Arquitectura de salud pública / Public Health Architecture

Uno de los ocho principios rectores para la transformación digital del sector de la salud promovidos por la Organización Panamericana de la Salud (OPS) es la arquitectura de salud pública. Este documento de política presenta conceptos clave, líneas de acción recomendadas e indicadores para su monitoreo con el objetivo de avanzar en la arquitectura de salud pública. De acuerdo con la definición de la OPS, este principio rector se propone diseñar la arquitectura de salud pública en la era de la interdependencia digital. "La arquitectura de salud pública, en la era de la interdependencia digital, debe enmarcarse en la agenda digital del gobierno. Debe ser transversal, para articular las distintas vertientes de gobernanza y optimizar la planificación estratégica y la gestión de los recursos. Debe basarse en el aprovechamiento de normas y procedimientos a favor de múltiples áreas, no solo de la esfera de la salud; este es el caso de la conectividad y el ancho de banda, que influyen indistintamente en salud, en educación y en todos los sectores". La mayoría de los avances en salud digital se dan como aplicaciones y sistemas de información individuales que funcionan independientemente. Esto genera islas de información, con grandes desafíos para alcanzar la eficiencia y mejorar los resultados de salud. La propuesta es lograr una arquitectura de salud como plataforma que sirva de base para que los diversos sistemas de información interoperen y trabajen juntos de manera integrada. Existen diferentes formas de alcanzar este intercambio de datos, y todos ellos implican establecer la gobernanza, un marco de confianza (dado por normativas y su cumplimiento) y de arquitectura tecnológica de interoperabilidad

Research on the Sustainable Renewal of Architectural Heritage Sites from the Perspective of Extenics-Using the Example of Tulou Renovations in LantianVillage, Longyan City.

Fujian Tulous in China are important international architectural heritage sites that reflect precious human cultural heritage. Currently, only a small number of Tulou buildings have been listed as world cultural heritage sites, resulting in a lack of attention and financial support for most Tulou buildings. Thus, it is difficult to effectively renovate and repair Tulou buildings to adapt to modern life, and therefore they are facing the severe challenge of abandonment and desolation. Due to the special conditions of Tulou buildings, there are significant limitations in renovation and repair work, with a number of problems such as the lack of innovative renovations. Therefore, through a problem model analysis of a design system for Tulou renovations, in this study, we adopt the methods of divergent tree, conjugate pair, correlative net, implied system, and split-merge chain analyses in extenics to carry out extension transformation and solve the problem and we verify its feasibility using the example of the Tulou renovation projects in Lantian Village, Longyan City. We explore an innovative methodology for scientific renovation of Tulou buildings, and we establish a design system for Tulou building renovations that enriches and supplements original renovation methods; thus, we provide a basis for the repair and reuse of Tulou buildings, to extend their service life and to realize the sustainable development of Tulou buildings. The research results show that extenics can be implemented in innovative renovations of Tulou buildings, and it is concluded that the essence of achieving sustainable renewal in Tulou building renovations is to solve contradictory problems, including contradictions in conditions, objectives, and design. This study verifies the possibility of applying extenics in the design of Tulou building renovations, makes corresponding contributions to the application of extension methods in the renovation and renewal of Tulou buildings, and also contributes to the renovation, renewal, and protection of other types of architectural heritage sites.

Health Implications of Virtual Architecture: An Interdisciplinary Exploration of the Transferability of Findings from Neuroarchitecture.

Virtual architecture has been increasingly relied on to evaluate the health impacts of physical architecture. In this health research, exposure to virtual architecture has been used as a proxy for exposure to physical architecture. Despite the growing body of research on the health implications of physical architecture, there is a paucity of research examining the long-term health impacts of prolonged exposure to virtual architecture. In response, this paper considers: what can proxy studies, which use virtual architecture to assess the physiological response to physical architecture, tell us about the impact of extended exposure to virtual architecture on human health? The paper goes on to suggest that the applicability of these findings to virtual architecture may be limited by certain confounding variables when virtual architecture is experienced for a prolonged period of time. This paper explores the potential impact of two of these confounding variables: multisensory integration and gravitational perception. This paper advises that these confounding variables are unique to extended virtual architecture exposure and may not be captured by proxy studies that aim to capture the impact of physical architecture on human health through acute exposure to virtual architecture. While proxy studies may be suitable for measuring some aspects of the impact of both physical and virtual architecture on human health, this paper argues that they may be insufficient to fully capture the unintended consequences of extended exposure to virtual architecture on human health. Therefore, in the face of the increasing use of virtual architectural environments, the author calls for the establishment of a subfield of neuroarchitectural health research that empirically examines the physiological impacts of extended exposure to virtual architecture in its own right.

