Dennis G. Willms

Environmental factors affecting the occupations of children with physical disabilities

Abstract Children with physical disabilities encounter environmental constraints that limit their participation in daily occupations. The purpose of this qualitative research study was to work together with parents to discover environmental situations which presented substantial challenges to their children. The study took place in a city of 92,000 people in southern Ontario, Canada. Twenty‐two families who had a child with a disability between the ages of 3 to 12 years participated. Through focus groups and individual interviews, participants identified environmental factors which supported or hindered the daily occupations of their children. Social and institutional barriers were identified as the most significant environmental barriers. Although many physical barriers were identified, participants believed that attitudes or lack of knowledge prevented these barriers from being changed. The primary themes for change emerging from this study include parents’ desire for more control, increased use of incl...

A qualitative study of the transition to adulthood for youth with physical disabilities.

The purpose of this qualitative study was to explore the experiences, perceptions, and needs of youth with physical disabilities in transition from adolescence to adulthood. Purposeful sampling strategies were used to select 34 study participants who lived in three regions of south-central Ontario, Canada. Data collection methods were individual and focus group interviews, and were guided by a set of open-ended questions. An editing style of analysis sorted the text into codes for description and interpretation. Themes emerged about context, the transition process, needs, and services. Participants identified a poor fit between young persons with disabilities and the adult world they were entering. They recommended that services be focused on environmental supports to enable them to “build their own bridges” to the adult world. Community-based transition services need to be planned in collaboration with youth with disabilities and their parents. Concepts of person-environment fit and health promotion can be incorporated into services to enable young persons with disabilities to experience a

Psychosocial impacts in populations exposed to solid waste facilities

This interdisciplinary study uses a parallel case study design to investigate psychosocial impacts in populations exposed to three solid waste facilities in Southern Ontario. Impacts are examined at three social scales: individual, social network and community levels. The objectives and design derive from a feasibility study recently completed by the same research team. A two stage approach is adopted. The first is an epidemiologic survey to determine the prevalence of psychosocial impacts in the populations within a prescribed area around each site. A disproportionate stratified (by distance) random sample of 250 households is surveyed at each site. Data on awareness, knowledge, concern and action regarding the site are also obtained. Scores on pre-validated health measurement scales will be compared with population norms to determine the frequency distribution above, within and below the range of normal. The second stage involves the use of qualitative methodologies to provide an in-depth analysis of the individual, social network and community level factors affecting psychosocial impacts and reactions to the situation. Depth interviews with a sub-sample of survey respondents explore individual perceptions, attitudes and actions. Focus groups composed of members of relevant organizations and discussion groups comprising non-members uncover social network and community perspectives in an interactional setting. Interviews and group sessions are taped and transcribed for content analysis of salient themes. Textual analysis of media reports and other relevant documentation provide insights regarding the informational environment and the community context of the issues.

Towards a ``Good'' Death: End-of-Life Narratives Constructed in An Intensive Care Unit

End-of-life decisions regarding the withdrawal and withholding of lifesupporting technology have become commonplace within intensive careunits (ICUs). In this paper, we examine the dialogue between ICU teammembers and families regarding limitation of treatment as a therapeuticnarrative – that is, as a story which frames therapeutic events aswell as the critically ill patients experience in a meaningful andpsychologically comforting way for families and health care providersalike. The key themes of these end-of-life narratives are discussed, aswell as the qualities that the stories share with other narratives ofthe same genre.

Vaccines in the public eye

Preventive vaccines are widely acknowledged as the best hope for protection against infectious pathogens such as avian flu, HIV and SARS. As a result, they have received much recent attention in the media that has exposed some of the challenges involved in optimally using vaccine technology.

Can interfaith research partnerships develop new paradigms for condom use and HIV prevention? The implementation of conceptual events in Malawi results in a ‘spiritualised condom’

Objectives The aim of this intervention research study was to engage senior leaders of faith-based organisations (FBOs) in Malawi in a participatory process to construct an interfaith theology of HIV/AIDS. This process was designed to enhance the capacity of faith leaders to respond more effectively to the HIV/AIDS pandemic. Methods An evidence-driven combination of ethnographic and participatory action research methodologies was utilised. Conceptual events—innovative participatory action research processes—were held over the 4-year project and brought together health service providers, policy makers and a non-governmental organisation in partnership with FBOs and grassroots faith-based communities. Results Through facilitated dialogue, an interfaith theology of HIV/AIDS emerged, resulting in the proposition that a ‘spiritualised condom’ endorses a ‘theology of protecting life’. This proposition was based on the following convictions: (1) life is sacred and to be protected, (2) to kill or murder is a ‘greater sin’ than the ‘lesser sin of infidelity’, (3) protection of the innocent is a moral and religious requirement, (4) condoms have the potential to prevent the death of an innocent person and (5) condoms need to be encouraged, even in the context of marriage. Conclusions Clinicians, non-governmental organisations, health service providers and policy makers, assisted by health social scientists, can successfully partner with FBOs and their leaders to (1) modify and transform faith-based understandings of HIV risk and (2) bring about attitudinal and behaviour changes that help to address the challenges associated with HIV/AIDS.

Vaccine preparedness: lessons from Lyantonde Uganda.

To explore how to better educate rural Africans about preventive HIV/AIDS vaccine trials, 15 semi-structured, open-ended interviews were conducted with villagers in Lyantonde, Rakai District, Uganda. This study reports on the findings by focusing on the attitudes, knowledge and questions the rural villagers had about HIV/AIDS-preventive vaccine testing. While several interviewees confused preventive vaccines with therapeutic vaccines, most were clear about the distinction and about key questions to ask about vaccine testing. In addition, some subjects manifested high levels of trust in the likely effectiveness of preventive vaccines, even in the testing stages, most subjects demonstrated the potential to be intelligently inquisitive about the likely effects. In sum, these villagers show the potential to be reliable subjects, motivated for appropriate reasons, and willing to play a role in advancing the progress of HIV/AIDS vaccine development in Africa.