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    Mindful Streets: Examining the politics and practices of everyday mobility negotiated by those who are neurodivergent and the potential for more inclusive (and just) street design for ‘all’
    (University of Waterloo, 2025-12-18) Leger, Samantha
    Accommodating ‘all abilities’ in the planning and design of streets and transport-spaces has been a longstanding, yet unmet, objective in transportation planning. Although the discipline has been striving to become more inclusive with efforts to plan for ‘complete streets’ that accommodate diverse mode-users of ‘all ages & abilities’, the ways in which different abilities are planned for often remain limited. This is evidenced in cursory and unnuanced considerations that do not engage with the relational lived experiences of getting around whilst dis/abled or differently abled (Stafford et al., 2022). As such, despite objectives to accommodate ‘all’ abilities in complete streets planning paradigms, differential mobilities produced by being differently abled can remain under-considered. This is especially true for people who experience cognitive difference or who are neurodivergent, whose mobility needs are too often not well-articulated and are entirely or nearly absent from inclusivity considerations. The misalignment between the promises and outcomes of planning for complete streets inclusivity promises is representative of a broader tension in the planning and design of transportation, wherein inclusive-transportation paradigms are constrained within wider politics of automobility and rationalist legacies within the transportation planning discipline. In this, for what (and whom) the street functions is contested within an inertia of autocentric values, ideologies, and ways-of-planning that have proven difficult to unsettle. However, the resultant status-quo of flattened and ‘one-size-fits-all’ approaches to accommodating differential abilities cannot be upheld. As of 2022, 8 million people across Canada live with some form of dis/ability. Particularly, many of those people fall within the umbrella of being ‘neurodivergent’, including in developmental, learning, and mental-health dis/abilities. Notably, those with development dis/abilities (including Autism Spectrum Condition) were the most likely to report unmet accommodations needs (70%). Moreover, learning dis/abilities, such as Attention Deficit and Hyperactivity Disorder (ADHD), were the second-most emergent form of dis/ability for youth (after only mental-health dis/abilities) (Statistics Canada, 2024a). In this, there is an evident need for transportation planning to challenge the current ways in which neurodivergence is included within the efforts to plan for ‘all’ abilities; but the question then becomes, how? Utilizing a framework informed by both the neurodiversity paradigm, that reframes neurodivergence not as a deficit but rather part of the full-spectrum of cognitive ability and Mimi Sheller’s Mobility Justice, that situates transportation planning within the politics and production of mobilities across the macro, mesa, and micro-political, the enclosed thesis responds to this gap in a three-fold approach which 1) explores how politics of automobility continue to shape emergent transportation-planning paradigms, 2) engages with the lived-experiences of getting around in everyday travel for people who are neurodivergent (those who identify as either Autistic or with ADHD) and 3) interrogates how such experiences can inform more-inclusive efforts to plan for ‘all abilities’ in transportation. To respond to the objectives, a qualitative research approach was designed based in both critical analysis of complete street planning documents (n=5) and sit-down (n=30) and go-along (n=14) interviews with people who are neurodivergent on their experiences of being-in-travel and navigating everyday-travel spaces. The findings were discussed in three manuscripts enclosed within this thesis. Particularly, the first objective is addressed in manuscript #1, which examines the current politics of complete streets through a critical discourse analysis of current complete street design guidelines sourced from across Ontario. This review allowed for a better understanding of how complete street planning paradigms remain embedded within politics of automobility, and the resistant potential of complete streets to emulate vélomobility. This thus provided insight into how transportation planning both influences and is influenced from the macro-political (or from “above”). Of note, the first manuscript provides the basis in which the second and third manuscript were informed, noting that complete street planning paradigms are not untethered from broader societal power-structures which can then construct (or constrain) inclusivity-potential. In the second manuscript, the focus shifted to then unpacking how mobility was then produced in micro-political mobility practices (or from “below”), tracing the differential mobilities produced by people who are neurodivergent. Particularly, this manuscript interrogated the lack of research that engages with dis/abled mobilities, and the relational and lived experiences of navigating and negotiating everyday travel. Based on 30 sit-down interviews with people who identify as Autistic or with ADHD, this analysis traced the emotional influences of mobility and how focus, habit, navigation, and sensory sensitivities constructed everyday mobility practices. Further, the