Mamwi Gidaanjitoomin/Together We Build It: A Systematic Review of Traditional Indigenous Building Structures in North America and Their Potential Application in Contemporary Designs to Promote Environment and Well-Being.

(1) Background: Housing has long been recognized as an essential determinant of health. Our sense of home goes beyond physical shelter and is associated with personal or collective connections with spaces and places. However, modern architecture has gradually lost its connections between people and places; (2) Methods: We examined traditional Indigenous architecture and how it can be utilized in contemporary settings to restore connections to promote the environment, health, and well-being. (3) Results: We found that traditional Indigenous building structures may be the best manifestation of the Indigenous interconnected and holistic worldviews in North America, containing thousands of years of knowledge and wisdom about the land and the connection between humans and the environment, which is the foundation of reciprocal well-being; (4) Conclusions: Learning from the traditional structures, we proposed that modern architects should consider the past, present, and future in every endeavor and design and to utilize traditional knowledge as a crucial source of inspiration in creating works that are beneficial for both current and future generations by taking collectivism, health and well-being, and the environment into consideration in designs.

Making Space for Midwifery in a Hospital: Exploring the Built Birth Environment of Canada's First Alongside Midwifery Unit.

BACKGROUND: Canada's first alongside midwifery unit (AMU) was intentionally informed by evidence-based birth environment design principals, building on the growing evidence that the built environment can shape experiences, satisfaction, and birth outcomes. OBJECTIVES: To assess the impact of the built environment of the AMU for both service users and midwives. This study aimed to explore the meanings that individuals attribute to the built environment and how the built environment impacted people's experiences. METHODS: We conducted a mixed-methods study using a grounded theory methodology for data collection and analysis. Our research question and data collection tools were underpinned by a sociospatial conceptual approach. All midwives and all those who received midwifery care at the unit were eligible to participate. Data were collected through a structured online survey, interviews, and focus group. RESULTS: Fifty-nine participants completed the survey, and interviews or focus group were completed with 28 service users and 14 midwives. Our findings demonstrate high levels of satisfaction with the birth environment. We developed a theoretical model, where "making space" for midwifery in the hospital contributed to positive birth experiences and overall satisfaction with the built environment. The core elements of this model include creating domestic space in an institutional setting, shifting the technological approach, and shared ownership of the unit. CONCLUSIONS: Our model for creating, shifting, and sharing as a way to make space for midwifery can serve as a template for how intentional design can be used to promote favorable outcomes and user satisfaction.

Conceptualizing the Socio-Built Environment: An Expanded Theoretical Framework to Promote a Better Understanding of Risk for Nonmedical Opioid Overdose Outcomes in Urban and Non-Urban Settings.

Nonmedical opioid (NMO) use has been linked to significant increases in rates of NMO morbidity and mortality in non-urban areas. While there has been a great deal of empirical evidence suggesting that physical features of built environments represent strong predictors of drug use and mental health outcomes in urban settings, there is a dearth of research assessing the physical, built environment features of non-urban settings in order to predict risk for NMO overdose outcomes. Likewise, there is strong extant literature suggesting that social characteristics of environments also predict NMO overdoses and other NMO use outcomes, but limited research that considers the combined effects of both physical and social characteristics of environments on NMO outcomes. As a result, important gaps in the scientific literature currently limit our understanding of how both physical and social features of environments shape risk for NMO overdose in rural and suburban settings and therefore limit our ability to intervene effectively. In order to foster a more holistic understanding of environmental features predicting the emerging epidemic of NMO overdose, this article presents a novel, expanded theoretical framework that conceptualizes "socio-built environments" as comprised of (a) environmental characteristics that are applicable to both non-urban and urban settings and (b) not only traditional features of environments as conceptualized by the extant built environment framework, but also social features of environments. This novel framework can help improve our ability to identify settings at highest risk for high rates of NMO overdose, in order to improve resource allocation, targeting, and implementation for interventions such as opioid treatment services, mental health services, and care and harm reduction services for people who use drugs.

