Ageing and menopause considerations for women with HIV in the UK

OBJECTIVES: Treatment rollout has dramatically improved life expectancy for people with HIV and AIDS. Women represent a substantial proportion of patients in the UK (approximately one-third of patients in care are female according to the HIV Annual Report 2014). This study examines psychosocial and biomedical issues for women diagnosed with HIV in the UK, comparing those above and below 45 years of age to examine menopause and ageing issues. METHODS: Consecutive clinic attenders in a large outpatient London HIV clinic were invited to participate in the study. Data were available for 170 (68%) women. In 57 women above the age of 45 data were available regarding menopause detailed insights. RESULTS: Compared with women aged under 45, women >45 years old were significantly less likely to be in a relationship (P=0.01), had higher anxiety scores (P=0.002), more likely to be classified as moderate to severe (25.9% vs 9.1%; χ(2)=6.1, P=0.01). There were no differences in terms of suicidal ideation, which was high for both groups of women (56.6%). Older women had higher psychological symptoms on the MSAS scale form and significantly higher PHQ-9 depression levels. A higher proportion of older women scored above the cut-off point for moderate to severe depression (9.2% vs 21.8%; χ(2)=3.7, P=0.048). Fewer older women had no mental health challenges (26.1% vs 42.4%) and more had multiple comorbidities (P=0.07). CONCLUSIONS: The vast majority of women reported experiencing a variety of physical and psychological menopause-related symptoms and there was a high suicide ideation rate in both groups of women. Over half of the group of menopausal women recorded distressing symptoms such as hot flushes, sweating, decreased sexual desire, back pain, night sweats, avoiding intimacy, involuntary urination and skin changes, yet few sought help. Age-specific, psychosexual and menopause services should be routinely available for women with HIV

Creative and productive workplaces: a review

The built environment affects our well-being and this in turn influences our effectiveness in the workplace. Poor environments contribute to absenteeism and to people not working as well as they might. This is an enormous cost to the nation. High-quality environmental design is an investment, as occupants are healthier, staff-retention rates are higher, productivity is higher and sustainability ideals are more likely to be met. Workplaces reflect the culture of companies and are places that are not just functional and convenient but give the occupant a wholesome experience in terms of body and spirit

What is an intelligent building? Analysis of recent interpretations from an international perspective

In recent years, the notion of intelligent buildings (IBs) has become increasingly popular due to their potentials for deploying design initiatives and emerging technologies towards maximized occupants’ comfort and well-being with sustainable design. However, various definitions, interpretations, and implications regarding the essence of IBs exist. Various key performance indicators of IBs have been proposed in different contexts. This study explores the notion of IBs and presents an analysis of their main constituents. Through a comparison of these constituents in different contexts, this study aims to extract the common features of IBs leading to an evolved definition which could be useful as a reference framework for design, evaluation, and development of future IBs. Findings also scrutinize the long run benefits of IBs, while demonstrating the constraints and challenges of the current international interpretations

Developmental challenges in HIV infected children-An updated systematic review

Children with HIV infection are at risk of developmental and behavioural challenges. A systematic review in 2009 set out the extent of delay documented in HIV positive children. This study presents an update and re-analysis. Full searches were conducted in Medline, Cochrane Database and PsycINFO, from which reviewers selected abstracts and followed references to provide detailed studies on HIV and cognitive performance in children under 18 to cover the period 2008–2013. The search generated 21 new studies, 17 of which (81%) report some form of cognitive delay for HIV positive children compared to controls. Some domains measured seem to be more affected than others, with mixed evidence on language and executive functioning. The need for more definitive control of variables was highlighted by the environmental factors contributing to behavioural and cognitive outcomes. In conclusion this systematic review confirms the prevalence of cognitive delay in children with HIV and explores the complexity of the issue. The findings suggest the need for internationally agreed monitoring tools and studies which control for known contributing factors. Research for children is needed with a full understanding of developmental challenges, to point the way forward for effective interventions

Flourishing workplaces: a multisensory approach to design and POE

How can we design workplaces which occupants thrive in, which are functional but are also expressive? Drawing on research about the senses and office related studies this paper demonstrates how buildings can be designed to allow for positive multi-sensory experiences. In order to design a creative and productive workplace, it is essential to consider how the environment is making us feel, behave and act within it. As the workplace continues to evolve, the case is made for a sensory palette framework to drive a systems approach to building environmental design enabling the integration of the multi-modal sensory relationship of people’s reactions within various environmental settings. Technological advances, in the form of wearables that monitor our physiological and stress responses offer the opportunity to capture empirical data, further enabling the investigation to see how a diverse range of environmental settings affect our physical, mental and social wellbeing. The paper goes on to develop the established conceptual theories of ‘Flourish’ proposing a move beyond comfort when designing the interiors and the mechanics of facility controls towards a sensory impacts framework that considers a whole life costing approach using the Flourish Model sets the basis for a design and post-occupancy evaluation toolkit

