Figure - uploaded by Andrea Brambilla
Content may be subject to copyright.
Assessment framework of macro areas and criteria with the number of evaluation variables allocated (in brackets)
Source publication
Sustainable, inclusive and resilient cities and urban settlements are fundamental in enabling people to live long and healthy lives. Elderly population is growing all over the world and in Italy is among the largest. Within this scenario, epidemiological data show that Alzheimer disease, a dementia which manifest with ageing, is also forecast to ra...
Context in source publication
Citations
... The pandemic emergency has highlighted the weakness of the health system, placing a heavy burden on hospital centers and especially on emergency departments; therefore, it is pivotal to achieve more extensive and homogeneous levels of service, reduce hospitalization demand, and use digitalization and telemedicine tools, where applicable, to monitor the health of citizens. This change will not be able to disregard the management of an efficient network of places intended for other forms of assistance and the concrete involvement of home care, increases in rehabilitation hospitalization facilities, health residences, and territorial outpatient clinics, and the careful management of services that precede rapid and targeted therapeutic interventions in hospitals [79,80]. ...
Background. Urban planning is a key tool to promote health in cities. The COVID-19 emergency accelerated several social, environmental, and digital challenges, stressing the importance of some issues regarding housing, urban mobility, green areas, and health service networks, urban health policies, and actions. These issues were the subject of an intensive residential course (the 57th) held in Erice, Sicily, in June 2021 in the "International School of Epidemiology and Preventive Medicine G. D'Alessandro", and the main findings are described here. Methods. Lectures presented the topics, subsequently developed them, and argued them in parallel practical sessions using the World Café technique, since it is well suited for the interaction of participants and the involvement of groups. Results. The World Café provides new insights into how to improve the livability and health of urban spaces, and a set of strategies and actions were proposed for each topic. Discussion and Conclusions. All attendees agreed on the importance of participation in the planning processes, but also on the need for strong political support to ensure the resources needed and a full integration of health with other local policies.
... These facilities must be suitable for a fragile category of users like PwD. It is extremely important to design and build adequate structures, properly designed and implemented as places where patients find themselves having to live as their disease slowly progresses (4,5). ...
... Nowadays it is clear that a built environment can be crucial in the health and well-being of the elderly as well as PwD. (4,5,15,16). As a physical health issue related to elderly people, falling is among the most frequent problems and it can result in other health concerns. ...
Background and aim:
Italy is a country where the percentage of elderly population is very high (23% over 65). The aim of the investigation is to bring out which aspects of the spaces intended to accommodate elderly People with Dementia pathologies should be most present and potentially interested in becoming cornerstones of a new model of Long-Term Care facilities (LTC).
Methods:
This research uses a case studies analysis followed by a web based survey as methodological tools. The questions were identified following an analysis of recent European case studies. The survey has been submitted to a panel of stakeholders (users, pratictioner, designer and manager in the healthcare sector). It is articulated in eight items touching on functional, configurational, and perceptual aspects of the LTC.
Results:
The 210 responses received provided a basis for comparison with the trend lines detected by the case study analysis, establishing continuity on some configurational aspects and providing divergent views for others. The research found a strong need to introduce new service activities and technologies aimed at the care and assistance of guests with dementia. These specific needs often involve the introduction of new spaces and environments or the redefinition of the same, where already present.
Conclusions:
The results highlights that a new model of residence must incorporate new technological applications, outdoor spaces, that are perceived significantly by both patients and practitioners, and improve well-being of all users.
... Due to the age and multimorbidity of the patient, is one of the most frequent visitors of healthcare facilities, and long-term care in many cases becomes their home. These structures often do not consider the real needs of the patient who, because of the pathology, relates differently to the environment than other kinds of patients (3)(4)(5). ...
Background and aim:
The number of People with Dementia (PwD) is rising worldwide and represents a complex figure because of the changes in the cognitive sphere, altering perceptions of the Built Environment (BE). Even though the role of the built environment in the health and well-being of people it's nowadays well known, few studies analyze and evaluate the impact of specific Architectural Features. To this end, this contribution provides a systematic review that will underline the impacts of BE on the Health and Well-being of PwD and set a matrix of the relationship with measurable outcomes.
