Arts, Health and Well-Being across the Military Continuum

Is there an active, meaningful role for the arts and creative arts therapies in addressing this vast array of critical human readiness issues across the military continuum? In general, "readiness" is the #1 issue for the military at all times. The connection of the arts to the human dimension of readiness is key. Military leaders say we need every weapon in our arsenal to meet the many challenges we face today. However, one of the most powerful tools we have in our arsenal -- the arts -- is often under-utilized and not well understood within the military and the healthcare system. The arts and creative arts therapists are -- and have been -- a part of military tradition and missions across all branches, supporting military health services, wellness, and mission readiness, including family support. For example, the War Department ordered the use of music in rehabilitation for the war wounded in World War II. In June 1945, the Department of War issued "Technical Bulletin 187: Music in Reconditioning in American Service Convalescent and General Hospitals." This bulletin was a catalyst for the growth and development of music therapy being used as a rehabilitative service for active duty service members and veterans alike during and after WWII. Although many gaps exist in our knowledge regarding the arts in military settings, what we do know to date holds great promise for powerful outcomes for our service members, veterans, their families, and the individuals who care for them. Today, a growing number of members of the public and private sectors are eager to collaborate with military leaders to help make these outcomes a reality.Nowhere was the momentum for greater collaboration more evident than in October 2011, when the first National Summit: Arts in Healing for Warriors was held at Walter Reed National Military Medical Center (now referred to as Walter Reed Bethesda) and the National Intrepid Center of Excellence (NICoE). Rear Admiral Alton L. Stocks, Commander of Walter Reed Bethesda, hosted the National Summit, in partnership with a national planning group of military, government, and nonprofit leaders. The 2011 Summit marked the first time various branches of the military collaborated with civilian agencies to discuss how engaging with the arts provides opportunities to meet the key health issues our military faces -- from pre-deployment to deployment to homecoming.Building upon its success, a multi-year National Initiative for Arts & Health in the Military was established in 2012, with the advice and guidance of federal agency, military, nonprofit, and private sector partners (see Figure 2). The National Initiative for Arts & Health in the Military (National Initiative) represents an unprecedented military/civilian collaborative effort whose mission is to "advance the arts in health, healing, and healthcare for military service members, veterans, their families, and caregivers."Members of the National Initiative share a commitment to optimize health and wellness, with a deep understanding and awareness that the arts offer a unique and powerful doorway into healing in ways that many conventional medical approaches do not. The Initiative's goals include working across military, government, private, and nonprofit sectors to: 1. Advance the policy, practice, and quality use of arts and creativity as tools for health in the military; 2. Raise visibility, understanding, and support of arts and health in the military; and 3. Make the arts as tools for health available to all active duty military, medical staff, family members, and veterans

Landscape architecture and health

Swedes are living increasingly longer lives, but the number of years lived in good health is decreasing. The present doctoral dissertation is focused on the threat to Swedish public health that is constituted by aches and pain and various types of mental illnesses, of which fatigue reactions, often called ”burnout syndromes,” are increasing most rapidly. Besides the personal suffering involved, the costs of increased ill health constitute a threat to the welfare of Swedish society. According to the Swedish government, good health has become a resource – perhaps even the country’s most important resource for sustainable development. Today, several scientific disciplines consider health to be a positive and holistic state encompassing the individual’s entire life situation: biological, cultural, social and not least environmental aspects. With the Swedish Parliament’s adoption of the public health bill Public Health Objectives, public health work in Sweden is to be based on the idea of finding different societal factors that promote good health on equal terms for the entire population. The present doctoral dissertation focuses on a health factor represented by different types of natural environments. The dissertation is based on two studies of two different types of health-promoting natural environments: Healing gardens – Improvement of ill health Urban green spaces – Maintenance and fortification of good health Healing gardens are gardens that are purposely designed to promote health among a certain group of patients. The dissertation focuses on the type of healing garden that is specially intended for patients suffering from fatigue reactions or burnout syndromes. Interest in healing gardens is spreading rapidly throughout the world. However, both in Sweden and in other countries, ”healing gardens” are being laid out that do not actually possess health-promoting qualities. In order for health to actually be improved, purposeful design based on the patient group’s special needs is required. There is a great need for scientific knowledge concerning how these gardens should be designed. For a long time past in our history, the importance of city greenery for city dwellers’ health and wellbeing has been pointed out. In the present dissertation, urban green spaces – i.e. greenery in the city such as parks, green areas, schoolyards and gardens belonging to a house – are viewed as healthpromoting elements of city planning. Interest in how urban green spaces can maintain and fortify human health is spreading among scientists, architects, politicians and the public. Despite this interest, the problem remains of how urban green spaces should be planned and designed so as to attract the urban population. The dissertation has an applied perspective and is aimed at both scientists and practitioners. It presents findings from two different studies, one on how healing gardens may be designed for people with burnout syndromes and the other on how urban green spaces may be planned from a health-promoting perspective. The overall purpose is, thus, that the dissertation should contribute to the evidence-based design and planning of health-promoting outdoor environments

