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PubMed2004

Community concepts.

Since the publication of "Sustainable Communities--building for the future", Government attention has focused largely on high-density affordable housing in the four "growth areas": Thames Gateway; Ashford; Milton Keynes--South Midlands, and London--Stansted--Cambridge. In this article, Thomas Yeung and Tony Bates suggest that a greater and more sustainable impact would be achieved if architects, planners, and developers considered the potential for community-based water and waste management and on-site energy generation and distribution right from the start of the project. In particular, they consider that the communal nature of hospitals, universities, and public/community housing provides a great opportunity for on-site renewable CHP and/or distributed heating, which could combine global environmental benefits with improved local amenities. They describe a simple model for prioritising energy management in the built environment, and draw on lessons learnt at ETRCL in Dagenham and BedZED in Surrey to offer a few recommendations for Government and developers. Tony Bates is the business development manager for Scott Wilson in the South East and is responsible for the promotion of sustainable communities through relationships with architects, developers, land owners and local authorities. Thomas Yeung leads the Energy Infrastructure Technologies group in Scott Wilson. This team offers an integrated approach to clean community-based energy generation, energy management, waste and water management, sustainable transport, and sustainable buildings/communities.

Conservation of Energy Resources↗

PubMed2004

The prevention of obesity in children.

A dramatic increase in the prevalence of overweight and obesity among children in Europe has occurred in the last twenty years, especially the last ten years. The number of overweight children is increasing in the EU by at least 400,000 every year, of which 85,000 are obese. Prevention of further cases is a priority, but the evidence base for child obesity prevention is limited in scope and provides only a few general observations. Prevention will probably require policies that affect not only the family and the school but also affect the wider social context, such as controls on marketing to children and improved safety in the built environment. Scientists and physicians can help to influence policy makers through their professional organisations.

Child↗

PubMed2006

Aging, disability, and frailty: implications for universal design.

Throughout the world all populations are seeing burgeoning numbers of "elders", defined as persons aged 65 year and older. In many countries, including Japan, the United States, Norway, Sweden and the United Kingdom, those aged over 65 are at or approaching 15% of the population. As their numbers have increased, so have their health care expenses, leading to extensive research on the health, well being, and life expectancy of these increasingly older elders. Today this group is further sub-divided: the young-old ages 65-74, the old-old ages 75-84, and the oldest-old ages 85+, for both health care and research purposes. However broad variation still characterizes even these groupings. Rates of frailty and disability increase with increasing age among these elders. For example, inabilities to complete at least one activity of daily living increased from about 5-7% at ages 65-69 years to about 28-36% at ages 85+ in 1987. Death rates continue to decline at all ages past 50 years and rates of disability seem to be doing the same. For the foreseeable future, we may expect increasing numbers of older, frail elders than in previous decades. Thus, people are not only living longer, they generally are healthier at advanced ages than were previous cohorts, thus "old age" disabilities of the 20th century will be put off to even older ages during the 21st century. As yet there is no clear way to assess senescent changes in humans, although activities of daily living, allostatic load, and frailty indices have all been suggested. One future need is greater development and use of universal and accessible design in all aspects of the built environment.

Activities of Daily Living↗

PubMed1989

Epidemiological, demographic, and social correlates of disability among the elderly.

The magnitude and quality of the problem of disability for the United States elderly population was analyzed in a series of projections. An analysis of the impact of disability on this population is more difficult than for other disabled groups because previously, in both the popular and scientific literature, there was the assumption that the prevalence and severity of disability was a natural consequence of the aging process. Such a perspective has implications not only for initiatives to improve the health and functional states of the elderly population but also for the perception of the level of disability, the handicaps associated with it, and the types of services that are appropriately provided. This image of the natural emergence of frailty with age is now challenged by a number of studies. The extreme heterogeneity of functional status in even the oldest-old (those aged 85 and over) population is evidence that functional impairment among the elderly is not a natural consequence of aging and must be evaluated on an individual basis. There is also increasing evidence that the physiological processes generating impairment are subject to intervention and, in some cases, may even be partly reversed and function regained. Recent research has begun to identify the risk factors for such processes and to explicate the mechanisms of these processes so that more effective interventions can be developed. Whatever interventions may be introduced, the demographic aging of the population will cause large increases in the number of disabled elderly. This is a national problem whose magnitude will depend upon the degree to which the broadly defined needs of this population are or are not met. We considered needs on a number of levels. In terms of basic self-care only bathing and toileting are reported as currently "unmet" to a considerable degree. The most serious deficiencies on a relative basis were for physical equipment and changes in the built environment. All of these factors contribute to a general assessment of changes in the size, structure, and needs of the disabled elderly population. It is clear that no single response will suffice given the magnitude of the problems. Thus, a multidimensional approach involving the private sector and state and federal programs, and their coordination, will be needed to develop adequate responses to the problem.(ABSTRACT TRUNCATED AT 400 WORDS)

