Search

To explain the ethnic paradox of mental health in aging, we evaluated whether Black and Latinx older adults experience (1) fewer depressive symptoms (DepSx), but more physical problems, and (2) greater psychological resilience as a result of life stressors than White older adults.DepSx, physical health, and recent stress were obtained biennially from 25,893 older adults (77% White, 15% Black, 9% Latinx) in the U.S. Health and Retirement Study, across 16 years. Psychological resilience, lifetime stress, and discrimination experiences were available for 13,655 individuals. We conducted mixed-effects and linear regression analyses.For Blacks and Latinxs, experiencing more-than-usual stress events was associated with less increase in DepSx compared to Whites, although on average Blacks and Latinxs experience more DepSx. Black adults showed worse physical health than White adults and weaker effects of stress on psychological resilience despite experiencing more stress of all types. Findings were mixed for Latinxs.Studying effects of time-varying stress on changes in health and multiple stressors on psychological resilience by race/ethnicity elucidates mechanisms for later-age health disparities.Cross-sectional evaluations of stress and psychological health in a clinical setting may provide incomplete appraisals of health risks for Black and Latinx older Americans.

In the general population, the construct of race is associated with disparities in cognitive aging. There are notable racial group disparities and inequities among people living with schizophrenia (PLWSz). Despite the salience of the construct of race in schizophrenia, there remains a knowledge gap about racial disparities in cognitive impairment among older adults in this vulnerable population. Our study uses mediation analysis to examine racial disparities in cognitive impairment among older adults with schizophrenia.We assess global cognition in PLWSz over age 55 with the Measurement and Treatment Research to Improve Cognition in Schizophrenia cognitive test battery in our "all-comer" sample (There was a Black/non-Black group racial disparity in global cognitive score (-2.8, 95% CI: -4.4, -1.3) after adjusting for confounding and interaction. This disparity was significantly mediated by years of education.There are notable racial disparities in cognitive impairment among older adults with schizophrenia; however, differences in cognitive scores between racial groups are mediated by level of education.Social determinants of health, particularly educational attainment, are important risk factors for cognitive impairment in PLWSz and should be considered by clinicians. Early screening and assessment of cognitive symptoms is essential to addressing health disparities/inequalities among older adults living with schizophrenia.Controlled Direct EffectsHIV: Human Immunodeficiency VirusMATRICS: Measurement and Treatment Research to Improve Cognition in SchizophreniaMCCB: MATRICS Consensus Cognitive BatteryMTE: Marginal Total EffectsNDE: Natural Direct EffectsPANSS: Positive and Negative Symptom ScalePLWSz: People with schizophrenia.

When developing behavior change interventions in a systematic way, it is important to select determinants relevant to the target behavior. Data is needed to gain insight into the determinant structures (the relative strengths of associations between determinants and behavior) and their univariate distributions. This insight is crucial to select the most relevant determinants, but at the same time institutions tasked with behavior change (e.g., prevention organizations, municipal health services) often operate under prohibitive resource constraints, which also extend to how easily they can collect data from a sample. This paper introduces CIBERlite - an approach that furnishes the intervention developer with an idea of the relevance of a limited number of determinants using short measurements informed by theory. The first study (N=401) in a series of three explores the convergent validity of short and full measurements of determinants derived from the Reasoned Action Approach. The short measurements are used in the main study (N=415) that serves as a proof-of-concept for the CIBERlite plot, an efficient visualization combining data of determinant structures and their univariate distributions for eight behaviors. The unexpected patterns detected in the main study led to an expert estimation study (N=45), which shows that individual experts have difficulty in predicting how people score on determinants. This stresses the importance of conducting determinant studies and CIBERlite is a valuable alternative to do so if resources are limited.