Una propuesta de interpretación de la cruz en la arquitectura doméstica como simbología de hospitalidad / Uma proposta de interpretação da cruz na arquitetura doméstica como símbolo de hospitalidade / A proposal for the interpretation of the cross in domestic architecture as a symbol of hospitality

El hallazgo sobre 32 hospitales históricos rurales en Álava (España) de 10 con una cruzesculpida en sus accesos sugiere un potencial significado de hospitalidad que no seevidencia en la bibliografía. A fin de determinar esta posible asociación, se realizó una búsqueda exhaustiva de cruces enaccesos de arquitectura doméstica de la provincia hallando 53 que cumplían los criterios deinclusión y exclusión. Distribuidas por toda la geografía provincial, 48 son de facturaprofesional y 5 son incisiones elaboradas. 36 son cruces únicas por localidad, cuestionando interpretaciones mágico-religiosas dominantes en la antropología y etnografía. Treinta y siete (69’8%)se encuentran en localidades que tuvieron hospital, si bien solo en 10 casos hay correspondenciacruz-hospital documentada y en 3 probablemente. El Camino a Santiago, fundamental en el desarrollo hospitalario, queda mejor representado desde el análisis de las cruces que desde los hospitales. Aunque no hay dos cruces iguales, 50 son latinas de calvario y al menos 14 presentan susbrazos remarcados (Trinidad), pudiéndose hacer lecturas bíblicas de estas características relacionándolas con la hospitalidad. Aunque queda establecida la asociación entre cruces y hospitalidad, diversas limitaciones en la búsqueda y el análisis no permiten ser concluyentes, requiriéndose de estudios comparados en otras regiones.(AU)

The finding on 32 rural historic hospitals in Álava (Spain) of 10 with a sculpted crosson their entrances suggests a potential meaning of hospitality that is not evident in the literature. In order to determine this possible association, an exhaustive search for crosses on the entrances of domestic architecture in the province was carried out, finding 53 that met the inclusion and exclusion criteria. Distributed throughout the province, 48 are professionally madeand 5 are elaborate incisions. 36 are unique crosses per locality, questioning dominant magicalreligious interpretations in anthropology and ethnography. Thirty-seven (69.8%) are found inlocalities that had a hospital, although in only 10 cases is there a documented cross-hospitalcorrespondence, and in 3 probably. The Road to Santiago, fundamental in the development ofhospitals, is better represented from the analysis of the crosses than from the hospitals. Although no two crosses are the same, 50 are Latin Calvary crosses and at least 14 have their armsmarked (Trinity), making it possible to make biblical readings of these characteristics relatingthem to hospitality. Although the association between crosses and hospitality is established,several limitations in the search and analysis do not allow us to be conclusive, requiring comparative studies in other regions.(AU)

A descoberta em 32 hospitais históricos rurais em Álava (Espanha) de 10 com uma cruzesculpida nas suas entradas sugere um significado potencial de hospitalidade que não é evidentena literatura. A fim de determinar esta possível associação, foi realizada uma busca exaustiva decruzes nas entradas da arquitectura doméstica na província, encontrando 53 que preenchiam oscritérios de inclusão e exclusão. Distribuídas por toda a província, 48 são feitas profissionalmentee 5 são incisões elaboradas. 36 são cruzes únicas por localidade, questionando as interpretaçõesmágico-religiosas dominantes em antropologia e etnografia. Trinta e sete (69,8%) encontramseem localidades que tiveram um hospital, embora em apenas 10 casos exista uma correspondênciainterhospitalar documentada, e em 3 provavelmente. O Caminho de Santiago, fundamental nodesenvolvimento dos hospitais, é melhor representado a partir da análise das cruzes do que apartir dos hospitais. Embora não haja duas cruzes iguais, 50 são cruzes do Calvário Latino e pelomenos 14 têm os braços marcados (Trindade), o que permite fazer leituras bíblicas destas características relacionandoas com a hospitalidade. Embora a associação entre cruzes e hospitalidadeseja estabelecida, várias limitações na pesquisa e análise não nos permitem ser conclusivos, exigindo estudos comparativos noutras regiões.(AU)

Digital Protection of Historic Buildings in Urban Planning.

