RESUMO
BACKGROUND: Numerous mechanisms link outdoor weather and climate conditions to human health. It is likely that many health conditions are more directly affected by indoor rather than outdoor conditions. Yet, the relationship between indoor temperature and humidity conditions to outdoor variability, and the heterogeneity of the relationship among different indoor environments are largely unknown. METHODS: We use 5-14 day measures of indoor temperature and relative humidity from 327 dwellings in New York City for the years 2008-2011 to investigate the relationship between indoor climate, outdoor meteorological conditions, socioeconomic conditions, and building descriptors. Study households were primarily middle-income and located across the boroughs of Brooklyn, Queens, Bronx, and Manhattan. RESULTS: Indoor temperatures are positively associated with outdoor temperature during the warm season and study dwellings in higher socioeconomic status neighborhoods are significantly cooler. During the cool season, outdoor temperatures have little effect on indoor temperatures; however, indoor temperatures can range more than 10 °C between dwellings despite similar outdoor temperatures. Apartment buildings tend to be significantly warmer than houses and dwellings on higher floors are also significantly warmer than dwellings on lower floors. Outdoor specific humidity is positively associated with indoor specific and relative humidity, but there is no consistent relationship between outdoor and indoor relative humidity. CONCLUSIONS: In New York City, the relationship between indoor and outdoor temperature and humidity conditions vary significantly between dwellings. These results can be used to inform studies of health outcomes for which temperature or humidity is an established factor affecting human health and highlights the need for more research on the determinants of indoor climate.
RESUMO
Given the survival benefits of adjuvant chemotherapy for advanced ovarian cancer (OC), we examined the associations of survival with the time interval from debulking surgery to initiation of chemotherapy and with the duration of chemotherapy. Among patients > or =65 years with stages III/IV OC diagnosed between 1991 and 2002 in the Surveillance, Epidemiology, and End Results-Medicare database, we developed regression models of predictors of the time interval from surgery to initiation of chemotherapy and of the total duration of chemotherapy. Survival was examined with Cox proportional hazards models. Among 2558 patients, 1712 (67%) initiated chemotherapy within 6 weeks of debulking surgery, while 846 (33%) began treatment >6 weeks. Older age, black race, being unmarried, and increased comorbidities were associated with delayed initiation of chemotherapy. Delay of chemotherapy was associated with an increase in mortality (hazard ratio (HR)=1.11; 95% CI, 1.0-1.2). Among 1932 patients in the duration of treatment analysis, the 1218 (63%) treated for 3-7 months had better survival than the 714 (37%) treated for < or =3 months (HR=0.84; 95% CI, 0.75-0.94). This analysis represents one of the few studies describing treatment delivery and outcome in women with advanced OC. Delayed initiation and early discontinuation of chemotherapy were common and associated with increased mortality.