How the Built Environment Promotes Residents' Physical Activity: The Importance of a Holistic People-Centered Perspective.

Promoting adequate physical activity (PA) such as walking and cycling is essential to cope with the global health challenge of non-communicable diseases (NCDs). Much research has been conducted to analyze how the built environment can promote PA, but the results are not consistent. Some scholars found that certain built environments such as green spaces generated positive impacts on PA, while some other studies showed no correlations. We suspected that the built environment should be measured in a deeply holistic nuanced way in order to properly reflect its impact on PA. Therefore, our research adopted an integral urban-analysis comparing three typical neighborhoods in Beijing, China. Our data show that the highest PA occurs in the neighborhood with the lowest density, amount of green space and street connectivity, apparently compensated by its low-rise housing type and high appreciation of the quality of sidewalks and street safety. This indicates that dimensions impacting PA have to be considered in context, and the peoples' perception of the built environment matters.

Research on the Healing Potential of Rural Community Streets From the Perspective of Audiovisual Integration: A Case Study of Four Rural Communities in China.

Rural communities have become a hot topic in academic circles because of their graceful natural environment and great healing potential. However, existing research still lacks attention to the street space in rural communities and rarely considers its integrated visual and soundscape design in terms of their effect on public health. As a result, the healing potential of rural community streets cannot be fully used in design practice. Relevant audiovisual materials were collected from a field investigation in four rural communities in southwestern China. Based on these data, the subjective and objective healing index data of subjects under comprehensive audiovisual conditions were collected and analyzed through laboratory experiments. The results revealed that type of street space affects healing potential, and the artificial-natural enclosed and natural semi-enclosed streets are the street types with the best healing effect. When the total sound pressure level was 55dB(A), the sound combination with birdsong accounting for 70% had a significant positive effect on improving the healing effect of rural community streets. In contrast, the sound combination with birdsong accounting for 50% or less had no significant effect on improving healing. The subjective healing perception of street space in rural communities was significantly positively correlated with aesthetic preferences. There was also a significant correlation between subjective healing perception and physiological index data in the audiovisual combination. This research explored the impact of different types of street space and sound combinations on the healing effect of rural community streets in an integrated audiovisual environment and provided a scientific basis for the healing landscape design of rural community streets in an integrated audiovisual environment. It was expected to provide new ideas for the construction of rural community landscapes, including acoustic landscapes, to promote physical and mental healing.

Nature-based Pathways to Health Promotion: The Value of Parks and Greenspace.

The built environment is a key social determinant of health. Exposure to parks and greenspace can improve physical and mental health and provide other benefits that enhance well-being. Programs and initiatives that capitalize on nature-based opportunities offer health care providers with a cost-effective alternative for upstream health promotion.

The Relationship between Sustainable Built Environment, Art Therapy and Therapeutic Design in Promoting Health and Well-Being.

At present, a smart city from the perspective of the United Nations Sustainable Development Goals (SDGs) emphasizes the importance of providing citizens with promising health and well-being. However, with the continuous impact of coronavirus disease 2019 (COVID-19) and the increase of city population, the health of citizens is facing new challenges. Therefore, this paper aims to assess the relationship between building, environment, landscape design, art therapy (AT), and therapeutic design (TD) in promoting health within the context of sustainable development. It also summarizes the existing applied research areas and potential value of TD that informs future research. This paper adopts the macro-quantitative and micro-qualitative research methods of bibliometric analysis. The results show that: the built environment and AT are related to sustainable development, and closely associated with health and well-being; the application of TD in the environment, architecture, space, and landscape fields promotes the realization of SDGs and lays the foundation for integrating digital technologies such as Building Information Modeling (BIM) into the design process to potentially solve the challenges of TD; and the principle of TD can consider design elements and characteristics from based on people's health needs to better promote human health and well-being.

The relationship between the neighborhood built and social environment and hypertensive disorders of pregnancy: A scoping review.

