Asthma is one of the most common respiratory diseases in Canada. It not only brings pain to more than 7.8% of Canadians but it also costs millions of dollars every year. In this project we study the influence that environmental factors have on asthma based on the data from the National Population Health Survey (NPHS) conducted by Statistics Canada. A descriptive analysis is done first to get an initial understanding of the environmental factors' effects on asthma. Then we do a x2-test to test for the homogeneity of asthma distribution across the levels of each environmental factor. Most of the factors included in our study are significant except those representing whether living in the metropolitan areas of Montreal or Vancouver, the number of persons living in the household, and whether there are small children in the household. For ordinal variables we test for trend on asthma prevalence. The trend tests indicate that there are significant trends between asthma and most of the ordinal factors except for a few, including the number of bedrooms in the household and the number of cigarettes smoked daily by the daily smokers. Then odds ratio and relative risk analyses are done to obtain statistical insights on the relative risk of the factors. The result shows that living in Nova Scotia, Ontario and Quebec, urban areas, engaged in finance, community services, personal service, young, attend physical activities, born in Canada, white, single or widowed, separated, divorced, start smoking early, do not own the dwelling living in, female adult, male children, and overweight and underweight adult, are all contributing factors for asthma. To model and investigate the joint effect of factors on asthma prevalence, we use logistic and log-linear regression models. To avoid collinearity problems, a reduced number of predictors is used. The results suggest that environmental factors have a significant joint influence on asthma prevalence. / Thesis / Master of Science (MS)

Background Nigeria, with a population growth rate (2000-2005) of 2.5% and with 5% of the total population aged 60 years and above, has the potential for a rapid growth rate of the older population in coming years.1 The implication of this in a country with large population as reported by the National Population Census 2006, limited number of health care professionals and care homes, is difficulty in meeting the various needs of the elderly, hence, the importance of identifying the palliative care needs of the elderly. Aim The study was set out to assess the palliative care needs of and provision of care to elderly patients seen in the selected clinics of the University College Hospital, Ibadan, Oyo state, Nigeria. Objectives 1. To describe characteristics of elderly patients seen in the selected clinics. 2. To explore the current use of the hospital palliative care team in the care of geriatric patient. 3. To explore the current use of the hospital palliative care team in the care of geriatric patient. Methods A descriptive cross-sectional study was conducted over a 3-month period using an interviewer administered questionnaire after full consent was given by participants. The questionnaire was a combination of the Africa Palliative Care Outcome Scale (APCA-POS), the Edmonton Symptom Assessment Scale (ESAS) and Hope Spiritual Assessment Tool. Demographic information regarding gender, age, nationality, abode and referral to the Care Centre was obtained. Scaled questions from selected tools were ticked with respect to physical, psychosocial and spiritual needs and expectations of palliative care. The validated data collection tools (APCA-POS, ESAS, HOPE) were used in the questionnaire. Ethical approval was obtained from the relevant organizations. Data was analysed using IBM SPSS statistics 21. Results 424 participants completed the questionnaire and most patients (330; 77.8%) were recruited from the geriatric wards with a 2:1 female to male ratio. Most participants fell in the 60 -69 year-old age group. The most common symptom was pain in 240 patients with moderate pain in single or multiple areas. A high percentage (45.8%) were moderately worried about their disease condition and only 66 out of 422 freely discussed this feeling with their family members. Other symptoms observed were nausea, vomiting, constipation and loss of appetite. Conclusion The study showed the palliative care needs of the elderly and calls for collaboration between the palliative care team and the physicians in the geriatric unit for better management of the needs of the elderly.

Philosophiae Doctor - PhD / The advantage of a well-developed health information system is the significant role played by records produced by such a system beyond recording medical history of individuals. They are the foundation for birth registrations which when fully complete is an important tool for acquiring data necessary for planning and monitoring child and maternal health in a country. This study aimed to investigate the potential of hospital birth records to estimate the number of births in the country and supplement birth registrations data. Data was abstracted from public facilities where births occur in two municipalities; Germiston in Gauteng and Nkomazi in Mpumalanga for the period 2014 to 2016. Modified version of the BORN Data Quality Framework (BORN-DQF) of the Ontario Agency for Health Protection and Promotion (2016) was used to assess the contents and quality of hospital birth records. / 2022

