Nightshift workers go against the natural sleep–wake rhythm. Light can shift the circadian clock but can also induce acute alertness. This placebo-controlled exploratory field study examined the effectiveness of light glasses to improve alertness while reducing the sleep complaints of hospital nurses working nightshifts. In a crossover within-subjects design, 23 nurses participated, using treatment glasses and placebo glasses. Sleepiness and sleep parameters were measured. A linear mixed model analysis on sleepiness revealed no significant main effect of the light intervention. An interaction e ect was found indicating that under the placebo condition, sleepiness was significantly higher on the first nightshift than on the last night, while under the treatment condition, sleepiness remainedstable across nightshift sessions. Sleepiness during the commute home also showed a significant interaction effect, demonstrating that after the first nightshift, driver sleepiness was higher for placebo than for treatment. Subjective sleep quality showed a negative main effect of treatment vs. placebo, particularly after the first nightshift. In retrospect, both types of light glasses were self-rated as effective. The use of light glasses during the nightshift may help to reduce driver sleepiness during the commute home, which is relevant, as all participants drove home by car or (motor) bike.
The effects of stress may be alleviated when its impact or a decreased stress-resilience are detected early. This study explores whether wearable-measured sleep and resting HRV in police officers can be predicted by stress-related Ecological Momentary Assessment (EMA) measures in preceding days and predict stress-related EMA outcomes in subsequent days. Eight police officers used an Oura ring to collect daily Total Sleep Time (TST) and resting Heart Rate Variability (HRV) and an EMA app for measuring demands, stress, mental exhaustion, and vigor during 15–55 weeks. Vector Autoregression (VAR) models were created and complemented by Granger causation tests and Impulse Response Function visualizations. Demands negatively predicted TST and HRV in one participant. TST negatively predicted demands, stress, and mental exhaustion in two, three, and five participants, respectively, and positively predicted vigor in five participants. HRV negatively predicted demands in two participants, and stress and mental exhaustion in one participant. Changes in HRV lasted longer than those in TST. Bidirectional associations of TST and resting HRV with stress-related outcomes were observed at a weak-to-moderate strength, but not consistently across participants. TST and resting HRV are more consistent predictors of stress-resilience in upcoming days than indicators of stress-related measures in prior days.
OBJECTIVES: To evaluate the effects of exercise interventions on sleep disturbances and sleep quality in patients with mixed cancer diagnoses, and identify demographic, clinical, and intervention-related moderators of these effects.METHODS: Individual patient data (IPD) and aggregated meta-analyses of randomized controlled trials (RCTs). Using data from the Predicting OptimaL cAncer RehabIlitation and Supportive care project, IPD of 2173 adults (mean age = 54.8) with cancer from 17 RCTs were analyzed. A complementary systematic search was conducted (until November 2018) to study the overall effects and test the representativeness of analyzed IPD. Effect sizes of exercise effects on self-reported sleep outcomes were calculated for all included RCTs. Linear mixed-effect models were used to evaluate the effects of exercise on post-intervention outcome values, adjusting for baseline values. Moderator effects were studied by testing interactions for demographic, clinical and intervention-related characteristics.RESULTS: For all 27 eligible RCTs from the updated search, exercise interventions significantly decreased sleep disturbances in adults with cancer (g = -0.09, 95% CI [-0.16; -0.02]). No significant effect was obtained for sleep quality. RCTs included in IPD analyses constituted a representative sample of the published literature. The intervention effects on sleep disturbances were not significantly moderated by any demographic, clinical, or intervention-related factor, nor by sleep disturbances.CONCLUSIONS: This meta-analysis provides some evidence that, compared to control conditions, exercise interventions may improve sleep disturbances, but not sleep quality, in cancer patients, although this effect is of a small magnitude. Among the investigated variables, none was found to significantly moderate the effect of exercise interventions on sleep disturbances.
