Philosophiae Doctor - PhD / The ubiquitous urban informality that characterises the cityscape of most sub-Saharan cities, has been impacted by states’ rationalised urban planning interventions to make urban spaces, and the activities of citizens more legible and governable. This study aimed at understanding the effects of urban planning and the regulatory environment on the business operations of the home-based entrepreneurial households and the strategies employed by these households to ensure their livelihood survival. The study used Katanga slum in Kampala, Uganda as a case study. The study approaches urban planning as a dialectical process, and therefore critically discusses the production and use of space (through urban planning) at different spatial scales of the city, slum and household, while highlighting the challenges experienced by the households and how they cope with these challenges. To facilitate the understanding of these issues, the study employed an integrated theoretical framework that comprised of Lefebvre’s theory of the production of space, Scott’s concept of state legibility, Jalan & Ravallion’s concept of urban spatial poverty traps, and Clark’s border theory.

Background: Physical training is recommended in various national and international guidelines for patients with cancer. Observational studies have shown that physical activity leads to reduced recurrence and mortality rates by 20–40% in colorectal, breast, and prostate cancer. Despite existing evidence, a systematic care structure is still lacking. The primary aim of this study is to implement and evaluate an online training platform to strengthen physical performance and patient empowerment after cancer surgery. Methods: The evaluation will be conducted as a prospective multicenter randomized controlled trial with three subgroups (colorectal-, breast-, and prostate cancer). Each group will include 100 patients (total 300 patients including dropouts; clinical stages T1–3 and/or N+; M0 after surgery intervention) and the primary endpoint (13% increase in the maximal oxygen consumption during exercise) will be examined. The intervention group will receive a 6-month home-based online training (2–3 times per week strength-endurance training using video presentations), bidirectional activity feedback information, online communication, and online counseling. The control group (usual care) will be advised lifestyle improvement. In-hospital testing will be performed before, during, and after the intervention. In addition to cardiopulmonary capacity, tumor specific diagnostics (liquid biopsy, depression and fatigue assessment, metabolic and endothelial screening) will be applied. Discussion: Due to the increasing incidence of cancer, associated with considerable mortality, morbidity and impaired quality of life, there is an imperative requirement for improved cancer care, of which structured physical training may become an integral component.

Students at a Title I middle school in Georgia have scored low on standardized state tests for several years. Of the many possible ways to address low test scores, the school focused on increasing parental involvement, which can have a strong positive correlation with academic success. Researchers have indicated that parental involvement programs are more successful when created based on the specific motivations of parents. Therefore, the purpose of this study was to examine the effects of parental motivation on parents' home-based and school-based involvement behaviors. The theoretical framework for this study was the work of Hoover-Dempsey and Sandler who determined 3 kinds of motivation to influence parental involvement behavior including personal motivation for involvement, invitations for involvement, and life context. A survey was used to collect data on the 3 kinds of motivation from 174 parents of 6th graders. Regression analysis revealed invitations for involvement to have a strong, positive effect on school-based involvement and a slight positive effect on home-based involvement behaviors. Life context had a moderate positive effect on home-based involvement. Personal motivations had no significant effect on either type of involvement behaviors. These results support some prior findings, but conflict with others, emphasizing that each school site is different and needs a customized approach. Recommendations included increasing invitations for parental involvement, which would increase both school-based and home-based involvement behaviors. Such use of the findings may positively affect social change by increasing parental involvement and ultimately the academic success of students.

Adolescent engagement in home-based treatment is a challenge within the social work field. Studies have suggested that the foundation of clinical practice relies on the clinician's ability to understand the process of engaging adolescents in treatment, which may also include a period of adaptability, relatability, and connectedness within the treatment setting. The purpose of this study is to explore the clinical practice approaches, roles, and experiences utilized in home-based treatment to adolescents residing in a large city in northeastern United States. This study was grounded in the ecological systems theory which provides social workers with an opportunity to assess the relationships between an individuals behaviors and the environment. A qualitative research design was used in this study. Social work clinicians participated in focus groups to address the clinical roles, characteristics, and skills essential for reducing barriers related to adolescent engagement in home-based treatment and explore the clinical practice approaches and knowledge base related to adolescent engagement in home-based treatment, including the areas of competence, respect, empathy, and passion. Data were analyzed using audiotapes of the focus groups, the transcription process, coding, and a reliability check. Findings from this study suggest that effective social work practice techniques depend upon the clinician's ability to engage the adolescent throughout the entire treatment process. The outcomes for this action research study included both challenging and rewarding opportunities for clinicians to increase understanding of characteristics, skills, values, and experiences in providing home-based treatment to adolescents of a large city in the northeastern United States.

