The architecture of the psychiatric milieu

The last time a peer-reviewed volume on the future of mental health facilities was produced was in 1959, following a symposium organised by the American Psychological Association. The consensus was easy enough to follow and still resonates today: the best spaces to treat psychiatric illness will be in smaller, less restrictive units that offer more privacy and allow greater personalisation of space – possibly a converted hotel (Goshen, 1959). In some way, all those ideals have come to pass. An ideal typology was never established, but even so, units have shrunk from thousands of beds to units that typically house no more than 50 patients. Patients are generally more independent and are free to wander (within a unit) as they please. But the trend toward smaller and freer is reversing. This change is not driven by a desire to find the ideal building nor better models of care, but by growing concerns about budgets, self-harm and psychiatric violence. This issue of the Facilities comes at a time when the healthcare design is increasingly dominated by codes, statutes and guidelines. But the articles herein are a call to stop and think. We are not at the point where guidelines can be helpful, because they do not embody any depth of knowledge nor wisdom. These articles are intended to inject some new research on psychiatric/environmental interactions and also to remind planners and managers that guidelines might not tackle a core misunderstanding: fear-management about patient safety and the safety of society is not the purpose of the psychiatric facility. It is purpose is to create spaces that are suitable for improving the well-being of the mentally ill.

Are diverse factors proxies for architectural influences? A case for architecture in the aetiology of schizophrenia

Introduction The last half-century of epidemiological enquiry into schizophrenia can be characterized by the search for neurological imbalances and lesions for genetic factors. The growing consensus is that these directions have failed, and there is now a growing interest in psychosocial and developmental models. Another area of recent interest is in epigenetics – the multiplication of genetic influences by environmental factors. Methods This integrative review comparatively maps current psychosocial, developmental and epigenetic models for schizophrenia epidemiology to identify crossover and theoretical gaps. Results In the flood of data that is being produced around the schizophrenia epidemiology, one of the most consistent findings is that schizophrenia is an urban syndrome. Once demographic factors have been discounted, between one-quarter and one-third of all incidence is repeatedly traced back to urbanicity – potentially threatening more established models, such as the psychosocial, genetic and developmental hypotheses. Conclusions Close analysis demonstrates how current models for schizophrenia epidemiology appear to miss the mark. Furthermore, the built environment appears to be an inextricable factor in all current models and indeed may be a valid epidemiological factor on its own. The reason the built environment hasn’t already become a de rigueur area of epidemiological research is possibly trivial – it just doesn’t attract enough science, and lacks a hero to promote it alongside other hypotheses.

