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View Through a Window May Influence Recovery from Surgery

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Abstract

Records on recovery after cholecystectomy of patients in a suburban Pennsylvania hospital between 1972 and 1981 were examined to determine whether assignment to a room with a window view of a natural setting might have restorative influences. Twenty-three surgical patients assigned to rooms with windows looking out on a natural scene had shorter postoperative hospital stays, received fewer negative evaluative comments in nurses' notes, and took fewer potent analgesics than 23 matched patients in similar rooms with windows facing a brick building wall.
... No entanto, é a dimensão social das árvores que revela o grande potencial da arborização para a qualidade de vida nas cidades. A importância social de áreas verdes nas cidades é reconhecida há muito tempo, como afiram diferentes autores (Ulrich 1984;Kaplan 1995). No Brasil, por exemplo, já nos anos 1940, deixar áreas livres para a criação de áreas verdes era vista como meio de propiciar uma melhor qualidade de vida para os cidadãos urbanos, sendo associadas a um melhor arejamento e insolação (Lüdke 1998). ...
... Mais significativos ainda são os dados que demonstram uma melhora na qualidade da saúde de moradores de locais com maior arborização. Entre esses efeitos estão a melhora de condições cardíacas como pressão e batimentos cardíacos (Ulrich 1981) e recuperação mais rápida de cirurgias, com menores complicações pós-cirúrgicas e menor uso de analgésicos (Ulrich 1984). ...
Experiment Findings
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O Anel Viário em SJC possui uma ampla área em seu entorno passível de ser arborizada. A arborização dessa área tem o potencial de prover diferentes serviços ambientais (p.ex., culturais, de provisão, de suporte e de regulação) que podem beneficiar a população urbana do município e melhorar a ambiência da cidade. Utilizando técnicas de geoprocessamento, as áreas passíveis de arborização foram vetorizadas e a área quantificada. Com o valor de área, foi calculado o número potencial de árvores que a área suportaria. A partir desse número potencial e da área disponível, com o uso de equações já estabelecidas, foram estimados os benefícios ambientais (sequestro de CO2 pela vegetação e pelo solo, retenção de material particulado, e absorção de ozônio) e econômicos de tal área, contrastando então com os custos de implantação. Baseando a implantação do projeto calculando os benefícios econômicos de apenas quatro serviços ambientais, nossos cálculos demonstram o retorno financeiro superaria os custos em apenas um ano (assumindo as diferentes fases de crescimento e provimento dos serviços ambientais).
... In 1984, a pioneering study found that patients whose windows looked out upon a group of trees healed from surgery faster and needed fewer painkillers than those whose windows had no view of nature (Ulrich 1984). Since then, a rapidly expanding and compelling body of evidencespanning disciplines as diverse as epidemiology, psychology, forestry, and geography-suggests that forests and nature play an important role in human health. ...
... In areas of interest where few or no review articles exist, we consulted relevant empirical studies in the primary literature (nonreview papers), identified via scholarly databases, review of reference lists, and additional recommendations from internal and external experts, As a relatively young field, few studies on the specific health benefits of urban forests exist. Many of the reviews we identified referenced the same seminal studies (e.g., Ulrich 1984or Kuo 2003. Similarly, many narrowly focused review articles (e.g., reviews of forest bathing) survey and dissect the same small body of literature. ...
Article
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Better Forests, Better Cities evaluates how forests both inside and outside city boundaries benefit cities and their residents, and what actions cities can take to conserve, restore and sustainably manage those forests. This report is the first of its kind comprehensive resource on the connection between cities and forests, synthesizing hundreds of research papers and reports to show how all forest types can deliver a diverse suite of benefits to cities.
... A desirable Moshabak is one that provides views to the outside while shielding the interior from unwanted gaze and glare. Research shows that being able to see the outside can improve productivity [7][8][9], positive psychology [10][11][12] and health [13,14]. In this context, the design of Moshabak becomes critical since it affects the daylighting performance, visual perception of spaces, visual connection between inside and outside and ultimately, the flow of space. ...