BACKGROUND: Theory and limited empirical research suggest that the neighborhood environment influences maternal health outcomes. The goal of this scoping review is to summarize extant research considering the impact of the built and social environment of resident neighborhood on hypertensive disorders of pregnancy (HDP) globally. METHODS: We performed a systematic search of the literature using four databases, PubMed, Web of Science, CINAHL, and Embase on July 15, 2020. We excluded articles not in English, that did not consider one or more HDP as a primary or secondary outcome, and that did not include an element of the neighborhood built or social environment as an exposure. We applied a modified version of the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies to evaluate quality of included studies. RESULTS: Our search identified 11,385 unique abstracts for screening. Following exclusions, we included 64 articles in the final review. The majority of articles measured an element of the built environment (70.3% (44)), most commonly traffic-related air pollution (42.2% (27)). A third of articles (31.3% (20)) considered an element of the neighborhood social environment, most commonly neighborhood deprivation (10.9% (7)). Global quality ratings were mostly moderate (29.7% (19)) or weak (68.8% (44)), primarily due to inattention to neighborhood-level confounding. CONCLUSION: Critical gaps remain in understanding how the resident neighborhood may impact HDP. Future research should focus on designing high-quality studies incorporating elements of both the built and social environment to holistically understand how context may impact maternal health.

Reducing the health effects of hot weather and heat extremes: from personal cooling strategies to green cities.

Heat extremes (ie, heatwaves) already have a serious impact on human health, with ageing, poverty, and chronic illnesses as aggravating factors. As the global community seeks to contend with even hotter weather in the future as a consequence of global climate change, there is a pressing need to better understand the most effective prevention and response measures that can be implemented, particularly in low-resource settings. In this Series paper, we describe how a future reliance on air conditioning is unsustainable and further marginalises the communities most vulnerable to the heat. We then show that a more holistic understanding of the thermal environment at the landscape and urban, building, and individual scales supports the identification of numerous sustainable opportunities to keep people cooler. We summarise the benefits (eg, effectiveness) and limitations of each identified cooling strategy, and recommend optimal interventions for settings such as aged care homes, slums, workplaces, mass gatherings, refugee camps, and playing sport. The integration of this information into well communicated heat action plans with robust surveillance and monitoring is essential for reducing the adverse health consequences of current and future extreme heat.

An examination of the intersection environment associated with perceived crash risk among school-aged children: using street-level imagery and computer vision.

While computer vision techniques and big data of street-level imagery are getting increasing attention, a "black-box" model of deep learning hinders the active application of these techniques to the field of traffic safety research. To address this issue, we presented a semantic scene labeling approach that leverages wide-coverage street-level imagery for the purpose of exploring the association between built environment characteristics and perceived crash risk at 533 intersections. The environmental attributes were measured at eye-level using scene segmentation and object detection algorithms, and they were classified as one of four intersection typologies using the k-means clustering method. Data on perceived crash risk were collected from a questionnaire conducted on 799 children 10 to 12 years old. Our results showed that environmental features derived from deep learning algorithms were significantly associated with perceived crash risk among school-aged children. The results have revealed that some of the intersection characteristics including the proportional area of sky and roadway were significantly associated with the perceived crash risk among school-aged children. In particular, road width had dominant influence on risk perception. The findings provide information useful to providing appropriate and proactive interventions that may reduce the risk of crashes at intersections.

Pedestrian estimation of their crossing time on multi-lane roads.

Estimation of one's own crossing time is an important process in making road-crossing decisions. This study evaluated the pedestrian's (esp. the elderly) ability to estimate crossing time in a field experiment. The estimated crossing time was measured by an interval production method (participants produced an interval to represent their estimated crossing time) and an imagined crossing method. The results showed that while young pedestrians generally had an accurate estimation of their crossing time, old pedestrians consistently underestimated the crossing time in both methods, especially at a wider road. What's worse, even fast walking cannot compensate for the large underestimation. Further analysis showed that although old pedestrians had the declined motor imagery ability and the worse general timing accuracy, none of them can account for the inaccuracy of estimation. These findings suggest that underestimation of crossing time may be one of the important reasons for the acknowledged risky road crossing decision-making in old pedestrians. It also calls for studies on assistive roadway designs and intervention programs targeting old pedestrians.

