Designing for dementia : an assessment of the impact of the physical environment on wayfinding success for residents in long term care settings

It is acknowledged that one of the consequences of the ageing process is cognitive decline, which leads to an increase in the incidence of illnesses such as dementia. This has become ever more relevant due to the projected increase in the ageing demographic. Dementia affects visuo-spatial perception, causing difficulty with wayfinding, even during the early stages of the disease. The literature widely recognises the physical environment’s role in alleviating symptoms of dementia and improving quality of life for residents. It also identifies the lack of available housing options for older people with dementia and consequently the current stock is ill-equipped to provide adequate support.
Recent statistics indicate that 80% of those residing in nursing or residential care homes have some form of dementia or severe memory problems. The shift towards institutional care settings, the need for specialist support and care, places a greater impetus on the need for a person-centred approach to tackle issues related to wayfinding and dementia.
This thesis therefore aims to improve design for dementia in nursing and residential care settings in the context of Northern Ireland. This will be undertaken in order to provide a better understanding of how people with dementia experience the physical environment and to highlight features of the design that assist with wayfinding. Currently there are limited guidelines on design for dementia, meaning that many of these are theoretical, anecdotal and not definitive. Hence a greater verification to address the less recognised design issues is required. This is intended to ultimately improve quality of life, wellbeing, independence and uphold the dignity of people with dementia living in nursing or residential care homes.
The research design uses a mixed methods approach. A thorough preparation and consideration of ethical issues informed the methodology. The various facets were also trialled and piloted to identify any ethical, technological, methodological, data collection and analysis issues. The protocol was then amended to improve or resolve any of the aforementioned issues. Initially a questionnaire based on leading design recommendations was conducted with home managers. Semi-structured interviews were developed from this and conducted with staff and resident’s next of kin. An evidence-based approach was used to design a study which used ethnographic methods, including a wayfinding task. This followed a repeated measures design which would be used to actively engage residents with dementia in the research. Complementary to the wayfinding task, conversational and semi-structured interviews were used to promote dialogue and direct responses with the person with dementia. In addition to this, Space Syntax methodologies were used to examine the physical properties of the architectural layout. This was then cross-examined with interview responses and data from the wayfinding tasks.
A number of plan typologies were identified and were determined as synonymous with decision point types which needed to be made during the walks. The empirical work enabled the synthesis of environmental features which support wayfinding.
Results indicate that particular environmental features are associated with improved performance on the wayfinding tasks. By enhancing design for dementia, through identifying the attributes, challenges with wayfinding may be overcome and the benefits of the physical environment can be seen to promote wellbeing.
The implications of this work mean that the environmental features which have been highlighted from the project can be used to inform guidelines, thus adding to existing knowledge. Future work would involve the dissemination of this information and the potential for it to be made into design standards or regulations which champion design for dementia. These would increase awareness for designers and stakeholders undertaking new projects, extensions or refurbishments.
A person-centred, evidence-based design was emphasised throughout the project which guaranteed an in-depth study. There were limitations due to the available resources, time and funding. Future research would involve testing the identified environmental features within a specific environment to enable measured observation of improvements.

Analysis of Transmission Loss with Droop Control in a Multi-Terminal HVDC System

High Voltage Direct Current (HVDC) electric power transmission is a promising technology for integrating offshore wind farms and interconnecting power grids in different regions. In order to maintain the DC voltage, droop control has been widely used. Transmission line loss constitutes an import part of the total power loss in a multi-terminal HVDC scheme. In this paper, the relation between droop controller design and transmission loss has been investigated. Different MTDC layout configurations are compared to examine the effect of droop controller design on the transmission loss.

Investigations on the Analysis and Design of Aperiodic Frequency Selective Surfaces for Space Applications

An investigation on the design of aperiodic FSS is presented. First, an accurate yet efficient method which allows the analysis of finite sized aperiodic FSS has been developed. Subsequently, an optimisation method is implemented which optimises all the FSS elements to obtain an FSS design with an aperiodic element layout. Preliminary designs of aperiodic FSS are presented and the numerical results are discussed.

