Aim: The overall aim of this thesis was to generate further knowledge about prosthetic and orthotic services in developing countries. In particular, the thesis focused on patient mobility and satisfaction with prosthetic and orthotic devices, satisfaction with service delivery, and the views of staff regarding clinical practice and education. Methods: Questionnaires, including QUEST 2.0, were used to collect self-reported data from 83 patients in Malawi and 139 patients in Sierra Leone. In addition, 15 prosthetic/orthotic technicians in Sierra Leone and 15 prosthetists/orthotists in Pakistan were interviewed. Results: The majority of patients used their prosthetic or orthotic devices (90% in Malawi, and 86% in Sierra Leone), but half of the assistive devices in use needed repair. Approximately one third of patients reported pain when using their assistive device (40% in Malawi and 34% in Sierra Leone). Patients had difficulties, or could not walk at all, with their prosthetic and/or orthotic device in the following situations; uneven ground (41% in Malawi and 65% in Sierra Leone), up and down hills (78% in Malawi and 75% in Sierra Leone), on stairs (60% in Malawi and 66% in Sierra Leone). Patients were quite satisfied or very satisfied with their assistive device (mean 3.9 in Malawi and 3.7 in Sierra Leone out of 5) and the services provided (mean 4.4 in Malawi and 3.7 in Sierra Leone out of 5), (p<0.001), but reported many problems (418 comments made in Malawi and 886 in Sierra Leone). About half of the patients did not, or sometimes did not, have the ability to access services (71% in Malawi and 40% in Sierra Leone). In relation to mobility and service delivery, orthotic patients and patients using above-knee assistive devices in Malawi and Sierra Leone had the poorest results. In Sierra Leone, women had poorer results than men. The general condition of devices and the ability to walk on uneven ground and on stairs were associated with both satisfaction of assistive devices and service received. Professionals’ views of service delivery and related education resulted in four themes common to Sierra Leone and Pakistan: 1) Low awareness and prioritising of prosthetic and orthotic services; 2) Difficulty managing specific pathological conditions and problems with materials; 3) The need for further education and desire for professional development; 4) Desire for improvements in prosthetic and orthotic education. A further two themes were unique to Sierra Leone; 1) People with disabilities have low social status; 2) Limited access to prosthetic and orthotic services. Conclusion: High levels of satisfaction and mobility while using assistive devices were reported in Malawi and Sierra Leone, although patients experienced pain and difficulties when walking on challenging surfaces. Limitations to the effectiveness of assistive devices, poor comfort, and limited access to follow-up services and repairs were issues that needed to be addressed. Educating prosthetic and orthotic staff to a higher level was considered necessary in Sierra Leone. In Pakistan, prosthetic and orthotic education could be improved by modifying programme content, improving teachers’ knowledge, improving access to information, and addressing issues of gender equality.

Doctor Legum - LLD / In recent years, the rights of persons with disabilities have received substantial attention both in South Africa and internationally. While certain rights have received widespread coverage, other rights have not yet been examined to determine the importance thereof for persons with disabilities and to establish the best way in which these rights can be implemented. A right which has not yet been examined in detail is the right to social protection, as guaranteed by Article 28 of the United Nations Convention on the Rights of Persons with Disabilities. Social protection involves the provision of financial support as well as certain services in order to ensure that persons with disabilities are able to participate in society on an equal basis with others. One of the essential components of the right to social protection is the provision of adequate social security for persons with disabilities. Since detailed research on the scope and content of Article 28 has not yet been undertaken, this thesis will investigate what is required of states in relation to the provision of social security in terms of Article 28 of the Convention on the Rights of Persons with Disabilities. In addition, the current provision made for social security for persons with disabilities in South Africa will be examined and evaluated. The investigation into the current social security measures for persons with disabilities in South Africa will commence with the Constitution and proceed to a detailed examination of relevant legislation. Similar legislation and policies from other jurisdictions will also be considered in order to gauge whether any lessons may be learned from the approach taken in these jurisdictions where they differ from the South African approach.

Magister Legum - LLM

People with learning disabilities are subject to a wide range of potential interferences with their choices and freedoms when they are 'placed' in institutional care services. The cumulative and pervasive impact of these regimes can be monumentally detrimental to self and wellbeing. Some have suggested that a new law, the Mental Capacity Act 2005, may limit the interferences that people with disabilities are subject to in care services. In this thesis, I subject the Mental Capacity Act to a critique drawn from new republican political theory. I argue that far from limiting the interferences that people with disabilities are subject to, the Act creates a mechanism which permits a proliferation of arbitrary interferences in people's everyday lives, with little recourse for people to 'invigilate' such interferences. I base this argument on a critical analysis of case law connected to the Mental Capacity Act, and by critically examining four key mechanisms of enforcement: Independent Mental Capacity Advocates, the Court of Protection, complaints procedures and regulation by the Care Quality Commission. I argue that, paradoxically, a framework for detention introduced by the Act - the deprivation of liberty safeguards - in fact contains more ingredients for ameliorating states of domination in these services than the Mental Capacity Act itself. However, the safeguards also suffer from serious defects. I conclude by discussing what lessons may be drawn from the problems with the Mental Capacity Act and the safeguards for wider reform efforts connected with the UN Convention on the Rights of Persons with Disabilities.

