Insomnia has a negative impact on mental health and is a potential risk factor for impulsive and problematic behavior. This multicenter, cross-sectional study investigated the prevalence of insomnia and underlying and maintaining factors in a group of forensic psychiatric inpatients (N = 281). Insomnia severity, subjective sleep quality, sleep hygiene and erroneous cognitions about sleep were measured with the Insomnia Severity Index, Pittsburgh Sleep Quality Index, Sleep Hygiene questionnaire and Dysfunctional Beliefs and Attitudes about Sleep, respectively. Impulsivity was derived from risk assessment instruments routinely completed by trained professionals. Almost half of the patients (48.7%) appeared to suffer from insomnia. Particularly moderate-severe insomnia (26.7%) was significantly associated with worse sleep quality, poorer sleep hygiene, stronger endorsement of dysfunctional sleep cognitions and higher impulsivity scores. It can be concluded that insomnia is rather common in forensic psychiatric patients. Insomnia appears related to various sleep hygiene behaviors and sleep-related cognitions, and probably also to diverse situational and environmental factors as well as a lack of autonomy. Cognitive behavioral therapy for insomnia, with some adjustments specific for this population, may be an effective intervention, ameliorating sleep problems and possibly also emotional and behavioral dysregulation.
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Background: Pain assessment is a necessary step in pain management in older people in palliative care. In older people, pain assessment can be challenging due to underreporting and atypical pain manifestations by other distressing symptoms. Anxiety, fatigue, loss of appetite, nausea, insomnia, dyspnoea, and bowel problems correlate with pain in palliative care patients. Insight into these symptoms as predictors may help to identify the underlying presence of pain. This study aimed to develop and test a prediction model for pain in community-dwelling frail older people in palliative care. Methods: In this cross-sectional observational study, community-care nurses from multiple organizations across the Netherlands included eligible patients (life expectancy < 1 year, aged 65+, community-dwelling and frail). The outcome pain and symptoms were assessed by means of the Utrecht Symptom Diary. Also, demographic and illness information, including relevant covariates age, sex and living situation, was collected. Multivariable logistic regression and minimum Akaike Information Criterion(AIC) were used for model development and Receiver Operating Characteristics(ROC)-analysis for model performance. Additionally, predicted probability of pain are given for groups differing in age and sex. Results: A total of 157 patients were included. The final model consisted of insomnia(Odds Ratio[OR] = 2.13, 95% Confidence Interval[CI] = 1.01–1.30), fatigue(OR = 3.47, 95% CI = 1.11–1.43), sex(female)(OR = 3.83, 95% CI = 2.11–9.81) and age(OR=-1.59, 95% CI = 0.92–1.01) as predicting variables. There is an overall decreasing trend for age, older persons suffer less from pain and females have a higher probability of experiencing pain. Model performance was indicated as fair with a sensitivity of 0.74(95% CI = 0.64–0.83) and a positive predictive value of 0.80(95% CI = 0.70–0.88). Conclusions: Insomnia and fatigue are predicting symptoms for pain, especially in women and younger patients. Further testing of the model in external cohorts is needed before clinical adoption.
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Introduction: Besides dyspnoea and cough, patients with idiopathic pulmonary fibrosis (IPF) or sarcoidosis may experience distressing non-respiratory symptoms, such as fatigue or muscle weakness. However, whether and to what extent symptom burden differs between patients with IPF or sarcoidosis and individuals without respiratory disease remains currently unknown. Objectives: To study the respiratory and non-respiratory burden of multiple symptoms in patients with IPF or sarcoidosis and to compare the symptom burden with individuals without impaired spirometric values, FVC and FEV1 (controls). Methods: Demographics and symptoms were assessed in 59 patients with IPF, 60 patients with sarcoidosis and 118 controls (age ≥18 years). Patients with either condition were matched to controls by sex and age. Severity of 14 symptoms was assessed using a Visual Analogue Scale. Results: 44 patients with IPF (77.3% male; age 70.6±5.5 years) and 44 matched controls, and 45 patients with sarcoidosis (48.9% male; age 58.1±8.6 year) and 45 matched controls were analyzed. Patients with IPF scored higher on 11 symptoms compared to controls (p<0.05), with the largest differences for dyspnoea, cough, fatigue, muscle weakness and insomnia. Patients with sarcoidosis scored higher on all 14 symptoms (p<0.05), with the largest differences for dyspnoea, fatigue, cough, muscle weakness, insomnia, pain, itch, thirst, micturition (night, day). Conclusions: Generally, respiratory and non-respiratory symptom burden is significantly higher in patients with IPF or sarcoidosis compared to controls. This emphasizes the importance of awareness for respiratory and non-respiratory symptom burden in IPF or sarcoidosis and the need for additional research to study the underlying mechanisms and subsequent interventions.
