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

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Mental disorders, substance use disorders and recidivism: exploring a complex inter-relationship in the British Columbia correctional population

Date created: 
2012-04-19
Abstract: 

Abundant research confirms a high prevalence of substance use and mental disorders in correctional samples. It is unclear, however, how these contribute to the risk of repeat offending. The present study examined offence trajectories among a Canadian Provincial population (N= 31,014), and observed that offenders with non-substance related mental disorders were at no greater risk of recidivism than those with no diagnosis. However, odds of recidivism were significantly higher among those with substance use and/or co-occurring disorders. These findings add strength to the emerging conclusion that non-substance related mental disorders are, as a group, less likely to predict recidivism than substance use disorders. Notably, nearly 50% of the offender population had a physician-diagnosed substance use disorder in the five years prior to their index offence. Results are discussed in relation to necessity for evidence-based partnerships between health and corrections sectors that are responsive to both public health and safety.

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

Understanding the oral health needs of government assisted refugees

Date created: 
2012-04-13
Abstract: 

This research examines the oral health needs of Government Assisted Refugees (GARs) living in the communities of Burnaby, Langley and Surrey British Columbia. This secondary data analysis examined access and barriers to dental care, utilization of dental services, dental health practices, self-report and professional assessment of treatment needs and oral health outcomes, by refugee camp status and gender. Interview questions and clinical protocol were those utilized in the Canadian Health Measures Survey, the Inuit Oral Health Survey and the First Nations Oral Health Survey. Results indicate that GARs have high debris, calculus, gingivitis scores and a DMFT score that all suggest a significant unmet oral health need and lack of access to dental services. With limited dental insurance through the Interim Federal Health Program, these findings suggest that an inequality in oral health needs for GARs may exist. Future research should seek to further examine this important public health issue.

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

Injection drug use among homeless adults with mental illness: a gender-based analysis

Date created: 
2011-12-05
Abstract: 

Increasing evidence suggests that women are disproportionately vulnerable to the serious health and social harms associated with injection drug use (IDU). This research examines the prevalence and health correlates of IDU, by gender, among a cohort of homeless adults with mental illness. The Vancouver At Home study is a research demonstration project investigating interventions for people who are homeless and living with mental illness. Participants completed a baseline questionnaire eliciting information on a detailed set of clinical, health, social and substance use measures. In multivariable models adjusting for severity of homelessness, and additionally sex work among females, IDU was positively associated with infectious disease and less severe mental illness. In addition, IDU was associated with the increased use of health and social services, but only among men. These findings suggest that gender-specific harm reduction, prevention and treatment strategies for IDU women should be prioritised as an important public health issue.

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

An assessment of the sexual health of Asian gay and bisexual men in B.C.

Author: 
Date created: 
2010-06-15
Abstract: 

In Canada, Men who have Sex with Men (MSM) form the group with the highest prevalence of Human Immunodeficiency Virus (HIV) infection. Studies conducted in other developed countries indicated that MSM of visible minority groups have a higher prevalence of HIV infection and lower HIV testing rate. The objectives of this study are to describe the prevalence of HIV, and Sexually Transmitted Infections (STI) among Asian MSM in Vancouver.We conducted secondary data analysis of the ManCount survey, conducted in Vancouver. Participants were categorized into Asian and non-Asian MSM according to self-reported ethnicity status. We found that HIV/STI prevalence was significantly lower in the non-Asian MSM population. Moreover, HIV/STI testing rate was lower, especially among younger Asian MSM. Lower HIV/STI prevalence among Asian MSM population means we have a very good opportunity to reduce further spread of HIV/STI among this vulnerable population in BC.

Document type: 
Graduating extended essay / Research project
File(s): 
Senior supervisor: 
Dr. Robert Hogg
Dr. Mark Gilbert
Department: 
Health Sciences: Faculty of Health Sciences
Thesis type: 
(Project) M.P.H.

Examination of current awareness and understanding of mental health promotion among tertiary care providers

Date created: 
2010-07-20
Abstract: 

Mental health is an integral component and determinant of health. Mental health promotion (MHP) is a key primordial and primary preventive strategy that aims to enhance the capacity of individuals and communities to take control over their lives and improve their mental health and wellbeing. Development of mental health promoting healthcare systems is essential to promoting the mental wellbeing of a population and is dependent on having a skilled and informed workforce. This paper examines current awareness and understanding of MHP among tertiary care providers. Results showed that participants understood the relationship between mental and physical health, and the individual and social level factors that determine one’s mental health. Participants exhibited minimal understanding of the societal and economic determinants of health, and of MHP. It is recommended that MHP education and training resources be developed for tertiary care providers to effectively incorporate MHP into tertiary care services.

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

Influences of obesity in the social and economic environment: the role of a multisector alliance in BC

Date created: 
2010-04-26
Abstract: 

Rapidly rising obesity rates are a major public health concern. Obesity is a well-established risk factor for many chronic diseases, the leading causes of death and disability in Canada with costs estimated at $4.3 billion per year. The fundamental causes of obesity are believed to be societal, resulting from environments that promote sedentary lifestyles and the consumption of high fat, energy-dense diets. In 2007, a multisector Alliance was formed in BC to study obesity prevention through policy changes in the built environment. The purpose of this report is to provide a synthesis of the literature looking at influences of obesity in the social and economic environment. Although more evidence is needed, there is currently enough evidence to support broadening the scope of obesity prevention to include influences within the social environment, including schools, food, and advertising and marketing, and in the economic environment including neighbourhood SES and food costs.

