Exploring Mechanisms of (Dis)Engagement in Health and Physical Education Class with Adolescent Boys

Currently, there remains a primitive understanding of the potential mechanisms that promote participation, disengagement and withdrawal in Health and Physical Education class (HPE) among adolescent boys. Of central concern then, and the foundation of this research, is to develop a substantive and theoretical understanding of the intersubjective and intrasubjective meanings ascribed to HPE among adolescent boys who are transitioning into their final year of institutionalized HPE in Ontario. Drawing from an ethnographic, grounded theory case study conducted at an independent elementary school for boys', this research elucidates the mechanisms of HPE (dis)engagement from 15 adolescent boys (12-14 years of age) of varying physical abilities. In conjunction with Pierre Bourdieu's conceptual tools of field, capital, habitus, practice and symbolic violence, it is proposed that a habitus of HPE (dis)engagement is formed through the reflexive observation, somatization and naturalization of the valorized forms ofM.Sc

Physical Activity Participation among Adolescent Boys with Autism Spectrum Disorder

The purpose of this dissertation was to examine the physical activity (PA) participation of adolescents with autism spectrum disorder (ASD) as they are reported to be less active than their age-related peers. Driven by Norbert Elias’ Figurational Sociology, this study explored the lives and perspectives of a group of adolescent boys with ASD, and examined how their PA participation was mediated by wider social, cultural, institutional norms, values, and beliefs (socio-cultural processes). The objective was to understand how the identified socio-cultural processes interacted with bio-physical and psycho-behavioural processes to enhance, shape, and curtail their participation. A critical qualitative study using a multi-method design was used where 10 adolescent boys with ASD participated in two face-to-face interviews, and each created a digital story. Findings of this study make three substantive contributions to the literature on PA participation. First, data generated with participants added novel, rich, and in-depth descriptions of PA participation, and preliminary insights into the daily lives of adolescents with ASD. Second, in examining the daily lives of participants, findings highlight that PA was not merely a behaviour determined at the level of the individual. The analysis illuminated how PA was shaped by wider social values, norms and assumptions about ASD, and by practices, and interactions within particular PA spaces. These socio-cultural processes in turn influenced the (conscious and unconscious) choices and preferences made by participants in their particular social contexts, and shaped their habitus toward PA (dis)engagement. Finally, socio-cultural processes do not exist, or function in isolation. Rather, the study demonstrated how the interaction of bio-physical, psycho-behavioural, and socio-cultural processes interact to enhance, shape and curtail PA participation in numerous ways. These findings illuminate the complexity of PA participation, add nuance to the understanding of (in)activity, and highlight the need to consider these interdependent relationships when studying, conceptualizing and developing PA programs, opportunities, and interventions.Ph.D

Keep fit: marginal ideas in contemporary therapeutic exercise

Exercise has a long history as a therapeutic modality and has existed, in some form, in all cultures throughout recorded history. In recent years, therapeutic exercise has taken on new significance as a relatively low cost medical intervention designed to improve people's health and well-being and reduce the downstream effects of comorbidity. Drawing our inspiration from Foucault and Deleuze, we argue that seeing therapeutic exercise as primarily 'medical' carries with it consequences - some recognised, others unseen that are problematic and worthy of consideration. Our focus is on the acts of marginalisation, exile and exclusion implicit in the quotidian practice of therapeutic exercise, and how these acts mediate people's daily lives. In the paper we explore how therapeutic exercise is being instrumentalised, normalised and constrained, arguing for much greater critical attention towards its putative 'goodness' and virtue as a health intervention

Suicidal Thoughts and Behaviours Among Autistic Adults Presenting to the Psychiatric Emergency Department: An Exploratory Chart Review

Despite increasing attention on suicidality in autistic people, we know little about suicidal presentations when autistic individuals present to hospital emergency departments (ED). We conducted an exploratory retrospective chart review of suicidal thoughts and behaviours (STB) of autistic adults who presented to a psychiatric ED. The analysis included 16 charts over a 10-week period. Findings highlight that reported STB were not always the presenting issue. Life transitions and interpersonal conflicts were common antecedents, and active rumination about STB was distressing and fatiguing. Findings imply that ED visits serve as important opportunities for suicidal risk reduction for autistic individuals, through implementation of strategies for identification of STB such as active screening, and the provision of suicide resources tailored to autistic people

Are you ready? Exploring readiness to engage in exercise among people living with HIV and multi-morbidity in Toronto, Canada: a qualitative study

Objectives: Our aim was to explore readiness to engage in exercise among people living with HIV and multimorbidity. Design: We conducted a descriptive qualitative study using face-to-face semistructured interviews with adults living with HIV. Setting: We recruited adults (18 years or older) who self-identified as living with HIV and 2 or more additional health-related conditions from a specialty hospital in Toronto, Canada. Participants: 14 participants with a median age of 50 years and median number of 9 concurrent healthrelated conditions participated in the study. The majority of participants were men (64%) with an undetectable viral load (71%). Outcome measures: We asked participants to describe their readiness to engage in exercise and explored how contextual factors influenced their readiness. We analysed interview transcripts using thematic analysis. Results: We developed a framework to describe readiness to engage in exercise and the interplay of factors and their influence on readiness among adults with HIV and multimorbidity. Readiness was described as a diverse, dynamic and fluctuating spectrum ranging from not thinking about exercise to routinely engaging in daily exercise. Readiness was influenced by the complex and episodic nature of HIV and multimorbidity comprised of physical impairments, mental health challenges and uncertainty from HIV and concurrent health conditions. This key factor created a context within which 4 additional subfactors (social supports, perceptions and beliefs, past experience with exercise, and accessibility) may further hinder or facilitate an individual’s position along the spectrum of readiness to exercise. Conclusions: Readiness to engage in exercise among people living with HIV is a dynamic and fluctuating construct that may be influenced by the episodic nature of HIV and multimorbidity and 4 subfactors. Strategies to facilitate readiness to exercise should consider the interplay of these factors in order to enhance physical activity and subsequently improve health outcomes of people with HIV and multimorbidity

Understanding disability in healthcare: exploring the perceptions of parents of young people with autism spectrum disorder

Purpose: How autism spectrum disorder (ASD) is understood (i.e., as a medical problem or natural human variation) has profound implications for how healthcare services are designed and delivered. As the recipients of these services, children and families are highly invested in these debates, yet little research has sought to investigate their views. The purpose of this study was to explore parents’ conceptualizations of ASD in relation to disability, and how they align with, or diverge from, conceptualizations they encounter within healthcare. Materials and methods: Nine semi-structured qualitative interviews were conducted with parents of children with ASD and thematically analyzed. Results: The accounts suggested that participants integrated multiple and sometimes contradictory conceptualizations of disability that reflected both “medical” and “social” models and sources of disablement. While the participants often advocated for acceptance and inclusion of their child, the label of “neurodiversity” was commonly rejected due to the concern for potential loss of funding for services. Conclusions: Study findings highlight the relationship between how parents conceptualize ASD and their experiences accessing supportive services within current delivery structures. Implications for ASD service providers emphasize accommodating parents’ unique and evolving values and priorities for healthcare and their relation to current service systems. Implications for Rehabilitation Parents conceptualizations of ASD both inform and are influenced by their experiences of accessing supportive services. This study highlights that parents’ perspectives are fluid, context-dependent, and do not exclusively represent a single model or perspective of disability. To meet family needs, service providers including healthcare professionals must recognize parents’ unique understandings of their child’s ASD and appreciate how healthcare shapes these perceptions