Methods:
A literature review has been conducted on scientific databases. 40 studies that relate health outcomes and aspects of the built environment have been identified and organized on a comparison matrix that clearly shows the relationships between Architectural Features of BE and Health and Wellbeing Outcome. This matrix allows to identify which are the aspects that can impact on PwD as well as possible lacks.
Results:
Many aspects appear to be widely explored, such as BPSD or wandering. In addition, significant gaps in the relationship between recognized aspects of the built environment recognized as relevant to the well-being of people with dementia and the real impacts on health outcomes such as the location and personalization of spaces.
Conclusions:
This study collected the most recent studies to underline the relationship between BE and dementia, providing a set of outcomes and architectural features that can be analyzed to assess the quality of BE for PwD.
... The biophysical dimension revealed that there is a lack of systematic information about the state of housing accessibility in the ordinary housing stock, as well as a low level of knowledge and insufficient evidence on the health and wellbeing impacts on individuals and society. Here, the application of performance-based assessment methodologies for quality evaluation of built environments (see e.g., [38,39]) might have the potential to contribute to the much-needed evidence base. ...
While accessible housing is known as important to promote healthy ageing, the societal issue of providing accessible housing for the ageing population bears the characteristics of a “wicked problem”. The aim of this study was to gain a better understanding of crucial variables for decision-making about the provision of accessible housing for the ageing population in Sweden. Materials used for a deductive content analysis were elicited through a research circle involving three researchers and twelve non-academic representatives. Brown and colleagues’ conceptual five-dimension framework to address wicked problems was used for the understanding of crucial variables in decision-making about housing provision. The findings show that such reasoning is dominated by the socioeconomic dimension. Findings in the biophysical dimension reveal well-known challenges pertaining to the definition and interpretation of the concept of accessibility and its operationalization. The dimensions are intertwined in a complex manner, which is essential for effective and efficient decision-making. The findings could make decision-makers aware of the diversity of individual thinking involved when addressing this wicked problem. Acting upon the crucial variables identified in this study could contribute to progressive decision-making and more efficient ways to develop and provide accessible housing to promote health ageing.
... This capillary model encourages access to care for the population (6), reducing the patients' transfer across the territory, decreasing the overcrowding of the emergency departments, and minimizing hospital-based cross-contamination among users and healthcare staff. These healthcare facilities should be configured as integrated hub between healthcare professionals and healthcare and social services, also for NGOs and voluntary associations for addressing fragile users needs (22)(23)(24). In addition, the use and application of healthcare devices for the smart hospital, as well as telemedicine programs, can easily support and strengthen the health network and the monitoring of the users' health status, even in the presence of healthcare emergencies (18,25). ...
Background and aim:
The COVID-19 pandemic has upended the global healthcare systems. The surge in infections and sick critically ill patients has tested the resilience of healthcare infrastructures and facilities forcing organizations to quickly adapt and embrace emergency solutions. The paper proposes a decalogue of design strategies applicable both to new hospitals and to the refurbishment of existing hospitals.
Methods:
The authors conducted observations at hospitals, during public health webinars and through experts working groups from March to May 2020.
Results:
In this commentary, the authors present a list of strategies for creating critical care surge capacity and exploring design strategies for healthcare design for resilient hospital facilities. The strategies are organized into two tiers: I) design and II) operations. The (I) Design phase strategies are: 1) Strategic Site Location; 2) Typology Configuration; 3) Flexibility; 4) Functional program; 5) User-centerdness. The (II) Operation phase strategies are: 6) Healthcare network on the territory; 7) Patient safety; 8) HVAC and indoor air quality; 9) Innovative finishing materials and furniture; 10) Healthcare digital innovation.
Conclusions:
Hospitals, health care systems, and institutions urgently need to assess their resources, identify potential bottlenecks, and create strategies for increasing critical care surge capacity. The COVID-19 pandemic disrupted healthcare operations and accelerated the processes of innovation and transformation. The design and operational strategies can enable the achievement of resilient hospital facilities. Further multidisciplinary researches is needed to validate the strategies empirically.
