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

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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No, item is not peer reviewed.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No, item is not peer reviewed.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.)

Integrating health objectives into the urban planning process: Silverdale study

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No, item is not peer reviewed.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

This paper describes the process of integrating health objectives into a neighbourhood design plan for the area of Silverdale in Mission, BC. In collaboration with urban planners, land owners, technical consultants, District staff and community residents, a Design Brief was developed to guide the development of a sustainable neighbourhood plan for Silverdale. The process involved working collaboratively across multiple sectors to establish planning principles for the development, soliciting public input into the process, and developing goals and objectives for each of the planning principles. The process was rooted in sustainable development theory, a key pillar of which is individual and community health. Individual and community health was fleshed out and health objectives were integrated in a deliberate way into the planning process using Trevor Hancock’s Basic Framework for Indicators as a guide. Lessons were learned throughout the process that may provide insight to future healthy and sustainable urban planning.

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

Alcohol, tobacco and illicit drugs among youth: Exploring Epidemiological trends and school-based drug prevention programs

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No, item is not peer reviewed.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

The use of alcohol, tobacco and illicit drugs is very common in British Columbia and in Canada. The burden of suffering associated with substance use problems is significant. This paper examines the epidemiological trends in use of alcohol, tobacco and illicit drugs among youth on the North Shore. I also present selected indicators of substance use issues and pr evention initiatives implemented by Vancouver Coastal Health to reduce the damage associated with the use of these substances. In addition, I explore empirical research, especially data generated from evaluation research in the implementation of school-based drug prevention programs. Attention is paid to assumptions and theories that underlie these educational interventions. The information presented here can be useful to inform Vancouver Coastal Health’s decisions with respect to prevention and policy approaches to identify and address substance use issues in the community.

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

Epidemiology of Lyme disease in BC residents from 1997-2006

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

Lyme disease (LD) is a bacterial infection transmitted through the bite of infected ticks. This research sought to clean and reconcile the data held within three databases at the BC Centre for Disease Control (BCCDC). The goal was to determine an accurate count of LD infections from 1997-2006. Through this process demographic characteristics would also be revealed. Capture-recapture (CR) methodology was applied to the data to in order to estimate the total, potential population and then finally the confirmed cases were overlaid against suspected ecological niches. This research indicated that 68 confirmed cases were reported in British Columbia. The majority of cases were male and <41 years of age. CR- methodology suggested that the total number of LD cases could be 137 (CI: 23 – 784) highlighting possible gaps in the existing surveillance and reporting structures. Finally, after overlaying confirmed cases against suspected ecological niches, there was 94% model accuracy.

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

Using socio-economic status and media use to predict excess weight in adolescent girls attending school in Kolkata, India

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

The health problems associated with obesity and overweight have been recognized as public health problems affecting populations worldwide. Increases in the prevalence of obesity are documented in all ages, in both developed and developing countries. Younger age groups deserve particular attention in obesity prevention since the long-term consequences of overweight persist into adulthood. This study draws on data collected from the Kolkata Girls’ Health Survey, a cross-sectional study examining health issues of girls in Kolkata, India (n=373). The objective of this study was to examine socio-economic status and media use as predictors of overweight. Results: A higher level of parental educational attainment was significantly associated with overweight. Greater levels of media use were associated with higher socio-economic status, but not with overweight. Subsequent analyses need to explore other aspects related to socio-economic status such as diet and physical activity, which are likely to contribute to overweight in adolescent girls.

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

Task shifting in Malawi: the role of expert patients

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

The human resources shortage in sub-Saharan Africa is having a devastating impact on a region of the world already struggling under the pressure of HIV/AIDS. The number of people requiring medical attention greatly outweighs the number of skilled health workers. As a result, health professionals work under stress and without adequate support, and patients are not receiving adequate attention. To fill gaps in care, countries have adopted task shifting techniques to utilize lower cadres of health for basic health duties. As an example, Dignitas International has developed an Expert Patient Program at Tisungane clinic in Malawi to alleviate the workload of nurses and clinicians. The model has been successful in its goals, but not without challenges. For task shifting initiatives to be a sustainable solution to the health worker shortage, lower cadres of health must be part of the formal health care sector, have clear objectives and good training.

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

Rural seniors’ access to health care: a review of the issues in developing countries and an illustration from grandmothers in rural South Africa

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

The number of older people globally is rapidly increasing, as are their health care needs. In developing countries, where governments already struggle to provide adequate health care to their general populations, seniors experience tremendous barriers in accessing health care. This paper explores the concept of access and the challenges older people in developing countries face in obtaining health care. It also presents research done in a remote rural area of South Africa to identify health access challenges of grandmothers of AIDS orphans. Methods included a survey (N=50) and additional staff interviews. Participants experienced similar barriers to accessing health services as do seniors in other developing countries: distances to health centres, inability or challenges walking due to health conditions that come with ageing, lack of roads, costs of transportation, and lack of time due to household responsibilities. More effort is needed to meet the health needs of this older generation.

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

An integrated supervised injecting program within a care facility for HIV-positive individuals: A qualitative evaluation

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

To date, little attention has been given to the potential role supervised injecting programs could play in the care for HIV-positive injection drug users (IDU). We analyzed semi-structured interviews with HIV-positive IDU and healthcare staff regarding a supervised injection program integrated in an HIV focused care facility. Participant and staff reports indic ated that the integrated supervised injection program promoted safer injection practices and influenced access to care by fostering more open relationships, facilitating engagement in safer injection education and improving the management of infections. Participants and staff viewed the program as facilitating the delivery of care through mediating overdose risks and reducing the need to punitively manage drug use onsite. For some participants, however, feelings of shame regarding their substance use complicated uptake of the program. Despite these concerns, our findings highlight the benefits of addressing HIV-positive IDUs’ drug use in the context of comprehensive models of healthcare.

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

Reading between the lines: A comparative analysis of exclusion versus inclusion of grey literature on conventional literature search results when developing a research question.

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

This comparative analysis demonstrates how the inclusion of grey literature changes the understanding of an issue and influences the formation of a research question. Due to various resource constraints, researchers commonly choose a conventional literature search of academic and peer-reviewed journals to search for previous work conducted on the proposed issue. Grey literature is not routinely included as part of this process. Grey literature is information that would not be published in mainstream scientific/peer-reviewed journals, and conventional repositories or otherwise accessible when conducting a literature search. The definition is one that is constantly being redefined and it includes unpublished materials like policy reports, research studies from organizations and community-generated information. This comparison demonstrates the significant implications and contextual value added to the process of research question development through the inclusion of grey literature pertaining to the issues of HIV incidence, harm reduction, and segregation of HIV-positive prisoners in Canada.

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