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

Receive updates for this collection

Prevalence of menstrual pain and associated risk factors among Iranian women

Author: 
Peer reviewed: 
No, item is not peer reviewed.
Date created: 
2009
Abstract: 

Objective: Dysmenorrhea is a common disorder among women. The aim of this study was to estimate the prevalence of dysmenorrhea and to investigate the associated risk factors in Iranian women. Methods: In a cross-sectional study, 381 women in Tehran, Iran completed a questionnaire regarding dysmenorrhea. Descriptive statistics, spearman rho correlation, and ordinal regression model were used to present the results. The response rate was 72%. Results: The prevalence of no, mild, moderate, and severe menstrual pain was 9.8%, 40.9%, 27.5%, and 21.7% respectively. The mean age at menarche was 12.3 years. Age, socioeconomic status, fruit and vegetable intake, fatty diet, stress level, and family history of dysmenorrhea were all associated with menstrual pain. There was no association between BMI, parity, smoking, and physical activity with dysmenorrhea. Conclusion: menstrual pain is a common complaint in Iranian women. By identifying modifiable risk factors, recommendations could be made to reduce dysmenorrhea.

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

How do community health centres evaluate their effectiveness in meeting the needs of their Aboriginal clients?

Author: 
Peer reviewed: 
No, item is not peer reviewed.
Date created: 
2009
Abstract: 

Aboriginal peoples in British Columbia experience serious health disparities, including higher rates of disease, lower life expectancy and higher hospital utilization rates, compared to the non-Aboriginal population. Community-based clinics are a promising model of primary care for vulnerable populations for the following reasons: focus on prevention and cost-effectiveness, and responsiveness to community needs. Community-based clinics are in place in many regions of British Columbia, and several of these serve a largely Aboriginal client population. This research project asked whether and how these clinics evaluate effectiveness in meeting the needs of Aboriginal clients. Although formal evaluations had not been conducted by all clinics, interviewees believed that the system of integrated healthcare offered by the community clinic model was successful at meeting the needs of their Aboriginal clients because the multi-disciplinary approach met complex client needs, and because they gained the trust of their communities and remained responsive to community needs.

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

Medical migration: options and responsibilities for the “brain drain”

Peer reviewed: 
No, item is not peer reviewed.
Date created: 
2009
Abstract: 

Various strategies have been proposed in the literature to reduce medical migration or ‘brain drain’ and mitigate its effects on health status. This paper outlines an ethical framework and uses it to examine these strategies, emphasizing the goal of a basic level of health care for all people, the protection of rights and the fostering of responsibilities, and the prioritization of the least-advantaged. A social connection model of responsibility is used to consider the different duties of migrants, source countries, destination countries, and global institutions. Solutions which change the inequities driving medical migration are preferable to those which simply reduce the harm resulting from the phenomenon.

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

Assessing Canada’s compliance with the core capacities of surveillance and response of the International Health Regulations (2005): a case study of the 2008 listeriosis outbreak

Peer reviewed: 
No, item is not peer reviewed.
Date created: 
2009
Abstract: 

Member states of the World Health Organization are expected to develop and maintain public health systems compliant with the Core Capacities of Surveillance and Response of the International Health Regulations(2005). Compliance with Core Capacities is intended to promote a local response sufficient to control public health emergencies of international concern. The 2008 listeriosis outbreak provided an opportunity to assess Canada’s compliance with the IHR(2005). The activities and events of the outbreak were reconstructed using media and government reports, then assessed according to Core Capacities of detection, reporting, response, confirmation and risk assessment. Canada was deemed partially compliant with the IHR(2005) Core Capacities, as they were exhibited during the listeriosis outbreak. Resources and technical capacities of public health exhibited the potential to comply; however, obstacles in public health governance, policy and politics introduced delays in detection, investigation and risk communication of the outbreak, and uncertainty in setting direction for public health.

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

Community-based injury prevention: recommendations for Vancouver's North Shore

Peer reviewed: 
No, item is not peer reviewed.
Date created: 
2009
Abstract: 

Background: Injury is a major cause of hospitalization and death across all age groups in Canada, British Columbia and Vancouver’s North Shore. Injury prevention saves lives, reduces disability and reduces the economic burden on our health care system. Methods: In this study, I reviewed the components of community-based injury prevention strategies and investigated the barriers to implementing a community-based injury prevention program on the North Shore. Findings: Lack of surveillance, awareness, accountability, coordination, resources and evaluation pose significant barriers to the implementation of an injury prevention strategy on the North Shore. Successful community-based injury prevention models require community participation, multidisciplinary collaboration and adapting interventions to local context. The Safe Communities model is discussed as a framework for community-based injury prevention. A comprehensive community-based injury prevention strategy is recommended to reduce the local burden of injury on Vancouver’s North Shore.

