This thesis was undertaken to assess the characteristics of individuals who smoke crack cocaine and to examine the health-related risks and healthcare needs of this population. A literature review of 147 published articles was conducted to synthesize evidence regarding behaviours associated with crack use and to assess the risks of disease transmission through crack smoking behaviours. Qualitative interviews were subsequently conducted with thirty Ottawa residents who smoke crack to learn about their experiences with healthcare and harm reduction services. Results identified barriers related to accessing primary healthcare and drug treatment programming among people who smoke crack and gaps within existing harm reduction services. Individuals who smoke crack represent a marginalized population who are often missed through traditional health promotion and harm reduction programming. There is a need for increased coverage of current programming and a reduction of factors which currently hinder the delivery and effectiveness of crack-specific harm reduction programs.

Purpose: The first objectives of the current study was to determine whether disparities exist in mental health and mental health service use between minority and majority Canadian Francophone and Anglophone communities both within and outside of Quebec. The second objectives was to examine if official language minority-majority status was associated with the presence of common mental health problems and mental health service utilization.<p> Methodology: The current study used data from the Canadian Community Health Survey: Mental Health and Well-being, Cycle 1.2.7 Two main comparisons were made: Quebec Francophones to Quebec Anglophones, and outside Quebec Francophones to outside Quebec Anglophones. Twelve-month and lifetime prevalences of mental disorders and mental health service use were examined through bivariate analyses. Logistic regression analyses determined whether official language minority-majority status significantly predicts mental health problems and mental health service use using the Determinants of Health Model8-10 and Andersens behavioural model.11-13<p> Results: Very few significant differences were found between official language groups both outside and within Quebec, though some notable differences were found between Quebec and outside Quebec: Anglophones and Francophones outside Quebec had a higher prevalence of poor mental health and low life satisfaction compared their respective language counterparts in Quebec. Respondents from outside Quebec had a higher prevalence of consulting with a psychiatrist than respondents from Quebec. There was no significant association between membership in an Official Language Minority Community and mental health problems, and mental health service use. Implications: Although our results indicate that very few differences exist between official language minority and majority groups, these findings remain important and can help aid key stakeholders redirect resources and develop policies and programs towards areas and geographic locations wherein health disparities exist.

My thesis explores the knowledge, subjectivities and work performances that activist social workers bring to their practice in Ontario, Canada during a period of workplace restructuring that includes cuts to services, work intensification, increased surveillance and the evolving discourses of neoliberalism. A key aspect of my dissertation is the exploration of tensions between the attachments, desires and aspirations of the activist social work self and what that self must do every day to get by. I am interested in how it is that social workers produce and maintain their sense of identities – their integrity, ethics and responsibilities as activists – while also managing to navigate the contradictions of restructured workplaces. My aim is to understand not how power in the form of restructuring policies is imposed on people, but rather, how power acts through subjects who find themselves both implicated in, and struggling to resist neoliberal restructuring. My research lens draws on Michel Foucault’s ideas about governmentality and on feminist poststructural, critical race, and postcolonial theories. I use these theories to see neoliberal strategies of rule as working in diffuse ways through social and health service workplaces, encouraging service providers to see themselves as individualized and active subjects responsible for particular performances that enact specific types of change. My research findings reveal that activist social workers respond to neoliberal strategies of rule in multiple ways while constituting themselves through a variety of competing discourses that exist in their lives. Social workers subjectivities appear to be produced through a range of discourses drawn from their family histories, unique biographies and the intersections of socially produced distinctions that are based on gender, race, class, sexuality, age and nationalism. My dissertation traces some of the many ways that social workers position themselves within and beyond the changing context of neoliberalism. In doing so, my research reveals tentative pathways for building critical resistance practices and suggests future social welfare measures that are based on social justice and equity.

From September 2000 through May 2001, a team of two psychologists and two psychology graduate students (myself included) from the University of Saskatchewan delivered a variety of psychological services to a remote reserve community in northern Saskatchewan via telehealth from the Royal University Hospital in Saskatoon. Using telehealth, we provided psychoeducational information, therapy, assessments, case consultations and support services to Aboriginal health workers in this community. The present study is an evaluation of the use of telehealth in the delivery of psychological services to remote reserve communities. A semi-structured interview was employed to gain knowledge about the experiences of people involved in this telehealth project as well as the insights, thoughts and beliefs of Aboriginal and non-Aboriginal mental health workers regarding the use of telehealth with remote communities. In total, eight interviews were conducted for this study. Results indicate that although telehealth technology was seen as positive, psychology is often perceived in a negative manner by Aboriginal people. Due to this disconnection between Aboriginal people and Western psychology, psychological service provision with telehealth needs to be considered in conjunction with building relationships and trust in the community. Despite the difficulties, the results indicate that there is much that can be gained by providing psychological services to remote Aboriginal communities via telehealth.

Purpose: The first objectives of the current study was to determine whether disparities exist in mental health and mental health service use between minority and majority Canadian Francophone and Anglophone communities both within and outside of Quebec. The second objectives was to examine if official language minority-majority status was associated with the presence of common mental health problems and mental health service utilization.<p> Methodology: The current study used data from the Canadian Community Health Survey: Mental Health and Well-being, Cycle 1.2.7 Two main comparisons were made: Quebec Francophones to Quebec Anglophones, and outside Quebec Francophones to outside Quebec Anglophones. Twelve-month and lifetime prevalences of mental disorders and mental health service use were examined through bivariate analyses. Logistic regression analyses determined whether official language minority-majority status significantly predicts mental health problems and mental health service use using the Determinants of Health Model8-10 and Andersens behavioural model.11-13<p> Results: Very few significant differences were found between official language groups both outside and within Quebec, though some notable differences were found between Quebec and outside Quebec: Anglophones and Francophones outside Quebec had a higher prevalence of poor mental health and low life satisfaction compared their respective language counterparts in Quebec. Respondents from outside Quebec had a higher prevalence of consulting with a psychiatrist than respondents from Quebec. There was no significant association between membership in an Official Language Minority Community and mental health problems, and mental health service use. Implications: Although our results indicate that very few differences exist between official language minority and majority groups, these findings remain important and can help aid key stakeholders redirect resources and develop policies and programs towards areas and geographic locations wherein health disparities exist.