Health Benefits of Urban Agriculture

Health professionals increasingly recognize the value of farm-and garden-scale urban agriculture. Growing food and non-food crops in and near cities contributes to healthy communities by engaging residents in work and recreation that improves individual and public well-being. This article outlines the benefits of urban agriculture with regard to nutrition, food security, exercise, mental health, and social and physical urban environments. Potential risks are reviewed. Practical recommendations for health professionals to increase the positive benefits of urban agriculture are provided

Affordance of garden towards restorative process of hospitalized children

This study investigates sense of affordance attains by hospitalized children participating in a pediatric-ward garden during their restoration in hospital. Affordances are the functional meanings generated when children play with the garden features, either alone or with peers. According to ecological perceptual psychology, the affordances are interrelated with stimulation and feedback when the children interact with the garden contents. The functional meanings of the garden can be seen in four different levels of affordances: potential, perceived, utilized and shaped affordances. The affordances generate movement through play and positive perceptual judgments such as attachment, affiliation, memory, bonding and affection toward the garden features. Responses from 31 patients, aged 6-12 years, are elicited by semi-structured interview. It is found that 84% (n=26) patients perceived and utilized the affordances of play equipment. However, less number of patients (52%; n=16) perceived the plant as significant element of the garden. This perception suggests the affordances of the play equipment are greater than the plant. Moreover, all patients recognized the affordances of microclimatic factors (rain, sunlight, temperature and wind). Thus through play participation with the garden elements afford the patients to increase their cognitive performances, improve performance tasks (i.e. play) and increased social performances. In healthcare delivery, these improvements are considered restoration. This seems to suggest that garden is an environmental intervention in affording hospitalized children to foster health recovery

Evaluating Staff Perceptions of Supportive Healing Environment in Healthcare Facilities

Evidence-based design strategies can improve stress-free environments in healthcare, by emphasizing strategic opportunities to influence the design of health facilities. Evidence-based design (EBD) as a tool for healthcare planning is a method that began in healthcare having a general purpose of providing evidence based medicine. It involved Gathering information and evidence and using this evidence to mold the environment which supports the programming stage in design problem-solving. The connection between the theories and use of findings in (EBD), have not been adequately revealed enough to be used as a tool in design. As such, several factors, or characteristics, evident in numerous studies about healing environment and (EBD), require categorization into tangible and non-tangible dimensions in order to apply them during the design process successfully. Among others, four distinct variable or factors summarized from the work of two researchers – Dilani (2001) and Ulrich (1991) have been selected to be tested in this research; (1) enhancement of social support, (2) stimulating design features, (3) flexibility and coherence (4) connection to nature, focusing on the hierarchy of the above mentioned attributes according to their relevance in application and outcomes. Two research questions served as a foundation for the investigation of attributes in healing environments: What critical attributes can be identified by healthcare staff related to Dilani and Ulrich's research findings? Is a hierarchy of attributes perceived by healthcare staff? The aim of this research is to closely examine the factors of Psychosocial Supportive Design theory by Alan Dilani (2001) and Supportive design theory (SDT) by Roger Ulrich (1991) on the staff in Eastern Mediterranean university health centre. Questioners and site visit were used for data collection. SPSS was used to obtain percentages from data collected. The result of the study reveals a hierarchy of factors perceived by the staff that can promote supportive healing