Article
Traditional solar screens in Iran (called Moshabak) are architectural devices used mainly in hot-arid regions, with two interrelated functions: controlling the penetration of sunlight and gaze from outside. Consequently, Moshabak plays a significant role in veiling the interior from both and improving the quality of space. This research investigates the significance of aperture proportions for the lighting behaviour and transparency characteristics of Moshabak. The experiments are conducted in a typical residential room, under the sunny and clear sky of Kashan - a typical desert city in Iran. The study is divided into three stages and uses three kinds of Moshabak based on aperture proportions: horizontal, vertical, and square. Stage one of the research focuses on daylighting behaviour, stage two measures annual glare and stage three analyses transparency. For each type of Moshabak three different perforation percentages are used in order to better clarify the performance of different aperture proportions. The research findings show that aperture proportion has a significant impact on the performance of Moshabak. Moreover, Moshabak with horizontal apertures perform better than the rest, while Moshabak with vertical aperture proportions had the lowest performance in the three stages of the study.
... Previous studies have associated connection to the natural environment with positive health outcomes (Ulrich, 1984;Wilson, 1984). Humans are thought to have an innate tendency to seek connections to nature and thus to other forms of life (Wilson, 1984). ...
Thesis
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This thesis explores the interrelations between the design characteristics of activity-based offices, users’ perceptions of them, and users’ sense of coherence. The goal is twofold: (i) contribute to conceptualizations of healthy activity-based offices and (ii) facilitate practical use of the sense of coherence theory for office designers. Most research into healthy offices has focused on harm-causing factors (pathogenic aspects) while overlooking the health-promoting design characteristics in activity-based offices (salutogenic aspects). This thesis is a response to the call for a paradigm shift and explores the particular design characteristics of activity-based offices that promote health, drawing on the salutogenic approach and sense of coherence theory. The thesis builds on a literature review and two mixed methods case studies on activity-based offices. Drawing on the sense of coherence framework, three types of design characteristics were identified: (i) those that promote a clear understanding of office environments, (ii) those that enhance users' access to relevant resources, and (iii) those that evoke meaning for users to cope with stressors. These characteristics and the perceptions of them are interrelated meaning that they can have multiple impacts on users’ sense of coherence. The findings also highlighted temporal changes in users’ perceptions, indicating that novelties of the new office wore off and the initial problems observed in the office environment worsened. Moreover, activity-based offices were not always perceived as intended because of suboptimal design solutions and contextual factors. In conclusion, there are no definitive answers to how to design healthy activity-based offices. Activity-based offices are complex environments and consist of many interacting aspects including the design characteristics, individuals’, and their work-related prerequisite as well as organization-related factors that influence users’ perceptions and their sense of coherence. The framework developed in this thesis may contribute to better-informed discussions about designing for sense of coherence. The thesis suggests that healthy activity-based offices should be viewed as a "moving project" that develops over time through experimentation and adaptation, with management’s involvement. Thus, a healthy activity-based office provides users resources and opportunities to codesign an environment that enables them (i) build meaningful social relationships, (ii) manage visual and acoustic distractions, (iii) read and understand workspaces, and (iv) receive support from management in their daily work.
... Considerations on health of the patients have been a pivotal point in the planning of hospitals, in a balance of course, with other considerations, such as economy, operation costs, etc. Or rather, in a symbiosis with these considerations, since a balanced, healing environment directly influenced a wide range of other factors, such as recovery time, treatment of patients (3,4,5) together with the general performance and overall efficiency of a hospital over time (6). Over the years the planning of hospitals has changed dramatically. ...