My thesis explores the knowledge, subjectivities and work performances that activist social workers bring to their practice in Ontario, Canada during a period of workplace restructuring that includes cuts to services, work intensification, increased surveillance and the evolving discourses of neoliberalism. A key aspect of my dissertation is the exploration of tensions between the attachments, desires and aspirations of the activist social work self and what that self must do every day to get by. I am interested in how it is that social workers produce and maintain their sense of identities – their integrity, ethics and responsibilities as activists – while also managing to navigate the contradictions of restructured workplaces. My aim is to understand not how power in the form of restructuring policies is imposed on people, but rather, how power acts through subjects who find themselves both implicated in, and struggling to resist neoliberal restructuring. My research lens draws on Michel Foucault’s ideas about governmentality and on feminist poststructural, critical race, and postcolonial theories. I use these theories to see neoliberal strategies of rule as working in diffuse ways through social and health service workplaces, encouraging service providers to see themselves as individualized and active subjects responsible for particular performances that enact specific types of change. My research findings reveal that activist social workers respond to neoliberal strategies of rule in multiple ways while constituting themselves through a variety of competing discourses that exist in their lives. Social workers subjectivities appear to be produced through a range of discourses drawn from their family histories, unique biographies and the intersections of socially produced distinctions that are based on gender, race, class, sexuality, age and nationalism. My dissertation traces some of the many ways that social workers position themselves within and beyond the changing context of neoliberalism. In doing so, my research reveals tentative pathways for building critical resistance practices and suggests future social welfare measures that are based on social justice and equity.

Official-language minorities in Canada may face specific issues in accessing health care services that can lead to negative consequences on their health, utilization of health care services and satisfaction with the health care system. A secondary data analysis of the 2006 Survey on the Vitality of Official-Language Minorities revealed significant differences between the Anglophone minority (n=5,161) and the Francophone minority (n=12,029) with regards to general health, and access to and use of health care services. Important predictors of these outcomes included age, education level, household income, marital status and place of residence (urban/rural). Access to health care services in the minority language was associated with self-perceived health in the Anglophone minority only. Health policy recommendations elaborated in light of the findings include working on both the supply and the demand of health care services offered in the two official languages, while taking into consideration important contextual differences between regions.

This thesis was undertaken to assess the characteristics of individuals who smoke crack cocaine and to examine the health-related risks and healthcare needs of this population. A literature review of 147 published articles was conducted to synthesize evidence regarding behaviours associated with crack use and to assess the risks of disease transmission through crack smoking behaviours. Qualitative interviews were subsequently conducted with thirty Ottawa residents who smoke crack to learn about their experiences with healthcare and harm reduction services. Results identified barriers related to accessing primary healthcare and drug treatment programming among people who smoke crack and gaps within existing harm reduction services. Individuals who smoke crack represent a marginalized population who are often missed through traditional health promotion and harm reduction programming. There is a need for increased coverage of current programming and a reduction of factors which currently hinder the delivery and effectiveness of crack-specific harm reduction programs.

Background: School health services of today focus on prevention and health promotion within the school. A collaboration between the school health services and the student care team from the guidelines with focus on the student, is expected. Purpose: The purpose was to illustrate School nurses  vocational experiences and what the role of school health services in the student care team at upper secondary schools of John Bauer in relationship to the vision of the school. Method: Qualitative content analysis with inductive approach was used (Lundman &amp;Hällgren-Graneheim, 2008). Data was collected by interviewing  school nurses at  School of John Bauer. Result: From the results school nurse´s health enhancement-and promoting work, team cooperation, prioritizing, management and co-ordination were found. From the data eight categories were found such as teamwork, health promoting tools, follow-up of schoolenvironment, knowledge, accessibility, low prioritized student care team, inadequate management and co-ordination of the team. Conclusion: According to the study, time limits and lack of comprehension from school management makes it more difficult for school health service to reach its fully potential. Theresults can be used to improve school nurses´ situation through self-education and encourage education of other student care team members and quality assurance.

From September 2000 through May 2001, a team of two psychologists and two psychology graduate students (myself included) from the University of Saskatchewan delivered a variety of psychological services to a remote reserve community in northern Saskatchewan via telehealth from the Royal University Hospital in Saskatoon. Using telehealth, we provided psychoeducational information, therapy, assessments, case consultations and support services to Aboriginal health workers in this community. The present study is an evaluation of the use of telehealth in the delivery of psychological services to remote reserve communities. A semi-structured interview was employed to gain knowledge about the experiences of people involved in this telehealth project as well as the insights, thoughts and beliefs of Aboriginal and non-Aboriginal mental health workers regarding the use of telehealth with remote communities. In total, eight interviews were conducted for this study. Results indicate that although telehealth technology was seen as positive, psychology is often perceived in a negative manner by Aboriginal people. Due to this disconnection between Aboriginal people and Western psychology, psychological service provision with telehealth needs to be considered in conjunction with building relationships and trust in the community. Despite the difficulties, the results indicate that there is much that can be gained by providing psychological services to remote Aboriginal communities via telehealth.