mobile geographies of neurodiversity were then scaffolded; examining the adaptive tactics (relating to negotiating predictability and agency/interest) that emerged and could then subvert expectations for how mobility practice ‘ought’ to function. Finally, the third manuscript examined the experiences of people who are neurodivergent in journeying everyday-transport spaces, and the ways in which differential ways-of-knowing can construct capabilities on the street. Guided by go-along interviews conducted in Waterloo, ON, this manuscript identifies specific transport-spaces that can be overwhelming or disorienting for people who are neurodivergent (including transit stations/stops, shared-spaces, and intersections). From this, recommendations were made for rescoping efforts to plan for ‘all abilities’ which consider neurodivergence and can have the potential to more-inclusively engage with the many ways in which ability is relationally and pluralistically constructed. Overall, this thesis provides transportation planning scholars and practitioners with an alternative framework for confronting the complex politics that then construct for whom streets and everyday-transport spaces function; interrogating how to more meaningfully- and mindfully- plan for ‘all abilities’ on the street and in transport spaces. Aptly, throughout this research, transportation planning, particularly complete street planning paradigms, are (re)situated within the production of mobilities as a means to close-the-gap between current complete street initiatives, and their mobility-justice potential (Sheller, 2018).
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    Health System Resilience for Climate Change Adaptation: An Empirical Evaluation of Access and Utilization in Western Province, Zambia
    (University of Waterloo, 2025-12-18) Chiarot, Cameron B.
    Background Achieving Universal Health Coverage (UHC) in low- and lower-middle-income countries (LMICs) is jeopardized by the convergence of climate-related shocks and chronic health systems stressors. In Western Province (WP), Zambia, a vast, rural, and remote area characterized by the Barotse Floodplain, progress toward UHC is hindered by the interplay between seasonal flooding variations and pre-existing challenges such as low health facility density and geographic barriers to accessing and utilizing essential primary health care services. A significant gap exists in the empirical evidence necessary to quantify these adverse synergistic interactions, improve routine surveillance systems that currently lack reliable population denominators, and develop dynamic models to assess the impact of shocks and stressors on health service utilization. Objectives This dissertation develops and applies a comprehensive methodological framework to empirically evaluate access to and utilization of essential health services in WP, Zambia. It endeavors to (1) define and measure the dimensions of access, encompassing supply- and demand-side conditions within the context of spatial and temporal parameters; (2) establish an innovative methodology for generating population denominators to enhance disease surveillance and epidemiological metrics; (3) quantify the synergistic impacts of environmental and systemic challenges on service utilization through a novel econosyndemic framework; and (4) model health system resilience dynamically by forecasting utilization patterns and evaluating the effects of various shocks and stressors over time. Furthermore, this dissertation concludes with a policy brief, representing a preliminary policy assessment (Phase I) that employs a location-allocation model to optimize the current health facility network for geographical efficiency, thereby identifying existing access gaps and redundancies within the system. This initial optimization serves as a foundation for a proposed multi-stage framework designed to generate actionable investment strategies by integrating health system capacity, cost considerations, and evolving population needs into future analyses (Phase II). Ultimately, this work offers an integrated, evidence-based framework aimed at strengthening health system resilience as a vital climate change adaptation strategy, thereby advancing the overarching objective of ensuring equitable access to healthcare for vulnerable populations. Methods This dissertation, grounded in comprehensive research, comprises four empirical studies in addition to a policy analysis. Study no. 1 employed a cross-sectional design utilizing geospatial analysis of 220 health facilities (centres and posts) to assess access through metrics such as facility density, population growth, travel durations, and personnel distribution. Study no. 2 introduced and applied an innovative Spatially Defined Catchment Area and Population Under Rooftop (SCSO-PUR) methodology, leveraging satellite data to establish denominators for 321 health facilities, as exemplified in a malaria surveillance epidemiological case study spanning 2017 to 2024. Study no. 3 presented and quantified the econosyndemic framework within an ecological longitudinal study of 62 health centres and posts from 2017 to 2023, employing beta regression and structural equation models (SEM) to analyze the interaction between flood exposure and health system capacity concerning maternal and child health, as well as overall general utilization (i.e., outpatient visits). Study no. 4 utilized time-series forecasting and an Interrupted Time Series (ITS) analysis on the same