Back pain is an important health and economic problem affecting a significant part of our population. It is of interest to both medical and behavioral professionals concerned with the complex role of the social and psychological factors in the etiology of somatic ailments. Although there has been much written about back injuries in military and industrial settings, little is known about the epidemiological patterns in a general population (Nagi et al., 1973). The objective of this study is to find: a) the major factors connected to back pain, b) whether the general work-stress index is related to back pain, where the general work-stress index is the sum of job stressors including psychological demands, job insecurity, physical exertion, decision latitude and the social support at work, and c) the relationship especially amongst back pain, activity restriction, age, job satisfaction and income. The National Population Health Survey (NPHS) database is used in this project. Some statistical techniques such as logistic regression and log-linear models are used for data analysis. In this project all explanatory variables in logistic regression models are treated as continuous variables; all variables when used in log-linear models are treated as categorical data. Results are compared between these different methods. They are in close agreement with each other. We conclude that age has very high impact on back pain with significance level being lower than 1 %; activity restriction also has a strong relationship with back pain; chronic stress, childhood and adult stressors all have high association with back pain; job stressor and recent life bad events are related fairly to back pain at significant level 5%; and income and job satisfaction do not have direct impact on back pain. Although there is not much that can be done to change the normal aging process of the spinal column, some of the predictors identified such as job stressors are amenable to change. / Thesis / Master of Science (MS)

Magister Chirurgiae Dentium (MChD) / The South African population is made up of Blacks, Whites, Coloureds and Asians. Since each population group is distinct in its culture and habits and have widely differing life styles and socioeconomic levels an ideal oppurtunity exists for the study of environmental influences on the aetiology of particular cancers. In addition accurate epidemiological data is essential in order to assess changing .patterns of the disease and the efficacy of the prevention programmes. The aim of this study was to etermine age standardised incidence rates and age specific morbidity rates of intra-oral squamous cell carcinoma for Blacks on the Witwatersrand. All new cases of intra-oral cancer during the period (1971-1980) were traced. The population at risk was determined from the National Population Censuses of 1970 and 1980. According to the method used in the International Union Against Cancers (U.I.C.C.) publication (Waterhouse et al 1976 and 1982) age standardised incidence rates and age specific morbidity rates were calculated for tongue, floor of mouth, buccal mucosa, hard and soft palates and gingivae and alveolar ridge using standard World, European and African populations. These results indicate that in the population group studied intra-oral cancer is much more common in males and than females (5,55:1 standardised rates) most commonly affects the tongue followed by the floor of mouth, palate, buccal mucosa and gingivae and alveolar ridge and is a disease of the elderly occurring most commonly in the seventh decade in males and in the sixth decade in females. When compared with standardised rates reported, either for Blacks in other geographic locations in South Africa, or for other population groups in this country, or for selected countries elsewhere in the World, important differences have emerged which probably reflect differences in exposure to specific aetiological agents amongst the various population groups compared.

Psychotropic medication use is widely implicated as a risk factor for injuries, and it is believed that the adverse effect profiles of these medications are exacerbated by the consumption of alcohol. The objectives of this study are (a) to examine the associations between the use of specific classes of psychotropic medications and injuries among elderly participants of the National Population Health Survey (NPHS), and (b) to determine whether and how associations between psychotropic medications and injuries are modified by the consumption of alcohol. Data from Cycles 1 (1994/95), 2 (1996/97), and 3 (1998/99) of the NPHS household longitudinal file were used in this study, selecting community-dwelling participants aged 65 years of age and older in 1994/95. Among antidepressant medications, the magnitude of the risk of injuries was higher for users of tricyclic derivatives (OR=1.4; 95%CI: 0.7 – 2.9) than SSRIs (OR=0.3; 95%CI: 0.1 – 1.0). Benzodiazepine use for any indication increased the risk of injuries, but that effect was not consistent across indications. The use of benzodiazepine antianxiety medications resulted in an increased risk of injuries (OR=2.0; 95%CI: 1.3 – 3.1), but there were no significant effects on the injury risk among benzodiazepine hypnotic and sedative users (OR=0.8; 95%CI: 0.4 – 1.7). Results pertaining to the second objective of this study raised as many questions as they resolved. Alcohol consumption decreased the odds of injury among hypnotic and sedative users, but otherwise, no consistent results were observed. Findings from this study underscore the importance of identifying appropriate alcohol measures for research among elderly populations. They also stress the need to separately consider the impact of different classes of psychotropic medications on injuries (tricyclic antidepressants separate from SSRI antidepressants and antianxiety benzodiazepines separate from hypnotic and sedative benzodiazepines).

