Thesis (Ph. D.)--University of Florida, 1982. / Description based on print version record. Typescript. Vita. Includes bibliographical references (leaves 131-135).

<p> This dissertation is comprised of three essays that explore the connections between buildings and their impacts on outcomes associated with occupant health. The essays are: 1. The Effect of Certified Green Office Buildings on Occupant Health: A Systematic Review and Meta-Analysis, 2. Understanding Evidence-Based Design Through a Review of the Literature, 3. Future Directions for Evidence-Based Design in Health Care Facilities.</p><p> Essay one, entitled The Effect of Certified Green Office Buildings on Occupant Heath: A Systematic Review and Meta-Analysis, explores the connections between certified green office buildings and their impacts on occupant health via the application of a systematic review and meta-analysis. An extensive literature search was conducted to locate any studies that examined the health of occupants in conventional buildings versus the health of the same populations after a move into a certified green building. The literature review followed the Cochrane Collaboration protocol for conducting systematic reviews. The results of a meta-analysis of the two studies uncovered by the systematic review show a positive relationship between certified green office buildings and improved occupant health (SMD 1.09), yet there was insufficient power (CI -0.88, 3.05) to prove causality.</p><p> Essay two, entitled Understanding Evidence-Based Design Through a Review of the Literature, relates the current understanding of the concept of Evidence-Based Design (EBD), as specifically related to health care facilities, through the vehicle of an annotated bibliography of the relevant literature. EBD lacks a universally agreed upon definition, but one of the stronger definitions from the architecture discipline states that evidence-based design is a process for the conscientious, explicit, and judicious use of current best evidence from research and practice in making critical decisions, together with an informed client, about the design of each individual and unique project. The outcomes of primary concern with health care facilities tend to fall into three categories&mdash;patient/family outcomes, staff outcomes and fiscal outcomes.</p><p> The thirty-one annotated articles reveal that the concept of EBD is quite complex, especially as it relates to the gathering and assessment of data and how such data is used to inform the building project. The bulk of the complexity lies with the word `evidence.' The current literature suggests disparity among researchers and practitioners over the collection, assessment and incorporation of evidence related to the collection, analysis and incorporation of evidence into building projects that seek to have a positive impact on the three main outcome categories of interest in healthcare facilities&mdash;patient outcomes, staff outcomes and fiscal outcomes.</p><p> Essay three, entitled Future Directions for Evidence-Based Design in Health Care Facilities, anticipates the future of evidence-based design as related to the design and construction of health care facilities. Reimbursement policies are driving health care to include more community based and customer services oriented delivery models. Pay based on performance&mdash;quality and efficiency of health care delivered&mdash;as well as customer satisfaction are taking on new importance and will drive designers of health care facilities to develop ever new methodologies for gathering and assessing evidence.</p>

In recent years there has been a resurgence of interest in the use of arts, humanities and media-based approaches to teaching students in medicine, health, and social care-related disciplines. Here, it is widely assumed that 'the arts' are an undifferentiated force for good which will humanise curricula dominated by medical and scientific perspectives. Such approaches tend, however, to be implemented in something of a theoretical vacuum with little consideration of critical perspectives derived from cultural studies. 'Cinemeducation' is a term recently coined for the use of mainstream films which touch on particular medical conditions or 'disorders' in the education of medical students (Alexander et al, eds 2005). What is overlooked by advocates of this approach is that such films often perpetuate stereotypical views of the nature and causes of physical and emotional ill-being, and collude in their medicalisation. Scriptwriters and directors may also give in to the temptation to sensationalise or misrepresent conditions because this makes for box office success. Finally, there are subtleties related to denotation and connotation in film which mean that little can straightforwardly be assumed about educational outcomes. This presentation will draw on a study of both independent and mainstream films related to memory loss and cognitive impairment in the context of my own teaching in dementia studies, and will include clips from source material. Drawing on Ricoeur's concept of the hermeneutics of suspicion I seek to introduce a note of caution to the current 'arts and health' agenda.

This descriptive ethno-theatre case study explored the impact of intergenerational engagement through a reminiscence theatre arts initiative on the psychosocial quality of life for older adults with mild to moderate cognitive decline. Study participants were comprised of 11 adults 65 years and older residing in a dementia-specific residential care facility unit, and 13 University of Victoria Theatre students. Both qualitative and quantitative procedures were integrated into the case study. Qualitative processes consisted of older adult life history interview transcriptions, ethno-theatre field notes of theatre devising and performance processes, and post-program drama evaluations. Quantitative measures included pre- and post-administered instruments: CASP-19; Alzheimer’s Disease-related Quality of Life (ADRQL) – Revised; and older adult health perception surveys. Overall, it appears from the data that active engagement in reminiscence theatre (the process of creating and performing theatre from real life memories and stories) results in a positive impact on older adults’ well-being – increased self-esteem, elevated mood and social engagement, decreased isolation and boredom, and desire to continue with activities. This study’s findings suggest that the integration of reminiscence arts initiatives into residential care plans for older adults with mild to moderate cognitive impairment can substantially enhance psychosocial quality of life. These findings are consistent with reminiscence and life review theory in that intergenerational engagement in these processes promotes healthy aging. This study demonstrated that intergenerational connection between young and older adults through drama and storytelling activities occurred. The creative reciprocal initiatives of reminiscence arts in turn fostered a context for social and emotional engagement that appeared to reduce older adults’ isolation. / Graduate