Exploiting dynamic timing margins in microprocessors for frequency-over-scaling with instruction-based clock adjustment

Static timing analysis provides the basis for setting the clock period of a microprocessor core, based on its worst-case critical path. However, depending on the design, this critical path is not always excited and therefore dynamic timing margins exist that can theoretically be exploited for the benefit of better speed or lower power consumption (through voltage scaling). This paper introduces predictive instruction-based dynamic clock adjustment as a technique to trim dynamic timing margins in pipelined microprocessors. To this end, we exploit the different timing requirements for individual instructions during the dynamically varying program execution flow without the need for complex circuit-level measures to detect and correct timing violations. We provide a design flow to extract the dynamic timing information for the design using post-layout dynamic timing analysis and we integrate the results into a custom cycle-accurate simulator. This simulator allows annotation of individual instructions with their impact on timing (in each pipeline stage) and rapidly derives the overall code execution time for complex benchmarks. The design methodology is illustrated at the microarchitecture level, demonstrating the performance and power gains possible on a 6-stage OpenRISC in-order general purpose processor core in a 28nm CMOS technology. We show that employing instruction-dependent dynamic clock adjustment leads on average to an increase in operating speed by 38% or to a reduction in power consumption by 24%, compared to traditional synchronous clocking, which at all times has to respect the worst-case timing identified through static timing analysis.

PatchCity: Procedural City Generation using Texture Synthesis

PatchCity is a new approach to the procedural generation of city models. The algorithm uses texture synthesis to create a city layout in the visual style of one or more input examples. Data is provided in vector graphic form from either real or synthetic city definitions. The paper describes the PatchCity algorithm, illustrates its use, and identifies its strengths and limitations. The technique provides a greater range of features and styles of city layout than existing generative methods, thereby achieving results that are more realistic. An open source implementation of the algorithm is available.

Museum City - Improvisation and the narratives of space

This paper provides four viewpoints on the narratives of space, allowing us to think about possible relations between sites and sounds, reflecting on how places might tell stories, or how practitioners embed themselves in a place in order to shape cultural, social and/or political narratives through the use of sound. I propose four viewpoints that investigate the relationship between sites and sounds, where narratives are shaped and made through the exploration of specific sonic activities. These are:
- sonic activism
- sonic preservation
- sonic participatory action
- sonic narrative of space

I examine each of these ideas in turn before focusing in more detail on the final viewpoint, which provides the context for discussing and analysing a recent site-specific music improvisation project, entitled ‘Museum City’, a work that aligns closely with my proposal for a ‘sonic narrative of space’.
The work ‘Museum City’ by Pedro Rebelo, Franziska Schroeder, Ricardo Jacinto and André Cepeda specifically enables me to reflect on how derelict and/or transitional spaces might be re-examined through the use of sound, particularly through means of live music improvisation. The spaces examined as part ‘Museum City’ constitute either deserted sites or sites about to undergo changes in their architectural layout, their use and sonic make-up. The practice in ‘Museum City’ was born out of a performative engagement with[in] those sites, but specifically out of an intimate listening relationship by three improvisers situated within those spaces.
The theoretical grounding for this paper is situated within a wider context of practising and cognising musical spatiality, as proposed by Georgina Born (2013), particularly her proposition for three distinct lineages that provide an understanding of space in/and music. Born’s third lineage, which links more closely with practices of sound art and challenges a Euclidean orientation of pitch and timbre space, makes way for a heightened consideration of listening and ‘the place’ of sound. This lineage is particularly crucial for my discussion, since it positions music in relation to social experiences and the everyday, which the work ‘Museum City’ endeavoured to embrace.