Psychotropic medication use is widely implicated as a risk factor for injuries, and it is believed that the adverse effect profiles of these medications are exacerbated by the consumption of alcohol. The objectives of this study are (a) to examine the associations between the use of specific classes of psychotropic medications and injuries among elderly participants of the National Population Health Survey (NPHS), and (b) to determine whether and how associations between psychotropic medications and injuries are modified by the consumption of alcohol. Data from Cycles 1 (1994/95), 2 (1996/97), and 3 (1998/99) of the NPHS household longitudinal file were used in this study, selecting community-dwelling participants aged 65 years of age and older in 1994/95. Among antidepressant medications, the magnitude of the risk of injuries was higher for users of tricyclic derivatives (OR=1.4; 95%CI: 0.7 – 2.9) than SSRIs (OR=0.3; 95%CI: 0.1 – 1.0). Benzodiazepine use for any indication increased the risk of injuries, but that effect was not consistent across indications. The use of benzodiazepine antianxiety medications resulted in an increased risk of injuries (OR=2.0; 95%CI: 1.3 – 3.1), but there were no significant effects on the injury risk among benzodiazepine hypnotic and sedative users (OR=0.8; 95%CI: 0.4 – 1.7). Results pertaining to the second objective of this study raised as many questions as they resolved. Alcohol consumption decreased the odds of injury among hypnotic and sedative users, but otherwise, no consistent results were observed. Findings from this study underscore the importance of identifying appropriate alcohol measures for research among elderly populations. They also stress the need to separately consider the impact of different classes of psychotropic medications on injuries (tricyclic antidepressants separate from SSRI antidepressants and antianxiety benzodiazepines separate from hypnotic and sedative benzodiazepines).

My dissertation is composed of an introductory chapter followed by three independent chapters focusing on two themes: health and retirement. The last chapter concludes. After the introductory chapter, the second chapter investigates whether self reported general stress is a mediator in the relationship between socio-economic status (SES) and health. I use a six-year long panel of the Canadian Survey of Labour and Income Dynamics and employ dynamic econometric modelling techniques to study men and women who are major income earners in their families. I find little evidence that general stress is a pathway from SES to health. While the results suggest a strong negative association between stress and health for both men and women, they provide little support to the hypothesis of a significant effect of income on stress, consistent with the direction of the SES-health gradient. The third chapter studies whether self-assessed health status (SAH) contains information about future mortality and morbidity, beyond the information that is contained in standard "observable" characteristics of individuals (including pre-existing diagnosed medical conditions). Using a ten-year span of the Canadian National Population Health Survey, we find evidence that SAH does contain private information for future mortality and morbidity. Moreover, the extra information in SAH is greater at older ages. Our results suggest that a shift from defined benefit to defined contribution pension arrangements may carry with it the cost of exacerbated adverse selection in the market for annuities, especially at older ages. That would make it more difficult for older individuals to insure longevity risk. The fourth chapter looks at whether differences in early retirement pathways are associated with differences in post-retirement outcomes of health, stress and dwelling tenure. I use a 5 ample of men from the Canadian Survey of Labour and Income Dynamics, years 1996 to 2004. I find that differences in pre-retirement health indicators (such as self-assessed health and disability), as pathways to early retirement, are likely to be associated with differences in post-retirement health and stress. In addition, the results suggest that "involuntary" retirees (men who may have retired because of health and/or health related coniitions) are more likely to experience worse post-retirement outcomes (in terms of health and stress) than men who retire "voluntarily". Retirement circumstances are found to have no statistically significant effect on dwelling tenure. / Thesis / Doctor of Philosophy (PhD)

No description available.

Utilizing the longitudinal component of the National Population Health Survey (NPHS) (1994/1995-2000/2001), designed to collect comprehensive information on the health status of the Canadian population and related socio-demographic information, differences in health status between immigrants and non-immigrants (i.e., native-born individuals) were explored. Specifically, the analysis investigated how chronic conditions influence the health of immigrants, the role of stress and mental health upon immigrant health status, and the influence and role of previously underrepresented variables such as age and arrival cohorts on foreign-born health status. The conceptual approach of this project draws upon a 'population health' perspective, which suggests that the most influential determinants of human health status are non-medical in nature, but rather can be identified as the social and economic characteristics of individuals. Analysis was completed through the use of ordinary least squares stepwise regression and logistic stepwise regression in association with descriptive stochastic methodologies. Analysis of the mental health and stress variables suggests that, contrary to what has been expressed in literature in the past, both immigrants and the native-born do not perceive stress, distress, or depression to be major problems or health concerns in their lives. Furthermore, the analysis indicated, as was expected, that older immigrants are at greater risk of developing more chronic conditions relative to younger groups, and that arrival cohorts, the period in which an immigrant entered the nation, do exert a considerable influence on the health status of the foreign-born. Surprisingly, this analysis indicates that the Healthy Immigrant Effect (HIE), which proposes that recent immigrants, regardless of country of birth, tend to be in better health than the Canadian-born population upon entering the nation, may be more apparent than real, especially when investigating mental health and stress conditions amongst the foreign-born. / Thesis / Master of Arts (MA)