Resident Comfort Level Research Articles

A review on outdoor urban environment modelling

Abstract Outdoor environment modelling is crucial for multiple facets of a sustainable urban development, such as mitigating the detrimental environmental impacts (i.e. greenhouse gas emissions), proposing energy-efficient building designs, optimizing the usage of green resources, and improving the overall comfort level of urban residents. This paper presents a comprehensive review of the techniques and models related to the various aspects of an outdoor urban environment modelling, including the microclimate dynamics modelling, solar radiation modelling, wind-flow and air-temperature assessment simulations, urban-canyons and heat island effects modelling, and green-infrastructure planning. Each section covers and compares the traditionally used methods and models in the field with the newer artificial intelligence (AI) based models, aiming to explore their relevant efficiencies and areas of improvement. For instance, microclimate’s traditional models like radiative transfer models are evolving to machine-learning based high-resolution remote sensing methodologies and community-based participatory models. Similarly, wind-flow section encompasses the traditional CFD, and wind-tunnel models modified by machine learning (ML) and data-driven methodologies. Moreover, the paper also discusses the urban heat island (UHI) phenomenon and the related models. Overall, the paper aims to provide a comprehensive state of the art on the traditional and cutting-edge methodologies of all the necessary aspects of outdoor environment modelling, to help provide informed decision-making for sustainable urban environments.

Dermatology resident comfort level treating hair conditions related to patients with skin of color.

Although recent studies demonstrated resident satisfaction in the treatment of skin of color (SOC) related disease, comfort levels treating hair specific to populations within the SOC spectrum is unclear. The purpose of this study is to assess dermatology residents comfort level in recognizing and treating various common hair conditions with a focus on those specific to SOC. An Institutional Review Board-approved survey was distributed to United States residents of Accreditation Council for Graduate Medical Education-accredited dermatology programs. Data pertaining to hair care knowledge and treatment comfort levels were collected. Analysis was completed using equal variance 2-sample t tests and analysis of variance F tests, P < .05. Dermatology residents were relatively comfortable with common conditions such as androgenetic alopecia and alopecia areata, but uncomfortable with creating healthy hair regimens, discussing natural hair care products, and treating trichorrhexis nodosa. Resident self-identification as underrepresented in medicine significantly impacted resident knowledge of hair care and treatment in patients with SOC. This study was limited due to small sample size and potential recall bias. This study highlights knowledge gaps in understanding hair-related care for patients with SOC, affirming the continued importance of diversifying dermatology programs as well as hair-specific training for residents.

A didactic simulation to increase OB/GYN resident knowledge and comfort level with vaginal pessaries

A didactic simulation to increase OB/GYN resident knowledge and comfort level with vaginal pessaries

Advancing Sustainable Building Practices: Intelligent Methods for Enhancing Heating and Cooling Energy Efficiency

Our work is dedicated to enhancing sustainability through improved energy efficiency in buildings, with a specific focus on heating and cooling control and the optimization of thermal comfort of occupants. With an energy consumption of more than 60% in buildings, HVAC systems are the biggest energy users. By integrating advanced technology, data algorithms, and digital twins, our study aims to optimize energy performance effectively. We have developed a Neural Network-based Model Predictive Control (NNMPC) to achieve this goal. Leveraging technologies such as MQTT communication, Wi-Fi modules, and field-programmable gate arrays will enhance scalability and flexibility. Our findings demonstrate the efficacy of the NNMPC system deployed on the PYNQ board for reducing sensible thermal energy usage for both cooling and heating purposes. Compared to traditional On/Off control systems, the NNMPC achieved an impressive 40.8% reduction in heating energy consumption and a 37.8% decrease in cooling energy consumption in 2006. In comparison to the On/Off technique, the NNMPC demonstrated a 25.6% reduction in annual heating energy consumption and a 28.8% drop in annual cooling energy consumption in the simulated year of 2017. We observed that, across all strategies and platforms, there were no instances where the Predicted Mean Vote (PMV) fell below −0.5. However, a significant proportion of PMV values (ranging from 65% to 83%) were observed between −0.5 and 0.5, signifying a high level of occupant comfort. Additionally, for PMV values between 0.5 and 1.0, percentages ranged from 16% to 33% for both years. Importantly, the NNMPC exhibited notable efficiency in maintaining occupants’ comfort within this range, requiring less energy while ensuring highly satisfactory environments.

