REED - Rehabilitation centre on Egholm for Eating Disorders by Emilie

REPORT

ABSTRACT The respective report presents the semester project of MSc02 Arch, group 7, Sustainable Architecture at Architecture and Design, Alborg University. The project aim is to develop a proposal for a health care center on Egholm island located in Aalborg for user groups suffering from psychological trauma. Through Problem Based Learning and an iterative approach with the Integrated Design Process a proposal to a health care center offering the right setting for various treatments of people with eating disorders has been made. The treatment has been facilitated and focused on healing through natural settings in combination with agricultural farming and gardening. This will ensure quality support and treatment of the chosen users, their relatives, and the advocated staff. Architectural quality is secured by use of reused materials and natural waste product to minimize the impact on the environment. Architectural passive and active strategies have been applied to reach low energy demands and high indoor quality by taking advantage of the micro-climate. The aspects of aesthetic, spatial, social, functional, healing architectural, and technical parameters are iteratively taken into consideration throughout the process endorsed by methodologies and its tools.

READING GUIDE The report consists of three major parts structured to follow the integrated design process. Part 1 contains the preliminary work of exploring and utilizing the problem through initial analysis, whereas part 2, sketching and synthesis, seeks to solve the concluding problems drawn in phase 1. Lastly, phase 3 will present the suggestion of the solution to the problem and thereby the final project proposal. An annex, to which reference is made throughout, supports the content with in-depth explanatory investigations and arguments that have not been included in the respective report. The structure of the report is chronological in order to translate the process to a third person. The process is, in fact, iterative and not chronological. Therefore, the reader must be aware that the structure is done for the opportunity to understand a process, which is not chronological when acting out. It is recommended to read the report in the aforementioned order. An expansion of The Integrated Design processâ&#x20AC;&#x2122; five phases explains the strategy of the approach towards the project and highlights what subjects have been investigated in each phase. The complexity of the model is the beforementioned iterative approach and therefore dotted lines are placed to indicate the practical complexity among phases. A methodology chapter is written at the very beginning of the respective report explaining the methods and its underlying tools used throughout the project, not only in the preliminary work. A further expansion of the complicated iterative approach within the sketching and synthesis phase, part 2, is illustrated at the beginning of the chapter. As well as illustrated in the diagram of the IDP, solid lines represent the theoretical chronological structure and the dotted lines the practical approach. The preliminary work contains subsections with sub-conclusions that will sum up a set of design strategies, a room program with additional functional diagram, and lastly a vision of the problem-oriented purpose of the project. The subsequent part is the so-called design process where the design criteria will be displayed as small icons in each subchapter to underline the focus of the sketching and synthesis. Lastly, drawings such as plans, sections, axonometric diagrams and renders supported by a short conclusion will communicate the final project proposal.

DEPARTMENT OF ARCHITECTURE, DESIGN & MEDIA TECHNOLOGY

PROJECT TITLE

REED

PROJECT TIME

01.02.2020-03.06.2020

SEMESTER

MSc02 ARCH-Sustainability

SUPERVISORS

Andrea Jelic Olena Kalyanova Larsen

NUMBER OF PAGES

153

ANNEX

CHRISTINE ELNEGAARD

EMILIE HELLERUP

JOHANNE LYNGKLIP GAARDBO

LASSE MIDTGAARD PEDERSEN

LEONIE BECHER

CONTENTS 2.0 SKETCHING & SYNTHESIS

0.0 INTRO Field of study IDP & Methods

PHASE 01 Design process content Initial sketching Choosing a concept

8 10

1.0 PROBLEM & ANALYSIS 1.1 THEORY Sustainability & DGNB Design for disassembly Eating disorders in DK Treatment methods Treatment facilities BR18 1.2 USERS Intro Patients Staff & relatives Healing architecture & gardens 1.3 SITE User->Site About Egholm Phenemenological analysis Context and materiality of site Natural materials Other building materials Sun-hour study Wind-rose study Flooding Passive & active strategies Case studies 1.4 CONCLUSION Room program Design criteria

PHASE 02 Form follows function Implementing a courtyard Quality of the plan layout Incorporating the structural system Be18 & daylight testing PHASE 03 Energy sources Passive shading LCA & LCC wall Interior atmospheres Facade study LCA & LCC foundation Outdoor areas

17 20 22 24 26 28

30 32 34 36

39 40 42 44 46 48 50 51 52 54 56 63 68

72 74 76

78 80 82 84 86

88 90 92 94 96 98 100

3.0 PRESENTATION Introduction Context 1:5000 Exterior render Masterplan 1:500 Outdoor areas Exterior render Section A 1:500 Section B1:500 Exterior+interior renders Plan 1:200 Visual comfort Interior renders Section C 1:100 Section D 1:100 Interior renders Wall detail 1:25 Loggia detail 1:25 Exploded structural system Various details 1:10 Foundation build-up Straw insulation modules Natural ventilation Mechanical ventilation Fire safety Water management - waste Water management - rainwater Final LCA & LCC results Conclusion Reflection References Illustration list

4.0 ANNEX 104 105 106 108 109 110 112 113 114 116 117 118 121 122 124 126 128 129 130 132 133 134 135 136 137 138 140 141 143 144 152

Interview with LMS Design solutions from users Wind analysis Ventilation rate calculations Natural ventilation calculations Heating systems Bsim & Be18 process Be18 process Facade cladding Outdoor areas

156 159 161 163 166 171 173 179 187 189

FIELD OF STUDY What is the scope of the project?

The project aim is to develop a proposal for a health care center offering the right setting for various treatments, alternative therapeutic techniques and short overnight stays for user groups suffering from psychological trauma, whilst making it a great work environment for related staff. The psychological trauma defined in this project lays in the presence of eating disorders (ED). An ED can be triggered by a mental illness or lead to one, caused by a trauma or another influencing factor, but the cause can differ from person to person. A large number of eating habits are triggered by the changes in our bodies when entering puberty. These changes are uncontrollable, and therefore one will incorporate irregular eating habits to regain control. According to Rosenvinge and Pettersen, 75% of patients with eating disorders develop other psychological illnesses, which makes the disorder the most comorbid disruption (Rosenvinge et. al 2015). The cause of the disorder is therefore difficult to define, and treatment will need to consist of multiple therapeutic techniques.

The setting of the health care center is Egholm Island, an island consisting of beautiful natural surroundings, a remote area in the middle of Limfjorden with a perfect opportunity to enable architectural design supporting health and wellbeing through nature. The total building area must be between 650 - 700 m2, be Low Energy Class 2020, whereas the building materials shall be low C02-emitting evaluated through life cycle assessment (LCA) and life cycle cost (LCC) to meet the demands for sustainable architecture. The demands of such a building will be examined and explored throughout the design process in order to evaluate the best strategy.

Aalborg

Illus 1 - Map of Denmark

Egholm

Aalborg

Illus 2 - Map of Aalborg & Egholm

PROCESS & METHODS Which process and methods were used throughout the project and how?

INTEGRATED DESIGN PROCESS (IDP) The integrated design process (IDP) aims to unify aspects from the architectural and engineering fields. The IDP facilitates a focus on design, construction, building operation and occupancy etc. through five phases: problem, analysis, sketching, synthesis and presentation. The complexity of the method lies within the iterative approach, where different tools in different phases provide greater insight into the project (Hansen and Knudstrup 2005). In this project, the IDP will be used as a strategy to approach the project and design process. In the following, the methods used in this process are presented.

Tools: Research articles, databases, peerreviewed articles etc. INTERVIEW Analysis phase

GATHERING KNOWLEDGE

An interview is a method to collect possible opportunities and challenges in the project. The interview can be conducted in multiple formats; qualitative research, where respondents are interviewed personally, or in the form of a questionnaire. In this project, a semi structed interview is conducted, in order to collect valuable information of the users. (Aarhus Universitet n.d.). Tools: Qualitative and quantitative interviews, interview guide, recording and transcription.

EVIDENCE BASED DESIGN

CASE STUDIES

Analysis phase

Evidence-based design (EBD) aims to develop design and architecture based on knowledge that has been demonstrated in practice and proven effective (Frandsen et al. 2009). Studies of environmental psychology have highlighted how the physical setting has an impact on the human perception of feelings, behaviour, and thinking. EBD draws on this knowledge (Peavey and Vander Wyst 2017). The method can be utilized to establish a foundation for decisionmaking regarding the final design, but also ensuring the possibility to gather documented data from existing studies (Frandsen et al. 2009). â&#x20AC;&#x153;Evidence-based healthcare design can be used to create therapeutic environments for patient care that are supportive of family involvement, efficient for staff performance, and restorative for workers under stress.â&#x20AC;? (Hamilton 2004).

Studying existing projects, considering a series of factors related to the project, creates a foundation for the sketching and synthesis phases. The approach to the cases must nevertheless be with a critical eye, leaving out information that is not relevant for the project, and aiming to gather knowledge of what to do and what not to do. Tools: Literature, architectural magazines, interview MAPPING Analysis phase

Mappings provide information on the site and its context, aiming to understand the extent to which the site can and will influence the design process and vice versa. Therefore, data, like access, functions, morphology and vegetation density etc. can be presented through mapping

Illus 3 - How the Integrated design model is used throughout the project

noting down the information in order to provide a degree of understanding of the setting of the context. Considering locations of possible local building materials as well as flooding can also be investigated to enhance a sustainable approach. Tools:Qgis, site visits, klimatilpasning.dk,

Using calculation methodologies in the process is greatly what makes the process integrated. In the very first initial sketching and modelling it is evident to implement fast calculations in order to test, if the design has a potential in different aspects. Such a calculation could be a 24-hour of overheating in a room before modelling in a PHENOMENOLOGY simulation program like Bsim. Analysis phase, sketching phase, synthesis Tools: Be18, Microsoft Excel, hand calculations phase

An overall method that aims to understand the sensorial aspects of a site, compared to mapping. Studies in this field are constructed through observations from a subjectsâ&#x20AC;&#x2122; point of view, commonly through senses, and can be presented through words, illustrations and photographs. Photographs are especially utilized to document the atmosphere and materiality at Egholm. Tools: Site visits, photographs, notes

PARAMETRIC DESIGN

Simulations can provide specific knowledge of both microclimate and building, providing an understanding of total performance. Simulations has been done for microclimate in Rhino, daylight conditions in Velux Visualizer and indoor environment quality in Bsim and used throughout the design process in order to optimize the design gradually. Tools: Velux Visualizer, BSim, Be18

IDEA GENERATING METHODOLOGIES

Analysis phase, sketching phase, synthesis phase

Parametric design methodologies combine a design with a technical aspect from the very beginning, which is crucial when doing integrated design. This method saves time and is more precise than combining a design with either a separate simulation program or calculations. Unfortunately, only a few parametric programs TECHNICAL METHODOLOGIES are available. The method has shown great potential in simulating microclimate of sun and SIMULATIONS wind. Analysis phase, sketching phase, synthesis Tools: Rhino, grasshopper, and its plug-ins phase

COLLAGES Sketching phase, synthesis phase

Creating collages, mood boards or artboards generates a design flow, inspiration and a clear vision of a design. The method is utilized to show individual, separate parts of a project as well as a wholesome project where a specific mood or concept is desired. Tools: InDesign, Adobe sketch digital, pictures

CALCULATION METHODOLOGY Analysis phase, sketching phase, synthesis phase

SKETCHING

atmospheres of both interior and exterior and Sketching phase to provide the possibility to communicate the The method of sketching is generating ideas senses of a spaces, their volumes and how they quickly based on the analysis conducted with relate to each other. help from collages and such. It usually has a Tools: Lumion, Enscape goal to achieve and boundaries to consider. The method is an iterative process and an essential ILLUSTRATIONS part of the integrated design, in fact, a phase by Analyzing phase, synthesis phase, presentation phase itself in the integrated design process. Tools: analogue sketching, digital sketching The technique of visualizing different aspects of tools; Adobe sketch, Sketch-up, Rhino, ArchiCAD the project aims to communicate what cannot, or will not, be written in words. Illustrations can visualize a concept, a process and be composed VOLUMETRIC STUDIES Analysis phase, sketching phase, synthesis specifically in order to show a certain style. The phase, presentation method can be utilized through all phases of the Translating a 2D drawing into a 3D reveal project. potentials and challenges within an initial design Tools: Photoshop, Illustrator, AutoCAD, or concept. Constantly changing between 2D ArchiCAD, Revit, Rhino, Adobe sketch and 3D in analogue sketching and digital and physical modelling is important in order to GROUP WORK explore as many unsolved issues as possible. A ONLINE MEETINGS digital 3D model is a great tool used throughout Analyzing phase, sketching phase, synthesis the entire process from the very first initial phase, presentation phase concept drawing to presentation. It provides Greatly influenced by the Corona virus, the opportunities to investigate details separately group work for this semester, was limited to and in connection to each other, in order to online communication platforms. Morning achieve a greater understanding of each space meetings, discussing results and challenges, 3D and how various design solutions and strategies model work and planning future assignments, is implemented best possible. somewhat resembles an everyday life before the Tools: Physical model making, Revit, Rhino, virus. Small questions that should arise throughout Sketch-up, ArchiCAD, the day is solved via texting, or through online meetings either all group members or only PRESENTATION selected individuals. RENDERINGS Tools: Microsoft teams, Messenger/Facebook Synthesis phase, presentation phase chat Generating photorealistic illustrations based on a 3D model. The aim of the method is to visualize

SITE

1 PROBLEM & ANALYSIS

1.1 THEORY

1.1

SUSTAINABILITY & DGNB Why is sustainability becoming more important, and what does it entail?

In recent years, the effects of climate change have increased faster than scientists had predicted. The year 2019 was one of the warmest on record and extreme climate events occurred all over the world and therefore the change of climate has become increasingly evident in our daily lives (Un.org, 2020). To limit global warming from increasing uncontrollable IPCC suggests a decline in carbon dioxide emissions of 45 percent by 2030 and an ambition of net zero in 2050. (Ipcc.ch, 2020)

on their health and well-being. The DGNB ranking system is a tool for assessing the sustainability of buildings and for establishing a measurable reference. The system is based on the life cycle approach and incorporates all three aspects of sustainability.

ENVIRONMENTAL SUSTAINABILITY Environmental sustainability focuses on protecting the ecosystem, air quality, integrity and sustainability of our resources and focusing on the The concept of sustainability must be an integral elements that place stress on the environment part of the building construction sector to re- (Environmentalscience.org, 2020). duce CO2 emissions. It is necessary to perceive sustainability holistically through the three pil- A central role must be assigned to the construclars within environmental, social and economic tion materials used. During their entire life cycle, sustainability. The pillars are the core aspects to they contribute significantly to the overall perbe considered in sustainable development and formance of a sustainable building. This begins defined in the Brundtland report as: â&#x20AC;&#x153;Sustainable with the availability of resources and the respondevelopment is a development that meets the needs sible extraction of raw materials. The choice of of the present without compromising the ability materials has a direct impact on the overall perof future generations to meet their own needsâ&#x20AC;?. formance of the project in about half of the cri(BĂŚredygtig udvikling, 2020) teria of the DGNB evaluation system. Criteria with a direct influence on ecologiThis project will focus on environmental as well cal sustainability include the LCA of a building, as social sustainability, while limiting the eco- meaning emission-related environmental impacts nomic aspects. The characteristics of the site and the consumption of limited resources overallow the use of local materials but also poses all life phases of buildings from raw material to challenges due to climate change, such as the demolition. (DGNB criterion ENV1.1) Other dipossible rising sea level. Therefore, local and rect influencing factors are risks of the local enlow environmental impact building materials will vironment, such as environmental compatibility be used and evaluated through LCA, and eco- of materials. (ENV1.2) Furthermore, responsible nomic sustainability will be considered through resource extraction according to ecological the LCC. Furthermore, an ambition of the project and social standards. Here, for example, the use is to encourage users to ensure a positive impact of re-growing raw materials is positively evalu-

ated (ENV.1.3) and the drinking water demand and wastewater volume are to be reduced. Water-saving measures such as rainwater use, or the installation of water-saving taps have a positive influence. (ENV2.2)

crease the individual’s well-being. (SOC1.5) User satisfaction and well-being are also strongly influenced by visual comfort whereas natural light has a positive effect. In addition, good use of daylight provides a high energy saving potential for artificial lighting and room temperatures. SOCIAL SUSTAINABILITY Especially, visual relations to the outside space, Social sustainability should enable a stable so- absence of glare and the quality of the artificial ciety in which all members can participate and light are crucial. (SOC1.4) guarantee human dignity, labor standards, and human rights now and for future generations. The Barrier-free building increases the attractiveness user of the building is the center of social sus- of buildings for all groups of people regardless tainability, whereas buildings and their surround- of age, physical or mental limitations. This apings have a vast impact on health, well-being and plies to internal and external access, i.e. approuser’s productivity level, an impact can be both priate signage and direction, accessibility and negative and positive. equipment and dimensioning of sanitary rooms. (SOC2.1) (Braune et al., 2019). A high sense of security is the fundamentals of human comfort. Insecurity and anxiety, on the other ECONOMIC SUSTAINABILITY hand, restrict freedom of movement. Measures Economical sustainability in the building sector is that increase the feeling of safety are particu- important for a holistic approach to sustainable larly important to patients with ED because of architecture due to the overall topic in the buildits comorbidities. Design strategies in favor for ing industry economy. this are e.g. well illuminated main paths, paths on parking lots for cars and bicycles and well-visible When considering the economy, it is vital to inand clearly arranged common areas. (SOC1.7) vestigate the production, running and future costs of the building (Ramboll.com, 2020). To assess The method of ensuring high indoor air quality the building’s economical sustainability a LCC should, according to Braune, 2020, be “Where will be done. The following categories should passive solutions can achieve the same or a better be considered when calculating building-related effect, passive solutions should be used.” (Braune, life-cycle costs: construction costs, occupancy 2020), and preferably be combined with Imple- (including operation costs, cleaning, energy conmenting user control i.e. measures giving the user sumption, operation, inspection, maintenance) of buildings the greatest possible influence on and dismantling/disposal costs. (ECO1.1) the ambient climate conditions and thereby in-

SUSTAINABILITY

Illus 4 - Three main pillars of sustainability

1.1

DESIGN FOR DISASSEMBLY Explanation of design for disassembly and some of the general concepts behind it

A circular economy seeks to design outwaste to increase the well-being of people and environments. Keeping products and materials circulating at their highest value in the construction sector requires the introduction of design for disassembly. (Jensen, K. and Sommer, J. 2016).