Health facilities humanisation: Design guidelines supported by statistical evidence

Background. Healthcare building humanisation is currently a widely debated issue and the development of patient centered and evidence based design is growing worldwide. Many international health organizations and researchers understand the importance of Patient Centred Design and leading architects incorporate it into the design process. In Italy this design approach is still at an early stage. The article refers to research com- missioned by the Italian Health Ministry and carried out by R. Del Nord (Università degli Studi di Firenze) and G. Peretti (Politecnico di Torino) with their collaborators. The scope of the research was the definition of design guidelines for healthcare facilities humanisation. Method. The methodology framework adopted is the well established need and perfor- mance approach in architectural design. The article deals with the results of statistical investigations for the definition and ranking of users' needs and the consistent expres- sion of their requirements. The investigations were carried out with the cooperation of psychologists of the Università degli Studi di Torino and researchers of the Università degli Studi di Cagliari. The proposed evaluation system allows ranking of health facilities according to the level of humanisation achieved. Results. The statistical investigation evidence collected allowed the definition of human- isation design guidelines for health-care facilities and for the assessment of their specific level of humanisation

Healing gardens for the elderly: a review of design guidelines and the comparisons with the existing Senior Outdoor Survey (SOS) tool

This systematic review evaluated 15 literature that discussed design considerations for outdoor areas for the elderly at hospitals, nursing homes, hospices and also public spaces. An existing result from a study to evaluate the outdoor spaces at the elderly’s facilities called Senior Outdoor Survey (SOS) tool was being used to compare with the design recommendations from other literature. The comparison of the SOS tool with the other literature was intended to simplified the guidelines for the design of healing gardens for the elderly. Two types of literature were reviewed in the study which were the peer-reviewed papers and best practice guidelines. Finally, a list of the most essential design features was identified in which may be useful for the health policy makers, hospital administrators and designers who are involved with the outdoor spaces for the elderly. The results have shown that the most essential features to be considered included aspects such as seating, paving material, the activities and, the location of the gardens

Design Characteristics of Healing Garden for down’s Syndrome Children in Malaysia

Healing landscapes have always been associated with studying and planning for a specific type of population. Therefore, this study was carried out in order to identify the design characteristics of healing gardens for the Down’s syndrome children in Malaysia. The behavior and disabilities of children with the Down’s syndrome were studied together with the level of awareness and preferences of their parents towards healing garden. These will later determine the design characters in the healing garden that could contribute towards the wellbeing of the children. A total of 58 parents with children who have Down’s syndrome and registered with the Malaysian Society of Down’s Syndrome aged between 1 to 12 years old were involved in the study. Close and open- ended questionnaires with lists of landscape characters for the parents to rate were based on recommendations and guidelines for healing gardens from past studies. The parents had to identify the activities and the landscape design characters that their children most preferred when in a garden. Behavioral observation was also carried out to support this. Results from the findings have shown that for the Down’s syndrome patients who are mostly affected by sensory deficits such as hearing and visual impairment, difficulty in speech and delay in socialization, the healing garden should offer facilities that could encourage a sense of security, space for interaction and easy supervision. It should also heighten their sensory awareness and experience. The design considerations were listed into four groups that consist of the garden layout, spaces, hardscape and softscape characters based from the preferences of the parents. The result suggests that the healing garden should be considered as part of an early intervention and as a part of an out door therapy programme for children with Down’s syndrome