Configuration and design in caring environments: syntax and quality of life in a sample of residential care homes for older people

Space syntax techniques for the analysis of spatial layouts were the first to demonstrate, in a numerical way, clear and systematic relations between spatial design and observedfunctioning across a range of building and urban types. In this project, the techniques have been applied for the first time to the problem of layout design in care homes for older people as part of a wider study of care home performance, Design in Caring Environments (DICE), carried out by Sheffeld University.We were able to do this because the DICE dataincluded both building plans and quantitative measures of the quality of life of residents and staff. The aim of the work that is reported here was to add the syntactic dimension and to test to see if this related to the DICE quality of life variables.Complex, multi-level regression methods (Gorard, 2003) had been used by the DICE team to plot relationships between the main physical features of each building and quality of life data for residents and staff. An identical approach was used to explore the relationship between a range of syntactic variables and the residents' quality of life scores for eachbuilding. In the final event, only two syntactic variables showed significant associations with quality of life outcomes, but these turned out to be the two most important configu-rational measures - axial global and local integration of the building. These measures are known to work well in predicting space occupancy, use and interaction in buildings thatembed a weak organisational programme, where unplanned movement and activity are likely to make a positive contribution to community formation, but prior to this study we were unsure of the extent to which building layout would be able to overcome the effects of a strong organisational programme of the kind that exists in the care home sector andwhich is usually backed up by rules restricting access to different parts of the building. The results from multi-level modelling revealed clear and positive correlations betweenspatial design variables and three critical performance variables: the proportion of the residents' active time, frequency of the residents' enjoyable activity and the extent of the residents' choice and control over environment. The research thus shows unambiguously that, as many designers and care home managers suspect, design is indeed a criticalvariable in care home management and performance. Space syntax techniques for the analysis of spatial layouts were the first to demonstrate, in a numerical way, clear and systematic relations between spatial design and observedfunctioning across a range of building and urban types. In this project, the techniques have been applied for the first time to the problem of layout design in care homes for older people as part of a wider study of care home performance, Design in Caring Environments (DICE), carried out by Sheffeld University.We were able to do this because the DICE dataincluded both building plans and quantitative measures of the quality of life of residents and staff. The aim of the work that is reported here was to add the syntactic dimension and to test to see if this related to the DICE quality of life variables.Complex, multi-level regression methods (Gorard, 2003) had been used by the DICE team to plot relationships between the main physical features of each building and quality of life data for residents and staff. An identical approach was used to explore the relationship between a range of syntactic variables and the residents' quality of life scores for eachbuilding. In the final event, only two syntactic variables showed significant associations with quality of life outcomes, but these turned out to be the two most important configu-rational measures - axial global and local integration of the building. These measures are known to work well in predicting space occupancy, use and interaction in buildings thatembed a weak organisational programme, where unplanned movement and activity are likely to make a positive contribution to community formation, but prior to this study we were unsure of the extent to which building layout would be able to overcome the effects of a strong organisational programme of the kind that exists in the care home sector andwhich is usually backed up by rules restricting access to different parts of the building. The results from multi-level modelling revealed clear and positive correlations betweenspatial design variables and three critical performance variables: the proportion of the residents' active time, frequency of the residents' enjoyable activity and the extent of the residents' choice and control over environment. The research thus shows unambiguously that, as many designers and care home managers suspect, design is indeed a criticalvariable in care home management and performance

Communities of Co-presence and Surveillance: how public open space shapes awareness and behaviour in residential developments

12-15 June 200

The Housing and Support Needs of Older People with Visual Impairment

Visual impairment is one of the most prevalent anddisabling conditions among older people, and yet verylittle research has been conducted that could inform thedevelopment of appropriate public services. In order toaddress this deficiency, Thomas Pocklington Trust fundedresearch to examine the housing and support needs of 400visually impaired people aged over 55.The study found that:? There is little professional recognition, or offers of help andadvice for the anxiety, depression, and sense of profoundloss that people experience with late onset of visualimpairment.? Both blind and partially sighted people need timely andholistic assessment, rehabilitation, affordable equipment andregular review.? People with sight loss do not wish to leave their homes.Home is the epicentre of a mental map that assistsorientation and continuity following sight loss.? Social isolation and lack of human contact are majorproblems for people with sight loss.? People with sight loss have poor knowledge of supportgroups, community services and/or specialist housingoptions for older people with visual impairment. Visual impairment is one of the most prevalent anddisabling conditions among older people, and yet verylittle research has been conducted that could inform thedevelopment of appropriate public services. In order toaddress this deficiency, Thomas Pocklington Trust fundedresearch to examine the housing and support needs of 400visually impaired people aged over 55.The study found that:? There is little professional recognition, or offers of help andadvice for the anxiety, depression, and sense of profoundloss that people experience with late onset of visualimpairment.? Both blind and partially sighted people need timely andholistic assessment, rehabilitation, affordable equipment andregular review.? People with sight loss do not wish to leave their homes.Home is the epicentre of a mental map that assistsorientation and continuity following sight loss.? Social isolation and lack of human contact are majorproblems for people with sight loss.? People with sight loss have poor knowledge of supportgroups, community services and/or specialist housingoptions for older people with visual impairment

Meeting the needs of older peoplewith visual impairment: social care orsocial exclusion?

