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

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Toward the development of culturally safe birth models among northern First Nations: The Sioux Lookout Meno Ya Win Health Centre experience

Date created: 
2010-05-04
Abstract: 

This paper presents the approach taken by the Sioux Lookout Meno Ya Win Health Centre (SLMHC) to improve maternal and newborn care for First Nations peoples in Northwestern Ontario. I use a cultural safety lens to explore whether the SLMHC’s focus on birthing meanings, beliefs, attitudes, and practices as described by elders may contribute to the development of a more culturally safe hospital birth model. Findings suggest that a transcultural approach aimed at understanding and involving birthing beliefs, practices, and meanings into the health care setting is a necessary aspect of returning control back to the community and is thus an important preliminary step in achieving cultural safety in the clinical realm. In areas in which health and social challenges prevent women from giving birth in their home communities, efforts such as the SLMHC initiative should be made to ensure that existing health care settings are more culturally safe.

Document type: 
Thesis
File(s): 
Supervisor(s): 
Dr. Nicole Berry
Department: 
Health Sciences: Faculty of Health Sciences
Thesis type: 
(Thesis) M.P.H.

Suicide assessment and management initiative (SAM): evaluating the implementation and uptake of suicide prevention activities in a healthcare setting.

Date created: 
2010-07-22
Abstract: 

Suicide is one of the leading causes of death among Canadian men and women from adolescence to middle age and is strongly associated with mental illness. BC Mental Health and Addiction Services has developed Suicide Assessment and Management (SAM) Guidelines to identify safety risks within its client populations. Rigourous evaluation of the SAM Guidelines Initiative is essential to determine the impact of the intervention. This paper describes the literature review and logic model for the SAM Guidelines. Evaluation frameworks are discussed and the literature related to suicide prevention in healthcare settings is reviewed to inform the development of the program logic model. Stakeholder engagement and organizational context were identified as key considerations in the evaluation process.

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

Experiences of gender-based violence among HIV-positive Rwandan women beyond the period of disclosure and implications for HIV programming

Date created: 
2010-04-12
Abstract: 

The relationship between gender-based violence (GBV) and HIV has gained prominence in the field of public health. In the context of Rwanda, poverty and the lasting affects of the 1994 Rwandan Genocide further complicate this relationship. In partnership with Women’s Equity in Access to Care and Treatment, an HIV treatment centre in Kigali, Rwanda, this study uses qualitative research methods to capture the experiences of GBV among HIV-positive Rwandan women. Participants spoke to the variety of ways that living openly with HIV shaped their experience of GBV and interacted with their experience of gender inequities in access to land and resources. Women framed their experience of GBV as including; being prevented from seeking medical care and an inability to assert agency in sexual relationships. Exploring how women jointly experience GBV and HIV can provide insight into future public health practice and research on the relationship between GBV and HIV.

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

The harms of help: exploring women's experiences with anti-violence, addictions and mental health services within British Columbia

Date created: 
2010-05-25
Abstract: 

Despite the intention of the anti-violence, addictions and mental health sectors to enhance women's health and safety, research has revealed that these services can unintentionally cause harm. This qualitative study used focus groups to explore, understand and describe the harms of British Columbia's anti-violence, addictions and mental health services from the unique and varied perspectives of women who have experiences of abuse, substance use and mental health issues. Five themes of service harms emerged. Exclusion from services undermined women's ability to escape high-risk situations; contact with services triggered women's substance use; mistreatment from service providers created a barrier to help-seeking; inattention to women's experiences of abuse made services unreflective of women's needs; and child apprehension directly contributed to mother's use of substances. To eliminate service harms, recommendations are provided for the provision of women-centred care; trauma-informed and trauma-specific services; and the integration of anti-violence, addictions and mental health services.

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

Assessing the Vancouver Coastal Health Authority's pandemic influenza vaccine program: a case study of the 2009-2010 H1N1 influenza pandemic

Date created: 
2010-05-19
Abstract: 

Due to the looming threat of an influenza pandemic, global investment was been placed into pandemic preparedness and response planning in order to mitigate and reduce the associated negative impacts. In June 2009, the first influenza pandemic of the 21st century was declared; however, the negative consequences that transpired were not as dire as those projected. As such, the 2009 H1N1 influenza pandemic provided an opportunity to test current pandemic preparedness plans in order to identify and close gaps between actual and ideal performances. This paper assessed the execution of the Vancouver Coastal Health Authority's pandemic vaccine program plan, comparing it with the events of this pandemic. Areas for improvement identified include: issues surrounding implementation and enforcement of priority groups; expansion of activities aimed at increasing vaccine uptake; increasing public support of vaccines in general; and building in adaptation capacity within preparedness plans. Recommendations were made to address these issues.

