<p> Autism spectrum disorder (ASD) is characterized by deficits in social interaction and social communication skills. High ASD prevalence rates have increased public concern about how persons diagnosed with the disorder will interact with others in their communities. Police officers routinely interact with people diagnosed with a variety of disabilities and mental illnesses. Current law enforcement training includes a broad focus on mental illness that may not be sufficient to prepare law enforcement officers to interact with persons diagnosed with ASD. The present study evaluated the effectiveness of a privately-owned ASD training program developed for law enforcement officers. A total of 195 police officers participated in this study during 3 separate training events at 2 police departments in Southern California. Results showed a significant increase in participants&rsquo; knowledge of core ASD symptoms in 4 out of 6 program training modules. In addition, participants reported gains in the following domains: perceived confidence in interacting with persons with ASD, perceived practicality of providing accommodations for people diagnosed with ASD, and perceived relevance to participants&rsquo; work as police officers. The implications of these findings are discussed and recommendations are made regarding future presentations of the training and future areas of research.</p><p>

Scoliosis of the spine is defined as a side-to-side deviation from the normal frontal axis of the body resulting in body asymmetry, and as a complex, three-dimensional and multifaceted deformity, not only affects a female adolescent’s appearance - fit, usability and appearance of clothing - but can also compromise her health and ability to function. Scoliosis affects at least 2.9% of the population in Greece, appearing particularly among children aged 8-14 years, and more frequently in girls (9 girls for 1 boy). This study traces previous initiatives and current provision for clothing people with divergent body figures, exploring issues at the intersection of human anatomy and fashion, while it takes place in Greece, starting with measuring procedures specifically adapted for body asymmetry that comply with the appropriate code of ethics. External body measurements provide non-invasive evaluation of changes in external asymmetry due to scoliosis, while analysis of the measurements related to the trunk can document the asymmetry arising from the different types and degrees of spinal curvature, providing a 3D classification of scoliotic deformities. Both right and left body halves of 75 females aged 16-22 years of age, diagnosed with Adolescent Idiopathic Scoliosis (AIS), are measured in order to register their different body shapes and to classify them in different scoliotic groups, according to the magnitude and type of their scoliosis. The asymmetric basic pattern blocks derived from the median body measurements for each scoliotic group will be more tolerant of bodies with scoliosis, providing a better garment fit than conventional symmetrical patterns. These new ‘blocks’ will have the potential to be used in mass production, after the development of sizing systems based on body asymmetry, whereby an ‘aesthetic’ and an ‘ethical’ dimension in design could be then incorporated. Applying auto-ethnography, as well as using participant observation and interviewing methods, this research will help gain a deeper understanding of the culture and the needs of the specific target group. Future challenges relate to design perspectives of fashionable clothing for females with non-standard body dimensions, with particular emphasis on scoliosis, having potential for wider application in mass customised apparel for scoliosis.

The corpus of literature about disabled therapists within physiotherapy omits one important factor: the experiences of disabled physiotherapy students. Therefore, this research aimed to fill this gap by exploring the integration of disabled students into the physiotherapy profession. This participatory research sought to investigate the phenomenon from multiple perspectives to incorporate the voice of disabled students, an analysis of the policies which regulate the profession, and the opinions of representatives from the Chartered Society of Physiotherapy and the Health and Care Professions Council. In stage one of the project ten disabled physiotherapy students were recruited. These students completed narrative interviews and Kawa drawings to document their experiences. Stage two explored the available information for prospective disabled students by conducting an internet survey. Finally in stage three, the policies of the Health and Care Professions Council and Chartered Society of Physiotherapy were examined for ableist language and then two representatives from each organisation were interviewed about the integration of disabled students. The data collected were analysed by critical narrative analysis with the student participants contributing to the generation of categories and themes. Further analysis was conducted using Bourdieu’s Theory of Practice and the SEAwall model of discrimination. My research has identified two paradoxes that affect the integration of disabled students. Firstly, the paradox of the perfect physiotherapist, applied via a narrow physiotherapy corporeal standard, which particularly limits access for people with physical impairments. Secondly, the paradox of supporting students whilst maintaining qualification standards. Again this limits access for disabled students, particularly when fitness to practise standards are applied during the admission process. These competing imperatives create a dilemma for disabled students around disclosing their disability status. This dilemma will only be solved by reducing discrimination at all levels of the system. However, in order to achieve this change, disabled physiotherapists and students will need to adopt a more affirmative orientation to disability to act as facilitators of change within the profession.