Activities of Daily Living↗

PubMed1994

MARU.

MARU is a research, postgraduate teaching, information and consultancy unit based in the School of Architecture and Interior Design at the University of North London. We are particularly concerned with the match between health care services and facilities. Our role is to keep abreast of changing philosophies in health service provision and develop ideas and strategies for creating the built environment to implement these changes. We undertake research and consultancy on commission with current specific areas of activity in developing databases of past research in the field, design guidance for primary care buildings for LIG and the Department of Health, strategic studies of services, organisation and space use at primary, secondary and tertiary levels of care.

Architecture↗

PubMed1994

The management of health and safety hazards in tourist resorts. World Tourism Organization.

The enjoyment of a holiday has to do with landscape, buildings, people, and their activities. For truly sustainable development, these components need to become better integrated. Ways of achieving this were discussed at the IVth World Health Organization International Conference on Tourist Health, Rimini, Italy, in May 1994. It was agreed that attention to the health enhancing aspects of each component in the built environment is essential. Risks to health from man-made hazards in tourist resorts therefore need to be eliminated where possible, or otherwise minimised, contained or controlled. A systematic approach is outlined here in which owners, managers, operators, workers and users all have responsibilities and in which occupational physicians can contribute.

Accident Prevention↗

PubMed1993

[Losing your way in the nursing home: spatial orientation from an architectural viewpoint. A review].

Many elderly with senile dementia living in an old people's home or nursing home have problems with spatial orientation and finding their way. The same holds true for confused and disturbed elderly who still live at home. To a large extent these problems result from cognitive and perceptual impairments. However, another important and often underestimated factor is the influence of the built environment. The design of many buildings and outdoor spaces offers insufficient environmental support for route-learning, route-finding and topographical memory, which promotes disorientation. Disorientation is enhanced by repetition of identical units, little differentiation in form, colour and material, and a lack of places with striking perceptual characteristics. This review of the literature on spatial orientation of the frail elderly focuses on dementia patients. It turns out that many guidelines can be offered to reduce spatial disorientation, such as a clear layout of the building, clear functions of spaces and places, adequate contrasts of forms and colours, personalization of places and application of the so called Gestalt Laws. However, empirical research to evaluate the effects of application of these guidelines is still scare.

Aged↗

PubMed1998

[Therapy through architecture].

The paper contains in its introductory part a short analysis of the problem of disability giving the proposal of the strategy for solving the problem of opening the built environment to the disabled people in Poland in the light of experiences of the countries with accessibility legislation. Promoting the idea that all people have only one thing in common--that they are different. To the present time, in the world and in Poland, the amenities provided to disabled persons could be regarded as being minimal in nature, satisfying basic needs. The necessity of disabled persons on the dependence on others, and the lack of independence has created a problem, whereby the disabled persons is unable to fully participate in social and public life, as well as partake of cultural amenities. Universal design is the architectural design philosophy in which the needs of all environment users irrespective of their physical abilities, are recognized in the natural way. At the end of this paper some interesting examples of the German designs for disabled people are presented. The main focus of the E. Feddersen & W. Herder Office is on the social aspect of architecture, especially on the designing of tenements, schools, kindergartens, hospitals and homes for the disabled, retarded and elderly people.

Aged↗

PubMed2006

Built and social environments associations with adolescent overweight and activity.

