Assessing the physical environment of older people’s residential care facilities: development of the Swedish version of the Sheffield Care Environment Assessment Matrix (S-SCEAM)

Background There is emerging evidence that the physical environment is important for health, quality of life and care, but there is a lack of valid instruments to assess health care environments. The Sheffield Care Environment Assessment Matrix (SCEAM), developed in the United Kingdom, provides a comprehensive assessment of the physical environment of residential care facilities for older people. This paper reports on the translation and adaptation of SCEAM for use in Swedish residential care facilities for older people, including information on its validity and reliability. Methods SCEAM was translated into Swedish and back-translated into English, and assessed for its relevance by experts using content validity index (CVI) together with qualitative data. After modification, the validity assessments were repeated and followed by test-retest and inter-rater reliability tests in six units within a Swedish residential care facility that varied in terms of their environmental characteristics. Results Translation and back translation identified linguistic and semantic related issues. The results of the first content validity analysis showed that more than one third of the items had item-CVI (I-CVI) values less than the critical value of 0.78.  After modifying the instrument, the second content validation analysis resulted in I-CVI scores above 0.78, the suggested criteria for excellent content validity. Test-retest reliability showed high stability (96% and 95% for two independent raters respectively), and inter-rater reliability demonstrated high levels of agreement (95% and 94% on two separate rating occasions). Kappa values were very good for test-retest (κ= 0.903 and 0.869) and inter-rater reliability (κ= 0.851 and 0.832). Conclusions Adapting an instrument to a domestic context is a complex and time-consuming process, requiring an understanding of the culture where the instrument was developed and where it is to be used. A team, including the instrument’s developers, translators, and researchers is necessary to ensure a valid translation and adaption. This study showed preliminary validity and reliability evidence for the Swedish version (S-SCEAM) when used in a Swedish context. Further, we believe that the S-SCEAM has improved compared to the original instrument and suggest that it can be used as a foundation for future developments of the SCEAM model.

Building materials selection: greenhouse strategies for built facilities

This paper aims to consider the embodied energy of building materials in the context of greenhouse gas emission mitigation strategies. Previous practice and research are highlighted where they have the potential to influence design decisions. Latest embodied energy figures are indicated, and the implications of applying these figures to whole buildings are discussed. Several practical examples are given to aid building designers in the selection of building materials for reduced overall life cycle greenhouse gas emissions.

Understanding Concepts of Efficiency and Effectiveness in Architectural Facilities Space Planning and Design

Although contemporary literature treats efficiency and effectiveness extensively, virtually no objective understanding of both is found in architectural facilities space planning and design. It is imperative that both concepts are definitively explained as they apply to these disciplines. Hence, the contemporary views of both concepts are reviewed and attempts made to interpret them within more amenable contexts. The objectives are (1) to objectively elucidate the factual differences between efficiency and effectiveness; and (2) to contribute to their better understanding in architectural facilities space planning and design. Diagrammatic and mathematical means are engaged to demonstrate efficiency and effectiveness in these fields.

Characteristics of soy bread users and their beliefs about soy products

A two-stage random telephone/mail survey was conducted during the last quarter of 1998 among Adelaide residents to determine consumers' use of soy bread and other soy products and their health expectations of soy products. One in five (21%) of 1477 telephone subscribers usually consumed soy bread and related soy products. Comparisons of soy bread consumers and non-consumers, based on the mail survey sample, showed that more soy bread consumers used dietary supplements and ate low fat and vegetarian diets, though their experiences of ill health were similar. Soy bread consumers held stronger universalism (pro-nature) values than non-consumers. They also held more positive expectations about the benefits of soy consumption, including reductions in menstrual and menopausal symptoms, increased bowel regularity and reductions in the risk of heart disease and cancer. The findings are discussed in relation to the psychology of dietary supplementation, values orientations and physiological plausibility. Further investigations are suggested.

Incorporating sustainability in textile effluent treatment facilities

Sustainable development encompasses environmental, social and
economic considerations. As such the stakeholders include industry, government, individuals and communities. When designing or operating an industrial plant, it is Insufficient to consider only the economic viability of the facility. This paper examines the background to current sustainability awareness and presents a case study that incorporates sustainability principles in the design of an efluent treatment plant for a textile plant. The likely design of the treatment system (electro flotation followed by filtration) will do more than just meet regulatory requirements, it will maximise possible reuse of water and so minimise environmental impact of the facility.

