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

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Improving hand hygiene compliance for the reduction of nosocomial infections: recommendations for behaviour change in a health care setting

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No, item is not peer reviewed.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

Nosocomial infection rates are highly dependent on hand hygiene compliance within health care facilities. This paper examines the literature concerning elements of effective hand hygiene interventions and relevant behaviour change theory, in addition to current practice surrounding hand hygiene interventions in leading institutions, in order to inform and propose recommendations for the improvement and success of the University Health Network’s current hand hygiene initiative. The results of these literature reviews support the use of the Theory of Planned Behaviour for promoting successful behaviour change in the context of hand hygiene compliance in health care settings. Further, the findings here suggest that the employment of an intervention that is tailored to the specific barriers and facilitators of a given setting, that evokes support from multiple levels within the institution, and one that is multifaceted, will be more likely to achieve sustained improvement in hand hygiene compliance and reduced nosocomial infection rates.

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

Mining Mongolia: resource access, climate change and vulnerability on the steppe

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No, item is not peer reviewed.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

Pastoralism, a sustainable enterprise appropriate to the fragile steppe ecosystem, accounts for 30% of Mongolia’s gross domestic product. The transition to a liberal market economy, which began in 1990, opened up pastoral lands to mining development. Subsequently, conditions began to change on the rangelands, affecting household ability to herd. Mining adversely affects ecosystem health, already vulnerable due to climate change, and household well-being by limiting access to water, pasture and mobility, with the requisite privatization of land. However, a paradox exists: the mines that deplete and pollute the lands and waters on which pastoralists depend provide income opportunities for herders attempting to cope with the effects of climate change. Employing an ecosystem health approach, this study examines the political, social, economic, and health impacts of mining development on rural herders in the context of broader environmental change.

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

Breast cancer screening in British Columbia: implications of diagnostic trajectories

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

Despite reductions in mortality rates, breast cancer remains the most common cancer and the second most common cause of cancer death in Canadian women. Organized screening programs have contributed to the decrease in breast cancer mortality by allowing for early diagnosis and treatment. The diagnostic phase following an abnormal screen has implications for patient well-being, clinical practice, and resource management in health care. We present data from British Columbia that show that improvements at the diagnostic phase are necessary in order to capitalize on the benefit offered by breast cancer screening. The results are discussed in the context of population and public health practice, and recommendations for further study and improvement of the efficiency of the diagnostic phase are suggested.

Document type: 
Thesis
File(s): 
Supervisor(s): 
M
Department: 
Not in list supplied - Simon Fraser University
Thesis type: 
Project (M.Sc.)

The use of lay counsellors for the prevention of mother-to-child transmission of HIV: a case study of Botswana’s national PMTCT programme

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

Through the successful implementation of prevention of mother-to-child transmission of HIV (PMTCT) interventions, paediatric AIDS has been largely eliminated in high-income countries. A number of factors, however, continue to impede the scale-up of PMTCT programmes in many Sub-Saharan African countries. One of the largest barriers to the scale-up of PMTCT programmes is the shortage of trained health workers. The health workforce crisis is contributing to the on-going high child mortality rates due to AIDS in Southern Africa despite the fact that there are affordable prevention mechanisms available. Innovative solutions are needed. This paper explores the implementation of one type of human resource intervention in Botswana’s national PMTCT programme aimed at addressing health worker shortages in order to scale-up PMTCT coverage and access – the Lay Counsellor. Botswana’s experience provides a potentially useful model for other countries in the region facing similar HIV epidemics in the context of health professional shortages.

Document type: 
Thesis
File(s): 
Supervisor(s): 
C
Department: 
Not in list supplied - Simon Fraser University
Thesis type: 
Project (M.Sc.)

New information and communication technologies to communicate with patients: text messaging

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

New information and communication technologies such as cell phone communication hold great potential for improvements in health care access and delivery. This paper addresses the use of text messaging for patient communication. It includes a case study that is one of the first to examine the use of text messaging to notify patients of STD results. Findings from 2 focus groups with 15 participants from an urban STD clinic show patients reacted positively regarding the use of text messages. Reasons for positive reactions include ease of use; privacy, convenience; control over the process; and the speed of receiving and responding to a text message. Participants’ concerns about sending health information over text message include lack of privacy; and access to cell phone and cost. The new information age and the availability of internet and computers have created room for the advancement of communication in health.

