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All over the world, teenagers suffer from stress-related mental illness, and research shows that being in natural environments can bring about recovery. However, centrally located areas in cities where teenagers like to hang out are being densified at the expense of green spaces. The health-promoting function of small, centrally located parks is thus becoming increasingly important. This study examines Iranian teenagers' assessment of the restorative potential of small, centrally located parks. Such parks include attributes typical of city centers, such as trees, lighting, park benches and flowers. A discrete sampling method was used to collect responses from a sample of 265 Iranian teenagers. They were asked to randomly rate the perceived recovery potential of digitally designed models of green spaces. The results show that the teenagers evaluated the presence of water in waterbeds to have a strong positive effect on recovery possibilities. The entire green area should also be screened off from the rest of the city and convey a soft impression. It should have lighting from tall lampposts, contain plant beds and, not least, have distinctive cultural attributes such as crescent arches and fountains. In the discussion of the article, we address the practical and theoretical implications of the findings. [ABSTRACT FROM AUTHOR]

Over the past few decades, several analytical approaches have been developed to understand urban form and to address the complexity of human settlements as well as various socio-economic and environmental challenges. Each approach is characterized by specific disciplinary and geographical trends, often emerging from distinct schools of thought within urban morphology. Typically, these approaches are associated with specific research centers or individual researchers and have frequently been applied in isolation, with some exceptions. The teaching of urban morphology in higher education institutions across Europe faces the challenge of training future graduates to effectively address contemporary urban issues from often isolated perspectives rooted in the aforementioned schools of thought, either reflecting specific national educational trends or adopting a globalized approach that overlooks local specificities. Furthermore, the relationship between professional practice in urban and planning fields and higher education institutions is a notable concern. While the importance of broad knowledge and multidisciplinary skills for urban professionals is recognized, the connection between academia, research and practice is minimal. The increasing demand for evidence-based approaches in urban design highlights the need for solutions grounded in sound knowledge. To address the relationship between academic research and its integration into professional practice, innovation in teaching practices is crucial, aligning academia with the evolving needs of planning, architecture, and urban design professions. This involves focusing on developing learners' fundamental and transversal skills and providing tools, methods, and research findings applicable in professional settings. This paper is based on two research projects that sought to bridge the gaps between different morphological approaches in teaching and between academic research and practical application. The projects, Emerging Perspectives on Urban Morphology (EPUM) and the Knowledge Alliance for Evidence-Based Urban Practices (KAEBUP), brought together partners from various South and Central European countries to address these gaps. EPUM focused on integrating different morphological approaches within the context of teaching, while KAEBUP aimed to connect theoretical knowledge with practical actions concerning the built environment. The situative pedagogical perspective, rooted in communities of practice and supported by a blended learning approach, is central to this endeavor. This perspective provides a collaborative framework for educators, students, and professionals in urban morphology to co-create knowledge through integrated learning, teaching, and research activities. [ABSTRACT FROM AUTHOR]

Since individuals with severe and profound Intellectual Disabilities (IDs) have no concept of time, it is difficult for them to autonomously maintain daily structures. Those affected are dependent throughout their lives on external care structures. Even though research suggests that individuals with IDs should live in smaller facilities, individuals with higher support needs are more likely to be placed in large institutions and clustered group homes. The aim of this study was to define design criteria and test their applicability to a residential building design whose architecture enables individuals with IDs to develop autonomy through spatially experienced temporality. Qualitative data was collected in a mixed method evidence-based design approach: systematic behavioural observations, structured interviews, focus groups, and the UV-index method. Four design criteria could be described that contribute to an autonomy-promoting temporality: (a) spatial sequencing and repetition, (b) privacy-related variation of spatial dimensions, (c) spatial orchestration of daylight, and (d) constant emotional proximity to the caregiver. The hypothesis of using architecture to promote temporality in clients with IDs and Challenging Behaviour (CB) has proven to be potentially effective in designing a therapeutic environment. Our findings provide valuable data on how long-stay facilities should be designed in the future. [ABSTRACT FROM AUTHOR]

Since individuals with severe and profound Intellectual Disabilities (IDs) have no concept of time, it is difficult for them to autonomously maintain daily structures. Those affected are dependent throughout their lives on external care structures. Even though research suggests that individuals with IDs should live in smaller facilities, individuals with higher support needs are more likely to be placed in large institutions and clustered group homes. The aim of this study was to define design criteria and test their applicability to a residential building design whose architecture enables individuals with IDs to develop autonomy through spatially experienced temporality. Qualitative data was collected in a mixed method evidence-based design approach: systematic behavioural observations, structured interviews, focus groups, and the UV-index method. Four design criteria could be described that contribute to an autonomy-promoting temporality: (a) spatial sequencing and repetition, (b) privacy-related variation of spatial dimensions, (c) spatial orchestration of daylight, and (d) constant emotional proximity to the caregiver. The hypothesis of using architecture to promote temporality in clients with IDs and Challenging Behaviour (CB) has proven to be potentially effective in designing a therapeutic environment. Our findings provide valuable data on how long-stay facilities should be designed in the future.