The current study explored whether substance abuse recovery houses could be categorized into meaningful classes, which might be associated with house evictions as well as changes in individual-level recovery capital. A total of 602 individuals from 42 recovery homes were followed for up to 6 data collection periods over 2 years. House level latent class analyses were based on house-level data. A 3-class model fit very well (entropy 0.94) and better than a 2-class model. Class profiles examined concurrent (averaged across waves 1 and 2) house and resident-level variables (e.g., gender, race, age, employment, education). Class was then used to prospectively predict outcomes of the hazard of eviction and improvement in a recovery index over waves 3-6. One latent class representing 45% of the recovery houses had the highest density of members willing to loan, able to pay their rent, active involvement in outside chapter activities-this group of houses had the best outcomes including the lowest eviction rate and highest mean recovery factor. The two other classes had higher eviction rates, with one having the lowest density of friendship, selectivity of residents, and ability to pay rent. The other of the higher eviction-rate classes surprisingly had the highest density of friendship and advice seeking, but the lowest density of willingness to loan. These findings suggest that there are meaningful differences in types of recovery homes, and that house characteristics appear to influence recovery changes and eviction outcomes.

Among persons with HIV (PWH), homelessness is associated with poorer health. From 2009-2014, national HIV prevention goals included a reduction in homelessness among PWH. We sought to examine social ecological factors associated with homelessness among PWH at a sub-national level during that period.National data were used to identify Delaware as the only jurisdiction where homelessness among PWH declined from 2009-2014. We analyzed population-level indicators and conducted telephone interviews with 6 key stakeholders to further examine this trend.Overall homelessness, household poverty, and median housing price were associated with homelessness among PWH in Delaware. Key stakeholders indicated that centralized intake processes improved screening, referral, and linkages of clients to housing units.In addition to social and economic factors, collaborative program strategies may improve housing outcomes for PWH. Monitoring trends at sub-national levels can help identify successful approaches as well as needed services or policy change.

This study examined whether domain-general cognitive weaknesses in processing speed (PS) or executive functioning (EF) moderate the relation between word reading scores and anxiety such that lower word reading scores in combination with lower cognitive scores are associated with higher anxiety symptoms. The sample included 755 youth aged 8–16 who were recruited as part of the Colorado Learning Disabilities Research Center twins study. Lower scores on PS ( R2 = .007, p = .014), EF ( R2 = .009, p = .006), and word reading ( R2 = .006–.008, p = .010–.032) were associated with higher anxiety scores. In addition, the word reading × cognitive interactions were significant such that lower scores on PS ( R2 = .010, p = .005) or EF ( R2 = .013, p = .010) combined with lower word reading were associated with higher-than-expected anxiety symptoms. Results suggest that weaknesses in PS, EF, and word reading are modestly associated with higher anxiety symptoms, and these anxiety symptoms may be compounded in youth with both PS or EF weaknesses and word reading difficulties. These findings can guide assessment approaches for identifying youth with word reading challenges who may be at increased risk for anxiety.

HIV infection and in utero exposure, common in Sub-Saharan Africa, are associated with pediatric neurocognitive impairment. Cognitive screening can identify impairments, but it is rarely used in this setting. The Penn Computerized Neurocognitive Battery (PennCNB), an evidence-based cognitive screening tool, was adapted for use in Botswana. To facilitate future implementation, 20 semi-structured interviews were conducted to elicit key stakeholders' perspectives on factors likely to be related to successful uptake of the PennCNB in clinical settings. An integrated analytic approach combining constructs from the Consolidated Framework for Implementation Research and modified grounded theory was used. Results underscore the need for cognitive screening in Botswana and the acceptability of the PennCNB. Implementation barriers include limited time and resources, whereas facilitators include standard procedures for introducing new tools into medical settings and for training implementers. Recommended implementation strategies include integrating screening into the existing workflow, implementing the tool in the medical and educational sectors, and targeting selection of children for assessment. This research addresses the research-to-practice gap by engaging in pre-implementation inquiry and designing for implementation. Results will inform the development of strategies to maximize the likelihood of successful implementation of the PennCNB to identify neurocognitive impairment in children in this high-need setting.

