The main building of the former Helsinki University of Technology (TKK) designed by Alvar Aalto is part of the cultural heritage in Finland. The building underwent a major renovation in 2011-2015 and has now become an awarded Undergraduate Centre for the modern interdisciplinary education of Aalto University. This paper presents how the architectural masterpiece from the 1960's was renovated and updated into a modern and accessible university building. Particular attention was paid for entering the building by wheelchairs, prams and pushchairs. The successful renovation was awarded in 2015 by the 'Esteetön Suomi -palkinto' (Accessible Finland Award), given every two years as a mark of recognition to activities or locations implementing the principles of accessibility and Universal Design for all on a broad scale and in a nationally significant way.
The aim of this study was to validate the conceptual definitions of accessibility and usability, and to explore differences between objective accessibility assessments and subjective ratings of usability in different client groups.
The Housing Enabler and the Usability in My Home instruments were used for 131 persons above 18 years of age, living in ordinary housing and receiving a housing adaptation grant. Covariation between accessibility in four different housing sections and three different usability aspects were explored, for the total sample and for six sub-samples reflecting person-environment-activity transactions or demographic factors.
Significant correlations were found in the total sample, among clients aged 75-84, women, clients living alone, as well as among clients with high dependence in personal and instrumental ADL and in outdoor activities. Subjective usability evaluations of activity aspects and physical environmental aspects were correlated to accessibility indoors and outdoors, while personal and social aspects of usability were correlated to outdoor accessibility.
Accessibility and usability are concluded to be different but related concepts. The results indicate that e.g. age, civil status and ADL dependence affect how clients assess aspects of their housing situation. For efficient planning and evaluation of housing adaptations, assessment of housing accessibility, usability, and dependence in ADL is recommended.
In Sweden, governmental agencies and bodies are required to implement a higher level of accessibility in their buildings than that stipulated by the National Building and Planning Act (PBL). The Swedish Agency for Participation (MFD, Myndigheten för delaktighet) develops holistic guidelines in order to conceptualize this higher level of accessibility. In conjunction to these guidelines, various checklist protocols have been produced. The present study focuses on the efficiency of such checklist protocols. The study revolved around the use of a checklist protocol in assessments of two buildings in Stockholm: the new head office for the National Authority for Social Insurances (ASI) and the School of Architecture at the Royal Institute of Technology (KTH). The study included three groups: Group 1 and Group 2 consisted of 50 real estate managers employed by the ASI, while Group 3 consisted of three participants in a course at the KTH. The results were similar in all of the groups. The use of the checklist protocol generated queries, which related mainly to two factors: (1) the accompanying factsheet consisted of textual explanations with no drawings, photographs or illustrations and (2) the order of the questions in the checklist protocol was difficult to correlate with the two buildings' spatial logic of accessing, egressing and making use of the built space.
Owing to physical inaccessibility persons with mobility restrictions and other functional limitations often face problems in public environments, leading to restrictions in activity and participation. To investigate general accessibility and perceived problems of accessibility to the public environment in a town centre, as well as visiting preferences to public facilities, among teenagers with functional limitations.
An interview questionnaire specific to a south Swedish town was constructed and used with 33 Swedish teenagers with functional limitations.
To a varying degree, all 33 teenagers commented on accessibility problems, e.g. concerning uneven surface material outdoors, steps at entrances, heavy doors and restricted space indoors. The results also indicated that teenagers with functional limitations to a high extent want to visit the same environments as other teenagers, but that it is often impossible owing to accessibility problems. Furthermore, because of accessibility problems, many of the teenagers were dependent on personal assistance.
Inaccessibility results in dependence, which might affect personal development negatively, and much effort are required in order to ensure activity and societal participation. Efficient priorities in public environment accessibility matters and discussions with the actors involved require valid and reliable data on local accessibility problems.
