[The impact of urban architecture on health: the PAKARA model]. / Wie Stadtarchitektur die Gesundheit beeinflusst: das PAKARA-Modell.

Humankind is in constant interaction with the environment. If this interaction leads to individual internalization of the environment, which is also called "appropriation" in psychology, it has a positive effect on health and wellbeing. To promote appropriation, urban architecture must respond to human needs. The PAKARA model illustrates the dynamic interaction of these needs with urban architecture, distinguishing three sectors: preventive, curative, and rehabilitative architecture. The PAKARA model was developed in 2019 at the Technical University of Munich.In addition to the model, the article explains three central needs that, influenced by urban architecture, can lead to health-promoting saturation or health-damaging over- or undersaturation: stimulation, identification, and privacy. Conclusively, it is shown that the future challenge is to expand close interdisciplinary cooperation against the background of a drastic increase in the global urban population and an associated complexity of need-oriented design. The needs of the individual - even if they contradict each other and change over the course of a lifetime - are the driving motor behind the health of an entire community. Urban architecture has the potential to keep this motor running, or, destroy it.

Unlimited Surrounding: A Scoping Review on the Impact of the Built Environment on Health, Behavior, and Quality of Life of Individuals With Intellectual Disabilities in Long-Term Care.

OBJECTIVES: To identify available literature on the impact of built environments on health, behavior, and quality of life of individuals with intellectual disabilities in long-term care. Additionally, we aimed to map the available literature, (re)frame the overall research situation in this area, and formulate recommendations. BACKGROUND: Long-term care facilities in the Netherlands are planned without using knowledge from research regarding evidence-based design because it is unclear what evidence is available about the impact of long-term care built environments on individuals with intellectual disabilities receiving 24/7 care. METHODS: Twelve scientific databases were searched for keyword combinations. After systematically screening 3,095 documents, 276 were included in the analysis. RESULTS: There is an underrepresentation of research and publications in intellectual disabilities, compared to other user groups living in long-term care facilities. A total of 26 design components were found in all groups; as for intellectual disabilities, research was available on only seven of them. Community care, home-likeness, and variety seem to have a positive effect on health, behavior, and quality of life. There are conflicting results regarding the effects of house size. CONCLUSIONS: Although individuals with intellectual disabilities live in long-term care facilities, sometimes for life, little research has been conducted on the impact of the built environment on them. In the future, more empirical research should be conducted, addressing all aspects of quality of life and specific design components, with hypotheses based on needs assessments and the use of good research designs. This requires an investment of time and funding.

The Parent-Child Patient Unit (PCPU): Evidence-Based Patient Room Design and Parental Distress in Pediatric Cancer Centers.

Children with cancer are frequently hospitalized during diagnosis and treatment. Since the early 1980s, parents are co-admitted because their presence positively affects children's adjustment to hospitalization and reduces post-traumatic stress. However, the size and overall architectural design of the rooms were never adapted to the doubling of the occupancy rate. Since studies show that many parents experience high levels of distress due to their child's illness, the purpose of this study was to investigate the impact of the architecture of the aged patient rooms on parental distress. A video observation targeted parent-child interaction related to five architectural determinants: (a) function and place of interaction, (b) distance between parent and child, (c) used space, (d) withdrawal, and (e) duration of the interaction. A total of 22 families were included in two Dutch children's hospitals. Results show a significant association between parental distress and three architectural determinants: The less anxious the parents were and the better they estimated their child's well-being, the more distance they created between themselves and their child, and the more space, privacy, and withdrawal options were used. These findings are discussed within a new patient room typology, the parent-child patient unit (PCPU), which reacts to the evident association of parental distress and the design.