Evaluation of blue light exposure, illuminance level and the associations with sleep/wake patterns in two populations living with sensory impairment

Exposure to sufficient light during the daytime is fundamental for the regulation of the sleep/wake cycle, with the blue part of the spectrum most influential. This thesis explores exposure to environmental blue light and level of illuminance in two populations that experience circadian disruption i.e. older people and young people with autism spectrum disorder (ASD). The aim was to examine associations between blue light exposure, illuminance level and sleep/wake and physical activity patterns. Firstly, an exploratory study was conducted in adolescents with ASD living in a residential school setting aged 13-17 years (n=8). Secondly, a cross-sectional study carried out in two seasons (summer and winter) with a comparative study between seasons of varying light exposure and sleep/wake and physical activity outcomes was conducted in older people aged 72-99 years (n=20). In both studies quantitative measures were used to examine personal light exposure and sleep/wake patterns by use of novel equipment known as an actiwatch. This research demonstrated that objective measures of sleep/wake and light monitoring could be successfully administered in two populations with complex sensory issues. Preliminary findings from the exploratory study in adolescents with ASD indicated that exposure to blue light prior to bedtime was associated with a delay in sleep onset. The methodology developed for participant recruitment and engagement in a study using body sensors proved to be successful. Results for the study in older people suggested that between seasons daytime physical activity, blue light exposure and illuminance levels were significantly higher in summer. Correlated component regression (CCR) was used to investigate predictors of sleep parameters, suggesting morning blue light exposure (a predictor of total night-time sleep), daytime activity level (a predictor of sleep efficiency) and visual function (a predictor of minutes awake during the night) may contribute to sleep quality. The findings from these studies suggested that light exposure and health outcomes, such as physical activity and visual function could be responsible for sleep quality. This has important implications for design and health interventions promoting health and wellbeing, i.e. morning light exposure and time outdoors are important for circadian entrainment and building design and routine should reflect a diurnal light pattern light

Sun protection education for adolescents: a feasibility study of a wait-list controlled trial of an intervention involving a presentation, action planning, and SMS messages and using objective measurement of sun exposure

Background: People increase their risk of melanoma unless they are protected from the harmful effects of sun exposure during childhood and adolescence. We aimed to assess the feasibility of a three-component sun protection intervention- presentation, action planning, and SMS messages - and trial parameters.Methods: This feasibility wait-list trial was conducted in the United Kingdom in 2018. Students aged 13–15 years were eligible. Feasibility outcomes were collected for recruitment rates; data availability rates for objective measurements of melanin and erythema using a Mexameter and self-reported sunburn occurrences, severity and body location, tanning, sun protection behaviours and Skin Self-Examination (SSE) collected before (baseline) and after the school summer holidays (follow-up); intervention reach, adherence, perceived impact and acceptability. Quantitative data were analysed using descriptive statistics; qualitative data were analysed thematically.Results: Five out of eight schools expressing an interest in participating with four allocated to act as intervention and one control. Four parents/carers opted their child out of the study. Four hundred and eighty-seven out of 724 students on the school register consented to the study at baseline (67%). Three hundred and eighty-five were in intervention group schools. Objective skin measurements were available for 255 (66%) of the intervention group at baseline and 237 (61%) of the group at follow up. Melanin increased; erythema decreased. Complete self-report data were available for 247 (64%) students in the intervention group. The number of students on the school register who attended the presentation and given the booklet was 379 (98%) and gave their mobile phone number was 155 (40%). No intervention component was perceived as more impactful on sun protection behaviours. Adolescents did not see the relevance of sun protection in the UK or for their age group.Conclusions: This is the first study to use a Mexameter to measure skin colour in adolescents. Erythema (visible redness) lasts no more than three days and its measurement before and after a six week summer holiday may not yield relevant or meaningful data. A major challenge is that adolescents do not see the relevance of sun protection and SSE.Trial registration: International Standard Randomised Controlled Trial Number ISRCTN11141528. Date registered 0/2/03/2018; last edited 31/05/2018. Retrospectively registered

A randomised control crossover trial of a theory based intervention to improve sun-safe and healthy behaviours in construction workers:Study protocol