This paper is based on the research study ?Housing and supportneeds of older people with visual impairment ? experiences andchallenges? (Hanson et al, 2002).1The full findings of this study are reported in another occasionalpaper produced by Thomas Pocklington Trust.2 It is, however, usefulto state that this study found evidence that sight loss in later life hassignificant emotional consequences, often unacknowledged byprofessionals. It also showed how older people with visionimpairment often have their own coping strategies, but are less ablethan sighted peers to carry out certain daily tasks.The study suggested that professionals should offer sensitive andtimely support, in a more collaborative manner, and that serviceshave to be monitored and evaluated to avoid wide-ranging needsremaining unmet. In respect of the home environment, researchindicated that adequate and accessible domestic space in which todo housework safely, low vision equipment and the provision ofovernight accommodation for guests and carers was required.Most participants in the study wished to stay in their homes andneighbourhoods. When asked about possible alternative options,participants emphasised the importance of location and sufficientspace. If they were considering supported housing, they requiredfull information about how it addressed their particular needs.This paper focuses on whether older people with visual impairmentare vulnerable to social exclusion if their social care needs are unmet. In particular, this paper argues that:? Greater professional collaboration is required to improve eyeclinic and community support services.? Relevant staff should aim to provide timely and holisticassessments of need.? Older people with vision impairment have significant needs asregards home care support, access to information, psychologicalstress and social isolation.? Initiatives such as peer support groups and resource centres offeropportunities to tackle social exclusion arising from unmetneeds. This paper is based on the research study ?Housing and supportneeds of older people with visual impairment ? experiences andchallenges? (Hanson et al, 2002).1The full findings of this study are reported in another occasionalpaper produced by Thomas Pocklington Trust.2 It is, however, usefulto state that this study found evidence that sight loss in later life hassignificant emotional consequences, often unacknowledged byprofessionals. It also showed how older people with visionimpairment often have their own coping strategies, but are less ablethan sighted peers to carry out certain daily tasks.The study suggested that professionals should offer sensitive andtimely support, in a more collaborative manner, and that serviceshave to be monitored and evaluated to avoid wide-ranging needsremaining unmet. In respect of the home environment, researchindicated that adequate and accessible domestic space in which todo housework safely, low vision equipment and the provision ofovernight accommodation for guests and carers was required.Most participants in the study wished to stay in their homes andneighbourhoods. When asked about possible alternative options,participants emphasised the importance of location and sufficientspace. If they were considering supported housing, they requiredfull information about how it addressed their particular needs.This paper focuses on whether older people with visual impairmentare vulnerable to social exclusion if their social care needs are unmet. In particular, this paper argues that:? Greater professional collaboration is required to improve eyeclinic and community support services.? Relevant staff should aim to provide timely and holisticassessments of need.? Older people with vision impairment have significant needs asregards home care support, access to information, psychologicalstress and social isolation.? Initiatives such as peer support groups and resource centres offeropportunities to tackle social exclusion arising from unmetneeds

Bolam with the benefit of hindsight

The aim of this article is to consider the effects of hindsight bias on findings of negligence in medico-legal litigation and of the potential of the original Bolam direction to eliminate bias from the decision making process. The Bolam test may have been expanded beyond its appropriate scope in the past but these excesses have now largely been undone. It will be shown that Bolam still has an important role to play in tort cases. By considering breach of duty cases in which the Bolitho “gloss” has been applied attention is drawn to the potential dangers of disregarding practices within the medical profession

An investigation of condensation heat transfer in a closed tube containing a soluble noncondensable gas

A more exact one-dimensional condensation heat transfer model for insoluble gases was developed and compared with experimental data. Modifications to this model to accommodate soluble gas behavior were also accomplished, and the effects on gas front behavior demonstrated. Analytical models for condensation heat transfer are documented, and an optical method used for measuring gas concentration profiles is outlined. Experimental data is then presented and interpreted

Oceanographic features in the lee of the windward and leeward islands: ERTS and ship data

Analysis of the ERTS data in portions of the eastern Caribbean are presented for October 1972 showing features which are, as yet, not explained. Ground truth data obtained in that area during November 1972 are presented. These include vertical temperature structure in the mixed layer and thermocline, and surface measurements of salinity, temperature, and chlorophyll

DSIF station schedules

System manages Deep Space Instrumentation Facilities /DSIF/ equipment construction and modification planning. Versatile program applies to such tasks as employee time and task schedules, pay schedules, operations schedules, and plant and equipment procurement, construction, modification or service

Midwives fear of litigation: justified or not?

Existing research has identified links between the fear of litigation and defensive practice (Symons 2006; 1998; Hood et al 2010; Charles et al 1985). Although there have been studies of doctors perceptions of litigation little has been written about the position on midwives (Vincent et al 1994). Specifically there is a lack of research in England on measuring the actual likelihood of litigation set against midwives’ perceptions of the threat. This project explores midwives' fear of legal action, and if present, what they fear and their perceived assessment on how this may affect their practice. The project will assess whether fears match the reality as measured by the number and types of clinical negligence claims brought against midwives nationally in a specified period. The research strategy will use: (1) qualitative assessment of midwives’ perceptions in a focus group of a sample of midwives working in an NHS Trust (2) quantitative assessment of the extent of the identified fears (3) evaluation of the extent of fears against the actual incidences of litigation. The project challenges the perceptions, myths and misunderstandings midwives may have by reference to the likelihood of legal action and therefore its consequent impact on professional practice. The anticipated benefits of the research include additions to the body of knowledge which informs the training of midwives in respect of their perceptions of the threat of litigation as well as identifying any myths or misunderstandings