The health care center will be specifically tailored to its users and the particular location. The goal is therefore not to break down the building into modules to rebuild it somewhere else, possibly for different use. It is rather, enabling the building to be dismantled in small units for the restoration of systems, components and materials for other projects. The recycled materials can then be given a new life in a new setting.

Design for disassembly is an approach towards designing products that can easily be taken apart at the end of the productâ&#x20AC;&#x2122;s life in order to be recycled or reused. It allows various elements to fit into a closed material cycle, where they can be reassembled and recycled to new products of comparable high quality. Especially relevant in modern times, design for disassembly is important, and includes different advantages, such as: easy to repair, sustain and upcycle, which makes the long-term costs lower. Less waste is generated and thereby reduces resource scarcity the industries are facing, as well as the demand for new raw materials. The construction process is simpler and quicker, and operation and maintenance are improved.

The materials should be chosen by considering their future effects and be of high quality because materials that retain their value are more suitable for reuse and recycling. It is also important to document materials and methods for deconstruction to make dismantling easier. Connections should be visually, physically and ergonomically accessible to increase efficiency and avoid the need for expensive equipment. Simple structural systems and simple shapes allow for easy construction and gradual deconstruction. The use of chemical connections should be minimized, as glue makes it difficult to separate and recycle the materials. The use and limited amount of standard connections In order to design for disassembly, different (screw, bolt and nail connections) reduce the aspects must be considered such as materials, need for tools and the time and effort required service life, standards, connections, and to switch between them. The separation of deconstruction (see illus 5). mechanical, electrical and sanitary systems from the assemblies that house them facilitates the Egholm is at risk of being flooded, due to the separation of materials for repairs, replacement, rising sea level, so the separation of the building reuse, and recycling. (Guy, 2008) components should be made particularly simple.

materials service life standards connections deconstruction

Illus 5 - 5 principles for designing for disassembly

1.1

EATING DISORDERS IN DENMARK How many people in Denmark are affected by eating disorders, and why is it important? Due to our modern affluent society, EDs are becoming more common (Simonsen and Møhl, 2017, p.478). ED is a collective name for a list of different psychological afflictions, characterized by a disturbed relationship to food, body, and weight to such an extent that it impairs the patients mental and physical health, and affects the psychosocial function. Typical for ED is selfperception and self-low esteem. (Simonsen and Møhl, 2017, p.478). In Denmark, 75.000 people struggle with an eating disorder. There are different types of eating disorders, in which the most common are anorexia nervosa (AN), bulimia nervosa (BN) and binge-eating (BED). (LMS, 2020).

next few days in order to compensate for the calorie intake. (Simonsen and Møhl, 2017, p.488) The purging provides instant relief; however, it is followed by shame and self-contempt. (LMS, 2020)

BINGE – EATING DISORDER BED is characterized by repetitive episodes of coercive excessive eating without purging or other forms of immediate and inexpedient compensatory behavior (Sundhedsstyrelsen, 2016). The patients attempt to control the intake of food, but lose that control and eat excessively, and is often categorized as a way to regulate feelings. They often experience negative and self-blaming thoughts, prompting an urge to eat, ANOREXIA NERVOSA and to continue eating until past their saturation Patients with AN have an unhealthy ideal body limit. (LMS, 2020) These episodes mostly lead image, and are afraid of gaining weight, usually to shame, guilt and disgust and mostly happens with hopes of losing a lot of weight. (LMS, in secret, possibly leading to isolation of social 2020) The patients are often very ambitious and activities. (Sundhedsstyrelsen, 2016). set high standards for themselves, bordering perfectionism, leading to a restrictive eating OTHER EATING DISORDERS pattern due to anxiety of losing control When diagnosing patients with ED, specific overeating and gaining weight. (Simonsen criteria are used to categorize the diagnosis and and Møhl, 2017, p.483) They often exercise some patients don’t meet those criteria. They can excessively or take laxatives, leading to a very have signs of multiple eating disorders but don’t low BMI, causing serious health issues. completely fit the category and are therefore diagnosed with an atypical eating disorder. BULIMIA NERVOSA Other ED’s such as orthorexia entail an obsessive The characteristic of patients with BN is focus on healthy eating, while muscle dysmorphia excessive eating when feeling the loss of control has a large focus on getting bigger and more followed by compensatory behavior. Looking at muscular. These diseases have nevertheless not a psychological perspective, excessive eating yet been recognized as official diagnostics. episodes are often a symptom of very deeply rooted emotional and personal problems. The Considering the statistics, there will be a focus patient will therefore either purge, take laxatives, on patients with AN, BN and BED, in the age work out excessively or starve themselves the range 13-30.

75.000

ANOREXIA

BULIMIA

5.000

30.000

10%

BINGE-EATING

40.000 - 50.000

10%

30% 90%

90%

13-20 YEARS

15-24 YEARS

70%

15-45 YEARS

Illus 6 - Statistics of different eating disorders in Denmark. (LMS, 2020)

1.1

TREATMENT METHODS Different types of treatment methods for patients with eating disorders The most important component in the treatment of an eating disorder is psychotherapy. Psychotherapy can take place in individual sessions, in group sessions or in a combination of both. Often it is also useful to include important reference persons (partner, family). Procedures in psychotherapy consider behavioral problems, problematic thinking patterns, self-worth and body perception, dealing with feelings, problems in relationships, impulsiveness, perfectionism, and life in the family. Psychotherapy is usually not utilized on its own, but in combination with the following other methods:

a balance between control independence. Some sessions are conducted only with relatives and some include the patient. (Zeek and Herpetz, 2015) The spatial need for this type of therapy is a big enough room for relatives, patient and psychologist to sit comfortably without them feeling cramped up in a corner but also small enough to provide an intimate non-dominating atmosphere. BODY BASED TREATMENT The body and its perception is the focus of the therapeutic work. These include, for example, concentrative movement therapy, dance therapy, as psychotherapeutic methods, or methods for relaxation, breathing and sports. (Zeek and Herpetz, 2015) The architectural design requirements for body-based therapy is a room big enough for an instructor and preferably more than one patient. The requirements of the ventilation system will need to meet the people load, especially in sport-related activity and the light conditions will need to be good enough to visually follow the performance of movement.

ONE-TO-ONE SESSIONS A one-to-one type of therapy is most commonly cognitive-behavioral therapy and interpersonal psychoanalysis. Cognitive behavioral therapy is a treatment method based on the knowledge that the learning background of people is primarily responsible for their â&#x20AC;&#x153;unfavorableâ&#x20AC;? selfdamaging behavior and that it can be treated through therapy. Interpersonal psychotherapy assumes that an eating disorder has been caused or maintained by interpersonal problems, in shapes of conflicts, loss or other major changes in personal life circumstances. The treatment is based on solving these interpersonal problems. (Zeek and Herpetz, 2015) The treatment is of one patient by a single psychologist and will therefore require an architectural design solution of one private room with enough space for comfortable seating for two.

NUTRITIONAL THERAPY Nutritional therapy can be useful as an accompanying measure in addition to intensive psychotherapy in order to incorporate normal eating habits into a structured daily life and to gain knowledge about balanced, sufficient and healthy dieting. (Zeek and Herpetz, 2015) The spatial requirements of this therapy type require more than one specific custom-made room, it FAMILY-BASED THERAPY requires a range of facilities. An overall structure According to Zeek and Herpetz family-based of the spaces for such a treatment method could therapy has been proven effective, especially be open spaces for dining and cooking for for children and adolescents. It teaches relatives multiple patients at the same time and a space how to cope with the eating disorder, helps the where the origin of food is explained, preferably patient and how to solve conflicts and establish through nature. 24

nutritionist dining space cooking space

nutritional therapy family based treatment body based treatment instructor multiple patients big room

interpersonal psychoanalysis cognitive- behavourial therapy

psychologist relatives patient big private room

psychologist patient private room

Illus 7 - Treatment methods

These design requirements and physical and a psychologist to sit comfortably in a safe, framework of the above-mentioned treatment intimate non-dominating atmosphere. methods will, in combination with other • A room big enough for an instructor and more atmospheric and spatial requirements, be than one patient. Ventilation system that meets translated into design criteria to formulate the load of people, especially in sport-related the desired environment of the users. The activity. Light conditions will need to provide preliminary design criteria for the treatment efficient light to visually follow performance of methods are thereby: movement. • Open spaces for dining and cooking for • One private room with enough space for multiple patients at the same time with an easy comfortable seating for the patient and overview for the nutritionist. A space where the psychologist. nutritionist can explain about the food’s origin, • A room big enough for a patient, relatives, preferably through nature.

1.1

TREATMENT FACILITIES Different treatment settings and their respective advantages and disadvantages In order to design the spaces required for the therapy to be conducted in the best possible way, the question on the facility’s purpose must be taken into consideration when designing the atmosphere and additional spaces. The treatment of eating disorders can be carried out in many different settings. According to Herpertz et al. three types of treatment facilities are relevant when treating eating disorders, an ambulant setting, a stationary and a day clinic. Which setting is suitable depends on the severeness of the eating disorder, the type and number of other accompanying illnesses, the treatment facilities available in the region, the living conditions and the decision-making behavior of the person affected. (Herpertz et al., 2011) The three treatment types can be divided into two categories. A stationary treatment and shortterm treatments. These two categories require different spatial needs, which will be investigated in the following.

personal responsibility and independence. As inpatient care, a combination of different treatment methods is easier to achieve, such as group therapy, medical care or family sessions in addition to individual therapy but it is a premise that patients can travel daily from their home to the day clinic. A patient can be treated in a day clinic setting from the beginning, if their physical condition permits, but it has also been proven to be effective at the end of an in-patient treatment. (Herpertz et al., 2011)

AMBULANT TREATMENT SETTING In the ambulant treatment, the patient remains in his/her familiar home environment and visits the psychotherapist and family doctor for physical examination on agreed appointments in order to normalize the patients eating behavior and weight. It advantages the patient’s usual surroundings and thus does not lose social connection. If intensive medical care is necessary, STATIONARY TREATMENT SETTING this is only possible to a very limited extent. A hospital stay is necessary if patients suffering (Herpertz et al., 2011) from anorexia are at risk of death due to a very low weight. In the stationary stay, the patient is To sum up, the 3 kinds of treatment facilities will given clear guidelines and assistance with eating fit the individual patient’s needs, depending on behavior and different types of therapy can be the state and type of their condition and will easily combined. A disadvantage, however, is require different spatial settings. A stationary that it is necessary to interrupt work or school treatment will need a highly sterile environment and the ability to live independently can be because people are at risk of death or have unlearned during very long and repeated severe injuries. The treaters’ work environment hospital stays. (Herpertz et al., 2011) will therefore overrule the otherwise homely and casual environment that might be seen in an DAY CLINIC TREATMENT SETTING ambulant - or day clinic setting. In order to define The benefits of treatment in a day clinic is that the setting of the health care center on Egholm, longer stays in a hospital can be avoided and the one must take the physical location of Egholm and daily change between intensive care and return the specific users into consideration. Patients with to everyday life can emphasize the patient’s AN have the biggest risk of being hospitalized 26

referral to

Patient consults with family doctor, specialist or psychotherapist

stationary tratment OR further outpatient treatment

Ambulant psychotherapy alone or with the family

day-clinic (partly stationary)

Illus 8 - Treatment settings

and since they are least represented in the Danish statistics of people with eating disorders, another hospital for stationary treatment might not be necessary. Moreover, Egholm Island is a remote place and difficult to get to, even though it is close to Aalborg mid-town, and especially not a place for severe emergency treatment.

The setting of the health care center of Egholm must therefore be a place for daily treatment, with the possibility to stay overnight, combined with ambulant treatment, that will include the spatial needs stated in the â&#x20AC;&#x2DC;treatment methodâ&#x20AC;&#x2122; chapter. This will be explored further in the indepth analysis of the specific users and site characteristics of Egholm.

1.1

BR18 What are the different requirements from BR18? To develop a health care facility with optimal indoor environment and good life conditions for its users, the Danish building regulations and requirements for building performance is studied.

Energy use 1

CATEGORY Dwelling Office

Lighting 2

Acoustic

Thermal

II4 II4

Air quality - CO2

Ventilation rate 2

DESIGN CRITERIA 27 kWh/m2 per year 33 kWh/m2 per year 300 LUX =3% daylight factor Noise indoor: 55dB (from rooms outside the dwelling)3 Noise outdoor: 25 dB (from traffic)3 Summer: 21-26oC5 Winter: 19-25 oC5 660 ppm (Outdoor C02 concentration: 360ppm) Supply: 0.3 l/s per m2 Extract: Kitchen: 20 l/s Bathroom: 15 l/s WC and utility room: 10l/s Heat recovery: 85%

Danish building regulations. Low energy class 2020. (Trafik - Bygge og Boligstyrelsen 2018) Danish building regulations. Chapters 16, 17, 22. (Trafik -, Bygge- og Bolig styrrelsen 2018) 3) DS 490. Tables 1 & 5b. (DS 490, 2007) 4) DS/EN 15251. Table 1. (DS/EN 490, 2007) 5) DS 474. Figure V 2,3 & Annexes B & C. 1) 2)

SUB-CONCLUSION

1.2 USERS

Egholm Island is a remote place and difficult to get to making it undisturbed compared to the city and is therefore perfect for a daily ambulant treatment of people with AN, BN, and BED in the age range of 13-30. The setting will complement the architectural design solution specific to the design criteria of such specified in the treatment method chapter. The design will focus on optimal local, low emission materiality solutions in terms of the 3 sustainable aspects analysed through LCA and LCC, while limiting the economic aspects and encourage the user to participate in a sustainable lifestyle. All will need to match the Be18 low energy class 2020.

1.2

USERS Who are the users, what are their backgrounds and key problems, and what is the process behind?

Through the course â&#x20AC;&#x2DC;Architecture, Health and Well-beingâ&#x20AC;&#x2122;, several personas have been created in order to represent different patient types that would be present in the daily life at the health center. These personas have been translated into users and included in the project. The patients have been selected from the statistics (see page 23), whilst the staff has been selected through research of different types of treatment of the patients (see page 26) For example, the most common EDâ&#x20AC;&#x2122;s are AN, BN, and BED, and therefore these three have been selected. Creating such a specific user group, allows for more concrete design criteria, addressing the individuals more profoundly.