Ambient Scent as a Positive Distraction in Long-Term Care Units: Theory of Supportive Design.

AIM: This study was designed to explore the associations between an ambient scent environment and residents' wellness in long-term care facilities. BACKGROUND: The number of older adults living in an institutional setting has been steadily but slowly increasing. Because of a higher chance of having psychological disorders among people living in institutional settings than people living in noninstitutional settings, providing a supportive institutional setting is critical to enhance their wellness. The theory of supportive design suggests healthcare facilities can lower people's stress levels via three conditions (i.e., perceived control, social support, and positive distractions). METHOD: A single-blind and placebo-randomized controlled study investigated the impacts of ambient scent environment, as a positive distraction, on residents' depression levels. The recruited residents (N = 58) were randomly assigned into either the intervention group, which received a 1% dilution of lavender scent for 2 weeks nearby their bedside or the placebo group, which received a nonscent for 2 weeks. RESULTS: Their depression levels were measured by the Geriatric Depression Scale. Based on the t tests, both intervention and placebo groups had improvement in depression, indicating a placebo effect of lavender scent. Further regression analyses explored the interaction effects of built environments (e.g., building, distance to a ventilation system, and square footage). However, no statistically significant impact of the built environment was found. CONCLUSION: Despite a placebo effect of ambient scent environment and nonsignificant built environment on depression, this study has valuable implications of being a positive distraction during the healing process as developed by the Theory of Supportive design.

Principles for designing the built environment of mental health services.

Although there is an increasing amount of literature on the key principles for the design of mental health services, the contribution of the built environment to outcomes for the service user is a largely neglected area. To help address this gap, we present evidence that highlights the pivotal role of evidence-based architectural design in service users' experience of mental health services. We propose six important design principles to enhance the care of mental health service users. Drawing on research into the delivery of mental health services and best-practice approaches to their architectural design, we outline a holistic conceptual model for designing mental health services that enhance treatment outcomes and experiences, provide benefits to families and the community, and promote community resilience. In this Personal View, we argue that the design of mental health services needs to extend across disciplinary boundaries to integrate evidence-informed practice across individual, interpersonal, and community levels.

A Scoping Review of the Impact on Children of the Built Environment Design Characteristics of Healing Spaces.

AIM: This article elucidates current understanding in pediatric healthcare building design via scoping review of research on the impacts on the health and well-being of children of the architectural and landscape characteristics of healing spaces. BACKGROUND: Studies indicate that patients' phenomenological experiences of the built environment characteristics of healthcare buildings can impact their healing and well-being. It follows that understanding the healing effects of landscape and architecture can inform the design of healthcare settings for increased health benefits. METHOD: This method comprises five search stages: (1) research question is formed; (2) key words, search terms, and search strategy are identified; (3) databases are searched, and papers are assessed via inclusion and exclusion criteria; (4) information of the selected articles is extracted and summarized; and (5) key findings are interpreted and reported via comparative tabulation. RESULTS: One hundred seventy-three papers were found during the first search stage. After screening and evaluating for relevance and quality, 13 articles were selected for study. Analysis indicates that the built environment characteristics of pediatric healthcare environments that have healing benefits include access to nature, music, art and natural light, reduced crowding, reduced noise, and soft, cyclical, and user-controlled artificial lighting. CONCLUSIONS: While it is important to understand the design variables that influence pediatric healthcare, it is also necessary to contextualize them and to distinguish these variables from each other and appreciate their interaction. In other words, a more rounded understanding of these variables is required via research so that their individual and combined impacts are reflected in holistic design recommendations.

Residential green space and seasonal distress in a cohort of tree pollen allergy patients.