dataset to measure the dynamic effects of three distinct shocks—the 2019 drought, the 2021 COVID-19 pandemic, and the 2023 complex flood event —on overall utilization, namely outpatient visits. The Policy Brief, Preliminary Assessment (Phase I), employed a Set Covering Problem (SCP) model on the network of 321 facilities to optimize geographic coverage and identify system-wide efficiencies. Findings Geographic access constitutes a primary barrier, with projected declines in facilities per capita and estimated mean travel times ranging from 6.6 to 13.9 hours. A substantial proportion of the population (26.4%, exceeding 322,000 individuals) resides beyond the World Health Organization's recommended two-hour travel time to a comprehensive Health Centre. The SCSO-PUR methodology has demonstrated feasibility in establishing standardized denominators, thereby elucidating previously obscured spatial-demographic disparities in malaria risk. The econosyndemic framework has been empirically validated; notably, the interaction between high flood depths and health system stressors was found to significantly disrupt essential services, including antenatal care (ANC) and facility-based births. The Interrupted Time Series (ITS) analysis indicates that various shocks yield distinct and quantifiable impacts on overall utilization patterns, ranging from immediate declines (drought) to paradoxical increases (COVID-19) and gradual recoveries (i.e., complex flood event). Lastly, the health system optimization analysis uncovers significant spatial redundancy; specifically, while comprehensive geographic coverage could be theoretically achieved with only 46 of the 321 existing facilities, this would entail accepting travel times of up to 7.5 hours, thereby underscoring a crucial trade-off between efficiency and equitable access. Conclusion This dissertation provides a comprehensive, empirically grounded framework for understanding and strengthening health system resilience in a climate-vulnerable setting. It demonstrates that the adverse synergistic interaction between environmental shocks and systemic supply- and demand-side stressors creates an econosyndemic that dynamically and inequitably disrupts access to and utilization of essential health services. The novel methodologies developed offer scalable, data-driven tools for ministries of health to transition from reactive to proactive, evidence-based planning. The findings provide a clear policy directive: building health system resilience for climate adaptation requires targeted, context-specific interventions that address underlying vulnerabilities in infrastructure and geographic accessibility.
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    The Role of ICT MNCs in Climate Adaptation Through Disaster Response: Motivations, Technology, and Climate Security Implications
    (University of Waterloo, 2025-12-18) Battikh, Joe Yousr
    Climate change is intensifying the frequency and severity of natural disasters with devastating effects, particularly in developing countries where vulnerabilities are amplified, while traditional disaster management and governance systems are increasingly overstretched. These climate-driven crises, which cost billions and displace millions annually, demand urgent adaptation to mitigate their catastrophic impacts on fragile societies. Multinational corporations (MNCs), especially those from the Information and Communications Technology (ICT) sector, are emerging as critical actors in disaster response, leveraging their resources and expertise to support relief and recovery efforts. This dissertation examines the role of ICT MNCs in addressing natural disasters, and explores their interventions, motivations, and potential to mitigate climate security risks by enhancing resilience in vulnerable regions. Through a multi-method approach, including bibliometric analysis, content analysis of sustainability reports, and a qualitative case study, this research reveals the growing involvement of ICT MNCs in disaster response by utilizing their technological capabilities to bridge critical gaps. However, a concerning geographical disparity is identified with declining corporate engagement in developing countries, despite their increased vulnerability. The case study of ICT MNCs' response to the 2024 Cyclone Hidaya floods in Kenya proposes the empirically grounded TEC Response framework (Triggering response–Engagement motivation–Championing technology), illustrating how corporate interventions are triggered by local presence, driven by a complex interplay of corporate social responsibility (CSR), ethical imperatives, and strategic interests, and implemented by leveraging core technological competencies. This dissertation affirms established CSR theory and contributes novel empirical insights to private governance scholarship by providing empirical evidence of the strategic and ethical dimensions of MNC involvement in disaster contexts and by highlighting their voluntary, uneven, and often unaccountable role in disaster governance, including their capacity to mitigate or inadvertently reinforce climate-induced vulnerabilities. The findings offer practical insights for policymakers and MNCs, emphasizing the importance of cross-sector collaboration, technological integration, and long-term resilience-building to enhance equitable and sustainable disaster management and climate adaptation efforts while addressing critical gaps in mitigating climate-induced vulnerabilities in fragile settings.