Creation of a Prototype Cochlear Training Model.

Creation of a novel 3D-printed physical cochlear model that demonstrated the feasibility of creating the model, and impact of a Graphical User Interface (GUI) system on training insertion metrics. Feasibility study with a pilot prospective data collection. Tertiary academic center. The study was IRB exempt. Five resident trainees (PGY1-PGY5) practiced electrode insertions in cadaveric temporal bones before using the simulator. Nine students were educated on how to hold the electrodes and position them, and then allowed to use the simulator. All trainees were instructed that slower insertions were favorable. One cochlear implant (CI) surgeon used the simulator. The GUI captured the real video feed, but also provided distance, trajectory, and velocity measurements. The program is designed to plot the real-time depth of insertion and speed of insertion of the electrode; the user is also provided real-time occurrence of any kinks and back-outs. A total of 14 trainees and 1 CI surgeon inserted the electrode at least 5 times without the use of the GUI (before) and then at least 5 times with the use of the GUI (after). Average Speed before and after (100.84 and 53.23 mm/s); Average minimum speed before and after (59.34 and 9.65 mm/s); and Average maximum speed before and after (416 and 285.81 mm/s). Statistically significant improvements were noted in all the measured speeds of insertion (P < .001). The other variables improved but not to a statistical significance. Real-time training using the 3D-printed model and GUI for cochlear implantation can help improve surgical resident training and comfort levels with electrode insertion for surgical trainees. The advantage of this model is that surgeons/trainees can use it as many times as they like, as the whole set-up is easy, economical, and reusable. The real time graphical user interface enhances training and retention of the practiced skills.

Performance evaluation of high-rise buildings using database-assisted design approach

In recent years, performance-based design (PBD) has gained attention and is sought to be the benchmark approach in the field of wind engineering. While the concept of performance-based design is well-accepted in earthquake engineering, it is yet to be embraced for the design of buildings to resist severe wind loads. This paper introduces a framework for the performance-based wind design (PBWD) of tall steel buildings using a time domain analysis that keeps the process of wind effects and the structural design process integrated, transparent, and fully auditable. From the perspective of PBWD, the main objective is to achieve a desirable performance level for a given hazard level, i.e., mean recurrence interval of extreme wind. The wind effects are directly related to the mean annual return of wind through a well-accepted simulation approach. A 180 m tall standard CAARC building is used for the case study to illustrate the proposed methodology. The wind load time histories are determined using the pressure tap data on exterior faces of the building measured in the wind tunnel. With the calculated wind loads, nonlinear dynamic analysis is conducted with various wind directions and mean wind speeds based on database-assisted design (DAD) approach. The key performance measures such as demand-to-capacity indices, inter-story drift, damage deformation index, and floor accelerations are calculated as a function of wind directions and mean wind speed. The obtained responses are used in conjunction with a local wind climatological database to determine the extreme wind effects for any specific mean recurrence interval. The performance of the steel building is evaluated for three performance criteria, including occupant comfort, operational, and continuous occupancy. The conducted performance assessment reveals that building fails to satisfy the serviceability requirement of drifts. However, the building satisfies the requirements for the occupant comfort and operational performance levels for strength design, while it also satisfies the continuous occupancy, limited interruption in Risk category II. The result reveals that the proposed framework provides realistic assessment of performance of the building incorporating the wind directionality and return period of the wind speeds.

Development of a Building Simulation Model for Indoor Temperature Prediction and HVAC System Anomaly Detection

In order to reduce global energy consumption, energy-efficient, green and smart buildings have to be built. In addition to the application of other energy efficiency measures, an effective management of HVAC systems is required. High quality management and control of these systems ensures optimal occupant comfort levels, proper operation, rational energy consumption, and a positive impact on the environment. This is especially important for large buildings with complex systems such as hotels. As a contribution to the creation of appropriate tools for the management and control of HVAC systems in smart buildings, this paper presents the results of the current development of a detailed dynamic simulation model based on data collected from a smart room system in a hotel in Zagreb, Croatia. The smart room system, which is integrated into the hotel's building management system, provides historical data on set and current room temperatures, room occupancy schedule, window opening, fan coil operation status, fan rotation speed, valve opening, and operating mode with a time step of 5 minutes. The simulation model based on the TRNSYS software uses a part of the available data and calculates the current internal room temperatures. A comparison of the predicted and measured temperatures at each time step showed that the deviations are within the acceptable limits. The final objectives of the model development are the identification of anomalies in the operation of the HVAC system and the optimization of its operation with the aim of reducing energy consumption.