Adolescents and young adults (AYA) 13-24 years old make up a disproportionate 21% of new HIV diagnoses. Unfortunately, they are less likely to treat HIV effectively, with only 30% achieving viral suppression, limiting efforts to interrupt HIV transmission. Previous work with mindfulness-based stress reduction (MBSR) has shown promise for improving treatment in AYA living with HIV (AYALH). This randomized controlled trial compared MBSR with general health education (HT). Seventy-four 13-24-year-old AYALH conducted baseline data collection and were randomized to nine sessions of MBSR or HT. Data were collected at baseline, post-program (3 months), 6 and 12 months on mindfulness and HIV management [medication adherence (MA), HIV viral load (HIV VL), and CD4]. Longitudinal analyses were conducted. The MBSR arm reported higher mindfulness at baseline. Participants were average 20.5 years old, 92% non-Hispanic Black, 51% male, 46% female, and 3% transgender. Post-program, MBSR participants had greater increases than HT in MA (

Objectives The study aimed to describe daily sleep characteristics for dementia care dyads in the context of adult day services (ADS) use and examine the associations with sleep quality and daytime functioning (fatigue, affect, and behavior problems). Methods Caregivers (CG; N = 173) reported daily bedtime, wake time, and sleep quality for themselves and the persons living with dementia (PLWD) across 8 consecutive days (N = 1359), where PLWD attended ADS at least 2 days of the week. On each day, caregivers also reported their own fatigue and affect and PLWD's daytime behavior problems and nighttime sleep problems. Considering the context of ADS use, we compared mean differences in bedtime, wake time, and total time in bed on nights before versus after ADS use. We estimated multilevel models to examine daily sleep-well-being associations. Results On nights before an upcoming ADS day, care dyads went to bed and woke up earlier, and spent less time in bed. Further, PLWD had better sleep quality the night before an upcoming ADS day. Using ADS during the day buffered the negative impact of PLWD's sleep problems in the previous night, reducing daytime negative affect for caregivers. For caregivers, using ADS yesterday attenuated the association between shorter than typical time in bed and daytime fatigue; it also attenuated the association between PLWD's nighttime sleep problems and lowered daytime positive affect. Conclusions Regular ADS use may promote earlier sleep timing and protect against the adverse impact of sleep disturbances on daytime functioning for dementia care dyads.

The aim of this study was to evaluate the activity within the primary health care (PHC) in Greenland by identifying the patterns of all registered contacts made by patients in 2021, and to compare the most frequently used types of contacts and diagnostic codes in Nuuk to the rest of Greenland. The study was designed as a cross-sectional register study using data from the national electronic medical records (EMR) and diagnostic codes from the ICPC-2-system. In 2021, 83.7% (46,522) of the Greenlandic population were in contact with the PHC, resulting in 335,494 registered contacts. The majority of the contacts with PHC was made by females (61.3%). On average, females were in contact with PHC 8.4 times per patient per year, while males were in contact with PHC 5.9 times per patient per year. The most frequently used diagnostic group was "General and unspecified", followed by "Musculoskeletal" and "Skin". The results are in line with studies from other northern countries and indicate an easily accessible PHC system, with a predominance of female contacts.

Responses to the current energy crisis and to action against climate change have produced a wide variety of experimentations. Positive Energy Districts (PEDs) and Energy Communities (EC) are spreading as aggregators of enabling technologies, but the knowledge and skills required to plan, implement and monitor them still need to be developed. Technology alone is not enough to facilitate knowledge sharing and the experimentation and co-creation of solutions. The paper focuses on methods and tools that allow to support the creation of “energy citizens” through considerations developed in project H2020 GRETA (Green Energy Transition Actions) and in COST Action ‘PED-EU-NET’.

Technological upgrading in recent decades has allowed, at the urban level, the definition of new tools to address issues related to climate change. The research focuses on methodologies and technologies that are useful for the definition of new morphometric classifications (RLCZ, Rome Local Climate Zone) and the consequent construction of specific parametric models for the fabric of the historic city, starting from the case study on the city of Rome. This is to support an informed design-making process that is compatible with the peculiarities of complex fabrics. The proposed methodology and tools, which can be tested on similar scenarios or recalibrated for different realities, can provide an additional piece of knowledge, integrated with ongoing international experiments.

