The trend towards patient-and family-centered care (PFCC) invites families of critically ill patients to participate more fully in the care and recovery of their loved ones through partnerships with the medical team and personalized care that respects the values, beliefs and experiences of the individual. In response to the growing needs of families, healthcare institutions are re-designing the way patient and family care is delivered in terms of policy, culture and the physical environment. Despite the many benefits that come with closer collaboration, nurses report that "challenging" families are a key source of workplace stress. This exploratory case study documents some of these challenges as perceived by staff nurses at Emory University Hospital's Neuro ICU while examining the role the built environment plays in shaping such perceptions. Through a series of ethnographic interviews and observational methodologies, the study identifies some of the challenges and benefits that come with balancing patient and family needs. Nurse strategies developed to reassert spatial and temporal control over work environments are also identified. The second phase of research compares communication patterns generated from two different ICUs to explore the link between unit design and the frequency and quality of nurse-family interactions. Findings suggest that space plays a role in moderating the degree of nurse exposure to the often unstructured and unpredictable aspects of family interactions. These encounters, set within a highly charged critical care setting, may contribute to these perceived challenges. Healthcare stands at an important moment of transition in which attitudes, behaviors and expectations are changing. Together these results reinforce the need for adequate tools, training and education to further support nurses in the transition to this new care culture.

The aim of this study was to investigate and analyze what is required for the environmental quality objective Good built environment to be fulfilled by 2020 in the Swedish county Jämtland. The focus of the study was to gain an understanding of the work that the local government does and further investigate the problems that the officials face with implement these questions in themunicipal planning. The study is based on semi structured interviews with officials in the municipalities of Jämtland county. General plan and programs for the municipality have been reviewed, based on how the plans highlights these issues linked to sustainability and Good built environment. The results of the study show that there are major problems with the formulations of the environmental quality goal in itself and its specifications. The environmental quality goal is formulated to suit the entire Sweden. But as it turns out in the analysis it does not work on the basis of the conditions inJämtland with sparsely populated areas and scattered dwellings. The environmental quality goal needs to be formulated after the conditions that the county has to be measured and fulfilled by 2020. The officials agreed that a regional vision is needed, adapted to Jämtland conditions.