With the rapid development of urbanization, urban land has been expropriated and developed on a large scale. Moreover, people's awareness of the protection of historical buildings is relatively weak, so some historical buildings have been demolished or rebuilt. Historical buildings have played an important role in the spread of national culture, so how to use some methods to protect historical buildings from being destroyed has become an urgent problem to be solved. The protection of historical buildings includes a series of complicated and rigorous procedures, such as on-site drawing and mapping, survey and design, and scheme discussion and construction. The surveying and mapping of traditional historical buildings require people to do it by themselves, so it is inevitably time-consuming and labor-intensive. This paper first discussed and analyzed the significance of historical building protection, and then used digital technology to make up for the shortcomings of traditional manual surveying and mapping and historical building protection methods. Modern technologies such as three-dimensional laser scanning technology and virtual reality technology are used to restore the style and appearance of historical buildings. Among them, in terms of the color of historical buildings, the restoration degree of buildings based on digital protection technology has reached 56.1%; at the same time, the efficiency of information collection and processing, and virtual model construction has also been improved. Thus, the ultimate goal of historical building protection is achieved, and it provides a reference for the digital protection of historical buildings.

Evaluation of virtual tour in an online museum: Exhibition of Architecture of the Forbidden City.

Online virtual museum tours combine museum authority and an academic approach with the diversity and interactivity of online resources; such tours have become an essential resource for online scientific research and education. Many important museums around the world are developing this type of online service. Comprehensive evaluation of such tours is, however, urgently needed to ensure effectiveness. This paper establishes a heuristic evaluation scale based on the literature. Taking the online virtual tour of the Exhibition of Architecture of the Forbidden City as a case study, confirmatory factor analysis was then carried out to improve the scale. Interviews were conducted to discuss and analyze the research results. The developed evaluation scale has four dimensions: authenticity, interaction, navigation, and learning. The results from the case study showed, first, that the exhibition had visual authenticity, but the behavioral authenticity was insufficient; second, the exhibition was generally interactive, but this aspect could be improved by enriching the links; third, the lack of effective navigation design for the exhibit was the main factor affecting experience quality. Fourth, the exhibition was informative and supported learning, but needs further improvement to the quantity and quality of information provided. Finally, the interviews revealed that the online exhibition did not entirely support people of different ages and abilities, so it needs further improvement to be wholly inclusive.

Differences in regional gray matter volume predict the extent to which openness influences judgments of beauty and pleasantness of interior architectural spaces.

Hedonic evaluation of sensory objects varies from person to person. While this variability has been linked to differences in experience, little is known about why stimuli lead to different evaluations in different people. We used linear mixed-effects models to determine the extent to which the openness, contour, and ceiling height of interior spaces influenced the beauty and pleasantness ratings of 18 participants. Then, by analyzing structural brain images acquired for the same group of participants, we asked if any regional gray matter volume (rGMV) covaried with these differences in the extent to which the three features influence beauty and pleasantness ratings. Voxel-based morphometry analysis revealed that the influence of openness on pleasantness ratings correlated with rGMV in the anterior prefrontal cortex (Brodmann area (BA)-10), and the influence of openness on beauty ratings correlated with rGMV in the temporal pole (BA38) and cluster, including the posterior cingulate cortex (BA31) and paracentral lobule (BA5/6). There were no significant correlations involving contour or ceiling height. Our results suggest that regional variance in gray matter volume may play a role in the computation of hedonic valuation and account for differences in the way people weigh certain attributes of interior architectural spaces.

Analysis of the spatial differentiation and scale effects of the three-dimensional architectural landscape in Xi'an, China.