<p>Internationally, the rights of persons with disabilities to participate as full members of society through inclusive education has become a high priority with the adoption of the first legally binding treaty, the Convention on the Rights of Persons with Disabilities (2006). In keeping with our culture of acknowledging the rights of all, South Africa has already made great strides towards fulfilling these rights and is in the implementation phase of Education White Paper 6: Building an Inclusive Education and Training System (Department of Education, 2001). In spite of this, the practicability of implementing inclusive education is questioned by many. The inclusion of learners who are blind in neighbourhood schools, as opposed to &lsquo / special schools&rsquo / , is a particularly daunting task. However, the more local cases we have from which to draw insights, the better our chances of making inclusive education both practicable and widely accessible across a range of local contexts. A public, mainstream neighbourhood school that included two learners who are blind was therefore investigated to learn more about how the learners who are blind were physically, socially and academically included in the local school community. Qualitative data collection methods including semi-structured interviews and observations were used to uncover useful strategies, challenges and enabling factors that contributed to their successful inclusion. The findings revealed that the participants in this study had very little knowledge or experience in building an inclusive educational setting at the outset, but engaged in the process with open minds, creativity and trust. By adopting a collaborative approach and an attitude of &lsquo / failing forward&rsquo / , the objective of social and academic inclusion was to a great extent achieved in the school.</p>

<p>Internationally, the rights of persons with disabilities to participate as full members of society through inclusive education has become a high priority with the adoption of the first legally binding treaty, the Convention on the Rights of Persons with Disabilities (2006). In keeping with our culture of acknowledging the rights of all, South Africa has already made great strides towards fulfilling these rights and is in the implementation phase of Education White Paper 6: Building an Inclusive Education and Training System (Department of Education, 2001). In spite of this, the practicability of implementing inclusive education is questioned by many. The inclusion of learners who are blind in neighbourhood schools, as opposed to &lsquo / special schools&rsquo / , is a particularly daunting task. However, the more local cases we have from which to draw insights, the better our chances of making inclusive education both practicable and widely accessible across a range of local contexts. A public, mainstream neighbourhood school that included two learners who are blind was therefore investigated to learn more about how the learners who are blind were physically, socially and academically included in the local school community. Qualitative data collection methods including semi-structured interviews and observations were used to uncover useful strategies, challenges and enabling factors that contributed to their successful inclusion. The findings revealed that the participants in this study had very little knowledge or experience in building an inclusive educational setting at the outset, but engaged in the process with open minds, creativity and trust. By adopting a collaborative approach and an attitude of &lsquo / failing forward&rsquo / , the objective of social and academic inclusion was to a great extent achieved in the school.</p>

Magister Educationis - MEd / Internationally, the rights of persons with disabilities to participate as full members of society through inclusive education has become a high priority with the adoption of the first legally binding treaty, the Convention on the Rights of Persons with Disabilities (2006). In keeping with our culture of acknowledging the rights of all, South Africa has already made great strides towards fulfilling these rights and is in the implementation phase of Education White Paper 6: Building an Inclusive Education and Training System (Department of Education, 2001). In spite of this, the practicability of implementing inclusive education is questioned by many. The inclusion of learners who are blind in neighbourhood schools, as opposed to ‘special schools’, is a particularly daunting task. However, the more local cases we have from which to draw insights, the better our chances of making inclusive education both practicable and widely accessible across a range of local contexts. A public, mainstream neighbourhood school that included two learners who are blind was therefore investigated to learn more about how the learners who are blind were physically, socially and academically included in the local school community. Qualitative data collection methods including semi-structured interviews and observations were used to uncover useful strategies, challenges and enabling factors that contributed to their successful inclusion. The findings revealed that the participants in this study had very little knowledge or experience in building an inclusive educational setting at the outset, but engaged in the process with open minds, creativity and trust. By adopting a collaborative approach and an attitude of ‘failing forward’, the objective of social and academic inclusion was to a great extent achieved in the school. / South Africa

Die Sächsische Staatsregierung hat zur Umsetzung der UN- Behindertenrechtskonvention einen Aktionsplan beschlossen – ein Meilenstein, um die Chancengleichheit von Menschen mit Behinderungen zu verbessern und ihre Diskriminierung zu verhindern. Der Aktionsplan enthält mehr als 200 konkrete Maßnahmen der Staatsregierung, die die gleichberechtigte Teilhabe von Menschen mit Behinderungen in Sachsen sicherstellen sollen. Er trat zum 1. Januar 2017 in Kraft. Die Publikation des Aktionsplans greift die Gestaltung der Kampagne »Behindern verhindern – Zeit für barrierefreies Handeln!« auf. Eine Ausgabe in Leichter Sprache ist in Vorbereitung. Redaktionsschluss: 10.04.2017

