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Conceptualisation of an Intelligent Salutogenic Room Environment
Abstract
Human functioning in the built environment is affected by the degree of “fit” or congruence between a user and her/his surroundings. By extension, the culture of care-giving and physical environment of care settings are inextricably linked. This conceptual model, developed in the context of the MyRoom project, is based on analysis of prerequisites for psychosocial congruence, drawn from theories of environmental psychology, and from the evidence-base. The model examines how these requirements may be addressed through architectural design enhanced by ubiquitous affective computing, integrated into the built environment, to maximise person-environment fit in healthcare settings. Where specific user needs, arising from cognitive and physical impairment associated with ageing and dementia, are not fully met by the built environment, these needs may be addressed through affective computing. This is to be achieved by means of real-time processing of data from an integrated system of Body Sensor Networks and Room Sensor Networks. This paper describes in detail an adaptive salutogenic single-user room in an elderly care setting, as a template of how an environment responsive to a user’s physical and emotional state might be realised, promoting salutogenesis through optimal congruence. Psychosocial congruence, on which this paper focuses, is enhanced through actuation of multisensory applications designed to provide appropriate stimulation. Recent research on affective computing for children with ASD may be translational. A majority of elderly persons in residential care have some form of dementia. This implies that design of residential care and dementia care environments for elderly people is effectively inseparable. Architecture, further enhanced by ambient technologies, has the capacity to act as a major, and timely catalyst for a radical re-thinking of the culture and environment of care.
Environments which aim to promote human well-being must address both functional and psychosocial needs. This paper comprises a description of a framework for a smart home environment, which aims to comprehensively address issues of environmental fit, in particular for a person with cognitive impairment associated with dementia, by means of introducing sensing of user affect as a factor in system management of a smart personal life space, and in generation of environmental response, adapting to changing user need. The introduction of affective computing into an intelligent system managing environmental response and adaptation is seen as a critical component in successfully realizing an interactive personal life-space, where a continuous feedback loop operates between user and environment, in real time. The overall intention is to maximize environmental congruence for the user, both functionally and psychosocially, by factoring in adjustment to changing user status. Design thinking, at all scales, is perceived as being essential to achieving a coherent smart environment, where architecture is reframed as interaction design.
The findings suggest that stressed individuals feel significantly better after exposure to nature scenes rather than to American urban scenes lacking nature elements. Compared to the influences of the urban scenes, the salient effect of the nature exposures was to increase Positive Affect — including feelings of affection friendliness, playfulness, and elation. The increase in positive affect produced by the nature scenes is consistent with the finding that the nature exposures also significantly reduced Fear Arousal. According to psychological theories, a reduction in arousal or activation produces pleasurable feelings if an individual is experiencing stress or excessive arousal (Berlyne, 1971, pp. 81–82). In contrast to the nature scenes, the urban views tended to work against emotional well‐being. The major effect of the urban scenes was to significantly increase Sadness. There was also a consistent but non‐significant tendency for the urban scenes to‐aggravate feelings of Anger/Aggression, and for the nature scenes to reduce such feelings. The urban exposures also held the attention of subjects somewhat less effectively than the nature exposures. These findings were stable across sexes, and applied to subjects who had grown up in either rural or urban environments.
https://www.researchgate.net/publication/251066815_MyRoom_A_model_for_an_intelligent_salutogenic_room_prototype_for_an_elderly_user#fullTextFileContent
This paper discusses physiological data as one stream of personal data available to drive adaptations in architecture. Physiological data here refers to data such as heart rate, respiration and brain activity that can be measured, manipulated and to some extent be interpreted to say something about the inhabitants’ emotional state. An iteratively developed prototype, the ExoBuilding, allowed the exploration of some of the salient issues in this space, and this exploration highlighted the possibility for a biofeedback loop emerging between the inhabitant and their ‘physiologically’ adaptive environment. An associated early consideration of the possible mappings between physiological data and the building fabric gave rise to an initial model of physiological data in Adaptive Architecture, presented here, which sets out the relationship between inhabitant, physiological data, actuation and effect with biofeedback being a special case specific to the context of this work. An outline of a series of hypothetical case studies explores the mappings between physiological data and the building fabric, which in turn leads to the suggestion that adaptive architecture best be understood as socio-technical system.