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Background: Pain assessment is a necessary step in pain management in older people in palliative care. In older people, pain assessment can be challenging due to underreporting and atypical pain manifestations by other distressing symptoms. Anxiety, fatigue, loss of appetite, insomnia, dyspnoea, and bowel problems correlate with pain in palliative care patients. Insight into these symptoms as predictors may help to identify the underlying presence of pain. This study aimed to develop a prediction model for pain in independently living frail older people in palliative care.Methods: In this cross-sectional observational study, community-care nurses from multiple organizations across the Netherlands included eligible patients (life expectancy < 1 year, aged 65+, independently living and frail). The outcome pain and symptoms were assessed by means of the Utrecht Symptom Diary. Also, demographic and illness information, including relevant covariates age, sex and living situation, was collected. Multivariable logistic regression and minimum Akaike Information Criterion(AIC) were used for model development and Receiver Operating Characteristics(ROC)-analysis for model performance. Additionally, predicted probability of pain are given for groups differing in age and sex.Results: A total of 157 patients were included. The final model consisted of insomnia(Odds Ratio[OR]=2.13, 95% Confidence Interval[CI]=1.013-1.300), fatigue(OR=3.47, 95% CI=1.107-1.431), sex(female)(OR=3.83, 95% CI=2.111-9.806) and age(OR=-1.59, 95% CI=0.922-1.008) as predicting variables. There is an overall decreasing trend for age, older persons suffer less from pain and females have a higher probability of experiencing pain. Model performance was indicated as fair with a sensitivity of 0.74(95% CI=0.64-0.83) and a positive predictive value of 0.80(95% CI=0.70-0.88).Conclusion: Insomnia and fatigue are predicting symptoms for pain, especially in women and younger patients. The use of a symptom diary in primary care can support the identification of pain.
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Background: Patients with chronic obstructive pulmonary disease (COPD) demonstrate reduced levels of daily physical activity (DPA) compared to healthy controls. This results in a higher risk of hospital admission and shorter survival. Performing regular DPA reduces these risks. Objective: To develop an eHealth intervention that will support patients with COPD to improve or maintain their DPA after pulmonary rehabilitation. Methods: The design process consisted of literature research and the iterative developing and piloting phases of the Medical Research Council (MRC) model for complex clinical interventions and the involvement of end users. Participants were healthy adults and persons with COPD. Results: The mobile phone interface met all the set requirements. Participants found that the app was stimulating and that reaching their DPA goals was rewarding. The mean (SD) scores on a 7-point scale for usability, ease of use, ease of learning, and contentment were 3.8 (1.8), 5.1 (1.1), 6.0 (1.6), and 4.8 (1.3), respectively. The mean (SD) correlation between the mobile phone and a validated accelerometer was 0.88 (0.12) in the final test. The idea of providing their health care professional with their DPA data caused no privacy issues in the participants. Battery life lasted for an entire day with the final version, and readability and comprehensibility of text and colors were favorable. Conclusions: By employing a user-centered design approach, a mobile phone was found to be an adequate and feasible interface for an eHealth intervention. The mobile phone and app are easy to learn and use by patients with COPD. In the final test, the accuracy of the DPA measurement was good. The final version of the eHealth intervention is presently being tested by our group for efficacy in a randomized controlled trial in COPD patients.