Public Administration in a Context of Engaging Local Communities for Solar Energy Spreading: Analysis of Innovative Models and Challenges for Ukraine

The article examines the opportunities and challenges related to the implementation of innovative solar energy models in urban and rural (settlement) territorial communities. It is identified that in urban communities, where there is high competition for space, solar energy opens up new possibilities for sustainable development through the integration of solar panels on the roofs of buildings, in office centers, and other urban structures, contributing to the reduction of dependence on traditional energy sources and decreasing carbon emissions. Innovative solutions, such as solar roads and facades generating energy, demonstrate significant potential for further integration into urbanized environments. At the same time, rural (settlement) areas face their own set of challenges and opportunities in using solar energy, where the lack of access to centralized energy supply makes it an ideal solution for providing local communities with electricity. Solar systems can be installed on individual houses, in schools, and hospitals, not only providing them with electricity but also contributing to social and economic development. Particularly, in the context of ensuring safety and improving the comfort level of local residents, the use of autonomous street lighting systems in remote areas, capable of operating without connection to the electrical grid due to being fully powered by solar energy, which is unlimited in supply and harmless to the natural environment, deserves special attention. Moreover, the agricultural sector can also reap significant benefits from the development of solar energy by using photovoltaic systems for irrigation, ventilation, and other needs of farming operations. At the same time, the transition to solar energy is accompanied by certain challenges, including integration into existing power grids, energy storage, regulatory and financial barriers, etc. However, progress in battery technology development, improvements in the political and economic climate, and increasing public support are contributing to the industry’s development. The article analyzes how solar energy can transform urban and rural landscapes, creating new business models and promoting sustainable and economically viable futures. A series of successful solar energy use cases that demonstrate its potential for urban and rural (settlement) areas are considered. The article emphasizes the importance of integrating solar energy into the overall energy system and the need to focus joint efforts of public authorities, business structures, and civil society to overcome existing challenges. The scientific novelty of the study lies in the comprehensive analysis and synthesis of contemporary cutting-edge approaches to the implementation of projects in the field of solar energy, which can ensure efficient use of solar energy under the conditions of various types of territorial communities, which is extremely relevant under the conditions of post-war recovery and development.

Natural Ventilation and Indoor Air Quality in Domestic School Building: CFD Simulation and Improvement Strategies

Natural ventilation is a process of replenishing used air from the interior environment with fresh outer air without the use of mechanical equipment. This project aims to investigate the feasibility and performance of implementing natural ventilation in dilapidated classroom designs of actual geometry. Computer models of an existing classroom were created using SOLIDWORKS based on real-scale building floor plans, while the same software was applied to compute flow simulation studies to visualise the airflow pattern, temperature distribution, relative humidity, and the thermal comfort level of occupants in the classrooms. Estimated climate parameters were input in the simulation process to illustrate better the effect of hot and humid climate conditions in Malaysia towards the thermal comfort level of occupants. In this project, a visualised wind tunnel was created to simulate the prevailing wind source that supplies wind to the designed classroom, and the airflow pattern across the designed building was analysed. From the initial simulation results, it was discovered that the airflow into the classroom is uneven, whereby some locations in the building are experiencing extremely low wind breeze, which eventually affects the comfort level of occupants in the room. On the other hand, an internal analysis focusing on the interior comfortability of the classrooms was applied to examine the thermal comfort condition while using the naturally ventilated classrooms. Recommendation optimisation approaches such as the louvre angle and introduction of a windcatcher was presented in this project to improve the natural ventilation performance of the designed classroom.