Background In a rehabilitation centre designed for drug and alcohol recovery, the therapeutic environment may enhance the psychosocial well-being of sufferers and facilitate a speedy recovery. This study aims to investigate the psychosocial well-being needs (PWNs) of users in an alcohol and drug rehabilitation centre (ADRC) and how therapeutic architectural solutions (TASs) can promote a healing environment through design. Methods The study employed a mixed research method (qualitative and quantitative). The research strategy was a case study of four rehabilitation centres in Nigeria’s busiest cities; Lagos, Abuja, Port Harcourt, and Enugu. Data were collected via survey questionnaires, an in-depth interview guide, an observation guide, and a checklist of TACs in a healthcare facility. We first investigated what the PWNs of alcohol and drug sufferers (ADSs) are, then identified the therapeutic architectural components (TACs) of an ADRC, before determining what effect TACs have on the recovery process of substance abuse patients. Results The findings identify eight PWNs and nine TACs essential in an ADRC. The result indicates that TACs have a significant effect on the recovery process of ADSs. However, based on the study results, a framework (framework here refers to using an intelligent and sensitive conceptual design structure as a standard guide for the building archetype rehabilitation facility, which supports mental health service delivery) may be recommended for rehabilitation facilities with TASs for Substance Abuse Disorder (SUD). Conclusion The study result presents a correlation between ADSs’ recovery rates and a well-designed therapeutic environment. So, there is a need for evidence-based design (EBD) of rehabilitation centres with full compliments of a therapeutic architectural environment and integration of mental health services into routine care in sub-Saharan Africa. Limitations include that analyses were cross-sectional and thus may not deduce causal directions, and the authors based the result on self-report.

Objective: This study utilized the evidence-gap map method and critically examined the scope, methodologies, and focus of the studies that investigated the influence of the built environment on inpatient healthcare settings over a decade (2010–2021). Methods: We conducted a systematic review per the preferred reporting items for systematic reviews and meta-analyses guidelines and surveyed 406 articles, primarily from North America and Europe. Results: Our findings revealed a dominant focus on architectural features (73%), such as room design and ward layout. Comparatively, there was less emphasis on interior-, ambient-, social-, and nature-related features. Most previous studies explored multiple environmental features, which indicated the intricacy of this field. Research outcomes were diverse, with person-centered care (PCC) being the most frequently investigated, followed by safe care, emotional well-being, activity, and behavior. Furthermore, research methods varied considerably based on the study's outcomes and features. Clinical outcomes and safe care favored quantitative methods, activity and behavior favored mixed methods, and PCC favored qualitative research. Conclusion: This review provides an in-depth overview of the existing studies on healthcare design research and sheds light on the current trends and methodological choices. The insights garnered can guide future research, policy-making, and the development of healthcare facilities. [ABSTRACT FROM AUTHOR]

Aim: This literature review is conducted to identify knowledge gaps and shape a framework for the development of guidelines and future research on programming and design of rehabilitation environments. Background: Patients suffering from trauma, stroke, neurological or cardiopulmonary conditions, or recovering from surgery or cancer treatment require rehabilitation services. A comprehensive rehabilitation program can support continuum of care for inpatient and outpatient groups. However, within most facilities, rehabilitation environments are found to be outdated and undersized compared to other programs or lack the correct adjacencies within the facility. Unfortunately, this deficiency is echoed by limited guidelines on programming, planning, and design of these environments. General guidelines derived from healthcare environments research is not adaptable to rehabilitation environments, because the paradigm used in most healthcare environment research does not address specific needs of rehabilitation patients in regaining confidence or relearning daily life skills. Method: We conducted a structured literature review, using Preferred Reporting Items for Systematic Reviews and Meta-Analyses as a basis for reporting the available body of work on evidence-based research in rehabilitation environments. Result and Conclusion: Through analysis of the limited literature, specific mediators such as patient confidence and motivation were identified. An environment that creates a balance between privacy and social interaction can promote these mediators. Creating enriched environments through elements that engage the senses and encourage more social and physical interaction is essential for recovery. Finally, accessibility and wayfinding are of great importance in these environments due to potential limited mobility or cognitive impairments of patients. [ABSTRACT FROM AUTHOR]

Objectives: Falls in hospitals pose a significant safety risk, leading to injuries, prolonged hospitalization, and lasting complications. This study explores the potential of augmented reality (AR) technology in healthcare facility design to mitigate fall risk. Background: Few studies have investigated the impact of hospital room layouts on falls due to the high cost of building physical prototypes. This study introduces an innovative approach using AR technology to advance methods for healthcare facility design efficiently. Methods: Ten healthy participants enrolled in this study to examine different hospital room designs in AR. Factors of interest included room configuration, door type, exit side of the bed, toilet placement, and the presence of IV equipment. AR trackers captured trajectories of the body as participants navigated through these AR hospital layouts, providing insights into user behavior and preferences. Results: Door type influenced the degree of backward and sideways movement, with the presence of an IV pole intensifying the interaction between door and room type, leading to increased sideways and backward motion. Participants displayed varying patterns of backward and sideways travel depending on the specific room configurations they encountered. Conclusions: AR can be an efficient and cost-effective method to modify room configurations to identify important design factors before conducting physical testing. The results of this study provide valuable insights into the effect of environmental factors on movement patterns in simulated hospital rooms. These results highlight the importance of considering environmental factors, such as the type of door and bathroom location, when designing healthcare facilities. [ABSTRACT FROM AUTHOR]