Article
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This paper presents preliminary results of analyzes of the indoor environmental quality (IEQ) in a full scale rotatable 1:1 mockup of a patient room. As initial part of the planning of the indoor environment at a new mental hospital, the project seeks to uncover the natural differences and limitations of the building, caused by the geographical orientation. Examining the outdoor diurnal variations and their effect on the indoor environment, in order to create a balance between on the one hand, daylight and artificial lighting and on the other hand the demand for passive cooling, using natural ventilation. The analysis discuss potential health aspects of daylight and fresh air and proposes a new strategy for dynamic artificial lighting, including natural ventilation to supplement mechanical ventilation. In this article we uncover daylight conditions based on two main parameters; 1) the geographic orientation (N, S, E and W) and 2) the season (summer and winter). Based on the preliminary data and the regional daylight conditions, the article proposes a new way to plan the indoor environmental quality called Lattitude and Orientation Compensated Architectural Lighting (LOCAL).
Chapter
The population in urban areas has increased substantially in the last few decades and is expected to reach 60% of the world population by 2050. Urban forests provide a full spectrum of ecosystem services, serving as a nature-based solution to many environmental problems in cities. Identifying the ecosystem services and understanding the preferences of local communities could inform better decision-making in terms of land use planning and zoning, especially in highly urbanised areas. This chapter explores local residents’ perfection and preferences for ecosystem services provided by four remnant urban forests located in the Klang Valley region, Malaysia, which exhibit different natural attributes and management approaches. This case study illustrates the potential roles of environmental issues, as well as residents’ knowledge and motive to visit the urban forests in shaping their perception of ecosystem services provided by the urban forests. The findings also reveal that a lack of direct engagement with the forests and ecosystem services is unlikely to be regarded as a contributor to residents’ quality of life.
Article
Citation: Berto, R., Barbiero, G., and Salingaros, N.A. (2022) Biophilic design of building façades from an Evolutionary Psychology framework: Visual Attention Software compared to Perceived Restorativeness. Visions for Sustainability, 18, 7054, 1-34. http://dx.
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This paper presents a qualitative descriptive case study that aims to build awareness about the need for improvement of the indoor environment in classrooms and to exemplify how renewal-oriented processes can be initiated. The study focuses on innovation processes that have resulted in both completely new designs and further spread of innovative solutions. The reason for the need to improve is that too many pupils and students have problems with concentration, relaxation and recuperation. The number of diagnoses such as Autism and ADHD is growing. One factor which significantly influences the pupil’s mental well-being is the daily physical environment. The single aspect which may be improved in reasonable time, at a reasonable cost, is the lighting design of classrooms. An underlying reason for the habit to continue installing insipid uniform static “light-carpets” is the lack of awareness about how lighting affects wellbeing and health. As with innovation in other industries, it is an innovation dilemma that the vast majority of the people who sell and procure classroom lighting tend to prefer the established solutions that they are used to. The article describes how Malmö’s early investment in Human Centric Lighting and the unique indoor environment of the Study hall in the Centre for Economic Sciences at Uppsala University are used as role models for lighting design in classrooms. The case study combines the authors’ own observations and earlier interviews with users. Malmö’s temporal light variation and parts of the Study hall’s lighting design are used in more than 30 classrooms, in Malmö, Stockholm Business School and Iggesund. The article concludes with suggestions on how today’s lighting design knowledge and technology can be combined to provide more advanced adaptations to the varying lighting needs of pupils, students and teachers.
Article
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Subjects viewed sixty color slides of either (1) nature with water, (2) nature dominated by vegetation, or (3) urban environments without water or vegetation. The information rates of the three slide samples were equivalent. Measurements were taken of the effects of the slide presentations on alpha amplitude, heart rate, and emotional states. Results revealed several significant differences as a function of environment, which together indicate that the two categories of nature views had more positive influences on psychophysiological states than the urban scenes. Alpha was significantly higher during the vegetation as opposed to urban slides; similarly, alpha was higher on the average when subjects viewed water rather than urban content. There was also a consistent pattern for nature, especially water, to have more positive influences on emotional states. A salient finding was that water, and to a lesser extent vegetation views, held attention and interest more effectively than the urban scenes. Implications of the findings for theory development in environmental aesthetics are discussed.