In the first part of this thesis, GPS data for a year's worth of travel by 255 Seattle households is used to illuminate how plug-in electric vehicles (PEVs) can match household needs. Data from all vehicles in each of these households were analyzed at a disaggregate level primarily to determine whether each household would be able to adopt various types of PEVs without significant issues in meeting travel needs. The results suggest that a battery-electric vehicle (BEV) with 100 miles of all-electric range (AER) should meet the needs of 50% of Seattle's one-vehicle households and the needs of 80% of the multiple-vehicle households, when households charge just once a day and rely on another vehicle or mode just 4 days a year. Moreover, the average one-vehicle Seattle household uses each vehicle 23 miles per day and should be able to electrify close to 80% of its miles, while meeting all its travel needs, using a plug-in hybrid electric vehicle with 40-mile all-electric-range (PHEV40). Households owning two or more vehicles can electrify 50 to 70% of their total household miles using a PHEV40, depending on how they assign the vehicle across drivers each day. Cost comparisons between the average single-vehicle household owning a Chevrolet Cruze versus a Volt PHEV suggest that, when gas prices are $3.50 per gallon and electricity rates are 11.2 ct per kWh, the Volt will save the household $535 per year in energy/fuel costs. Similarly, the Toyota Prius PHEV will provide an annual savings of $538 per year over the Corolla. The results developed in this research provide valuable insights into the role of AER on PEV adoption feasibility and operating cost differences. The second part of this thesis uses detailed travel data from the Seattle metropolitan area to evaluate the effects of built-environment variables on the use of non-motorized (bike + walk) modes of transport. Several model specifications are used to understand and explain non-motorized travel behavior in terms of household, person and built-environment variables. Land-use measures like land-use mix, density, and accessibility indices were also created and incorporated as covariates to appreciate their marginal effects. The models include a count model for household vehicle ownership levels, a binary choice model for the decision to stay within versus departing one's origin zone (i.e., intra- versus inter-zonal trip-making), discrete choice models for destination choices and mode choices, and a zero-inflated negative binomial model for non-motorized trip counts per household. The mode and destination choice models were estimated separately for interzonal and intrazonal trips and for each of three different trip types (home-based work, home-based non-work, and non-home-based), to recognize the distinct behaviors at play when making shorter versus longer trips and different types of trips. This comprehensive set of models highlights how built-environment variables -- like the number and type of intersections present around one's origin and destination, the number of bus stops available within a certain radius, household and jobs densities, parking prices, land use mixing, and walk-based accessibility -- can significantly shape the pattern of one's non-motorized movement. The results underscore the importance of street connectivity (quantified as the number of 3-way and 4-way intersections in a half-mile radius), higher bus stop density, and greater non-motorized access in promoting lower vehicle ownership levels (after controlling for household size, income, neighborhood density and so forth), higher rates of non-motorized trip generation (per day), and higher likelihoods of non-motorized mode choices. Destination choices are also important for mode choices, and local trips lend themselves to more non-motorized options than more distance trips. Intrazonal trip likelihoods rose with higher street connectivity, transit availability, and land use mixing. For example, the results suggest that an increase in the land-use mix index by 10% would increase the probability of choosing to travel within the zone by 12%. As expected destinations with greater population and job numbers (attraction), located closer (to a trip's origin), offering lower parking prices and greater transit availability, were more popular. Interestingly, those with more dead ends (or cul de sacs) attracted fewer trips. Among all built environment variables tested, street structure offered the greatest predictive benefits, alongside jobs and population (densities and counts). For example, a 1-percent increase in the average number of 4-way intersections within a quarter-mile radius of the sampled households is estimated to increase the average household's non-motorized trip generation by 0.36%. A one-standard-deviation increase in the (mean) number of 4-way intersections at the average trip origin is estimated to increase the probabilities of bike and walk modes for interzonal home-based-work trips by 57% and 30%, respectively. In contrast, increasing the number of dead-ends at the origin by one standard deviation is estimated to decrease the probability of biking for both home-based-work and non-work trips by ~30%. These results underscore the importance of network density and connectivity for promoting non-motorized activity. The regional non-motorized travel (NMT) accessibility index ( derived from the logsum of a destination choice model) also offers strong predictive value, with NMT counts rising by by 7% following a 1% increase in this variable -- if the drive alone accessibility index is held constant (along with all other variables, evaluated at their means). Similarly, household vehicle ownership is expected to fall by 0.36% with each percentage point increase in the NMT accessibility index, and walk probabilities rise by 26.9% following a one standard deviation increase in this index at the destination zone. A traveler's socio-economic attributes also have important impacts on NMT choices, with demographics typically serving as much stronger predictors of NMT choices than the built environment. For example, the elasticity of NMT trip generation with respect to a household's vehicle ownership count is estimated to be -0.52. Males and tose with drivers licenses are estimated to have 17% and 39% lower probabilities, respectively, of staying within their origin zone, relative to women and unlicensed adults (ceteris paribus). Non-motorized model choices also exhibit strong sensitivity to age and gender settings. Several of the regional variables developed in this work, and then used in the predictive models, are highly correlated. For example, bus stop and intersection densities are very high in job- and population-dense areas. For example, the correlation co-efficients between the bus stop density and 4-way intersection density is 0.805, between NMT and SOV AIs is 0.830 and between 4-way intersection density and NMT AI is 0.627. As a result, many variables are proxying for and/or competing with each other, as is common in models with many land use covariates, and it is difficult to quantify the exact impact of each of these variables. Nonetheless the models developed here provide valuable insight into the role of several new variables on non-motorized travel choices. Some final case study applications, moving all households to the downtown area (that has high accessibility indices and density), illustrate to what extent these revealed-data-based models will predict shifts toward and away from non-motorized trip-making. It appears that average household vehicle ownership level reduces to 0.57 from 1.89 (a 70% reduction) and average two-day NMT trip generation increases to 5.92 from 0.83 (an increase of more than 6 times). Such ranges are valuable to have in mind, when communities seek to reduce reliance on motorized travel by defining new built-environment contexts. / text