Designing pediatric healthcare facilities requires a thorough understanding of the unique needs of children, which differ from those of adults in terms of physical, emotional, and developmental requirements. Addressing these needs ensures that pediatric patients receive specialised care for their well-being and recovery. Little evidence is available regarding the design variables of pediatric healthcare facilities. Evidence-based design (EBD) has emerged as a sustainable approach that integrates research, empirical evidence, and best practices into the healthcare design process. This paper identifies the design variables of pediatric healthcare facilities impacting the outcomes of patients, families, and staff and develops a conceptual framework for the pediatric healthcare-built environment. A literature review were conducted to identify the design variables of pediatric healthcare environments and the opinion of experts was gathered to finalise the design variables. A conceptual framework for pediatric healthcare environments was developed consisting of 96 design variables under eight therapeutic goals namely: child-friendly environment; nature and outdoors; privacy; positive distraction; therapeutic play; peer and family support; safety and security; and comfort that have the potential to impact the outcomes of patient, families, and staff. Incorporating these variables into the design would contribute to improved patient outcomes. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is to analyze the consistency, variability, and potential standardization of terminology used to describe architectural variables (AVs) and health outcomes in evidence-based design (EBD) studies. Background: In EBD research, consistent terminology is crucial for studying the effects of AVs on health outcomes. However, there is a possibility that diverse terms have been used by researchers, which could lead to potential confusion and inconsistencies. Methods: Three recent large systematic reviews were used as a source of publications, and 105 were extracted. The analysis aimed to extract a list of the terms used to refer to the unique concepts of AVs and health outcomes, with a specific focus on people with dementia. Each term's frequency was calculated, and statistical tests, including the χ2 and the post hoc test, were employed to compare their distributions. Results: The study identified representative terms for AVs and health outcomes, revealing the variability in terminology usage within EBD field for dementia-friendly design. The comparative analysis of the identified terms highlighted patterns of frequency and distribution, shedding light on potential areas for standardization. Conclusions: The findings emphasize the need for standardized terminologies in EBD to improve communication, collaboration, and knowledge synthesis. Standardization of terminology can facilitate research comparability, enhance the generalizability of findings by creating a common language across studies and practitioners, and support the development of EBD guidelines. The study contributes to the ongoing discourse on standardizing terminologies in the field and provides insights into strategies for achieving consensus among researchers, practitioners, and stakeholders in health environmental research. [ABSTRACT FROM AUTHOR]

Objective: In this study, we aim to develop and propose an evaluation method for analyzing the design of operating rooms (ORs) from the perspective of surgical teams' reported experiences and stress levels. Background: Stress and burnout of surgical team members can lead to diminished performance and medical errors, which endangers the safety of both the patients and team members. The design and layout of the OR play a critical role in managing such stress. Methods: To understand surgical teams' spatial needs related to their experiences and stress, we administered a survey and in-depth focus group discussions to three surgical teams from the same organization. The identified spatial needs were translated into functional scenarios and spatial metrics, essentially viewing the OR through the perspective of users. Results: Our analysis revealed four integral sections—patient flow, room organization, access to facilities/medical equipment/support staff/team members, and staff well-being—identified as critical design factors associated with the experiences and stress levels of the surgical teams in the ORs. Conclusions: We expect this method to serve as a tool for evaluating the effect of the design of OR layouts on stress, thereby supporting the well-being and resiliency of surgical teams. [ABSTRACT FROM AUTHOR]

Objectives: This systematic literature review synthesizes and assesses empirical research concerning the use of the built environment as a therapeutic intervention in adult mental health inpatient facilities. The review explores the impact of facility design on patient outcomes. Background: There is a growing recognition that the built environment in mental health facilities must strike a balance between ensuring safety and providing a therapeutic atmosphere. A review addressing how facility design contributes to this therapeutic environment is warranted. Methods: Database searches were conducted in CINAHL, Embase, PsychInfo, PubMed, and Web of Science from inception up to March 10, 2022. The Scottish Intercollegiate Guidelines Network (SIGN50) critical appraisal checklists were used to assess the quality of included studies. Results: Of the 44 peer-reviewed studies identified from nine countries, several factors emerged as vital for the therapeutic environment in mental health inpatient facilities. These included personal spaces prioritizing privacy and control of the environment, daylight-optimized spaces, versatile communal areas promoting activities and interaction, designated areas for visits and spiritual/contemplative reflection, homelike environments, the inclusion of artwork in units, open nursing stations, and dedicated female-only areas. Yet, there is a need for research yielding stronger evidence-based designs harmonizing with therapeutic needs. Conclusion: This review offers initial guidance on designing mental health facilities that foster a therapeutic environment, while highlighting that the influence of facility design on mental health inpatients is considerably under-researched. [ABSTRACT FROM AUTHOR]

Aim: The architecture of neonatal units plays a key role in developmental strategies and preterm outcomes. The aim was to evaluate the design of Spanish neonatal units and its impact on the participation of parents in neonatal care. Methods: A web‐based survey was sent to all level III Spanish neonatal units, including questions about hospital data, architectural design, facilities and family participation. Results: The study included 63 units. Most units (87%) had part or all the intensive care patients located in open bay units, while 54% had at least one individual patient cubicle. Single family rooms, defined as those including enough space and furniture for family members to stay with the infant without restrictions, were available in 8 units (13%). Eighteen units (29%) had a structured programme of family education. Units with single family rooms were more likely to have parental participation in rounds (p < 0.01), safety protocols (p = 0.02), oxygen management (p < 0.01) and nasogastric tube feeding (p = 0.02), as well as to allow siblings to participate in kangaroo care (p < 0.01). Conclusion: Widely variable architectural designs and policies were found in Spanish neonatal units. The presence of single family rooms may have impacted the participation of parents in neonatal care. [ABSTRACT FROM AUTHOR]

Changing the physical environment of healthcare facilities can positively impact patient outcomes. Virtual reality (VR) offers the potential to understand how healthcare environment design impacts users' perception, particularly among those with brain injuries like stroke, an area with limited research. In this study, our objective was to forge a new pathway in healthcare environment research by developing a comprehensive, six-module 'user-centered' design decision support approach, utilizing VR technology. This innovative method integrated patient engagement, architectural design principles, BIM prototyping, and a sophisticated VR user interface to produce realistic and immersive healthcare scenarios. Forty-four stroke survivors participated, experiencing 32 VR scenarios of in-patient bedrooms, followed by interactive in-VR questions and semi-structured interviews. The results of the approach proved to be comparatively efficient and feasible, provided a high level of immersion and presence for the participants, and effectively elicited extremely rich quantifiable response data, which revealed distinct environmental preferences. Our novel approach to understanding end-user responses to stroke rehabilitation architecture demonstrates potential to inform user-centered evidence-based design decisions in healthcare, to improve user experiences and health outcomes in other healthcare populations and environments. [ABSTRACT FROM AUTHOR]