Projecto de receptores integrados de banda larga

O presente trabalho tem como objectivo o estudo e projecto de receptores optimizados para sistemas de comunicações por fibra óptica de muito alto débito (10Gb/s e 40Gb/s), com a capacidade integrada de compensação adaptativa pós-detecção da distorção originada pela característica de dispersão cromática e de polarização do canal óptico. O capítulo 1 detalha o âmbito de aplicabilidade destes receptores em sistemas de comunicações ópticas com multiplexagem no comprimento de onda (WDM) actuais. O capítulo apresenta ainda os objectivos e principais contribuições desta tese. O capítulo 2 detalha o projecto de um amplificador pós-detecção adequado para sistemas de comunicação ópticos com taxa de transmissão de 10Gb/s. São discutidas as topologias mais adequadas para amplificadores pós detecção e apresentados os critérios que ditaram a escolha da topologia de transimpedância bem como as condições que permitem optimizar o seu desempenho em termos de largura de banda, ganho e ruído. Para além disso são abordados aspectos relacionados com a implementação física em tecnologia monolítica de microondas (MMIC), focando em particular o impacto destes no desempenho do circuito, como é o caso do efeito dos componentes extrínsecos ao circuito monolítico, em particular as ligações por fio condutor do monólito ao circuito externo. Este amplificador foi projectado e produzido em tecnologia pHEMT de Arsenieto de Gálio e implementado em tecnologia MMIC. O protótipo produzido foi caracterizado na fábrica, ainda na bolacha em que foi produzido (on-wafer) tendo sido obtidos dados de caracterização de 80 circuitos protótipo. Estes foram comparados com resultados de simulação e com desempenho do protótipo montado num veículo de teste. O capítulo 3 apresenta o projecto de dois compensadores eléctricos ajustáveis com a capacidade de mitigar os efeitos da dispersão cromática e da dispersão de polarização em sistemas ópticos com débito binário de 10Gb/s e 40Gb/s, com modulação em banda lateral dupla e banda lateral única. Duas topologias possíveis para este tipo de compensadores (a topologia Feed-Forward Equalizer e a topologia Decision Feedback Equaliser) são apresentadas e comparadas. A topologia Feed-Forward Equaliser que serviu de base para a implementação dos compensadores apresentados é analisada com mais detalhe sendo propostas alterações que permitem a sua implementação prática. O capítulo apresenta em detalhe a forma como estes compensadores foram implementados como circuitos distribuídos em tecnologia MMIC sendo propostas duas formas de implementar as células de ganho variável: com recurso à configuração cascode ou com recurso à configuração célula de Gilbert. São ainda apresentados resultados de simulação e experimentais (dos protótipos produzidos) que permitem tirar algumas conclusões sobre o desempenho das células de ganho com as duas configurações distintas. Por fim, o capítulo inclui ainda resultados de desempenho dos compensadores testados como compensadores de um sinal eléctrico afectado de distorção. No capítulo 4 é feita uma análise do impacto da modulação em banda lateral dupla (BLD) em comparação com a modulação em banda lateral única (BLU) num sistema óptico afectado de dispersão cromática e de polarização. Mostra-se que com modulação em BLU, como não há batimento entre portadoras das duas bandas laterais em consequência do processo quadrático de detecção e há preservação da informação da distorção cromática do canal (na fase do sinal), o uso deste tipo de modulação em sistemas de comunicação óptica permite maior tolerância à dispersão cromática e os compensadores eléctricos são muito mais eficientes. O capítulo apresenta ainda resultados de teste dos compensadores desenvolvidos em cenários experimentais de laboratório representativos de sistemas ópticos a 10Gb/s e 40Gb/s. Os resultados permitem comparar o desempenho destes cenários sem e com compensação eléctrica optimizada, para os casos de modulação em BLU e em BLD, e considerando ainda os efeitos da dispersão na velocidade de grupo e do atraso de grupo diferencial. Mostra-se que a modulação BLU em conjunto com compensação adaptativa eléctrica permite um desempenho muito superior á modulação em BLD largamente utilizada nos sistemas de comunicações actuais. Por fim o capítulo 5 sintetiza e apresenta as principais conclusões deste trabalho.

Ist Leichte Sprache ein Konzept verständlichen Textens? Leichte Sprache für Menschen mit geistiger Behinderung

