ABSTRACT: THE EFFECT OF A COMPREHENSIVE OCCUPATIONAL THERAPY INTERVENTION PROGRAMME ON THE OCCUPATIONAL PERFORMANCE OF PEOPLE WITH RHEUMATOID ARTHRITIS, LIVING IN SOWETO. C Dreijer du Plessis Post-graduate student, University of the Witwatersrand, Johannesburg, South Africa Introduction: Rheumatoid Arthritis (RA) is a chronic disabling joint disease. Empowering patients with RA to self manage the disease can lead to changes in behaviour, pain or physical health and psychosocial health status. Limited evidence exists for the efficacy of comprehensive Occupational Therapy (OT) intervention for patients with RA in improving functional ability. Objective: The primary objective of the study was to evaluate the impact of comprehensive OT intervention on patients with RA in producing a sustained improvement in patients' functional ability. Methods: A prospective randomized control study over 4 months in which patients with moderately disabling RA, following a week of in-patient rehabilitation care, received either home visits and focus group care (group 1) or standard care (group 2). Primary outcome measures included the modified Health Assessment Questionnaire Disability Index (HAQ-DI), Disease activity score (DAS28) and SF- 36 scores. Results: There were 29 and 22 patients in each group, respectively. The HAQ-DI improved significantly in both groups following the 1 week in-patient care (p<0.05) and there was a clinically significant difference between the groups at the 4 months follow-up visit. The SF-36 scores did not change significantly for group 1 while group 2 showed significant improvements in 5 of the 8 domains at four months. However, group 2, had significantly worse SF-36 scores at baseline compared to group 1. There was a significant improvement in disease activity with the experimental group having 25% fewer tender joints. During the focus groups,the two main themes of "behavior and self management" and "problems that interfere with occupational performance" emerged. Conclusion: A comprehensive in-patient occupational therapy programme does lead to sustained significant improvement in functional ability and Health related quality of life (HR-QOL). Focus groups and home based intervention appears to have a clinically significant impact on disease activity. Key words: Rheumatoid Arthritis, Comprehensive Occupational Therapy intervention, Home based intervention, Occupational Performance.

I denna uppsats görs en jämförelse mellan läromedel i spanska för nybörjare. Betoningen ligger på grammatik och länderkunskap. / This essay presents a comparasion between different educational materials for beginners in Spanish. The author emphasizes grammar and knowledge about the Spanish speaking countries.

Bringing nature back to cities to counteract the negative impacts of rapid urbanization has resulted in a series of greening terms coined by multidisciplinary scholars to emphasize the importance of natural areas and green environment in developing cities. Green infrastructure and nature-based solutions are popular scientific terms that are used to describe planning interventions for naturalization cities, but most of their studies still focus on academic literature, lacking attention to municipal plans. This study aims to identify terms related to green infrastructure and nature-based solutions in planning, analyze how these terms are used and varied in the municipal comprehensive plans in Stockholm County, and explore if the socioeconomic factors and context of these municipalities correlate to any variation. The study used systematic mapping literature and personal communication with planners to identify the relevant terms of green infrastructure and nature-based solutions, in order to carry out quantitative and qualitative analyses of the identified terms in the comprehensive plans of the municipalities in the county using NVivo and SPSS. The quantification analyses show that the integration of these terms varies significantly among municipalities even though the number of terms grows over time; however, this variation does not follow or correlate to any socioeconomic factors that characterize the municipalities. There are also differences between municipal plans in terms of definitions, functions, and other categories of content about the use of the terms. Regional plans are found to impact narrowing these differences significantly. Thus, regional authorities are suggested to publish the core principles on these terms to ensure the consistency of understanding among municipalities. Furthermore, a diagram of these terms showing how they are currently related to each other in most of the plans is concluded as a basis for future cross-municipal and intra-regional conversations. Future studies are recommended to focus on green infrastructure and nature-based solutions in detailed plans and green plans for implementation and a deeper understanding and to have more interviews with the planners for supporting planning practices of green infrastructure and nature-based solutions in cities.

The purpose of this qualitative study was twofold: (a) to investigate how a service-learning class assisted in achieving the goals of a comprehensive guidance and development program in a junior high school, and (b) to examine the effects of a service-learning class on junior high school students. Thirty students who had been in the service-learning class participated in semi-structured interviews. Parents and teachers were also interviewed to cross-validate student perceptions. Interviews were transcribed and analyzed to identify core meanings. Using phenomenological analysis, eight major themes were identified: personal awareness, social skills development, learning skills, career interests, character education, application of class, class satisfaction, and program administration. Each of the eight themes also had several sub-themes. Currently, there is a paucity of research regarding counselors using service-learning as a method to assist in achieving comprehensive guidance program goals. This study found that service-learning is an effective method of comprehensive guidance program delivery and is beneficial to students. Limitations of the study are described and ideas for future research are presented.

京都大学 / 新制・論文博士 / 博士(農学) / 乙第13507号 / 論農博第2905号 / 新制||農||1095(附属図書館) / 学位論文||R4||N5407(農学部図書室) / (主査)准教授 沈 金虎, 教授 浅見 淳之, 教授 栗山 浩一 / 学位規則第4条第2項該当 / Doctor of Agricultural Science / Kyoto University / DFAM

京都大学 / 新制・課程博士 / 博士(農学) / 甲第24673号 / 農博第2556号 / 新制||農||1099(附属図書館) / 学位論文||R5||N5454(農学部図書室) / 京都大学大学院農学研究科応用生命科学専攻 / (主査)教授 矢﨑 一史, 教授 梅澤 俊明, 教授 伊福 健太郎 / 学位規則第4条第1項該当 / Doctor of Agricultural Science / Kyoto University / DGAM

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