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.

Higher education, professionalism and skills in the built environment: the impact of the new urban agenda on teaching and learning

In the mid-to-late 1990s, the New Urban Agenda initiated a rethinking of urban development strategies placing a greater focus on regeneration of central urban spaces. The skills and competencies required by urban planners and built environment professionals to successfully implement regeneration schemes tend to differ from those required for greenfield development. The working paper summarises skills and competencies required by urban regeneration practitioners and how they are delivered through public and/or private sector providers at present. The role of the newly established regional Centres of Excellence and the professional bodies of the Built Environment professions in defining skills and educational requirements and providing training are explored. An analysis of supply and demand of skills training reveals that there is a mismatch rather than a lack of provision. The report draws on a conference where research findings were presented and discussed. It concludes with suggestions for improving the skills provision at the local government as well as community level. Skills audits were found useful tools in defining training needs. A set of sample workshop programmes outline flexible, tailor-made approaches guaranteed to address specific and identified needs.

Evaluation of the Electric Vehicle Impact in the Power Demand Curve in a Smart Grid Environment

Smart grids with an intensive penetration of distributed energy resources will play an important role in future power system scenarios. The intermittent nature of renewable energy sources brings new challenges, requiring an efficient management of those sources. Additional storage resources can be beneficially used to address this problem; the massive use of electric vehicles, particularly of vehicle-to-grid (usually referred as gridable vehicles or V2G), becomes a very relevant issue. This paper addresses the impact of Electric Vehicles (EVs) in system operation costs and in power demand curve for a distribution network with large penetration of Distributed Generation (DG) units. An efficient management methodology for EVs charging and discharging is proposed, considering a multi-objective optimization problem. The main goals of the proposed methodology are: to minimize the system operation costs and to minimize the difference between the minimum and maximum system demand (leveling the power demand curve). The proposed methodology perform the day-ahead scheduling of distributed energy resources in a distribution network with high penetration of DG and a large number of electric vehicles. It is used a 32-bus distribution network in the case study section considering different scenarios of EVs penetration to analyze their impact in the network and in the other energy resources management.

Implementing the OPTIMAL model : the impact on students' motivation in an elementary school games environment

Optimal challenge occurs when an individual perceives the challenge of the task to be equaled or matched by his or her own skill level (Csikszentmihalyi, 1990). The purpose of this study was to test the impact of the OPTIMAL model on physical education students' motivation and perceptions of optimal challenge across four games categories (i. e. target, batting/fielding, net/wall, invasion). Enjoyment, competence, student goal orientation and activity level were examined in relation to the OPTIMAL model. A total of 22 (17 M; 5 F) students and their parents provided informed consent to take part in the study and were taught four OPTIMAL lessons and four non-OPTIMAL lessons ranging across the four different games categories by their own teacher. All students completed the Task and Ego in Sport Questionnaire (TEOSQ; Duda & Whitehead, 1998), the Intrinsic Motivation Inventory (IMI; McAuley, Duncan, & Tanmien, 1987) and the Children's Perception of Optimal Challenge Instrument (CPOCI; Mandigo, 2001). Sixteen students (two each lesson) were observed by using the System for Observing Fitness Instruction Time tool (SOFTT; McKenzie, 2002). As well, they participated in a structured interview which took place after each lesson was completed. Quantitative results concluded that no overall significant difference was found in motivational outcomes when comparing OPTIMAL and non-OPTIMAL lessons. However, when the lessons were broken down into games categories, significant differences emerged. Levels of perceived competence were found to be higher in non-OPTIMAL batting/fielding lessons compared to OPTIMAL lessons, whereas levels of enjoyment and perceived competence were found to be higher in OPTIMAL invasion lessons in comparison to non-OPTIMAL invasion lessons. Qualitative results revealed significance in feehngs of skill/challenge balance, enjoyment and competence in the OPTIMAL lessons. Moreover, a significance of practically twice the active movement time percentage was found in OPTIMAL lessons in comparison to non-OPTIMAL lessons.