BACKGROUND: Residential green space may improve human health, for example by promoting physical activity and by reducing stress. Conversely, residential green space may increase stress by emitting aeroallergens and exacerbating allergic disease. Here we examine impacts of exposure to residential green space on distress in the susceptible subpopulation of adults sensitized to tree pollen allergens. METHODS: In a panel study of 88 tree pollen allergy patients we analyzed self-reported mental health (GHQ-12), perceived presence of allergenic trees (hazel, alder, birch) near the residence and residential green space area within 1 km distance [high (≥3 m) and low (<3 m) green]. Results were adjusted for patients' background data (gender, age, BMI, smoking status, physical activity, commuting distance, education level, allergy medication use and chronic respiratory problems) and compared with distress in the general population (N = 2467). RESULTS: Short-term distress [mean GHQ-12 score 2.1 (95% confidence interval 1.5-2.7)] was higher in the study population than in the general population [1.5 (1.4-1.7)]. Residential green space had protective effects against short-term distress [high green, per combined surface area of 10 ha: adjusted odds ratio OR = 0.94 (95% confidence interval 0.90-0.99); low green, per 10 ha: OR = 0.85 (0.78-0.93)]. However, distress was higher in patients who reported perceived presence of allergenic trees near their residence [present vs. absent: OR = 2.04 (1.36-3.07)]. CONCLUSIONS: Perceived presence of allergenic tree species in the neighbourhood of the residence of tree pollen allergy patients modulates the protective effect of residential green space against distress during the airborne tree pollen season.

Healthy urban planning: an institutional policy analysis of strategic planning in Sydney, Australia.

Rapid urbanization requires health promotion practitioners to understand and engage with strategic city planning. This policy analysis research investigated how and why health was taken up into strategic land use planning in Sydney, Australia, between 2013 and 2018. This qualitative study develops two case studies of consecutive instances of strategic planning in Sydney. Data collection was done via in-depth stakeholder interviews (n = 11) and documentary analysis. Data collection and analysis revolved around core categories underpinning policy institutions (actors, structures, ideas, governance and power) to develop an explanatory narrative of the progress of 'health' in policy discourse over the study period. The two strategic planning efforts shifted in policy discourse. In the earlier plan, 'healthy built environments' was positioned as a strategic direction, but without a mandate for action the emphasis was lost in an economic growth agenda. The second effort shifted that agenda to ecological sustainability, a core aspect of which was 'Liveability', having greater potential for health promotion. However, 'health' remained underdeveloped as a core driver for city planning remaining without an institutional mandate. Instead, infrastructure coordination was the defining strategic city problem and this paradigm defaulted to emphasizing 'health precincts' rather than positioning health as core for the city. This research demonstrates the utility in institutional analysis to understanding positioning health promotion in city planning. Despite potential shifts in policy discourse and a more sophisticated approach to planning holistically, the challenge remains of embedding health within the institutional mandates driving city planning.

Early-Life Environmental Exposures and Blood Pressure in Children.

BACKGROUND: Growing evidence exists about the fetal and environmental origins of hypertension, but mainly limited to single-exposure studies. The exposome has been proposed as a more holistic approach by studying many exposures simultaneously. OBJECTIVES: This study aims to evaluate the association between a wide range of prenatal and postnatal exposures and blood pressure (BP) in children. METHODS: Systolic and diastolic BP were measured among 1,277 children from the European HELIX (Human Early-Life Exposome) cohort aged 6 to 11 years. Prenatal (n = 89) and postnatal (n = 128) exposures include air pollution, built environment, meteorology, natural spaces, traffic, noise, chemicals, and lifestyles. Two methods adjusted for confounders were applied: an exposome-wide association study considering the exposures independently, and the deletion-substitution-addition algorithm considering all the exposures simultaneously. RESULTS: Decreases in systolic BP were observed with facility density (ß change for an interquartile-range increase in exposure: -1.7 mm Hg [95% confidence interval (CI): -2.5 to -0.8 mm Hg]), maternal concentrations of polychlorinated biphenyl 118 (-1.4 mm Hg [95% CI: -2.6 to -0.2 mm Hg]) and child concentrations of dichlorodiphenyldichloroethylene (DDE: -1.6 mm Hg [95% CI: -2.4 to -0.7 mm Hg]), hexachlorobenzene (-1.5 mm Hg [95% CI: -2.4 to -0.6 mm Hg]), and mono-benzyl phthalate (-0.7 mm Hg [95% CI: -1.3 to -0.1 mm Hg]), whereas increases in systolic BP were observed with outdoor temperature during pregnancy (1.6 mm Hg [95% CI: 0.2 to 2.9 mm Hg]), high fish intake during pregnancy (2.0 mm Hg [95% CI: 0.4 to 3.5 mm Hg]), maternal cotinine concentrations (1.2 mm Hg [95% CI: -0.3 to 2.8 mm Hg]), and child perfluorooctanoate concentrations (0.9 mm Hg [95% CI: 0.1 to 1.6 mm Hg]). Decreases in diastolic BP were observed with outdoor temperature at examination (-1.4 mm Hg [95% CI: -2.3 to -0.5 mm Hg]) and child DDE concentrations (-1.1 mm Hg [95% CI: -1.9 to -0.3 mm Hg]), whereas increases in diastolic BP were observed with maternal bisphenol-A concentrations (0.7 mm Hg [95% CI: 0.1 to 1.4 mm Hg]), high fish intake during pregnancy (1.2 mm Hg [95% CI: -0.2 to 2.7 mm Hg]), and child copper concentrations (0.9 mm Hg [95% CI: 0.3 to 1.6 mm Hg]). CONCLUSIONS: This study suggests that early-life exposure to several chemicals, as well as built environment and meteorological factors, may affect BP in children.

