Universal Design: Planning and Design for All

[Excerpt] This report attempts to develop and illustrate the concept of universal design. The aim of universal design is to develop theory, principles and solutions to enable everybody to use the same physical solutions to the greatest extent possible, whether it be buildings, outdoor-areas, means of communication or household goods. Universal design opposes, ideologically and politically, all unnecessary and stigmatizing specialized solutions, whether they are intended for people with disabilities or other groups of the population. Equal status, equal treatment and equal merit are key concepts. The discussion in this report covers extensive spheres such as planning, architecture and product design. One may object that we try to cover too large an area within a relatively brief report. It is therefore important to emphasise that our main intention is to include more professionals and politicians in the further discussion of universal design or design for all

Analysis of spatial conflicts of large scale salmonid aquaculture with coastal fisheries and other interests in a Norwegian fjord environment, using the novel GIS-tool SEAGRID and stakeholder surveys

The expansion of the Norwegian aquaculture industry has generated a need for balancing aquaculture with other societal interests in the coastal zone. The interactions, conflicts and synergies of different uses of a Norwegian coastal region heavily influenced by large-scale salmonid aquaculture was analyzed and mapped by means of systematic stakeholder participatory approach and a GIS-based spatial interaction analysis tool, SEAGRID. Our study focused on spatial conflicts/synergies, whereas non-spatial interactions were taken into account in order to elucidate the spatial effects. The questionnaire analysis showed that there was a large agreement across the respondents that aquaculture and fisheries compete for access to sea areas, which is also in agreement with the SEAGRID analysis. All but one of the interviewees thought that conservation issues will become more important in the future. We found that societal interests and infrastructure obstruct or displace private enterprises and economic interests, whereas environmental protection measures do so to a lesser extent; an exception are coral reefs which seem to be well protected against both fishing operations as well as new aquaculture facilities. Nature protection was not found to affect fisheries nor aquaculture to a large extent, with the exception of the single salmon fjord, which is protected from salmonid aquaculture, but otherwise open to other activities, such as fisheries, tourist fisheries and tourism in general. The restricted military areas had a limited extent, and were not viewed as a cause of conflicts. Stakeholder consultations, like our participatory GIS approach, combined with GIS-based tools for analysis of spatial conflicts/synergies may be useful in identifying areas where aquaculture production can increase with little increase in degree of conflict with fisheries, although some interactions are not strictly spatial. Our results indicated a certain degree of mistrust of management authorities since neither fishermen nor aquaculturists perceived that their own sector was given priority by management authorities, but thought the other sector was prioritized.Analysis of spatial conflicts of large scale salmonid aquaculture with coastal fisheries and other interests in a Norwegian fjord environment, using the novel GIS-tool SEAGRID and stakeholder surveyspublishedVersio

Prediction of function in daily life following multidisciplinary rehabilitation for individuals with chronic musculoskeletal pain; a prospective study

Background: The prevalence of chronic musculoskeletal pain is high, with widespread negative economic, psychological, and social consequences for the individual. It is therefore important to find ways to predict the outcome of rehabilitation programmes in terms of function in daily life. The aims of this study were to investigate the improvements over time from multidisciplinary rehabilitation in terms of pain and function, and analyse the relative impact of individual and psychosocial factors as predictors of function in daily life in individuals with chronic musculoskeletal pain. Methods: A prospective study was conducted among one hundred and forty three (N = 143) musculoskeletal pain patients. Measures of pain, function, and functional health status were obtained at baseline, after 5 weeks of intensive training, at the end of the 57-week rehabilitation programme, and at a 1 year follow-up, using validated self-administrated measures. Linear regression analysis was applied to investigate the relative impact of musculoskeletal pain, individual- , and psychosocial factors in function. Results: The participants studied showed a significant increase in function during the 57 weeks rehabilitation period. There was also a significant increase in function from the end of the rehabilitation period (57th week) to the one year follow-up measures. Pain intensity associated significantly with pain experience over all measurement periods. High levels of pain intensity (β = .42**) and pain experience (β = .37*), and poor psychological capacity (β = -.68*) at baseline, as well as poor physiological capacity (β = -.44**) and high levels of anxiety (β = .48**) and depression (β = .58***) at the end of the rehabilitation program were the most important prognostic factors of variance in functioning over the 4 measurement periods. Conclusion: The data suggest that physical capacity, emotional distress and coping skills should be priority areas in rehabilitation programmes to improve functioning in daily life

Midlife Physical Activity, Psychological Distress, and Dementia Risk: The HUNT Study