All over the world, teenagers suffer from stress-related mental illness, and research shows that being in natural environments can bring about recovery. However, centrally located areas in cities where teenagers like to hang out are being densified at the expense of green spaces. The health-promoting function of small, centrally located parks is thus becoming increasingly important. This study examines Iranian teenagers’ assessment of the restorative potential of small, centrally located parks. Such parks include attributes typical of city centers, such as trees, lighting, park benches and flowers. A discrete sampling method was used to collect responses from a sample of 265 Iranian teenagers. They were asked to randomly rate the perceived recovery potential of digitally designed models of green spaces. The results show that the teenagers evaluated the presence of water in waterbeds to have a strong positive effect on recovery possibilities. The entire green area should also be screened off from the rest of the city and convey a soft impression. It should have lighting from tall lampposts, contain plant beds and, not least, have distinctive cultural attributes such as crescent arches and fountains. In the discussion of the article, we address the practical and theoretical implications of the findings.

Health care–associated infections (HAIs) are a common issue in health care settings, caused by environmental microorganisms, leading to health risks and financial strain. Despite efforts to reduce HAIs, the role of the physical environment in reducing HAIs is not fully understood. This literature review aimed to identify physical environment variables contributing to HAIs. A literature search was conducted in scientific databases between 2016 and 2022 using keywords associated with infections and physical environment variables. After screening retrieved articles for eligibility, the articles were analyzed for relevant environmental and infection variables. Out of 145, 27 articles were identified. The findings were grouped into 8 categories, including layout design, surfaces, behavior, lighting, Internet of Things, materials, airflow, and air quality, with sub-themes in each group. The physical environment in health care facilities plays a crucial role in reducing and preventing the spread of HAIs. Proper design and construction of health care buildings, including ventilation and air conditioning systems, help prevent infection spread between functional areas. Antimicrobial materials, cleaning and disinfection protocols, and personal hygiene practices, such as hand hygiene, are key factors in infection control. The positioning of hand hygiene stations is also essential to improve compliance among health care professionals. • The physical environment can impact infection spread. • Materials, Airflow, layout design, and user behavior affect the infection rate. • Antimicrobial materials, ventilation, and hand hygiene can prevent HAIs. [ABSTRACT FROM AUTHOR]

Objectives: Evaluating evidence from peer-review literature for use in evidence-based design is often challenging for the design disciplines, requiring access to the peer-reviewed literature, expertise in evaluating methods and findings, and translating the results into actionable design and operational recommendations. Purpose: The purpose of this methods paper is to elucidate the process for systematic evaluation of research to translate evidence into practical application to improve design for occupant health and wellness. Background: Researchers have found strong connections in environmental design influence on health and wellness that have proven to be substantiative in the effort to improve health and well-being. Design has the capacity to encourage healthy choices and decisions within the built environment. Translation of evidence into applied design solutions may improve public health. Methods: A protocol is presented that culminates in the translation of evidence into design recommendations focused on improving occupant health. The protocol includes preparation for the literature search and review, search strategy, study selection, data analysis, and development of the literature review. Results: After evaluation of the evidence is completed, there were several positive findings in the example that stakeholders could utilize to improve the health of building occupants with programs and design to support nutrition, physical activity, and circadian entrainment. Conclusions: There are a variety of software tools and processes to utilize in the curation of evidence to improve the built environment with relevant design recommendations and operational considerations affecting the personal, social, and economic health of our society. [ABSTRACT FROM AUTHOR]

Objective: Translational research to advance design criteria and apply the Childbirth Supporter Study (CSS) findings to practice. Background: The physical design of birth environments has not undergone substantial improvements in layout or ambiance since the initial move to hospitals. Cooperative, continuously present childbirth supporters are beneficial and are an expectation for most modern birth practices, yet the built environment does not offer support for the supporter. Methods: To advance design criteria, we use a comparative case study approach to create translational findings. Specifically, CSS findings were used as indicators to advance the Birth Unit Design Spatial Evaluation Tool (BUDSET) design characteristics in pursuit of better support for childbirth supporters in the built hospital birth environment. Results: This comparative case study provides eight new BUDSET design domain suggestions to benefit the supporter-woman dyad, and subsequently the baby and care providers. Conclusions: Research-informed design imperatives are needed to guide the inclusion of childbirth supporters as both a supporter and as an individual in the birth space. Increased understanding of relationships between specific design features and childbirth supporters' experiences and reactions are provided. Suggestions to enhance the applicability of the BUDSET for birth unit design facility development are made, specifically ones that will better accommodate childbirth supporters. [ABSTRACT FROM AUTHOR]

Background: The impact of the physical environment on healthcare staff well‐being and work performance is well recognised, yet there is a lack of instruments assessing environmental features from the perspective of staff working in residential care facilities (RCFs) for older people. Objectives: To develop and provide initial validation of the instrument Staff Perceptions Of Residential care facility Environments (SPORE). Design: An instrument development and psychometric evaluation study. Methods: Based on material from a British project, items were translated and adapted for Swedish residential care facilities as SPORE. Care staff (N = 200), recruited from 20 Swedish RCFs, completed a questionnaire‐based survey containing the SPORE instrument and two other instruments selected as suitable for use in the validation. In addition, an environmental assessment instrument was used for further validation. Analyses were performed at individual (staff) level and home (RCF) level. Results: The SPORE subscales demonstrated good internal consistency reliability and were moderately to strongly correlated at the individual level with the subscales of measures of person‐centred care, and strongly correlated with the same measures at the home level. The SPORE subscales were also highly correlated with the total score of the instrument used to assess the quality of the physical environment. Conclusion: The initial validation indicates that the SPORE instrument is promising for measuring care staff perceptions of environmental features in care facilities for older people. SPORE can be a valuable instrument for use in research and in practice to evaluate the environment as part of working towards high‐quality care. Implications for Practice: The design of the physical environment within RCFs can affect the staff's health and work performance. The instrument is useful for evaluating the environment and informing decisions about design solutions that support staff in their important work. [ABSTRACT FROM AUTHOR]