The interview was one-to-one by phone whilst taking live notes and taping, with the aim of transcribing the interview afterwards. The semi-structured interview with a general guide approach would still allow a degree of freedom and adaptability according to the responses from the interviewee, who was the representative of the LMS hotline on that day and not a treater herself. The results are therefore subjective and qualitatively relying on her professional knowledge. It was conducted in Danish in order to let the interviewee feel comfortable to answer questions in an informal manner. An English summary of the interview has been made. The entire interview can be found in annex p. 154.

The users have been created by the use of dif- The following two pages introduce the different ferent research methods and tools, (see illus 9) users, focusing on their background, key proballowing knowledge of their individual back- lems and the design solutions of those. grounds, key problems, and specific possible design criteria through state-of-the-art. For example, in order to analyze the treatment challenges of a patient with an ED and generate general knowledge with an explorative approach, an interview with LMS (Landsforeningen mod spiseforstyrrelser og selvskade) was conducted.

ACADEMIC RESEARCH STUDIES UNDERSTANDING THE PATIENT DOCUMENTARY/ MOVIE DESIGN STRATEGIES INTERVIEW FROM A RESEARCH JOURNAL SHAPING THE PERSONA INTERVIEW FROM LMS STAFF TREATMENT STRATEGIES LITERATURE STUDIES KEY PROBLEMS PERSONAL EXPERIENCE

Illus 9 - Process behind creating a persona

1.2

PATIENTS USER

TIMELINE

KEY PROBLEMS

CAROLINE

7:00 skipping breakfast. 8:30 parents drive her to Egholm 9:00 family therapy session 11:00 attends cooking class and walk in the garden 13:00 dining time 14:00 socializing with other patients 15:00 relaxing in private space 17:00 Leaves Egholm

• Social anxiety, isolates herself due to fear of losing control • Hard to concentrate – thinking about what she eats. • Constantly getting pressure from surroundings • Cognitive dissatisfaction with appearance • Physical changes such as hair thinning, weight loss, etc.

6:30 eating breakfat alone 7:30 bikes to work 8:00 working in her office at the university 13:30 eating lunch with colleagues 14:30 biking to Ehgolm 15:00 private therapy session 16:00 attending yoga class 17:00 socializing with other patients 19:00 leaves Egholm

• Transitioning from hospital to milder treatment can be difficult without support and a safe place to be. • Lifetime disease, which can evolve into other eating disorders. Comorbid disease and difficult to define what the primary and secondary illness is. (Rosenvinge & Pettersen, 2015) • Same level of low self-esteem as depressed leading to binge eating and purging. (Cooper, Todd, & Wells, 1998)

ANOREXIA 11 years old

MARIA BULIMIA 29 years old

FELIX BED 31 years old

6:30 wakes up at the healthcare centre 7:30 breakfast with others 9:00 meeting with dietician 11:00 attends cooking class and walk in the garden 12:30 communal lunch 14:00 group theraphy session 16:00 socializing with other patients 19:00 decides to stay overnight

• Can lead to other eating disorders such as bulimia, and is a comorbid disease • Health problems related to obesity • Not willing to be seen in public due to guilt and shame • Feel a huge loss of control

FUNCTION DIAGRAM

Private therapy room

Common cooking/ dining

Activity room

Outdoor activity area

Private room

Private therapy room

Common cooking/ dining

Family therapy room

Excersice room

Outdoor space relating to food

DESIGN SOLUTIONS

Family therapy room

Group therapy room

Outdoor activity area

Outdoor space w. social interaction

Group therapy therapy room room

Exercise room

Private therapy room Family therapy room

• Private spaces with minimal levels of sound for more quiet respite, to reduce anxiety. • Playful elements that respond to children’s sensibilities, variating in scale, color, and form to distract the brain from thoughts of food intake (Glod C. A. et.al., 1994) • One-to-one therapy, family therapy, outdoor active areas in order to teach the patient to cope with pressure from surroundings (Battisto, D. et.al.) • Home-like atmosphere (e.g. wall art, comfortable seating, easy access) to make patient feel comfortable and thereby healthier (Glod C. A. et.al., 1994) .

• Provide a homely, non-clinical atmosphere in order to obtain a healthy routine and thereby eating habit (Erbino etal., 2015) • Provide rooms for, exercise, art therapy, group therephy, family therapy and one-to-one sessions in order to deal with the comorbid disease (Erbino etal., 2015) • Provide common dining/cooking area to prevent issue of skipping meals and binge eating (Söderback etal., 2004) • Multiply treatment and therapy rooms in order to treat the comorbid disease best possible (Erbino etal., 2015) • Should provide options for families to work, eat and be outdoors, in order to obtain healthy relationship with food (Battisto, D. et.al.) • Create outdoor spaces which create interactions with the different senses, include water features and interactive activities, and allow per - son-environment and person-to-person interactions to prevent shame in company with others (Ulrich, R.S. 1999.) • Exercise rooms for the patient to develop a healthy and natural habit of movement for better health in order to gain control of body image (Söderback etal., 2004) 33

1.2

STAFF & RELATIVES USER

MARY THERAPIST 38 years old

GRETA DIETICIAN 41years old

CHARLOTTE PARENT 45 years old

TIMELINE

KEY PROBLEMS

7:00 eating breakfast w. family at home 7:45 bikes to ferry to Egholm 8:00 staff meeting 9:00 family therapy session 10:30 officework 12:30 socializing in breakroom 13:00 joins dining time w. patients and colleagues 14:00 group therapy session 15:00 private therapy session 16:00 officework 17:00 leaves for the day

• Risk of stress and frustration due to no or little results in therapy and constant switch between therapy and keeping journals. • Feeling lonely, since she doesn’t have much time together with colleagues at work • Must constantly express empathy, positive thoughts and be professional.

6:30 eating breakfast w. family at home 7:30 bikes to ferry to Egholm 8:00 staff meeting 9:30 officework 11:00 cooking class and walk in the garden 13:00 dining time 14:00 break with colleagues 14:30 office work 16:00 yoga class therapy 17:00 end of day

• Co-ordination and co-operation with other therapists as the treatments shouldn’t interfere with each other. • -Dealing with reluctant patients. • Mentally and physically demanding work due to multidisciplinary work e.g. cooking, teaching, gardening, consulting, bureaucratic work. • Risk of illness as dietitians can run the risk of developing an eating disorder themselves.

7:00 eating breakfast w. family at home 8:30 drives Caroline to Egholm 9:00 family therapy session 11:00 leaves Egholm for work 11:30 work 14:00 socializing with relatives 16:00 returns to Egholm to talk to other relatives 17:00 spend time with Caroline in activity room

• Self-blamed guilt of her daughter’s eating disorder (Fox et al. 2015) • Exhausted of worrying about her daughter and her treatment. • High risk of depression during self-blamed guilt.

FUNCTION DIAGRAM

Sound protected office Private therapy room

Edible planting landscape

DESIGN SOLUTIONS

Common staff area Family therapy room

Teaching room Consultation room

Relatives

Common cooking/ dining area

On-site farming facility

Activity room Social area Outdoor activity area

Family therapy room

• Proper seating and office arrangements, with sound protection and user control of indoor comfort in order to reduce stress (Lee, S et.al., 2005) • Common breakroom for staff members for them to socialize preferably with views to/contact with nature and daylight, in order to prevent loneliness (Alimoglu, M. et.al, 2005) • Private space/office in order to separate herself form patients’ thoughts and feelings (Ulrich, R, 2008)

• Provide areas conductive to teaching, presentation and demonstrating cooking away from the traditional therapy one-to-one session rooms, in order to separate treatment methods (Sørensen et.al, 2013) • Create variety of seating arrangement to make each individual patient feel comfortable (Haas, 2011) • On-site farming facility in connection with kitchen in order to make her multidisciplinary work easier with direct access and use edible plantings for

• Space for a support group and family therapy for the parent to cope with self-blamed guilt (Fiorillo et al. 2016) • Homely and safe environment in the center in order to reinsure the parent, that her daughter is in a safe environment. • Include more interactive activities for children and relatives at the center to reduce the relatives selfblamed guilt (Battisto, D. et.al.)

1.2

HEALING ARCHITECTURE & GARDENS How can architecture and gardens contribute to the rehabilitation and well-being of patients?

Healing architecture is a design concept, that represents the vision, that architecture influences the wellbeing of humans, as well as contribute to or promote healing. The concept has a primary focus on health care facilities including especially hospitals, but also hospices, rehabilitation centers etc. (Frandsen et al. 2009). Therefore, the sources used in this analysis mostly have a focus on hospitals and humans in general, not people suffering from eating disorders, and should therefore be implemented carefully. More and more research on healing architecture has provided a basic understanding that factors such as light, views, noise, colors and art, could be implemented in hospital design. It is, however, difficult to design spaces that ensure faster healing but based on several studies, certain guidelines have shown to benefit the healing process, especially in hospitals.

NATURE Research studies also explore the correlation between human health and contact with nature. Being able to be in contact with or look at natural surroundings, appears to have a positive impact on both physical and mental health. Not only patients but relatives and staff as well, use the natural areas as a calming refuge (Frandsen et al. 2009). Roger Ulrich argues the importance of healing gardens for staff at healthcare facilities. Healthcare occupations can be stressful due to work overload, lack of control, etc. Consequences include lowered job satisfaction and a decrease in the quality of patient care. Healthcare staff use gardens as an escape from pressure and stress (Ulrich 2002). Angeliki Paraskevopoulou and Emmanouela Kamperi, who have studied healing gardens according to different diseases and users, highlight this as well. Staff needs a space where they can isolate themselves. For the garden to function as an escape, it should express the opposite of the inside of healthcare facilities. Soft surfaces, quietness, and sounds of nature, privacy, greenery, and colors, are among the design guidelines related to staff (Paraskevopoulou and Kamperi 2018). The same is relevant for patients suffering from mental disorders, where visible paths and access to buildings and signage, contact with nature, that utilizing the senses, as well as activities and family atmospheres are design strategies (Paraskevopoulou and Kamperi 2018).

LIGHT/VIEWS Studies indicate that daylight is an important factor to all occupants in healthcare facilities, be it patients, relatives or staff. The studies also found a significant correlation between the quality of light and the number of mistakes made. Such mistakes include wrong medication. Another important aspect is the use of light therapy (Frandsen et al. 2009). The somewhat famous study by Roger Ulrich â&#x20AC;&#x153;View through a Window May Influence Recovery from Surgeryâ&#x20AC;? indicates that patients with views of nature will be hospitalized for a shorter period of time, compared to patients who donâ&#x20AC;&#x2122;t have views towards nature (Ulrich 1984).

CONCLUSION As stated in the treatment chapter, the health care center will contain various treatment settings, being private one-to-one or social/family spaces. Privacy and acoustics are important in several aspects, for both patients, staff and relatives. Privacy, and thereby confidentiality, can influence the extent to which relatives will participate in the patient’s treatment. Frandsen et al. argues how several studies indicate how the physical appearance of relatives is crucial as they are important factors in patient treatment (Frandsen et al. 2009). Not only relatives can aid in the healing process. Interactions between two patients with the same disease has shown to reduce anxiety, worry and fear and thereby promote healing and reduce hospitalization time. Whether or not patients prefer a private or shared room is depending on their individual level of personal social interaction. For those who preferred a private room, the most common reason is “a space where one should not deal with anybody” (Frandsen et al. 2009) The above-mentioned design strategies are, as stated in the introduction, mostly a result of studies of hospitals and humans in general, not rehabilitation centers with ED. Therefore, in order to narrow the strategies down, and turn them into solutions, they have been filtered through the multiple aspects of patients, relatives and staff members and their individual behavior, requirements and wishes to design a health care facility that works for all. These are the resulting design criteria of such a process:

PATIENTS • Visible paths • Easy access to buildings and wayfinding • Contact with nature that utilizes the senses and activate its users, for example through green houses and plant beds • Private spaces for confidential talks • Private spaces to be alone • Social space for recognition and approval • Private family space RELATIVES • Private spaces for confidential talks • Social space for recognition and approval, a place where they can socialize with other families and patients. • Space for personal healing • Private family space STAFF • Gardens as an escape, including soft surfaces, quietness and privacy as well as calming sounds from nature • Greenery and colors. • Private spaces for confidential talks • Social space for recognition and approval • Space for personal healing

SUB-CONCLUSION

1.3 SITE

Among the users, several key problems have been identified. For patients, problems are naturally related to the disease, e.g. fear of loss of control, societal pressures and not wanting to appear in public settings and feelings of low self-esteem. These problems indicate the need for a space for them to feel acceptance and no pressure, as an escape. Another aspect is their health-related problems, where in fact all the patients must restore a healthier relationship with food and their body image. Relatives and staff membersâ&#x20AC;&#x2122; main problems are dealing with the disease objectively. Relatives, being non-suitable to handle the situation, have a high risk of illness themselves whereas staff members, who work in a mentally demanding environment, need a space where they can be recognized. Therapists also spend many hours working alone and could benefit from social spaces. The study of healing architecture has provided some design strategies, that could answer the abovementioned key problems.

1.3

USER SITE When visiting the project site in the very beginning of this project, the user was not yet defined. Since Egholm is an ecological island that produces local organic food, the idea of a center for people suffering from eating disorders was formed. The center should incorporate the history of the site, by implementing local farming and thereby restoring a healthy relationship with food.

The process was considered from the point of view of both the users and the site. The site fits the users in its location, being distanced from the city and closely connected to nature, facilitating meditative and restoring functions. Looking at the overall context of the site, the city of Aalborg and the entire region of Northern Jutland, have no rehabilitation facility similar to this project, which stresses the opportunity of designing such a facility. It is important to notice that the project’s aim, is not to restore patients to physical health, as it is in a hospital. The goal is to care for the patients’ mental health and help them to find back into everyday life without the disease.

Bakkely

Holmstrupgård Kildehøj

Ved Sønderåen Helheden

Askovhus Pomonahuset

Ungehuset

Illus 10 - Map of healthcare facilities in Denmark for eating disorders.

1.3

EGHOLM What is the story behind Egholm, how do you get around, and what does it consist of? ABOUT EGHOLM Egholm Island lies within a central location in Limfjorden, just 2 kilometers from Aalborg center. The island is 605 hectares and most of the land has been used for agriculture for over 500 years (Aalborg. dk(A), 2020). Recently, these areas have been purchased by ‘Folkefarm’ which produces local organic food for the residents of Aalborg. Egholm island is also the largest organic island in Denmark (Egholm Folkefarm, 2020). A wide variety of interesting plants and animals can be found and observed on Egholm. The northern part of the island is a “Nature 2000 Area”, a nature reserve where many migratory birds stay in spring and autumn. (Aalborg.dk (B), 2020) With its nature and landscape, Egholm is a paradise for inhabitants and tourists all year round. Every year more than 100,000 visitors come to enjoy the idyllic and peaceful nature near the city. Most of the island is privately owned, except for the 17 hectares ‘Kronborg Skov’, which is owned by the municipality. (Aalborg.dk (A), 2020)

ACCESS Since Egholm is an island, the only way to get to Egholm on foot or by car is with the ferry. The crossing with the Egholm ferry (Egholmfærgen) starts in Aalborg havn and takes less than five minutes. Paved roads lead car and bicycle drivers directly to Egholm town. All other roads are dirt roads and only suitable for walking. This will cause some challenges in terms of accessibility for wheelchairs, people with walking disabilities, general deliveries of goods to the health center, emergency exits and perhaps also the fact, that visitors, patients and staff members shall be able to walk to the center without getting wet and muddy feet. The only access to the site is beyond the site limit through the dirt road in the farthest back. Access can sometimes be possible from the front of the site walking by the waterfront, but because of the current climate changes water levels of the fjord rises rapidly and sometimes the path is gone by the water. This can happen from day to day. See flooding analysis further in the program, for an in-depth clarification. Directly at the ferry pier, there is an information FUNCTIONS, MORPHOLOGY AND GREENERY board where different walking routes are displayed. On Egholm folkefarms, the agricultural production Three marked hiking trails lead through meadows is based on vegetables, sheep and pigs, chickens and woods, passing farms and viewpoints over the and eggs, and the production of honey in beehives fjord. spread all over the island. Egholm town, which is no longer a town has different team-building exercise As illustrated in the study, the access to the site could facilities for everyone to book and enjoy. The great- benefit from establishing a proper roadway in the ness of the nature of the island and the Restaurant back of the site past the residential homes on the closest to the ferry attracts visitors from all over the road or create access through the dense wooden world and some people even decided to have a per- areas for walking. Other solutions to the problematic manent summerhouse east on the island. The variety state of easy access will be explored in the sketchof the greenery on the island makes for a landscape ing phase in combination with other favored design of diversity when walking on the marked hiking trails strategies. whereas some of the dense woods are made for public camping.