Background: Physical activity (PA) is associated with a decreased dementia risk, whereas psychological distress (distress) is linked to an increased dementia risk. Objective: We investigated independent and joint associations of midlife moderate-to-vigorous PA (MVPA) and distress with incident dementia. Methods: Our study comprised 28,916 participants aged 30–60 years from the Nord-Trøndelag Health Study (HUNT1, 1984–1986). Data on MVPA and distress from HUNT1 was linked to the Health and Memory Study in Nord-Trøndelag for dementia case identification. Participants were followed from 1995 until 2011. We used adjusted Cox regression models to estimate hazard ratios (HRs) and 95% confidence intervals (95% CI). Results: In fully adjusted analyses, MVPA was associated with a reduced dementia risk (HR 0.81, 95% CI 0.62–1.06), compared to no MVPA. Distress was associated with an increased dementia risk (HR 1.30, 95% CI 0.99–1.70). Compared to distressed participants not taking part in MVPA, non-distressed no-MVPA participants had a reduced dementia risk (HR 0.72, 95% CI 0.54–0.96). The same applied to distressed MVPA participants (HR 0.50, 95% CI 0.22–1.14), and non-distressed MVPA participants (HR 0.63, 95% CI 0.44–0.90). Our results indicated an additive interaction between MVPA and distress on dementia risk. Conclusion: Our results suggest that midlife MVPA reduces risk of incident dementia among both distressed and non-distressed individuals.acceptedVersion© 2018. This is the authors' accepted and refereed manuscript to the article. The final authenticated version is available online at: http://dx.doi.org/10.3233/JAD-18076

Current and Future Prevalence Estimates of Mild Cognitive Impairment, Dementia, and Its Subtypes in a Population-Based Sample of People 70 Years and Older in Norway: The HUNT Study

Background: Having accurate, up-to-date information on the epidemiology of mild cognitive impairment (MCI) and dementia is imperative. Objective: To determine the prevalence of MCI and dementia in Norway using data from a large population-based study. Methods: All people 70 + years of age, n = 19,403, in the fourth wave of the Trøndelag Health Study (HUNT4) were invited to participate in the study HUNT4 70 + . Trained health personnel assessed participants using cognitive tests at a field station, at homes, or at their nursing home. Interviewers also completed a structured carer questionnaire in regard to participants suspected of having dementia. Clinical experts made diagnoses according to DSM-5 criteria. We calculated prevalence weighing the data to ensure population representativeness. Results: A total of 9,930 (51.2%) of the possible 19,403 people participated, and 9,663 of these had sufficient information for analysis. Standardized prevalence of dementia and MCI was 14.6% (95% confidence interval (CI) 13.9–15.4) and 35.3% (95% CI 34.3–36.4), respectively. Dementia was more prevalent in women and MCI more prevalent in men. The most prevalent dementia subtype was Alzheimer’s disease (57%). By adding data collected from a study of persons < 70 years in the same region, we estimate that there are 101,118 persons with dementia in Norway in 2020, and this is projected to increase to 236,789 and 380,134 in 2050 and 2100, respectively. Conclusion: We found a higher prevalence of dementia and MCI than most previous studies. The present prevalence and future projections are vital for preparing for future challenges to the healthcare system and the entire society

Current and Future Prevalence Estimates of Mild Cognitive Impairment, Dementia, and Its Subtypes in a Population-Based Sample of People 70 Years and Older in Norway: The HUNT Study

Background: Having accurate, up-to-date information on the epidemiology of mild cognitive impairment (MCI) and dementia is imperative. Objective: To determine the prevalence of MCI and dementia in Norway using data from a large population-based study. Methods: All people 70 + years of age, n = 19,403, in the fourth wave of the Trøndelag Health Study (HUNT4) were invited to participate in the study HUNT4 70 + . Trained health personnel assessed participants using cognitive tests at a field station, at homes, or at their nursing home. Interviewers also completed a structured carer questionnaire in regard to participants suspected of having dementia. Clinical experts made diagnoses according to DSM-5 criteria. We calculated prevalence weighing the data to ensure population representativeness. Results: A total of 9,930 (51.2%) of the possible 19,403 people participated, and 9,663 of these had sufficient information for analysis. Standardized prevalence of dementia and MCI was 14.6% (95% confidence interval (CI) 13.9-15.4) and 35.3% (95% CI 34.3-36.4), respectively. Dementia was more prevalent in women and MCI more prevalent in men. The most prevalent dementia subtype was Alzheimer's disease (57%). By adding data collected from a study of persons < 70 years in the same region, we estimate that there are 101,118 persons with dementia in Norway in 2020, and this is projected to increase to 236,789 and 380,134 in 2050 and 2100, respectively. Conclusion: We found a higher prevalence of dementia and MCI than most previous studies. The present prevalence and future projections are vital for preparing for future challenges to the healthcare system and the entire society. Keywords: Alzheimer’s disease; dementia; epidemiology; population study; prevalence