Three-dimensional landscape patterns are an effective means to study the relationship between landscape pattern evolution and eco-environmental effects. This paper selects six districts in Xi'an as the study area to examine the spatial distribution characteristics of the three-dimensional architectural landscape in the city's main urban area using three-dimensional information on the buildings in 2020 with the support of GIS. In this study, two new architectural landscape indices-landscape height variable coefficient and building rugosity index-were employed in landscape pattern analysis, whilst a system of rigorous and comprehensive three-dimensional architectural landscape metrics was established using principal component analysis. A mathematical model of weighted change of landscape metrics based on the objective weighting method was applied to carry out scale analysis of the landscape patterns. Spatial statistical analysis and spatial autocorrelation analysis were conducted to comprehensively study the differentiation of three-dimensional architectural landscape spatial patterns. The results show that the characteristic scale of the three-dimensional landscape pattern in Xi'an's main urban area is around 8 km. Moreover, the three-dimensional landscape of the buildings in this area is spatially positively correlated, exhibiting a high degree of spatial autocorrelation whilst only showing small spatial differences. The layout of the architectural landscape pattern is disorderly and chaotic within the second ring, whilst the clustering of patch types occurs near the third ring. Moreover, the building density in the Beilin, Lianhu, and Xincheng districts is large, the building height types are rich, and the roughness of the underlying surface is high, such that these are key areas to be improved through urban renewal. The height, volume, density, morphological heterogeneity, and vertical roughness of the architectural landscape vary amongst functional areas within the study area. This paper is the first to apply the study of spatial heterogeneity of three-dimensional landscape patterns to Xi'an. It does so in order to provide a quantitative basis for urban landscape ecological design for urban renewal and the rational planning of built-up areas, which will promote the sustainable development of the city's urban environment.

Origins and spread of formal ceremonial complexes in the Olmec and Maya regions revealed by airborne lidar.

City plans symbolizing cosmologies have long been recognized as a defining element of Mesoamerican civilizations. The origins of formal spatial configurations are thus the key to understanding early civilizations in the region. Assessment of this issue, however, has been hindered by the lack of systematic studies of site plans over broad areas. Here, we report the identification of 478 formal rectangular and square complexes, probably dating from 1,050 to 400 BC, through a lidar (laser imaging, detection and ranging) survey across the Olmec region and the western Maya lowlands. Our analysis of lidar data also revealed that the earlier Olmec centre of San Lorenzo had a central rectangular space, which possibly provided the spatial template for later sites. This format was probably formalized and spread after the decline of San Lorenzo through intensive interaction across various regions. These observations highlight the legacy of San Lorenzo and the critical role of inter-regional interaction.

The concept of monument in the map of 1942. Ibagué, Colombia.

The beginning of the concept of architectural monument in Colombia is in the laws from the late XIX century and early XX century. We recompose the international context through the technic of aero photography, used by the Military Geographical Institute during the Second World War and the consequent tensions between U.S. and the powerful nations of the axis in relation to Colombia and Brazil in Latin America. The Liberal Party emerges like an ideology that tried to reorganise the country through the establishment of education and control the soil. This party negotiated a pact to stop the Colombian-Peruvian war 1932-1933, and signed the Roerich Pact in 1935 to protect the monuments. Therefore, the 1942 plan is the end of a process of mapping the national territory and the generation of criteria about cultural heritage in the first half of XX century, and the base to study how it affected the protection of architectural monuments up to date.

Study on the mechanical response of anticlastic cold bending insulating glass and its coupling effect with uniform load.

Cold bending is a characteristic of significance for the beautiful curved glass curtain walls, because it affects them in terms of energy-efficiency and cost-efficiency. The increasing engineering projects call for more special studies on the mechanical properties of cold-bent glass panels, especially when the walls are built by insulating glass that is currently widely used while its relevant research is very scarce. This paper is devoted to studying the mechanical properties of anticlastic cold-bent insulating glass while taking different factors into consideration, including glass thickness, cold-bent torsion rate and cavity thickness. 9 pieces of insulating glass were manufactured for anticlastic cold-bending test and their coupled effect with identical load is also studied, and numerical finite element analysis sessions were carried out to simulate the experimental results for each one of them. Further, we analyzed the stress distribution performance of the sample pieces under cold bending and a uniform load, followed by discussions about stress transfer controls in glass plates. The results showed that the cold-bent control stress is on the surface with direct loads from cold bending and close to the cold-bent corner on the short edge, and it is transferred from the parts around the corner to the center when the uniform load plays a leading role in generating stress. This transfer could occur under a relatively small load with a small cold-bent torsion rate. A higher cold-bent torsion rate in cold bending contributed mostly to greater center stress in the glass, and as the glass thickness grows, stress and deflection at the plate center would significantly drop. However, the effect of cavity thickness on the anticlastic mechanical response of insulating glass was found to be trivial.

Through the eyes of the expert: Evaluating holistic processing in architects through gaze-contingent viewing.