Optimization of Air Handler Controllers for Comfort Level in Smart Buildings Using Nature Inspired Algorithm

This research seeks to improve the temperature control of AHU in building sub-levels using optimization algorithms. Specifically, the study applies the FA and PSO algorithms to optimize the PID control of AHU’s temperature. The study addresses the issue of temperature control in building sub-levels, which is a common challenge in HVAC systems. The study uses optimization algorithms and a nonlinear model to improve temperature control and reduce fluctuations in temperature from the desired setting. Additionally, a NL-ARX algorithm is utilized to create a nonlinear model based on the thermal dynamics and energy behavioral patterns of ACMV cooling systems. The study evaluates the performance of three controllers—PID, FA-PID, and PSO-PID—based on ITSE as a performance index. The study compares the performance of these controllers to achieve the desired temperature setting, and it analyses the influence of temperature regulation on occupant comfort levels. In this study, we compare different controllers using ITSE as a performance indicator. This shows how well different optimization algorithms work at setting the right temperature. The research gap is the lack of efficient temperature control solutions in building sub-levels that can optimize occupant comfort and energy efficiency. The experimental findings confirm that PSO-PID outperforms conventional PID and FA-PID optimization in terms of achieving the goal objective via computational complexity. Overall, this study’s focus is to explore and compare different optimization algorithms to improve temperature control and occupant comfort in building sub-levels.

Evaluating feasibility and acceptability of an innovative personalized hybrid longitudinal communication skills training program.

428 Background: Effective patient-physician communication plays a vital role in providing care. Improved patient satisfaction and reduced burnout are among the many benefits of effective communication. Medical training in this area through didactic lectures, group discussions, and role play with feedback can facilitate better acquisition and honing of communication skills. We aimed to create a longitudinal training program assisting residents in developing communication skills. Methods: Internal Medicine (IM) residents participated in a 6-month project as part of their training. Residents completed a baseline questionnaire to assess confidence in communication skills, followed by a curriculum comprised of 3 x 1-hour sessions every 5 weeks where expert lecturers guided didactics on pertinent topics (e.g., delivering bad news, discussing goals of care (GOC), and completing a Practitioner Orders for Life-Sustaining Treatment (POLST)). Participants completed post-session surveys after each training, and a comprehensive post-training self-assessment. Comfort level was assessed on a 1-5 scale (1 least comfortable, 5 most comfortable) throughout the surveys. Results: Pre-intervention, most residents utilized “Ask, Tell, Ask (ATA)” (46.67%) and “Setting, Perception, Invitation, Knowledge, Emotion, Summarize (SPIKES)” (40%) frameworks to facilitate conversations with patients. Post-intervention, a greater number of residents utilized SPIKES (52.08%) compared to ATA (37.5%). 1st (PGY1) and 2nd (PGY2) year residents reported completing +25.71% and +60% more POLST forms post-intervention. In the inpatient (IP) setting, resident comfort levels in initiating GOC increased by +15.8% (for PGY1s) and +6.7% in total (all classes). Comfort levels in breaking bad news to patients in the IP setting increased by +9.09% (+24.14% for PGY1s specifically). PGY2s had the most substantial increase in comfort level in completing POLST forms (+21.08% IP, +31.52% outpatient (OP)), with an overall improvement in comfort from all classes of +12.32% (IP) and 12.53% (OP) post-intervention. Conclusions: This curriculum represents a helpful tool to improve physician-patient communication among IM residents. PGY1s demonstrated the most substantial improvement in confidence following the program, which may indicate the importance of prioritizing training for first year residents. Qualitative feedback from residents included distributing sessions throughout the year (beginning, middle, end), holding sessions in the intensive care unit (ICU) for applicability to patients in real-time, and continued instruction of practical skills. These findings may allow for future curriculum planning to help bolster trainee confidence and skills when facilitating meaningful conversations with their patients.

