HERD Research Papers - Academia.edu (original) (raw)

During 1997–1999, 32 Woodland Caribou (Rangifer tarandus caribou) were translocated from the Sustut Herd to the Telkwa Mountains in westcentral British Columbia to augment recovery of the Telkwa Caribou Herd. The animals were fitted with... more

During 1997–1999, 32 Woodland Caribou (Rangifer tarandus caribou) were translocated from the Sustut Herd to the Telkwa Mountains in westcentral British Columbia to augment recovery of the Telkwa Caribou Herd. The animals were fitted with radiocollars and located during 1997–2000 to determine selection of habitat features and terrain variables. Six Caribou calves were also collared to determine causes and timing of calf mortality during summer 1999. Defining available habitat for newly translocated animals is often arbitrary and subjective, and we based the analyses on ranks for habitat use and availability as this is less sensitive to the inclusion or exclusion of a questionable resource. This method represents some loss of information but provides indications of the relative importance of various habitat types without classifying any as avoided. High elevation habitat (> 1700 masl) on moderate slopes (16 – 45°) received the highest ranks, as did “warm” (136 – 315°) aspects and f...

Bovine besnoitiosis, caused by the apicomplexan parasite Besnoitia besnoiti is considered an emergent disease in Europe. This study aimed to determine the prevalence and geographic distribution of B. besnoiti in cattle herds in... more

Bovine besnoitiosis, caused by the apicomplexan parasite Besnoitia besnoiti is considered an emergent disease in Europe. This study aimed to determine the prevalence and geographic distribution of B. besnoiti in cattle herds in continental Portugal and to identify potential spatial clustering of infection. A stratified two-stage cross-sectional serological survey was carried out between March 2012 and May 2013 with the five administrative NUTS II regions, Norte, Centro, Lisboa, Alentejo, and Algarve, as the stratification level. Sera from 391 herds in 220 parishes and 83 municipalities were analyzed by a serial testing strategy, with the modified agglutination test (B-MAT) as the first screening assay and the immunofluorescent antibody test (IFAT) as the confirmatory test. Within-herd prevalence of positive herds varied between 0.7 and 72.4% and was ≥10.3% in half of the infected herds. Using a Bayesian approach, the true prevalence of B. besnoiti in cattle herds was determined to be 5.1% (confidence interval (CI), 3.1-7.8%) and the mean within-herd prevalence of positive herds was 33.0% (CI, 20.3-46.0%). The sensitivity and specificity of the B-MAT were estimated to be 96.9% (CI, 93.7-98.8 %) and 99.7% (CI, 99.6-99.8%), whereas those of the IFAT were 89.6% (CI, 86.0-92.5%) and 99.7% (CI, 98.5-99.9%), respectively. Spatial scan statistics analysis identified one spatial cluster covering the majority of the Alentejo region. Seropositive herds were detected for the first time outside Alentejo, in the region Centro and in the northeast of Portugal. Further epidemiological research is needed to identify eco-biological factors, which could explain the geographic clustering of B. besnoiti in Portugal.

This article outlines preliminary findings of a 3-year project that explored on-site food production on institutional properties, primarily healthcare facilities. There are growing pressures on healthcare facilities to improve their food... more

This article outlines preliminary findings of a 3-year project that explored on-site food production on institutional properties, primarily healthcare facilities. There are growing pressures on healthcare facilities to improve their food offerings and incorporate food gardens into their health programs. While several healthcare facilities produce food on-site, there are few studies that explore opportunities, capacities, and institutional barriers related to on-site food production. The study employed mixed methods including historical review, case studies, surveys, interviews, pilot garden projects, and Geographic Information System mapping. The number of participating institutions varied by method. Benefits associated with on-site food production can be health, economic, environmental, and social. There are also institutional barriers including administrative roadblocks, perceived obstacles, and the difficulty in quantitatively, measuring the qualitatively documented benefits. The...

Multisensory environments (MSEs) for people with dementia have been available over 20 years but are used in an ad hoc manner using an eclectic range of equipment. Care homes have endeavored to utilize this approach but have struggled to... more

Multisensory environments (MSEs) for people with dementia have been available over 20 years but are used in an ad hoc manner using an eclectic range of equipment. Care homes have endeavored to utilize this approach but have struggled to find a design and approach that works for this setting. Study aims were to appraise the evolving concept of MSEs from a user perspective, to study the aesthetic and functional qualities, to identify barriers to staff engagement with a sensory environment approach, and to identify design criteria to improve the potential of MSE for people with dementia. Data were collected from 16 care homes with experience of MSE using ethnographic methods, incorporating semi-structured interviews, and observations of MSE design. Analysis was undertaken using descriptive statistics and thematic analysis. Observations revealed equipment that predominantly stimulated vision and touch. Thematic analysis of the semi-structured interviews revealed six themes: not knowing ...