Verwaltungsformulare, Verträge, Gesetzestexte, die Bedienungsanleitung einer Kaffeemaschine oder auch der Beipackzettel eines Medikaments – jeder kennt solche Texte und fast immer gibt es ein Problem mit der Verständlichkeit. Was wollen die jetzt von mir? Was soll ich machen? Das sind Fragen, die am Ende offen bleiben. Der Leser steht hilflos vor kompliziert und unverständlich, meist auch ermüdend geschriebenen Texten. Eigentlich sollte aber jeder diese Texte verstehen können. Um die Benutzerfreundlichkeit und die Qualität einer Bedienungsanleitung gewährleisten zu können, sind in Normen, wie VDI 4500, DIN EN ISO 121000 und DIN EN 62079, Kriterien bzgl. Inhalt, Layout und Beschaffenheit festgelegt. Bei der Verständlichkeit wird quasi am Minimum angesetzt, weil wirklich jeder die Anleitung verstehen soll. Doch was ist mit denen, die die Anleitung zwar verstehen sollen, aber eben nicht können? Menschen mit geistiger Behinderung werden im Alltag mit einer Vielzahl an Texten konfrontiert, die sie nicht verstehen. Der Textinhalt bleibt somit ein nicht zu lösendes Rätsel. Dass Menschen mit geistiger Behinderung ein selbstbestimmtes und selbstständiges Leben führen können, wird so von vornherein ausgeschlossen. Die Möglichkeit durch Kommunikation an der Gesellschaft teilzunehmen, wird weitestgehend unterbunden. Um diesem Ausschluss entgegenzuwirken, muss bei der Verwendung von Sprache und Erstellung von Texten unmittelbar bei dieser Zielgruppe angesetzt werden, so dass Texte und Sprache der vorhandenen Lesekompetenz entsprechend zugänglich werden. Hier setzt das Konzept Leichte Sprache an. Durch Unterstützung und Förderung beim Einsatz von Leichter Sprache sollen Menschen mit geistiger Behinderung schulische und berufliche Fähigkeiten erwerben und erfolgreich am sozialen Leben teilnehmen können. In der folgenden Arbeit wird, um Diskriminierung vorzubeugen, zunächst die Begrifflichkeit "geistige Behinderung" geklärt und deren Verwendung festgelegt. Dann wird das Konzept Leichte Sprache vorgestellt. Grundlagen von Verständlichkeit im Allgemeinen und bezogen auf die möglichen Zielgruppen, u.a. Menschen mit geistiger Behinderung, werden erläutert. Um feststellen zu können, ob eine Eingrenzung von Texten notwendig ist, bei denen Verständlichkeit gefördert bzw. überprüft werden soll, wird zwischen verschiedenen Textsorten abgegrenzt. So kann schließlich im Ergebnis überprüft werden, ob Leichte Sprache ein Konzept verständlichen Textens ist.

Avaliação do cumprimento da normativa sobre aspectos gráficos na acta médica portuguesa

Objectivo: Avaliar o grau de ajuste da Acta Médica Portuguesa às normas internacionais de elaboração e apresentação de publicações periódicas. Métodos: Análise do cumprimento das normas internacionais de edição de publicações periódicas, reconhecidas numa recente revisão realizada pela Fundação Espanhola para a Ciências e Tecnologia. Só foram avaliados capítulos relativos à normativa de aspecto, e não os relativos às normas para autores e política editorial. O cumprimento das normas dos capítulos características gerais e índice de fascículos é comparado com o conteúdo da página web da Acta Médica Portuguesa; o capítulo contributos compara-se com o aspecto dos artigos publicados em 2007. Resultados: Em 2007 foram publicados 70 artigos nos seis fascículos do volume 20 da Acta Médica Portuguesa. Entre os 76 critérios avaliados, sete foram considerados não aplicáveis. Dos 69 restantes critérios, a Acta Médica Portuguesa cumpre 27 (39,1%). Discussão: São propostas soluções simples para o cumprimento de 51 critérios (73,9%), deixando 10 critérios como discutíveis tendo em consideração a edição moderna de revistas electrónicas. O presente estudo não avaliou os critérios normativos relativos às normas para autores nem à política editorial, que deveriam ser objecto de outra análise. Conclusão: A Acta Médica Portuguesa cumpre 41% dos critérios normativos analisados para a apresentação de revistas, e com pequenas alterações pode chegar ao cumprimento de 75% dos critérios.

Creating and sustaining mixed income communities: a good practice guide

A comprehensive guide to planning and consultation issues around mixed income communities. This guide explores how to create attractive and well-managed places that meet the needs of all sections of the community. Drawing on the latest research, and featuring nine case study areas, it includes detailed guidance on: developing a strategy and negotiating the planning process; good practice in masterplanning, design, layout and long-term financial viability; how stakeholders can collaborate effectively and ensure that local residents are fully involved at all stages; how barriers to the development of sustainable communities might be overcome. The guide explores all types of mixed income communities, from the diversification of single-tenure inner-city estates to greenfield development on the urban fringe.

Creating and sustaining mixed income communities in Scotland: a good practice guide

A good practice guide to creating and sustaining mixed income communities in Scotland. This guide explores how to create attractive and well-managed places that meet the needs of all sections of the community. Drawing on the latest research, and featuring 11 case studies from Scotland and England, it offers a comprehensive guide to the issues that need to be planned for and addressed. The book includes detailed guidance on: -Developing a strategy and negotiating the planning process; -Good practice in masterplanning, design, layout and long-term financial viability; -How stakeholders can collaborate effectively and ensure that local residents are fully involved at all stages; -How barriers to the development of sustainable communities might be overcome. The guide explores all types of mixed income communities, from the diversification of mono-tenure estates in inner city areas to greenfield development on the urban fringe.