This article uses an ecological approach to analyze factors in the effectiveness of work teams—small groups of interdependent individuals who share responsibility for outcomes for their organizations. Applications include advice and involvement, as in quality control circles and committees; production and service, as in assembly groups and sales teams; projects and development, as in engineering and research groups: and action and negotiation, as in sports teams and combat units. An analytic framework depicts team effectiveness as interdependent with organizational context, boundaries, and team development. Key context factors include (a) organizational culture, (b) technology and task design, (c) mission clarity, (d) autonomy, (e) rewards, (f) performance feedback, (g) training/consultation, and (h) physical environment. Team boundaries may mediate the impact of organizational context on team development. Current research leaves unanswered questions but suggests that effectiveness depends on organizational context and boundaries as much as on internal processes. Issues are raised for research and practice. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
A century of research and practice have optimized the use of electric lighting in buildings to support human vision. However, recent lines of research show that light is also important to human circadian regulation, as reflected in such diverse phenomena as depression, sleep quality, alertness, and, perhaps, even health. Although light is essential to both vision and circadian regulation, research shows that the biophysical processes that govern circadian regulation are very different from those that govern vision. This growing body of research will probably influence the architectural lighting community and manufacturers to reoptimize the use of electric lighting in buildings to support both human vision and circadian functions. The present paper is concerned with establishing a framework for lighting practice and applied research that will assist lighting practitioners and manufacturers in interpreting this emerging research.
Stressful life experiences are likely etiological factors in sporadic forms of Alzheimer's disease (AD). Many AD patients hypersecrete glucocorticoids (GCs), and their GC levels correlate with the rate of cognitive impairment and extent of neuronal atrophy. Severity of cognitive deficits in AD correlates strongly with levels of hyperphosphorylated forms of the cytoskeletal protein TAU, an essential mediator of the actions of amyloid β (Aβ), another molecule with a key pathogenic role in AD. Our objective was to investigate the sequential interrelationships between these various pathogenic elements, in particular with respect to the mechanisms through which stress might precipitate cognitive decline. We thus examined whether stress, through the mediation of GCs, influences TAU hyperphosphorylation, a critical and early event in the cascade of processes leading to AD pathology. Results from healthy, wild-type, middle-aged rats show that chronic stress and GC induce abnormal hyperphosphorylation of TAU in the hippocampus and prefrontal cortex (PFC), with contemporaneous impairments of hippocampus- and PFC-dependent behaviors. Exogenous GC potentiated the ability of centrally infused Aβ to induce hyperphosphorylation of TAU epitopes associated with AD and cytoplasmic accumulation of TAU, while previous exposure to stress aggravated the biochemical and behavioral effects of GC in Aβ-infused animals. Thus, lifetime stress/GC exposure may have a cumulative impact on the onset and progress of AD pathology, with TAU hyperphosphorylation serving to transduce the negative effects of stress and GC on cognition.
We present a simple, low-cost method for measuring multiple physiological parameters using a basic webcam. By applying independent component analysis on the color channels in video recordings, we extracted the blood volume pulse from the facial regions. Heart rate (HR), respiratory rate, and HR variability (HRV, an index for cardiac autonomic activity) were subsequently quantified and compared to corresponding measurements using Food and Drug Administration-approved sensors. High degrees of agreement were achieved between the measurements across all physiological parameters. This technology has significant potential for advancing personal health care and telemedicine.
People on the autism spectrum often experience states of emotional or cognitive overload that pose challenges to their interests in learning and communicating. Measurements taken from home and school environments show that extreme overload experienced internally, measured as autonomic nervous system (ANS) activation, may not be visible externally: a person can have a resting heart rate twice the level of non-autistic peers, while outwardly appearing calm and relaxed. The chasm between what is happening on the inside and what is seen on the outside, coupled with challenges in speaking and being pushed to perform, is a recipe for a meltdown that may seem to come 'out of the blue', but in fact may have been steadily building. Because ANS activation both influences and is influenced by efforts to process sensory information, interact socially, initiate motor activity, produce meaningful speech and more, deciphering the dynamics of ANS states is important for understanding and helping people on the autism spectrum. This paper highlights advances in technology that can comfortably sense and communicate ANS arousal in daily life, allowing new kinds of investigations to inform the science of autism while also providing personalized feedback to help individuals who participate in the research.
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.
