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The purpose of this thesis was to explore socially constructed discursive barriers to physical activity for people with physical disabilities. This research was informed by a critical disability studies framework. Eight interviews were conducted, split between end-users and stakeholders. The end-user article discusses their perspectives with regard to their own PA participation, their use of PA resources, and their views of how disability is constructed. The stakeholder article deals with their views with regard to Canada’s progress in creating inclusive PA guidelines, the research process as it effects people with physical disabilities, and how disability is constructed. The results showed awareness among both groups of the social model of disability, but that the medical model is still firmly rooted. Work is needed to create inclusive promotional materials and disseminate them effectively. An effective advocacy and lobbying effort was suggested as one avenue towards a possible solution to this issue.

The aim of this study was to investigate and compare health beliefs among employees. The study looked at the African Traditional Model and the Medical Model in relation to HIV risk among employees in the Eastern Cape, South Africa. The study sample was made up of 96 participants, all African, and predominately female. The study established employees` health beliefs by asking them to indicate their health beliefs on the Biographical Questionnaire provided in the study. HIV risk among employees was assessed through the use of HIV Risk-Taking Behaviour Scale (HRBS), Attitude to Condom Use, a sub-scale of the Sexual Risks Scale (SRSA) and Sexual Risk Cognitions Questionnaire (SRCQ). A comparison of HIV risk between the two groups of employees was achieved by performing ANOVA. In addition, the study conducted secondary analyses using correlations to establish relationships between variables. The results obtained in this study showed a statistically significant difference in HIV risk between employees who believed in the African Traditional Model and those who believed in the Medical Model in HIV prevention. Secondary correlational analyses between variables showed a significant, negative relationship between participants` attitude toward condom use and their sexual risk cognitions. The results indicated that employees who had a positive attitude towards condom use reported low sexual risk cognitions towards unsafe behaviour. In contrast, employees who had a negative attitude towards condom use showed high sexual cognitions towards unsafe sexual behaviours. Directions for future studies could focus on education and training strategies to reduce negative health beliefs among employees in the fight against HIV and AIDS in South Africa.

<p>The more geneticists discover about which genes cause what traits, the more medical practitioners as well as ethicists will have to deal with questions such as which of the myriad of identifiable conditions could or should be allowed for preimplantation genetic diagnosis (PGD) and subsequent implantation via in vitro fertilization. Not a lot of controversy seems to be raised when it comes to performing PGD for serious genetic conditions such as Tay-Sachs disease or Lesch-Nyhan syndrome, but what about other characteristics, for example, those which we normally would call disabilities? This thesis tackles this question, and in partifular the possibility of implanting embryos with that screen positive for deafness, as deaf parents, especially those coming from the Deaf community who see their condition as a positive part of their identity and cultural belongingness, have expressed interest in ensuring the birth of a deaf child. This thesis thus raises the questions: is deafness a disease, or just an unfortunate condition? Are the deaf justified in purposefully implanting a baby diagnosed to be deaf? The thesis tries to grapple with why deaf parents may want deaf children, and show how these wishes may be justified. Concluding that neither the medical model of disease nor the principle-based approach—which weighs beneficence, nonmaleficence, autonomy and justice—are sufficient in opposing the implantation of deaf babies, it is proposed that a different theory, model or philosophy of health should be espoused if we are still to find the implantation of deaf babies problematic. That is, while the mainstream may ask: “Why ensure the birth of a deaf child?”, we ask, “Why not?” Policymakers and ethicists must be able to tackle this question sufficiently if they would allow to screen for deafness, but only to ensure the birth of hearing children.</p>

The more geneticists discover about which genes cause what traits, the more medical practitioners as well as ethicists will have to deal with questions such as which of the myriad of identifiable conditions could or should be allowed for preimplantation genetic diagnosis (PGD) and subsequent implantation via in vitro fertilization. Not a lot of controversy seems to be raised when it comes to performing PGD for serious genetic conditions such as Tay-Sachs disease or Lesch-Nyhan syndrome, but what about other characteristics, for example, those which we normally would call disabilities? This thesis tackles this question, and in partifular the possibility of implanting embryos with that screen positive for deafness, as deaf parents, especially those coming from the Deaf community who see their condition as a positive part of their identity and cultural belongingness, have expressed interest in ensuring the birth of a deaf child. This thesis thus raises the questions: is deafness a disease, or just an unfortunate condition? Are the deaf justified in purposefully implanting a baby diagnosed to be deaf? The thesis tries to grapple with why deaf parents may want deaf children, and show how these wishes may be justified. Concluding that neither the medical model of disease nor the principle-based approach—which weighs beneficence, nonmaleficence, autonomy and justice—are sufficient in opposing the implantation of deaf babies, it is proposed that a different theory, model or philosophy of health should be espoused if we are still to find the implantation of deaf babies problematic. That is, while the mainstream may ask: “Why ensure the birth of a deaf child?”, we ask, “Why not?” Policymakers and ethicists must be able to tackle this question sufficiently if they would allow to screen for deafness, but only to ensure the birth of hearing children.