Examining the efficacy of cooling pad technology to address increasing building cooling demand in Latvia

Over the past decades there has been a strong evidence of a temperature rise across the world that has led to a growing concern of more extreme weather patterns and regular seasonal heat waves globally. As such, building occupants are at a continuously growing risk to overheating exposure inside the premises throughout the warm season of the year. This study investigates the utilization of cooling pad technology as a potential solution to enhance cooling efficiency. Compared to traditional cooling methods, the implementation of cooling pads leads to significant reductions in temperature and enhanced humidity control, while consuming relatively lower amounts of energy. The study contains a comprehensive analysis of the climatic conditions in Latvia, focusing on temperature and humidity variations throughout the year over the last decade in three cities–Riga, Daugavpils and Liepaja, that extensively represent the scope of climatic variations across Latvia, featuring coastal and continental climate patterns. This study aims to evaluate the effectiveness and suitability of cooling pad technology in Nordic climate, focusing on three Latvian cities. The novelty of the study lies in its analysis of cooling pad technology’s effectiveness in Nordic climatic conditions in addressing the increasing cooling demand. The paper examines the fundamental principles behind cooling pad technology, its impact on chiller performance, and its ability to optimize the cooling process. The utilization of cooling pad technology as an effective means to enhance cooling efficiency across the building stock to improve occupant comfort level and IEQ is highlighted. The results demonstrate 5.47% COP increase during average summer temperature conditions, and 17.78% COP increase in peak summer temperature conditions after implementation of cooling pads. This study contributes to the existing knowledge on cooling technologies, offering practical recommendations for the implementation of cooling pad systems use in Latvia and across the wider Nordic region, which is experiencing the gradual rise in summer temperature and humidity level.

Resident perception of obstetrics and gynecology residency breast disease curriculum: a national study

As part of the education objectives in obstetrics and gynecology residency programs, the Council on Resident Education in Obstetrics and Gynecology includes benign breast disease and breast cancer screening, diagnosis, and management. However, obstetrics and gynecology residency curricula vary highly in their focus on this subject. The comfort level of the average obstetrics and gynecology resident in the United States in managing breast disease is unknown. This study aimed to examine the perspective of obstetrics and gynecology residents in the United States on their education and training in breast disease. An 18-question survey was distributed to all Accreditation Council for Graduate Medical Education program coordinators to distribute to their residents collect demographic information, training environment, and perspective on breast disease education. All statistical analysis was performed using SPSS (version 2.0; IBM Corporation, Armonk, NY). The survey was distributed to 241 programs, and a response was received from 28 programs (a program response rate of 12.0%). Based on the programs' response, there was a total of 582 eligible residents, and the survey was completed by 180 residents (a response rate of 31.0%). Of all responses, 121 residents (67.2%) did not have a dedicated breast disease rotation or clinical time. Most residents were uncomfortable with their education, training, and ability to manage benign breast disease (mean of 4.14 on a scale of 1-10). Most residents desired additional dedicated time to breast education during their obstetrics and gynecology training. The only variable associated with an improved resident comfort level for the management of breast disease was dedicated clinical time (relative risk [RR], 2.0; 95% confidence interval [CI], 0.04-1.45; P=.04). Obstetrics and gynecology residency programs should consider adding dedicated clinical time to breast disease to increase their residents' comfort with breast disease management.

Clinical Physics Boot Camp for Radiation Oncology Residents: A Pilot Study

The physics curriculum is a source of anxiety both for medical students considering radiation oncology (RO) as a possible career and for current residents facing the physics boards. To improve the orientation process for residents and medical students, we created a physics boot camp using clinically relevant patient vignettes to teach physics fundamentals. The initial boot camp was a week-long program of 1.5 to 2 hours daily, with each day consisting of a didactic session and hands-on laboratory. Boot camp topics covered included physics fundamentals, electron treatments, photon treatments, brachytherapy, and urgent clinical setups. Learners completed pre- and postsurveys, where each rated their knowledge and comfort level with RO workflow on a 5-point scale. Learners also completed daily knowledge-based assessments testing the information presented before and after these daily sessions. A total of 10 participants were included in the initial boot camp: 8 residents and 2 medical students. A repeat, single-day, multi-institutional boot camp a year later included 5 of the original resident participants. Participant scores were paired for analysis using student t tests. For the initial boot camp, all participants reported significantly increased confidence in the physics aspects of the RO workflow (mean 3.24 vs 4.18; P = .0023). However, when comparing those self-assessment scores from participants with more than a year of physics background to those earlier in their training, only the early training participants’ scores remained significant (advanced learners: mean 4.0 vs 4.38, P = .129; early learners: mean 2.66 vs 4.02, P = .0025). All participants had improved scores on their knowledge-based assessments (mean 74% vs 89%; P = .0001), which remained statistically significant for both early learners (mean 68% vs 87%; P = .0005) and advanced learners (mean 84% vs 93%; P = .0447). For repeat participants, preboot camp knowledge showed continued improvement (mean 61% vs 79%; P = .049) at 1 year. A formal physics boot camp orientation improves both resident comfort level and knowledge base with clinical physics, with participants early in their training deriving the greatest benefit.

