Individual thermal comfort prediction using classification tree model based on physiological parameters and thermal history in winter

Individual thermal comfort models based on physiological parameters could improve the efficiency of the personal thermal comfort control system. However, the effect of thermal history has not been fully addressed in these models. In this study, climate chamber experiments were conducted in winter using 32 subjects who have different indoor and outdoor thermal histories. Two kinds of thermal conditions were investigated: the temperature dropping (24–16 °C) and severe cold (12 °C) conditions. A simplified method using historical air temperature to quantify the thermal history was proposed and used to predict thermal comfort and thermal demand from physical or physiological parameters. Results show the accuracies of individual thermal sensation prediction was low to about 30% by using the PMV index in cold environments of this study. Base on the sensitivity and reliability of physiological responses, five local skin temperatures (at hand, calf, head, arm and thigh) and the heart rate are optimal input parameters for the individual thermal comfort model. With the proposed historical air temperature as an additional input, the general accuracies using classification tree model C5.0 were increased up by 15.5% for thermal comfort prediction and up by 29.8% for thermal demand prediction. Thus, when predicting thermal demands in winter, the factor of thermal history should be considered

Perceptions of hypertension treatment among patients with and without diabetes

<p>Abstract</p> <p>Background</p> <p>Despite the availability of a wide selection of effective antihypertensive treatments and the existence of clear treatment guidelines, many patients with hypertension do not have controlled blood pressure. We conducted a qualitative study to explore beliefs and perceptions regarding hypertension and gain an understanding of barriers to treatment among patients with and without diabetes.</p> <p>Methods</p> <p>Ten focus groups were held for patients with hypertension in three age ranges, with and without diabetes. The topic guides for the groups were: What will determine your future health status? What do you understand by "raised blood pressure"? How should one go about treating raised blood pressure?</p> <p>Results</p> <p>People with hypertension tend to see hypertension not as a disease but as a risk factor for myocardial infarction or stroke. They do not view it as a continuous, degenerative process of damage to the vascular system, but rather as a binary risk process, within which you can either be a winner (not become ill) or a loser. This makes non-adherence to treatment a gamble with a potential positive outcome. Patients with diabetes are more likely to accept hypertension as a chronic illness with minor impact on their routine, and less important than their diabetes. Most participants overestimated the effect of stress as a causative factor believing that a reduction in levels of stress is the most important treatment modality. Many believe they "know their bodies" and are able to control their blood pressure. Patients without diabetes were most likely to adopt a treatment which is a compromise between their physician's suggestions and their own understanding of hypertension.</p> <p>Conclusion</p> <p>Patient denial and non-adherence to hypertension treatment is a prevalent phenomenon reflecting a conscious choice made by the patient, based on his knowledge and perceptions regarding the medical condition and its treatment. There is a need to change perception of hypertension from a gamble to a disease process. Changing the message from the existing one of "silent killer" to one that depicts hypertension as a manageable disease process may have the potential to significantly increase adherence rates.</p

Rakennusten kosteusvauriot ja ylilämpeneminen muuttuvassa ilmastossa – RAIL

Tutkimuksessa tehtiin laskennallisia tarkasteluja ulkoseinärakenteiden rakennusfysikaalisesta toimivuudesta nykyisessä ja projisoiduissa tulevaisuuden ilmastoskenaarioissa. Lisäksi laskennallisella mallinnuksella tarkasteltiin ilmastonmuutoksen vaikutuksia rakennusten ylilämpenemiseen ja lämpöviihtyvyyteen. Rakennusten kosteusvaurioiden ja niihin liittyvien mikrobien yhteyttä ihmisten terveyteen tarkasteltiin kahdella systemaattisella katsauksella. Korkeiden kesäajan lämpötilojen vaikutusta terveyteen nyt ja tulevaisuudessa arvioitiin epidemiologisin sekä vaikutusarvioinnin menetelmiin. Tehtyjen tarkastelujen perusteella suurin osa Suomessa yleisesti käytössä olevista ulkoseinä­rakenteista pärjää myös muuttuvassa ilmastossa. Homehtumisriski nousee sellaisissa ulkoseinärakenteissa, jotka päästävät viistosadetta lävitseen, pidättävät vettä rakenteen huokosverkostossa (tiili, läpäisevä betoni) ja tuuletus on heikkoa. Palvelutalojen sekä asuntojen laskennalliset ja havaitut lämpötilat nousevat korkeiksi jo nykyisessä ilmastossa. Pelkät auringonsuojausratkaisut eivät ole riittäviä pitämään huone­lämpötiloja riittävän alhaisella tasolla, vaan sen lisäksi tarvitaan myös aktiivista jäähdytystä erityisesti helleaaltojen aikana. Jäähdytys tulisi kohdistaa rakennuksiin, joissa asuu ikäihmisiä, sillä heillä terveysriskit ovat suurimmat. Ilman lisätoimia tulevat korkeiden lämpötilojen terveyshaitat huomattavasti lisääntymään Suomessa jo lähitulevaisuudessa väestön ikääntyessä

The influence of health systems on hypertension awareness, treatment, and control: a systematic literature review.

BACKGROUND: Hypertension (HT) affects an estimated one billion people worldwide, nearly three-quarters of whom live in low- or middle-income countries (LMICs). In both developed and developing countries, only a minority of individuals with HT are adequately treated. The reasons are many but, as with other chronic diseases, they include weaknesses in health systems. We conducted a systematic review of the influence of national or regional health systems on HT awareness, treatment, and control. METHODS AND FINDINGS: Eligible studies were those that analyzed the impact of health systems arrangements at the regional or national level on HT awareness, treatment, control, or antihypertensive medication adherence. The following databases were searched on 13th May 2013: Medline, Embase, Global Health, LILACS, Africa-Wide Information, IMSEAR, IMEMR, and WPRIM. There were no date or language restrictions. Two authors independently assessed papers for inclusion, extracted data, and assessed risk of bias. A narrative synthesis of the findings was conducted. Meta-analysis was not conducted due to substantial methodological heterogeneity in included studies. 53 studies were included, 11 of which were carried out in LMICs. Most studies evaluated health system financing and only four evaluated the effect of either human, physical, social, or intellectual resources on HT outcomes. Reduced medication co-payments were associated with improved HT control and treatment adherence, mainly evaluated in US settings. On balance, health insurance coverage was associated with improved outcomes of HT care in US settings. Having a routine place of care or physician was associated with improved HT care. CONCLUSIONS: This review supports the minimization of medication co-payments in health insurance plans, and although studies were largely conducted in the US, the principle is likely to apply more generally. Studies that identify and analyze complexities and links between health systems arrangements and their effects on HT management are required, particularly in LMICs. Please see later in the article for the Editors' Summary