This paper seeks to analyze healthcare facility managers' perceptions regarding the materials used for interior wall finishes and the criteria used to select them. It also examines differences in wall finish materials and the... more

This paper seeks to analyze healthcare facility managers' perceptions regarding the materials used for interior wall finishes and the criteria used to select them. It also examines differences in wall finish materials and the selection process in three major hospital spaces: emergency, surgery, and in-patient units. These findings are compared with healthcare designers' perceptions on similar issues, as currently documented in the literature. Hospital design and the materials used for hospital construction have a considerable effect on the environment and health of patients. A 2002 survey revealed which characteristics healthcare facility designers consider when selecting materials for healthcare facilities; however, no similar study has examined the views of facility managers on building finish selection. A 22-question survey questionnaire was distributed to 210 facility managers of metropolitan, for-profit hospitals in Texas; IRB approval was obtained. Respondents were ask...

A bottom-up method for creating a hierarchy of Entity-Relationship diagrams (HERD) from a given, ‘‘flat’’ ER diagram (ERD) is proposed. The hierarchy consists of simple and interrelated diagrams - ER structures - with external... more

A bottom-up method for creating a hierarchy of Entity-Relationship diagrams (HERD) from a given, ‘‘flat’’ ER diagram (ERD) is proposed. The hierarchy consists of simple and interrelated diagrams - ER structures - with external relationships to other structures. The HERD-tree diagram, which provides the most general view of the conceptual schema, is located at the top of the hierarchy. The method is based on packaging operations, which group entities and relationships according to certain criteria. These operations are applied in several steps on a given (presumably largescale) ERD. We describe the new constructs, which are added to the ER model to enable the creation of HERD,and a bottom-up method for creating HERD. We also evaluate HERD from the point of view of user comprehension and preference, based on an experimental comparison to flat ERDs.

To present a comprehensive review of the research literature on the effects of the architectural designs of mental health facilities on the users.BACKGROUND: Using a team of cross-disciplinary researchers, this review builds upon previous... more

To present a comprehensive review of the research literature on the effects of the architectural designs of mental health facilities on the users.BACKGROUND: Using a team of cross-disciplinary researchers, this review builds upon previous reviews on general and geriatric healthcare design in order to focus on research undertaken for mental health care facility design.METHODS: Sources were gathered in 2010 and 2011. In 2010 a broad search was undertaken across health and architecture; in 2011, using keywords and 13 databases, researchers conducted a systematic search of peer reviewed literature addressing mental health care and architectural design published between 2005 to 2012, as well as a systematic search for academic theses for the period 2000 to 2012. Recurrent themes and subthemes were identified and numerical data that emerged from quantitative studies was tabulated.RESULTS: Key themes that emerged were nursing stations, light, therapeutic milieu, security, privacy, designin...

The purpose of this study was to determine the effect viewing directives can have when encountering art in hospitals. A secondary objective of the study was to understand the responses of viewers to an art exhibit on the theme of medical... more

The purpose of this study was to determine the effect viewing directives can have when encountering art in hospitals. A secondary objective of the study was to understand the responses of viewers to an art exhibit on the theme of medical student empathy toward patient pain and suffering. Displaying art in hospitals has been credited with increasing well-being of patients, visitors, and staff. Generally, hospital curators have focused on the type of art to display (natural, symbolic, and abstract). This focus has neglected the possibility that in addition to the type of art, the way that viewers engage art may also be responsible for the healing effect. Participants (n = 97) were randomly allocated into one of the viewing directives: (1) reflecting on one artwork, (2) creating a drawing or poem in response to one artwork, or (3) no direction. Prior to looking at the art and immediately after, participants were administered the Brief Mood Introspection Scale (BMIS) and offered an oppo...