The authors compared the therapeutic effect of morning bright and dim light exposure on rest-activity (R-A) rhythm disorders in patients with vascular dementia (VD) and patients with dementia of Alzheimer's type (DAT). Participants in this study were 12 patients with VD (M/F = 5/7; average age = 81 years) and 10 patients with DAT (M/F = 4/6; average age = 78 years). They were exposed to 2 weeks of bright light (BL; 5000-8000 lux) and 2 weeks of dim light (DL; 300 lux) in the morning (09:00-11:00) in a randomized crossover design in which the 2-week treatment period took place between pretreatment (1 week) and posttreatment (1 week) periods. Continuous R-A monitoring was performed at 1-minute intervals throughout the study using an actigraph around the nondominant wrist. The BL exposure for 2 weeks induced a significant reduction in both nighttime activity and percentages of nighttime activity to total activity compared with the pretreatment period, as well as compared with the DL condition in the VD group, but not in the DAT group. These findings support the assumption that the therapeutic efficacies of morning BL exposure are prominent in VD patients and are mainly due to its photic effect rather than nonphotic effects such as the intensification of social interaction accompanying light therapy.
Background:
Chronic stress is associated with hippocampal damage and impaired memory in animals and humans.
Objective:
To examine this relationship with clinical and pathologic data from the Religious Orders Study.
Methods:
Older Catholic clergy members underwent annual clinical evaluations, which included clinical classification of Alzheimer's disease (AD) and detailed cognitive function testing from which composite measures of global cognition and specific cognitive functions were derived. At the baseline evaluation, participants completed a measure of the tendency to experience psychological distress, a stable personality trait that served as an indicator of susceptibility to negative emotional states across the life span. More than 90% of participants who died underwent a uniform postmortem examination of the brain from which summary measures of AD pathology were derived. The association of distress proneness with incident AD and cognitive decline and with measures of AD pathology was examined in analyses adjusted for selected demographic and clinical variables.
Results:
During a mean of 4.9 years of follow-up, 140 persons developed AD. Those high in distress proneness (90th percentile) had twice the risk of developing AD than those low in distress proneness (10th percentile). Distress proneness was related to decline in episodic memory but not in other cognitive domains, with a >10-fold increase in episodic memory decline in those high in distress proneness compared with those low in the trait. Among those who died, however, distress proneness was not related to common measures of AD pathology.
Conclusion:
Proneness to experience psychological distress is a risk factor for AD, an effect independent of AD pathologic markers such as cortical plaques and tangles.
Because the illness erodes and destroys an individual's humanness and personality, patients and families affected by Alzheimer's Disease have particularly critical needs for help with its psychosocial sequelae. This article develops a model of psychosocial management and details specific interventions to help patients and caregivers develop and maintain adaptations during the long course of the disease.
SUMMARY This paper provides a critical look at the challenges facing the field of health promotion. Pointing to the persistence of the disease orientation and the limits of risk factor approaches for conceptualizing and conduct- ing research on health, the salutogenic orientation is presented as a more viable paradigm for health promo- tion research and practice. The Sense of Coherence framework is offered as a useful theory for taking a salutogenic approach to health research.
Dementia of the Alzheimer's type (DAT), termed the disease of the century (Braly, 1986), has affected over two million Americans (Katzman, 1986). As the population ages, this figure will rise, presenting a continued challenge to health care systems and to occupational therapists who will increasingly confront people with DAT In their various clinical settines. The Model of Human occupation is suggested as a framework Kr guiding assessment and treatment for the person with DAT. A brief review of the symptoms and potential disturbances affecting occu ational function within the framework of the model is presented, followed by a case study illustrating clinical application bf the model.
Discusses a salutogenic model (SM) of health and illness, which focuses on why people remain healthy despite stress. It is proposed that what is common to all resistance resources is that they help make sense out of the stressors with which individuals are constantly bombarded. The concept sense of coherence is described, which expresses the extent to which an individual has a pervasive, enduring though dynamic, feeling of confidence that life is comprehensible, manageable, and meaningful. The SM is compared to the traditional pathogenic approach to health. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Reviews the literature (1922–1985) concerning psychosocial intervention strategies in terms of the nature of senile dementia and its complicating factors. Intervention approaches are critically examined, and their application to the practice of psychosocial occupational therapy is discussed. Approaches considered include sensory stimulation, activity stimulation, milieu modifications, reality orientation, group therapy, and behavioral techniques. A cognitive disability approach is described that provides a neuroscientific theoretical basis for occupational therapists to use in prescribing the appropriate environmental stimuli and supports to help compensate for specific cognitive impairments. Patient assessment issues are reviewed. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Although much of the recent concern for privacy as a central issue in the study of interpersonal behavior has arisen within the area of environmental psychology, the environment presented in this literature tends to lack enduring properties which set it apart from the behavior to which it is presumably related. By contrast, a model of the environment is proposed which is sensitive to physical properties which are independent of normative and symbolic associations imposed by tradition. This model indicates how the selection of one's location and orientation within an architecturally bounded setting can affect both the acquisition of information about surrounding activities and the abilities of others to take notice of one's own behavior. Within this framework selective conspicuousness is suggested as the chief means of privacy regulation. Selective conspicuousness involves a trade off between the environmental and behavioral options available for concealing or disclosing information about oneself with the physical environment presenting certain initial conditions upon which behavior is contingent.
