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Nationally representative data from the 2012 School Health Policies and Practices Study examined whether state assistance on indoor air quality (IAQ) was associated with district-level policies and practices related to IAQ and integrated pest management (IPM). Districts in states that provided assistance on IAQ were more likely than districts not in such states to (1) have an IAQ management program (p < 0.001); (2) require schools to conduct periodic inspections of the heating, ventilation, and air conditioning system (p < 0.05); of the building for cracks, leaks, or past water damage (p < 0.01); for mold (p < 0.01); for clutter that prevents effective cleaning and maintenance (p < 0.05); of the plumbing system (p < 0.01); and for condensation in and around school facilities (p < 0.001); (3) have an engine idling reduction program (< 0.001); (4) have a policy to purchase low-emitting products (p < 0.05); and (5) require IPM strategies (p < 0.05). Increasing the number of states that provide IAQ-related assistance to school districts and schools may improve school IAQ.

The integration of environmental policies with political support for action on these policies is of prime significance for mobilization and progression of improving indoor environments. However, state licensing agencies and local county ordinances for child care centers do not universally follow these policies and standards. As a result, most early childhood educational programs operate without proper indoor environments. Indoor air quality, temperature, ventilation, daylighting, and acoustics are crucial factors for educational settings in early childhood education. This study documents the physical environment in early childhood education centers in three counties in Maryland. Results indicate that building performance and indoor air quality standards vary according to the socioeconomic status of children who attend early childhood programs, and environmental factors correlate with educational achievement (as measured by kindergarten readiness scores).

Background: We tested the hypothesis that classroom carbon dioxide (CO[subscript 2]) concentration is inversely related to child school attendance and educational attainment. Methods: Concentrations of CO[subscript 2] were measured over a 3-5?day period in 60 naturally ventilated classrooms of primary school children in Scotland. Concentrations of CO[subscript 2] were related to the class average annual attendance and proportions attaining a national standard for reading, writing, and numeracy, adjusted for socioeconomic status and class size. Results: The median (interquartile range, IQR) CO[subscript 2] concentration averaged over the school day was 1086?ppm (922, 1310). In the model, Time Weighted Average CO[subscript 2] concentrations were inversely associated with school attendance but not academic attainments. An increase of 100?ppm CO[subscript 2] was associated with a reduced annual attendance of 0.2% (0.04, 0.4) roughly equivalent to 1 half day of school per annum, assuming schools are open on 190?days per year. Indoor temperature and relative humidity were not related to attendance or academic attainment. Conclusions: Inadequate classroom ventilation, as evidenced by CO[subscript 2] concentration exceeding 1000?ppm, is not uncommon and may be associated with reduced school attendance. A relationship between inadequate classroom ventilation and adverse health outcomes in children may be present and this needs to be explored.

Glazing can be optimized to enhance passive solar heating and daylight harvesting by exceeding the prescriptive limits of the energy code. This savings can be garnered without the high cost of external overhangs or expensive glazing products. The majority of savings from solar glazing are attributable to the increase in solar heating and secondarily to daylight illumination. Glazing with high solar gains can have a compelling advantage over code-compliant conventional glazing with low solar gains. In this article, the author discusses how solar glazing can benefit schools, and offers tips for school construction.