M.A. (Psychology) / Although recent research findings suggest that perceptualmotor training in the education of the child with learning problems is irrelevant and superfluous, clinicians have maintained that this method has notable success. The primary objective of the study was to explore the consequences of perceptual-motor therapy on the academic achievement, intellectual ability, and personality development of the MBD child. The subjects used were children in the aid classes of eight different schools. These children had been classified by the school psychologists and doctors as showing symptoms of MBD. A Solomon Four Group Design was utilised in the experimental investigation. This entailed the division of subjects into experimental and control groups. These groups were further subdivided so that half of each group received pre-testing and the other half no pre-testing. All the subjects received posttesting. Thus practice effect could be separated from treatment effect. There were sixty five subjects in the study, thirty two in the experimental group and thirty three in the control group.

People with disabilities from culturally and linguistically diverse (CLD) backgrounds experience discrimination related to their multiple cultural identities. Complex organizational responses and workforce training are needed to effectively address the resulting inequalities they experience. Yet, there is little guidance about effective practices for organizations serving people with disabilities from CLD backgrounds. Similarly, little research exists about effective cultural and linguistic competence (CLC) training provided by such organizations. Chapter 1 details a scoping review study that identified 29 documents related to CLC for organizations supporting people with disabilities from CLD backgrounds. Frequency counts and a qualitative thematic analysis were used to describe those documents and their recommendations. Although 24 themes were identified that provide relevant organizational CLC recommendations, few of the reviewed documents attended to the intersection of disability and race/ethnicity, exhibited methodological rigor, or included perspectives of diverse people with disabilities. Often, recommendations in the identified documents lacked clarity and detail, and were therefore not easily translatable into interventions. In most documents, little attention was paid to standards or methods that could be used to evaluate the recommended CLC initiatives. A series of tables present the documents, their qualities, and 24 recommendation themes. Chapter 2 is an exploratory, holistic, and retrospective single-case study of CLC training provided by an interdisciplinary leadership training program. Multi-source interviews and review of archival data were used to research evidence of the presence of activities, content, and structure of infused CLC training in a year-long training program designed to develop leadership abilities in an interdisciplinary group of disability-serving professionals and advocates. Interviews were conducted with three course faculty and three trainees of the 2015-2016 training year. Archival data from the 2015-2016 training year contributed triangulation across type of data. Qualitative analysis and interpretation were performed by a diverse research team. The results and discussion are presented via thick description and illustrate a model of CLC training that seeks to acculturate trainees to a collaborative culture of humility, inclusion, and social justice via a learning community mechanism.

Magister Scientiae (Physiotherapy) - MSc(Physio) / The aim of this study was to determine the types of sport that are available for the learner with a physical disability in ordinary schools in the Western Cape and what prevents and facilitates participation in sport. / South Africa