Minimalism in ubiquitous interface design allows computational augmentations to coexist with unmodified artifacts and the constellations of task behaviors surrounding them. By transparently integrating aspects of the digital world into real artifacts, we strive to provide ubiquitous interfaces to computation that do not obscure or destroy the highly refined interaction modalities of everyday artifacts in the physical world. Minimalism does not necessarily imply limited functionality. Transparent design means minimizing cognitive demands on the user by limiting the changes to the pre-existing constellation of behaviors surrounding the artifact being augmented. For example, the augmented go system transparently adds game recording and an automatic move clock to traditional face-to-face play with no change to the traditional experience.
The patterns of information available in the environment are often ignored in analyses of the fit or congruence between person and environment. By viewing such information patterns (in conjunction with the environmental constraints on behavior and the individual's purposes) as potential sources of incompatibility, it is possible to understand a substantially wider range of human-environment relationships. From this perspective, person-environment incompatibility turns out to be a problem that is widespread and that extracts high psychological costs. It might seem that the solution to such problems requires an increase in environmental controllability; such an assumption can, however, be questioned on a number of grounds. An alternative approach is proposed in terms of the concepts of supportive and restorative environments. Peer Reviewed http://deepblue.lib.umich.edu/bitstream/2027.42/66976/2/10.1177_0013916583153003.pdf
This study describes how older people endow the home environment with meaning. Specifically, it describes the nature and meaning
of the linkages between the older individual and the home environment, suggesting that the home environment is given meaning
through three classes of psychosocial processes relating the person to (a) the sociocultural order, (b) the life course, and
(c) the body. Seven discrete components of the processes are illustrated, using extensive case examples derived from lengthy
ethnographic interviews with seven elderly informants. In the context of the relationship of the individual to culture, the
study assumes the salience of personal meaning as a significant level of analysis.
Patients with Alzheimer's disease and nondemented elderly control subjects participated in studies of cortisol secretion during sleep and at 9:00 a.m. and were given dexamethasone suppression tests (DSTs) and lumbar punctures. Nocturnal and 9:00 a.m. cortisol concentrations were significantly higher in the demented patients. CSF MHPG negatively correlated with mean nocturnal cortisol. The most severely demented patients had the highest 9:00 a.m. and mean nocturnal cortisol concentrations. DST results did not distinguish samples with substantially different nocturnal cortisol concentrations. These results suggest that measurements of basal plasma cortisol concentrations and dexamethasone suppression provide different information but support the notion of somewhat higher than normal cortisol concentrations in Alzheimer's disease patients.
The physical environment can be an important contributor to occupational stress. Factors that contribute to stress and other negative outcomes include: lack of control over the environment, distractions from coworkers, lack of privacy, noise, crowding, and environmental deprivations (such as lack of windows and aesthetic impoverishment). The design of "salutogenic" environments requires not only the elimination of negative stress inducing features, but also the addition of environmental enhancements, including such factors as increased personal control, contact with nature and daylight, aesthetically pleasing spaces, and spaces for relaxation alone or with others. Salutogenic environments also take into consideration positive psychosocial "fit," as well as functional fit between people and environments. At the heart of the current interest in the work environment are two major concerns: organizational productivity and employee well being.
The general therapeutic effect of light on seasonal affective disorder (SAD) has been widely acknowledged. However, the antidepressant effect of light does not seem to be the same for different spectra of light. In this study, the authors attempted to study the spectral properties of phototherapy for SAD using a meta-analytical procedure. The findings suggested that light of short to medium wavelengths (blue/green/yellow) seem to be essential for the therapeutic effect of light on SAD. Red wavelengths were relatively ineffective. It was then postulated that SAD may be predisposed and/or precipitated by the inefficiency of the S and M cones in the retina. Furthermore, ultraviolet (UV) waves did not seem to be essential for SAD symptom alleviation by artificial light. Therefore, these potentially harmful UV waves should be blocked in any clinical application of phototherapy for SAD.
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