Apartment Living and Community Care: Experiences of People With Intellectual Disability, Their Families, and Support Staff

Understanding how the design of urban infrastructure influences the independence and autonomy of people with intellectual disability has far-reaching implications for community inclusion and participation. This article explores how urban design elements of an apartment complex influence how a person with an intellectual disability receives support and participates in the wider community. The study reports on the post-occupancy evaluation of an Australian development of over 400 apartments in Sydney, where 25 people with intellectual disability received 24-hour support. Fifty-three interviews were conducted with people with intellectual disability, their families, and disability support staff. Participants with intellectual disability described what living in their new apartment was like and appreciated the outdoor gardens. However, they also explained that wayfinding was more difficult than in their previous homes—all free-standing group homes. Disability support staff discussed how providing community care for people with intellectual disability in an apartment differed from a suburban free-standing house. Findings were translated into design suggestions for improving service provision to people with disability through the urban design around multi-tower sites of mixed-tenure apartments. The article concludes with recommendations for urban design features to support safe, efficient, and quality care in a high-density urban setting. When viewed through a lens of social infrastructure, the results show how urban design has the potential to influence the collective independence and provision of care to diverse communities in urban centres and cities and is relevant to people with disability, older people, and other community groups who rely on community-care support to remain living independently at home

Ageing in place and the internet of things – how smart home technologies, the built environment and caregiving intersect

© 2018, The Author(s). Smart technologies and the Internet of Things (IoT), have the potential to play a significant role in enabling older people to age in place. Although there has been substantial development of new applications of sensor technology in the home, this has tended to be tele-health focused, and there has been less work done on the role of IoT and ageing in place that more broadly considers caregiving and the built environment. Research in the field of IoT development and evaluation has recognised a number of challenges and limitations associated with past smart technology developments to support Ageing in Place, calling for user centeredness and better integration with broader systems. Compounding this, research into Ageing in Place and home environments has focused on built environments and largely ignored the impact of technology in the lives of older people staying at home. Recognising a gap in acknowledging the potential impact of technology on Ageing in Place theories, the purpose of this paper is to conceptualise a way of framing smart technology within an Ageing in Place model that acknowledges the interaction of smart technology with the built environment and caregiving and to present a framework for visualising the interactions that take place. A review of Environmental Gerontology model development is undertaken and a new model is presented that recognises the role of technology in Ageing in Place. Based on this model, a template is developed and three case studies of older people’s experiences of smart home technology, home modifications and caregiving are mapped out. These are used to demonstrate “proof of concept” of the relationships put forward in the HAST model and the pre-curser for a template to help people map smart technology and its role in supporting caregiving and ageing in place. This paper’s position is that technologies such as IoT further support the role of the built environment and caregiving to produce outcomes that enable older people to remain autonomous, independent, safe and well at home. However, a number of risks were also identified through the case studies, the issues of maintenance, cost and ease of use, and willingness to use are considerations and potential barriers to the benefits of smart technology

Individualized Apartment Accommodation for People With Intellectual Disability: Protocol for a Qualitative Study Examining the Well-Being and Support Outcomes Linking Housing and Health.

BACKGROUND:Understanding the outcomes associated with both receiving and providing support to people with intellectual disability in specific settings can facilitate the alignment of health providers, community care providers, architects, and urban planners to strengthen levels of autonomy and community participation of people with intellectual disability living in the community. This study explores the impact of providing support (available 24 hours a day) for people with intellectual disability in a high-density apartment. It seeks the perspectives of people with intellectual disability who have moved into an apartment from a group home (where 4-6 people with disability live), their families, and support staff. It will enable comparison between two models of supported accommodation, group homes and individualized apartments, in a community setting. OBJECTIVE:The aims of this study are to explore the impact of an individualized apartment model of supported accommodation in a high-density setting on the well-being, autonomy, and participation of people with intellectual disability living and receiving support; the experience of providing care or support; and how this setting impacts the logistics of how quality support is provided. METHODS:Qualitative research methods were employed as the primary means of collecting and analyzing data. There are two main sources of data in this study: (1) semistructured interviews with participants in up to 3 waves (pre, post 1, and post 2) and (2) pre- and postoccupancy evaluation data on the design, layout, and location details of the built environments. Coded interview data will be paired with pre- and postoccupancy evaluations of the two accommodation settings. RESULTS:As of May 2020, we have recruited 55 participants. There have been 96 interviews conducted in 2 waves with people who have moved into supported accommodation, families, and staff. Collected data are currently being analyzed. We expect the results of the trial to be published in a peer-reviewed journal in late 2020. CONCLUSIONS:This paper sets out a study of an alternative housing and support model for people with intellectual disability. It will capture personal experiences of people with intellectual disability receiving support in an apartment compared to their experiences in a group home. It will also capture the experiences of support staff working in the new setting and reveal how this differs from a group home setting. The inclusion of pre (group home) and post (apartment integrated into a community setting) measures addresses evaluative and comparative questions around the nature and impacts of the small-scale apartment and support model for both those who live and receive support, and those who support them. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID):DERR1-10.2196/18248

Progetto di un complesso residenziale situato nel quartiere Pisanova-Via I. Bargagna, Pisa