BACKGROUND: Little is known about the patterning of neighborhood characteristics, beyond the basic urban, rural, suburban trichotomy, and its impact on physical activity (PA) and overweight. METHODS: Nationally representative data (National Longitudinal Study of Adolescent Health, 1994-1995, n = 20,745) were collected. Weight, height, PA, and sedentary behavior were self-reported. Using diverse measures of the participants' residential neighborhoods (e.g., socioeconomic status, crime, road type, street connectivity, PA recreation facilities), cluster analyses identified homogeneous groups of adolescents sharing neighborhood characteristics. Poisson regression predicted relative risk (RR) of being physically active (five or more bouts/week of moderate to vigorous PA) and overweight (body mass index equal or greater than the 95th percentile, Centers for Disease Control and Prevention/National Center for Health Statistics growth curves). RESULTS: Six robust neighborhood patterns were identified: (1) rural working class; (2) exurban; (3) newer suburban; (4) upper-middle class, older suburban; (5) mixed-race urban; and (6) low-socioeconomic-status (SES) inner-city areas. Compared to adolescents living in newer suburbs, those in rural working-class (adjusted RR[ARR] = 1.38, 95% confidence interval [CI] = 1.13-1.69), exurban (ARR = 1.30, CI = 1.04-1.64), and mixed-race urban (ARR = 1.31, CI = 1.05-1.64) neighborhoods were more likely to be overweight, independent of individual SES, age, and race/ethnicity. Adolescents living in older suburban areas were more likely to be physically active than residents of newer suburbs (ARR = 1.11, CI = 1.04-1.18). Those living in low-SES inner-city neighborhoods were more likely to be active, though not significantly so, compared to mixed-race urban residents (ARR = 1.09, CI = 1.00-1.18). CONCLUSIONS: These findings demonstrate disadvantageous associations between specific rural and urban environments and behavior, illustrating important effects of the neighborhood on health and the inherent complexity of assessing residential landscapes across the United States. Simple classical urban-suburban-rural measures mask these important complexities.

Adolescent↗

PubMed2026

Urban Design Quality and Clinical Mental Health: A Systematic Review.

ObjectivesThis systematic review synthesizes empirical evidence on core urban design dimensions that affect clinical mental health outcomes and examines how environmental exposures mediate or moderate these relationships.BackgroundUrban design has increasingly been recognized as a determinant of psychological well-being, yet a standardized framework to evaluate its mental health impact remains underdeveloped.MethodsFollowing PRISMA 2020 guidelines, we systematically reviewed 19 quantitative empirical studies published through January 2025, examining relationships between outdoor urban design features and validated clinical mental health indicators across four major databases.ResultsFindings reveal that urban design influences clinical mental health outcomes (depression, anxiety, stress, cognitive decline) through two objective spatial scales: street-level features (imageability, enclosure, human scale, complexity) and neighborhood environments (land use mix, density, green infrastructure). Environmental exposures (traffic, noise, air pollution) operate as perceptual and experiential mechanisms that mediate or moderate the mental health effects of these spatial design features.ConclusionsWe propose an integrated three-domain conceptual framework distinguishing objective spatial design scales from subjective exposure mechanisms. This framework provides evidence-based guidance for urban planners and policymakers toward creating mentally healthier urban environments.

Humans↗

PubMedDate not supplied

When worlds collide: observations on the integration of epidemiology and transportation behavioral analysis in the study of walking.

Since obesity has emerged as a public health crisis in the United States, the factors that influence physical activity are of interest to both epidemiologists and transportation researchers. This article describes different approaches taken by the two disciplines to this issue. "Utilitarian" walking to accomplish a task, as opposed to structured exercise, could be a highly sustainable way for people to achieve recommended levels of physical activity. Transportation planners have begun to investigate factors of urban form and transportation services that influence the choice to walk. Epidemiologists have become more aware of the importance of factors in the built and social environment that could influence health behaviors like walking. Few transportation studies focus on the generation of the utilitarian walk trip as the key variable; rather, they include it in more general discussions of urban form. Likewise, most epidemiologic studies have not focused on utilitarian walking, but have folded it into an overall measure of physical activity that emphasizes structured exercise. Further transportation research should examine the effects of improved mobility services in addition to alterations of the built environment. Integration of epidemiologic and transportation behavioral research could enhance our understanding of the role of urban and transportation factors on physical activity.

Epidemiologic Studies↗

PubMedDate not supplied

The CAREPLAN knowledge base. A prototype expert system for postpartum nursing care.