Illus 11 - Access

250

500

750

1000m

Illus 12 - Functions, Morphology and Greenery density of Egholm

1.3

PHENEMENOLOGICAL What is the overall atmosphere of the site? WORD MAP Phenomenological research methods seek to establish an in-depth understanding of a phenomenon through quality. The purpose of the following word map and picture analysis, conducted with a Genius Loci approach, is to describe the atmosphere on the site by approaching it as a space rather than a place, opposite to mapping. Making notes of the experiences with words and pictures that portray or elicit a feeling, a sense, is a way of communicating a subjective experience of the atmosphere of the space into an objective.

island are, among others: wind, open, views, waves, birds and salty. Those towards the northwest of the site are: openness, loud, noise, light, surprise, and vegetation. The two edges of the site are therefore described very differently and will be used in the sketching phase of the design development of the Health Center in order to either adapt the word of the senses and implement it in the design or otherwise handled. The east and west part of the site is dominated by clusters of trees and wood-like-feeling. The words used to describe the character are dark, embracing, The words describe the subjective sensorial and rusting, closed and noise and will like the others visual experience of a site visit by noting down, to be used in the sketching phase to design with what feelings were activated and what physical its character. elements were important to the subject. The site has a deep connection to the nature of the island. It is located just on the edge of the island with a view of the fjord and Aalborg city with its urban vibe and tall buildings in the distance on the mainland. Looking towards the west are fields, greenery and few houses alongside the water. Words describing this edge of the

FRIENDLY

VARIABILITY

WELCOMING

ET AT I

DA R

VI W

W EW AV ES S

HI NG

SW AN BIRD S S

EN Y OPSALT

W OO

UELS BLSEA

UR G K IN AR AC D

RA IGHT EW I GE NBO ES W E V

L CO

SK ONES W Y N S NA E M T T

L E L OS T RP CA CL US R HI LO UD ISE T A LO TC NOWHE GH LI

G IN SE OW RI BL URP

IDYLLIC

PLAYING

Illus 13 - Word map illustrating a phenemenological perception of the site and surroundings

100

150

1.3

CONTEXT AND MATERIALITY OF SITE The site illustrated through pictures

Illus 14 - Pictures of site

1.3

NATURAL MATERIALS Which natural materials are present on the site, and what are their properties? Looking further into the sustainable environment, an investigation of the natural materials that can be found on Egholm is conducted. There are many natural materials found which could be used as building materials for different purposes.

regulations, a thickness of 75 mm must be added when calculating the U-value. (Munch- Andersen and Møller Andersen, 2004) RAMMED EARTH Rammed earth consists of a mixture of gravel, sand, mud and a small amount of clay, which is pressed into a frame. The mixture is naturally found in the soil in Denmark. Rammed earth constructions can be mixed with 5-10% concrete to increase durability and strength. (Minke, 2009) The thermal conductivity of rammed earth is quite poor but can be improved with additives such as expanded clay, straw or other natural insulating materials. Rammed earth constructions have a high thermal mass, which provides a stable temperature inside a building. Due to the absence of flammable materials, a high level of fire protection is given. Tests have also shown excellent sound reverberation properties and no generated echoes, as with materials such as concrete. (Yourhome.gov.au, 2020) When considering natural materials, it is important to consider the amount of material needed to construct the building, whether this amount is available and whether it is a viable alternative natural solution. If the material is limited in its natural form, artificially treated or transported over long distances, it is no longer a sustainable alternative. A positive example could be the utilization of 100,000 tons of shellfish waste product from seafood production. The only emission caused by the use of this material would be transporting the product to the construction site. (Munch-Andersen and Møller Andersen, 2004). Another positive example is the 2,2 million tons of straw as a waste product from agriculture in Denmark (Munch- Andersen and Møller Andersen, 2004), which in theory could be used as building materials, depending on the treatment.

STRAW Straw is a natural CO2 embedded waste product from agriculture which can be found on Egholm. There are several different ways to treat straw: It can be compacted and used as insulation, set in a structural wooden frame. Straw has different thermal conductivity depending on if the straw’s heat flow is perpendicular or parallel. (MunchAndersen and Møller Andersen, 2004). There is also a company that produces prefabricated straw panels for construction, which meet the requirements of the building regulations. (EcoCocon, 2020) EELGRASS Eelgrass is a natural resource found on the coast around Egholm (Livet på det lave vand, 2020). During its lifetime, eelgrass embodies CO2, collects nutrients and cleans the ocean. Usually, the eelgrass is removed by the local municipality, resulting in high costs (Pallesen, 2018). If it is not collected, the embedded CO2 and nutrition will be released into nature. Eelgrass can be processed into an insulation material with the same thermal conductivity as traditional rock wool insulation (Pallesen, 2018). SEASHELLS Seashells are a natural material that is formed in the ocean around Egholm, which have potential of being used as building materials. When building with seashells, the first 75 mm thick layer of mussels in capillary-hydrating layers is assumed to be moist. To ensure that it meets the building 46

Seashells Eelgrass Nature Protected area Straw Soil Forrest

Illus 15 - Natural materials on Egholm

STRAW -Biproduct from Agriculture -Thermal conductivity: 0,052 W/mK

SEASHELLS -Natural material from sea -Thermal conductivity: 0,112 W/mK (Stamped) (Munch-Andersen and MĂ¸ller Andersen, 2004) -Available for Capillary-hydrating layer -Function best for horizontal layers

EELGRASS -Natural product from Sea -Thermal conductivity: 0,037 W/mK (Pallesen, 2018). -Fire protecting: Class B -Cradle to Cradle gold certificate

RAMMED EARTH -Natural material from ground -Thermal conductivity (Mixed): 0,18 to 0,20 W/mK (Minke, 2009) -High thermal mass Illus 16 - Material properties

1.3

OTHER BUILDING MATERIALS What other materials are available?

As not all building materials can be found locally on site, further studies of materials are done, focusing on reuse and design for disassembly. Waste from the building industry represent a third of the overall amount of waste in Denmark, and it is therefore important to reuse materials and ensure a more circular approach (Miljøstyrelsen 2018).

CLAY PLASTER Clay is a natural material, meaning that no dangerous chemistry is used to produce the material. The material is not burnt or has undergone other processes and therefore in total emits very little CO2. Clay can absorb moisture and releases it again when the circumstances allows it. This enables the possibility to use clay plaster especially in wet rooms such as kitchen and bathroom REUSED BRICKS as well as living rooms. However, the clay can’t A LCA by the Danish Technical University (DTU), withstand direct water and will need to be treathas shown significant environmental advantag- ed with either paint or chalk, especially on the es if bricks are reused, rather than crushed and exterior. It is more over sensible to damages and used as road fill. ‘Gamle Mursten’ is a company can easily break when hanging a painting on the working on extracting and cleaning bricks for wall. Luckily it is easy to repair, as small cracks reuse and at this point they produce 2 million can be fixed with just a little water and a sponge, per year (Miljøstyrelsen 2018). According to whereas larger holes can be filled with a new Miljøstyrelsen, 2000 reused bricks save the envi- clay mixture (Byg Sundt n.d.). ronment one ton of CO2 (Gamle Mursten 2011). Gamle Mursten has several locations in Denmark, LOCAL MATERIALS including Northern Jutland. Locally found materials can be extracted from unused buildings. According to Miljøstyrelsen REUSED WOOD et al. thousands of buildings, both dwellings and Wood absorbs and stores CO2 from the atmo- commercial, are unused. The materials are local sphere during its growth and use. Reusing wood, resources and popular to reuse in order to be rather than burning it for energy, stores the CO2 more sustainable. Abandoned buildings can conwithin the material. The concept ‘GENTRÆ’ is a tribute to new buildings, not only through consustainable circular approach, where construc- struction materials, but also through windows, tion sites can sort reusable wood, from e.g. tem- doors and furniture. (Miljøstyrelsen et al n.d.). porary railings, and send it to the factories that analysis the quality of the wood. They will thereafter resend it to builders’ merchant stores for resale (gentræ.dk, n.d.)

Constructio

Windowfram Egholm

Hunton Win

6,6 km 5,5 km

Construction wood

Bygma STARK gentrĂŚ

Windowframes Hunton Windproof Screws

6,4 km

7,3 km Aalborg

Raat og godt Recycling station

50 km

Skave

Illus 17 - Map of materials nearby site

A bit of everything Roof tiles Bricks Wood Windows, doors, indoor fixtures

Illus 18 - Map of recycled materials in Denmark

Screws

1.3

SUN HOUR - STUDY SUN HOUR - STUDY Variations in the localised climate around a building has a very important effect on both the energy- and environmental performance of a building both in heating season and summer. Sunhour and wind simulations, as well as studies on flooding, has therefore been conducted in order to specify the possibilities and challenges of placing a building on Egholm island.

south of the shelterbelt. In spring and autumn, however, the site is significantly shaded by the surrounding trees near the shelterbelt, and the hours of sunshine are particularly low towards the north. The most sun exposure is still seen towards south. In summer there are generally many hours of sunshine. Therefore, the best location of a building would be just in-between the shelterbelt and the forest towards east. Here, the The analyses show how the shelterbelt casts building take advantage of the sun south of the large shadows in the north-western part of the shelterbelt in winter and be shaded from it in the site during the winter solstice, while good sun summer by the trees. conditions appear in the north and especially

Illus 19 -

Illus 20 -

EQUINOX

WINTER SOLSTICE

Illus 21 - SUMMER SOLSTICE

1.3

WIND ROSE - STUDY WIND ROSE- STUDY Another important aspect of the microclimate is the wind, which, just as the sun hours, shows the possibilities of implementing active and passive strategies. A parametric simulation of wind direction at different seasons, conducted with general data from Denmark, shows that the wind comes from the west/ south-west in winter and that the forest located southwest of the site provides wind shelter. The direction of the wind during

In summer and autumn, wind from the west and north-west dominates, while no vegetation functions as protection. .

m/s

Illus 22 -

spring is in general more diverse with slight dominance of western, southern and south-eastern directions. The shelterbelt shelters the northern part of the site.

m/s

19,00<

15.90<

17,10

14,31

15,20

12,72

13,30

1113

11,40

9,54

9,50

7,95

7,60

6,36

5,70

4,77

3,80

3,18

1,90

1,59

<0.00

>0.00

WINTER

Illus 23 - SPRING

m/s

13,40<

17,00<

12,06

15,30

10,72

13,60

9,38

11,90

8,04

10,20

6,70

8,50

5,36

6,80

4,02

5,10

2,68

3,40

1,43

1,70

>0.00

Illus 24 - SUMMER

Illus 25 -

AUTUMMN

1.3

FLOODING To what extent will the flooding be critical, and what are some design solutions? Egholm island has its highest point at 1,5 m above the dike when combining the solution with other sea level and it is therefore necessary to investi- design strategies in order not to block the views gate the impact of flooding and different strate- of the water (Kystdirektoratet 2018). gies to prevent a flooded rehabilitation center. SEA WALL RISING SEA WATER LEVELS and STORMFLOODS A seawall is a freestanding, man-build wall in The rising seawater level is a consequence de- between the coast and the area that needs prorived from global warming. The level of the water tection. The wall might have openings, allowing rise depends on the climate changes and is there- passage through and can be closed in case of fore difficult to predict. Danmarks Meterolo- flooding. The wall materials can vary depending giske Institut (DMI) predicts an average increase on its supposed lifespan and can therefore easily of seawater levels to 0,8 m with a maximum of 1,2 be incorporated in the city but might be a bold m before the year 2100 (Kystdirektoratet 2018). move in an open natural area closing off views, Exceptionally high water levels are caused by paths and sense of direction. (Kystdirektoratet weather conditions such as strong winds and 2018). heavy rains. On such occasions, the water levels on Egholm are expected to rise 1,41 m in total ELEVATION OF STRUCTURE within this century. In combination with the rising The elevation of a structure is a strategy where seawater, the water is expected to reach a to- the building is raised from the ground to protect tal height of 2.2 - 2.6 m above the current sea from flooding. The elevation will create space level. (Kystdirektoratet 2019). As illustrated on underneath the construction that might be used the maps of flooding, the site would benefit from for storage, parking or access to the building. protection. Therefore, this study presents a list of Another strategy is to build on pillars but remeans that could be used to protect the site from quires a proper evaluation of construction mahigh water levels. terials that will withstand the impact of flooding on the foundation and loadbearing structure. DIKE (Guide, B, 2020) A dike is a small human-made elevation of the landscape, mostly situated nearby coasts or CONCLUSION streams protecting the land against flooding. The different flood protection strategies proLocating the dike closest to the field with a bit vide basic knowledge on possible design stratof land towards the water will protect the dike egies for securing the building yet need to be from the pressure and reduce the energy and combined with design strategies formulated for height of the waves and thereby its impact on the the specific users, the purpose of the center, acdike. The dike is a simple solution, easy to repair cessibility, and the site analysis. and the top can effortlessly be used for walking paths. One might have to consider the height of

0,8 m

1,2 m

2,2 m Illus 26 - Flooding of Egholm in the future

PASSIVE AND ACTIVE STRATEGIES What are the possibilities for active and passive strategies on the site?

The possibilities of active and passive strategies derived from the results of the micro-climate analysis and can be developed to secure an environmentally sustainable low energy demanding building.

solar panels or solar collectors, appears to be reasonable to take advantage of the sun exposure and could potentially work as shading as well.

Making use of the greenery on site the treeline The sun-hour analysis shows how the expose of and forest provide the opportunity of natural sunlight on site changes throughout the year. In passive shading. The trees are deciduous and winter, the sun offers great possibilities of using will therefore bloom in summer with great bright passive solar heat generation to reduce prima- leaves shading the sun and avoid excessive heatry energy use for heating. Buildings located in ing in the room it is shading. In the winter, the cold climates should have a tight and efficient trees will lose their leaves and let solar radiabuilding envelope with a low u-value to minimize tion pass through the windows. Combining the the transmission loss, and thereby the need for solar condition with a wind analysis allows best heating. Working with and implementing thermal compatible passive strategies. The wind analysis mass through choice of material can be utilized shows a wind flow from west and north-west that to secure good and stable indoor comfort, both can work as an advantage for natural ventilation regarding heat and cooling. in summer, reducing the need for cooling and thereby total energy consumption and adequate During summer passive shading strategies in the indoor thermal and atmospheric comfort. form of overhangs can be implemented with the general knowledge of the sunâ&#x20AC;&#x2122;s path in the sky. Placement of renewable energy sources, such as

Illus 27 - Passive and active strategies

ASKOVHUS Keywords: Homely feeling, ED rehabilitation, living concept Location: Nørrebro, Copenhagen, Denmark Client: Askov Fond, non-profit NGO Year: 1983 Typology: Rehabilitation center for 17 years-old and up. Size: Apartments 66-180 m2 Architects: none Engineers/partners: none

ing concepts that will suit the individuality of the patients. Some patients may be suitable for a ‘solo-house’, living alone within a 5-minute walking distance to the daily offers of treatment, offices and therapy rooms. The room is suitable for patients with a severe comorbid disorder that might be triggered by other patients. Other patients might function best in a ‘double-house’, where the patient will live alongside a student, who is trained, in order to push forward the process of living with others who are not affected by an eating disorder. The last concept is for patients who will function well in a shared house with other patients and a student. The concept layout is apartments in a building block that changes in sizes according to the housing concept.

The essence of this rehabilitation center is the concept of homely living, which is therefore studied in order to understand how such could be designed. The setting is a residential area in the vibrant city center of Copenhagen alongside normal family apartments, and therefore very different from the idyllic setting of Egholm Island. The rehabilitation center is built on 3 liv-

CENTER FOR KRÆFT & SUNDHED Keywords: Human scale, private sanctuary, healing architecture Location: Nørrebro, Copenhagen, Denmark Client: Copenhagen Municipality Year: 2005-2009 Typology: Healtcare centre for cancer patients Size: 1.800 m2 Architects: NORD architects Engineers/partners: Wessberg

The cancer center houses patients of all ages in severe conditions or remission. The core of the cancer house is an inner courtyard, monasterystyle, with a cladding of warm wood contrasting the light-reflecting aluminum facades. The courtyard is described as a sanctuary, where patients and relatives can grow vegetables and spend time contemplating in the sun.

