education. The relationship between race and health service use was much less significant. Long-term immigrants demonstrate tri-use patterns close to those of Canadian born individuals; however, service differentials remain even after controlling for health needs, in favour of native-born Canadians. Medical pluralism is also associated with health related-need as support was found for both illness and wellness care. Lastly, regional differences point to a greater likelihood of medical pluralism in western Canada, but not always in urban areas. In future, a longitudinal examination of medical pluralism is necessary and would help establish the sequencing of services and how services are used in relation to the disablement process. Health policy would thus benefit from insight into the extent of service duplication for specific conditions and clarify the role of medical doctors in referral processes. / Graduate