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

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The Role of the Retinoblastoma Protein on Hypoxia-Inducible Factor Dependent Tumor Cell Transformation: Microarray Validation

Peer reviewed: 
No, item is not peer reviewed.
Date created: 
2015-08-26
Abstract: 

Intratumoral hypoxia results in tumour cell adaptations mediated by the hypoxia inducible factor 1-α (HIF1-α) and its dimerization partner the aryl hydrocarbon receptor nuclear translocator (ARNT). This process is attenuated by the retinoblastoma protein (Rb) via its association with the thyroid hormone receptor/retinoblastoma interacting protein (TRIP230). This study’s aim was to examine the role of Rb on HIF1 tumour cell transformation. By interrogating the transcriptome of human MCF-7 and LNCaP cells using gene expression microarrays, we developed a list of 21 common HIF1 target genes further up-regulated following loss of Rb. Real-time PCR, immuno-blotting and immuno-cytochemistry were used to validate mRNA and protein levels of genes. Wound healing assays were used to measure cell migration following loss of Rb and hypoxia. Results show loss of Rb exacerbates the expression of HIF1 genes associated with neuroendocrine differentiation; however no change in cell migration was observed.

Document type: 
Thesis
File(s): 
Senior supervisor: 
Timothy Beischlag
Department: 
Health Sciences: Faculty of Health Sciences
Thesis type: 
(Thesis) M.Sc.

Social marketing: Pitfalls and promise for change

Author: 
Date created: 
2015-07-29
Abstract: 

Background: Since 1971, social marketing (SM) has been adopted as a behaviour change approach to address various social issues, including those of public health and the environment. In a context of proliferating health promotion and intervention approaches, as well as a changing communication environment, SM as a field has had to respond to various challenges. The purpose of this research was to explore the current context of SM, understand the challenges to the practice of SM, and explore its fit as a strategic framework within a broader set of public health oriented social change planning and implementation approaches currently in use. Specifically, the research objectives were to a) explore how the core constructs of SM were being represented and implemented, b) identify the challenges practitioners were facing in adopting and implementing SM, and c) assess the current position of the discipline within the broader social change landscape through three unique assessments. Methods: A multiple methods case study research design was employed to address the research objectives. First, semi-structured interviews were conducted with renowned experts/leaders (n = 16) in the field of SM. Next I carried out a scoping review of literature examining the use of SM in the prevention of chronic disease. Finally, semi-structured interviews with practitioner end users (n = 9) of SM elicited their perspectives and provided, along with the other studies, data for exploring how to design SM so that it is an accessible and desirable tool for social change. Results: Results of each study are reported separately before integration, however, data from across all three resulted in consistent themes. Data from experts, the scoping review, and end users illustrated strong endorsement of the approach, but concerns about its current directions and status were acknowledged. Although SM has reportedly achieved success in its efforts, results highlighted challenges for the discipline of SM. Assertions for SM included the need for consensus about appropriate benchmark criteria, more effectiveness studies, inconsistencies in the application of SM approaches, the need for continued and sustained leadership, and the ability to be innovative in the design and delivery of social marketing efforts. Diffusion of Innovations theory provided a useful framework for summarizing the critical considerations that may enhance the continued sustainability of SM as both an approach to social change in public health and as a discipline. Conclusion: This dissertation provides a unique glance at how SM can be adapted to better serve academics and practitioners in their pursuit of behavioural and upstream change objectives. Relevance, evidence, audience perspective and leadership must all be considered to move SM forward as a primary tool for social change.

Document type: 
Thesis
File(s): 
Senior supervisor: 
Kitty Corbett
Department: 
Health Sciences: Health Sciences
Thesis type: 
(Dissertation) Ph.D.

Examination of HIV evolution in response to host pressures

Author: 
Date created: 
2015-06-12
Abstract: 

The overarching aim of this thesis was to study the evolution of HIV-1 in response to host pressures. The main data chapter comprises a detailed HIV-1 transmission study where we identified a putative case of X4 HIV-1 transmission from a CCR5-wt/wt donor to a recipient homozygous for the naturally-occurring 32 base pair deletion in the CCR5 gene (CCR5-∆32/∆32). This rare genotype confers resistance to infection by CCR5-using (“R5”) HIV-1 strains not CXCR4-using (“X4”) strains. Using ultradeep sequencing and phylogenetic analysis, we estimate the number of founder viruses that established infection in both donor and recipient (one in each case), reconstruct their sequences, and study within-host HIV-1 evolution and coreceptor usage. Notably, results suggest that HIV-1 infection in the recipient was initiated by transfer of an infected cell (i.e. not a virion) from the donor, and reveal differential HIV-1 evolution in both members of the pair.

Document type: 
Thesis
File(s): 
Senior supervisor: 
Zabrina Brumme
Department: 
Health Sciences: Health Sciences
Thesis type: 
(Thesis) M.Sc.