A growing body of literature mainly in the context of consumer research indicates that the formal-aesthetic and conceptual design of objects can influence users' thoughts, emotions and even behavioural patterns. While there is strong evidence regarding these effects on actual purchasing decisions, evidence on the effect of aesthetic design features (e.g., haptics, colour) on health-related mental concepts and intentions for health behaviour change is scarce. Based on insights from material and conceptual priming, this article illustrates the research-driven and evidence-based design process of two design primes and comprises pre-tests and an experiment in two settings on the effect of design on health behaviour focusing i.a. on intention for health behaviour change. In an evidence-based and research-driven process, two lecterns were designed to work as primes, i.e., to have a positive vs. negative influence on several mental constructs (sense of control, sense of coherence, resiliency, self-efficacy) and health-related intention. The lecterns differed mainly in terms of aesthetic appearance (e.g., material, colour, proportion, steadiness). They were tested in (a.) a university setting with students (n = 83) and (b.) a clinical setting with orthopaedic rehabilitation patients (n = 38). Participants were asked to perform an unrelated task (evaluation of an unrelated product) while standing at and using the lecterns. Overall, t-tests and Mann-Whitney-U tests show no significant differences but differing tendencies in a mentioning task. When asked to name health-promoting activities, in the clinical setting, participants using the "positive" prime (i.e., the steady lectern, n = 13) mentioned more sport-related aspects on average and a higher portion of sport-related aspects of their answers than participants using the "negative" prime (n = 11). In the university setting (positive: n = 36; negative n = 38), no such differences emerged. This finding gives reason to believe that the prime might be specifically effective in the clinical setting as it relates to physical activity being the most relevant topic of the patients' pathology. [ABSTRACT FROM AUTHOR]

Purpose: This conceptual paper connects the literature on the experiences and needs of youth in therapeutic residential care, trauma-informed frameworks utilized in these settings, and early research on trauma-informed design to facilitate an understanding of these connections and move towards developing a blueprint for trauma-informed design in residential settings for traumatized youth. Methods: A critical literature review drawing on trauma theory, trauma-informed care, evidence-based design, and trauma-informed design was conducted to inform the argument presented in this conceptual paper. Results: While many therapeutic residential care models engage trauma-informed care approaches to support staff in promoting healing environments for youth who have histories of complex trauma, the focus has remained on the psychosocial environment of care, and has yet to be systematically applied to the design of the built environment in which these programs are implemented. By applying the principles of trauma-informed care to the built environment, trauma-informed design has the potential to reduce retraumatization and promote resiliency among youth in care. Conclusions: Ultimately, this conceptual paper illustrates the value of further developing trauma-informed design principles to apply to settings that serve traumatized youth, such as therapeutic residential care facilities. [ABSTRACT FROM AUTHOR]

Over the past few decades, several analytical approaches have been developed to understand urban form and to address the complexity of human settlements as well as various socio-economic and environmental challenges. Each approach is characterized by specific disciplinary and geographical trends, often emerging from distinct schools of thought within urban morphology. Typically, these approaches are associated with specific research centers or individual researchers and have frequently been applied in isolation, with some exceptions. The teaching of urban morphology in higher education institutions across Europe faces the challenge of training future graduates to effectively address contemporary urban issues from often isolated perspectives rooted in the aforementioned schools of thought, either reflecting specific national educational trends or adopting a globalized approach that overlooks local specificities. Furthermore, the relationship between professional practice in urban and planning fields and higher education institutions is a notable concern. While the importance of broad knowledge and multidisciplinary skills for urban professionals is recognized, the connection between academia, research and practice is minimal. The increasing demand for evidence-based approaches in urban design highlights the need for solutions grounded in sound knowledge. To address the relationship between academic research and its integration into professional practice, innovation in teaching practices is crucial, aligning academia with the evolving needs of planning, architecture, and urban design professions. This involves focusing on developing learners’ fundamental and transversal skills and providing tools, methods, and research findings applicable in professional settings. This paper is based on two research projects that sought to bridge the gaps between different morphological approaches in teaching and between academic research and practical application. The projects, Emerging Perspectives on Urban Morphology (EPUM) and the Knowledge Alliance for Evidence-Based Urban Practices (KAEBUP), brought together partners from various South and Central European countries to address these gaps. EPUM focused on integrating different morphological approaches within the context of teaching, while KAEBUP aimed to connect theoretical knowledge with practical actions concerning the built environment. The situative pedagogical perspective, rooted in communities of practice and supported by a blended learning approach, is central to this endeavor. This perspective provides a collaborative framework for educators, students, and professionals in urban morphology to co-create knowledge through integrated learning, teaching, and research activities.

The term ‘environmental design for dementia’ relates to both the process and outcomes of designing to support or improve cognitive accessibility in physical environments. Environmental design for dementia is evidenced as an effective nonpharmacological intervention for treatment of the symptoms of dementia and is associated with higher levels of independence and wellbeing for people living with a variety of age-related cognitive, physical, and sensory impairments. Evidence-based dementia design principles have been established as a means of supporting both the design and evaluation of environmental design for dementia.

This study discussed how seating arrangements and seat selection influence interactions between older people. Two congregate meal sites were selected for the experiment, and a nonparticipant observation was adopted wherein the entire dining process of older people at the site was examined. Further adjustments were then made to seating arrangements and an evaluation of the benefit thereof was made. Observation revealed that over 90% of the participants selected the same seat at each gathering. Participants tended to sit in the same or relatively similar location; additionally, participants who sat in the same area tended to share similar behavioral features. After adjusting the seating arrangements, this study discovered that an orthogonal seating arrangement greatly reduced bilateral gazing and lessened the stress of some participants. A face-to-face seating arrangement can encourage not only bilateral and unilateral gazing but cross-sectional conversation behaviors for participants who linger for a longer mealtime.