Questo progetto nasce come risposta a indicazioni realmente presenti nel Regolamento Urbanistico del Comune di Pisa che prevede, per l’area in oggetto, l’edificazione di un complesso ad uso misto residenziale – commerciale articolato con aree verdi private e pubbliche Il lotto in esame è compreso tra Via I. Bargagna e Via Frascani nel quartiere di Pisanova e attualmente è costituito per la maggior parte da terreni liberi. Il progetto si inserisce all’interno di un contesto di residenza privata e aree libere in via di trasformazione. E’ finalizzato alla creazione di un centro di aggregazione pubblica che si articola su di un asse principale che taglia l’area di intervento diagonalmente da ovest verso est in direzione dei Monti Pisani. Su questo asse, in posizione quasi centrale, si pone un fulcro intorno al quale, in maniera concentrica, si sviluppano i vari edifici che mantengono il loro fronte principale rivolto verso la piazza ellittica posta al centro

Housing design and community care: How home modifications reduce care needs of older people and people with disability

© 2019 by the authors. Licensee MDPI, Basel, Switzerland. The extent to which housing design can minimise levels of community caregiving has remained largely unmeasured. This paper reports the potential for home modifications to reduce caregiving in the peoples’ homes, particularly older people and people with a disability. It contributes to new knowledge in understanding how housing can play a role in community caregiving and acknowledges the role of the built environment in managing care levels in ageing societies. This paper analyses self-reported care data from 157 Australian community care recipients (average age: 72 years) who had received home modifications within the past 6 months. A before/after comparison of care provided revealed that home modifications reduced hours of care provided by 42% per week. More detailed analysis revealed that the positive association of home modifications with care reduction is stronger with informal care (46% reduction) followed by formal care (16% reduction). These results suggest the role that home modifications, and housing design in general, play in reducing care needs in a community setting

SIRT1 Activity Is Linked to Its Brain Region-Specific Phosphorylation and Is Impaired in Huntington’s Disease Mice

Huntingtons disease (HD) is a neurodegenerative disorder for which there are no disease-modifying treatments. SIRT1 is a NAD+-dependent protein deacetylase that is implicated in maintaining neuronal health during development, differentiation and ageing. Previous studies suggested that the modulation of SIRT1 activity is neuroprotective in HD mouse models, however, the mechanisms controlling SIRT1 activity are unknown. We have identified a striatum-specific phosphorylation-dependent regulatory mechanism of SIRT1 induction under normal physiological conditions, which is impaired in HD. We demonstrate that SIRT1 activity is down-regulated in the brains of two complementary HD mouse models, which correlated with altered SIRT1 phosphorylation levels. This SIRT1 impairment could not be rescued by the ablation of DBC1, a negative regulator of SIRT1, but was linked to changes in the sub-cellular distribution of AMPK-α1, a positive regulator of SIRT1 function. This work provides insights into the regulation of SIRT1 activity with the potential for the development of novel therapeutic strategies

Optimisation of a Nacelle Electro-Thermal Ice Protection System for Icing Wind Tunnel Testing

Abstract Aircraft are equipped with ice protection systems (IPS), to avoid, delay or remove ice accretion. Two widely used technologies are the thermo-pneumatic IPS and the electro-thermal IPS (ETIPS). Thermo-pneumatic IPS requires air extraction from the engine negatively affecting its performances. Moreover, in the context of green aviation, aircraft manufacturers are moving towards hybrid or fully electric aircraft requiring all electric on-board systems. In this work, an ETIPS has been designed and optimised to replace the nacelle pneumatic-thermal system. The aim is to minimise the power consumption while assuring limited or null ice formation and that the surface temperature remains between acceptable bounds to avoid material degradation. The design parameters were the length and heat flux of each heater. Runback ice formations and surface temperature were assessed by means of the in-house developed PoliMIce framework. The optimisation was performed using a genetic algorithm, and the constraints were handled through a linear penalty method. The optimal configuration required 33% less power with respect to the previously installed thermo-pneumatic IPS. Furthermore, engine performance is not affected in the case of the ETIPS. This energy saving resulted in an estimated reduction of specific fuel consumption of 3%, when operating the IPS in anti-icing mode

Measuring non-shelter effects of housing design: A mixed-methods exploration of home modifications, care-giving and health-related quality of life

Increasing demand for care services in the home has resulted in care systems under pressure operating within stressed government health budgets. This thesis explores an alternative approach to care provision and investigates how improving Australia‘s housing, through a program of home modifications, substitutes for care while also influencing quality of life. Using a mixed-methods research design with three phases, the study included 157 participants (average age 72 years). All participants were older or living with a disability and all were recent recipients of home modifications. Quality of life scores and informal and formal care hours were compared for before and after home modifications to analyse how the participants were affected by the home modifications. The second phase of the study was qualitative, and served the purpose of supporting and elaborating upon the quantitative results. The third phase integrated these two sets of results. The theoretical framework for this study is founded on the principles of the human/activity/space model, which provided a way of mapping the fundamental interactions occurring between environment and person following a home modification. The results of the quantitative phase revealed that the home modification was associated with an average 42% reduction in care-giving hours (both formal and informal) and an average 40% increase in health-related quality of life levels. The qualitative phase revealed that participants associated home modifications across six effect themes: increased safety and confidence, improved mobility at home, increased independence, supported care-giving role, increased social participation and ability to return home from hospital. Phase three, the integration of the qualitative and quantitative results, further strengthens the evidence for how and why home modifications reduce or replace care-giving. The study found that home modifications not only support care-giving but substitute for it, and suggests a relationship between home modification installation and improved health-related quality of life. The cost alone of home modification did not predict in the degree of either care savings or quality-of-life improvement; rather, it pointed towards the importance of individualised design solutions to ensure that a home modification targets the individual needs of the participant