Health Sciences - Theses, Dissertations, and other Required Graduate Degree Essays

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In search of reason: prevention of mother-to-child transmission (PMTCT) failures in the era of programmatic scale-up in Soweto, South Africa

Date created: 
2010-10-04
Abstract: 

The 2008 scale-up of South African public sector prevention of mother-to-child transmission (PMTCT) to an AZT/sdNVP regimen led to significant reductions in vertical HIV transmission, yet incident paediatric infections continue. The objectives of this study were to 1) identify mothers of newly HIV-infected infants, and assess whether they received per-guideline PMTCT antiretroviral (ARV) regimens, and 2) qualitatively explore contextual factors contributing to these prescription failures and MTCT risk. Eligible women included birthmothers of HIV-infected infants in Soweto. Participants (n=45) first completed a questionnaire, and then a focus group or structured interview. Through triangulation of data, it was determined that 29 mother-infant pairs (64%) did not receive per-guideline PMTCT ARV regimens. Identified issues of importance include preterm birth, delayed antenatal care attendance, operational difficulties implementing PMTCT, and HIV-related stigma. While improved PMTCT regimens are available, social and structural factors must be addressed to ensure access to and uptake of prevention services.

Document type: 
Graduating extended essay / Research project
File(s): 
Supervisor(s): 
Cari Miller
Department: 
Health Sciences: Faculty of Health Sciences
Thesis type: 
(Project) M.P.H.

The evaluation of Vancouver Coastal Health's strategic plan to reduce head injuries on the North Shore: how does it measure up to accepted standards?

Date created: 
2010-12-01
Abstract: 

In 2010, Vancouver Coastal Health’s (VCH) North Shore (NS) division and the NS Injury Prevention Community Action Committee created a Strategic Plan to reduce head injuries on the NS, but planning for an evaluation of the program was not completed. Evaluation is a vital component in any public health program and this project aims to generate an evaluation for VCH’s Strategic Plan. This project outlines what program evaluation entails, including the types, steps and standards of evaluation. It considers the components of previous injury prevention program evaluations to better inform the design of an appropriate evaluation for the head injury program. The paper presents an evaluation plan based on Patton’s utilization-focused approach (Patton 2008) and designed using the US Center for Disease Control’s (CDC) evaluation framework. The evaluation plan is then examined against the CDC’s four evaluation standards recommended by the CDC: utility, feasibility, propriety, and accuracy.

Document type: 
Graduating extended essay / Research project
File(s): 
Supervisor(s): 
Stephen Corber
Department: 
Health Sciences: Faculty of Health Sciences
Thesis type: 
(Project) M.P.H.

Does Tai Chi increase aerobic capacity in adults without cardiorespiratory disease? A systematic review and implications for public health and Tai Chi practitioners

Date created: 
2010-09-30
Abstract: 

This systematic review examined data from 19 studies to ascertain whether Tai Chi provides an acceptable level of aerobic capacity and intensity to be recommended for cardiovascular disease prevention. Two comparisons were conducted: Tai Chi vs. walking, and traditional forms of Tai Chi vs. modified versions. Out of five studies using a modified Tai Chi style, the difference between intervention and control was statistically significant in two, and of the seven studies using a traditional long form, the difference between intervention and control was statistically significant in six and favoured the traditional long form of Tai Chi. The review discussed systemic problems with Tai Chi research and made recommendations including the need to establish a dose-response relationship between a particular style of Tai Chi and energy expenditure with VO2max, as well as between other parts of the traditional Tai Chi curriculum and energy expenditure with VO2max.

Document type: 
Graduating extended essay / Research project
File(s): 
Supervisor(s): 
Michel Joffres
Department: 
Health Sciences: Faculty of Health Sciences
Thesis type: 
(Project) M.P.H.

News media, mental illness and homelessness in Canada: has depiction of mental illness and homelessness changed in Canadian national newspapers since the release of ‘Out of the Shadows at Last’?

Date created: 
2010-09-15
Abstract: 

On May 9, 2006, a Senate Committee report entitled "Out of the Shadows at Last" was published, highlighting the crisis in the mental health system in Canada. It stressed the critical need to develop the mental health system and to change public attitudes towards mental illness. Using agenda setting and framing theories, the current study explores whether the depiction of mental illness and homelessness changed in Canadian National newspaper coverage since the release of this report. Relevant articles from a 2003-2009 were coded using a categorical codesheet. The results show a significant and lasting increase in the agenda setting potential of Canadian National newspaper coverage regarding mental illness and homelessness since the release of the report. The evidence suggests that the report appears to have played a catalytic role in increasing the overall frequency of reporting on a number of prominent themes concerning mental illness and homelessness.

Document type: 
Thesis
File(s): 
Supervisor(s): 
Julian Somers
Department: 
Health Sciences: Faculty of Health Sciences
Thesis type: 
(Thesis) M.P.H.

There is no food in the house: the gap between food security policy and practice in Ghana

Date created: 
2010-09-13
Abstract: 

The purpose of this paper was to examine whether food security policy has been effectively translated into practice. To investigate this, the programs at a childhood undernutrition rehabilitation centre in a food insecure district in Ghana were compared with international food security policy. It was found that the policy recommendations were generally not reflected in practice. In the few instances where practice complied with policy, similarities were superficial and food insecurity was inadequately addressed. These findings are consistent with the rhetoric-action gap that has been noted between food security policies and action to reduce food insecurity on the ground. One of the major challenges identified in transforming policy to practice is that national governments are charged with primary responsibility for policy implementation. This approach is impractical considering capacity limitations of low-income countries and disregards moral obligations of other parties who influence the inequitable global system in which food insecurity persists.