Banging down doors: parents' experiences of gaining access to autism care services

Author: 
Date created: 
2015-04-22
Abstract: 

Although a great amount of attention has been recently paid to the state of autism care services in Ontario, little of this attention has been focused on the services for school-aged children and the services in rural-remote regions. This study presents the access experiences of three parents of school-aged children (ages 4-12) in Northwestern Ontario. Parents take on the role of the Navigator-Advocate in order to facilitate access to services for their child in three identified systems: education, health and medical services, and community-based services. Key themes in parents’ experiences include having their experience of a service being dependent on a particular individual, a lack of compassionate understanding from others, insufficiently educated service providers, and exclusion. Parents’ experiences of access could be ameliorated through the development of an integrated care model for autism that is responsive to navigational experiences and the geographical and human resource challenges of Northwestern Ontario.

Document type: 
Thesis
File(s): 
Senior supervisor: 
Malcolm Steinberg
Department: 
Health Sciences:
Thesis type: 
(Thesis) M.P.H.

Intersecting Risk Factors: Diagnosed Alcohol Dependence and Criminal Sentencing in British Columbia’s Aboriginal Populations

Date created: 
2015-04-14
Abstract: 

Alcohol use is commonly reported as a short-term criminal risk factor; however there is minimal research on long-term effects of alcohol misuse on crime. Canadian Aboriginal offenders exhibit both disproportionate crime and alcohol disorder prevalence. This thesis examines the impact of diagnosed alcohol dependence on Aboriginal ethnicity and criminal sentencing in British Columbia (BC). An administrative linkage database was used to develop a retrospective cohort of 77719 offenders sentenced through BC courts from 2001-2010. A coefficient difference mediation analysis was used to evaluate the mediating effect of alcohol dependence. Adjustment for alcohol dependence rate resulted in a small and statistically insignificant change in the sentencing rate (2%, 95% Confidence Interval: -13%, 14%). This study demonstrates that alcohol dependence does not have a mediating effect on sentencing rate among BC offenders. Nonetheless, the prevalence of alcohol dependence suggests that alcohol misuse is an important health policy target among offenders.

Document type: 
Thesis
File(s): 
Senior supervisor: 
Lawrence McCandless
Department: 
Health Sciences:
Thesis type: 
(Thesis) M.Sc.

A Qualitative Exploration of Injection Cessation among Youth in Vancouver, BC

Date created: 
2014-10-10
Abstract: 

Cessation of injection drug use among youth is an important public health objective that has potential to reduce injection-related harm. We undertook this qualitative study to examine experiences of injection cessation and relapse among young people living in Vancouver, BC. Participants were recruited from the At-Risk Youth Study (ARYS), a longitudinal cohort of street-involved youth who use illicit drugs. Twelve semi-structured interviews were conducted with 7 females and 5 males, ages 20 to 30 years. Interviews were audio-recorded, transcribed verbatim, and a thematic analysis was conducted, drawing on the risk environment framework. In this study, facilitators of injection cessation were low-barrier and integrated youth services, supportive housing, access to methadone maintenance therapy (MMT), and the use of marijuana. Based upon these findings, recommendations for promoting injection cessation include increasing access to low-barrier supports for youth, and promoting non-injection routes of administration to reduce the health consequences of injection drug use.

Document type: 
Thesis
File(s): 
Senior supervisor: 
Cari Miller
Department: 
Health Sciences:
Thesis type: 
(Thesis) M.Sc.

Exploring Academic and REB Members' Attitudes Toward Post-trial Access

Author: 
Date created: 
2014-09-05
Abstract: 

There is currently no international consensus around post-trial obligations toward research participants, community members, and host countries. This literature review and interview-based study investigate arguments and attitudes toward post-trial access. The literature review found that academic discussions focused on the rights of research participants, but offered few practical recommendations. Similarly, there are few regulations or legislation pertaining to post-trial access. Interviews with REB members indicated that respondents understood post-trial access to the intervention as being the role of the state, and many of the views on benefits were shaped by the fact that respondents were based in Canada. Since REB members are uniquely influential as gatekeepers of clinical trials and research, more information on their views and attitudes is particularly important. If regulatory changes are necessary, we need to understand the current arguments, legislation, and REB members’ attitudes towards post-trial access and participants, community members, and adolescents.

Document type: 
Thesis
File(s): 
Senior supervisor: 
Jeremy Snyder
Department: 
Health Sciences: Faculty of Health Sciences
Thesis type: 
(Thesis) M.P.H.

Facilitators and barriers to public bike share adoption and success in a city with compulsory helmet legislation: A mixed-methods approach

Author: 
Date created: 
2014-08-21
Abstract: 

Public bike share (PBS) programs offer a flexible and convenient transport option that may also offer public health benefits from increased physical activity. Emerging evidence suggests several factors as important to bike share use, but little data exists from users where bicycle helmets are required. We completed two surveys, one a randomised telephone survey of Vancouver residents (n=901), and the other an observational survey of helmet use amongst cyclists in downtown Vancouver (n=4126). We also conducted a content analysis of print news articles to identify bike share topics and framing (n=62). We found that infrastructure and weather would be the most important considerations to bike share users. Overall, helmet use was high, but varied by personal and trip characteristics. The news media reported bike share topics in line with new policy developments, but framing depended on the media source. These findings suggest that efforts to increase system uptake should target the cycling infrastructure environment.