The aim of this work is to understand how certain public buildings play an essential role in the evolution of cultural identity over time. Its main approach distinguishes the denotation of tangible heritage from the connotation of its intangible counterpart. These terms are not understood through semiotics, but, through phenomenology. In other words, meaning is not transmitted by an object; it is adjudicated by a subject. In this sense, the phenomenological experience of such buildings is divided in two: perception brings forth an initial denotation of some universal validity; while memories and dreams engender connotations that are rooted in specific spatiotemporal conditions. In this model, denotation stems from the tangible aspects of heritage, while connotation grows from its intangible dimension. To examine the interaction of these components over time, three case studies are surveyed: Rome's Pantheon, Teotihuacan's Sun Pyramid, and Granada's Alhambra. Their examination begins with an analysis of their basic, primordial denotation, as "centers of power." This type of analysis is followed by a condensed history, which identifies the physical transformations that each building experienced over time. Lastly, a series of context companions present a horizon of expectations, from which multiple users at a given time may have received inspiration to elaborate different connotations of meaning. These sections are portrayed as "glimpses" of intellectual history and literary criticism. Their approach is mostly driven by Wilhelm Dilthey's theory of worldviews and Hans Robert Jauss's reception theory. Each case study suggests a different characterization of an overall historical outcome, associated with the cultural evolution of specific groups: the Pantheon reflects some sense of continuity, for Western Civilization; the Sun Pyramid conveys an overwhelming sense of loss, for Mesoamerica; and Alhambra displays a pervasive sense of exclusion, for al-Andalus. The spirit behind these characterizations strives to understand the modalities in which heritage and cultural identity are shaped by the passage of time. Its goal is to increase our awareness about the fragility of the intangible heritage, when it is separated from its tangible substrate. / text

European modernist architectural design and urban planning for suburbs have often been theorized as dystopic creation myths. These narratives focus on the unfulfilled promises of activist designers to deliver equality, overscaled and generic neighborhoods, and contemporary social exclusion. Södertälje offers another view. This dissertation combines history, ethnography, and formal analysis to examine how architects, urban planners, and immigrant residents conflict and collaborate in the production of the city. The Swedish town of Södertälje serves as a lens through which to view these processes: it is both a nexus of high modernist spatial and social planning and the ostensible capital of the diasporic Syriac Christians, who now comprise approximately 26% of the local population. Postwar Swedish designers sought to reduce class differences through home standardization and a blurred public-private divide; this happened just as the country received numerous refugees, including Syriacs, who had left difficult conditions in Turkey, Syria, and Lebanon and quickly concentrated in Södertälje. There, they became active designers of a new urban landscape, first claiming welfare state public spaces but then slightly altering their uses. This suggests that “generic” modernist urbanism was more successful at accommodating difference than has typically been argued. More recently, Syriacs have built a state-of-the-art soccer stadium and colossal churches that – while sited in industrial zones in Södertälje – function as monuments and pilgrimage sites for the diaspora. In new, Syriac-dominated neighborhoods of custom-designed, single-family houses, Syriac participation has exceeded the “voice” that planners typically allocate to immigrants; their architectural displays of difference and affluent forms of segregation generate anxieties for planners trained in the welfare state’s traditions, which have long linked spatial uniformity to social equality. In aggregate, the Syriacs’ discrete projects have changed the way that the city functions, both in space and in the practices of the town’s expert designers, a development that I label “urban design from below.” This justifies a call for new orientations toward modernism, segregation, and participation in space making and suggests future trends for other European peripheries, where immigrants are also using and reconstructing postwar housing projects.

"Urban Legends: The South Bronx in Representation and Ruin" examines the construction of the South Bronx in the American imagination during the 1970s and 1980s--a time when the South Bronx was synonymous with the failures of urbanism. The project attempts a multidisciplinary excavation of the cultural manifestations of urban ruin as articulated through the histories, literatures, and visual arts produced within and inspired by the ruins of the Bronx. The dissertation contends that Bronx ruins offered a site for visual artists, writers, and photographers to create new ways of understanding the production and perception of urban environments, while shaping the forms and styles that these creations took. The project theorizes the emergence and legacy of these forms alongside what it terms "municipal art": public works of city governmental bodies which, themselves, responded to ruin, and that might also be read as art. The dissertation's first part places the building cuts of the artist Gordon Matta-Clark in dialogue with the trompe l'oeil window decals of New York's "Occupied Look" program. It argues, on one hand, that Matta-Clark's artworks employ the tactics and effects of trompe l'oeil, and, on the other, that the seemingly failed "Occupied Look" project presents, upon close examination, vastly more interesting questions about temporality, duration, stasis within the built environment. The dissertation's second part views 1980s New York City Department of Finance tax assessment photographs within and against documentary and conceptual art contexts to reveal aesthetic debts owed by photographers and artists to "administrative" or systematic modes. The dissertation argues that these tax photos, despite their empirical intention, are inevitably productive of narrative, and demand an empathetic model of viewership that gestures at historic ruin-gazing while puncturing mythological understandings of urban ruin. The dissertation's third part examines how the popular fiction of Tom Wolfe and Don DeLillo imagined the Bronx built environment. The dissertation argues that the infrastructures that animate these portions of their fiction--abhorred in one and celebrated in the other--bind the South Bronx to city, making it less an alienated nowhere than one that is intimately tied to the world around it.