Document type: 
Graduating extended essay / Research project
File(s): 
Supervisor(s): 
Dr. Susan Erikson
Department: 
Health Sciences: Faculty of Health Sciences
Thesis type: 
(Project) M.P.H.

Assessing the feasibility and scope of community mobilization of injecting drug users in HIV/AIDS prevention: A preliminary study in Manipur and Nagaland

Date created: 
2010-08-17
Abstract: 

Community mobilization has increasingly become a key strategy and continues to be a proven success to HIV prevention in the realm of sex workers, men having sex with men and transgenders who by a presence of intrinsic factors have enormous benefits in terms of legal recognition, protection, health and human rights by being mobilized as a community. Injecting Drug Users(IDU) are yet to exhibit the same levels of enthusiasm and success in the mobilization approach of thel HIV intervention program. This study attempts to review the feasibility of mobilizing the IDU community and assess the contextual and structural factors that act as facilitators or barriers to which the community could be mobilized in the high prevalence districts for HIV in North East India .This study is a result of a qualitative thematic analysis of data collected through in depth interviews and focus group discussions

Document type: 
Graduating extended essay / Research project
File(s): 
Supervisor(s): 
John O' Neil
Department: 
Health Sciences: Faculty of Health Sciences
Thesis type: 
(Project) M.P.H.

MDR-TB in China

Author: 
Date created: 
2010-08-26
Abstract: 

China faces a critical epidemic of high incidence of multi-drug resistant Tuberculosis (MDR-TB) in a setting of insufficient control and prevention strategies. By systematically reviewing and analyzing the history of the Chinese medical system, this study focuses on analysing and exploring the problems of the current health care system, which impact TB and MDR-TB prevention and control programs. Special attention is paid to high risk populations. Low TB and MDR-TB case detection rates among high- risk population groups, limited resources and work force in poor areas, low quality of health care services, and lack of co operation among health care facilities are the main barriers to the success of TB and MDR-TB control programs in China. These programs can be improved upon through public education and the strengthening of the national reporting, referral, and tracking system with government commitments and financial support.

Document type: 
Graduating extended essay / Research project
File(s): 
Supervisor(s): 
Steve Corber
Department: 
Health Sciences: Faculty of Health Sciences
Thesis type: 
(Project) M.P.H.

Access to HIV/AIDS treatment services among urban aboriginal peoples in Vancouver, B.C.: a cultural safety perspective

Date created: 
2010-08-16
Abstract: 

Disparities in health care access need to be addressed to help reduce health inequities among Aboriginal Canadians. A literature review examines the role cultural safety can play in reducing access barriers among urban Aboriginal peoples living with HIV/AIDS. Despite its aim to address power dynamics and structural inequities within the health care system this concept lacks methodological application at an institutional level. Key organizational initiatives to provide culturally appropriate health care in Vancouver are discussed in the context of this literature. While cultural competency terminology predominates, efforts exemplify some support and value in moving towards the concept of cultural safety that is well positioned to address the underlying mistrust and negative experiences that dissuade many Aboriginal people from accessing care. A preliminary organizational self-assessment tool is developed to invite discussion and application of cultural safety to strengthen best practice in providing culturally appropriate health care that ensures equitable access.

Document type: 
Graduating extended essay / Research project
File(s): 
Supervisor(s): 
Malcolm Steinberg
Department: 
Health Sciences: Faculty of Health Sciences
Thesis type: 
(Project) M.P.H.

Community based rehabilitation: its role in regions of conflict and as a contributor to peace

Date created: 
2010-08-17
Abstract: 

Within the past few decades, health initiatives inspired by the emerging Peace through Health field have been implemented in regions of armed conflict with varying success. This paper, based on a literature review, examines Community-based Rehabilitation (CBR) within conflict situations and as a Peace through Health initiative. The paper concludes that CBR embodies elements that suggest success in both goals of improving health status in conflict situations & contributing to peace. Drawing together both strategies of implementing CBR in regions of conflict and as a peace-building initiative in a formal way is essential to achieving these goals. Development of specific guidelines for CBR in regions of conflict as a Peace through Health initiative, use of the emerging CBR global database, and collaboration with the WHO Disability and Rehabilitation Team are vital to the further development of this field.

Document type: 
Graduating extended essay / Research project
File(s): 
Supervisor(s): 
Stephen Corber
Department: 
Health Sciences: Faculty of Health Sciences
Thesis type: 
(Project) M.P.H.

Where are the nongovernmental organizations and why? Mapping and exploring the distribution of NGO activity in Bolivia

Date created: 
2010-08-18
Abstract: 

The presence and influence of NGOs in the landscape of global health and development has dramatically proliferated since the 1980s. However, little is known about the distribution of NGO activity. This paper explores the distribution of NGO activity, using Bolivia as a case study, and examines the question: what factors are related to the distribution of NGO activity across municipalities in Bolivia? A geographic information system (GIS) and a multiple regression analysis of count data are utilized to answer the questions at hand. These analyses show that NGO activity is uneven distributed across municipalities and that NGO activity is related to population size, extent of urbanization, size of the indigenous population, and health system coverage. The literature and the case study results inform three main recommendations: 1) Create and implement national NGO Codes of Conduct, 2) Improve surveillance of NGO activity, and 3) Re-focus and re-orient NGO related research.

Document type: 
Graduating extended essay / Research project
File(s): 
Supervisor(s): 
Kitty Corbett
Department: 
Health Sciences: Faculty of Health Sciences
Thesis type: 
(Project) M.P.H.