Southern Norway holds the last remaining population of wild reindeer (Rangifer tarandus tarandus) in Europe. Roads, railroads, and power lines have fragmented the original population into 26 separate herds. The reindeer populations are... more

Southern Norway holds the last remaining population of wild reindeer (Rangifer tarandus tarandus) in Europe. Roads, railroads, and power lines have fragmented the original population into 26 separate herds. The reindeer populations are regulated directly according to availability of winter forage. These winter ranges, generally at lower elevations, are however, often subjected to development. Effects of infrastructure and associated human activity on the distribution of wild reindeer during winter were investigated in the Nordfjella mountain region of western Norway. Systematic aerial surveys of the distribution of ca. 2500 reindeer were conducted during late winter 1986–1998. Areas within 2.5 km from power lines were used less than available in 6 of the 8 sampling years, and areas beyond this zone more than expected. Density of reindeer was 79% lower within 2.5 km from power lines compared with background areas, and increased with increasing distance from infrastructure for comparable habitat. Available forage in terms of lichen cover declined 15–30-fold with distance, and was lowest in the undisturbed areas with the highest density of grazing animals. Areas within 5 km from resorts or from roads and power lines in combination were avoided in all years. Continued construction of roads, power lines and cabin resorts endanger these available winter ranges, and hence the long term survival of the population.

This paper addresses issues arising in the literature regarding the environmental design of inpatient healthcare settings and their impact on care. Environmental design in healthcare settings is an important feature of the holistic... more

This paper addresses issues arising in the literature regarding the environmental design of inpatient healthcare settings and their impact on care. Environmental design in healthcare settings is an important feature of the holistic delivery of healthcare. The environmental influence of the delivery of care is manifested by such things as lighting, proximity to bedside, technology, family involvement, and space. The need to respond rapidly in places such as emergency and intensive care can override space needs for family support. In some settings with aging buildings, the available space is no longer appropriate to the needs-for example, the need for privacy in emergency departments. Many aspects of care have changed over the last three decades and the environment of care appears not to have been adapted to contemporary healthcare requirements nor involved consumers in ascertaining environmental requirements. The issues found in the literature are addressed under five themes: the des...

Our review evaluated both the effects of single-occupancy patient rooms (SPRs) on patient outcomes for hospitalized adults and user opinion related to SPRs. In 2006, a requirement for SPRs in hospitals was instituted in the United States.... more

Our review evaluated both the effects of single-occupancy patient rooms (SPRs) on patient outcomes for hospitalized adults and user opinion related to SPRs. In 2006, a requirement for SPRs in hospitals was instituted in the United States. This systematic literature review evaluates research published since that time to evaluate the impact of SPRs. The review adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Databases searched included MEDLINE, CINAHL, and Scopus. Supplemental searches were performed. We included studies reporting patient outcomes or user opinion related to SPRs. Appraisal was conducted using a dual appraisal system of evidence levels and methodological quality. Forty-three studies qualified for appraisal. Three were excluded due to methodological quality (no appraisal score). One study was appraised for three individual outcomes (i.e., falls, infections, and user opinion). Eleven studies with low methodological quality scor...

This paper introduces a new design tool to increase efficiency in acute care settings. This visual tool facilitates matching spatial flow with caregivers' workflow to reduce waste and redundancies, as recommended by Lean thinking.... more

This paper introduces a new design tool to increase efficiency in acute care settings. This visual tool facilitates matching spatial flow with caregivers' workflow to reduce waste and redundancies, as recommended by Lean thinking. Providing work environments that protect caregivers from fatigue, interruptions, and redundancies can contribute to quality patient care. By studying the Guidelines for Design and Construction of Health Care Facilities and reviewing the literature, the authors identified the main clinical spaces supporting nursing care and their important linkages. Space syntax, a diagrammatic analysis of relationships, was used to decode spatial relationships among the clinical spaces in five case studies. The movement distributions were measured and possible conflicts with focus-demanding tasks, such as noise and interruptions, were identified. The information was summarized in a visual diagram providing the "syntactic anatomy" of the most important work sp...

Wild herbivore diversity and abundance have declined in African savannas for the past 20 years. Competition for forage resources between wild herbivore and livestock species might contribute to this decline, given habitat and diet overlap... more

Wild herbivore diversity and abundance have declined in African savannas for the past 20 years. Competition for forage resources between wild herbivore and livestock species might contribute to this decline, given habitat and diet overlap under conditions of resource ...

This is a translational science article that discusses copper alloys as antimicrobial environmental surfaces. Bacteria die when they come in contact with copper alloys in laboratory tests. Components made of copper alloys were also found... more

This is a translational science article that discusses copper alloys as antimicrobial environmental surfaces. Bacteria die when they come in contact with copper alloys in laboratory tests. Components made of copper alloys were also found to be efficacious in a clinical trial. There are indications that bacteria found on frequently touched environmental surfaces play a role in infection transmission. In laboratory testing, copper alloy samples were inoculated with bacteria. In clinical trials, the amount of live bacteria on the surfaces of hospital components made of copper alloys, as well as those made from standard materials, was measured. Finally, infection rates were tracked in the hospital rooms with the copper components and compared to those found in the rooms containing the standard components. Greater than a 99.9% reduction in live bacteria was realized in laboratory tests. In the clinical trials, an 83% reduction in bacteria was seen on the copper alloy components, when com...