Past, present and future mathematical models for buildings (i)

This is the first of two articles presenting a detailed review of the historical evolution of mathematical models applied in the development of building technology, including conventional buildings and intelligent buildings. After presenting the technical differences between conventional and intelligent buildings, this article reviews the existing mathematical models, the abstract levels of these models, and their links to the literature for intelligent buildings. The advantages and limitations of the applied mathematical models are identified and the models are classified in terms of their application range and goal. We then describe how the early mathematical models, mainly physical models applied to conventional buildings, have faced new challenges for the design and management of intelligent buildings and led to the use of models which offer more flexibility to better cope with various uncertainties. In contrast with the early modelling techniques, model approaches adopted in neural networks, expert systems, fuzzy logic and genetic models provide a promising method to accommodate these complications as intelligent buildings now need integrated technologies which involve solving complex, multi-objective and integrated decision problems

Past, present and future mathematical models for buildings (ii)

This article is the second part of a review of the historical evolution of mathematical models applied in the development of building technology. The first part described the current state of the art and contrasted various models with regard to the applications to conventional buildings and intelligent buildings. It concluded that mathematical techniques adopted in neural networks, expert systems, fuzzy logic and genetic models, that can be used to address model uncertainty, are well suited for modelling intelligent buildings. Despite the progress, the possible future development of intelligent buildings based on the current trends implies some potential limitations of these models. This paper attempts to uncover the fundamental limitations inherent in these models and provides some insights into future modelling directions, with special focus on the techniques of semiotics and chaos. Finally, by demonstrating an example of an intelligent building system with the mathematical models that have been developed for such a system, this review addresses the influences of mathematical models as a potential aid in developing intelligent buildings and perhaps even more advanced buildings for the future

Workplace productivity and office type: an evaluation of office occupier differences based on age and gender

Purpose Open plan office environments are considered to offer workplace productivity benefits because of the opportunities that they create for interaction and knowledge exchange, but more recent research has highlighted noise, distraction and loss of privacy as significant productivity penalties with this office layout. This study aims to investigate if the purported productivity benefits of open plan outweigh the potential productivity penalties. Design/methodology/approach Previous research suggests that office environments are experienced differently according to the gender and age of the occupier across both open-plan and enclosed configurations. Empirical research undertaken with office occupiers in the Middle East (N=220) led to evaluations to establish the impact different offices had on perceived productivity. Factor analysis was used to establish five underlying components of office productivity. The five factors are subsequently used as the basis for comparison between office occupiers based on age, gender and office type. Findings This research shows that benefits and penalties to workplace productivity are experienced equally across open-plan and enclosed office environments. The greatest impact on perceived workplace productivity however was availability of a variety of physical layouts, control over interaction and the 'downtime' offered by social interaction points. Male occupiers and those from younger generations were also found to consider the office environment to have more of a negative impact on their perceived workplace productivity compared to female and older occupiers. Originality/value The originality of this paper is that it develops the concept of profiling office occupiers with the aim of better matching office provision. This paper aims to establish different occupier profiles based on age, gender and office type. Data analysis techniques such as factor analysis and t-test analysis identify the need for different spaces so that occupiers can choose the most appropriate space to best undertake a particular work task. In addition, it emphasises the value that occupiers place on ‘downtime’ leading to the need for appropriate social space

Sick building syndrome: are we doing enough?

Health and well-being are vitally important aspects of people centric building design and are the roots of productivity. Sick building syndrome (SBS) is a collection of factors that can negatively affect physical health in several ways. Besides physical health is also related to psychological well-being because the human body is one interactive biological system. This paper focuses on reviewing the current state of knowledge on building sickness syndrome which has been prevalent as a building illness since the 1970s especially in offices and schools. While the concepts of intelligent, smart and sustainable buildings have gained considerable attention during recent decades, there is now increasing attention being given to designing healthy buildings. This study provides a review about SBS symptoms. Several negative effects of SBS are identified and potential solutions are advocated. Finally, the study stresses the role of built environment and concludes that ongoing research towards tackling SBS and developing healthy indoor environments should not be limited to a single formula as any health-related building design approach is dependent on several interacting factors