The purpose of this thesis was to explore socially constructed discursive barriers to physical activity for people with physical disabilities. This research was informed by a critical disability studies framework. Eight interviews were conducted, split between end-users and stakeholders. The end-user article discusses their perspectives with regard to their own PA participation, their use of PA resources, and their views of how disability is constructed. The stakeholder article deals with their views with regard to Canada’s progress in creating inclusive PA guidelines, the research process as it effects people with physical disabilities, and how disability is constructed. The results showed awareness among both groups of the social model of disability, but that the medical model is still firmly rooted. Work is needed to create inclusive promotional materials and disseminate them effectively. An effective advocacy and lobbying effort was suggested as one avenue towards a possible solution to this issue.

The purpose of this research is to examine the institutional narrative of substance use disorders (SUDs) in the U.S. military and the extent to which it reflects the medicalization process. Three general research questions guided my analysis of the narrative surrounding SUDs in the military: (1) How does the military characterize the problems and resolutions of SUDs? (2) How and to what extent does this narrative reflect medicalization? (3) What are the limitations inherent in the institutional narrative of SUDs in the military? In order to address these questions, I draw on three conceptual lenses: (1) The work of Loseke (2007) and others on the powers of institutional narratives; (2) The work of Conrad and Schneider (1980) in which they propose that medicalization can be understood in multiple ways and on at least three distinct levels (the conceptual, the institutional, and the interactive); and (3) The work of disability scholars on the limitations of the medical model and the importance of adopting a social model of the causes and consequences of disability (Oliver and Barnes 2012; Shakespeare 2014; Berger 2012). In this study, I use these lenses to conduct a textual analysis of the VA/DoD Clinical Practice Guideline for Management of Substance Use Disorders. This manual was developed under the auspices of the Veterans Health Administration (VHA) and the Department of Defense (DoD) pursuant to directives from the Department of Veteran Affairs (VA). The document was designed to provide recommendations for the performance or exclusion of specific procedures or services related to identification and response to substance use among active duty personnel and veterans in all branches of the US military. The information and recommendations presented in the document were then disseminated throughout all branches of the military for implementation. This document is, therefore, a powerful codification of the institutional narrative of substance use in the military. Using Conrad and Schneider’s model as a template (1980), I examined the document in order to see how the military has framed the discussion surrounding SUDs. My analysis began with a close reading of the manual several times without much reflection in order to get a general feeling for the story being constructed by the text. However, as I continued with the close reading, I began making comments about the practices and overall impressions the manual puts forth. After several readings and thorough note taking, it became clear that there was a significant amount of medicalization occurring throughout the military manual, and evidence for medicalization could be seen on all three of the levels suggested by Conrad and Schneider. Words and phrases of text were eventually coded and categorized into the three levels of medicalization. The narrative within the document depicts a specific story of how the military addresses matters involving SUDs through a system of screening, assessment and treatment. First, the document’s language relating to diagnostic assessments, laboratory biomarkers and other screening devices used to categorize and measure one’s substance use can all be considered evidence for medicalization at the conceptual level. Multiple segments of text have been identified and categorized on a conceptual level. Second, clear indications of medicalization on the institutional level can be seen with references to specialty treatment, “specialty care” and “other clinics.” Again, multiple text segments have been identified as being representative of medicalization at the institutional level. Finally, evidence for interactive medicalization can be seen through the use of medical referrals, pharmacological treatments and the ongoing monitoring of medical consequences of substance use. The findings suggest that the military has adopted what many now consider a medical model approach toward understanding substance use and evidence can be found at all three levels of medicalization proposed by Conrad and Schneider. Strengths and weaknesses of exclusive reliance on a medicalized narrative of the causes of substance use among military personnel and veterans are discussed in light of the lessons learned from the social model of disability and other critiques of medicalization. I conclude that the success of a medicalized response to substance use may be hampered by the tension between the two widely circulating cultural narratives that intersect in the case of substance use among military personnel.