Tila tilassa : Liturgian ja tilan dialogi alttarin äärellä

This study examines the organisation and transformation of altar space in the modern Evangelical Lutheran Church of Finland in liturgical and architectural perspective. The research data consists of 65 altar spaces in The Finnish Evangelical Lutheran church buildings. All of these were characterised in Church Government records as churches , built 1962 1999 and had been consecrated. The main data was collected by means of observation, photographing, and drawing sketches of altar spaces. The focus of this study concerns the organisation of modern Finnish Evangelical Lutheran altar spaces and, in particular, their changes also in relation to the liturgical movement. The challenge of this approach was especially in discovering the spatial identity of an altar space in terms of unequivocal boundaries. The analysis was realised in three stages. Interiors, the organisation of altar space, as well as architectonic qualities of altar spaces in terms of floor elevations, shapes of ceilings, lighting, and openings in the altar space were analysed. Moreover, attention was focused on furnishing and fixed versus movable pieces of furniture (such as the altar, altar rail, the pulpit, the baptismal font, and lectern). Finally, the potential qualitative and quantitative changes in altar space were examined. All in all, the majority of churches in the data featured elongated church halls with an altar at the end of the nave. To look at the data in chronological perspective, increasingly wide church halls had been built since the 1980s (yet there was only one central hall in which the altar was placed at the middle point of the church). Every third church altar was movable. As for the focal point of this study and the altar in particular, it was my aim to pay attention to the versus populum altar and its development in relation to the (Lutheran) liturgy. Hence, it was meaningful to determine, in terms of interior design, whether liturgists were able to celebrate facing the people attending the service. In the 1960s and 70s, a versus orientem altar featured in more than half of all new Finnish Lutheran churches, yet in 2000 two out of three churches featured a versus populum altar. For architectural and esthetic reasons (and not primarily due to liturgical ideas), also altars standing freely off the walls had been constructed. In terms of the liturgy, versus populum altars had been realised in expectation of increased communication between liturgist and worshippers. However, the analysis indicated that the altar could also become a divider of space. This aspect is a novel finding in relation to earlier and concurrent discussions concerning the liturgical movement. This study concluded, all in all, that altars had been increasingly constructed closer and closer to the worshiping parish and, accordingly, used increasingly often in the versus populum manner. Lecterns were often movable until the millennium this was the case in most altar spaces. Baptismal fonts did not have a permanent place in this data, and the data even included altar spaces with no baptismal fonts in the choir, nor the church hall. The position and status of fonts was generally weakened even if baptism in the Lutheran Church was regarded as one of the two sacraments together with the eucharist. The study concluded that even if baptism is regarded as a sacrament in the church, the position and status of baptismal fonts had weakened overall in newer church architecture. In other words, the tendency of the liturgical movement to emphasise the service and its celebration had obviously had its effect on the placement of baptismal fonts in the church hall. This research indicated that the pieces of furniture that mostly involved (many kinds of) visual and spatial changes included the altar and the lectern. In certain instances, fixed furnishings had been substituted by movable pieces or, moreover, new pieces of furniture and paraphernalia such as music instruments, pieces of art, tables, chairs and plants were brought in. In the Evangelical Lutheran Church of Finland, liturgical changes were principally inspired by the Catholic Church, in which liturgical changes are essentially based on Canon Law. Unlike Finnish Lutheranism, Catholicism provides detailed rules and principles even regarding the design of an altar space. According to this study, in the Finnish Lutheran Church, the primarily functional nature of given guidelines and instructions characterises several practical solutions in furnishing.

Living Poetically in the Modern Age : The Situational Aspects of Kierkegaard's Thought

How did Søren Kierkegaard (1813 1855) situate the human subject into historical and social actuality? How did he take into consideration his own situatedness? As key for understanding these questions the research takes the ideal of living poetically that Kierkegaard outlined in his dissertation. In The Concept of Irony (1841) Kierkegaard took up this ideal of the Romantic ironists and made it into an ethical-religious ideal. For him the ideal of living poetically came to mean 1) becoming brought up by God, while 2) assuming ethical-religiously one s role and place in the historical actuality. Through an exegesis of Kierkegaard s texts from 1843 to 1851 it is shown how this ideal governed Kierkegaard s thought and action throughout his work. The analysis of Kierkegaard s ideal of living poetically not only a) shows how the Kierkegaardian subject is situated in its historical context. It also b) sheds light on Kierkegaard s social and political thought, c) helps to understand Kierkegaard s character as a religious thinker, and d) pits his ethical-religious orientation in life against its scientific and commonsense alternatives. The research evaluates the rationality of the way of life championed by Kierkegaard by comparing it with ways of life dominated by reflection and reasoning. It uses Kierkegaard s ideal of living poetically in trying to understand the tensions between religious and unreligious ways of life.

Optimal maintenance policy for equipment subject to random deterioration and random failure A modern control theory approach.