The objective of the study was to determine the hydrodynamics of the two stage counter-current cascade wet scrubbers used during incineration of medical waste. The dependence of the hydrodynamics on two main variables was studied: Inlet air flow rate and inlet liquid flow rate. This study introduces a new wet scrubber operating features, which are liquid accumulation, together with a detailed analysis of liquid-to-gas ratio and pressure drops. Liquid accumulation at the base of each scrubber helps to prevent the gas from short circuiting to the scrubber solution feed tanks. It was observed that liquid accumulation increases linearly with inlet scrubbing liquid flow rate beyond 0.2 L/s in the absence of flue gas flow. When flue gas is flowing into multistage wet scrubber the accumulation level increases abruptly starting from inlet scrubbing liquid of 0.45 L/s and stabilizes at accumulation level of 0.1 m beyond 0.75 L/s. Increasing the flue gas flow rate increases the minimum inlet scrubbing liquid flow rate at which initial accumulation was observed. The outlet scrubbing solution flow rate and liquid accumulation in the bottom of the scrubber increase as the inlet liquid flow rate increases. Beyond inlet liquid flow rate of 0.75 L/s, the outlet liquid flow rate does not increase any more, the wet scrubber enters flooding range, whereby, the volume of accumulated liquid increases faster with inlet scrubbing liquid flow rate. The maximum liquid-to-gas ratio was observed to be 1.9 L/m[superscript 3] and the minimum liquid-to-gas ratio was 0.1 L/m[superscript 3]. Based on liquid accumulation and minimum flooding conditions, the operating liquid-to-gas ratio was recommended to be 0.6 to 1.9 L/m[superscript 3], while the allowable inlet liquid flow rate ranged between 0.45 and 0.75 L/s, giving a constant accumulation of scrubbing liquid in the wet scrubber. The pressure drop across the wet scrubber remained constant at lower flow rate and increased linearly beyond U[subscript g] = 5 m/s. The maximum pressure drop of the multistage wet scrubber was 75 kPa. (Contains 10 figures and 1 table.)

This article stresses the importance of building design above technology as a relatively inexpensive way to reduce energy costs for a library. Emphasis is placed on passive solar design for heat and daylighting, but also examines passive ventilation and cooling, green roofs, and building materials. Passive design is weighed against technologies that actively capture renewable energy. Best practice examples include new construction and retrofits. Active technologies for capturing renewable energies, such as photovoltaic panels, can be employed when passive solutions are not realistic due to limitations resulting from site selection. Building or remodeling an environmentally sustainable building is more costly than a conventional equivalent, but long-term savings in energy and maintenance can more than compensate for the initial investment. Passive solar heat is particularly compatible with library functionality because it invites natural light into living spaces and eliminates noise that would otherwise exist with forced-air HVAC systems. Practical suggestions for subtle improvements to existing buildings are offered in addition to more ambitious construction projects.

The anatomy curriculum at Namibia's first, and currently only, medical school is clinically oriented, outcome-based, and includes all of the components of modern anatomical sciences i.e., histology, embryology, neuroanatomy, gross, and clinical anatomy. The design of the facilities and the equipment incorporated into these facilities were directed toward simplification of work flow and ease of use by faculty, staff, and students. From the onset, the integration of state of the art technology was pursued to facilitate teaching and promote a student-centered pedagogical approach to dissections. The program, as realized, is comprised of three 16-week semesters with seven hours of contact time per week, namely three hours of lectures and four hours of dissection laboratory and microscopy time. Set outcomes were established, each revolving around clinical cases with integrated medical imaging. The design of the facility itself was not constrained by a legacy structure, allowing the School of Medicine, in collaboration with architects and contractors, to design the building from scratch. A design was implemented that allows for the sequential processing of cadaveric material in a unidirectional flow from reception, to preparation, embalming, storage, dissection, and maceration. Importantly, the odor of formaldehyde typically associated with anatomy facilities was eliminated outside of the dissection areas and minimized within via a high-performance ventilation system. By holistically incorporating an integrated curriculum, facility design, and teaching at an early stage, the authors believe they have created a system that might serve as a model for new anatomy programs.

Perfluorocarbons (PFCs) are fully fluorinated hydrocarbons that are used as blood plasma substitutes, in medical imaging and in the cosmetics industry. Most are inert and can also be used as tracers for applications such as air flow. However, because of their C-F bonds and their longevity in the atmosphere, PFCs have large global warming potentials and are a current concern in terms of climate change. At present, their levels in the atmosphere are very low (parts per quadrillion, 1 in 10[superscript 15]) but, once released, they are immortal on human timescales. Measuring such low levels is difficult and methodologies developed by the Atmospheric Chemistry Research Group at the University of Bristol are described. (Contains 3 figures and 1 table.)