Magister Scientiae (Physiotherapy) - MSc(Physio) / Sport participation can play a vital role in enhancing life of youth with physical disabilities. This is because of the rehabilitative influence sport can have not only on the physical body but also on rehabilitating people with disability into society. A successful sport programme in which the youth with disabilities are involved should possibly respect youth‟s wishes regarding the preference of the sport. The Review of the literature revealed that little has been documented about the status of disability sport in developing countries. Given the psychosocial and physiological benefits of sport in everyone‟s life, including those with physical disabilities, there is a need for a study to document the status of sport of this sub-population in Rwanda. This study, therefore, aimed to identify the factors associated with sport preferences among youth with physical disabilities in Rwanda. A sequential mixed model design was used to collect data, specifically the sequential explanatory strategy. Data was collected by means of a self-administered questionnaire and a total number of 204 participants voluntarily answered the questionnaire. Semi-structured interviews were conducted among four (4) NPC staff to collect data regarding the challenges experienced by youth with physical disabilities with regard to sport preferences. The Statistical Packages for Social Sciences (SPSS) version 19 was used for data capturing and data analysis. Descriptive statistics were employed to summarize demographic information as means, standard deviation, frequencies and percentages. Inferential statistics (chi-square and independent samples t-tests) were used to test the associations between different categorical variables (p<0.05). For the qualitative data, audiotaped interviews were transcribed and translated from Kinyarwanda into English, and the expressed ideas were coded and reduced into subthemes and categories. Thematic analysis was then done under the generated sub-themes. Permission to conduct this study was obtained from the concerned authorities. Ethical issues pertaining to informed consent, anonymity, confidentiality and the right to withdraw from the study were respected in this current study. The results of the current study revealed that the top five sports played by youth with physical disabilities were sit ball, sitting volleyball, volleyball, table tennis and wheelchair basketball. It also showed that youth with physical disabilities were committed to and enjoyed their sport experience. Additionally, they have had strong feelings about their physical abilities. Discouragingly, the results indicated that the youth with physical disabilities have had low perception that their parents were supportive of their participation in sport. The findings further showed that age, gender, use or non-use of mobility aids, and type of impairment influenced the choice of sport. However, there was no statistically significant association between demographic characteristics and some sports codes played in Rwanda. During the semi-structured interviews, the participants reported the challenges experienced by youth with physical disabilities with regard to sport preferences including physical factors (lack of accessible facilities, uneven playgrounds, transport to and from sport fields, resources and limited sporting codes available), social factors (lack of parental support and models) and financial factors (inhibit the implementation of many sport codes, high cost of adaptive equipment) which influence the youth with physical disabilities to choose a sport with sufficient facilities even if they do not like it. Factors that emerged as facilitators for sport preferences include: sport availability, perceived ability to handle a sport, friendship, facilities, improved individual competences, independence in mobility gained, and to take part in international tournaments. Based on the results of this study, and the role of sport in preventing many chronic diseases, it is apparent that there is a need to widen the spectrum of sport opportunities and to create awareness among youth with physical disabilities. Furthermore, there is a need to provide social and a local barrier-free inclusion of various stakeholders in recommending and designing sport programmes for the youth with disabilities. / South Africa