Home-based psychotherapy has expanded in the mental health community; however, little was known about the therapists' comfort level in a home-based venue. The purpose of this quantitative study was to assess therapists' comfort level (TCL) in providing psychotherapy in a home-based setting and how therapeutic competency (TC), therapeutic relationship (TR), and advanced therapeutic training (ATT) related to the comfort level. The social-ecological systems theory and the theory of comfort served as the theoretical frameworks. The present study used the Therapist Comfort Scale, Counseling Competencies Scale-Revised, the Scale to Assess Therapeutic Relationship in Community Mental Health Care-Clinician, and a demographic questionnaire. A multiple linear regression and correlational analysis were conducted to assess the predictive relationships among the variables. The participants were 76 therapists who provided psychotherapy in a home-based setting. The results revealed a statistically significant positive relationship between TCL and TR. This finding indicated that as the TR score increased, TCL also increased. There was a statistically significant positive relationship between TCL and TC, which indicated that as the TC score increased, TCL also increased. There was a statistically significant positive relationship between TCL and ATT, which indicated that as the ATT score increased, TCL also increased. It was hoped that this study's findings can serve to inform and guide the home-based psychotherapists to improve their therapeutic relationship. Once the therapeutic relationship is formed, the therapists will obtain a high level of comfort in discussing concerns openly with the patients, and parents/caregivers. In addition, when therapists reach a high level of comfort, it could make a positive difference in the patients' treatment outcomes. Thus, the findings of this study initiated positive social change at the level of the individual home-based therapist as well as to the vulnerable population that they serve.

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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.

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Background: People who have experienced a moderate or severe traumatic brain injury (TBI) will most likely live with motor and cognitive deficits including balance and poor mobility. These deficits may lead to limitations in activity participation, life satisfaction, and may increase the risk of falls. Improving access to rehabilitation care in the chronic phase of recovery is essential to prevent ongoing health issues. However, geographical restrictions, cost of transportation, or recently the COVID-19 pandemic restrictions may limit access to rehabilitation services. Telerehabilitation could serve as an alternative method to provide rehabilitation care while increasing access. Objectives: The overall objective of this dissertation was to understand the implementation of high-intensity telerehabilitation exercise programs for people living with a moderate or severe TBI and their family partners. This was accomplished by 1) determining the feasibility of using telerehabilitation, 2) investigating the effectiveness of high-intensity home-based telerehabilitation exercise programs on physical activity, functional mobility and dynamic balance, 3) understanding the perspectives and lived experiences of completing a telerehabilitation program, and 4) exploring how interpersonal behaviours can influence practice and be perceived in a telerehabilitation setting. Methodology: Influenced by a people-centered approach and explained by the Self-Determination Theory, this dissertation followed a mixed-method alternating single-subject design methodology. Five dyads composed of five persons living with a moderate or severe TBI and their family partners completed two high-intensity telerehabilitation programs remotely supervised, daily and weekly. The feasibility and effectiveness of the telerehabilitation programs were measured from a quantitative and qualitative perspective to replicate the clinical realities and understand all perspectives. Results: In this dissertation, the feasibility of using telerehabilitation with this population was highlighted by reporting high adherence, high usability, active engagement and safety. The effectiveness on physical activity levels, functional mobility, dynamic balance and concerns with falling was also demonstrated with no differences between the daily and weekly remote supervision schedule. The dyads described being highly satisfied, engaged, and enjoyed the remotely supervised exercise programs. The individuals with the TBI perceived more supportive behaviours than thwarting behaviours from the physiotherapist. Conclusion: This dissertation advances knowledge on telerehabilitation implementation for people living with cognitive and motor deficits following a TBI. High-intensity home-based telerehabilitation programs were shown to be feasible and effective. I introduced the importance of assessing needs-supportive and needs-thwarting interpersonal behaviours in the telerehabilitation context. Integrating these novel telerehabilitation concepts within emerging telerehabilitation models of care could significantly impact long-lasting positive health outcomes for individuals living with a moderate or severe TBI.