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

Perceptions of HIV and fertility among adolescents in Soweto, South Africa: stigma and social barriers continue to hinder progress

Author: 
Peer reviewed: 
No, item is not peer reviewed.
Date created: 
2009
Abstract: 

The scale up of highly active antiretroviral therapy (HAART) has raised new concerns regarding stigma associated with HIV and childbearing. High rates of infection and fertility make adolescents a crucial demographic to qualify perceptions of HIV and childbearing. Two focus groups were conducted with participants ascertained from an HIV adolescent community advisory board in Soweto, South Africa. Grounded theory, as a method of qualitative analysis was used to draw thematic conclusions. Adolescents raised concern over re-infection by HIV positive couples and justified the attitude that infected partners should adopt when faced with fertility desire. Also, participants spoke of a need to revise adolescent sexual and reproductive health services in a way that addresses stigma generated by community healthcare workers. This study should be used as preliminary findings to guide future research, both qualitative and quantitative, which further explores motivations for negative attitudes towards HIV and childbearing.

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

Diabetes prevalence and associated risk factors among Canadians of South Asian origin: estimates from a national survey

Author: 
Peer reviewed: 
No, item is not peer reviewed.
Date created: 
2009
Abstract: 

International evidence suggests that prevalence of type 2 diabetes (T2D) is higher among people of South Asian origin, however, limited information exists about T2D in Canadians belonging to this ethnic group. This study estimates the prevalence of self-reported T2D and assesses its relationship with demographic, socioeconomic and lifestyle factors in South Asians using data from the 2003 Canadian Community Health Survey, Cycle 2.1. Canadians of South Asian origin were compared with following ethnic groups: Whites, Chinese and Aboriginals. Descriptive statistics and odds ratios were calculated. T2D prevalence varied by ethnicity with South Asians having one of the highest rates (8.0%). Independent of age, sex, household income, education, body mass index and physical activity, South Asians had higher odds (2.9) of T2D compared with Whites. T2D occurred at a younger age and at lower body mass in this ethnic group compared with Whites.

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

Patient comprehension of HIV antiviral drug resistance: implications for treatment and clinical practice

Peer reviewed: 
No, item is not peer reviewed.
Date created: 
2009
Abstract: 

A patient’s health literacy can affect their decisions regarding treatment. Patient knowledge of developing HIV drug resistance and their treatment outcomes were explored in a cohort of HIV+ persons on HAART. Data was obtained from the Longitudinal Investigation into Supportive and Ancillary health services (LISA) study and a linkage with the Drug Treatment Program (DTP) at the BC Centre for Excellence in HIV/AIDS. Less than 4% completely defined HIV resistance and 20% reported not discussing resistance with their physician. The model showed discussing medication with physicians and receiving counseling by a pharmacist are predictive of completely or partially defining HIV antiviral drug resistance. Understanding of HIV resistance showed no differences in clinical variables, however, overall adherence and complete understanding of HIV resistance is low. If patient knowledge were improved through discussions with physicians and pharmacists, the potential exists to enhance overall adherence and treatment outcomes in a self-management system.

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

Taking care of their own: Mysore sex workers unite in leading HIV/AIDs prevention

Peer reviewed: 
No, item is not peer reviewed.
Date created: 
2009
Abstract: 

This paper discusses how commercial sex workers in Mysore, India have accepted and taken ownership of an HIV/AIDS prevention program focused on improving their health. The researcher collected data while in Mysore on a practicum for three months. Information was collected through in-depth interviews, focus groups, speaking with key informants, reviews of office documents and participant observation. The HIV prevention project was implemented in 2004 and its success has been due largely to the fact that the community was placed at the forefront since inception. The sex workers in Mysore formed a collective called ‘Ashodaya Samithi’. They have been actively involved in the decision-making process throughout the evolution of the project and have been empowered to make healthier choices. Community ownership will be taken to a new level when the project is handed over to them at the end of 2009 in order to become a sustainable community-based organization (CBO).

Document type: 
Thesis
File(s): 
Supervisor(s): 
J
Department: 
HIV/AIDS; Empowerment; Sex Workers; India; Avahan; Community Ownership - Simon Fraser University
Thesis type: 
Project (M.P.H.)

Perspectives on methyl mercury exposure locally, nationally, and globally

Author: 
Peer reviewed: 
No, item is not peer reviewed.
Date created: 
2008
Abstract: 

Methyl mercury exposure by consumption of fish and marine mammals is associated with a variety of negative health outcomes, particularly during early developmental stages. In British Columbia, there is a lack of knowledge relating to exposures in the freshwater angler population, identified elsewhere as a population at risk. Exposure assessment methods can help to characterize the risk to populations from dietary fish consumption. In Canada, the Aboriginal population is particularly vulnerable due to traditional dietary intake of fish and marine mammals; however, managing the risk from methyl mercury needs a careful approach as changing cultural practices can negatively affect social determinants of health. Globally, the use of mercury in gold mining is increasing exposure to methyl mercury among communities consuming contaminated fish. An informed understanding of patterns of exposure, health outcomes, and culture provides a basis to construct effective policies for the protection of human health.

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