Doctor Scientiae / Following the introduction of the Health Act of 1995, the Primary Healthcare Package for South Africa, a set of norms and standards was developed in 2000, to ensure good quality of care and to act as a guide to provide good service at this level of care. Related to this, and bringing health services to the people, was the aspect of rehabilitation. It was highlighted that rehabilitation services should be restructured and strengthened in order to improve access to these services for those who did not have them before. This led to the development of the National Rehabilitation Policy in 2000, which focused on improving accessibility to all rehabilitation services, in order to facilitate the realisation of every citizen’s constitutional right to have access to healthcare services, but this policy was not implemented. During 2002, the Department of Health produced a strategic plan for the reshaping of public health services in the Western Cape. This initiative, Healthcare 2010, the Future for Health in the Western Cape 2020, mapped the way forward to improve substantially the quality of care provided by the health service. This plan was based on the primary healthcare approach and aimed to shift patients to more appropriate levels of care. It became evident that in order to move forward with the 2020 vision, there needed to be a greater understanding of the current situation. This study focused primarily on the aspect of rehabilitation, with a specific focus on systematic review and three dimensions of the process of care, namely patient information; service provider information; and realised access. These dimensions assisted in evaluating the rehabilitation service in order to understand what was happening in the delivery of rehabilitation services, focusing on the experiences of patients with physical disabilities, as well as service providers and caregivers, and realised access that included satisfaction of all participants in the rehabilitation centres. Hence the aim of this study was to evaluate the process of care at three selected rehabilitation centres in the Western Cape Province within the contextual framework of the National Rehabilitation Policy (NRP) and the United Nations Convention Rehabilitation Policy for People with Disabilities (UNCRPD). To assist in achieving this aim, objectives were developed as follows: to determine the reported barriers and facilitators to rehabilitation services through a systematic review; to determine the profile of patients with disabilities accessing rehabilitation services at three rehabilitation centres in the Western Cape Province; to determine the profile of service providers providing rehabilitation service to patients with disabilities attending rehabilitation centres in the Western Cape Province; to explore clients’ perceptions of and satisfaction with the rehabilitation services; to explore caregivers’ perceptions of and satisfaction with the rehabilitation services; to explore the experiences of service providers with the rehabilitation services; and to map the links between the experiences and perceptions of the key stakeholders. This was an evaluation study, which was primarily descriptive, with the focus on process evaluation. Process evaluation provides an indication of what happened, and why. The study was conducted at three rehabilitation centres in the Western Cape Province. Voluntary participation of patients, service providers and caregivers was gained by signing a consent form. Both qualitative and quantitative methods of data collection were used in this study. Questionnaires were used for quantitative data collection and SPSS version 17 and 21 was used to analyse the data. Focus group discussions and in-depth interviews, which were based on interview guides and tape recorded, were used to gather information on experiences and perceptions of all the participants. Quantitative data capturing was checked for errors by using excel spread sheets, where data was entered twice in two different spread sheets and checked for differences, as responses were coded by using numbers. Qualitative data was checked for errors by following the trustworthiness process where data was transcribed verbatim, and where necessary translated by two different translators to ensure accuracy. The researcher consulted with the supervisors during data analysis to enhance quality in the coding process and identification of themes and relevant quotations. Results showed that barriers to rehabilitation outnumbered facilitators of the rehabilitation process. There was a gap identified in the profile of the patients with regards to their rehabilitation needs. Records of the patients had missing information posing a challenge to data collection and possible presenting a distorted picture of service provision. However, records showed that not all rehabilitation professionals were not consulted during the rehabilitation process of care. Ninety-five percent (95%) of the clients consulted with physiotherapists, whereas only 4% consulted social workers. Rehabilitation service providers did not reflect a rehabilitation team. There was a shortage of rehabilitation service providers, in that some centres had full time staff while other centres only had sessional rehabilitation professionals. Service providers were negligent with some of the processes to be followed when consulting clients, such as getting consent to treat the patient and educating patients regarding their ailments, which then affected satisfaction of the patients. However, there were also positive aspects like treating patients with respect and allowing patients to ask questions during consultation. Caregivers on the other hand were satisfied with the rehabilitation process, as they found the centre easily accessible for their family members and were involved in the rehabilitation of the patients. In conclusion, the rehabilitation process was satisfying to the participants of this study. The main challenge that patients and caregivers experienced was financial constraints. Staffing remains a problem in rehabilitation centres in the Western Cape Province, as there were not enough staff for rehabilitation service delivery at these selected rehabilitation centres. Other staff members were not utilised during the rehabilitation process. These findings raise issues for the Western Cape Department of Health to consider regarding rehabilitation, as people with disabilities are not receiving optimal care. The study makes recommendations to the Department of Health in the Western Cape Province regarding the improvement of the rehabilitation process of care.

