The effect of structures on indoor humidity--possibility to improve comfort and perceived air quality.

The research presented in this paper shows that moisture transfer between indoor air and hygroscopic building structures can generally improve indoor humidity conditions. This is important because the literature shows that indoor humidity has a significant effect on occupant comfort, perceived air quality (PAQ), occupant health, building durability, material emissions, and energy consumption. Therefore, it appears possible to improve the quality of life of occupants when appropriately applying hygroscopic wood-based materials. The paper concentrates on the numerical investigation of a bedroom in a wooden building located in four European countries (Finland, Belgium, Germany, and Italy). The results show that moisture transfer between indoor air and the hygroscopic structure significantly reduces the peak indoor humidity. Based on correlations from the literature, which quantify the effect of temperature and humidity on comfort and PAQ for sedentary adults, hygroscopic structures can improve indoor comfort and air quality. In all the investigated climates, it is possible to improve the indoor conditions such that, as many as 10 more people of 100 are satisfied with the thermal comfort conditions (warm respiratory comfort) at the end of occupation. Similarly, the percent dissatisfied with PAQ can be 25% lower in the morning when permeable and hygroscopic structures are applied.

Cancer treatment in rural areas.

The inability to deliver cancer prevention and treatment to the rural population poses a significant barrier in the national effort to reduce cancer mortality. Since 25 percent of the U.S. population lives in rural areas and few rural areas are readily accessible to cancer centers or Community Clinical Oncology Programs (CCOPs), the prospects for accomplishing the National Cancer Institute (NCI) Goals for the Year 2000 are limited unless substantive changes occur in rural cancer care delivery. This article reviews the problem of cancer risk and care in rural areas and describes one effort to deliver state-of-the-art cancer treatment to rural patients in Virginia. It describes the needs and barriers to access in rural Virginia, the structural elements of the Rural Cancer Outreach Program, and the health policy issues that result when subspecialty care is exported to disadvantaged areas.

Teaching specialty cancer medicine in rural hospitals: the cancer outreach program as a model.

Cancer doctors and nurses are clustered in the metropolitan areas of Virginia. However, cancer patients are found throughout the state, and cancer mortality time trends are worse in the rural areas. Efforts to recruit cancer physicians and nurses to rural hospitals have been unsuccessful due to the practice characteristics, educational isolation, and economic disincentives. Our rural cancer education program involves the physicians and nurses currently in practice at two rural hospitals. We provide hands-on training in cancer care, continuing education, and intense week-long educational sessions. We have observed changes in physician and nurse practice styles that benefit the cancer patient including effective pain management, enrollment of patients on clinical trials, increased use of adjuvant therapy, and breast conservation. We are providing state-of-the-art cancer care at the rural hospitals in the Cancer Outreach Program. We have improved the educational opportunities and increased utilization of the resources of the academic career center. We can modify the practice characteristics by providing needed clinical programs and enhancing the rural hospital/academic medical center link. We have shown that rural cancer care can be revenue-neutral or positive, and we are seeking creative solutions to the financial disincentives of rural specialty practice. We can assist the rural hospital in the recruitment of oncology specialty nurses and physicians by providing cancer care services, and the patient caseload is available to teach prospective rural subspecialty practitioners at the rural hospitals.