The stochastic version of Pontryagin's maximum principle is applied to determine an optimal maintenance policy of equipment subject to random deterioration. The deterioration of the equipment with age is modelled as a random process. Next the model is generalized to include random catastrophic failure of the equipment. The optimal maintenance policy is derived for two special probability distributions of time to failure of the equipment, namely, exponential and Weibull distributions Both the salvage value and deterioration rate of the equipment are treated as state variables and the maintenance as a control variable. The result is illustrated by an example

Conformationally Restricted Nucleocyclitols: a Study into their Conformational Preferences and Supramolecular Architecture in the Solid State

With the intent of probing the feasibility of employing annulation as a tactic to engender axial rich conformations in nucleoside analogues, two adenine-derived, ``conformationally restricted'' nucleocylitols, 9 and 10, have been conceptualized as representatives of a hitherto unexplored class of nucleic acid base-cyclitol hybrids. A general synthetic strategy, with an inherent scope for diversification, allowed rapid functionalization of indane and tetralin to furnish 9 and 10 respectively in fair yield. Single-crystal X-ray diffraction analysis revealed that the two nucleocyclitols under study, though homologous, present completely dissimilar modes of molecular packing, marked, in particular, by the nature of involvement of the adenynyl NH2 group in the supramolecular assembly. In addition, the crystal structures of 9 and 10 also exhibit two different conformations of the functionalized cyclohexane ring. Thus, while the six-membered carbocycle in cyclopenta-annulated 9 exists in the expected chair (C) conformation that in cyclohexaannulated 10, which crystallizes as a dihydrate, shows an unusual twist-boat (TB) conformation. From a close analysis of the (HNMR)-H-1 spectroscopic data recorded for 9 and 10 in CD3OD, it was possible to put forth a putative explanation for the uncanny conformational preferences of crystalline 9 and 10.

A hybrid agent architecture for modeling autonomous agents in SAGE

This paper highlights the Hybrid agent construction model being developed that allows the description and development of autonomous agents in SAGE (Scalable, fault Tolerant Agent Grooming Environment) - a second generation FIPA-Compliant Multi-Agent system. We aim to provide the programmer with a generic and well defined agent architecture enabling the development of sophisticated agents on SAGE, possessing the desired properties of autonomous agents - reactivity, pro-activity, social ability and knowledge based reasoning. © Springer-Verlag Berlin Heidelberg 2005.

Universalization of access to modern energy services in Indian households-Economic and policy analysis

Provision of modern energy services for cooking (with gaseous fuels)and lighting (with electricity) is an essential component of any policy aiming to address health, education or welfare issues; yet it gets little attention from policy-makers. Secure, adequate, low-cost energy of quality and convenience is core to the delivery of these services. The present study analyses the energy consumption pattern of Indian domestic sector and examines the urban-rural divide and income energy linkage. A comprehensive analysis is done to estimate the cost for providing modern energy services to everyone by 2030. A public-private partnership-driven business model, with entrepreneurship at the core, is developed with institutional, financing and pricing mechanisms for diffusion of energy services. This approach, termed as EMPOWERS (entrepreneurship model for provision of wholesome energy-related basic services), if adopted, can facilitate large-scale dissemination of energy-efficient and renewable technologies like small-scale biogas/biofuel plants, and distributed power generation technologies to provide clean, safe, reliable and sustainable energy to rural households and urban poor. It is expected to integrate the processes of market transformation and entrepreneurship development involving government, NGOs, financial institutions and community groups as stakeholders. (C) 2009 Elsevier Ltd. All rights reserved.

Finding design value in modern mundanity

This pictorial is a visual pondering of the potential hidden within the mundane aspects of everyday life. Grounded in the theoretical concepts of ‘design futuring’ and ‘undesign’, it is framed in a speculative context and seeks to propose avenues for thought within the design space. This paper is not a reflection of a design process, nor is it presenting new and novel concept designs. Instead, this paper combines visuals and literature to encourage the reader into a mode of theoretical and personal reflection on the open possibilities for the future of design - through the reimagining of the mundane.