With the growth of scientific knowledge in the health care disciplines, it has become increasingly difficult for practicing health care professionals to store and manipulate the information required to make clinical decisions. Where the decision making process can be defined and validated, expert systems will be able to assist beginning professionals to learn appropriate patterns of decision making. This article discusses the rationale for utilization of expert systems in a nursing environment. A prototype expert system called CAREPLAN, developed for use in an obstetrical environment, was built using Personal Consultant Plus, a software tool based on the LISP language. The project demonstrates that it is feasible to develop and validate an expert system for a specialized clinical environment in a relatively short period of time in comparison to traditional development methods. Graphics were used to enhance textual information and to increase user appeal. Strategies for future implementation and evaluation are outlined.

Expert Systems↗

PubMed2000

Light weight concrete: 226Ra, 232Th, 40K contents and dose reduction assessment

Four types of light weight concrete (LWC) commonly used in Hong Kong, namely, autoclave aerated concrete (plus lime), autoclave aerated concrete (plus Pulverized Fuel Ash or PFA), concrete with synthetic aggregate 'Leca' and concrete with polystyrene bean as aggregate were measured for their 226Ra, 232Th and 40K contents using high-resolution gamma spectrometry. All the radionuclide contents except those for the PFA autoclave aerated concrete were below the world averages of building materials. The Ra-equivalents for these four LWC were 49.6, 249, 122 and 44.2 Bq kg(-1), respectively, and were much smaller than a recommended limit of 370 Bq kg(-1) for construction materials for dwellings. The gamma-dose rate for an indoor environment with partition walls built with LWC was estimated to be about 20 x 10(-8) Gy h(-1), which corresponded to a reduction in the effective dose of about 0.25 mSv y(-1) when compared to that obtained for an indoor environment built with normal concrete (NC) only. The Rn exhalation rates from the three lowest Ra-equivalent LWC were calculated as 0.509, 1.28, and 0.335 mBq m(-2) s(-1), respectively, which corresponded to a reduction in the indoor Rn concentration of around 14 Bq m(-3) and reduction in the tracheobronchial dose reaching 1 mSv y(-1) by using the James lung-dosimetry model, when compared to the case of NC.

Journal Article↗

PubMed2006

Total approach is a must for small and medium enterprises to attain sustainable working conditions and environment, with special reference to Bali, Indonesia.

Attention and assistance to enhance the role of small and medium scale enterprises (SMEs) by the government is more emphasized due to the success of SMEs in earning significant amount of foreign currency when Indonesia had to face economical crisis in 1997. This policy has been highly recognized again since the bombing tragedy in 2002; with the excellent evidence to show how important SMEs is in helping and maintaining the economic development of Bali. But in the implementation the assistance needs to be remanaged again in a more proper and appropriate way to attain the ultimate goals. The three economic potentials, agriculture in broad sense, tourism and SMEs (cottage industry included), must be developed in harmony, interdependence, support and complementary each other, if possible as synergist to obtain sustainable development of Bali. While assistance to SMEs must be done in a more coordinated way among the government technical offices, universities, NGOs, banking, and other social community institutions. By doing so, there would be no duplication or gap, nor creation of new disadvantageous problems. It could be in form of ergonomics, occupational health and safety impacts and problems in particular, and in adverse working conditions and environment in general. Therefore it is a must at this moment to carry out total approach in helping SMEs, by integrating the effort to improve their working conditions and environment, built-in within the effort to enhance SMEs'quality of life through economic assistance. In this process a total approach through SHIP approach and Appropriate Technology intervention must be done wisely and timely. By so doing, SMEs'sustainable working conditions and environment shall be attained.

Capital Financing↗

PubMed1999

[Temperature environment and the heat exchange of astronaut in the emergency landing areas].

OBJECTIVE: To analyze the temperature environment of different emergency landing areas and discuss the heat exchange between astronaut and the temperature environment. In addition, countermeasures against the emergency temperature environment were discussed. METHOD: Heat exchange equation between man and environment was built using the law of energy conservation, and factors that affect the heat balance of human body were discussed. RESULT: It was found that temperature, humidity, air pressure, velocity of wind and solar radiation are factors affecting the thermal balance of the astronaut. CONCLUSION: It is important for an astronaut to act properly and use the living devices and the environment conditions correctly during the emergency landing.

