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Association of sleep deprivation with speech volume and pitch

Positive effects of indoor environmental conditions on students and their performance in higher education classrooms: A between-groups experiment

This study explores if multiple alterations of the classrooms' indoor environmental conditions, which lead to environmental conditions meeting quality class A of Dutch guidelines, result in a positive effect on students' perceptions and performance. A field study, with a between-group experimental design, was conducted during the academic course in 2020–2021. First, the reverberation time (RT) was lowered in the intervention condition to 0.4 s (control condition 0.6 s). Next, the horizontal illuminance (HI) level was raised in the intervention condition to 750 lx (control condition 500 lx). Finally, the indoor air quality (IAQ) in both conditions was improved by increasing the ventilation rate, resulting in a reduction of carbon dioxide concentrations, as a proxy for IAQ, from ~1100 to <800 ppm. During seven campaigns, students' perceptions of indoor environmental quality, health, emotional status, cognitive performance, and quality of learning were measured at the end of each lecture using questionnaires. Furthermore, students' objective cognitive responses were measured with psychometric tests of neurobehavioural functions. Students' short-term academic performance was evaluated with a content-related test. From 201 students, 527 responses were collected. The results showed that the reduction of the RT positively influenced students' perceived cognitive performance. A reduced RT in combination with raised HI improved students' perceptions of the lighting environment, internal responses, and quality of learning. However, this experimental condition negatively influenced students' ability to solve problems, while students' content-related test scores were not influenced. This shows that although quality class A conditions for RT and HI improved students' perceptions, it did not influence their short-term academic performance. Furthermore, the benefits of reduced RT in combination with raised HI were not observed in improved IAQ conditions. Whether the sequential order of the experimental conditions is relevant in inducing these effects and/or whether improving two parameters is already beneficial, is unknown.

Unravelling the potential mechanisms behind hospitalization-associated disability in older patients

BACKGROUND: Over 30 % of older patients experience hospitalization-associated disability (HAD) (i.e., loss of independence in Activities of Daily Living (ADLs)) after an acute hospitalization. Despite its high prevalence, the mechanisms that underlie HAD remain elusive. This paper describes the protocol for the Hospital-Associated Disability and impact on daily Life (Hospital-ADL) study, which aims to unravel the potential mechanisms behind HAD from admission to three months post-discharge.METHODS/DESIGN: The Hospital-ADL study is a multicenter, observational, prospective cohort study aiming to recruit 400 patients aged ≥70 years that are acutely hospitalized at departments of Internal Medicine, Cardiology or Geriatrics, involving six hospitals in the Netherlands. Eligible are patients hospitalized for at least 48 h, without major cognitive impairment (Mini Mental State Examination score ≥15), who have a life expectancy of more than three months, and without disablement in all six ADLs. The study will assess possible cognitive, behavioral, psychosocial, physical, and biological factors of HAD. Data will be collected through: 1] medical and demographical data; 2] personal interviews, which includes assessment of cognitive impairment, behavioral and psychosocial functioning, physical functioning, and health care utilization; 3] physical performance tests, which includes gait speed, hand grip strength, balance, bioelectrical impedance analysis (BIA), and an activity tracker (Fitbit Flex), and; 4] analyses of blood samples to assess inflammatory and metabolic markers. The primary endpoint is additional disabilities in ADLs three months post-hospital discharge compared to ADL function two weeks prior to hospital admission. Secondary outcomes are health care utilization, health-related quality of life (HRQoL), physical performance tests, and mortality. There will be at least five data collection points; within 48 h after admission (H1), at discharge (H3), and at one (P1; home visit), two (P2; by telephone) and three months (P3; home visit) post-discharge. If the patient is admitted for more than five days, additional measurements will be planned during hospitalization on Monday, Wednesday, and Friday (H2).DISCUSSION: The Hospital-ADL study will provide information on cognitive, behavioral, psychosocial, physical, and biological factors associated with HAD and will be collected during and following hospitalization. These data may inform new interventions to prevent or restore hospitalization-associated disability.

Unmet needs in the management of Cervical Dystonia.

Cervical dystonia (CD) is a movement disorder which affects daily living of many patients. In clinical practice, several unmet treatment needs remain open. This article focuses on the four main aspects of treatment. We describe existing and emerging treatment approaches for CD, including botulinum toxin injections, surgical therapy, management of non-motor symptoms, and rehabilitation strategies. The unsolved issues regarding each of these treatments are identified and discussed, and possible future approaches and research lines are proposed.

Exploring the Impact of Natural Light Exposure on Sleep of Healthy Older Adults

Studies among people with dementia demonstrated that the sleep quality and rhythm improves significantly when people are exposed to ambient bright light. Since almost half of the healthy older people also indicate to suffer from chronic sleep disorders, the question arises whether ambient bright light can be beneficial to healthy older people. Particularly the effect on sleep/wake rhythm in relation to the exposure to natural light is the focus. It was hypothesised that the sleep quality would be worse in winter due to a lower daylight dose than in summer due to the lower illuminance and exposure duration. A field study was conducted to examine the relationship between daylight exposure and sleep quality in 14 healthy older adults living independently in their own dwellings in the Netherlands. All participants were asked to take part of the study both during the summer period as well as during the winter period. Therefore, they had to wear an actigraph for five consecutive days which measured sleep, activity and light exposure. Results confirmed that people were significantly longer exposed to high illumination levels (>1000 lx) in summer than in winter. Sleep quality measures, however, did not differ significantly between summer and winter. A significant, positive correlation was found between exposure duration to high illuminance from daylight during the day and the sleep efficiency the following night in summer, implying that being exposed to high illuminance for a longer time period has a positive effect on sleep efficiency for the individual data. There was also a tendency of less frequent napping in case of longer exposure duration to light for both seasons. Sleep quality does not differ between summer and winter but is related to the duration of the exposure to bright light the day prior to the night. CC-BY Original article at http://solarlits.com/jd/5-14 http://dx.doi.org/10.15627/jd.2018.2 https://www.dehaagsehogeschool.nl/onderzoek/lectoraten/details/urban-ageing#over-het-lectoraat

Respiratory and non-respiratory symptoms in patients with IPF or sarcoidosis and controls

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.