Constructing the Vulvar Pain Assessment Questionnaire Inventory

The goals of this program of research were to examine the link between self-reported vulvar pain and clinical diagnoses, and to create a user-friendly assessment tool to aid in that process. These goals were undertaken through a series of four empirical studies (Chapters 2-6): one archival study, two online studies, and one study conducted in a Women’s Health clinic. In Chapter 2, the link between self-report and clinical diagnosis was confirmed by extracting data from multiple studies conducted in the Sexual Health Research Laboratory over the course of several years. We demonstrated the accuracy of diagnosis based on multiple factors, and explored the varied gynecological presentation of different diagnostic groups. Chapter 3 was based on an online study designed to create the Vulvar Pain Assessment Questionnaire (VPAQ) inventory. Following the construct validation approach, a large pool of potential items was created to capture a broad selection of vulvar pain symptoms. Nearly 300 participants completed the entire item pool, and a series of factor analyses were utilized to narrow down the items and create scales/subscales. Relationships were computed among subscales and validated scales to establish convergent and discriminant validity. Chapters 4 and 5 were conducted in the Department of Obstetrics & Gynecology at Oregon Health & Science University. The brief screening version of the VPAQ was employed with patients of the Program in Vulvar Health at the Center for Women’s Health. The accuracy and usefulness of the VPAQscreen was determined from the perspective of patients as well as their health care providers, and the treatment-seeking experiences of patients was explored. Finally, a second online study was conducted to confirm the factor structure, internal consistency, and test-retest reliability of the VPAQ inventory. The results presented in these chapters confirm the link between targeted questions and accurate diagnoses, and provide a guideline that is useful and accessible for providers and patients.

Examining Cognitive Processing in Children with an Arithmetic Disability

Currently there is no consensus as to the specific cognitive impairments that characterize mathematical disabilities (MD) or specific subtypes such as an arithmetic disability (AD). The present study sought to address this concern by examining cognitive processes that might undergird AD in children. The present study utilized archival data to conduct two investigations. The first investigation examined the executive functioning and working memory of children with AD. An age-matched achievement-matched design was employed to explore whether children with AD exhibit developmental lags or deficits in these cognitive domains. While children with AD did not exhibit impairments in verbal working memory or colour word inhibition, they did demonstrate impairments in shifting attention, visual-spatial working memory, and quantity inhibition. As children with AD did not perform more poorly than their younger achievement-matched peers on any of these tasks, impairments in specific areas of executive functioning and working memory appeared to reflect a developmental lag rather than a cognitive deficit. The second study examined the phonological processing performance of children with AD compared to children with comorbid disabilities in arithmetic and word recognition (AD/WRD) and to typically achieving (TA) children. Results indicated that, while children with AD did demonstrate impairments on all isolated naming speed tasks, trail making digits, and memory for digits, they did not demonstrate impairments on measures of phonological awareness, nonword repetition, serial processing speed, or serial naming speed. In contrast, children with AD/WRD demonstrated impairments on measures of phonological awareness, phonological short-term memory, isolated naming speed, serial processing speed, and the alphabet a-z task. Overall, results suggested that phonological processing impairments are more prominent in children with a WRD than children with an AD. Together, these studies further our understanding of the nature of the cognitive processes that underlie AD by focusing upon rarely used methods (i.e., age-matched achievement-matched design) and under-examined cognitive domains (i.e., phonological processing).

An Investigation into the Failure to Implement a Universal School Lunch Program during WWII and Postwar Reconstruction in Canada: The Case of Ontario

The purpose of this research is to investigate the various social, political and economic factors that contributed to Canada’s failure to implement a universal school lunch program during the 1940s. Although Canada developed several other social welfare programs in the post-war period, it remains one of the only industrialized nations that does not provide hot meals to children in elementary or secondary schools. Data from the province of Ontario, a major site of postwar reconstruction and policy-making, has been taken up to inform the broader national discourse on school lunches from the 1940s. National, Ontario provincial and City of Toronto archival records were collected and analyzed according to common themes, in order to identify key barriers that constrained government support of a hot meal program. Archival records were identified using key words, and were limited to materials created between 1930-1952. Analysis suggests that sufficient need for a hot meal program had not been established during the 1940s. Despite misleading nutrition messages, rates of malnutrition and nutrient-related disease were at an all-time low, and many Ontario school boards did not appear to have the necessary infrastructure required to supply all pupils with hot meals. The Canadian government had already employed significant resources to improve existing social security programs by coupling them with health education. This strategy reflected a shift in understanding malnutrition as a knowledge-based problem, as opposed to income-based. This understanding was further reinforced through the moralized dissemination of nutrition information, which placed blame on women for improperly raising their children. Ultimately, the strong uptake of nutrition as a public health issue in Ontario may have limited prospective responses to solutions already utilized in the public health domain, and directed favour away from a universal school lunch program for Canada.

Unsettling Histories: Representation and Indigenous Creative Art Praxis in Official Indian Residential School Redress

This dissertation offers an investigation of the role of visual strategies, art, and representation in reconciling Indian Residential School history in Canada. This research builds upon theories of biopolitics, settler colonialism, and race to examine the project of redress and reconciliation as nation and identity building strategies engaged in the ongoing structural invasion of settler colonialism. It considers the key policy moments and expressions of the federal government—from RCAP to the IRSSA and subsequent apology—as well as the visual discourse of reconciliation as it works through archival photography, institutional branding, and commissioned works. These articulations are read alongside the creative and critical work of Indigenous artists and knowledge producers working within and outside of hegemonic structures on the topics of Indian Residential School history and redress. In particular the works of Jeff Thomas, Adrian Stimson, Krista Belle Stewart, Christi Belcourt, Luke Marston, Peter Morin, and Carey Newman are discussed in this dissertation. These works must be understood in relationship to the normative discourse of reconciliation as a legitimizing mechanism of settler colonial hegemony. Beyond the binary of cooptation and autonomous resistance, these works demonstrate the complexity of representing Indigeneity: as an ongoing site of settler colonial encounter and simultaneously the forum for the willful refusal of contingency or containment.

‘Black Settlers’: Hybridity, Neoliberalism and Ecosystemic Change Among Tonga Farmers of Southern Zambia, 1964-2008

This dissertation examines a process of indigenous accumulation among Tonga farmers in Zambia’s Southern Province. In the 1970s multiple authors concluded that capitalist farmers had emerged among Tonga agro-pastoralists, predominantly within private titled holdings. Relying on archival research, newspapers, secondary sources and extensive oral testimony this thesis fills a 35-year gap on the topic, providing insights into the social and environmental impacts of neoliberal policy among African peasants and capitalist farmers. In contrast to dominant narratives of the post-independence period, this study argues that Zambia did experience a developmental process post-independence, which saw significant achievements made in the agricultural sector, including the doubling of national cattle stocks. The data reveals a painful process of disarticulation beginning in the late 1980s. Following neoliberal adjustment, we observe significant heterogeneity in production systems, some regional specialization, and processes of migration. Most importantly, the thesis uncovers processes of overwhelming ecosystemic change that contributed to livestock epidemics of severe scale and scope. Amazingly, this went largely undocumented because of the simultaneous crisis of the state, which left the national statistics office and other state bodies incapable of functioning from the late 1980s into the 2000s. In response, the Zambian state has introduced a number of neodevelopmental initiatives in the sector, yet the lack of animal traction remained up to 2008 and agricultural production declined, while more capitalized farmers (largely white, and/or with foreign direct investment) have become more significant players in the country. This thesis provides compelling evidence to challenge dominant economic thinking of the Washington institutions as well as many of the common Marxian formulations.