“The demand was clear and simple: create a healthcare center which is more like a home and “Copenhagen Center for Cancer and Health neither less like a hospital” (NORDarchitects.dk) looks nor smells like a hospital and is designed on a human scale as an example of healing architecture.” (Sundhed, 2020)

Illus 28 - (Askovhus, n.d.)

Illus 29 - (Askovhus, n.d.)

Illus 30 - (Nord Architects Copenhagen, n.d.)

THE RESOURCE ROWS Keywords: LCA, upcycle materials and reuse Location: Ørestad, Denmark Client: NREP A/S and Arkitektgruppen A/S Year: 2015-2019 Typology: Residential area Size: 9148 m2 Architects: Lendager Group Engineers/partners: NREP A/S, Arkitektgruppen A/S, MOE A/S

ro construction. “This means that newly built homes could reduce their CO2 footprints by up to 70% in the construction phase, since the building materials have already had a life in another context” (Lendager Group, 2020)

Lendager’s concept is new, thinks beyond building According to Lendager Architects the resource traditions and takes a step in the right direction rows are the first residential homes in Denmark of sustainable buildings. One might argue that built of materials from abandoned homes and the sustainability of recycling the waste material buildings. The façade cladding is reused brick from the metro construction of Copenhagen, will from the Carlsberg Breweries and the interior is be more sustainable, if the waste material in fact from upcycled wood from the Copenhagen met- wasn’t a waste and had not been produced in the

LIVSRUM Keywords: Healing architecture, human scale, homely atmosphere, spatial concept Location: Aalborg, Denmark Client: Kræftens bekæmpelse (Danish Cancer Society) Year: 2012-2013 Typology: Residential one family house Size: 1000 m2 Architects: POLYFORM Architects Engineers/partners: Søren Jensen Rådgivende Ingeniørfirma, Realdania

staff members and visitors and a general easy overview of the common areas from the staff offices, which are located right at the entrance. Polyform Architects, the architects behind the project, has implemented design strategies from the research of healing architecture, that argues how, for example, choice of materials, views to nature and open spaces will have a positive effect on the healing process (ArchDaily, 2020), hence the concept of 5 units of housing with one The counseling center for people with cancer big common area. Livsrum is designed with care and relatives, Livsrum, consists of 5 units with a for the patients but also the staff, and its concentralized common space, dining area, and cepts should be translated into the health care kitchen.. The house is designed in one level on center at Egholm. the ground floor allowing easy access between

Illus 31 - (Lendager Group, n.d.)

Illus 33 - Entertainment room (Stang, 2013)

Illus 32 - Top: Material use, Bottom: Energy savings -(Lendager Group, n.d.)

Illus 34 - Reading / relacation room (Stang, 2013)

1.3

MINI CO2 HOUSES - TRADITIONAL Keywords: LCA, maintenance, traditional building style Location: Nyborg, Denmark Client: Statens Byggeforskningsinstitut AAU Year: 2012-2014 Typology: Residential one family house Size: 136 m2 Architects: LETH & GORI Engineers/partners: Buro Happold aps

traditional building methods with traditional materials that have been proven efficient and thereby an evidence-based project. The main solution in order to reduce the CO2 emission is a brick exterior wall and big roof eaves of 1 m to protect the façade and windows. The wall is a simple construction of pure brick blocks with airgaps and no insulation material or vapor barrier.

The mini CO2 house is a project focusing on 6 residential houses that each test different concepts in order to reduce the CO2 pollution in the production, use and maintenance phases of a building lifetime. Realdania explores how much potential CO2-emission can be saved when a house is built to last for 150 years instead of the traditional 50. House ‘A’s’ concept is built with

This gives a diffusion-open structure that can absorb and emit moisture, so the fluctuations in humidity are balanced. The density of the brick wall works as a thermal mass that will store warmth in the winter and cool in the summer (Realdania.dk, 2020.)

MINI CO2 HOUSES - RENEWAL Keywords: LCA, maintenance, new building style Location: Nyborg, Denmark Client: Statens Byggeforskningsinstitut AAU Year: 2012-2014 Typology: Residential one family house Size: 566 m2 Architects: Arkitema Architects Engineers/partners: Sloth Møller

is seen in the glass wrapping of the house running from the 40-degree pitched roof down the facades. The wrapping is made from reused glass in one wholesome surface with protected joints to avoid leakage. The windows have been drawn back into the façade in order to passively protecting it from wind and rain.(Realdania.dk, 2020.)

House ‘B’s’ concept is building with new material that has not yet been proven efficient and is thereby a research-based project on its way to become evidence-based. The main material used in the construction is wood with a focus on ventilation on all facades of the house as well as underneath by raising the house on pillarfoundations. Protection of the wooden material

The mini CO2 houses represents two different approaches of how to build with a focus on minimizing CO2 emissions. Which materials that will be used in the health care center at Egholm, will be studied further in the design process through life cycle assessments.

Illus 35 - (Mini-CO2 husene: Traditionen, 2020)

Illus 36 - (Mini-CO2 husene: Fornyelsen, n.d.)

The entire region of Northern Jutland has no rehabilitation facilities for people with ED, making the need for such a centre more crucial. The centre should incorporate the ecological agriculture and farming, already existing on the island, through the Genius Loci approach using phenomenological research of the fields, the water and the cluster of trees. Furthermore, the use of materials and the combination of such needs to be local, preferably reused available material such as straw as it is a waste product existing on-site. It should be validated in LCA and LCC in order to choose the most sustainable solution and be cooperating with the microclimatic possibilities of taking advantage of the wind in the summer for cooling and the challenges of flooding.

1.4 CONCLUSION

SUB-CONCLUSION

1.4

ROOM PROGRAM “this singular density and mood, this feeling of presence, well-being, harmony, beauty...under whose spell I experience what I otherwise would not experience in precisely this way”(Zumthor, 2006).

The room program is structured and categorized according to different aspects of the users’ individual needs, evidence-based research, general building regulations, which can be seen on page 28 (BR18) and design strategies formulated on the users’ behalf.

Therefore, to have a sense of guidance in the EMOTIONAL ATMOSPHERE sketching phase of the Integrated Design process, As Peter Zumthor in his book ‘Atmospheres’ keywords have been noted down and in order to constitutes architectural atmospheres: emphasize the atmospheric experience:

Focus

Non-distracting environment with eleActive A range of different activities ments of proper lightening, prober seatfor different purposes at differing position and silence ent times. Including Space needs to provide elements for Welcoming Open plan layout on order for different personalities in terms of differpeople to have an overview of ent seating types and activities the activities going on. Homely A layout structure in human scale that Energetic Variations of colors, materiality allows everyone to be in the same and space for movement place at ones doing different things or activities together. Seen in ‘Livsrum’ Safe A physically safe environment so users View to Direct view to the nature either won’t be injured as well as separation nature in terms of a healing garden or from the tourists and other visitors of the the natural surroundings of Egisland that are not a part of the Centre. holm. Room for A room flexible enough to personalize. Easy access Accessible for all and easy personal- Elements of hanging stuff on the walls, to find, no matter age, mental ization bring personal elements or furniture of challenges and ability of movesuch seen in ‘Askovhus’ ment Warm The materiality and furnishing needs to Private Enclosed plan layout with corbe non-clinical of that seen in the priners, gaps and doors in order vate sanctuary of ‘Center for kræft og to mentally and physically close sundhed’ off unwanted noise and views Intimate Physically smaller room so you sit close to one another.

1.4

ROOM PROGRAM LEVEL OF PRIVACY The level of privacy relates to the atmosphere and will in the design phase be explored through different design strategies and a function program to provide the desired level of privacy.

the materials chosen and is therefore difficult to define when the sketching phase of The Integrated Design Process hasnâ&#x20AC;&#x2122;t begun. The values in the spreadsheet have their starting point in the Danish Building Regulations, that specify the following:

ATMOSPHERIC QUALITY The air change rate is calculated from the maximum number of persons in the room defined by the size and purpose of the room, measured on sensory pollution (olf).

(1) : Buildings, where the use of hours are similar to offices: max 100 h < 26oC and max 25 h < 27oC (2) : Dwellings, with possibility of natural ventilation: max 100 h < 27oC and max 25 h < 28oC

NATURAL LIGHT QUALITY The natural light quality defined for each room is a guideline. Some rooms have specific guidelines such as an office, where direct sunlight can affect the workstation and be distracting for staff. In rooms such as breakrooms, social spaces, and cooking areas, direct sunlight might give the room a spatial quality but there are no guidelines or rules that specify, that such a room shall have natural lighting.

NATURAL LIGHT QUANTITY Defined as an average in each room where guidelines specify the average for offices and remaining rooms as a rule of thumb. ARTIFICIAL LIGHT QUANTITY Amount of illuminance (lux) in a specified area of the room. This specific area can vary depending on the type of room.

The direct natural lightening might also need to be considered in terms of thermal comfort because, typically direct sunlight and heating comes together.

ORIENTATION The orientation is specified to obtain the quality of the light according to the path of the sun. The orientation of the individual rooms will be revised ones again when multiple aspects are combined in the sketching and synthesis phase of The Integrated Design Process.

THERMAL COMFORT The thermal comfort quality, depends on, among other things, the users of the facility and

Meeting rooms

Staff

Staff break room

Staff garden

Patients treatment Patients private

Shared office Staff oncall room

Meditation /Exercise

Gardens Common area

Toilets

Technical room

Storages

Dietitian consultation

Cleaning room Locker room /Toilets Outdoor activities

Storages

Therapy Private/family

Common area Patient bedrooms

Therapy Group

Social spaces Therapy garden

Toilets

Waiting area

Cooking /Dining

Entrance

Teaching garden

Illus 37 - Diagram of functions

Illus 38 - Table illustrating room program

1.4

DESIGN CRITERIA

The building components must be evaluated in an economic aspect, by using LCC to minimizethe overall cost of the buildingâ&#x20AC;&#x2122;s lifetime.

The building must use low impact materials that are environmentally compatible, preferably local re-grown raw material evaluated in the LCA.

The solution for flood protecting and rainwater management A Bmust be ecologically responsible without compro2020 mising accessibility and the safety of the users.

The structural system must be simple, separating mechanical, electrical and sanitary systems and be built from high-quality material with easily accessible joints retaining its value in order to recycle.

Must reach the demands of Low Energy Class 2020 as specified in BR18 preferably through passive strategies to reduce energy demand, need for cooling and secure indoor environment quality.

The design must provide an easily readable built environment and clearly arranged common areas to become an attractive building for all.

The healthcare facility should enhance patients to regain a normal relationship with food, through contact with nature such as green houses and nutritional therapy.

The health care facility must include various treatment possibilities for patients and relatives, being both private one-to-one settings, family therapy spaces, support groups and classes.

The center should incorporate the history of the site, by implementing local farming and thereby promoting a healthy relationship with food.

The health care center must include an outdoor environment and visual relations to the outside space for all user groups.

Direct acces to the garden from a workshop related area

Places for contemplating in the in-between spaces of the natural environment of Egholm and the garden.

2020

Illus 39 - Illustration of where the different design criterias derive from

PROBLEM How is a health care center designed in order to provide various treatment facilities for patients recovering from an eating disorder, which includes the unique nature of Egholm in the treatment through agriculture and nutrition? - And in which way can the design be welcoming on the inside and retreated on the outside, for users to feel welcome but still provide a private rehabilitation setting? - To what extent can the design aim to encourage the users to participate in a sustainable lifestyle and their well-being? How are the building materials of such a center chosen in respect to the users’ well-being as well as economical and environmental sustainability, documented through LCA and LCC assessments? - How are such materials broken down responsively through design for disassembly, when the buildings lifetime has come to an end? How can design elements from existing studies and evidence-based design on healing archi tecture benefit in setting an atmosphere that will have a healing effect on patients, staff and relatives?

2 SKETCHING & SYNTHESIS

SKETCHING & SYNTHESIS PROCESS

The diagram shows th design processâ&#x20AC;&#x2122; phase ly presented as a chro ganized and structure fact, in practice is it lines present a theore the dotted the prac also highlights the inte how aspects of aesth functional, healing technical parameters en into consideration

he complexity of a es that is theoreticalonological, well-ored progress but in terative. The black etical approach and ctical. The diagram egrated design and hetic, spatial, social, architectural and are iteratively takthroughout.

PHASE 01

INTIAL SKETCHING Methods: analogue & digital sketching MOTIVE The initial sketching phase emerges from some of the design criteria (page 68) organized in different sketching rounds with focal points of healing architecture, passive strategies, relation to the site, integration of users, materials and structure. Concepts in the multifarious sketching rounds are thereafter evaluated and compared to each other and the design criteria. The evaluation emerging into new sketching rounds attempting to combine different qualities of different concepts. DECISION The result of the sketching rounds are three concepts: View orientated The concept focuses on the three main characteristics of the site: the fields, the forest and the water. Narrative architecture Leaning towards an approach to healing, this concept ensures private therapy space by orientating them away from other building parts. It creates a distinction between the private and public areas, through form, orientation, and differing floor levels. Another aspect of this concept is stimulating the senses through materials and textures. Village concept The village concept consists of different building modules with different functions, placed around a large courtyard, which, for example, can be used for gardening. It encourages movement through nature between the different modules which are intended as small huts with views out to the surrounding nature.

NARRATIVE ARCHITECTURE

VIEW ORIENTATED

PASSIVE STRATEGIES

VILLAGE CONCEPT 75

PHASE 01

CHOOSING A CONCEPT Evaluating different concepts in relation to design criteria MOTIVE The three concepts are evaluated in terms of other design criteria in which qualities have been extracted to be included in the process. The outweigh can be seen in the table on the left presenting what design criteria the 3 concepts are made of. DECISION Not only one design concept has been chosen to proceed in the design process, but different qualities from the three concepts were brought together into one. However, the view orientated concept is selected as the base concept, due to its ability to emphasize the three natural elements represented in the surroundings on site. The curved facades embrace the surroundings in each direction of which the building shape relates to. Qualities from the narrative concept include a sensitivity towards the therapy spaces through different room heights, level changes and materials. The level changes require the users to either step up or down defining that other zone, creating the spatial settings for a change of mind going in and out of the therapy spaces.

Illus 40 - VIEW ORIENTATED

Illus 41 - NARRATIVE ARCHITECTURE

The village concept orientates towards an inner courtyard, resembling a shared space that can function as a communal garden. The clear separation of zones combined with a common space is highly user friendly.

Illus 42 - VILLAGE CONCEPT

DESIGN CRITERIA

Limited in terms of what types of materials can be used due to the big contrast in geometric and organic forms

Due to the different levels, its more complicated to create flood protection

Despite the organic shape, a simple structure is still possible

Contrast between organic and geometric, and different levels, indicate the structure can become quite complex

Due to many different buildings, will need more technical rooms, however, can have quite a simple structure, possibly a module system

One entire unit, therefore easier than other concepts to obtain a good energy class.

As the individual therapy rooms work almost as individual modules, more energy will be needed and ventilation systems.

The separate modules would mean there would be larger thermal loss and need for more ventilation. Would not work optimally in terms of energy demands.

Provides an easily readable built environment due to clear circulation

Circular movement, and therefore a very clear circulation and orientation system

Focuses a lot on the surrounding nature, and how to incorporate it into the healing aspects of the building

The different therapy rooms are orientated in such a way that no other building parts are visible, ensuring the feeling of privacy.

Courtyard can be used as vegetable garden. Privacy within huts, isolating nature and taking it into the building.

Relates to the site, the view to the three characteristics and uniqueness of the site. Embracing the trees across the site and connecting the forest

Creates different views from the different therapy rooms outwards, with a focus on creating that sense of being in one with nature

Focuses more inwards rather than outwards to the surroundings but does however still frame the nature.

Several buildings more faรงade area.

requires

PHASE 02

FORM FOLLOWS FUNCTION Placing forms which relate to the context and concept of the view orientated concept

MOTIVE To move forward in the design process, the focus shifts to the functions that were to be implemented in the building, in order to design optimal interior spaces. The motive is to implement studies from the analysis phase on the site, users and the need of identified functions represented through the room program (page 38) in order to design for unity.

have been placed on site in relation to each other, defining different building shapes, in which an easily readable built environment is achieved. Common for both shapes, is the concept of including the outdoor environments, through visual relations from the center of the building to all three natural characteristics on site.