Using the evolutionary mating algorithm for optimizing the user comfort and energy consumption in smart building

This paper presents a simulation study focused on optimizing user comfort and energy consumption in smart buildings. Managing energy efficiently in smart buildings poses a significant challenge. The aim of this research is to achieve a high level of occupant comfort while minimizing energy usage. The study considers three fundamental parameters for measuring user comfort: thermal comfort, visual comfort, and indoor air quality (IAQ). Data from temperature, illumination, and CO2 sensors are collected to assess the indoor environment. Based on this information, smart building systems can dynamically adjust heating, cooling, lighting, and ventilation to optimize energy usage and ensure occupant comfort. To address the optimization problem, the Evolutionary Mating Algorithm (EMA) is proposed. EMA belongs to the evolutionary computation group of nature-inspired metaheuristic algorithms and offers a promising solution. A comparative analysis is conducted with other well-known algorithms such as Particle Swarm Optimization (PSO), Differential Evolution (DE), Ant Colony Optimization (ACO), Biogeography-Based Optimization (BBO), Teaching-Learning Based Optimization (TLBO), and Beluga Whale Optimization (BWO). The findings demonstrate the effectiveness of EMA in achieving optimum comfort with minimal energy consumption in smart building systems.

Investigation on Thermal Comfort and Thermal Adaptive Behaviors of Rural Residents in Suibin Town, China, in Summer

With global warming, the climate is becoming hotter, even at higher latitudes. In order to clarify the thermal environment and thermal comfort level of rural residents at higher latitudes in summer, a field survey on thermal comfort was conducted in Suibin Town, China. The results show the following: (1) The correlation between the operative temperature and the mean thermal sensation score is stronger than that between the operative temperature and the thermal sensation score. Moreover, the applicability of the thermal comfort evaluation index of the operative temperature in severely cold areas was verified. The linear regression method showed that the neutral temperature is 25.1 °C and the thermal acceptable range is 22.5–27.6 °C. (2) There is a strong correlation between thermal sensation and thermal acceptability. (3) The preferred temperature in summer is 25.3 °C. Moreover, rural residents prefer cooler indoor temperatures in summer. (4) The clothing insulation of rural residents decreases with an increase in the indoor operative temperature. (5) Rural residents’ acceptance of the indoor temperature in summer is influenced by the economy, psychology, adaptive behaviors, etc. Moreover, rural residents expect cooler indoor temperatures in summer and will adapt to the thermal environment via low-cost adaptive behaviors.

Improving building occupant comfort through a digital twin approach: A Bayesian network model and predictive maintenance method

This study introduces a Bayesian network model to evaluate the comfort levels of occupants of two non-residential Norwegian buildings based on data collected from satisfaction surveys and building performance parameters. A Digital Twin approach is proposed to integrate building information modeling (BIM) with real-time sensor data, occupant feedback, and a probabilistic model of occupant comfort to detect and predict HVAC issues that may impact comfort. The study also uses 200000 points as historical data of various sensors to understand the previous building systems’ behavior. The study also presents new methods for using BIM as a visualization platform and for predictive maintenance to identify and address problems in the HVAC system. For predictive maintenance, nine machine learning algorithms were evaluated using metrics such as ROC, accuracy, F1-score, precision, and recall, where Extreme Gradient Boosting (XGB) was the best algorithm for prediction. XGB is on average 2.5% more accurate than Multi-Layer Perceptron (MLP), and up to 5% more accurate than the other models. Random Forest is around 96% faster than XGBoost while being relatively easier to implement. The paper introduces a novel method that utilizes several standards to determine the remaining useful life of HVAC, leading to a potential increase in its lifetime by at least 10% and resulting in significant cost savings. The result shows that the most important factors that affect occupant comfort are poor air quality, lack of natural light, and uncomfortable temperature. To address the challenge of applying these methods to a wide range of buildings, the study proposes a framework using ontology graphs to integrate data from different systems, including FM, CMMS, BMS, and BIM. This study’s results provide insight into the factors that influence occupant comfort, help to expedite identifying equipment malfunctions and point towards potential solutions, leading to more sustainable and energy-efficient buildings.