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

Homelessness and mental illness: a descriptive analysis of Vancouver At Home study participants

Author: 
Date created: 
2010-05-20
Abstract: 

The purpose of this paper was to describe the characteristics of the first 186 participants enrolled in the Vancouver At Home study, and compare these characteristics to those found in existing research involving similar samples of homeless, mentally ill individuals. A total of 24 publications were reviewed, their socio-demographic characteristics summarized, and contrasted with the Vancouver At Home study sample. The At Home sample showed similarities to other studies in terms of the distribution gender and age, but differences with respect to ethnic diversity and lifetime duration of homelessness. Results suggest that the emerging sample in Vancouver is representative of the parent population; however, the degree of variability between cities is unclear, thus our ability to generalize about populations across jurisdictions is uncertain. An overall lack of methodological consistency between existing studies underscores the need for improved rigor and standardization in the study of homeless, mentally ill populations.

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

The role of evidence in the development of treatment recommendations: application of the GRADE criteria to breast-feeding HIV-positive mothers

Peer reviewed: 
Yes, item is peer reviewed.
Date created: 
2009
Abstract: 

Over the last several decades, the role of clinical medicine in the development of practice guidelines has increasingly` become dependent upon evidence. This study aims to examine the role evidence played in the development of the treatment guidelines concerning infant feeding options for babies born to HIV-infected mothers in Sub-Saharan Africa. Clinical outcome data was reviewed from the evidence available from the World Health Organization. Outcomes of interest were assessed based upon the infants either being exclusively breastfed or exclusively formula fed with the relative risks of these outcomes given the exposure calculated and the evidence graded for its strengths and deficiencies within the framework of GRADE. The findings suggest that the evidence had some methodological flaws as well as inconsistencies that resulted in low quality grading. The clinical community would benefit from further research that will likely have an important influence on the confidence of the study estimates.

Document type: 
Thesis
File(s): 
Supervisor(s): 
Edward Mills
Department: 
Faculty of Health Sciences - Simon Fraser University
Thesis type: 
Thesis

The links between disasters, relief, rehabilitation and development

Peer reviewed: 
No, item is not peer reviewed.
Date created: 
2010
Abstract: 

This capstone discusses the relations between disasters, disaster relief and rehabilitation, and development. Natural disasters frequency and severity has increased over the last few decades with greater impacts on developing countries further impeding achievement of the Millennium Development Goals (MDGs). This capstone uses the Bangladesh floods, 2004 and the Asian tsunami in Sri Lanka, 2004 as case studies to assess the disaster response and development efforts undertaken in promoting development. Three main recommendations are given; (1) Build capacity to implement and maintain disaster reduction systems (2) Include elements of disaster reduction in developments efforts (3) Include elements of development in disaster response efforts. Potential challenges for achieving these recommendations are also described.

Document type: 
Thesis
File(s): 
Supervisor(s): 
Michel Joffres
Department: 
Faculty of Health Sciences - Simon Fraser University
Thesis type: 
Project (M.P.H.)

Health issues and needs of unsponsored refugee women in Canada: a qualitative study

Author: 
Peer reviewed: 
No, item is not peer reviewed.
Date created: 
2010
Abstract: 

Little is known about the unsponsored refugee women in Canada and about their health in particular. Through interviews with 11 unsponsored refugee women living in greater Vancouver area, this research project focuses on their health issues and needs. In order to better understand how their health is grounded in the varied historical and current contexts of their lives, through powerful narratives and stories of women, I document their own perspectives on health, the multiple factors that affect their health outcomes, and the pathways to care. I use qualitative methodology and a critical theoretical framework informed by intersectionality to study these aspects of health. Through intersectional analysis I illustrate how their experiences of health, health outcomes, determinants of health and pathways to care are shaped by intersecting circumstances of lived experiences, multiple identities and the larger social, political and economic processes and contexts within which they live.

Document type: 
Thesis
File(s): 
Supervisor(s): 
Rochelle Tucker
Department: 
Faculty of Health Sciences - Simon Fraser University
Thesis type: 
Thesis (M.Sc.)

Silence is golden: an exploration of local opposition to a Canadian gold mine project in Costa Rica

Peer reviewed: 
No, item is not peer reviewed.
Date created: 
2010
Abstract: 

Significant changes in the global gold industry have altered where the operations of mining corporations are located, how they are developed, and the impact they have on local communities. Despite efforts to incorporate sustainable development frameworks into industries’ operations, considerable negative health and environmental impacts associated with gold mining continue to affect local communities and their global allies. This paper explores the conflict between economic interests and environmental protection efforts involved in the gold mining sector through examining the Canadian-owned Crucitas gold mine project in Costa Rica. The corporation’s plans to develop the project have provoked a nation-wide grassroots movement against foreign-owned mineral extraction operations. The resistance has emerged out of concern that these operations are compromising the communities’ health and the ecological value of the region. The paper aims to uncover the complexities that underlie the experiences of local communities and their struggles to resist such operations.

Document type: 
Thesis
File(s): 
Supervisor(s): 
John Calvert, Lorraine Halinka Malcoe
Department: 
Faculty of Health Sciences - Simon Fraser University
Thesis type: 
Project (M.P.H.)