Body Temperature Regulation↗

PubMed1998

Mercury Accumulation and Biomagnification in Ospreys (Pandion haliaetus) in the James Bay and Hudson Bay Regions of Québec

Mercury exposure was examined in adults and nestlings of ospreys (Pandion haliaetus) from lakes, rivers, and hydroelectric reservoirs in northern Québec between 1989 and 1991 by assessing the amount of mercury transferred from fish to ospreys, which are voracious fish-eaters. The high mercury concentrations detected in adult feathers and tissues (feathers, blood, liver, kidneys, muscles, brain) of nestlings indicate an increase in mercury availability at recently constructed hydroelectric reservoirs (10-12 years for the La Grande-2 Reservoir). With mean total mercury levels of 37.3 mg/kg and 1.9 mg/kg in feathers (dry weight) and in blood (wet weight), respectively, contamination rates were, in both tissues, five times higher for chicks born near the La Grande Reservoirs (western sector) than in those reared in natural habitats. Furthermore, the mean quantity of total mercury in 40-day-old chicks reared near a reservoir was 10.5 mg, compared with to 1.6 mg for those reared in a natural environment. Modeling of mercury transfer from fish to osprey nestlings showed that the mercury level in chicks' blood provides a good estimate of mercury concentrations in ingested food. In addition, the relationship between mercury concentrations in the blood and that in feathers indicates that substantial biomagnification of mercury occurs from the ingested dose to the feathers. The intensity of this biomagnification varies with the age of the chicks and reaches a maximum value as the flight feathers start to form (at 20-25 days of age) declining thereafter until the bird is 45 days old and growth of those feathers is complete. Nevertheless, the mean number of young fledged on reservoirs where mercury exposure is greatest (>40 mg/kg of Hg in chicks' feathers) did not differ (1.6 +/- 0.7) from that observed elsewhere in built-up environments (1.9 +/- 0.7) or in natural habitats (2.0 +/- 0.7) (H = 4.39; p = 0.11). Storage of mercury in growing feathers (86% of all mercury in osprey) prevents accumulation in living tissues, thereby protecting the chick from related toxic effects. However, toxicological problems may arise after fledging. In particular, attention should be paid to postfledging survival before concluding that mercury exposure is insufficiently high in Osprey young reared at reservoirs.

Journal Article↗

PubMed2000

CXCR5-deficient mice develop functional germinal centers in the splenic T cell zone.

The chemokine receptor CXCR5 is thought to be essential for the migration of B cells into the network of follicular dendritic cells in the spleen. However, as shown here, B cells and follicular dendritic cells do co-localize, albeit aberrantly, even in the absence of CXCR5. In mice lacking CXCR5 both cell types are found in a broad ring around the sinuses of the marginal zones. Upon immunization with the T cell-dependent antigen 2-phenyl-oxazolone, ectopic germinal centers develop in the periarteriolar lymphocyte sheath. A network of follicular dendritic cells forms in the vicinity of the central arteriole within which the antigen-activated B cells proliferate. The analysis of the expressed V gene repertoire revealed that during B cell proliferation, hypermutation is activated and V region genes accumulate somatic mutations. The pattern of somatic mutations suggests that affinity selection may occur. This analysis confirms that in CXCR5-deficient mice, the organization of splenic primary follicles is severely impaired. However, within the T cell zone a micro-environment is built up, which provides all requirements needed for the affinity maturation to take place.

Animals↗

PubMed1997

B-cell activation and development within chronically inflamed synovium in rheumatoid and reactive arthritis.

In autoimmune diseases, B cells often accumulate in the affected tissue. In patients with rheumatoid arthritis or reactive arthritis, germinal center-like structures may develop in the inflamed synovial tissue. B cells from these structures were isolated and their V-gene repertoire determined. The majority of synovial B cells are long-term memory cells and thus are part of the chronic inflammatory reaction. In the synovium a micro-environment is built up which allows the activation of naive and memory B cells and the diversification of their V-gene repertoire. The analysis of plasma cells suggests that these cells are long lived and hence accumulate in the synovial tissue under chronic activation.

Arthritis, Reactive↗