This research is aimed at developing a new instrument to assess the healthy workplace qualities based on the environmental theory of stress, and ideas of salutogenic and biophilic design. A total of 319 respondents participated in the study (19-72 years; Mage = 40.86, SDage = 12.70; 69% women). Additionally, nine judges were invited to evaluate the items of the scale for content validity. Using a mixed inductive/deductive method, which included literature analysis and indepth interviews, an initial pool of 56 items was collected. From the initial pool of 56 items, the more relevant ones were selected. This list named the People in the Office Scale (POS) was subjected to a full psychometric examination. Results of the Exploratory and Confirmatory Factor Analyses show that POS has satisfactory structural and content validity, reliability, and measurement invariance across sex and age. In its final form, POS includes 27 items and five subscales: Ergonomics; Internal Communications; External Infrastructure; Freedom of Action; and Workplace as a Life Narrative. Convergent validity measured by correlating POS scores with the variables of restorative environment, workplace attachment, and organizational cynicism was satisfactory. Divergent validity measured by correlating with mental health, was also satisfactory. This new instrument can be recommended for use in both practice and research to provide evidencebased design guidance. [ABSTRACT FROM AUTHOR]

This article presents an argument for the enhanced utilisation of urban morphology in urban design, drawing inspiration from space syntax theory and methodologies, advocating for the integration of social, economic, and cultural considerations alongside physical structures. This perspective shift entails transitioning from descriptive analysis to quantitative inquiries for the prediction and assessment of urban dynamics. By incorporating spatial analysis and socio-economic factors, urban morphology offers a competent understanding of the complexities inherent to urban environments. This comprehension supports the development of evidence-based designs and predictive models that enable such an approach in urban design. To operationalise this approach, the article introduces a methodology that interlinks urban morphology and design through a cyclic process encompassing analysis, design, evaluation, and further design development. This framework is illustrated through the case study of Jilin City, where an assessment of the public transport system led to a comprehensive urban design strategy. The study demonstrates how urban morphology insights, supported by analytical investigations enabled by space syntax methodology, can actively influence urban design and planning practices. By effectively embedding this morphological approach, urban designers and planners acquire the tools needed to navigate the evolving urban systems while respecting the interplay between physical structures and human existence. The article concludes by highlighting the need for an ongoing evolution of this approach to maintain relevance in shaping future urban settings. [ABSTRACT FROM AUTHOR]

Eye-tracking technology has numerous applications in both commercial and research contexts. The recent introduction of affordable wearable sensors has significantly broadened the scope of potential uses, spanning fields such as computer gaming, education, entertainment, health, neuromarketing, and psychology, among others. Another development is the use of downloadable software, which permits participants to record their responses to presented images with the use of calibrated webcams without leaving their homes, allowing for easier recruitment of larger numbers of study volunteers online. This paper reviews findings from seven Building Studies conducted by the Human Architecture + Planning Institute with iMotions-Online eye-tracking software, highlighting the significance of the new technology and its ability to assess the human experience of the built environment, as well as its limitations. Overall, images with a certain type of organized complexity, such as that found in nature and pre-modern architecture, attracted the gaze faster and kept it for significantly longer, as compared to images lacking these features. These results add to our existing knowledge about environmental complexity and give us insights into non-conscious and early conscious actions such as first gaze attraction, helping us understand the role of specific morphological features in the architectural/environmental experience. [ABSTRACT FROM AUTHOR]

Background: Many countries and communities in sub-Saharan Africa suffer from inadequate access to healthcare and healthy lifestyles as reflected in their high mortality and morbidity rates. Large-scale interventions like the medical city project presented in this article are necessary to address the significant health burdens faced by populations in this region. Objectives: This article shows how evidence-based approaches and multisectoral partnerships guided the development of the 327-acre Medical City master plan in Akwa Ibom, Nigeria. This is envisioned to be the first-of-its-kind medical city in this medically underserved "healthcare desert." Methods: The five-phased, seven-year (2013–2020) master planning process was guided by the overarching design framework of "sustainable one health" along with its 11 objectives and 64 performance measures. The data/evidence used to guide the planning decision-making process came from case studies, literature reviews, stakeholder interviews, and on-site investigations. Results: The outcome of this project is a comprehensive medical city master plan that includes a self-contained, mixed-use community anchored by a hospital and a primary healthcare village. This medical city provides access to the full range of healthcare services (e.g., curative-to-preventive, traditional-to-alternative) and is supported by multimodal transportation systems and extensive green infrastructure. Conclusions: This project offers theoretical and practical insights on "designing for health" in a frontier market while responding to the complex local contexts that present many unique challenges and opportunities. Those insights provide useful lessons for researchers and professionals interested in promoting health and healthcare services in healthcare deserts. [ABSTRACT FROM AUTHOR]

Objectives: This study is focused on how architectural design of adolescent psychiatric hospitals could positively affect not only patients but also staff members working at the hospitals. Background: Adolescents between the ages of 12 and 18 are among the young population with the highest percentage of mental illness. However, there are limited number of intentionally designed psychiatric hospitals for adolescents. Staff who work in adolescent psychiatric hospitals may face workplace violence. Studies on environmental impacts suggest that the built environment affects patients' well-being and safety as well as staff's satisfaction, working condition, safety, and health. However, there are very few studies that focus on adolescent psychiatric hospitals and the impact of the built environment on both staff and patients. Methods: Data were collected through literature analysis and semi-structured interviews with staff of three psychiatric state hospitals with adolescent patient units. The triangulation of multiple data sources informed a set of environmental design conditions that captures the complexity and connectedness of architectural design and the occupants of an adolescent psychiatric hospital. Results: The results present architectural composition, atmosphere, lighting, natural environment, safety, and security as indispensable design conditions to create an enclosed and city-like campus that provides a serene, secure, and structured environment that benefit staff and adolescent patients. Conclusion: The specific design strategies that need to be incorporated in the architectural design of a safe and secure adolescent psychiatric hospital include an open floor plan that respects patients' autonomy and offers privacy while always providing staff with full visibility of patients. [ABSTRACT FROM AUTHOR]