Article
The therapeutic value of landscape in giving opportunity for 'spiritual renewal' through closer contact with nature has been the basis for much of the scenic conservation movement and lies behind a universal concept of National Parks as providing recreational resources for urban populations. This belief is tested in a series of classroom studies. -C.Laverick
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This study assesses the effectiveness of two stress-reducing strategies in a field setting. The first strategy consists of a coping device which entails the cognitive reappraisal of anxiety-provoking events, calming self-talk, and cognitive control through selective attention. The second strategy consists of supplying information about the threatening event along with reassurances for the purpose of producing emotional inoculation. Patients about to undergo major surgery were exposed to either the coping device, the preparatory information, both strategies, or neither. The prediction that the coping device would effectively reduce both pre- and post-operative stress was confirmed. An analysis of the nurses' ratings of preoperative stress showed a significant main effect for the coping device. There was also a significant main effect for the coping device on postoperative measures (number of pain relievers requested and proportion of patients requesting sedatives). The preparatory information, however, did not produce any significant effects on these postoperative measures.
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The current need for energy conservation has forced some fundamental re-evaluation of building design. One aspect that has come under much review is that of building fenestration. Although windows provide daylight and ventilation, they also can allow undesirable heat gain and loss. In the past, the provision of light and fresh air were essential functions of windows. A building was uninhabitable without windows. Now however, these functions can be fulfilled by artificial lighting and mechanical ventilation. As a result, a number of people have suggested that a substantial reduction in the size of windows, or their complete elimination is desirable in order to reduce excessive energy consumption. Nevertheless, even though a windowless building might be the best solution for eliminating energy loss through windows, there is considerable evidence that this may not be very desirable for the people in the building. In an attempt to delineate some of the functions of windows, the literature on the reaction to both the presence and the absence of windows was surveyed. In the first section, the psychological reaction to windowless buildings is examined to determine if the absence of windows in a building exerts any noticeable effect upon the occupants' behavior or attitudes. In the second section, the various characteristics of windows are reviewed to define some of their functions and benefits. (123 references) (from Introduction)
Article
Anxiety, depression, and pain were psychometrically assessed in 67 abdominal surgery patients on the day before surgery, on the first postoperative day, and on the third postoperative day. Patients were divided into kidney donor, kidney recipient, and general surgery groups, and a multi-variate analysis of variance was performed in order to compare the trends of response over days across groups. There were significant group differences in the pattern of scores over the three days. Trait anxiety was related to post-surgical pain, anxiety, and depression in general surgery and renal recipient patients, but not in kidney donors. Results suggest that the meaning attached to the stress of surgery significantly affects the subjective state changes surrounding the operation.
Article
Investigated the effects of surgery on state anxiety (A-state) and perceived pain in 59 white male surgical patients. The Melzack-Torgerson Pain Questionnaire, the State-Trait Anxiety Inventory (STAI), and the Fear of Surgery Scale (FSS) were given the day before the operation and again 10 days after surgery. Results indicate that surgery as a physical threat has an effect on A-state but not on anxiety as a personality disposition (trait anxiety; A-trait). The correlation of A-state and magnitude of reported pain postsurgery, but not presurgery, attributed to the existence of little pain variance before surgery, and to realistic concern over pain following surgery. (19 ref)
Article
: Surgical patients with similar medical problems differ greatly in their rate of postoperative recovery. This study investigated the relationship between the mode of coping with preoperative stress and recovery from surgery. Sixty-one preoperative surgical patients were interviewed and classified into three groups based on whether they showed avoidance vigilance, or both kinds of coping behavior, concerning their surgical problem. Coping dispositions referring to the same dimension, preoperative anxiety, and previous life stress were also measured. The five recovery variables included days in hospital, number of pain medications, minor medical complications, negative psychological reactions, and the sum of these. Results showed that the vigilant group had the most complicated postoperative recovery, although only two recovery variables (days in hospital and minor complications) were statistically significant. Coping dispositions, anxiety, and life stress showed no clear or consistent relationships with recovery. Ways in which mode of coping may have influenced recovery are discussed. Copyright (C) 1973 by American Psychosomatic Society
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