Studies in the psychology of visual expertise have tended to focus on a limited set of expert domains, such as radiology and athletics. Conclusions drawn from these data indicate that experts use parafoveal vision to process images holistically. In this study, we examined a novel, as-of-yet-unstudied class of visual experts-architects-expecting similar results. However, the results indicate that architects, though visual experts, may not employ the holistic processing strategy observed in their previously studied counterparts. Participants (n = 48, 24 architects, 24 naïve) were asked to find targets in chest radiographs and perspective images. All images were presented in both gaze-contingent and normal viewing conditions. Consistent with a holistic processing model, we expected two results: (1) architects would display a greater difference in saccadic amplitude between the gaze-contingent and normal conditions, and (2) architects would spend less time per search than an undergraduate control group. We found that the architects were more accurate in the perspectival task, but they took more time and displayed a lower difference in saccadic amplitude than the controls. Our research indicates a disjunctive conclusion. Either architects are simply different kinds of visual experts than those previously studied, or we have generated a task that employs visual expertise without holistic processing. Our data suggest a healthy skepticism for across-the-board inferences collected from a single domain of expertise to the nature of visual expertise generally. More work is needed to determine whether holism is a feature of all visual expertise.

House modifications for preventing malaria.

BACKGROUND: Despite being preventable, malaria remains an important public health problem. The World Health Organization (WHO) reports that overall progress in malaria control has plateaued for the first time since the turn of the century. Researchers and policymakers are therefore exploring alternative and supplementary malaria vector control tools. Research in 1900 indicated that modification of houses may be effective in reducing malaria: this is now being revisited, with new research now examining blocking house mosquito entry points or modifying house construction materials to reduce exposure of inhabitants to infectious bites. OBJECTIVES: To assess the effects of house modifications on malaria disease and transmission. SEARCH METHODS: We searched the Cochrane Infectious Diseases Group Specialized Register; Central Register of Controlled Trials (CENTRAL), published in the Cochrane Library; MEDLINE (PubMed); Embase (OVID); Centre for Agriculture and Bioscience International (CAB) Abstracts (Web of Science); and the Latin American and Caribbean Health Science Information database (LILACS), up to 1 November 2019. We also searched the WHO International Clinical Trials Registry Platform (www.who.int/ictrp/search/en/), ClinicalTrials.gov (www.clinicaltrials.gov), and the ISRCTN registry (www.isrctn.com/) to identify ongoing trials up to the same date. SELECTION CRITERIA: Randomized controlled trials, including cluster-randomized controlled trials (cRCTs), cross-over studies, and stepped-wedge designs were eligible, as were quasi-experimental trials, including controlled before-and-after studies, controlled interrupted time series, and non-randomized cross-over studies. We only considered studies reporting epidemiological outcomes (malaria case incidence, malaria infection incidence or parasite prevalence). We also summarised qualitative studies conducted alongside included studies. DATA COLLECTION AND ANALYSIS: Two review authors selected eligible studies, extracted data, and assessed the risk of bias. We used risk ratios (RR) to compare the effect of the intervention with the control for dichotomous data. For continuous data, we presented the mean difference; and for count and rate data, we used rate ratios. We presented all results with 95% confidence intervals (CIs). We assessed the certainty of evidence using the GRADE approach. MAIN RESULTS: Six cRCTs met our inclusion criteria, all conducted in sub-Saharan Africa; three randomized by household, two by village, and one at the community level. All trials assessed screening of windows, doors, eaves, ceilings or any combination of these; this was either alone, or in combination with eave closure, roof modification or eave tube installation (a "lure and kill" device that reduces mosquito entry whilst maintaining some airflow). In two trials, the interventions were insecticide-based. In five trials, the researchers implemented the interventions. The community implemented the interventions in the sixth trial. At the time of writing the review, two of the six trials had published results, both of which compared screened houses (without insecticide) to unscreened houses. One trial in Ethiopia assessed screening of windows and doors. Another trial in the Gambia assessed full screening (screening of eaves, doors and windows), as well as screening of ceilings only. Screening may reduce clinical malaria incidence caused by Plasmodium falciparum (rate ratio 0.38, 95% CI 0.18 to 0.82; 1 trial, 184 participants, 219.3 person-years; low-certainty evidence; Ethiopian study). For malaria parasite prevalence, the point estimate, derived from The Gambia study, was smaller (RR 0.84, 95% CI 0.60 to 1.17; 713 participants, 1 trial; low-certainty evidence), and showed an effect on anaemia (RR 0.61, 95% CI 0.42, 0.89; 705 participants; 1 trial, moderate-certainty evidence). Screening may reduce the entomological inoculation rate (EIR): both trials showed lower estimates in the intervention arm. In the Gambian trial, there was a mean difference in EIR between the control houses and treatment houses ranging from 0.45 to 1.50 (CIs ranged from -0.46 to 2.41; low-certainty evidence), depending on the study year and treatment arm. The Ethiopian trial reported a mean difference in EIR of 4.57, favouring screening (95% CI 3.81 to 5.33; low-certainty evidence). Pooled analysis of the trials showed that individuals living in fully screened houses were slightly less likely to sleep under a bed net (RR 0.84, 95% CI 0.65 to 1.09; 2 trials, 203 participants). In one trial, bed net usage was also lower in individuals living in houses with screened ceilings (RR 0.69, 95% CI 0.50 to 0.95; 1 trial, 135 participants). AUTHORS' CONCLUSIONS: Based on the two trials published to date, there is some evidence that screening may reduce malaria transmission and malaria infection in people living in the house. The four trials awaiting publication are likely to enrich the current evidence base, and we will add these to this review when they become available.