The impact of work settings on organisational performance measures in built facilities

A current facilities management discourse seeks to discover how the built environment promotes or retards organisational change. However, whether or not significant change arises at all is yet to be definitively established. Hence, a contribution to the school of thought in this direction is considered important. This research investigated organisational performance relative to innovative work settings. The aim of the study was to determine whether organisational performance and, hence, change are indeed brought about by innovative work settings. A sample of 102 work settings was studied, and several null hypotheses on innovative work settings and organisational performance were tested using the Kruskal-Wallis H test. Although subtle shifts were observed in the aspects of organisational performance that seem predicated on innovative work settings, to some extent the proposition that the physical properties and design of the workplace can influence organisational performance was validated.

Users` experiences of heroin and methadone treatment

The present study, conducted in 2003, Melbourne, Australia, examined and compared how different personal and social resources related to participants' use of both heroin and methadone, as well as their experiences of stigma and program regulation, and their evaluation of methadone treatment. In-depth interviews were conducted with 10 participants (five men, five women) aged between 25 and 42. Participants who had diverse personal and social circumstances were purposefully sought. Findings showed that users with “non-addict” or “functional” self-concepts had more resources and supportive social relationships that assisted them to develop realistic treatment expectations, avoid the stigma associated with methadone, and focus on the benefits of the treatment. Conversely, “conflicted” users with limited resources, few social connections, and negative self-concept saw methadone as an addiction, and as a highly stigmatizing and disempowering intervention. Social policies that differentiate users and address ways of improving users' personal and social resources are now needed.

Development of high quality university web sites: benefits to users and the learning organisation

In recent years, the online delivery of educational material has received much attention by researchers. University web sites are being used to supplement the delivery of knowledge in traditional bricks and mortar environments or as stand-alone external courses. The function of a university web site also has broader applications that can provide strategic benefits to the organisation as a whole. An Internet presence based on a high quality, easy to use web site can provide universities with a credible, professional image. This is particularly important as students and other users of university web sites expect the same high level of quality in these sites as they do from the sites of commercial organisations. This paper explores the various roles that a web site can provide to benefit higher education organisations and their customers. In addition, the paper outlines the results of a study of university web site users that identifies specific web site design features that are considered essential for a high quality university site that will meet the needs of students and other stakeholders in a university environment. By adopting these design principles, universities will be able to improve the quality of their web sites and ultimately, increase user satisfaction. Moreover, an understanding of the various roles that a web site can perform will allow universities to fully utilise the benefits of developing and maintaining an online presence while retaining their traditional role as knowledge managers.

Satisfaction with general practitioner treatment of depression among residents of aged care facilities.

Objective: This article investigates consumer perspectives on the treatment for depression among older people in residential facilities. Method: Aged care residents who were aware of being treated for depression in the past 6 months (24 women and 7 men, mean age = 83 years) participated in an interview that assessed their perspective on treatments. Results: Although more than half of the participants in the sample reported overall satisfaction with the medical treatments received for depression, qualitative data provided indications of unsatisfactory service delivery, including perceptions of low treatment efficacy, short consultation times, the failure to assess affective symptomatology, and negative responses to residents’ disclosure of symptoms. Discussion: The findings are discussed in relation to previous research on consumer satisfaction with health services and issues that may be pertinent to the elderly depressed. Training for general practitioners providing treatment in aged care is indicated.

Correlates of sexual assault in a sample of male African American crack cocaine users

Although numerous studies have reported an association between substance use and sexual assault, little is known about the impact of sexual assault on male African American crack cocaine users. This study found that from a sample of 137 respondents from Houston, Texas, one-third reported having been sexually assaulted at least once during their lifetime. Respondents who reported sexual assault were using cocaine more often and were more likely to be physically dependent on drugs and to report greater numbers of physical health problems due to their drug use. However, no differences were identified in respect of reported mental health problems, or problems with family, friends or the workplace associated with drug use. The findings suggest further research as to the impact of sexual assault on male crack cocaine users is warranted and that clinical staff working with male substance users require some awareness of the impacts of sexual assault.

The impact of religious affiliation while growing up on substance use by African-American crack cocaine users

This paper explores the relationship between church attendance while growing up and the substance use issues reported by 159 African American crack cocaine users in Houston Texas. It was found that more frequent juvenile attendance at church was associated with being less likely to suffer withdrawal symptoms or to take drugs to avoid withdrawal. However/ there were no differences between regular/ irregular and non-attendees in respect of number of substance use issues reported or attendance at a self help group for substance use/ even though these are often faith-based. The relevance of including questions on religious participation when young in screening instruments to be used with adult substance abusers is questioned.