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Background: Osteoarthritis (OA) is a chronic disease primarily affecting older adults, mainly impacting the hip and knee joints. The increasing prevalence of OA contributes to rising healthcare demands and costs. Current OA treatment guidelines emphasize the importance of self-management education and guidance, particularly in promoting physical activity and weight management. In addition, improving sleep is crucial for managing OA. Developing effective self-management interventions necessitates a comprehensive understanding of the factors that facilitate these behaviors. Especially for changing health behaviors, it is important to focus on psychosocial factors. Therefore, this systematic review aimed to identify the psychosocial factors associated with physical activity, weight management, and sleep in adults with hip and/or knee OA. Methods: Five databases (PubMed, Embase, CINAHL, PyschINFO, Web of Science) were searched for observational studies reporting statistics on the association between psychosocial determinants and physical activity, weight management, or sleep in people with OA. The methodological quality was assessed using the Quality Assessment Tool for Observational Studies of the National Heart, Lung, and Blood Institute. After screening 5,812 articles, 31 studies were included for analysis. Results: The results showed that intention, self-efficacy, and willpower beliefs were positively associated with physical activity. Kinesiophobia, pain catastrophizing and pain-related fear were negatively associated with physical activity. Depressive symptoms, negative affect, pain catastrophizing, and low willpower beliefs were associated with poor weight management. Anxiety, depression, pain anxiety, and post-traumatic stress disorder were related to poor sleep behavior. Conclusions This review enhances the understanding of the psychosocial factors underlying physical activity, weight management and sleep in OA. These insights are valuable for developing tailored behavior change interventions aimed at improving physical activity, weight management and sleep in patients with hip and/or knee OA.
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Er is veel geschreven over de rol van sport in het bevorderen van sociaal, psycho‐ logisch en fysiek welbevinden van mensen. Deze literatuur is echter grotendeels gericht op het sociaal domein en daarbinnen veel op jonge mensen, maar weinig op contexten binnen een justitieel kader, bijvoorbeeld de gevangenis of reclasse‐ ring. De wetenschappelijke aandacht voor de meerwaarde van sport en bewegen voor delinquenten is beperkt. In een lopend onderzoeksproject onderzoeken wij de belangrijkste factoren om sport in te zetten ter bevordering van participatie van mensen in een kwetsbare positie (in detentie, de reclassering en de maatschappelijke opvang). Daarbinnen is een literatuurstudie uitgevoerd naar de meerwaarde van sport en bewegen, specifiek voor delinquenten. Dit betreft dus personen die binnen een justitieel kader sport- en beweegactiviteiten ondernemen of binnen een sportcontext re-integreren (denk bij dat laatste bijvoorbeeld aan vrijwilligerswerk op een sportclub in de laatste fase van detentie). In dit artikel wordt antwoord gegeven op de vraag: wat is in de literatuur bekend over de meerwaarde van sport en bewegen voor het reintegreren van delinquenten?
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This research investigates the integration of stakeholders' values into the digital frameworks of Collective Management Organizations (CMOs) within the Dutch music copyright system. Utilizing Q methodology, the study captures diverse perspectives from composers, lyricists, publishers, and CMO representatives on values, value tensions, norms, and system requirements. A pilot study with four experts tested data collection methods and refined the study design for a larger, follow-up study involving 30 participants. Preliminary findings, based on factor analysis of participant rankings of 30 statements, reveal two distinct perspectives: one focused on "Fairness and Accountability," emphasizing trust-building and equitable treatment, and the other on "Technological Efficiency and Transparency," prioritizing clear information, verification mechanisms, and advanced IT systems. Qualitative insights from participant interviews provide nuanced understanding, highlighting the importance of transparency in royalty processes, balanced application of technology, and equitable royalty distribution in the digital age. This research contributes to the modernization of copyright management systems offering a conceptual model adaptable to other creative (Intellectual Property) industries
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Purpose:The International Commission on Illumination (CIE) recommends researchers to investigate a widevariety of behavioural and health outcomes. However, researchers often investigate only a part of occupationalhealth (OH) in relation to light. A literature study (2002–2017) regarding the relationship between office lightingconditions and OH was performed to identify gaps and methodological issues.Method:The OH outcomes investigated in this paper were grouped according to the International Classificationof Diseases and analysed per category: physical and physiological health, mental health, eye health, sleep param-eters and visual comfort.Results:Findings from the literature study (20 eligible papers) showed that all OH aspects were mostly but notexclusively measured subjectively. Furthermore, most studies investigated only a fraction of office lighting par-ameters and OH aspects.Conclusions:It seems that Correlated Colour Temperature (CCT) and illuminance mainly correlate with OH.However, this may also be explained by gaps and methodological issues in studies described in eligible papers.Based on the literature study, an overview was composed elucidating gaps and methodological issues of officelighting and OH studies. It can be used to design and target the purpose of light and health research.
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