Document type: 
Graduating extended essay / Research project
File(s): 
Senior supervisor: 
Michael Hayes
Department: 
Health Sciences: Faculty of Health Sciences
Thesis type: 
(Project) M.P.H.

Phthalate exposure in a Canadian birth cohort at three months of age: Exposure sources and the influence of socioeconomic status

Author: 
Date created: 
2012-04-05
Abstract: 

Exposure to ubiquitous plasticizers known as phthalates may contribute to the development of an inflammatory response and be a factor in the development of allergic disease through direct or adjuvant mechanisms. Some of the important exposure pathways of phthalates include ingestion, injection, inhalation, and dermal absorption. The Canadian Healthy Infant Longitudinal Development (CHILD) Study is a multicentre, multidisciplinary, longitudinal, population-based birth cohort study of 5,000 children enrolled “pre-birth” and followed for five years. The purpose of this birth cohort is to identify and quantify determinants of asthma and allergy in early childhood. We examined associations between phthalate exposures in the indoor environment, including indoor furnishings, occupation, household care products and personal care products with seven phthalate metabolites (monobutyl phthalate (MBP), monobenzyl phthalate (MBzP), monoethyl phthalate (MEP), mono-2-ethyl-5-oxohexyl phthalate (MEOHP), mono-2-ethylhexyl phthalate (MEHP), mono-2-ethyl-5-hydroxyhexyl phthalate (MEHHP) and monoethyl phthalate (MMP)) in urine from 578 CHILD subjects at three months of age. Additionally, we looked at their relationships with socio-economic status. We found higher levels of urinary phthalate metabolites associated with use of household product, such as bathroom tile cleaner; air fresheners, usage of plastic and personal baby care products such as baby wipes. Associations between household income and the levels of urinary phthalate metabolites concentrations were also found.

Document type: 
Thesis
File(s): 
Senior supervisor: 
Tim Takaro
Leilei Zeng, Ryan Allen
Department: 
Health Sciences: Faculty of Health Sciences
Thesis type: 
(Thesis) M.Sc.

Food security and stunting in children under five in the developing world

Author: 
Date created: 
2010-11-03
Abstract: 

Over the past decades, the concept of food security has evolved. The recent concept focuses on three pillars: food availability, food access and food use & utilization. This study used this broader definition of food security to identify the predictors of stunting among children in the developing world. Two stepwise regression models were run with national prevalence of stunting in children under 5 as the main outcome variable and 18 food security indicators as potential independent variables. The EM method was used to impute the missing values for the countries lacking data for the indicators. The models were also cross-validated. The models explained more than 67 % of the variance of stunting in the developing world. In both the models, the predictors of stunting were from all the three pillars of food security. This study highlights the importance of addressing all the pillars of food security to understand and tackle the stunting among children.

Document type: 
Graduating extended essay / Research project
File(s): 
Senior supervisor: 
Tim Takaro
Department: 
Health Sciences: Faculty of Health Sciences
Thesis type: 
(Project) M.P.H.

Reciprocal integration: creating socially connected communities to improve the settlement and health of Canada's immigrant populations

Date created: 
2010-07-28
Abstract: 

Great social, economic, and health disparities exist between immigrants and non-immigrants. One approach to eliminating these disparities is reciprocal integration whereby the responsibility for settlement is shared among immigrants and communities. I have developed the Reciprocal Integration Model to detail the responsibilities of governments, individuals, and communities in bridging immigrant and non-immigrant populations. Kelowna, British Columbia and Moncton, New Brunswick were examined as case studies of reciprocal integration in action. While both communities addressed key components of the Reciprocal Integration Model, their motivations for improving immigrant settlement influenced the activities conducted and the degree to which reciprocal integration was created. Moncton was driven by economics leading to active immigrant recruitment efforts. Kelowna, however, sought to address racism leading to greater attention on improving the social environment. The Reciprocal Integration Model can serve as a guide for policymakers and community planners on how to create community connectedness and improve immigrant settlement.

Document type: 
Graduating extended essay / Research project
File(s): 
Senior supervisor: 
Dr. Laurie Goldsmith
Department: 
Health Sciences: Faculty of Health Sciences
Thesis type: 
(Project) M.P.H.

The effect of area-level average income and individual level factors on small-for-gestational age: a population-based study of the Vancouver census metropolitan area, 2006-2009

Date created: 
2010-09-10
Abstract: 

The goal of this paper was to identify area- and individual-level predictors of small for gestational age birth (SGA). This cross-sectional study analyzed live singleton births from 2006 to 2009 in the Vancouver Census Metropolitan Area. Hierarchical logistic regression models were used to model odds of SGA with deprivation. A crude model of area-level average income was compared to models adjusted by individual-level variables. A strong association was found between SGA and material deprivation, which was greatly influenced by area-level average income. Individual-level variables attenuated the association between area-level average income and odds of SGA. Maternal race/ethnicity was found to have the strongest effect in reducing the area-level association with SGA. No association was found between area-level average income and SGA except in the White group. Future research should attempt to determine if maternal race/ethnicity variable stands as a proxy for structural, biological, social, behaviour/lifestyle, and/or environmental factors.

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