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    Examining the influence of attentional distraction and emotional distress on gait behaviour in Functional Gait Disorders
    (University of Waterloo, 2025-12-17) Girlea, Alexandra Laura
    Functional Gait Disorders (FGD) are a subgroup of Functional Neurological Disorders (FND) that are characterized by the presence of abnormal postures and movements whose appearance and severity fluctuate, or are inconsistent, over time. These movements appear voluntary but are reported to be involuntary by the patient. FGD symptoms may arise from abnormalities in attentional and emotional regulation, and these dysfunctions lead to loss of agency (control) over movement. These movements may mimic those of other neurological disorders, however sensory and motor testing reveals normal function. This preservation of function despite symptom presentation is referred to as symptom incongruency. Due to the inconsistency and incongruency FGD symptoms, as well as the heterogeneity in phenomenology across individuals with FGD, diagnosis proves a challenge. Individuals with FGD often face delays and excessive costs when pursuing an appropriate diagnosis, ultimately prolonging their disability and delaying access to adequate treatment. A majority of previous work has utilized qualitative approaches to phenotype FGD and aid in diagnosis. While these approaches provided key foundational information about FGD, they do not capture all aspects of FGD. Therefore, quantitative methods of FGD may provide more insight into its phenomenology. However, there is a lack of work utilizing quantitative approaches in FGD. Existing work has primarily focused on the influence of attentional distraction on symptom presentation and severity during gait, providing mixed evidence addressing the influence of attention on functional gait. Similar to qualitative descriptions, some quantitative evidence shows an improvement in symptom presentation and severity while completing a secondary task. To date, there have been no studies investigating the effect of emotional distress on gait in FGD, and this area would be important to investigate given that emotional dysregulation is a key component of FGD phenomenology. While anxiety during gait has been manipulated with postural threat paradigms, the threat of shock paradigm has also been shown to elicit anxiety in laboratory settings. However, the threat of shock has not yet been utilized in gait research. Investigating its validity for use in gait may provide more insight into how this paradigm provokes anxiety during walking, and how walking may change during this scenario. As such, the present thesis aims to address several gaps in the literature. The first is that there are few quantitative descriptors of FGD phenomenology, therefore identifying descriptors may complement and augment qualitative observation and subsequent diagnosis. The second is that while the influence of attention has been investigated in FGD, there has been limited work done investigating the influence of emotional distress on gait in this population, despite its self-reported influence on symptom provocation. Understanding or characterizing the influence of emotional distress on gait in this group may provide novel insights for clinical diagnosis. The use of the novel threat of shock paradigm may also provide more insight into the influence of anxiety on walking in FGD. Together, the present study aimed to address these gaps by utilizing the novel threat of shock paradigm to investigate the influence of attentional distraction and emotional distress on gait behavior and symptom severity in individuals with FGD. It was expected that the threat of shock paradigm would elicit anxiety in all participants. Additionally, it was expected that the dual task would lead to normalized gait in the FGD group, and that the threat of shock would yield a worsening of gait in the FGD group. Finally, it was anticipated that greater levels of movement reinvestment in FGD patients would be associated with a greater dual-task effect on gait in this group, meaning that greater reinvesters would show a greater degree of movement normalization when completing a dual task compared to walking in the absence of a dual task. Eleven FGD patients and 17 age- and sex-matched controls completed 11 walking trials that spanned 4 conditions (neutral, dual task, shock, dual task + shock). All participants self-reported their level of anxiety after each trial, and at the end of the study, completed a battery of questionnaires addressing their movement reinvestment and anxious tendencies. The present study confirmed the