DECISION Shaping the building via functions, whilst impleMETHOD menting the concept relating very much to the Each function has its own demands regarding characteristics of the site, results in a building size, location and direction, and can be divided shape that complements its context and prioritizinto three zones: staff, treatment and patient. es the functionality of the interior spaces, ensurBased on this knowledge, and the view orientating user-oriented quality. ed concept, the zones and functions within them,

meeting room staff bedroom

breakroom adm. office

common bedroom patient

dietician exersice

kitchen therapy group therapy

Illus 43 - placement of rooms according to their orientation and size - from the room program

meeting room staff bedroom

breakroom adm. office

common bedroom patient

dietician exersice

78 kitchen therapy group therapy

SHAPE 2

SHAPE 1

Illus 44 - Mapping out the different views

Illus 45 - Mapping out the different views

Illus 46 - Placing zones according to the roomprogram

Illus 47 - Placing zones according to the roomprogram

Illus 48 - Placement of functions within the zones

Illus 49 - Placement of functions within the zones

PHASE 02

IMPLEMENTING A COURTYARD Defining atmospheres of outdoor spaces

MOTIVE A courtyard is implemented to invite light and views of nature into the center of the building as well as the ability to add privacy and distinguish between zones. The distinguished separation of indoor and outdoor is also slightly eliminated as the courtyard functions as a transition zone. METHOD The process of implementing a courtyard mostly focuses on shape 2, as it invites to implement the tree line. The courtyard provides the opportunity to continue the trees through the building and put emphasis on the connection of the two forests. By implementing a courtyard, different plan iterations have been produced to fit the demands of the room program. The initial change has been to stretch the building to provide more space towards the north, where many of the therapy and working areas should be placed, according to the room program.

Illus 50 - Incorporation of courtyard in shape 1

DECISION Implementing the courtyard in shape 2 is the chosen solution as it is found to emphasize the concept. The shape finishes the treeline and connects it to the forest and frames the three nature characteristics on site. Interiorly, the combination of the building shape and the courtyard, provides the best spaces with a discrete zoning of functions.

Illus 51 - Incorporation of courtyard in shape 2

Illus 52 - The greenhouse in direct relation to kitchen and food-teaching area. Transition zone between inside and outside kitchen and teaching garden.

Inner courtyard darker place with less sunlight, to grow berries and other plants like moss that livw in forest areas. Darker and enchanted atmosphere (Courtyard, nd.d)

Illus 53 - Small nieches as retreat with deep connection to the exterior nature and inner courtyard d Illus 54 - Kitchen/dining furniture of

Patients

the room should be active Illus 55 - Have emphasis on this room, make it he centralized space. Becomes the common area and meeting point. Direct relation to greenhouse

Staff Therapy

Illus 56 - The healing garden must be the

Illus 57 - The teaching garden should

be related to the kitchen/dining/ common area, making it possible to heal through activity which evolves around food

nature of Egholm and connect with the building envelope. The healing garden is the surroundings (the way through the surroundings to the building) - no need to plant extra plants (except teaching garden

PHASE 02

QUALITY OF THE PLAN LAYOUT Refinement of zones, movement, functionality, private/public space

MOTIVE advantages are highlighted and combined into Different plan layouts have been made in order to achieve coherency between building shape, DECISION interior spaces and shape of the courtyard. The result is a plan layout which divides the different functions of staff, patient rooms and theraMETHOD py with an easily readable floorplan. In order to The different layouts 1, 2 and 3 are chosen as the ensure adequate indoor conditions calculations most efficient solutions and discussed on Micro- on structure, Be18, daylight and BSim will be consoft Teams. Each layouts’ individual qualities and ducted further. Advantages: Niches implemented create both cross-visibility and private areas. Due to flooding, the building is lifted, which makes the courtyard difficult to provide straight access to (concerning disability), and the niches are therefore a good “compromise”. The kitchen/ dining area located towards the west, and the exercise room towards the south, are good solutions. Challenges: Not enough patient bedrooms. The common space is difficult to design due to the shape of the courtyard and the level change. The zoning between users is not very clear. .

Courtyard Patient rooms Staff Therapy

Illus 58 -

PLAN LAYOUT 1

Courtyard

Advantages: Clear zoning of users and functions. More spacious and more patient bedrooms. Challenges: The facades are quite covered in rooms, which works against the concept of opening to the three nature views. The positioning of the kitchen separates the common spaces and divides into two sections with limited purpose.

Patient rooms Staff Therapy

Illus 59 -

PLAN LAYOUT 2

Courtyard

Advantages: Incorporates the level changes from the narrative concept, which is challenging in this specific shape. Clear division of staff and patient zones. The kitchen/dining area towards the west is a good solution. Challenges: Facades are covered in rooms and works against the concept of opening to the three nature. The courtyard is divided, which makes it difficult to continue the treeline through the building. Not enough patient bedrooms.

Patient rooms Staff Therapy

Illus 60 -

PLAN LAYOUT 3

Plan layout 1

Illustrated through hatches, the areas with one type of hatch, relate to the plan layout with that same hatch. For example, the courtyard from plan layout 2 is chosen, as well as therapy areas along the northern faรงade, which are found in both layout 2.

Plan layout 2 Plan layout 3

Illus 62 -

COMBINING THE DIFFERENT PLANS

Courtyard

Along with determining the final locations for the functions, the building shape is also decided, resembling the one found in plan layout 2. This also ensures the best coherency between the shapes of the building and the courtyard.

Patient rooms Staff Therapy Illus 61 -

FINAL PLAN LAYOUT

PHASE 02

INCORPORATING THE STRUCTURAL SYSTEM Structure and roofing

MOTIVE Throughout the sketching phase, different types of structural systems have been investigated to work optimally with the plan in terms of load bearing systems and aesthetics. The form of the building has been adjusted by the principle of the structural system into a stricter yet standardized form. Structural system 1 is based on a normal pitched roof. This leaves the building with a system that only requires simple frames or trusses reflecting the typology of the existing buildings on Egholm.

Illus 63 -

Structural system 2, is based on the same standard pitched roof, which is slightly shifted creating a corridor on the inside with a lower ceiling. The complexity of the frames and trusses requires more material than solution 1 and is therefore less sustainable. DECISION The final structural system is based on system 1. Instead of frames or trusses, it consists of beams resting on load bearing elements. The choice of the structural principle is then modified based on decisions made on materiality, interior concepts and visions.

STRUCTURAL SYSTEM 1

Illus 64 -

STRUCTURAL SYSTEM 2

Illus 66 - Simplified illustration of reference points and

measurements

PHASE 02

BE18 & DAYLIGHT TESTING Different forms and windows in terms of daylight simulations, and energy calculations

Daylight factor analysis The daylight simulation of both variations of the plans provide greater understanding of the visual quality of the indoor environment as well as highlighting critical areas that may need additional light exposure. Multiple smaller windows are found to provide a more even daylight distribution, whereas fewer but bigger windows result in larger areas with limited daylight.

Testing energy demands in BE18 and daylight in Honeybee, Rhino in relation to each other gives the possibilities of modifying an element and evaluating the modification in multiple aspects. It is well known that even the smallest modifications of a concept have great influence of multiple aspects of the overall performance. Therefore, considering gradually modifications in both BE18 and through daylight simulations visualize the possibilities and complications of such modifications. It supports the design process with reliable results rather than assumptions and rule of thumb guidance.

DECISION To decide which variation has the biggest potential for further redo a comparison of the MOTIVE two must be conducted where not only the Be18 calculations results of the energy demand and the daylight is The motive of doing a calculation on the energy compared within the variation itself but also as demand in the BE18 calculation tool early a total comparison weighting the pros and cons. in the process is to verify, through technical methodologies and tools, if the concept is The investigations show how neither variations suited for further investigations and detailing. If reach the total demands of energy class 2020 the building performance is far from adequate and wil therefore need further detailing to reach additional solutions will need to be implemented such demands. Additionally, it clarifies how differently and preferably early as possible. variation 2 has the biggest potential of reaching the demand more efficiently than variation 1. Energy calculations of two variations of the plan, The difference between variation 1 and 2 is 5,1 one, which is purely developed from functional kWh/m2 year. room organization and another modified by the structural system. The purpose is, to consider Modifying the variation 2 according to the which one has the biggest potential for further structural system has shown great results in the detailing. The two BE18 models is calculated with daylight conditions of the indoor environment as the same inputs regarding ventilation rate and the width of the building is narrower and thereby internal loads. allows daylight to enter the middle and most critical areas.

Illus 67 - VARIATION

BE18 ENERGY CALCULATIONS: Area: 718 m2 Window area: 176,83 m2 Energy demand: 100,0 kWh/ m2 year

Illus 68 - VARIATION

BE18 ENERGY CALCULATIONS: Area: 717 m2 Window area: 177,1 m2 Energy demand: 94,9 kwh/ m2 year

PHASE 03

ENERGY SOURCES Supplying the building with sufficient energy sources HEATING SYSTEM Egholm is not connected to district heating, therefore, four heat source solutions are studied: air-to-air, air-to-water, solar thermal collectors and ground source heating. Air-Air or Air-Water heat pumps are easy to install and design for disassembly, but they require a lot of maintenance and are noisy. The heat pumps would be placed for each room multiple times on the faĂ§ade, which is unfortunate aesthetically. Solar thermal connectors require the right position according to the sun and plenty of space on the roof. They depend on the constant change of weather and are inefficient when the sun is not shining, where an additional system would be needed to provide energy. Ground source heat pumps, either horizontal or vertical, has been found to be the best solution regarding efficiency and aesthetics. Despite the fact, that the solution can be difficult to install and is not easy for design for disassembly, the horizontal ground source heat pump has been chosen. More information on the different heat sources can be found in annex p.169 BE18 & BSIM To design a building that is low energy class, and have a proper indoor environment, a process of optimizing the building is done. Multiple passive strategies are investigated in simulation tools like BSim and Rhino for indoor climatic conditions and validated in the BE18 calculation tool. In Be18, the entire building is analyzed. The buildingâ&#x20AC;&#x2122;s geometry, ventilation system, heating system and internal loads are included, to calculate the energy frame. In BSim, the critical rooms, patient bedrooms and exercise room facing southeast are analyzed, to ensure the indoor thermal and atmospheric comfort. According to Danish building regulations, temperatures in dwellings must not exceed 100 hours above 27oC and 25 hours above 28oC. In other building types, different from dwellings the regulations are 100 hours above 26oC and 25 hours above 27oC (Trafik-, Bygge- og Boligstyrelsen 2018). The bedrooms should fulfill the requirements applied to dwellings, whereas all other rooms in the building should fulfil the requirements for other buildings than dwellings. The results below are based on a patient bedroom. The full process can be found in annex p. 171. In addition to this, the results of the indoor environment in the exercise room, can be found in annex p174. 88

Illus 69 - Ground heat pump - horizontal

Illus 70 - Ground heat pump - vertical

Illus 71 - Air to air heat pump

Illus 72 - Solar thermal collectors

Illus 73 -

BASE MODEL

BSim results: (hours >27: 444 ) (hours > 28: 208) (hours <20: 10) BE18 results: Total energy consumption: (74,8 kWh/m2year) (7,3 kWh/m2year caused by overheating)

Illus 74 -

HEAT PUMP

BE18 results: Total energy consumption: (42,2kWh/m2year) (7,4 kWh/m2year caused by overheating)

Illus 75 -

ADDING NATURAL VENTILATION BSim results: (hours >27: 108) (hours > 28: 22) (hours <20: 10)

BE18 results: Total energy consumption: (35,4 kWh/m2year) (2,2 kWh/m2year caused by overheating)

PHASE 03

PASSIVE SHADING Analysis of different shading solutions in terms of indoor environment and energy demand MOTIVE External solar shading is the best solution to avoid overheating in buildings, as it limits the amount of sunshine and thereby thermal radiation, entering the building. If the windows open outwards, the external shading must be designed to allow the windows to open (Andersen et al. 2018).

open and the sparse sunlight is let into the rooms. The windows must open inwards to allow the possibility of being open whilst the shutters are closed. OVERHANG & SIDEFINS Well-designed sun control and shading devices can also be an extended part of the building, but the efficiency depends on the solar orientation of the particular façade. For example, simple horizontal fixed overhangs are efficient shading south-facing windows in the summer when the sun angle is high. However, the device is inefficient at blocking low afternoon sun from entering west-facing windows in the summer (Kama, M, 2011).

FRAME & REDUCING WINDOW AREA Working with passive shading within the frame of the window takes advantage of an already existing element for multiple purposes. However, the extension must be at least 0,6 m to reach the demands of a low energy requirements of such specified in the building regulations, tested in BE18 and the required hours below 27o, simulated in BSim. This would be a drastic solution and not reflect the desired wish of designing a building that blends into the natural surroundings of Egholm. Reducing the window area automatically reduces the amount of sun radiation as it has been tested in the daylight analysis. It also improves the total u-value of the wall, ensuring more steady temperatures and limits the transmission loss through the envelope. The consequence of reducing the window size is however reduced visual contact to the outside.

To test the best solution for passive shading in BSim and combining it with architectural quality an extension of the roof of 1,5 m along the south-eastern façade has been made to create horizonal shading. The extension follows the typology of the building and provides the opportunity to design loggias outside each patient bedroom, adding value to the room. Additional side fins divide each loggia and provides privacy whilst blocking sunlight from an east and western direction. The entire shading system is designed with lamellas to still provide the views to the beautiful nature of Egholm.

SHUTTERS Shutters with lamellas let a certain amount of sunlight penetrate and allow a somewhat restricted view to the outside. Simultaneously overheating of the room is reduced as some of the solar radiation is blocked. If shutters are closed as soon as the temperature rises above 27 degrees, the number of overheated hours per year is reduced. Blinds with lamellas can be a subtle addition to the façade when using similar materials and the same orientation as the exterior cladding. In the winter months shading louvers are

DECISION The chosen solution is overhang and sidefins. It is the only solution that fulfils low energy class, and as all solutions meet the indoor environment requirements, this solution was chosen as it added the most value to the rooms. The analysis of the exercise room which can be found in annex p.174, show that the shutter solution doesn’t fulfil the indoor environment regulations, which is also one of the reasons why the overhang and sidefins solution was chosen.

Illus 76 -

FRAME & WINDOW SIZE REDUCTION BSim results: (hours >27: 94) (hours > 28: 22) (hours <20: 51)

BE18 results: Total energy consumption: (35,2 kWh/m2year) (2 kWh/m2year caused by overheating)

Illus 77 -

SHUTTERS

BSim results: (hours >27: 82) (hours > 28: 13) (hours <20: 10) BE18 results: Total energy consumption: (34,9 kWh/m2year) (1,7 kWh/m2year caused by overheating)

Illus 78 -

OVERHANG & SIDEFINS BSim results: (hours >27: 100) (hours > 28: 21) (hours <20: 41)

BE18 results: Total energy consumption: (33,0 kWh/m2year) 2 (0kWh/m year caused by overheating)

ODP [Kg R11 eq/m2 year]

PHASE 03

LCA & LCC WALL

MOTIVATION When designing a sustainable building, it is important to understand where and how the different building materials are produced and thereby how they affect the environment. An investigation in LCA and LCC has been conducted to find the best sustainable, environmental, and economic wall build-up that fulfill the defined design criteria. The investigation was conducted on two walls, focusing on the exterior and interior cladding: natural materials and recycled materials.

tion and the material is, in fact, only produced for the purpose of being harvest opposite to reused materials which has already served its purpose in a previous project. The wall of recycled material performs better in LCC even though it requires more lifetime maintenance than the other solution. The exterior cladding is reused wood and will therefore minimize the strain on the LCC analysis.

