Thermal Comfort, Energy Usage and Fuel Poverty in a Sample of Older Person’s Households in Dublin

This research was conducted in twenty nine Dublin City Council senior citizen sheltered housing dwellings. Temperature (°C) and relative humidity (% RH) was recorded inside all dwellings using data loggers over two separate monitoring periods of four months between December and March of 2011-2012 and 2012-2013. Energy usage including gas and electricity was also recorded for each dwelling during both monitoring periods. Outside ambient temperature data for both periods was acquired from Met Eireann. A dwelling occupant questionnaire was completed to obtain relevant technical, social and behavioural data, and to establish the prevalence of fuel poverty amongst the sample. The Building Energy Rating and information on age, design and heating systems was obtained for each dwelling. The average daily inside temperature for all dwellings was 19.3°C during monitoring period 1 and 18.5°C during monitoring period 2. In 70% of the dwellings during both monitoring periods the average daily temperature was below 20°C, which is the lower limit recommended by the World Health Organisation for thermal comfort. The average daily outside temperature was 6.6°C during period 1 and 4.4°C during period 2. Households consumed on average 20% more gas during period 2 when compared with period 1. This was an additional household spend of €62 on energy during period 2. However, despite this additional energy usage the sample dwellings maintained lower average temperatures during period 2. There were 32% and 21% of dwellings during periods 1 and 2 respectively which had average daily relative humidity levels above the ASHRAE recommended higher bound threshold for thermal comfort of 60%RH. The households who experienced the highest average daily relative humidity also experienced the lowest average daily temperatures. The subjective method of measuring fuel poverty using the EU-SILC indicators revealed that 17.9% and 25% of households during periods 1 and 2 respectively were experiencing fuel poverty. Fuel poor households (those declaring an inability to adequately heat their home) maintained lower average daily temperatures than other households. It is recommended that best practice in the design of housing for vulnerable groups including older people should incorporate smart home technologies i.e. integrated monitoring systems for security and health including temperature sensors for detection of extreme temperatures in the home. It is recommended that funding to Local Authorities for improving the thermal efficiency of their housing stock should continue and senior citizen complexes should be prioritised. It is also recommended that an additional fuel allowance payment is needed during particularly cold winters in order to prevent people falling into the fuel poverty trap. It is recommended that a survey similar to the Northern Ireland House Condition Survey and to include temperature monitoring, be conducted in the Republic of Ireland to provide a current picture of the housing stock in order to inform policy from both a health and environmental perspective

Fuel Poverty, Older People and Cold Weather: An All-Island Analysis

The research presented in this report is the culmination of 18 months of work which has been funded by The Centre for Ageing Research and Development in Ireland (CARDI). The research is concerned with older people and how they cope with cold weather, and whether they are able to keep sufficiently warm in winter. This report is structured into a number of distinct chapters, with each chapter dealing with a specific aspect of the fuel poverty issue

Gene Therapy: Charting a Future Course—Summary of a National Institutes of Health Workshop, April 12, 2013

Recently, the gene therapy field has begun to experience clinical successes in a number of different diseases using various approaches and vectors. The workshop Gene Therapy: Charting a Future Course, sponsored by the National Institutes of Health (NIH) Office of Biotechnology Activities, brought together early and mid-career researchers to discuss the key scientific challenges and opportunities, ethical and communication issues, and NIH and foundation resources available to facilitate further clinical advances

Optimal sequential file search : a reduced-state dynamic programming approach / 1993:110

Includes bibliographical references (p. 13)

