A novel spatiotemporal home heating controller design: system emulation and field testing

We have developed a spatiotemporal heating control algorithm for use in homes. This system utilises a combination of relatively low-tech hardware interfaced with electric heating systems and a smartphone interface to this hardware, and a central server that progressively learns users’ room-specific presence profiles and thermal preferences. This paper describes the associated spatiotemporal heating control algorithm, its evaluation utilising the dynamic building performance simulation software EnergyPlus, and a longitudinal deployment of the algorithm controlling a quasi-autonomous spatiotemporal home heating system in three domestic homes. In this we focus on the prediction of occupants’ presence and preferred set-point temperature as well as on the calculation of optimum start time and the utilisation of user-scheduled absences; this for two comfort strategies: to maximise comfort and to minimise discomfort. The former aims to deliver conditions equating to a ‘neutral’ thermal sensation, whereas the latter targets a ‘slightly cool’ sensation with corresponding heating energy savings. Simulation results confirmed that the algorithm functions as intended and that it is capable of reducing energy demand by a factor of seven compared with EnergyStar recommended settings for programmable thermostats. Field study results align with these findings and highlight the possibility to reduce energy under the minimise discomfort strategy without compromising on occupants’ thermal comfort

Community Nurses' Judgement for the Management of Venous Leg Ulceration: A Judgement Analysis

Background: Nurses caring for the large numbers of people with leg ulceration play a key role in promoting quality in health via their diagnostic and treatment clinical judgements. In the UK, audit evidence suggests that the quality of these judgements is often sub optimal. Misdiagnosis and incorrect treatment choices are likely to affect healing rates, patients’ quality of life, patient safety and healthcare costs. Objectives: To explore the diagnostic judgements and treatment choices of UK community nurses managing venous leg ulceration. Design: A judgement analysis based on Brunswik's psychological Lens Model theory. Setting: UK community and primary care nursing services. Participants: 18 community generalist nurses working in district (home) nursing teams and general practitioner services and 18 community tissue viability specialist nurses. Methods: During 2011 and 2012, 36 nurses made diagnostic judgements and treatment choices in response to 110 clinical scenarios. Scenarios were generated from real patient cases and presented online using text and wound photographs. The consensus judgements of a panel of nurses with advanced knowledge of leg ulceration judged the same scenarios and provided a standard against which to compare the participants. Correlations and logistic regression models were constructed to generate various indices of judgement and decision “performance”: accuracy (Ra), consistency (Rs) and information use (G) and uncertainty (Re). Results: Taking uncertainty into account, nurses could theoretically have achieved a diagnostic level of accuracy of 0.63 but the nurses only achieved an accuracy of 0.48. For the treatment judgement (whether applying high compression was warranted) nurses could have achieved an accuracy of 0.88 but achieved only an accuracy of 0.49. This may have been due to the nurses giving insufficient weight to the diagnostic cues of medical history and appearance of the leg and ulcer and insufficient weight to the treatment cues of type of leg ulcer and pain. Conclusion: Clinical judgements and decisions made by nurses managing leg ulceration are complex and uncertain and some of the variability in judgements and choices can be explained by the ways in which nurses process the information and handle the uncertainties, present in clinical encounters

Development and validation of a model to predict the 10-year risk of general practitioner-recorded COPD

There is increasing interest in the earlier detection of, and intervention in, patients at highest risk of developing chronic obstructive pulmonary disease (COPD).status: publishe