Objectives: The presented systematic review explores the empirical studies regarding environmental design strategies that support adaptive behaviors while improving problem behaviors of people with intellectual and developmental disabilities (IDD). Background: People with IDD perceive and interact with their environment differently from people without disabilities. Design research has not always considered these differences, and environmental design solutions are not commonly found. Methods: The review process followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocols. The study reports the findings from the systematic review of 32 peer-reviewed studies published in EBSCO, ERIC, ProQuest, PsycINFO, MEDLINE CINAHL, Consumer Health Complete (EBSCOhost), and Psychology and Behavioral Sciences Collection between 1990 and 2020. In addition, quality assessment tools appraised the study's quality. Results: The review identified 26 design strategies. Five themes qualitatively organized these environmental attributes: coherence, affordance, control, stimulation, and restoration. Conclusion: The evidence indicates that adequately designed physical environments can support the adaptive behaviors of people with IDD while alleviating behavioral problems. Design features not supported by strong empirical evidence should be further addressed in future studies. [ABSTRACT FROM AUTHOR]

Objective: The following research paper seeks to explore how post-occupancy evaluations (POEs) are undertaken in the nine health jurisdictions across Australia and Aotearoa New Zealand and investigate if the process can be strengthened to better inform healthcare design and investment. Background: Healthcare expenditure in both nations is increasing, and the rigorous evaluation of healthcare facilities can provide evidence to improve their return on investment. A POE is a research method used to undertake this analysis, usually 12 months after a facility has been occupied. There is limited information available about how POEs are undertaken in each jurisdiction, and there has never been research conducted to understand these processes across the region. Methods: Focus groups were conducted with participants from the government health organization in each jurisdiction to collect qualitative data regarding various aspects of POE processes and barriers to undertaking POEs. Results: Only five of the nine jurisdictions undertake POEs on healthcare facilities (with varied frequencies), and there is no standardized framework in use. However, every jurisdiction does undertake a "benefits realization" process. There is limited involvement of external consultants in POEs or benefits realization processes. POE benchmarks should be established at project commencement, and POE results should then inform future projects. Top-down support is required for POEs to occur. Conclusions: The primary conclusion is that strengthening any evaluation process requires a nuanced approach in each jurisdiction to account for their unique context and challenges. Regular rigorous evaluations are required to feed results into the Australasian Health Facility Guidelines and encourage innovative facility design. [ABSTRACT FROM AUTHOR]

Teachers are urged to provide differentiated instruction (DI), that is, deliberately adapting instruction to the learning needs of all students. DI can positively affect students' academic achievement and their social and emotional development, as well as foster teacher job satisfaction. However, international research, as well as research in the Dutch context, has shown that teachers feel unprepared to provide DI. Hence, the development of teacher professional development (TPD) programs is necessary. In the current paper, the design of a TPD intervention to support DI is presented, in which the content and design approach were deliberately chosen. The intervention content was based on an analysis of the skills and knowledge expert teachers use when providing DI. The design of the intervention was based on the whole-task approach from the 4C/ID model to promote the transfer of learning, among other things. Based on the experiences of the teachers participating in the training pilot (n = 4), we provide our recommendations for future TPD for DI. The next step will be to study the effects of this TPD program on a larger scale to obtain insight into what design characteristics do or do not work, which can be used to further improve this TPD intervention. [ABSTRACT FROM AUTHOR]

A low level of treatment adherence is one of the challenges facing the UK's healthcare system. An estimated 30% to 50% of patients with chronic diseases fail to adhere to prescribed medical interventions. While medical technology provides an opportunity to overcome existing challenges, poor adherence blurs this opportunity by reducing the intervention's positive impact. The spread of the Covid pandemic dramatically increased the pressure on healthcare systems and highlighted the urgency to address the low adherence problem. Various studies have investigated the underlying factors behind low adherence. However, two main gaps were identified: 1) lack of adherence frameworks that consider self‐administered treatment technology, and 2) lack of a practical mechanism to help companies consider adherence factors during the design and development of the technology. This paper introduces the development of an Adherence Framework for self‐administered treatment technology and a design‐focused adherence canvas used as a practical resource for companies to consider during the design process. Adherence factor data from literature and case studies were triangulated to an eDelphi study used to develop the adherence framework. The presented adherence canvas and Adherence Framework allow companies to consider adherence during the design of self‐administered treatment technology. [ABSTRACT FROM AUTHOR]

Today, numerous studies have shown that the physical environment in hospitals can significantly influence patients' well-being, comfort, and recovery. However, this is currently neglected in hospitals in the Global South. Therefore, there is an urgent need to increase awareness to make it more applicable worldwide. Thus, this study focuses on improving the healing environment standards by exploring the impact of evidence-based design and patient-centered care in hospitals for cancer patients, particularly the architectural space quality, on patient health outcomes as well as hospital staff health and well-being. In Global North countries such as the UK, the achieving excellence design evaluation toolkit (AEDET) is used by their National Health Services to assess the effectiveness of various environmental attributes. However, these toolkits have not been designed for and do not work well within Global South countries, such as Northern Cyprus. To examine and compare the effectiveness of different physical environmental attributes and to evaluate user responses, the post-occupancy evaluation method and the AEDET toolkit were used in this study. These were applied to both public and private hospitals in Northern Cyprus, involving cancer patients, staff, and professionals (n = 220). The findings reveal the strengths and weaknesses in terms of environmental comfort based on the aspects of the evidence-based design of the hospitals such as natural light, air quality, noise, view, infection control, etc., to create a more optimal physical environment for better psychological outcomes. They also reveal that these toolkits are not fit for purpose for Global South contexts and require adaptations. This is the first study to propose an adaptation of the AEDET toolkit to assist architects in designing healthcare facilities that are responsive to the requirements of hospital patients and staff and to promote the quality of a healing environment for improved health and well-being outcomes. [ABSTRACT FROM AUTHOR]