The mechanism of digitized landscape architecture design under edge computing.

The purposes are to analyze the mechanism of digitized landscape architecture design and stablize the garden landscape image display in constructing garden landscape digitization platform. According to previous research and mobile edge computing, a scheme of digitized landscape architecture design is proposed based on edge computing. This scheme uses discrete elevation calculation to preserve the landscape design image's frame. It adopts the Roberts edge detection and Laplacian operator for high-level stable preservation of landscape images. Simultaneously, the displayed image is stablized using edge computing algorithms. Simulation experiments are performed to verify the effectiveness of the proposed scheme of digitized landscape architecture design based on mobile edge computing. Results demonstrate that the discrete elevation calculation algorithm can avoid low visual rendering in the 3D image generation process, optimize the seed point matching of edge correlation, and ensure image clarity and stability. The edge computing algorithm can fundamentally avoid the problem of image shaking. The impact of different algorithm models on the classification and accuracy of landscape images is analyzed through parameter optimization. Compared with some latest models, the proposed landscape design scheme based on edge computing has better accuracy. The average accuracy can reach more than 90%, and the Kappa coefficient remains at 86.93%. The designed garden landscape digitization platform can stably display 3D garden landscape images while avoiding the shaking of 3D images, which can provide a theoretical basis and practical value for designing and planning landscape architecture.

Building for Change: Comparative Case Study of Hospital Architecture.

OBJECTIVE: This study assesses how architectural design strategies impact the flexibility of hospitals to change over time. BACKGROUND: Most hospitals are designed for highly specialized medical functions, which is often in conflict with the need to design the hospital facility to accommodate evolvement and change of functions over time. Architectural design strategies provide different approaches to the need to design for a specific medical program while planning for its future change. METHODS: The study compares two hospital buildings with a very similar configuration and medical program but with significantly different architectural design strategies: One was designed for an unknown future medical function, and the second was designed for a specific medical function. The study analyses the two hospital buildings by their design strategy, planning, design process, and construction by phases and compares their change in practice over the last twelve years. RESULTS: The design strategy to fit a specific function limited the hospital affordance to make changes during the design process, construction, and occupancy phases. Systematic design of system separation for an unknown function, in contradiction to a "tailor-made" approach in the design for a specific function, was found to support a variety of changing medical programs. CONCLUSIONS: Architectural design strategies developed in an early stage of the design process has a major impact on the future evolution of the hospital facility. The different results between the two projects also demonstrate the greater influence of healthcare policies, hospital organization culture, and infrastructure funding models on the architecture and flexibility of hospitals.

Lack of Pregraduate Teaching on the Associations between the Built Environment, Physical Activity and Health in Swiss Architecture and Urban Design Degree Programs.

BACKGROUND: Lack of physical activity (PA) is the fourth risk factor for all-cause mortality. Regular PA reduces noncommunicable disease (NCD) and mortality risk. The built environment (BE) is a determinant of spontaneous daily PA. Professionals who plan and build the BE therefore affect public health. We tested the hypothesis of a lack of formal pregraduate training about associations between the BE, PA and health in architecture, landscape architecture, and urban design academic degree programs (DPs) in Switzerland. METHODS: We reached out to all DPs in Switzerland to ask if and how these associations are taught. For those declaring to teach the topic, the program syllabus and course material were inspected. RESULTS AND DISCUSSION: For 30 out of 33 identified programs, information for the analysis was obtained. A total of 18 declared teaching the BE, PA and health associations, but this could be confirmed for only 5 after verifying the course content. Teaching principles of building PA-promoting BE represents an underutilized potential for public health promotion. CONCLUSIONS: There is a need to introduce formal learning objectives in architecture, landscape architecture, and urban design DPs in Switzerland on the associations between BE, PA and health. It is likely that similar needs exist in other countries.