Mock-up test on the application of phase change materials in underfloor radiant heating system in apartments

ABSTRACT Apartment housing in South Korea mainly uses underfloor radiant heating systems. However, the performance of these systems has not improved significantly in recent years. The heat storage capacity of the floor influences the heating energy required and impacts the comfort level of occupants. Thermal energy storage materials, such as phase change materials (PCMs), can be employed to increase the heat storage capacity. This study aims to investigate the appropriate installation position and phase change temperature of PCMs applied to an underfloor radiant heating system. Two mock-up tests were conducted. First, the PCM was installed on the top, side, and bottom of the heating pipe, and the floor surface temperature was compared with that of a conventional floor structure in each case. Second, PCMs with phase change temperatures of 34 and 43 ℃ were installed in different rooms, and the floor surface temperatures were compared. The results indicated that PCMs should ideally be installed at the bottom of the heating pipe, and a phase change temperature of 34 ℃ is appropriate for use in Korean underfloor radiant heating systems.

Education Research: Predictors of Resident Physician Comfort With Individuals With Intellectual and Developmental Disabilities: A Cross-sectional Study.

Individuals with intellectual and/or developmental disabilities (IDD) experience worse health outcomes compared with peers without a disability partly due to difficulties accessing age-appropriate health care. Provider discomfort with interacting and caring for individuals with IDD is a primary barrier to accessing care. The objectives of this study were to describe resident physicians' education, experiences, and comfort levels regarding individuals with IDD and to identify predictors of higher comfort levels with this patient population. In this cross-sectional study, we surveyed medical trainees in 7 residency programs in Boston, Massachusetts on their education, experiences, and comfort levels regarding individuals with IDD. The comfort level was assessed directly on a 6-point Likert scale. The relationship between comfort regarding people with IDD and several candidate explanatory variables was explored with Spearman and partial Spearman correlations (r s). The estimated survey response rate was 49%. Of 423 resident physicians included in the study, 96% reported they had treated a patient with IDD, while only 25% reported having formal education on caring for this population. On a scale of 1-6, with higher numbers corresponding to greater comfort, the mean comfort level treating individuals with IDD was 3.73 (CI 3.61-3.85). In bivariant analyses, the amount of prior experience with people with IDD had a moderate, positive correlation with increased comfort levels treating individuals with IDD (r s = 0.42, p < 0.01). The following characteristics had a weak, positive correlation with increased comfort levels: training in a pediatric-focused residency specialty (r s = 0.18, p < 0.01), number of hours of formal education on caring for people with IDD (r s = 0.15, p < 0.01), and age (r s = 0.12, p = 0.03). Only the amount of prior experience with this patient population remained positively correlated with higher comfort levels when the other variables were controlled for (r s = 0.38, p < 0.01). Prior experience with individuals with IDD predicted higher comfort levels with this population. This study supports the need for increased opportunities for medical trainees to engage with people with IDD to improve resident physicians' comfort caring for this patient population.

Factors Influencing Adoption of Building Management System in Commercial Buildings in Lagos State, Nigeria

Against the backdrop of increasing technological innovation and rising demand for sustainability in the built environment, there is a clear need to explore the application of Building Management System BMS in the Nigerian real estate sector. Accordingly, this paper examined the concept of adopting Building Management System (BMS) in commercial buildings in Lagos State, Nigeria with a view to assessing performance on SDG 11 (Sustainable cities and communities) where issues around resilience in buildings is hosted. The study administered one hundred and eighteen questionnaires to facility managers of commercial buildings that have adopted BMS in five local government areas in Lagos State. The data were processed using the principal component (factor) analysis and regression correlation analysis tool. It was found that a range of social and cost factors influenced the adoption of BMS in the study area. Specifically, level of occupant comfort and ease of use of the system were the most significant factor while implementation cost and extent of energy savings also strongly influenced BMS adoption in the study area. The chapter offers suggestions on strategies to improve adoption of BMS and recommends awareness campaigns and the introduction of promotional incentives to the public on BMS.