Detecção do vírus do papiloma humano por PCR em tempo real : relevância para medicina legal

Tese de mestrado, Medicina Legal e Ciências Forenses, Faculdade de Medicina, Universidade de Lisboa, 2014

Metodologias na banda desenhada : realização de um álbum de BD

This dissertation is an explanation of a methodology applied to the making of a comic book, with all that implies. The various stages of this process will be described, from the time when there was the decision to have ideas for the script to its finalization and subsequent publication of the album "Deixa-me Entrar". With this we intend to scrutinize how the inherent problems were solved in all these steps, either in the narrative construction method, as the visual part, such as drawing, coloring and subtitling were performed always seeking quality, not compromising the quality of the work. The time frame of the book was short since it was aimed for release during the twenty-fifth International Comics Festival of Amadora 2014, one of the main events of this kind in comic book releases. It can be said that this is one of the many events that are part of the context in which the practical component of this work fits, and so it is indispensable to context Comics in Portugal, specifically in a time window since the early twenty-first century, talking about relevant authors in recent years. In this explanation were also described some contractual bureaucracies that had to comply with the publisher "Polvo" and how the dialogue between author and publisher was done. Were also exposed advertising strategies through various platforms as well as how the book was received and concluded how the applied methodology resulted in this case study

Business Process Modelling based on formal temporal theory with an application to hospital patient flows

Existing Workflow Management Systems (WFMSs) follow a pragmatic approach. They often use a proprietary modelling language with an intuitive graphical layout. However the underlying semantics lack a formal foundation. As a consequence, analysis issues, such as proving correctness i.e. soundness and completeness, and reliable execution are not supported at design level. This project will be using an applied ontology approach by formally defining key terms such as process, sub-process, action/task based on formal temporal theory. Current business process modelling (BPM) standards such as Business Process Modelling Notation (BPMN) and Unified Modelling Language (UML) Activity Diagram (AD) model their constructs with no logical basis. This investigation will contribute to the research and industry by providing a framework that will provide grounding for BPM to reason and represent a correct business process (BP). This is missing in the current BPM domain, and may result in reduction of the design costs and avert the burden of redundant terms used by the current standards. A graphical tool will be introduced which will implement the formal ontology defined in the framework. This new tool can be used both as a modelling tool and at the same time will serve the purpose of validating the model. This research will also fill the existing gap by providing a unified graphical representation to represent a BP in a logically consistent manner for the mainstream modelling standards in the fields of business and IT. A case study will be conducted to analyse a catalogue of existing ‘patient pathways’ i.e. processes, of King’s College Hospital NHS Trust including current performance statistics. Following the application of the framework, a mapping will be conducted, and new performance statistics will be collected. A cost/benefits analysis report will be produced comparing the results of the two approaches.

A general framework for Business Process Modelling (BPM) based on Formal Temporal Theory with an application to Hospital Patient flows

Existing Workflow Management Systems (WFMSs) follow a pragmatic approach. They often use a proprietary modelling language with an intuitive graphical layout. However the underlying semantics lack a formal foundation. As a consequence, analysis issues, such as proving correctness i.e. soundness and completeness, and reliable execution are not supported at design level. This project will be using an applied ontology approach by formally defining key terms such as process, sub-process, action/task based on formal temporal theory. Current business process modelling (BPM) standards such as Business Process Modelling Notation (BPMN) and Unified Modelling Language (UML) Activity Diagram (AD) model their constructs with no logical basis. This investigation will contribute to the research and industry by providing a framework that will provide grounding for BPM to reason and represent a correct business process (BP). This is missing in the current BPM domain, and may result in reduction of the design costs and avert the burden of redundant terms used by the current standards. A graphical tool will be introduced which will implement the formal ontology defined in the framework. This new tool can be used both as a modelling tool and at the same time will serve the purpose of validating the model. This research will also fill the existing gap by providing a unified graphical representation to represent a BP in a logically consistent manner for the mainstream modelling standards in the fields of business and IT. A case study will be conducted to analyse a catalogue of existing ‘patient pathways’ i.e. processes, of King’s College Hospital NHS Trust including current performance statistics. Following the application of the framework, a mapping will be conducted, and new performance statistics will be collected. A cost/benefits analysis report will be produced comparing the results of the two approaches.