The increasingly pervasive use of artificial intelligence within the complexity of the world around us continues to fuel the scientific, philosophical, and political debate. Even within the construction sector (although still in an embryonic phase), it is possible to observe the first concrete results of the application of new digital processes, which are increasingly autonomous and support the design, definition, and validation of the project. The new frontiers of expansion of artificial intelligence systems, encouraged by the digital transition, require a careful reflection on the impact of new technologies in redefining the designer’s role in the decision-making process.

The paper analyses the evolutionary tendencies in the use of artificial intelligence in building design, highlighting: a) the ground lost by knowledge-based expert systems and the diffusion of systems combined with heuristic and stochastic approaches; b) the spread of evolutionary algorithms in the field of optimisation; c) a climax of the influence of probabilistic approaches around 2010; d) the progressive dominance of deep learning since 2012. It is likely that the next step requires hybridisation of deep learning and symbolic artificial intelligence, and it is expected that the contribution of design domain experts in terms of knowledge formalisation will be a fundamental driver of it.

Since the rise of the digital revolution in architecture, and even more so with the emergence of a new generation of enabling technologies structured on digital interfaces, the interactive-relational dimension has become central to the design agenda. The experimentation on responsive morphologies that emerge from the synergy between data and design, and whose artefacts mark a return to the real world that incorporates physicality into the design process is significant. In addition, they represent a synthesis of the ability of such digital technologies to dynamically discriminate, process, and interpret heterogeneous potential data derived from the context.

Climate scenarios require the implementation of climate proof actions. The effectiveness of such projects directly depends on the knowledge of local contexts and on the built environment’s characteristics in relation to climate risk conditions. Innovative methods of knowledge can be implemented through the use of enabling technologies. Based on these considerations, the paper proposes the Coast-RiskBySea model as support for climate proof decision-making in relation to coastal flood risk, with the aim of developing new synergies between environmental design and enabling technologies. The proposed model was tested on an application case in the city of Naples by simulating a climate proof measure to assess the effectiveness of this solution in terms of damage reduction, and to define the potential and criticality of the approach.

The current and increasingly intensive technocratic drift recognises the indiscriminate power of techniques in solving several problems, including the struggle against climate change and its impact on cities. One of the future challenges concerns the effective and conscious application of KETs for the creation of smart environments in historical heritage, which plays a strategic role for its conservative values, but also in the broader strategy for limiting greenhouse gas emissions. The proposed paper reports some preliminary results of a research aimed at investigating and acknowledging these technologies as an enabling medium to undertake more informed deterministic choices in the field of CH.

The technological advancement of robotic automation in construction allows for the identification of a renewed design agenda at the intersection of professional practice, academic research, higher education, and the cultural context in which innovations take place. This paper outlines research conducted in the field of large scale digital robotic additive manufacturing at Lawrence Technological University, College of Architecture and Design, in collaboration with the artchitecture firm Daub and the start-up Citizen Robotics in Metro Detroit. The creation of a prototype for a temporary installation is used to assess the building feasibility of a home scheduled for completion in 2023, in which a portion of the exterior will be 3D printed.

Wood actively equalises its moisture content in relation to its surrounding environment. Technical applications that can harness this characteristic can have a great impact in the improvement of indoor hygrometric comfort. So far few applications have made use of this unique property. The natural hygroscopic intelligence of wood can lead to the development of a new technology capable of ensuring improved indoor comfort. The natural material can thus be engineered by creating responsive composites made from wood waste and transformed through 4D printing. The biomimetic actuators studied in this paper are aimed at linking the transformation of form into environmental control functionality applied to building comfort in adaptive and passive solutions.

The growing performance of IT tools for the project allows to delegate entire phases of the conceptual and decision-making process thanks to the diffusion of algorithmic models referable to the category of artificial intelligence capable of automating important segments, if not the entire process of project production. The speed of evolution of these systems places us in a continuous transition phase in which it is necessary to reflect on the direction to be taken with respect to the many technical and IT opportunities. The text analyses the new instrumental and technical tools, reflecting on the limits and opportunities also with respect to the specific discipline of Architectural Technology, and on the need to reconsider the real meaning of their use.