Document type: 
Thesis
File(s): 
Senior supervisor: 
Meghan Winters
Department: 
Health Sciences: Faculty of Health Sciences
Thesis type: 
(Thesis) M.Sc.

The adoption of Health Impact Assessments in the Mongolian mining sector: A case study of the diffusion of policy innovation

Date created: 
2014-08-07
Abstract: 

Mongolia’s rapid economic growth, propelled by rapid development of the extractives sector requires that the country be better prepared for potential negative impacts to the health of the people and the country. People are both excited for the remarkable development opportunities that mining promises and are concerned with the potential social, environmental and health risks it could bring. As a country highly dependent on the mining sector, Mongolia has realized that it needs to develop a strategy and institutional process to manage the public health impacts of mining activities. With the support of an SFU-based team of researchers and policy advocates, Mongolia is thus in the process of adopting Health Impact Assessments (HIA), a policy innovation tool that has potential to inform the decision making process through assessing underlying health problems and generating evidence-based recommendations. However, the values, principles, methods and deliverables of HIA are not easily understood in capacity-limited Low and Middle Income Country (LMIC) settings, including Mongolia, which makes full adoption and proper use of HIA a difficult process to achieve. The overall goal of the research was to evaluate the uptake and adoption rate of the HIA concepts, tools and methods in the emerging Mongolian mining sector. This evaluation process involved key informant interviews, observations, literature reviews and policy analysis as data collection methods. To understand the processes of HIA adoption, the theory of the Diffusion of Innovations (DOI) was used as an analytical lens. Analysis of HIA adoption processes suggested that DOI theory was a useful framework to understand and improve the rate of uptake of new public health policy innovations such as HIA in that it assists with understanding both the attributes of innovation and the communication actions that influence adoption. The existing literature on HIA lacks analysis of how it is adopted and implemented in diverse settings. This research thus contributes to the knowledge needed to inform discussion of how to improve the rate and success of HIA adoption. I conclude that the adoption of systematic methods to manage the public health impacts of mining in Mongolia, centered on the HIA, is generally off to a good start. However, there are many remaining challenges, including: a lack of government leadership, poor collaboration between relevant public and private institutions, low levels of capacity to conduct and evaluate HIAs, poor quality or non-existent baseline data. These challenges will need to be addressed in order to keep the momentum going. Following from the research, I offer the following recommendations: to develop HIA management system, to implement existing MoU between relevant ministries, to create HIA training center, and to enact an independent HIA law. In conclusion, the currently legislated system, which incorporates HIAs into a newly redesigned licensure system based on international standard environmental impact assessment methods, must be implemented. Ideally, the development of an independent HIA system will be required if Mongolia is to build and sustain an effective public health system in mining-affected regions.

Document type: 
Thesis
File(s): 
Senior supervisor: 
Craig R. Janes
Department: 
Health Sciences: Faculty of Health Sciences
Thesis type: 
(Thesis) Ph.D.

"The way I see it": Towards a Community-informed understanding of the relationship between housing and health among people living with HIV in Vancouver, B.C.

Author: 
Date created: 
2014-04-22
Abstract: 

Background: Vancouver, British Columbia has one of the highest HIV prevalence rates in Canada and a growing housing crisis. The limited data available on the impact of housing instability on the health of people living with HIV in this setting has been generated without meaningful involvement of the community. In order to fill this gap, we launched a community-based research project aimed at developing an understanding of the housing-health nexus that is grounded in the experiences of people living with HIV. Methods: Eight Community Researchers – people living with HIV who have experienced homelessness in Vancouver - were recruited and trained by the Project Coordinator to co-facilitate this community based participatory action research project. The Project Coordinator proposed the use of Photovoice to ensure the meaningful engagement of the Community Researchers. Photovoice is a research method that assists people, often marginalized by social-structural inequity, to reflect on their capacities and needs, engage with policymakers and encourage social change. Results: The Community Researchers generated over 300 photographs and engaged in facilitated discussion with the Project Coordinator to identify emergent themes. The Community Researchers described the detrimental impact of inadequate housing on their physical and mental health, and the resiliency promoted by healthy environments. The analysis culminated in the development of a multi-level ecological framework mapping the determinants and impacts of housing instability in this population, representing the first step towards building a comprehensive, community-informed definition of healthy housing as viewed through the eyes of people living with HIV. Interpretation: The findings underscore the need to expand the focus of housing strategies to incorporate the broader political, economic and social context, and to meaningfully engage affected populations in developing policy and programming targeting housing instability.

Document type: 
Thesis
File(s): 
Senior supervisor: 
Robert Hogg
Department: 
Health Sciences: Faculty of Health Sciences
Thesis type: 
(Thesis) Ph.D.