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

An analysis of the constraints and opportunities for scaling-up health human resources in the delivery of a non-pharmacological intervention for the treatment of depression in Uganda

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

The use of non-pharmacological interventions for the treatment of depression is evidence-based, effective and has been successfully used in many developed countries. Evidence for the usage of these types of interventions to treat depression in developing countries is not as widespread. However, two recent randomized control trials have demonstrated that a non-pharmacological intervention, specifically group interpersonal therapy (IPT), can be successful on a small-scale in Uganda to treat depression. Following a call to action by the international mental health community to act on the significant burden of depression that is afflicting the developing world, this report seeks to analyze the opportunities and constraints for scaling-up the health human resources needed to deliver this evidence-based intervention on a larger scale. This analysis was conducted by examining a previously published framework for scaling-up a health intervention in a resource-poor setting.

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

Changes in food habits among Farsi and Dari speaking immigrant women in British Columbia, Canada

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

Changes in dietary habits due to international migration have been associated with chronic diseases including obesity, hypertension, cardiovascular disease and non-insulin dependent diabetes mellitus in immigrant populations. Four focus groups (n= 20) were conducted with the objective to provide information on food habit changes and the influencing factors on such changes in Farsi and Dari-speaking immigrant women after migration from their home countries to British Columbia, Canada .The findings of this study show that women believe that a variety of factors have led to changes in their dietary patterns. Major factors for change were children’s preference, work schedules, social relations, stress, weight concerns, digestion problems, food insecurity, taste, and positive culinary influence from different cultures in Canada.

Document type: 
Thesis
File(s): 
Supervisor(s): 
R
Department: 
Not in list supplied - Simon Fraser University
Thesis type: 
Project (M.Sc.)

The health care sector’s response to women impacted by abuse: barriers and strategies

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

Violence against women is established as a determinant of health with adverse health related consequences. A significant number of women in Canada each year are affected. Health care professionals are in a unique position to assist women impacted by violence. Unfortunately, these women experience numerous barriers to accessing appropriate health care. The findings from an environmental scan conducted at BC Women’s Hospital and Health Centre revealed various barriers for women affected by violence, both structurally and directly resulting from the abuse, that prevent them from accessing appropriate care. The study also revealed several strategies to reduce barriers and increase access to care for women affected by abuse.

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

Community engagement in global health research: case studies from the developing world—the Zomba District, Malawi case study

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

Community engagement influences the success of research. Investigators conducting international research necessitate an understanding of effective practices in community engagement. This case study examines the practice of community engagement in Zomba District, Malawi as part of a larger multiple case studies design with the objective of elucidating global practices of community engagement. Poverty and disease are widespread in Malawi. Dignitas International, an academic NGO, implemented a community home-based care model for HIV/AIDS services including an Information, Education, and Communication (IEC) community engagement component in Zomba in 2004. This research is based on the analysis of 26 interviews with key informants affiliated with the Dignitas IEC program. The success of the IEC program is influenced by a perception of community ownership and assurance the program can be sustained. Maintenance of the IEC program is dependent on financial, technical, and motivational support for those carrying out IEC activities.

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

Foreign born tuberculosis in Canada: Are current screening and control practices working?

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

Western countries including Canada have seen a steady decline in the incidence rates of tuberculosis (TB) since the advent of anti-tuberculosis drugs in the 1940s. However, less developed nations continue to struggle with high incidence rates as a result of inadequate prevention and treatment programs. The relatively high influx of immigrants from high-incidence countries poses a public health risk for individuals in low-incidence countries, such as Canada. This paper seeks to determine if TB prevention and control programs in Canada are adequately equipped to handle foreign-born TB (FB TB) cases and what improvements, if any, can be made to the current reporting and surveillance system. An overview of screening and surveillance procedures from a range of other countries is used to provide a basis for comparison and recommendations, as is an analysis of data from the Canadian Tuberculosis Reporting System (CTBRS).

Document type: 
Thesis
File(s): 
Supervisor(s): 
Steven Corber
Department: 
Not in list supplied - Simon Fraser University
Thesis type: 
Project (M.Sc.)