Background: To determine whether schools with a formal indoor air quality management program were more likely than schools without a formal program to have policies and practices that promote superior indoor air quality. Methods: This study analyzed school-level data from the 2006 School Health Policies and Programs Study, a national study of school health programs and policies at the state, district, and school levels. Using chi-square analyses, the rates of policies and practices that promote indoor air quality were compared between schools with and schools without a formal indoor air quality program. Results: The findings of this study show that 51.4% of schools had a formal indoor air quality management program, and that those schools were significantly more likely than were schools without a program to have policies and use strategies to promote superior indoor air quality. Conclusions: These findings suggest that schools with a formal indoor air quality program are more likely support policies and engage in practices that promote superior indoor air quality. (Contains 3 tables and 1 figure.)

The purpose of this study was to examine the effect of three ventilation conditions (i.e., normal, regimented, and no-ventilation) on the reproducibility of bioimpedance scores in humans for the forearm and trunk segments. One hundred able-bodied North American men and women, from 18 to 71 years of age, volunteered as participants. The experimenters used a Xitron Bio-Impedance Analyzer System model 4200 instrument with Hydra software (Xitron Technologies, San Diego, California, USA) to collect bioimpedance data on extracellular fluid and intracellular fluid scores. The experimenters analyzed the data using the generalizability theory,with persons as the facet of differentiation and time as the facet of generalization. The major findings were (a) ventilation conditions did not have a significant impact on the reproducibility of the test scores, (b) the forearm segment produced consistently higher intracellular fluid generalizability coefficients across three ventilation conditions for both gender groups when compared to the trunk segment, (c) the trunk segment produced intracellular fluid generalizability coefficients that were higher for the male group, and (d) the measurement error affected extracellular fluid scores less than segmental intracellular fluid scores. (Contains 5 tables.)

Background: Mechanical ventilation is commonly used during the acute management of cervical spinal cord injury, and is required on an ongoing basis in the majority of patients with injuries at or above C3. However, to date there have been limited systematic investigations of the options available to improve speech while ventilator-assisted post-cervical spinal cord injury. Aims: To provide preliminary evidence of any benefits gained through the addition of positive end expiratory pressure (PEEP) and/or a tracheostomy speech valve to the condition of leak speech. Methods & Procedures: Speech production in the three conditions was compared in two ventilator-assisted participants using a series of instrumental and perceptual speech measures. Outcomes & Results: The addition of PEEP or the use of a speech valve resulted in speech that was superior to leak speech for both participants; however, individual variation was present. Conclusions & Implications: Leak speech alone or with the addition of PEEP or a tracheostomy speech valve can facilitate functional communication for the ventilated patient, though PEEP and valve speech were found to be superior in the current study. These findings will be of assistance for clinicians counselling the growing population of patients who may require tracheostomy positive pressure ventilation long-term regarding communication options. (Contains 6 tables.)

Students often have great difficulties with applications of the energy principle, especially those from biology, although most introductory physics texts include a brief discussion of metabolism. We point out that many of these discussions are unsatisfactory, since they often fail to mention how biological systems are "thermal systems in stationary nonequilibrium states." This has important implications: in particular, that energy input is in the form of work (i.e., change of potential energy) and that energy outflux is in the form of heat, which is necessary to maintain a stationary state. We focus on some key aspects of metabolism by using a mechanical analogue: energy input is the work done by the gravitational force on an object with mass "m," and heat production is modelled as the energy dissipated by turbulent air flow around the object. (Contains 3 figures and 4 footnotes.)