The interior cladding has great architectural DECISION qualities as the surface can be modified in many Both walls perform well regarding to LCA and textures and colours that will have a positive have a low impact on the environment. The wall effect on aspects like acoustics and reflecting with natural materials, has a negative GWP, stor- of light. It is a natural product and has performs ing CO2 and thereby providing a better result. greatly LCA. A combination of the two walls is However, the wall is also thicker, heavier, and conducted and can be found on page 139. more expensive according to the LCC calculaIllus 79 -

LCA ASSESSMENT OF WALLS

Wall build-up 1 Wall build up 2

POCP [kg Ethene AP [kg SO2 eq/m2 eq/m2 year] year]

EP [kg PO4-3 eq/m2 year]

ADPe [Sb eq/m2 ADPf [MJ/m2 year PEtot [kWh/m2 Sek[kWh/m2 year] year] year]

Illus 80 -

WALL 1 NATURAL MATERIALS, U-value: 0,12 W/m2 thickness: 841,25mm From outside to inside Reeds facade 260mm Fire protection layer 1mm Counter batters in pine wood 500cc 45x45mm Hunton wind breaker 25mm Straw insulation panels (incl wood) 400mm Airtight barrier - Diffused open 0,25mm Straw insulation w wood 600cc 80mm Clay panel 25mm Clay plaster 5mm

Sd=0,045 Sd=0,42 Sd=0,52 Sd=6,45 Sd= 0,104 Sd= 0,22 Sd= 0,025

Amount

Unit price [DKK]

Lifetime [year]

Acquisition cost [DKK]

Reeds exterior cladding

250 m2

688,79

172 197,50

Straw insulation

250 m2

1734,25

100

433 562,50

Clay interior cladding

250 m2

590,42

147 605,00

Total

753 365,00 Maintenance 461 894 DKK

Illus 81 -

Recovery 89 717 DKK

Residual value -29 503 DKK

Total present value 1 275 472 DKK

WALL 2 RECYCLED MATERIALS, U-value: 0,12 W/m2 thickness: 607,25mm From outside to inside Recyled wooden lamella facade 15-35mm Counter batts pine wood 500cc 45mm x 45mm Hunton wind breaker 25mm Straw insulation panels (incl. wood) Artight barrier - Diffused open 0.25mm Straw insulation w/ wood 600cc 80mm Recycled OSB board 12mm

Sd=0,045 Sd=0,42 Sd=0,52 Sd=6,45 Sd= 0,104

Amount

Unit price [DKK]

Lifetime [year]

Acquisition cost [DKK]

Recycled wood cladding

250 m

514,54

128 635,00

Straw insulation

250 m

1734,25

100

433 562,50

Recycled OSB cladding

250 m

231,89

53 472,50

2 2 2

Total

615 670,00 Maintenance 377 472 DKK

Recovery 60 485 DKK

Residual value -28 422 DKK

Total present value 1 025 185 DKK

PHASE 03

INTERIOR Interior desired atmospheres

The interior space should be designed to complement the treatment methods in which patients will regain a healthy relationship to food and their self-image. A principal aspect of healing architecture is contact with nature. The surroundings of the project site consist of natural characteristics which are active elements in the experienced architecture. The characteristics should be emphasized in interior, through crossvisibility and effortless transition between inside and outside. The width off external walls in low energy buildings allow the windows to be utilized as seating, a space in-between interior and exterior. Putting emphasizes on the healing of the body can be done through choice of materials, choosing warm and wooden, which has a stress reducing effect (Burnard and Kutnar, 2015). Implementing stress relieving material in the seating windows provide clearly defined niches for contemplation, intimate talks and mindful physical presence.

blur the transition between inside and outside. The kitchen and the common area will most likely become a central space in the building, and should be flexible, providing various kinds of therapy, workshop areas and space for relaxation. The common area must be sensitive to the patients, as the comorbidity of the disease puts patients at risk of anxiety, stress and depression. An order and graduation of activity levels could provide different kinds of settings and atmospheres, whereas the patient can decide in which to interact, based on their state of mind. Each zone in the building is connected to another, via cross-visibility through the central courtyard, that additionally brings nature into the building. However, the staff area, should also be a space designed to fit staff members best possible, as they need a private space to disconnect themselves, and ensure their own personal mental health. As for patients, staff members also benefit from natural surroundings, as they could be used as calming refuges.

Patient bedrooms should be a space where patients quietly can disconnect, be private and respite. A homely non-clinical atmosphere, combined with the opportunity to personalize, contributes to obtaining a healthy routine. Views to nature are crucial, as they appear to have a positive effect on mental and physical health. (Frandsen et.al, 2009) A close connection with nature could be designed through direct access from the private area, which, if desired, could

A staff area located close to the entrance, provides the opportunity of a welcoming atmosphere, but also ensures an overview of the building, which is known to reduce stress among staff (Nejati et al., 2015).

Illus 82 - INTERIOR MATERIALS (Clayworks, 2020), (Dreamstime, n.d.), (Goldberg, 2017)

Illus 83 - STAFF AREA (Onsgaard, n.d.)

Illus 84 - THERAPY ROOMS (Vanilla decor, 2013)

Illus 86 - BEDROOMS (HomeWorldDesign, 2018), (Tietgenkollegiet, n.d.) Illus 85 - COMMON AREA & WORKSHOP (Archdaily, n.d.), (Lazure, 2018), (Tracy Anderson studios, n.d.)

PHASE 03

FACADE STUDY Selection of facade cladding in terms of aesthetics and tehnical aspects MOTIVE When choosing recycled wood as cladding, it is critical to consider the implications. The different sizes and colors of the recycled lamellas encourage design innovation and offer a raw, dynamic natural faĂ§ade. Timber claddingâ&#x20AC;&#x2122;s range of wood types and timber grades offer an entire spectrum of natural tones, with color evolving

Illus 87 -

as the wood weathers and ages. Therefore, different iterations of types of recycled wooden cladding have been investigated in terms of aesthetics, design for disassembly and technical aspects such as price and treatment.

SHINGLE CLADDING

Illus 88 -

Recycled wood cut into smaller parts, in and placed ontop of each other AESTHETICS + If using screws as an attachment, it is possible to hide the screws + Provides depth due to the different shadows different times of the day DESIGN FOR DISASSEMBLY + Possible to disassemble - Time consuming to assemble and dissassemble TECHNICAL + Easy for water runoff + Easy to replace single elements - Expensive - Extra use of material due to overlapping 96

BOARD AND BATTEN CLADDING

Consists of different thicknesses and types of lamellas, with a minimum length that fits the size of the facade, in which some are rotated 90 degrees. AESTHETICS + Provides a facade with depth + Various expressions throughout the day due to how the light hits DESIGN FOR DISASSEMBLY - May be a little more difficult to assemble TECHNICAL - More difficult to treat as not a plan surface - Critical areas can arise at the edges of the different lamellas

DECISION The recycled â&#x20AC;&#x2DC;various vertical claddingâ&#x20AC;&#x2122; (see illustration 89) wooden facade accommodates the surrounding forest of the island, with its vertically irregular lamellas referring to tree trunks. It has an even surface, and is therefore easier to

Illus 89 -

VARIOUS VERTICAL CLADDING

treat, and due to the sizes and simplicity of the lamellas, they are less time consuming to assemble, and easier to disassemble. Different iterations of the selected facade color can be found in annex p.185

Illus 90 -

Different recycled lamellas placed vertically attached with screws or shiplap connection AESTHETICS + Vertical cladding with different textures and sizes relate well to the surrounding forest and provide a dynamic and raw aesthetic DESIGN FOR DISASSEMBLY + Easy to assemble and disassemble by use of screws TECHNICAL + Easy to treat due to plan facade - Visible screws if using screws - If using shiplap connection, more energy on cutting the wood

WINDOW FRAMES CLADDING

Recycled wooden frames are used to create a facade. AESTHETICS + Gives a very lively facade, and illustrates the bark of a tree trunk very well, relating to the surroundings DESIGN FOR DISASSEMBLY - Difficult to disassemble, as would most likely have to use adhesive of some sort to connect the different lamellas TECHNICAL + Good reuse of window frames - Time consuming to assemble due to many small parts - Would need a large amount of window frames 97

PHASE 03

LCA & LCC FOUNDATION

MOTIVE Due to the risk of flooding, the building is raised on foundation pillars. To find the most environmentally and economically sustainable solution, two different solutions have been analyzed by using LCC and LCA. The calculation period is 50 years, in which the foundation consists of 150 pieces of 1,5 meter pillars. All prices are based on ‘Molio Prisdata’, which is based on Danish salaries and materials costs.

the ability of reusing the screw pillars in their original form or recasting it into new steel components. Nevertheless, the screw foundations is 58,35% more expensive than the concrete. This might be caused by supply and demand, the ability to extract the raw material but it is unknown and is not specified in the LCC. Even though the screw foundation is more expensive the saving on global warming potential has been chosen as more important in order to reach the vision of a sustainable healthcare SCREW FOUNDATION facility. The potentials of designing for disassembly A steel screw foundation which is drilled into the is also bigger with a screw foundation as it is easier ground, is an easily applicable, sustainable foun- to recycle and remove from the site. Furthermore, dation solution, and easy to disassemble. Screw economic savings on other building components foundations have a long lifetime and can be reused will secure bigger savings GWP in total. or recycled. A steel foundation does not absorb moisture from the surroundings. (Skruefundament – GWP Fremtidens Fundament, 2020) PREFABRICATED CONCRETE FOUNDATION The prefabricated concrete pillar foundation is dug into the ground, which requires heavy machinery and transport of soil. This type of foundation is commonly used since it is cheap and has a lifetime of 120 years. (Molio Prisdata)

Screw foundation - 2,3 % Screw foundation - 2,3 % Precast concrete foundation Precast concrete foundation 97,7% 97,7%

TOTAL PRICE

DECISION The two different foundations are also evaluated in LCA. Both the solutions have a longer lifetime than the remaining building components, therefore both foundation types can be reused or recycled. Both solutions are evaluated in the potential of recycling of such specified in the EPDs. According to the results of the LCA the potential of reusing steel is bigger than concrete. The screw foundation performs 97,7% better in GWP than the prefabricated concrete foundation. This is due to

TOTAL PRICE

Precast concrete foundation -

Precast 41,65% concrete foundation 41,65% Screw foundation - 58,35%

Screw foundation - 58,35%

Illus 91 - SCREW FOUNDATION

Machinery + Salary Screw foundation

Amount

Unit price [DKK]

1 pcs

16543,94

150 rm

1320,55

100

198 082,68

Present value w/o residual value 234 154 DKK

Lifetime [year] Total Acquisition cost [DKK]

Residual value -29 539 DKK

Total present value 204 615 DKK

Illus 92 - PREFABRICATED CONCRETE FOUNDATION

Amount Heavy Machinery + Salary Screw foundation

Unit price [DKK] Lifetime [year]

Total Acquisition cost [DKK]

78,75 m3

10325,26

150 rm

518,94

120

77840,64

Present value w/o residual value

Residual value -13 081 DKK

98 293 DKK

Total present value 85 212 DKK

PHASE 03

OUTDOOR AREAS Placement of outdoor areas in relation to context, users and maintenance

The design of the outdoor areas has its stepping-stone in the userâ&#x20AC;&#x2122;s ability to rehabilitate through the natural origin of food as well as the special surroundings of Egholm Island and the fjord, stated in the phenomenological analysis of atmospheres. Emphasis has been put on the three characteristic views. A boardwalk moving through the open, windy and salty atmosphere of the fjord, where waves are crashing and birds are singing through to the fields where openness, vegetation, light, and the sky set the mood. The woodâ&#x20AC;&#x2122;s dark, embracing, and rustling atmosphere completes the experience of a diverse natural set-

ting. Therefore, implementing a garden, that can be seen from the common spaces and has straight access from the kitchen and dining allows staff to evolve their therapy around food and provide the best possible treatment for the patients as well as supporting their own well-being. Patients are also encouraged to explore, engage, and participate in agriculture and thereby help them gain a natural relation to food. This is, among other things, done through the boardwalks as part of healing architecture.

Illus 93 - 1 Placement of agriculture and animals according to sun exposure and wind protection. Further explanation can be seen in annex p 187

100

Illus 94 - Placement of agriculture and animals according to level of maintnance.

The boardwalk allows easy access for all whilst possibilities of contemplating in the natural environment and taking care of the agricultural vegetation and animal keeping. The placement of the agriculture is determined by the plantâ&#x20AC;&#x2122;s/animalâ&#x20AC;&#x2122;s individual needs for sun and wind protecting, but also the level of maintenance has defined its placement. Agriculture, that require high maintenance is placed closest to the building where, also, most of the ground is exposed to sunlight. The rosehip, raspberries and blackberries are placed to provide protection from the wind. Gravel pathways allows on-ground easy access from the boardwalk, via ramps and the terrac-

es. The forest design of the courtyard has been determined by the desired atmospheres of the indoor environment. It puts an emphasis on the niches and the sitting windows along the interior walls making them a semi-private transition zone between out and indoor. The visual relation to the outside space, on both side of the faĂ§ade has an architectural healing affect to the patients of such stated by both Frandsen et al. (Frandsen et al. 2009) and Ulrich (Ulrich 1984). The forest design is also a continuation of the tree line farthest to the west connecting with the forest to the east, make the building become an integrated part of the surroundings.

101

3 PRESENTATION

REED

Rehabilitation on Egholm for Eating Disorders Between the trees at the southern part of Egholm, close to the ferry arrival, REED rises and blends in with the surrounding nature. REED is a sustainable welfare building offering treatment for people with eating disorders and their relatives by restoring a healthy relationship to food, through therapy and activities in close contact with nature. REED helps transitioning from inpatient to outpatient through daily and ambulant treatment offering psychotherapy, body-based and nutritional therapy tailored for the specific individual regardless of the origin of their disorder. REED is a 690 m2 low energy demanding building sustainably constructed form local and reused materials to minimize the environmental impact now and after the buildingsâ&#x20AC;&#x2122; lifetime is over. Its construction ensures environmental sustainability by designing for disassembly with the potential of reusing, recycle or up-cycle building components. The health care facility is not only a safe place to be, but also a responsible one.

104

105

CONTEXT PLAN 1:5000

ARRIVAL If arriving by car, the building is accessed via a gravel road alongside fields and pastures. On arrival, the building appears nestled between the three elements of water, forest, and fields.

106

BOARDWALK A slightly elevated, wooden boardwalk leads through the forest and past the garden to the building and offers an interplay of impressions. The changing play of light and shadow, open and closed, dark, and light places is a pleasant experience for the visitorsâ&#x20AC;&#x2DC; senses.

107

MASTERPLAN

108

MASTERPLAN 1:500

COURTYARD

FOREST BOARDWALK

GREENHOUSE

WATER BOARDWALK

BOARDWALK GARDENS

TEACHING GARDEN The teaching garden is seen as an important part of the rehabilitation process and is spatially connected to the kitchen and dining area. The wooden path leads through it and slopes down in certain places, making the various herb and vegetable beds accessible.

110

GREENHOUSE The greenhouse is located in front of the kitchen to ensure that gardening activities can also be carried out during the cold months. The shape of the building is continued, with the glasshouse acting as a transition zone between inside and outside.

111

SECTION A 1:500

112

113

SECTION B 1:500

114

115

THE INNER COURTYARD The inner courtyard visually draws the nature that surrounds the building into the interior. This allows views into nature in several directions from many viewpoints inside the building.

116

SITTING WINDOWS Several windows within the common area and along the corridors are constructed as seating windows. These invite visitors to sit down and let their gaze wander into the surroundings.

117

118

PLAN 1:200 119

VISUAL COMFORT

120

THE INNER COURTYARD AS AN ATRIUM In addition to its function of providing glances into nature, the inner courtyard also has the purpose of bringing light into the depths of the building. The arrangement of the windows in the atrium ensures a sufficient and even distribution of daylight into the rooms.

121

STAFF BREAK ROOM All rooms that only concern the employees of the centre are to be found in the north-eastern end of the building. The central meeting point here is the break room, where employees can exchange thoughts and take a break together.

122

KITCHEN & DINING AREA The kitchen is a social, open space with direct access to the greenhouse and from there to the vegetable garden. In these spaces, the healthy relationship with food is to be rebuilt as patients prepare and harvest the ingredients, cook and eat together.

123

SECTION C 1:100

124

125

SECTION D 1:100

126

127

PATIENTSâ&#x20AC;&#x2DC; ROOMS The patientsâ&#x20AC;&#x2DC; rooms are places of retreat. On a minimum of necessary space the patients have the possibility to be contemplative and entirely private. Each of the rooms also has its own small loggia, so that a stay in the open air can be enjoyed, shielded from the eyes of others and with a view to the ocean.

128

YOGA & MEDITATION The yoga room is located in the southern corner of the building and offers views of the sea and forest. The space has direct access to a shaded outdoor terrace where one can relax after a dip in the sea. The terrace also offers enough space for outdoor meditation classes when the weather is fine.