The Influence of Audio-Visual Interactions on Psychological Responses of Young People in Urban Green Areas: A Case Study in Two Parks in China.

Audio-visual interactions in green spaces are important for mental health and wellbeing. However, the influence of audio-visual interactions on psychological responses is still less clear. This study introduced a new method, namely the audio-visual walk (AV-walk), to obtain data on the audio-visual context, audio-visual experiences, and psychological responses in two typical parks, namely Cloves Park and Music Park in Harbin, China. Some interesting results are as follows: First, based on Pearson's correlation analysis, sound pressure level and roughness were significantly correlated with psychological responses in Cloves Park (p < 0.05). Second, the results of stepwise regression models showed the impact intensity of acoustic comfort was 1.64-1.68 times higher than that of visual comfort on psychological responses of emotion dimension, while visual comfort was 1.35-1.37 times higher than acoustic comfort on psychological responses of cognition dimension in Music Park. In addition, an orthogonal analysis diagram explained the influence of audio-visual interactions on psychological responses of young people. The audio-visual context located beside the waterscape with a relatively higher level of acoustic and visual comfort was the most cheerful (2.60), relaxed (2.45), and energetic (2.05), while the audio-visual context close to an urban built environment tended to be both acoustically and visually uncomfortable, and the psychological state was decreased to the most depressed (-0.25), anxious (-0.75), fatigued (-1.13) and distracted (-1.13).

A Systematic Measurement of Street Quality through Multi-Sourced Urban Data: A Human-Oriented Analysis.

Many studies have been made on street quality, physical activity and public health. However, most studies so far have focused on only few features, such as street greenery or accessibility. These features fail to capture people's holistic perceptions. The potential of fine grained, multi-sourced urban data creates new research avenues for addressing multi-feature, intangible, human-oriented issues related to the built environment. This study proposes a systematic, multi-factor quantitative approach for measuring street quality with the support of multi-sourced urban data taking Yangpu District in Shanghai as case study. This holistic approach combines typical and new urban data in order to measure street quality with a human-oriented perspective. This composite measure of street quality is based on the well-established 5Ds dimensions: Density, Diversity, Design, Destination accessibility and Distance to transit. They are combined as a collection of new urban data and research techniques, including location-based service (LBS) positioning data, points of interest (PoIs), elements and visual quality of street-view images extraction with supervised machine learning, and accessibility metrics using network science. According to these quantitative measurements from the five aspects, streets were classified into eight feature clusters and three types reflecting the value of street quality using a hierarchical clustering method. The classification was tested with experts. The analytical framework developed through this study contributes to human-oriented urban planning practices to further encourage physical activity and public health.