Purpose: This study examined alterations in ventilation and speech characteristics as well as perceived dyspnea during submaximal aerobic exercise tasks. Method: Twelve healthy participants completed aerobic exercise-only and simultaneous speaking and aerobic exercise tasks at 50% and 75% of their maximum oxygen consumption (VO[subscript 2] max). Measures of ventilation, oxygen consumption, heart rate, perceived dyspnea, syllables per phrase, articulation rate, and inappropriate linguistic pause placements were obtained at baseline and throughout the experimental tasks. Results: Ventilation was significantly lower during the speaking tasks compared with the nonspeaking tasks. Oxygen consumption, however, did not significantly differ between speaking and nonspeaking tasks. The perception of dyspnea was significantly higher during the speaking tasks compared with the nonspeaking tasks. All speech parameters were significantly altered over time at both task intensities. Conclusions: It is speculated that decreased ventilation without a reduction in oxygen consumption implies that utilization of oxygen by the working muscles was increased during the speaking tasks to meet the metabolic needs. A greater ability to utilize oxygen from inspired air is found in individuals who are at higher fitness levels, and therefore these findings may have implications for individuals who must complete simultaneous speech and exercise for occupational purposes (e.g., fitness/military drill instructors, singers performing choreography).

This brief review is meant to serve as a refresher for faculty teaching respiratory physiology to medical students. The concepts of ventilation and perfusion matching are some of the most challenging ideas to learn and teach. Some strategies to consider in teaching these concepts are, first, to build from simple to more complex by starting with a single lung unit and then adding additional units representing shunting, mismatch, and deadspace. Second, use simplified analogies, such as a bathtub, to help students conceptualize new ideas. Third, introduce the concept of alveolar to arterial O[subscript 2] differences and the mechanisms for increasing differences as additional lung units are added. Fourth, use the consistent thread of causes of hypoxemia through the lecture to maintain continuity and provide clinical relevance. Finally, use clinically relevant examples at each step and solidify new concepts by discussing differential diagnoses at the end of the lecture(s). (Contains 8 figures.)

When teaching and learning about alveolar ventilation with our class of 300 first-year medical students, we use four simple, inexpensive "models." The models, which encourage research-oriented learning and help our students to understand complex ideas, are distributed to the students before class. The students anticipate something new every day, and the models provide elements of surprise and physical examples and are designed to help students to understand 1) cohesive forces of the intrapleural space, 2) chest wall and lung dynamics, 3) alveolar volumes, and 4) regional differences in ventilation. Students are drawn into discussion by the power of learning that is associated with manipulating and thinking about objects. Specifically, the models encourage thinking about complex interactions, and the students appreciate manipulating objects and actually understanding how they work. Using models also allows us to show students how we think as well as what we know. Finally, students enjoy taking the models home to demonstrate to friends and family "how the body works" as well as use the models as future study aids. (Contains 6 figures.)

Many people narrowly focus on energy efficiency when defining a "high-performance" school--a school building that is economical with respect to heating, cooling, and electric lighting. That is certainly true, but in the broadest terms, a high-performance school is designed to minimize reliance on fossil fuels--and provide a comfortable, healthful, productive, and beautiful learning environment--by optimizing the efficiency of the building form and mechanical equipment. Working together, architects, engineers, and environmental designers can achieve this complex goal by integrating effective school planning, sustainable architecture, and sophisticated building performance analyses. In the process, they use energy modeling early in the design process to analyze the building envelope, and mechanical and electrical loads. Daylighting, ventilation, and mechanical/electrical strategies are used to develop and refine the design.