Magister Scientiae (Physiotherapy) - MSc(Physio) / Background and aim: Despite the high number of strokes globally, and among people of African origin in particular, there are few available data on stroke in most countries of sub-Saharan African (SSA), including Tanzania. In addition, the profile and challenges affecting stroke patients in these countries has not been adequately explored. The aim of this study was to determine the profile and explore the challenges experienced by stroke patients admitted at Haydom Lutheran Hospital in Tanzania. The objectives of the study were to determine the documented risk factors among the patients admitted to Haydom Lutheran Hospital, to identify the stroke on-set admission interval and length of hospital stay, to identify the process of physiotherapy for the stroke patients, and to explore the challenges experienced by stroke patients discharged from Haydom Lutheran Hospital, Tanzania. Methods: Qualitative and quantitative research designs were used to collect the data. The quantitative design used a retrospective descriptive study, in which medical records of stroke patients were reviewed. The qualitative approach included in-depth interviews to collect information regarding the challenges experienced by stroke patients residing in Haydom, Tanzania. Existing medical records were perused to obtain information related to demographic profile, medical characteristics and rehabilitation data among stroke patients admitted at Haydom Lutheran Hospital. Relevant data was captured on a data information sheet. The SPSS (14.0 version) and Microsoft Excel (2007) were used to analyse quantitative data. Descriptive Statistics were used to determine ranges, percentages, frequencies, means and standard deviations calculate. The qualitative interviews were transcribed verbatim and also translated from Kiswahili to English. Stated concepts were coded, grouped into categories, and reduced into sub-themes and main themes. Prior to conducting this study, final permission was obtained from the Senate Research Grant and Study Leave Committee at the University of the Western Cape as well as the relevant authorities of the Tanzania Ministry of Health, Tanzanian National Institute of Medical Research, and the Administration of Haydom Lutheran Hospital. Written informed consent were obtained from the participants prior to interviews. Results: A total number of 145 stroke patients were admitted to Haydom Hospital between 1st January 2004 and 31st December 2010. However, only 128 of the potential sample participants met the inclusion criteria for the sample. The mean age of the participants was 57.7years, (SD=18.673). Of these, 104 (81.2%) had haemorrhagic stroke and 24(18.7%) had ischemic strokes. HIV infection (78.1%), previous stroke (74.2%), smoking (58.5%) and hypertension (55.4%) were the most common risk factors for stroke. Among the participants, the documented impairments included emotional impairments 42(32.8%), speech impairment 47(36.7%), cognitive impairment 39(30.4%), muscle impairment 36(28.1%), and occurrence of coma 33(25.8%) respectively. The mean time from onset of stroke to admission was 1.2 days with (SD=0.42 days). The mean length of hospital stay was 12.16 days (SD=4.1 days), the majority (61.7%), started physiotherapy within 3 days after admission, mean duration of physiotherapy was 14.1 days (SD=5.79), and the mean number sessions of physiotherapy 3.7days (SD=18.8 days). The challenges that emerged during the qualitative interviews with participants were limitation in walking activities, inability to return to work and to participate in leisure activities as before the onset of stroke, and environmental factors such as physical barriers and attitude of family. Conclusion: The findings of the research reveal that stroke in Tanzanian patients occurs at a relatively young age, and that frequency of intra-cerebral haemorrhage is higher than that reported in developed countries. The clinical presentations and risk factors are similar to those in other studies. The qualitative findings revealed that the stroke patients had problems with limitation of activity, participation restrictions, and environmental challenges. They also expressed uncertainties as a result of a lack of knowledge about stroke and its effects, and discharge challenges relating to rehabilitation. These challenges should be addressed in the process of management of patients with stroke in the research setting.

Philosophiae Doctor - PhD / The publication A South African Boxer in Britain contains the unique aesthetic of the Cape Town born boxer Andrew Jeptha, the first black fighter to win a British welterweight title in 1907. The booklet was published in 1910 to offer pecuniary relief to the blinded author (Jeptha) who incurred the affliction during the very match that secured him the title. Thus, although masquerading as a ‘light read’ of sporting achievements and memories from abroad, I argue the booklet authorises a complex thinking on text, disability and boxing. The thesis takes care to present the publication as a crucial historical work that offers a level of psychic and racial strategy not naturally thought to exist in the genesis of a turn-of-the-century boxer. The textual ideation manifest in Jeptha’s booklet is mooted within the thesis as distinctive in its accommodation of both desire and difference, rendering a calculation that sees the text not as the deserted boundary where ‘mind’ and ‘flesh’ depart, but rather as a particular bibliographic configuration where both these worlds meet in a moment that remands reductive views of the gladiator and his words of care. / 2020-01-01