-Chatbots are being used at an increasing rate, for instance, for simple Q&A conversations, flight reservations, online shopping and news aggregation. However, users expect to be served as effective and reliable as they were with human-based systems and are unforgiving once the system fails to understand them, engage them or show them human empathy. This problem is more prominent when the technology is used in domains such as health care, where empathy and the ability to give emotional support are most essential during interaction with the person. Empathy, however, is a unique human skill, and conversational agents such as chatbots cannot yet express empathy in nuanced ways to account for its complex nature and quality. This project focuses on designing emotionally supportive conversational agents within the mental health domain. We take a user-centered co-creation approach to focus on the mental health problems of sexual assault victims. This group is chosen specifically, because of the high rate of the sexual assault incidents and its lifetime destructive effects on the victim and the fact that although early intervention and treatment is necessary to prevent future mental health problems, these incidents largely go unreported due to the stigma attached to sexual assault. On the other hand, research shows that people feel more comfortable talking to chatbots about intimate topics since they feel no fear of judgment. We think an emotionally supportive and empathic chatbot specifically designed to encourage self-disclosure among sexual assault victims could help those who remain silent in fear of negative evaluation and empower them to process their experience better and take the necessary steps towards treatment early on.
Regular physical activity is considered to be an important component of a healthy lifestyle that decreases the risk of coronary heart disease, diabetes mellitus type 2, hypertension, colon and breast cancer, obesity and other debilitating conditions. Physical activity can also improve functional capacity and therefore also the quality of life in older adults. Despite all these favorable aspects, a substantial part of the Dutch older adult population is still underactive or even sedentary. To change this for the better, the Groningen Active Living Model (GALM) was developed.Aim of GALM is to stimulate recreational sports activities in sedentary and underactive older adults in the 55-65 age band. After a door-to-door visit as part of an intensive recruitment phase, a fitness test was conducted followed by the GALM recreational sports program. This program was based on principles from evolutionary-biological play theory and insights fromsocial cognitive theory. The program was versatile in nature (e.g. softball, dance, self-defense, swimming, athletics, etc.) in two main ways: a) to improve compliance with the program different sports were offered, which was reported to be more appealing for older adults; b) by aiming at more components of motor fitness (e.g. strength, flexibility, speed, endurance and coordination). Between 1997 and 2005 more than 552,000 persons were visited door-to-door, over 55,700 were tested, and 41,310 participated in the GALM recreational sports program. The aim of the present thesis is to determine the effects of participation in the GALM recreational sports program on physical activity, health and fitness outcomes.Chapter 2 describes the effectiveness of the GALM recruitment in selecting and recruiting sedentary and underactive older adults. Three municipalities in the Netherlands were selected, and in every municipality four neighborhoods were included. Two of each of the four neighborhoods were randomly assigned as intervention and the others as control neighborhoods. In total, 8,504 persons were mailed and received a home visit. During this home visit the GALM recruitment questionnaire was collected on which the selection between sedentary/underactive and physically active older adults was based. Ultimately we succeeded inincluding 12.3% (315 of the 2,551 qualifying) of the older adults, 79.4% of whom could be indeed considered sedentary or underactive. The cost of successfully recruiting an older adult was estimated at $84.To assess the effects of a physical activity intervention on health and fitness and explain the results, it is necessary to know program characteristics regarding frequency, intensity, time and content of the activities. With respect to the GALM recreational sports activity program, the only unknown characteristic was intensity. Chapter 3 describes the intensity of this program systematically. Using heart rate monitors, data of 97 persons (mean age 60.1 yr) were collected in three municipalities. The mean intensity of all 15 GALM sessions was 73.7% of the predicted maximal heart rate. Six percent of the monitored heart rate time could be classified as light, 33% as moderate and 61% as hard. In summary, the GALM recreational sports program meets the 1998 ACSM recommendations for intensity necessary to improve cardiorespiratory fitness.Chapters 4 and 5 describe the effects of 6 and 12 months of participation in the