Purpose: To reveal the qualities and intensity of speaking-related dyspnea in healthy adults under conditions of high ventilatory drive, in which the behavioral and metabolic control of breathing must compete. Method: Eleven adults read aloud while breathing different levels of inspired carbon dioxide (CO[subscript 2]). After the highest level, participants provided unguided descriptions of their experiences and then selected descriptors from a list. On a subsequent day, participants read aloud while breathing high CO[subscript 2] as before, then rated air hunger, physical exertion, and mental effort (with definitions provided). Recordings were made of ventilation (with respiratory magnetometers), end-tidal partial pressure of CO[subscript 2], transcutaneous PCO[subscript 2], oxygen saturation, noninvasive blood pressure, heart rate, and the speech signal. Results: Unguided descriptions were found to reflect the qualities of air hunger, physical exertion (work), mental effort, and speech-related observations. As CO[subscript 2] stimulus strength increased, participants experienced increased perception of air hunger, physical exertion, and mental effort. Simultaneous increases were observed in ventilation, tidal volume, end-inspiratory and end-expiratory volumes, expiratory flow during speaking, nonlinguistic junctures, and nonspeech expirations. Conclusion: Two qualities of speaking-related dyspnea--air hunger and physical exertion--are the same as those reported for many other types of nonspeech dyspnea conditions and, therefore, may share the same physiological mechanisms. The mental effort quality associated with speaking-related dyspnea may reflect a conscious drive to balance speech requirements and ventilatory demands. These findings have implications for developing better ways to evaluate and manage clients with respiratory-based speech problems.

This article examines the argument that "green" schools enhance educational performance. Having set the context of the relationship between environmentalism and the design of schools in the twentieth century, the article explores the performance of a number of green schools built in the UK between 1980 and 1995. The aim is to discover whether attention to environmental or ecological design produces measurable benefits in terms of learning levels in the classroom and the general performance of the school. The focus of the research is upon two clusters of green primary schools built 1980-95 by the local education authorities in Essex and Hampshire. In order to undertake the evaluation a methodology is proposed with criteria established for what design and construction characteristics constitute a "green" school. Key performance indicators available as a consequence of OfStEd inspections, SATS results, teacher turnover and pupil absenteeism rates are used to assess the performance of the schools in educational terms. Central to the hypothesis is that good environmental design leads to enhanced educational performance by pupils and improved productivity on the part of teachers. The methodology consists of comparing the performance of green schools with that of orthodox schools which share similar characteristics of size, location and socio-economic features, and then relating variables of educational performance to design features. Three initial findings are highlighted: first, the importance of classroom daylight levels to learning; second, the benefits to the school of secondary sun spaces; third, the need for attention to the relationship between ventilation and acoustic control in open-plan solar schools.

The study was designed to determine the effect of upright-posture (UP) versus semirecumbent (SR) cycling on commonly used measures of maximal and submaximal exercise capacity. Nine healthy, untrained men (M age = 27 years, SD = 4.8 years) underwent steady-state submaximal aerobic testing followed by a ramped test to determine maximal oxygen consumption (V[subscript O2max]). Anaerobic peak and average power and total work were assessed with the Wingate test. All tests were performed in both SR and UP positions, in random order. Oxygen consumption (V[subscript O2]) and ventilation (V[subscript E]) at the maximum workrate were lower in the SR position (p less than 0.05). At submaximal workrates (50 W and 100 W), V[subscript O2] and V[subscript E] were equivalent in the UP and SR positions, despite differences in tidal volume and respiratory rate (p less than 0.05). There was no difference in peak or average anaerobic power in the two positions. In summary, SR exercise was associated with a reduced V[subscript O2max] and a significantly altered ventilatory response to aerobic exercise, with no change in anaerobic power output. (Contains 1 figure and 2 tables.)

Exercise prescription guidelines emphasize the importance of individual preferences for different intensities, but such preferences have not been studied systematically. This study examined the hypothesis that the preference scale of the Preference for and Tolerance of the Intensity of Exercise Questionnaire would predict self-selected exercise intensity. Twenty-three previously sedentary middle-aged women participated in a treadmill test and a 20-min session at a self-selected intensity. After controlling for age, body mass index, and peak oxygen uptake, the preference scale accounted for significant portions of the variance in the percentage of oxygen uptake associated with the ventilatory threshold at Minute 15 and Minute 20 of the session at self-selected intensity. (Contains 4 tables.)