utility of the threat of shock during gait, as participants reported greater anxiety when the shock was present. Interestingly, the dual task did not lead to gait normalization in FGD patients. Rather, both patients and matched controls showed worsened gait in the presence of the dual task. Additionally, the threat of shock only impacted step length variability in FGD patients, wherein patients showed greater variability compared to controls in both the presence and absence of shock. Finally, the present study revealed insights into the relationship between reinvestment and symptomology in FGD, wherein patients with a greater degree of reinvestment showed improved gait while dual tasking compared to their baseline gait. Taken together, the present study not only illustrates the utility of the threat of shock paradigm in gait assessments, but also shows nuances in the relationship between attentional distraction and FGD symptomology. Findings from the present study set the stage for future use of the threat of shock during gait, as well point to the importance of movement reinvestment in the presentation and potential resolution of symptoms in FGD. Future work should continue to investigate reinvestment in the context of FGD and should take a more nuanced and individualistic approach to better encapsulate the heterogeneity inherent in functional gait disorders. Doing so may provide a more complete picture of these disorders and may improve characterization, diagnosis, and treatment of these patients.
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    A Neural-network-based Solver for the Three Dimensional Shape of Vesicle Membranes
    (University of Waterloo, 2025-12-17) Rohanizadegan, Yousef
    A neural-network-based numerical solver is developed for computing three-dimensional (3D) equilibrium shapes of deformable biomembranes, specifically phospholipid vesicles modeled by Helfrich's curvature elasticity theory. The solver represents vesicle morphology using a phase-field formulation, in which a scalar field distinguishes the interior and exterior of the vesicle through a diffuse interface. The phase field is parameterized by a compact feedforward neural network, and the equilibrium shape is obtained by direct minimization of the Helfrich bending energy subject to global surface-area and volume constraints, enforced via Lagrange multipliers. Automatic differentiation is used to evaluate all spatial derivatives, thereby avoiding finite-difference truncation errors and explicit surface discretization. This framework produces both axisymmetric and fully non-axisymmetric vesicle shapes without imposing symmetry assumptions. Canonical free-space branches, namely prolates, oblates, and stomatocytes, are reproduced, and the classical bending-energy–reduced-volume diagram is recovered in close quantitative agreement with established results in the literature. In addition, a phase-field expression for the bilayer area-difference constraint is derived and incorporated into the solver, providing a numerical setting for the computation of non-axisymmetric equilibrium morphologies in free space. A major contribution of this work is a systematic investigation of vesicle morphology under confinement. Vesicles are studied within a range of hard-wall geometries, including cylindrical (tube), slit, spherical, and cubic confinements. By varying confinement size and reduced volume, the solver captures a rich spectrum of deformations, including biaxial squeezed states, bent prolates, squeezed stomatocytes, and cubic and clam-like morphologies. Stability diagrams, bending-energy curves, and phase diagrams are constructed for each confinement, revealing both discontinuous (first-order) and continuous (second-order) shape transitions, as well as hysteresis and metastable branches. These results extend existing confinement studies by providing fully three-dimensional, non-axisymmetric solutions across multiple geometries and different regimes of confinement (free space to weak to strong) within a unified computational framework. Overall, this work establishes a versatile and scalable neural-network-based phase-field approach for vesicle shape modeling. By unifying classical membrane elasticity theory with modern machine-learning optimization, the solver facilitates a structured exploration of equilibrium morphologies, phase transitions, and confinement effects beyond the reach of traditional axisymmetric or surface-discretization methods. The framework provides a foundation for future extensions to more complex membrane models, dynamic processes, and biologically relevant geometries in soft-matter and biophysical systems.