GALM recreational sports program, and 181 persons were followed over time. Results after 6 months revealed only few significant between-group differences favoring the intervention group (i.e. sleep, diastolic blood pressure, perceived fitness score and grip strength). Changes in energyexpenditure for leisure-time physical activities (EELTPA) showed an increase in both study groups. From 6 to 12 months a decrease in EELTPA occurred in the intervention group and an increase in the control group. The significant positive time effects for the health outcomes (diastolic blood pressure, BMI, percentage of body fat) that were found after 6 months were diminishedfrom 6 to 12 months. However, the energy expenditure for recreational sports activities (EERECSPORT) demonstrated a continuous increase over 12 months. Parallel to this, significant main effects for time were found in performance-based fitness outcomes (i.e. simple reaction time, leg strength, flexibility of hamstrings and lower back, and aerobic endurance). After 12 months only a significant between-group difference for flexibility of the hamstrings andlower back was found, favoring the control group. In conclusion, a short-term increase in EELTPA was found with accompanying improvements in health outcomes that more or less disappeared in 6 to 12 months. In the long term, results showed a continuous increase in EERECSPORT and performance-based fitness. This latter increase is probably a reflection of the significantimprovement over time in EERECSPORT and the fact that recreational sports activities are of a higher intensity.Aerobic endurance is regarded as the most important component of motor fitness that is relevant for older adults to function independently. In Chapter 6, the development in aerobic endurance after 18 months of participation in the GALM recreational sports program was assessed by means of changes in heart rate during fixed submaximal exercise. Since both groups were comparable regarding changes in energy expenditure for physical activity after 6 months and testing confirmed this, both groups were combined and considered as one group. Multilevel analyses were conducted and models for change were developed. A significant decrease in heart rate over time was found at all walking speeds (4, 5, 6 and 7 km/h). The average decrease in heart rate was 5.5, 6.0, 10.0 and 9.0 beats/min for the 4, 5, 6 and 7 km/h walking speeds, respectively. The relative decrease varied from 5.1 to 7.4% relative to average heart rates at baseline. These results illustrate that participation in the GALM recreational sports program has a positive significant effect on aerobic endurance, and that the participants are able to perform at submaximal intensity more easily.Based on the overall results it can be concluded that this study contributes to the field in how to effectively recruit sedentary and underactive older adults and stimulate them to become and stay active in recreational sports activities. As far as we know, this recruitment in combination with the recreational sport program is not only unique but also effective toward increasing performance-based fitness in the long term. Short-term effects were found in other leisure-time activities and health outcomes. To further stimulate other leisure-time and probably health outcomes besides the favorable effects that were already seen, additional interventions that pay more attention to behavioral change in terms of how to integrate other activities besides sports activities are recommended.
YOUNG-D is a European project on the prevention and management of anxiety, stress and sleep problems in people with early onset dementia (OED).The overall aim of this project is to increase awareness and knowledge of (future) health care providers in the included EU-partners on psychosocial and behavioral program YOUNG-D in people with early onset dementia in order to prevent and manage anxiety, stress and sleep problems, which in turn increases heart rate variability, wellbeing and quality of life.ErasmusprojectThis project aims to educate and sensitize health care providers, organisations and health care students and -lecturers about early onset dementia. More specifically, this project focuses on knowledge transfer about aspects in the prevention and management of anxiety, stress and sleep problems in people with early onset dementia by means of a psychosocial and behavioural program. Activities to implement(1) the development and organisation of a train-the-trainer course for professional health caregivers and organisations.; (2) the health care organisation partner in each European country (partner) will enroll the six week psychosocial and behavioural program in its own setting; (3) knowledge transfer towards future health care students and lecturers will be provided per country by means of a blended learning module. Planned results: (1) Development of the train-the-trainer course: a syllabus and a joint report(2) Implementation of the six week program in each health care setting in the included health care partners and a joint report (3) development of blended learning course and a joint report