Modern surgical treatment of otosclerosis

The modern unilateral surgical treatment of otosclerosis started in 1956. Simultaneous bilateral surgery has not been reported in stapes surgery and in case of bilateral otosclerosis ears are operated in two different sessions. Simultaneous surgery would give the patient the opportunity to gain advantages of bilateral hearing within one session, with less time spent in hospital and on sick leave. The mechanism for vestibular symptoms and the exact end organ affected after surgery is still unveiled. This thesis presents the results of experimental simultaneous bilateral stapes surgery, and vestibular symptoms and findings before and after unilateral stapes surgery. In addition, we explore reasons for outpatient failures in otosclerosis surgery. -- Study I examines the outcome of simultaneous bilateral surgery. Hearing was evaluated with standard pure tone and speech audiograms and vestibular apparatus with visual feedback posturography (VFP) during the one-year follow-up. Subjective symptoms and quality of life were assessed with questionnaires. In study II, reasons for outpatient failures in stapes surgery were explored. Forty-seven consecutive stapedotomies and stapedectomies performed by the same surgeon were included, and the effect of failures on hearing results were analysed. Vestibular symptoms and the end organ(s) affected after stapes surgery were investigated in studies III and IV. With video-oculography (VOG), nystagmus was measured preoperatively, and at one week, one month and 3 months postoperatively in the first phase (III). In the second phase (IV), recordings were obtained some hours postoperatively. The hearing results of the simultaneous bilateral surgery were comparable with unilateral surgeries reported. Recovery from the surgery was fast. Significant improvement in performance and quality of life was noted already month after operation in subjective evaluations. Based on these results, simultaneous bilateral surgery is a suitable approach in bilateral otosclerosis Significantly more outpatient failures occurred for medical reasons in the stapedectomy group (13%) than in the stapedotomy group (2%). Stapedotomy should be favoured if outpatient surgery is planned. However, unplanned admission did not worsen the prognosis. VOG measurements in study III did not show any specific type of nystagmus in patients having vestibular symptoms postoperatively. However, VOG measurements immediately after surgery (IV) revealed nystagmus consistent with a minor disturbance of the semicircular canals in 33% of the patients. Subjectively, half of the patients reported vestibular symptoms that were probably of diverse origin, and could have originated from both otolith and semicircular canal parts of the vestibular organ. Since vestibular symptoms and signs are mild, patients may be safely discharged some hours after stapes surgery.

Architecture designed ZnO hollow microspheres with wide-range visible-light photoresponses

It is a challenge to increase the visible-light photoresponses of wide-gap metal oxides. In this study, we proposed a new strategy to enhance the visible-light photoresponses of wide-gap semiconductors by deliberately designing a multi-scale nanostructure with controlled architecture. Hollow ZnO microspheres with constituent units in the shape of one-dimensional (1D) nanowire networks, 2D nanosheet stacks, and 3D mesoporous nanoball blocks are synthesized via an approach of two-step assembly, where the oligomers or the constituent nanostructures with specially designed structures are first formed, and then further assembled into complex morphologies. Through deliberate designing of constituent architectures allowing multiple visible-light scattering, reflections, and dispersion inside the multiscale nanostructures, enhanced wide range visible-light photoresponses of the ZnO hollow microspheres were successfully achieved. Compared to the one-step synthesized ZnO hollow microspheres, where no nanostructured constituents were produced, the ZnO hollow microspheres with 2D nanosheet stacks presented a 50 times higher photocurrent in the visible-light range (λ > 420 nm). The nanostructure induced visible-light photoresponse enhancement gives a direction to the development of novel photosensitive materials.

Architecture of a polymorphic ASIC for interoperability across multi-mode H.264 decoders

Run-time interoperability between different applications based on H.264/AVC is an emerging need in networked infotainment, where media delivery must match the desired resolution and quality of the end terminals. In this paper, we describe the architecture and design of a polymorphic ASIC to support this. The H.264 decoding flow is partitioned into modules, such that the polymorphic ASIC meets the design goals of low-power, low-area, high flexibility, high throughput and fast interoperability between different profiles and levels of H.264. We demonstrate the idea with a multi-mode decoder that can decode baseline, main and high profile H.264 streams and can interoperate at run.time across these profiles. The decoder is capable of processing frame sizes of up to 1024 times 768 at 30 fps. The design synthesized with UMC 0.13 mum technology, occupies 250 k gates and runs at 100 MHz.