BACKGROUND: Studies on the effect of heart failure clinics have been encouraging and convincing with respect to reduced hospitalizations, improved quality of life, and reduced cost. However, previous results have been derived from patient populations either recently discharged and with specific exclusion criteria or from heart transplant lists. We here report the establishment of a heart failure clinic that offers an integrated approach to both diagnosing and managing heart failure patients, the baseline characteristics of the first 283 patients treated, and the impact on heart failure hospitalizations during establishment. METHODS: Since September l, 1999, a heart failure clinic has been in operation at Frederiksberg University Hospital. The clinic was designed with both a diagnostic and a therapeutic unit. The diagnostic unit offers open access to all patients with suspected heart failure, either through referral from general practitioners or from the medical departments of the hospital. In the case of confirmed systolic heart failure, the patient is referred to the therapeutic unit for (1) uptitration and optimization of medical therapy and thorough information and education. In addition, the unit offers a rapid access track and the possibility of intravenous diuretic treatment. RESULTS: During the 21 months of operation, a total of 460 patients were referred to the clinic. Of these, 320 (70%) were found to have clinical evidence of heart failure, and 283 (88% of the patients with heart failure) had left ventricular systolic dysfunction (defined by an ejection fraction of
Although there is a great deal of interest in women's health, research on the health and well being of women with disabilities has not increased. In this article we present internal and structural barriers to wellness activities experienced by women with disabilities. We also discuss women's actual and recommended strategies to address these barriers. Data were collected in six focus groups in urban and rural Ontario, Canada. The participants represented a diversity of disability, age, and ethnoracial backgrounds. Our findings suggest that individual and structural barriers exist for the women, with structural barriers (physical, informational, and systemic access) being predominant. Barriers prevented women from engaging in desired wellness activities. Women discussed actual strategies to address these barriers, such as collective efforts to buy nutritious foods and recommendations to create greater access (e.g., increase health professionals' training in disability issues).
The purpose of this study was to investigate public grants for housing adaptation in modern housing and to explore attitudes to accessibility problems. Grants for housing adaptation in apartments in blocks of flats built during the 1980s in a Swedish urban district were investigated over a 3-year period. Twenty-nine apartments had been adapted, in most cases by making a few simple alterations. Interviews with key persons in the building process stated that the most common measures would have cost less if they had been planned as 'basic accessibility'. The most important reasons why accessibility problems still persisted were building traditions, lack of knowledge about disability, and technical problems. Occupational therapists have a wide knowledge of housing adaptation. Adding their competence to the planning process would most likely increase activity and improve quality of life for disabled individuals. This study indicates that positive effects on the public economy could be achieved by putting 'basic accessibility' into practice.
Inclusion of children with special needs in kindergartens and preschools may be approached from different angles. This paper raises the question of whether the physical framework of kindergartens makes any difference for daily life at the kindergarten at all, and whether it can support inclusion of some children with special needs. Hence the title - can we build inclusion? In the literature of Universal Design, accommodation and design features seldom reflect the less visible disabilities. The paper is based on a research project initiated to investigate how more or less space influences daily pedagogical practice in general. Twelve interviews were conducted with experienced teachers from twelve different kindergartens with different amounts of space, varying from a ratio of 2.1 m2 play area per child to 5.5 m2. The results indicated that, for a group of children with special needs in particular, the amount of space is crucial. This group consisted of children who were socially very extrovert, and who maybe were noisy, easily provoked, and quick to get involved in arguments with other children. Alternatively, children in the group were very restrained and withdrawn in social interaction. Based on the answers in the interviews, we found support for answering the question in the title in the affirmative; we can build inclusion! This is because the teachers' experience indicated that, if there was sufficient space per child, there were fewer conflicts and the children managed to stay in the same activity for a much longer period. Sufficient space made it possible to divide the children into smaller groups, and use any secluded space. Therefore, it was much easier for other children to include some children with special needs. Accordingly, we can say that, sufficient space per child and an adequate layout and furnishing of the kindergarten is an advantage for all children. This is a clear example of Universal Design in which architectural solutions that are good for one specific group are also beneficial for all children.
This paper focuses on challenges in implementation of research in community-based occupational therapy practice. Based on a two-year project in a south Swedish municipality aiming at studying implementation of structured assessment procedures in the housing adaptation process, the first purpose is to provide a detailed project description, and the second is to report on first results identifying challenges in implementation of research in practice. The project was managed following a non-profit marketing model involving activities based on user needs, e.g. assessment training, support visits, and seminars with the users, i.e. occupational therapists. In order to collect data on implementation challenges, a multidimensional approach was utilized. Involving all occupational therapists in the municipality under study, 422 housing adaptation cases were assessed by means of the Housing Enabler. Good inter-rater reliability was demonstrated (kappa=0.62), but large differences between districts in the municipality were seen. Qualitative analyses of diaries, e-mail correspondence and minutes from workshops and seminars elucidated three categories reflecting research implementation challenges: Utilizing research in practice is not straightforward; Utilizing information technology is demanding; and Establishing cooperation and communication is challenging. The results can be utilized for planning of research implementation projects in practice not used to scientific work.