Cities nowadays need to have long-term visions and perspectives to achieve the ambitious targets for which vast investments are being made. They need to act with competence and capability-based planning, and to come up with suitable solutions. Technology is unquestionably a factor of crucial importance when aiming for these targets. Digital innovation, based on data knowledge, analysis and projection, is crucial to tackle the most demanding challenges of our times. The methodological approach proposed here is an Urban Digital Twin applied to cities as a predictive model to obtain a projection of their development in terms of sustainability.

The paper describes both the method and the preliminary outcomes of the “Blind-assistive aUtonomous Droid Device: BUDD-e” research experience, funded by Polisocial Award 2021 of Politecnico di Milano, and designed to exploit a multidisciplinary approach to bridge the gap of inclusive design, making spaces and services accessible, functional, and usable by Blind and Visually Impaired (BVI) people. The research purpose is to develop accessible public places and indoor environments where the autonomous robot BUDD-e will act as guide for the BVI people. User-centred design principles will be applied to support accessibility to – both outdoor and indoor – public places, where the robot guide BUDD-e will be a primary feature in allowing access to services.

The research aims at identifying an information tool for design activities through enabling technologies, developed on the interactions between envelope and context. The methodology, articulated according to the phases of analysis, processing, and applicative validation, prefigures a response strategy to the phenomena of environmental and energy crisis with respect to the different scales of action. Considering the effect of climatic phenomena on the envelopes and the contemporary performance requirements they are called to meet, the contribution provides a dynamic data sheet (analysis and evaluation of energy-environmental performance) based on the model drawn up by the European Joint Research Centre, to verify the appropriateness of envelope design.

Cities are the main field of application of technological innovations for ecological transition and decarbonisation. With reference to its proximity spaces, the research proposes a multidisciplinary and transcalar vision in which analytical and quantitative methods of urban design are combined with qualitative assessment methods of technological design to simulate and measure the impacts of interventions in terms of mitigation and adaptation to the effects of climate change. A planning support tool, based on game theory, guides the choice between effective and interdependent solutions for decarbonisation through renewable energy production, ecosystem services and accessibility to essential services.

Housing plays a key role in the world path to energy transition, and retrofitting buildings is a major asset to this end. Unfortunately, despite the supporting measures and incentives promoted in many countries, the renovation rate is still too slow. This is even more complex within some specific assets, such as social housing, which, especially in Italy, depends on the availability of public funds. The study proposes a predictive tool conceived as an enabler in the decision-making process, capable of considering and comparing the performance levels that different retrofitting actions can reach, according to building features, intervention costs, timing, and resource availability. The tool is tested on a social housing case study in Bologna.

The paper describes the development of Living Hub: a laboratory for research, experimentation and training based on the Living Lab model, integrated with the use of the Simulation technique, to optimise the study of the interaction between people, environments, and technology. The lab aims to support the design of capacitating technologies and responsive environments that can adapt to the needs of their users, with reference to the home context. Located in Liguria, a region with the highest rate of ageing in the world, Living Hub focuses experimentation on innovative models for the care of the frail through different levels of scalar/modular integration of enabling technologies in the built environment.

Focus on the role of users is the heart of the ongoing research experience in the university Living Lab environment that investigates, systematises and tests the potential of the latest digital technologies in the construction sector (BIM-sensors-Digital Twin-IoT) to define enabling building-user interfaces that support the virtuous circle of energy efficiency/environmental well-being/proactive behaviour. Synchronising the real building/virtual model allows an augmented environmental experience and new levels of user involvement. It enriches the predictive systems of data-user experience, helping to calibrate the configuration of improvement scenarios in the design/operational phase on well-being objectives, expanding the awareness of the process actors for a new centrality of the decision as an ethical value.

Enabling Technologies have the potential to transform both the physical flow of materials and resources (production and construction methods), and the intangible organisational and managerial relationships (exchange and monitoring of data and relationships along the entire chain of value). They should, therefore, be considered important in supporting change processes aimed at the circular use of resources. This paper presents some research and experiments, at European and Italian level, aimed at developing and applying Enabling Technologies for circular economy, and at aligning them with the needs and challenges of society, by directly involving actors of the building sector ecosystem in moments of discussion and co-creation to define potential strategies and operational actions for innovation in the sector.