Foot and mouth disease (FMD) is a highly transmissible viral infection of cloven hooved animals associated with severe economic losses when introduced into FMD-free countries. Information on the impact of the disease in FMDV-endemic... more

Foot and mouth disease (FMD) is a highly transmissible viral infection of cloven hooved animals associated with severe economic losses when introduced into FMD-free countries. Information on the impact of the disease in FMDV-endemic countries is poorly characterised yet essential for the prioritisation of scarce resources for disease control programmes. A FMD (virus serotype SAT2) outbreak on a large-scale dairy farm in Nakuru County, Kenya provided an opportunity to evaluate the impact of FMD on clinical mastitis and culling rate. A cohort approach followed animals over a 12-month period after the commencement of the outbreak. For culling, all animals were included; for mastitis, those over 18 months of age. FMD was recorded in 400/644 cattle over a 29-day period. During the follow-up period 76 animals were culled or died whilst in the over 18 month old cohort 63 developed clinical mastitis. Hazard ratios (HR) were generated using Cox regression accounting for non-proportional haza...

Effects of maternal lineage on yield traits were examined by using animal models. Data were 6054 multiparous records of 2264 cows from six herds in North Carolina and the breeding herd of Iowa State University. Separate analyses were... more

Effects of maternal lineage on yield traits were examined by using animal models. Data were 6054 multiparous records of 2264 cows from six herds in North Carolina and the breeding herd of Iowa State University. Separate analyses were performed by using first lactation records from North Carolina, all records from North Carolina, and pooled records from North Carolina and Iowa. Traits were mature equivalent yields of milk, fat, and protein; percentages of fat and protein; and milk energy concentration and yield. Cattle were assigned to maternal lineages on the basis of the earliest female ancestor recorded. Fixed effects in the models were herd-year-season, parity, and maternal lineage; random effects were animal, permanent environment, and residual. All additive genetic relationships were considered. For all analyses, maternal lineage was associated with significant differences in fat percentage and milk energy concentration. Differences between maternal lineages for yield traits were not significant. Variance components were also obtained with REML using the same data and models, but with lineage as a random effect. Based on records pooled from Iowa and North Carolina, maternal lineage accounted for 2.7% of the variance in fat percentage. Otherwise, < 1.2% of the variance of any trait was associated with maternal lineage.

Evolutionary and emotional congruence theoretical perspectives support the use of certain types of artwork to reduce stress and promote improved outcomes in healthcare settings. This paper explores the artwork of three artists whose work... more

Evolutionary and emotional congruence theoretical perspectives support the use of certain types of artwork to reduce stress and promote improved outcomes in healthcare settings. This paper explores the artwork of three artists whose work falls outside the traditional representational art supported by these theoretical perspectives. The concept of curiosity as a common thread is proposed as the underlying theory in an effort to explain the success of such work in achieving positive outcomes for patients, families, and staff. Other concepts are explored as contributing theoretical frameworks. Research is needed to determine the impact of this emerging type of artwork and the implications of findings for individuals who create—as well as for those who select—art for healthcare settings.

Objectives: The aim of this study is to gain a deeper understanding of the experiences of visually impaired older people living independently at home. Background: As populations are aging globally, there is now an increase in the... more

Objectives: The aim of this study is to gain a deeper understanding of the experiences of visually impaired older people living independently at home. Background: As populations are aging globally, there is now an increase in the prevalence of visual impairment. That means for ongoing and future aging-in-place strategies that seek to enable older people to remain independent for longer, more attention needs to be given to the needs of those with visual impairment. As people develop visual impairment, they use adaptive strategies including modifying long-term homes or relocating to more suitable accommodation. In the United Kingdom, aging-in-place strategies include employing statutory lifetime home standards (LTHS) in the home or relocating to sheltered housing to live independently with support available if required. Methods: To get a better understanding of the needs of the visually impaired in the home, 12 interviews with six visually impaired occupants of LTHS homes and six from...