The Atlanta BeltLine is an innovative redevelopment project re-shaping Atlanta residents’ access to, multi-use trails, parks, public transportation, housing and employment opportunities. The primary purpose of this project was to develop a research proposal to study and analyze the health benefits associated with multi-use trails within BeltLine communities. A secondary purpose of this project was to evaluate the multi-sectoral and multi-institutional partnership that was formed to develop the research proposal and study the influence of the BeltLine on health outcomes. In August 2010 representatives from the Centers for Disease Control and Prevention, Emory University, Georgia Institute of Technology, Georgia State University, the Atlanta BeltLine Inc. and the Atlanta BeltLine Partnership formed the BeltLine Health Proposal Committee. Two online surveys using Survey Monkey were conducted to evaluate how this committee was operating, if roles and responsibilities were clear and to determine if this committee was an effective mechanism to integrate health and the built environment. Findings from the survey indicated that committee members believed this group was a unique partnership comprised of dedicated professionals sharing a common interest. Survey findings indicated there were several challenges that needed attention including improving communication, resolving competing interests, and identifying a lead organization. Findings from this evaluation can help resolve these issues and help the committee transition into a Health Advisory Group. The Health Advisory Group will serve as formal body that will review research proposals, conduct research, leverage funding and disseminate key health findings related to the BeltLine.

Safe Routes to School is a national program funded by the Department of Transportation. The goal of the program is to increase children’s active transport to and from school, primarily by walking, in response to the epidemic of childhood obesity. Implementation at the state and local level has had varying success. In my capstone presentation, I discuss the creation, implementation, and ongoing success of the program at Oak Grove Elementary, a local public school in Georgia. The program is comprised of the 5 Es: Education, Encouragement, Enforcement, Engineering, and Evaluation. Each of these five components will be focused on, as well as ongoing challenges in the struggle to retrofit a school to make it more walker-friendly in a car-dependent environment.

From 2000 to 2007, the five core county area of Metropolitan Atlanta (Fulton, Dekalb, Clayton, Cobb and Gwinnett) experienced 1,871 incidents involving child pedestrians. Nearly one-third of these incidents occurred during school-commuting hours. This study examines the geospatial locations of these incidents, with regards to the location of all 647 public schools within the study area. A GIS is used to analyze the spatiotemporal arrangement of these incidents in order to find risk factors and patterns in the data. Aspects of the built environment are then considered in areas with higher frequencies of child pedestrian-vehicle incidents. A walkability assessment is conducted to assess risk factors involved in the increased incident frequencies in an area of Stone Mountain. A correlation with the location of parks, recreation centers and other destinations are found. Improvements and installation of crosswalks are suggested in order to improve safety and walkability of child pedestrians in these areas.

Wide health gaps exist between Canada’s Inuit population and their non-Indigenous counterparts in nearly all categories. Two basic public health protection principles in any community worldwide are access to safe drinking water and sanitary wastewater management. The purpose of this research was to explore the relationships between public health and municipal water and wastewater systems in Coral Harbour, Nunavut. Using a qualitative case study approach, I conducted 37 interviews with residents and key informants and thematically analyzed the data. Findings suggest that crowded households experiencing domestic water shortages may result in negative health consequences. As well, pre and early settlement water customs are influencing current public health risks thereby requiring special consideration by municipal planners. Given these findings, recommendations include increasing domestic water access, strengthening source water monitoring programs, and establishing intergovernmental public health policies that co-benefit water resource management agendas as well as other priority issues in Nunavut.