There has been an increasing number of students with learning disabilities attending colleges and universities over the past two decades. As a result of federal legislation, institutions of higher education are required through an office of student support services to provide accommodations and modifications for students with disabilities in order to receive federal monies. This semi-structured interview-based qualitative study seeks to understand how four higher education students with disabilities make the choice to “come out” as possessing a learning disability in order to seek academic assistance from the office of student support services. The foundation for this inquiry emerges out of the differences between the medical and social models of disabilities. The framework for the medical model places the individual with a disability as needing to be cured in order to have a normal life, while the social model of disabilities focuses on how society is constructed around able-bodied individuals without substantive consideration for individual differences – specifically disabilities. The data collected were analyzed using a cross-interview analysis of participants’ responses to interview questions. Because little research has been conducted in this content area, the research focused on themes relating to the stigma of disability labels, the choice to come out as possessing a disability, the role of the academic resource center to obtain accommodations and modifications, and the meaning of success for higher education students with disabilities. The stigma associated with possessing a disability while attending an institution of higher education can place additional anxiety on individuals who decide to come out as possessing a disability. The significance of this research to the fields of higher education and disability studies is to gain a better understanding of how the stigma that is associated with students with disabilities affects the manner in which they choose to access student support services and identify themselves as possessing a learning disability. By making the choice to be identified as possessing a disability, students can access academic accommodations and modifications to support academic success, yet the same choice has the potential to have a negative social consequence of being socially labeled as an othered individual. The outcomes for this research study can inform policies and practices relating to the self-identification that students with disabilities must adhere to in order to obtain accommodations and modifications.

It is suggested that the lack of progress made towards understanding and preventing, or even in many cases even alleviating, psychological suffering has been due, in large part, to the way in which such suffering is conceptualised – as ‘disorder’, ‘illness’ or ‘disease’ which is located, and is thus potentially locatable, within the individual. This conceptualisation of psychological suffering is referred to in this thesis as the ‘Dysfunctional Mind Account’ (DMA). The DMA, it is argued, underlies all accepted models/theories of psychological suffering and is the dominant way of conceptualising such suffering for both professionals and lay-people in Western cultures. It is further argued that the main reason the DMA is unable to assist in understanding and alleviating psychological suffering is because it is underpinned by assumptions about human beings and their suffering which are inherently flawed. The account presented in this thesis places at its centre an analysis of persons and their experience that attempts to overthrow these assumptions. The resulting reconceptualisation presents a view of psychological suffering as emergent from our continual personal and embodied enmeshment within our social world, rather than as arising primarily out of the various processes occurring ‘within’ us (whether that be our neurochemistry or our ‘mental mechanisms’ or an ‘interaction’ between them). It is essentially suggested that psychological suffering emerges from the same source as all other aspects of our personal being; from the constant coactions between the various aspects of our being in the world – personal, organismic and molecular – with the environment within which we are enmeshed. This means that the feelings/thoughts/behaviours conceptualised as ‘mental disorder’ are as much part of our personal being as any other aspect of us; they are not ‘other’, they are not ‘disease’, ‘illness’ or ‘dysfunction’. Such feelings/thoughts/ behaviours, it is argued, almost always, perhaps inevitably, represent a very adaptive response, at every level of our being, to environmental contingencies. Thus, when understood in its full context, the suffering conceptualised as ‘mental disorder’ can be seen as the very understandable responses of the embodied person to what is happening to them, rather than ‘un-understandable’ dysfunctions, aberrations and pathological processes of the ‘mind’ (or brain).

Using an institutional ethnographic approach, this research explores the everyday experiences of women living with Multiple Sclerosis and the work they do to understand and manage their illness. Starting with the women's own accounts of their everyday experiences with MS, this research analyzes and explicates the social relations that are involved in their everyday taken-for-granted lifework. An exploration of the ruling institutions coordinating with the everyday work of these women provides insight to some of the struggles and problems people with MS encounter. This project explicates and problematizes the disjuncture between the actual lived experience of having MS and the biomedical institution's authority over the illness. / Graduate