129

DETAIL 1:25

130

131

DETAIL 1:25

132

133

Roof cladding with insulation

Rafters with ring beams hidden in the roof

2 Load-bearing structure

Floor deck

Screw foundation on pillars

EXPLODED VIEW OF STRUCTURAL SYSTEM 134

Roof beams rest on wooden ring beams lying horizontally in the wall place to bear and transfer loads to the supporting structure

Window elements are attached to the side of the wall elements with screws

Timber under-panels work as a ring beam and function as a base for an even mounting of the wall panels

DETAILS IN 1:10 135

FOUNDATION BUILD-UP 1

The construction of the deck is a raised wooden floor system. The deck is constructed as a pier and beam footing on screw pillar foundations to protect the building from the high water rise on Egholm. The selected type of connections in the build-up is screws, making assembly and disassembly easy manually.

Floor beams are placed in two layers to avoid cold bridges. DHF underlay boards are installed underneath the beams, which will hold the insulation in place.

Pressed straw insulation is placed between the wooden floor beams. The underlying DHF board is vapour-permeable and moisture-resistant, which protects the insulation from damage by moisture and pests.

136

A second layer of insulation is added between the floor beams to obtain a total insulation thickness if 400mm.

A floor sheathing of OSB boards is mounted with screws on top of the insulation layer so that the deck is walkable. Wooden under-panels, which act as a ring beam, are used as a base for mounting the wall panels. The under-panels are also fixed with screws.

The pressed straw insulation panels are placed on top of the under-panels and fixed with screws using pocket-holes. With this technique, the screws remain visible and simplify a later disassembly. The step by step construction of the walls can now begin.

137

STRAW BATT INSULATION MODULES The straw insulation modules are easy to handle and can therefore be placed and attached to the deck by manpower and using simple electrical tools. The thickest insulation module con-

sists of a load bearing frame structure with cross stabilizing plates in-between each straw bale. Additional side bracing is added to easily attach the vapor barrier and the next insulation layer.

The thinner straw insulation module is added for technical installations such as wires. The additional element saves the bigger element from cuts and damages if the technical instillations was to be added there. This makes the 400mm

straw element 100% re-usable. The straw elements are attached to each other with pocket holes joints through the wooden frame. This allows the screws to be clearly visible and accessible for later disassembly.

138

SINGLE-SIDED VENTILATION

CROSS VENTILATION

NATURAL VENTILATION To ensure a good atmospheric and thermal comfort and reduce the energy demand for mechanical ventilation, the building is designed with natural ventilation. Two different ventilation strategies are implemented, in the form of single sided and cross. For a room with many occupants, such as common and dining area, cross ventilation is applied were at least to windows in different facades, or a skylight, ensures the effi139

ciency. Other room such as the bedrooms is ventilated singled sided, where the thermal buoyancy though a single window is possible. This is only available when the room depth is lower than 2,5 times the height of the room (Windowmaster, 2020). The calculation of natural ventilation can be found in annex p.162

MECHANICAL VENTILATION As the natural ventilation is used for lowering the energy demand on cooling doing summer, the mechanical ventilation is needed during the winter as it contributes with heat recovery. This secures good thermal comfort and lowers the total heating demand in the building.

provide simple and uninterrupted aesthetics, that does not steal the focus from the views to the three characteristics of the nature. The three technical rooms are easily accessible, for maintenance of the Nilan CT300 system, which provide fresh air in a VAV system. Fresh air is supplied in every room, except the toilet and kitchen, where the air is exVENTILATION STRATEGY tracted. Along the pipes there is added regulaIn the building, there is three technical rooms, which tion valves and silencers, to control necessary air all contains ventilation aggregates, that supply the flow and ensure acoustic comfort. To reduce the whole building with fresh air to obtain a good at- length of pipes, the technical rooms are placed mospheric and thermal comfort. All the ventilation near toilets, which provide minimum length for air pips are hidden in the technical room and within a extraction. suspended ceiling in the rest of the building. This

140

FIRE SAFETY REED fulfil the requirement of fire safety, if the capacity is set to 25 people at the same time of either visitors, overnight staying patients and staff. The building belongs to fire class 5 since the building provides sleeping areas to people who is unaware of the escape routes according to BR18 ยง 85 (BR18, 2020)

have a minimum opening of at least 0,77 m and all escape routes have a minimum width of 1,3 m as stated as necessary according to BR18 ยง 56. With a placement of escape door in each sleeping room, there is no need for escape/panic lightning according to BR18 ยง 96. (BR18, 2020) A fire truck an access from the entrance road, where it can put out fire, with the maximum reThe building consists of passages and aisles, quirement distance to the building on 40 m. to ensure different escape routes distributed (Brandveje og brandredningsarealer, 2013) around the building, that leads to the outdoor, which fulfil BR18 ยง 94 requirements. All doorways

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WASTE WATER MANAGEMENT Egholm is not connection to the municipality sewer system. Therefore, the building needs a decentral rainwater and domestic waste-water system. The different systems must be efficient enough for the building size and incorporated in the urban planning, to ensure undisturbed views of the three natural elements of the project site. The domestic waste-water system is a sustainable and low energy percolation system, which is buried in the ground north of the building for low visibility. The percolation system functions as a two-chamber septic tank, where the first chamber allows solids to settle and scum to float. The solids are anaerobically digested and reducing the volume. The liquid component flows through a dividing wall into the second chamber, where further settlements take place. (US EPA, 2020) For further treatment, the water is pumped into a percolation system, where the water is released into a sand/soil mixture in the ground, where the natural bacterial clean the rest of waste-water.

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RAINWATER MANAGEMENT Rainwater management for the building is also a percolation system consisting of two ponds which can be seen below. The rainwater from the roof is directed into the ponds through hidden gutters on the building. When the rainwater is stored in the ponds, the water will slowly percolate into the ground and evaporate into the air over time (Klimatilpasning.dk. 2020). The ponds are dry indentations in the terrain, where local plants can grow in their natural and existing environment with risk of flooding and high water on Egholm.

WET

DRY

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FINAL LCA & LCC RESULTS The wall used for the building is a combination of natural and recycled materials. The investigations regarding LCA and LCC of two walls can be found on page 92. The chosen wall design contains straw insulation panels, consisting mostly of the waste product of agriculture and is locally found on Egholm. Using local materials also reduces the transport of the raw product and making it a more sustainable. The panels are constructed to ensure easy assembly and disassembly, as well as making it possible to recycle and reuse for later projects.

Clay plaster and clay board as interior material has been proven effective in terms of easy cleaning and maintenance, smooth surface as well as contributing to a good indoor environment. An LCA of the wall has been conducted and compared to the DGNB point-system to uncover the wall performance in terms of sustainability. The wall performance is great with a score of 91 points out of 100 compared to the DGNB reference building which has 50 points. An LCC has likewise been conducted showing how the building has a low maintenance during its lifetime of 50 years. This makes the final wall more The exterior consists of vertical orientated expensive than a wall consisting of recycled recycled wood, that refers to the treeâ&#x20AC;&#x2122;s trunks materials, but the buildings performance in LCA surrounding the building. The recycled wood and of indoor environment s better. pieces can differ in size and colour and gives a varying expression. The recycled wood has been proven efficient in earlier investigation, whereas reeds is proven more expensive.

GWP

ODP

GWP

Paper based vapour diffused barrier Lamella facade - recycled wood Straw insulation 400 mm Clay plaster Hutton windbreaker Counter batts Straw insulation 80 mm Clay panel DGNB 100%

0,176 kg CO2 eq/m2 year = 1,87%

6,28 e-07 kg R11 eq/m2 year = 118,54%

POCP

6,05e-04 Ethene eq/m2 year = 14,42 %

6,66e-03 SO2 eq/m2 year = 18,01%

2,12e-03 PO4-3 eq/m2 year = 44,69 %

Amount

Unit price [DKK]

Lifetime [year]

Acquisition cost [DKK]

Recycled wood cladding

250 m2

562,27

140 567,50

Straw insulation

250 m2

1734,25

100

433 562,50

Clay interior cladding

250 m2

590,42

147 605,50 709 802,50

Total Maintenance 376 049 DKK

Recovery 43 025 DKK

Residual value -60 964 DKK 145

Total present value 1 080 735 DKK

CONCLUSION REED is a proposal to a healthcare facility on Egholm tailored to help people with eating disorders and their relatives transitioning from intensive care to a full-functional everyday life. The facility is designed with principles of evidence-based knowledge on healing architecture combined with phenomenological values in a scientific aspect.

along the courtyard allows daylight to enter and securing adequate light qualities and quantities. High quality of individual treatment of patients is secured by therapy rooms small enough to provide an intimate atmosphere and big enough to work as a quality working space for the therapist. The rooms are furthermore placed facing north to avoid uncontrollable heat gains. In order to not only provide daily treatment, but The result can be seen in the dualistic purpose also ambulant, bedrooms have been placed east of choices from the greenhouse extending the in the facility as an offer to patients for them building typology and merging the in-between stay overnight regardless of the origin of the space of inside and out to the isolated niches disorder. An extension of the roof towards southon the inside that provides space for private east ensures passive shading and furthermore contemplating. functions as a transition zone between indoor and outdoor areas. The small loggias are placed Exactly the combination of self-contemplating for the patients to enjoy. and active therapy is the essence of the facility. Teaching interoceptive awareness that helps Materiality declares the relationship within people learn or regain pre-requisite skills the natural setting of Egholm island in which required to self-manage and self-regulate the protagonist is locally provided reused their unregular eating habits is done through wood as visible faรงade cladding as well as onactivity, teaching and involvement. The facility site assembled and produced straw insulation provides such settings through a common space batts hidden within the walls. The foundational big enough for all to participate in activities of construction of screw pillars is metallic, due physical therapy. Framing views to the teaching to design for disassembly and environmental garden enhance the awareness of food in a reasons, such as flooding. A timber extended natural setting that can be utilized for cooking walkway is designed to provide multiple classes in the kitchen and gardening in the pathways and permeability through the site greenhouse. Views elsewhere in the facility to increasing the possibilities of the patients to heal the natural environment of the fields, the forest, through architecture and relate to the elements and the water work as healing initiatives of such of the landscape and the water. described by Frandsen et. Al, 2009. Especially framing the views by floor to ceiling windows

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REFLECTION he evidence-based design that has been applied throughout the project, aims to develop a design solution relying on knowledge that has been proven effective in practice. The challenge of using such knowledge is the specifications of the research behind. Reliable evidential studies on the practical efficiency of healing architecture in combination with eating disorders is limited and has not yet been proven. Due to the comorbidity of eating disorders it has been estimated that the design solutions and principles of other mental diseases, such as depression, anxiety and stress can be translated into strategies for this specific user group as well. Additional personalized criteria have been formulated from research on the specific users and the effectiveness of implementing teaching through food as a part of the healing process. It is not possible, for us as designers, to know if introducing agriculture and farming in the healing process of patients will restore a healthy relationship to food. It could have a positive impact but on the contrary, the awareness of food might trigger relapses, as the life of an ED patient already constantly revolves around food. The project has nevertheless implemented teaching gardens. The island is in general risk of flooding which stresses the importance of designing responsibly according to construction. The general lifetime of a building is 80 years and materials are usually chosen according to the end of the life of the building, but in this case, the buildings lifetime is estimated to 50 years, hence less than a traditional building. Therefore, an alternative se-

lection of material might be more sustainable. In addition to this, the design of the rehabilitation centre is tailored to the location of Egholm and specifically to the users. It is therefore illogical to rebuild the centre elsewhere when the future flooding hinders the lifetime of the building. The choice of materials could potentially then be of shorter lifetime, locally harvested and preferably decomposable at the end of life, just like straw. The circumstance of this semesters group work has been highly influenced by the covid-19 virus, forcing communication to rely solely on online communication platforms. Having to discuss ideas, drawings, concepts and knowledge through spoken words and digital illustrations, has been found to enhance general communication skills. Another positive aspect of digital platforms is the fact, that everything is documented, and all material is stored online so when miscommunication occurs it is possible to track down the mistake. This can nevertheless also become a challenge as information, material and knowledge easily can get lost online, if structure and organisation of data is not implemented form the very beginning. The advantages and disadvantages of not meeting physically is perceived differently by individuals. Some group members have found working from home efficient as they have been able to develop an efficient organised undisturbed workflow whereas others have found it difficult to separate free time from worktime.

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ILLUSTRATIONS Illus 28 - Askovhus, n.d. Askovhus. [image] Available at: <https://askovhus.dk/> [Accessed 21 March 2020]. Illus 29 - Askovhus, n.d. Askovhus. [image] Available at: <https://askovhus.dk/> [Accessed 21 March 2020]. Illus 30 - Nord Architects Copenhagen, n.d. Cancer Center Copenhagen. [image] Available at: <https://www.nordarchitects.dk/cancercentre> [Accessed 21 March 2020]. Illus 31 - Lendager Group, n.d. The Resource Rows. [image] Available at: <https://lendager.com/en/ architecture/resource-rows/> [Accessed 21 March 2020]. Illus 32 - Lendager Group, n.d. The Resource Rows. [image] Available at: <https://lendager.com/en/ architecture/resource-rows/> [Accessed 21 March 2020]. Illus 33 - Stang, T., 2013. Livsrum / Polyform. [image] Available at: <https://www.archdaily.com/471391/ livsrum> [Accessed 26 March 2020]. Illus 34 - Stang, T., 2013. Livsrum / Polyform. [image] Available at: <https://www.archdaily.com/471391/ livsrum> [Accessed 26 March 2020]. Illus 35 - Realdania, 2020. Mini CO2 Houses - Traditionen. [image] Available at: <https://realdania. dk/projekter/mini-co2-husene-de-vedligeholdelsesfri-huse-traditionen> [Accessed 21 March 2020]. Illus 36 - Realdania, n.d. Minico2 Husene: Fornyelsen. [image] Available at: <https://realdania.dk/ projekter/mini-co2-husene-de-vedligeholdelsesfri-huse-fornyelsen> [Accessed 21 March 2020]. Illus 53 - Unknown, n.d. [image] Available at: https://i.pinimg.com/4https://i.pinimg.com/474x/30/ ff/9f/30ff9fa826992b0f11a2https://i.pinimg.com/474x/30/ff/9f/https://i.pinimg.com/474x/30/ff/9f/30ff9fa826992b0f11a218b0d5ea0bbf.jpg/30/ff/9f/30ff9fa826992b0f11a218b0d5ea0bbf.jpg, Unknown, n.d. [image] Available at: https://i.pinimg.com/474x/3a/ab/87/3aab8795102a3b137b72ee4539660ad1.jpg Illus 82 - Clayworks, 2020. Clayworks. [image] Available at: <https://clay-works.com/home/clayworks-versatile-clay-plaster-finishes-textures-modern-stylish-interiors-63/> [Accessed 28-05-2020]., Dreamstime, n.d. Wood texture [image] Available at: <https://www.dreamstime.com/wood-texture-surface-light-wood-background-design-decoration-wood-texture-surface-light-wood-background-design-image120820685> [Accessed 28-05-2020] Goldberg, R., 2017. Natural Clay Plaster Wall Finishes. [image] Available at: <https://www.houseplanninghelp.com/hph178-natural-clay-plaster-wall-finishes-with-clare-whitney-from-clayworks/> [Accessed 28 May 2020].

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Illus 83 - Onsgaard, C. K., n.d. 9 ting du skal vide, før du indretter dit køkkenalrum [image] Available at: <https://www.danskeboligarkitekter.dk/boligreportager/billedserier/9-ting-du-skal-vide-foer-du-indretter-dit-koekkenalrum/> [Accessed 28-05-2020] Illus 84 - Vanilla décor, 2013. Love your home [image] Available at: <http://vanilladecor.blogspot. com/> [Accessed 28-05-2020] Illus 85 - Archdaily, n.d. Architect’s Workshop / Ruetemple [image] Available at: <https://www.archdaily.com/775836/architects-workshop-ruetemple?ad_medium=gallery> [Accessed 28-05-2020] Lazure, C., 2018. Peek Inside a Minimal Getaway in Sweden [image] Available at: <https://nordicdesign.ca/peek-inside-a-minimal-getaway-in-sweden/> [Accessed 28-05-2020] Tracy Anderson studios, n.d. Faq’s. [image] Available at: <http://www.tracyandersonstudios.com/ faqs/> [Accessed 28-05-2020]. Illus 86 - Home World Design, 2018. Victorian Style House in Melbourne Gets an Elegant Refresh [image] Available at: <https://homeworlddesign.com/victorian-style-house-in-melbourne-gets-anelegant-refresh/> [Accessed 28-05-2020], Tietgenkollegiet, n.d. Sådan bor vi [image] Available at: <http://tietgenkollegiet.dk/livet-pa-kollegiet/sadan-bor-vi/> [Accessed 28-05-2020]

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