Critical Condition: A Historian's Prognosis on Canada's Aging Healthcare System

Foreword When a set of public policies fundamental to our wellbeing is so politically sensitive and shot through with conflicting real and perceived conflicts of interest as to produce paralysis, a smart and wise historian can often provide the long-term, evolutionary perspective required to find the more promising ways forward. Canadian healthcare is fundamental to our wellbeing and so politically charged that despite its widely perceived shortcomings, attempts at fundamental reform appear the electoral equivalent of touching the proverbial third rail on a subway track. Professor Michael Bliss is one of Canada’s most able and eminent historians. The C.D. Howe Institute’s 2010 Benefactors Lecture is his attempt to take stock of publicly funded healthcare in Canada in the light of how it came to be, and give his assessment of the right directions forward to ensure that it serves Canadians well in the decades ahead. A good historian draws from many disciplines, and Professor Bliss’s account draws on insights from medicine, political science, economics, and much else. His account of the development of what Canadians nowadays call “medicare” from provincial coverage of doctor and hospital services in the 1960s through the federal Canada Health Act in the 1980s and the alternating dips and boosts in spending in the 1990s and 2000s is clear and compelling. Without undue deference to any particular perspective, he argues convincingly that an economically advanced democratic society will devote a growing share of its resources to healthcare, and that Canadians’ support for access to it is a fact of life that even medicare’s more vociferous critics must accommodate in their reform proposals. When it comes to his own advice for reform, Professor Bliss puts forward some propositions that will – like all changes to healthcare – inevitably be controversial. He draws on experiences with other major programs in the Canadian welfare state, family and old-age benefits in particular, to argue that reducing public commitments to the healthcare of Canadians who are able to pay their own way is both fiscally necessary and politically acceptable. Hence, he encourages the evolution of our health insurance system from providing universality of benefits onto a needs basis, preserving the core value of equal access. Economists and others concerned with the way income- and asset-related withdrawal of benefits from the better off have produced welfare walls and high effective marginal tax rates on modest-income people will have reservations about this proposal. If he is right that it is the way out of the chronic fiscal squeeze that otherwise looms, however, the challenge is to craft the most adept way to do it. In an age of reduced deference to experts of all kinds, Professor Bliss’s second recommendation – that Canadians accept that medical researchers and practitioners should play a more prominent role in determining what is medically necessary – will also raise objections. It may presuppose a level of confidence in professional expertise, and improved standards for research and practice that would justify that confidence, that medicine, like all fields, has yet to achieve. Yet the importance of specialized knowledge in determining what is likeliest to work is so critical in medicine that the problems of letting third parties, including health ministries, overrule researchers and practitioners in the field oblige us to take this advice seriously. Professor Bliss’s third observation is less about how to move forward than it is about not staying stuck where we are. Whatever the devotion of some Canadians and a handful of advocates abroad to a single-payer government monopoly model may be, he points out that no other developed country has imitated it, and none is about to. Canada’s current approach is a product of specific Canadian circumstances, not least of which is its emblematic status as a differentiator of Canada from the United States – hardly a sound basis for determining how to provide and pay for the vast array of medical services that determine how healthy or sick we are, and even whether we live or die. His appeal to use more market mechanisms to harness the incentives of producers and patients in the service of better outcomes, rather than lamenting or denouncing them, is a general exhortation. In practice, it will require balancing against his other suggestions to abandon universality and defer more to medical expertise. Yet there can be no doubt that any reform that does not harness these incentives effectively cannot hope to succeed. The C.D. Howe Institute’s Benefactors Lecture is intended to encourage better understanding of major Canadian public policy challenges, and stimulate debate about how best to meet them. Many people besides Professor Bliss deserve credit for producing the 2010 version of the Lecture: I thank Pfizer for their financial support, the reviewers of earlier drafts for their comments, Barry Norris and James Fleming for their editing, and Bryant Sinanan for his page layout. As with all the Institute publications, the opinions expressed here are those of the author, and do not necessarily represent the views of the Institute’s members or Board of Directors. I commend Professor Bliss for having ably responded to the challenge of addressing the condition of Canadian healthcare, however, and hope all readers will take from it his valuable insights about how we got where we are, and what can help us do better. (William B.P. Robson President and Chief Executive Officer C.D. Howe Institute