Necesidad y uso de productos de apoyo y facilitadores arquitectónicos en población dependiente / Need and use of assistive devices and architectural facilitators in a dependent population

OBJETIVO: Describir la utilización y percepción de la necesidad de productos de apoyo e identificar su asociación con instrumentos para medir la dependencia y la sobrecarga de cuidados. DISEÑO: Estudio transversal. Emplazamiento: Atención Primaria del área sur de Pontevedra. PARTICIPANTES: Un total de 112 personas cuidadoras informales que atienden a 125 personas dependientes. Mediciones principales: Mediante entrevista personal se recogen datos sobre la utilización y percepción de necesidad de estos productos. Además, se obtienen datos sociodemográficos e información referida al tiempo dedicado al cuidado diario, la sobrecarga del cuidador, el Baremo de Valoración de Dependencia y el indicador de dependencia DEP-6D. Se ha utilizado un contraste de medias para identificar si existen diferencias significativas en dichos indicadores en función de si utilizan o no los productos facilitadores. Se ha calculado una regresión logística para identificar aquellas variables asociadas con tener una necesidad no cubierta. RESULTADOS: Un 60% (IC 95%: 50,9-68,7) de las personas dependientes tienen necesidades no cubiertas de estos dispositivos. Estas necesidades se asocian, principalmente, con una renta familiar baja, un mayor grado de dependencia y una mejor salud del cuidador, aunque en situaciones de gran dependencia y muy mala salud del cuidador estas carencias se suavizan. CONCLUSIONES: Existe una fuerte asociación entre grado de dependencia y utilización de estos productos. Sin embargo, también hay un elevado porcentaje de la muestra con necesidades no cubiertas de estos productos que están asociadas tanto con la situación socioeconómica del hogar como con las características del dependiente y de la persona cuidadora

OBJECTIVE: To describe the use and perception of the need for assistive devices and identify their relationship with instruments to measure dependence and caregiver burden. DESIGN: Cross-sectional study. LOCATION: Primary Health Care in the southern area of Pontevedra. PARTICIPANTS: A total of 112 informal caregivers providing care to 125 dependent persons. Key measurements: Through a personal interview, data was collected on the use and perception of the need for these devices. In addition, sociodemographic data and information on the time dedicated to daily care, caregiver burden, the Dependency Rating Scale, and the DEP-6D dependency indicator were obtained. A contrast mean was used to identify whether there are significant differences in these indicators, depending on whether or not they use the facilitator devices. A logistic regression was performed to identify those variables most associated with not having a need covered. RESULTS: More than half (60%: 95% CI; 50.9-68.7) of dependent persons have unmet needs for these devices. These needs are mainly associated with a low family income, a high degree of dependence, and better health of the caregiver; although in extreme situations of greater dependence and worse health of the caregiver these deficiencies are smoothed out. CONCLUSIONS: There is a strong association between the level of dependence and the use of these devices. However, there is a high percentage of the sample that do not have the products that they need, which are associated with the socioeconomic situation of the household as well as with the characteristics of the dependent person and the caregiver

Architecture, urban planning and collective identity: Bilbao as a case study.

The emergence of a collective identity, a complex social and psychological process, may be linked to a specific place and a particular urban layout. Architecture demarcates interior and exterior spaces that not only frame our relationships but can also generate a mirror image of the internal world. The authors examine relevant contributions from the sparse psychoanalytic literature on this subject, to support their hypothesis that changes to a city's landscape, design, or architecture, when wholeheartedly embraced by its citizens, can serve to forge a new collective identity that helps to deal with absence, pain, and loss. They present the city of Bilbao, Spain, as a case study. This once thriving industrial city had collapsed into economic ruin, rife with social conflict, but since the 1990s, in an urban renewal, has emerged as a unique tourist destination. It has become a modern art and cultural center, symbolized by its most famous piece of contemporary architecture.