Zoekresultaten

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.

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.

Association of sleep deprivation with speech volume and pitch

Systematic review on the interaction between office light conditions and occupational health: Elucidating gaps and methodological issues

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.

Protocol for a prospective, multicentre, cross-sectional cohort study to assess personal light exposure

Light profoundly impacts many aspects of human physiology and behaviour, including the synchronization of the circadian clock, the production of melatonin, and cognition. These effects of light, termed the non-visual effects of light, have been primarily investigated in laboratory settings, where light intensity, spectrum and timing can be carefully controlled to draw associations with physiological outcomes of interest. Recently, the increasing availability of wearable light loggers has opened the possibility of studying personal light exposure in free-living conditions where people engage in activities of daily living, yielding findings associating aspects of light exposure and health outcomes, supporting the importance of adequate light exposure at appropriate times for human health. However, comprehensive protocols capturing environmental (e.g., geographical location, season, climate, photoperiod) and individual factors (e.g., culture, personal habits, behaviour, commute type, profession) contributing to the measured light exposure are currently lacking. Here, we present a protocol that combines smartphone-based experience sampling (experience sampling implementing Karolinska Sleepiness Scale, KSS ratings) and high-quality light exposure data collection at three body sites (near-corneal plane between the two eyes mounted on spectacle, neck-worn pendant/badge, and wrist-worn watch-like design) to capture daily factors related to individuals’ light exposure. We will implement the protocol in an international multi-centre study to investigate the environmental and socio-cultural factors influencing light exposure patterns in Germany, Ghana, Netherlands, Spain, Sweden, and Turkey (minimum n = 15, target n = 30 per site, minimum n = 90, target n = 180 across all sites). With the resulting dataset, lifestyle and context-specific factors that contribute to healthy light exposure will be identified. This information is essential in designing effective public health interventions.

Can Special Light Glasses Reduce Sleepiness and Improve Sleep of Nightshift Workers?

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 eect 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.