A teoria do Poder Constituinte Derivado de Equivalência às Emendas Constitucionais busca abarcar por completo o fenômeno jurídico da aprovação de tratados e convenções internacionais sobre direitos humanos como equivalentes às emendas constitucionais, nos termos do §3º do art. 5º da Constituição, inserido pela Emenda Constitucional nº 45/04. Após a descrição crítica do panorama constitucional, doutrinário e jurisprudencial em que foi engendrado este novo dispositivo do art. 5º e o procedimento pelo qual foi aprovada a incorporação da Convenção sobre os Direitos das Pessoas com Deficiência e de seu Protocolo Facultativo como equivalentes às Emendas, seguem as três partes essenciais e imprescindíveis que compõem a abordagem do tema. A primeira está voltada à caracterização da presença de uma nova manifestação de Poder Constituinte, com o objetivo de oferecer soluções coerentes e consistentemente respaldadas em um arcabouço teórico comum para toda a problemática envolvida, que será especificamente examinada a partir das questões enfrentadas na Parte II. Já a terceira parte está mais atrelada às questões materiais, ao se preocupar com o objeto da equivalência constitucional: se esta inclui todo o diploma internacional; exclusivamente os direitos humanos nele previstos; ou também normas de outra natureza, abstraindo e projetando conclusões a partir da experiência concreta da Convenção. A mais intensa contribuição para o pensamento jurídico encontra-se evidentemente na identificação de uma nova modalidade do Poder Constituinte Derivado; mas também, na conceituação das normas equivalentes às emendas constitucionais; ao se apontar o exato objeto do §3º do art. 5º, desvelando-se a complexidade dos fenômenos envolvidos na introdução da Convenção e de seu Protocolo Facultativo; na delimitação do espectro normativo das normas equivalentes às emendas constitucionais; e na obtenção de uma maior conformidade teórica com os fundamentos dos sistemas jurídicos constitucional e internacional, a partir do entrelaçamento entre as teorias do direito e do Estado; e as disciplinas do direito constitucional; internacional; e dos direitos humanos. / The theory of Constitutional Amendments Equivalence of Derived Constitutional Power seeking to embrace fully the phenomenon of legal approval of international treaties and conventions on human rights as equivalent to constitutional amendments, pursuant to §3º of art. 5º of the Constitution, inserted by Constitutional Amendment nº 45/04. After critically describing the constitutional, jurisprudential and doctrinaire panorama in that was engendered in this new device of art. 5º and the procedure by which the incorporation of the Convention on the Rights of Persons with Disabilities and its Optional Protocol was approved as equivalent to the Amendments, follow three essential parts that make up the approach to the subject. The first is directed to describe the presence of a new manifestation of constituent power, with the goal of providing solutions coherent and consistently backed into a theoretical framework common to all the problems involved, which will be examined specifically from the issues faced in Part II. The third part is more tied to material issues, to worry about the object of constitutional equivalence: if this includes the entire international diploma; exclusively human rights therein, or also rules otherwise, abstracting and projecting findings from the concrete experience of the Convention. The most intense contribution to legal thought is evidently in the identification of a new type of constitutional derived power; but also in the conceptualization of equivalence to constitutional amendments norms; when pointing the exact object of §3º of art. 5º; revealing the complexity of the phenomena involved in the introduction of the Convention and its Optional Protocol; the delimitation of the spectrum of equivalent to constitutional amendments norms; and in obtaining greater theoretical conformity with the fundamentals of the constitutional and international legal systems, from entanglement between the theories of law and the State; and the disciplines of constitutional law; international law; and human rights

When should it be permissible to act against someone's expressed wishes in their best interests? In both political philosophy and legal practice, answers to this question often appeal to the concept of autonomy. Broadly, the idea is that if a person is sufficiently self-governing, then their wishes must prevail; but if they are not, then their wishes need not be respected when promoting whatever is good for them. This thesis analyses both philosophical models of autonomy and the practice of judges in England and Wales when implementing the Mental Capacity Act 2005. With regard to the philosophical models, it finds that, despite claims to the contrary, they do not offer a plausible way of assessing whether someone else is autonomous without appealing to values that are not the person's own. With regard to legal practice, it finds that, although judges speak about 'autonomy' in contradictory ways, a coherent account of when they will find that they must respect a person's expressed wishes can be constructed. This first stage of analysis makes a gulf between 'autonomy' in philosophy and law obvious. When philosophers talk about 'autonomy', they are largely concerned with the person's relationship to themselves. When judges talk about 'autonomy', they are largely concerned with the person's relationship to the world. 'Autonomy' in the philosophical sense cannot justify current practice because it does not deal with the same subject matter. Analysis of mental capacity cases does, however, allow the development of an alternative justification for actions against a person's expressed wishes. This justification lies in an evaluation of the entire situation, not of the person. It is not reducible to any model of autonomy, not even 'relational' models. Taken seriously, this justification requires a reorientation of the ethics of mental capacity law: away from overreliance on relatively few abstract 'principles' and towards articulating the difficulty and complexity of real situations. The thesis offers two papers towards the development of this latter mode.