Eradication of tuberculosis (TB) in cattle is a priority in the EU. However, and despite the resources invested, TB eradication is still a goal yet to be accomplished. As a consequence, the identification of risk factors contributing to... more

Eradication of tuberculosis (TB) in cattle is a priority in the EU. However, and despite the resources invested, TB eradication is still a goal yet to be accomplished. As a consequence, the identification of risk factors contributing to TB transmission and persistence is key to a better understand and, ultimately, more cost-effectively control and eradicate this complex zoonotic disease worldwide. This study aimed to identify the factors contributing to the TB occurrence, new infection, and persistence in one of the most TB-prevalent regions in the South-Central part of Spain (SCS), Ciudad Real (CR), and for which high quality and detailed information on cattle and wild ungulate demographics, management, and sanitary status was available for up to 5 years (2007-2011). Multilevel logistic modeling was used for this purpose. Results of this study revealed that the risk for TB (occurrence, new infection, and/or persistence) in cattle herds from CR is related to TB-persistence on farm in previous years, extensive production systems (beef and bullfighting being more risky that dairy) and large farm in terms of cattle number. Also, the presence and proximity of fenced hunting estates (which are usually intensively managed) significantly contributed to the risk of TB occurrence and persistence in CR. This association suggests that wild ungulates may play a role as TB-reservoirs and transmit TB to cattle in the CR, a region where TB is endemic and is associated with extensive farming of beef cattle. To the best of author's knowledge this is the first study to (i) evaluate the wild ungulate-domestic interface at a farm level using detailed information over an extensive region and period of time (2007-2011) and (ii) to identify a direct association between TB in cattle and the proximity and management practices of wild ungulates. Methods and results presented here may support policies to better prevent and control TB in the SCS and in other regions/countries with similar epidemiological conditions.

Background: Patients in intensive care units (ICUs) are among the most vulnerable, and they require support to start their recovery. The design of the patient area in the ICU can play a prominent role in both the quality of care and... more

Background: Patients in intensive care units (ICUs) are among the most vulnerable, and they require support to start their recovery. The design of the patient area in the ICU can play a prominent role in both the quality of care and patients’ recovery. The lighting environment has the opportunity to restore and strengthen the natural human circadian rhythm and health. Aim: To evaluate patients’ self-reported recovery after being cared for in an ICU room rebuilt according to evidence-based design principles that promote recovery. Method: An intervention was set up in a two-bed patient room including a cycled lighting system. Self-reported recovery was reported at 6 and 12 months after discharge. Data were analyzed using a 2(mechanically ventilated, nonmechanically ventilated) × 2(intervention room, ordinary room) analysis of covariance (ANCOVA) and 2(male, women) × 2(intervention room, ordinary room) ANCOVA. Results: Data from the different rooms showed no significant main effects fo...

To investigate the physiological and psychological effects of windows and daylight on registered nurses. To date, evidence has indicated that appropriate environmental lighting with characteristics similar to natural light can improve... more

To investigate the physiological and psychological effects of windows and daylight on registered nurses. To date, evidence has indicated that appropriate environmental lighting with characteristics similar to natural light can improve mood, alertness, and performance. The restorative effects of windows also have been documented. Hospital workspaces generally lack windows and daylight, and the impact of the lack of windows and daylight on healthcare employees' well being has not been thoroughly investigated. Data were collected using multiple methods with a quasi-experimental approach (i.e., biological measurements, behavioral mapping, and analysis of archival data) in an acute-care nursing unit with two wards that have similar environmental and organizational conditions, and similar patient populations and acuity, but different availability of windows in the nursing stations. Findings indicated that blood pressure (p < 0.0001) decreased and body temperature increased (p = 0.0...

Salmonella carriage in pigs represents a serious health problem that undoubtedly contributes to the spread of human disease. Thus, the efficient and reliable testing of farm animals for bacteria such as Salmonella is an important aspect... more

Salmonella carriage in pigs represents a serious health problem that undoubtedly contributes to the spread of human disease. Thus, the efficient and reliable testing of farm animals for bacteria such as Salmonella is an important aspect of any efficient control strategy. Serological analysis of 15 meat juice samples detected antibodies against Salmonella in some. but not all, of the animals identified bacteriologically as harboring the pathogen, indicating a lack of correlation between the bacteriological and serological methods used for Salmonella detection. The results suggest that testing by enzyme-linked immunosorbent assay is appropriate at the herd level, with culture methods preferable for individual animal analysis. A novel culture protocol detected Salmonella in the cecal contents of 15 pigs, whereas a method based on the European Standard identified only 9 pigs as being Salmonella-positive. During the study, an unusual finding was the relatively high incidence of Salmonell...