Coastal Tourism in Kerala: Its Impact on Economy and Environment

School of Industrial Fisheries, Cochin University of Science and Technology

Assessment of trophic change and its probable impact on tropical estuarine environment (the Kodungallur-Azhikode estuary, India)

The cumulative effects of global change, including climate change, increased population density and domestic waste disposal, effluent discharges from industrial processes, agriculture and aquaculture will likely continue and increases the process of eutrophication in estuarine environments. Eutrophication is one of the leading causes of degraded water quality, water column hypoxia/anoxia, harmful algal bloom (HAB) and loss of habitat and species diversity in the estuarine environment. The present study attempts to characterize the trophic condition of coastal estuary using a simple tool; trophic index (TRIX) based on a linear combination of the log of four state variables with supplementary index Efficiency Coefficient (Eff. Coeff.) as a discriminating tool. Numerically, the index TRIX is scaled from 0 to10, covering a wide range of trophic conditions from oligotrophic to eutrophic. Study area Kodungallur-Azhikode Estuary (KAE) was comparatively shallow in nature with average depth of 3.6±0.2 m. Dissolve oxygen regime in the water column was ranged from 4.7±1.3 mgL−1 in Station I to 5.9±1.4 mgL−1 in Station IV. The average nitrate-nitrogen (NO3-N) of KAE water was 470 mg m−3; values ranged from Av. 364.4 mg m−3 at Station II to Av. 626.6 mg m−3at Station VII. The mean ammonium-nitrogen (NH4 +-N) varied from 54.1 mg m−3 at Station VII to 101 mg m−3 at Station III. The average Chl-a for the seven stations of KAE was 6.42±3.91 mg m−3. Comparisons over different spatial and temporal scales in the KAE and study observed that, estuary experiencing high productivity by the influence of high degree of eutrophication; an annual average of 6.91 TRIX was noticed in the KAE and seasonal highest was observed during pre monsoon period (7.15) and lowest during post monsoon period (6.51). In the spatial scale station V showed high value 7.37 and comparatively low values in the station VI (6.93) and station VII (6.96) and which indicates eutrophication was predominant in land cover area with comparatively high water residence time. Eff. Coeff. values in the KAE ranges from −2.74 during monsoon period to the lowest of −1.98 in pre monsoon period. Present study revealed that trophic state of the estuary under severe stress and the restriction of autochthonous and allochthonous nutrient loading should be keystone in mitigate from eutrophication process

The institutional environment and its influence on political options to Protect Winnipeg’s Female garments Workers against the impact of globalization

The principal objective of this paper is to identify the relationship between the re­sults of the Canadian policies implemented to protect female workers against the impact of globalization on the garment industry and the institutional setting in which this labour market is immersed in Winnipeg. This research paper begins with a brief summary of the institutional theory appro­ach that sheds light on the analysis of the effects of institutions on the policy options to protect female workers of the Winnipeg garment industry. Next, this paper identi­fies the set of beliefs, formal procedures, routines, norms and conventions that cha­racterize the institutional environment of the female workers of Winnipeg’s garment industry. Subsequently, this paper descri­bes the impact of free trade policies on the garment industry of Winnipeg. Afterward, this paper presents an analysis of the ba­rriers that the institutional features of the garment sector in Winnipeg can set to the successful achievement of policy options addressed to protect the female workforce of this sector. Three policy options are considered: ethical purchasing; training/retraining programs and social engage­ment support for garment workers; and protection of migrated workers through promoting and facilitating bonds between Canada’s trade unions and trade unions of the labour sending countries. Finally, this paper concludes that the formation of isolated cultural groups inside of factories; the belief that there is gender and race discrimination on the part of the garment industry management against workers; the powerless social conditions of immi­grant women; the economic rationality of garment factories’ managers; and the lack of political will on the part of Canada and the labour sending countries to set effective bilateral agreements to protect migrate wor­kers, are the principal barriers that divide the actors involved in the garment industry in Winnipeg. This division among the prin­cipal actors of Winnipeg’s garment industry impedes the change toward more efficient institutions and, hence, the successful achievement of policy options addressed to protect women workers. 

Noise exposure impact in a manufacturing environment: A hearing conservation program needs assessment

This paper examines a study conducted to evaluate the impact of occupational noise exposure and the role of a hearing conservation program in the occupational setting.