Abstract Background Exposure to sunlight can have both positive and negative health impacts. Excessive exposure to ultra-violet (UV) radiation from the sun can cause skin cancer, however insufficient exposure to sunlight has a detrimental effect on production of Vitamin D. In the construction industry there are onsite proactive behaviours for safety, but sun-safety remains a low priority. There is limited research on understanding the barriers to adopting sun-safe behaviours and the association this may have with Vitamin D production. This paper reports a protocol for an intervention study, using text messaging in combination with a supportive smartphone App. The intervention aims to both reduce UV exposure during months with higher UV levels and promote appropriate dietary changes to boost Vitamin D levels during months with low UV levels. Method/design Approximately 60 construction workers will be recruited across the United Kingdom. A randomised control crossover trial (RCCT) will be used to test the intervention, with randomisation at site level – i.e. participants will receive both the control (no text messages or supportive App support) and intervention (daily text messages and supportive App). Using the Theory of Planned Behaviour (TPB) the intervention focuses on supporting sun-safety and healthy dietary decisions in relation to Vitamin D intake. The intervention emphasises cultivating the perception of normative support in the workplace, increasing awareness of control and self-efficacy in taking sun-protective behaviours, making healthier eating choices to boost Vitamin D, and tackling stigmas attached to image and group norms. Each study epoch will last 21 days with intervention text messages delivered on workdays only. The supportive App will provide supplementary information about sun protective behaviours and healthy dietary choices. The primary outcome measure is 25-hydroxy-Vitamin D [25(OH)D] level (obtained using blood spot sampling), which will be taken pre and post control and intervention periods. Secondary outcome measures are two-fold, (1) using the TPB to detect changes in behaviour, and (2) quantifying UV exposure during the UK peak radiation season (April–September) using body-mounted UV sensors. Discussion This study will provide important information about the effectiveness of a technology-based intervention to promote sun-safety and healthy behaviours in outdoor construction workers. Trial registration ISRCTN15888934 retrospectively registered 15.01.2018

A Functional NQO1 609C>T Polymorphism and Risk of Gastrointestinal Cancers: A Meta-Analysis

Background: The functional polymorphism (rs1800566) in the NQO1 gene, a 609C.T substitution, leading to proline-toserine amino-acid and enzyme activity changes, has been implicated in cancer risk, but individually published studies showed inconclusive results. Methodology/Principal Findings: We performed a meta-analysis of 20 publications with a total of 5,491 cases and 5,917 controls, mainly on gastrointestinal (GI) cancers. We summarized the data on the association between the NQO1 609C.T polymorphism and risk of GI cancers and performed subgroup analyses by ethnicity, cancer site, and study quality. We found that the variant CT heterozygous and CT/TT genotypes of the NQO1 609 C.T polymorphism were associated with a modestly increased risk of GI cancers (CT vs. CC: OR = 1.10, 95 % CI = 1.01 – 1.19, P heterogeneity = 0.27, I 2 = 0.15; CT/TT vs. CC: OR = 1.11, 95%CI = 1.02 – 1.20, Pheterogeneity = 0.14; I 2 = 0.27). Following further stratified analyses, the increased risk was only observed in subgroups of Caucasians, colorectal cancer in Caucasians, and high quality studies. Conclusions: This meta-analysis suggests that the NQO1 609T allele is a low-penetrance risk factor for GI cancers. Although the effect on GI cancers may be modified by ethnicity and cancer sites, small sample seizes of the subgroup analyse

A survey on indoor environmental condition and energy consumption in a care home setting

This report presents a feasibility study carried out in a Care Home in Edinburgh from December 2016 to March 2017. The aim of the study is to test a set of methods to assess room comfort and energy efficiency. The methods consist of a literature review on indoor comfort for older occupants, a survey on both objective and subjective thermal & humidity comfort in 10 selected rooms and an energy performance assessment for the building. The review suggests an idea comfort zone of 22-24C and 45%-60% for older people in care homes. The objective assessment shows that less than 1% of the time the room hygrothermal conditions were within the suggested comfort zone. The subjective assessment carried out using a questionnaire survey reveals 70% of the subjects felt “warm” and “slightly warm” on thermal site and 30% voted “slightly dry” on humidity side. The energy assessment, using standard methods, shows that the care home had a fair energy performance when compared against national benchmarks for similar buildings