Definition: The term 'environmental design for dementia' relates to both the process and outcomes of designing to support or improve cognitive accessibility in physical environments. Environmental design for dementia is evidenced as an effective nonpharmacological intervention for treatment of the symptoms of dementia and is associated with higher levels of independence and wellbeing for people living with a variety of age-related cognitive, physical, and sensory impairments. Evidence-based dementia design principles have been established as a means of supporting both the design and evaluation of environmental design for dementia. [ABSTRACT FROM AUTHOR]

Changing the physical environment of healthcare facilities can positively impact patient outcomes. Virtual reality (VR) offers the potential to understand how healthcare environment design impacts users’ perception, particularly among those with brain injuries like stroke, an area with limited research. In this study, our objective was to forge a new pathway in healthcare environment research by developing a comprehensive, six-module ‘user-centered’ design decision support approach, utilizing VR technology. This innovative method integrated patient engagement, architectural design principles, BIM prototyping, and a sophisticated VR user interface to produce realistic and immersive healthcare scenarios. Forty-four stroke survivors participated, experiencing 32 VR scenarios of in-patient bedrooms, followed by interactive in-VR questions and semi-structured interviews. The results of the approach proved to be comparatively efficient and feasible, provided a high level of immersion and presence for the participants, and effectively elicited extremely rich quantifiable response data, which revealed distinct environmental preferences. Our novel approach to understanding end-user responses to stroke rehabilitation architecture demonstrates potential to inform user-centered evidence-based design decisions in healthcare, to improve user experiences and health outcomes in other healthcare populations and environments.

A growing body of literature mainly in the context of consumer research indicates that the formal-aesthetic and conceptual design of objects can influence users’ thoughts, emotions and even behavioural patterns. While there is strong evidence regarding these effects on actual purchasing decisions, evidence on the effect of aesthetic design features (e.g., haptics, colour) on health-related mental concepts and intentions for health behaviour change is scarce. Based on insights from material and conceptual priming, this article illustrates the research-driven and evidence-based design process of two design primes and comprises pre-tests and an experiment in two settings on the effect of design on health behaviour focusing i.a. on intention for health behaviour change. In an evidence-based and research-driven process, two lecterns were designed to work as primes, i.e., to have a positive vs. negative influence on several mental constructs (sense of control, sense of coherence, resiliency, self-efficacy) and health-related intention. The lecterns differed mainly in terms of aesthetic appearance (e.g., material, colour, proportion, steadiness). They were tested in (a.) a university setting with students (n = 83) and (b.) a clinical setting with orthopaedic rehabilitation patients (n = 38). Participants were asked to perform an unrelated task (evaluation of an unrelated product) while standing at and using the lecterns. Overall, t-tests and Mann–Whitney-U tests show no significant differences but differing tendencies in a mentioning task. When asked to name health-promoting activities, in the clinical setting, participants using the “positive” prime (i.e., the steady lectern, n = 13) mentioned more sport-related aspects on average and a higher portion of sport-related aspects of their answers than participants using the “negative” prime (n = 11). In the university setting (positive: n = 36; negative n = 38), no such differences emerged. This finding gives reason to believe that the prime might be specifically effective in the clinical setting as it relates to physical activity being the most relevant topic of the patients’ pathology.

This research is aimed at developing a new instrument to assess the healthy workplace qualities based on the environmental theory of stress, and ideas of salutogenic and biophilic design. A total of 319 respondents participated in the study (19–72 years; Mage = 40.86, SDage = 12.70; 69% women). Additionally, nine judges were invited to evaluate the items of the scale for content validity. Using a mixed inductive/deductive method, which included literature analysis and in-depth interviews, an initial pool of 56 items was collected. From the initial pool of 56 items, the more relevant ones were selected. This list named the People in the Office Scale (POS) was subjected to a full psychometric examination. Results of the Exploratory and Confirmatory Factor Analyses show that POS has satisfactory structural and content validity, reliability, and measurement invariance across sex and age. In its final form, POS includes 27 items and five subscales: Ergonomics; Internal Communications; External Infrastructure; Freedom of Action; and Workplace as a Life Narrative. Convergent validity measured by correlating POS scores with the variables of restorative environment, workplace attachment, and organizational cynicism was satisfactory. Divergent validity measured by correlating with mental health, was also satisfactory. This new instrument can be recommended for use in both practice and research to provide evidence-based design guidance.

This article reports 36 in-depth interviews with patients (n = 20) and family members of palliative care patients (n = 16), during an inpatient stay within one of four contemporary palliative care facilities. Interviews were conducted to understand how patients and families felt the built environment supported their experience of palliative care, and the ways that it did not. Over the past decade, a growing body of literature has sought to understand how architectural design can support wellbeing within palliative care settings. Yet, despite evidence that promotes the prioritization of privacy, homeliness, and nature, the sheer complexity of hospital procurement often results in compromises to the successful implementation of best design practice. Here we argue that a deeper understanding of what these environmental affordances mean to patients being treated for a terminal illness, and to their families, may encourage a necessary re-examination of the ease with which these provisions are compromised relative to considerations of risk, cost, or convenience (in building construction and/or maintenance). Importantly, our findings confirm that privacy, homeliness, and nature do not operate in isolation but in accord to shape experiences of palliative care. [ABSTRACT FROM AUTHOR]