Spirometers are useful for enhancing students' understanding of normal lung volumes, capacities, and flow rates. Spirometers are also excellent for understanding how lung diseases alter ventilation volumes. However, spirometers are expensive, complex, and not appropriate for programs with limited space and budgets. Therefore, we developed a simple, inexpensive, small model of a spirometer. Activity-based models are more valuable for enhancing learning than many hours of passive instruction. The model spirometer enables students to measure ventilation volumes as well as simulate lung diseases and positive pressure (mechanical) ventilation. The spirometer consists of a glass 5-ml syringe connected to the "tracheal tube" of an existing model [(1), Fig. 1]. A glass syringe is used because the plunger slides with less resistance. The spirometer must be filled with air before it is attached to the tracheal tube. When the plunger of the lung apparatus ("diaphragm") is pulled down, the air contained in the spirometer flows into the balloon ("lung"). Conversely, when the diaphragm is pushed up, the air flows from the lung into the spirometer. This volume, "tidal volume," can be measured. In addition, the number of "breaths" per time, "respiratory rate," can be determined, and minute ventilation can be calculated by multiplying tidal volume by respiratory rate. By use of this approach, students are able to determine lung volumes, capacities, and flow rates. Furthermore, the effects of obstructive and restrictive lung diseases can be simulated. An obstructive lung disease can be simulated by placing a clamp on the tracheal tube. A restrictive lung disease can be simulated by limiting the range of the diaphragm movement. Finally, mechanical ventilation can be simulated by using the plunger of the spirometer, forcing air to move into and out of the lung. This simple addition to an existing model (1) enhances students? understanding of ventilation volumes.

Indoor air pollution is responsible for the deaths and illness of millions of young children in developing countries. This study investigated the acceptability (willingness to try) and feasibility (ability to perform) of four indoor air pollution reduction behaviors (improve stove maintenance practices, child location practices, ventilation practices and reduce the duration of solid fuel burning). The study further aimed to identify the motivations for and barriers against modifying the behaviors, the perceived impact of the behaviors on children's respiratory health, and families intention to continue with the behaviors. Thirty families in a rural village of South Africa tried out one or more of the behaviors over a 4-week trial period during winter 2002. Improving stove maintenance and reducing the duration of solid fuel burning proved to be very difficult for most families. It is recommended that the main intervention should focus on improving child location and ventilation practices. (Contains 1 table.)

Over the past decade, there has been an increase in premature births. Children born prematurely often present with complex medical conditions; some require a tracheostomy. Although many children with tracheostomies require assistance to achieve effective communication, speech-language pathologists may have limited information with respect to the medical issues and communication needs of this population. The purpose of this article is twofold. First, a review of basic information on tracheostomy and ventilatory support in the pediatric population is provided. Second, information on the assessment of communication skills and intervention specific to voice for the child with a tracheostomy is detailed. Two case studies are presented. The case studies illustrate the diversity and medical complexity common to this population and provide practical information for the clinician working with a child with a tracheostomy.

Presented as a conversation between a teacher and engineer about school design, addresses educators' preferences and engineers' perspectives on issues, such as windows, sustainable design, sinks, acoustics, and natural ventilation. (EV)

Reports on an investigation of the American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE) Standard 62-1999 on outdoor ventilation rates and space humidity levels for schools. Examined conventional cooling versus desiccant-based systems designed to control indoor humidity levels. Discusses the effectiveness of systems investigated, benefits offered by humidity control, and the need for increased ventilation. (EV)

Explores how the physical condition and design of school facilities can shape a child's learning experience. Discusses school environments' connection to asthma, heating and ventilation problems, noise problems, full-spectrum lighting, trends in teaching methods requiring different building designs, optimum school size, portable classrooms, and the now-substantiated link between a school's physical environment and learning. (EV)