The current study aims to assess the breeding system, the herd structure of the cattle farm and the climate changes in the municipality of Banikoara. It appears that the majority of farmers was from Fulani ethnic group, of 46 years old... more

The current study aims to assess the breeding system, the herd structure of the cattle farm and the climate changes in the municipality of Banikoara. It appears that the majority of farmers was from Fulani ethnic group, of 46 years old and married. Livestock farming was their main activity. The main crops produced included maize, sorghum, millet and cotton. The reared animal species were composed of cattle, goats, sheep, pigs, chickens and guinea fowl with the predominance of chicken (p <0.05) . The exploited cattle breeds were Borgou, Somba Zebu Peulh, Barougoudji, Bororo, Kiwali and Ketegui with a predominance of the cattle Borgou (p <0.001). The cattle breeding systems were of traditional type. The reported age at first calving varies between 2.5 and 4 years. The calving interval fluctuates between 8 and 13 months. The best daily milk production per cow was reported in the district of 5 (8.38 liters) and lowest yields was obtained in districts 1 (p <0.05). The longevity ...

Objectives: To identify patient needs and expectations that can be utilized to inform the design or renovation of medical–surgical patient rooms in a hospital. Background: There is an increased interest in supportive room design to... more

Objectives: To identify patient needs and expectations that can be utilized to inform the design or renovation of medical–surgical patient rooms in a hospital. Background: There is an increased interest in supportive room design to increase patient satisfaction and improve the healing process. Methods: Patients’ and family caregivers’ reactions were elicited to intentional room elements embedded in a set of five full-scale simulated room prototypes. Small groups of patients and caregivers toured two of the five rooms and provided verbal and written evaluations of room features. A grounded theory approach was employed to generate a codebook, identify the frequency of codes, and to group codes and memos into emerging themes. Insights from emergent themes were compared with findings from written surveys on the importance of various room design elements completed at the beginning of each session. Results: A theoretical design framework was generated, showing patients expect a hospital r...

The aim of this study was to compare different scenarios for bull dam selection in a nucleus herd. A deterministic simulation study using selection index methodology was undertaken. In the scenarios studied, differing amounts of... more

The aim of this study was to compare different scenarios for bull dam selection in a nucleus herd. A deterministic simulation study using selection index methodology was undertaken. In the scenarios studied, differing amounts of information on functional traits were available when bull dams were selected, and the resulting genetic responses in these traits were compared. Field-recorded fertility traits used in the scenarios were available as progeny test results of artificial insemination bulls: these included pregnant at first insemination (PFI), interval between calving and first insemination (CFI), and cases of reproductive disorders (RD). Similarly, field-recorded cases of clinical mastitis (CM), lactation somatic cell score (LSCS), and protein yield (PY) were included for pedigree selection. In the scenarios, heat intensity score and progesterone levels were treated as new indicator traits of fertility recorded in the nucleus herd. Traits CFI and LSCS were assumed to be better ...

To investigate the physiological and psychological effects of windows and daylight on registered nurses. To date, evidence has indicated that appropriate environmental lighting with characteristics similar to natural light can improve... more

To investigate the physiological and psychological effects of windows and daylight on registered nurses. To date, evidence has indicated that appropriate environmental lighting with characteristics similar to natural light can improve mood, alertness, and performance. The restorative effects of windows also have been documented. Hospital workspaces generally lack windows and daylight, and the impact of the lack of windows and daylight on healthcare employees' well being has not been thoroughly investigated. Data were collected using multiple methods with a quasi-experimental approach (i.e., biological measurements, behavioral mapping, and analysis of archival data) in an acute-care nursing unit with two wards that have similar environmental and organizational conditions, and similar patient populations and acuity, but different availability of windows in the nursing stations. Findings indicated that blood pressure (p < 0.0001) decreased and body temperature increased (p = 0.0...

There is a need for greater understanding of the health impact of various design elements in neonatal intensive care units (NICUs) as well as cost-benefit information to make informed decisions about the long-term value of design... more

There is a need for greater understanding of the health impact of various design elements in neonatal intensive care units (NICUs) as well as cost-benefit information to make informed decisions about the long-term value of design decisions. This is particularly evident when design teams are considering the transition from open-bay NICUs to single-family-room (SFR) units. This paper introduces the guiding principles behind target value design (TVD)-a price-led design methodology that is gaining acceptance in healthcare facility design within the Lean construction methodology. The paper also discusses the role that set-based design plays in TVD and its application to NICUs.