Indoors illumination and seasonal changes in mood and behavior are associated with the health-related quality of life

<p>Abstract</p> <p>Objective</p> <p>Seasonal changes in mood and behavior are common in a general population, being of relevance to public health. We wanted to analyze whether the HRQoL is associated with the seasonal changes in mood and behavior. Because the shortage of exposure to daylight or artificial bright light has been linked to the occurrence of the seasonal changes, we wanted to know whether illumination indoors contributes to the HRQoL.</p> <p>Methods</p> <p>Of the sample of 7979 individuals, being representative of the Finnish general population aged 30 and over, 88% were interviewed face to face, and 84% participated in the health status examination after which the self-report assessment of the HRQoL and the seasonal changes in mood and behavior took place. The illumination levels experienced indoors were asked during the interview and the 12-item General Health Questionnaire (GHQ-12) was filled in before the health examination.</p> <p>Results</p> <p>The HRQoL was influenced by both the seasonal changes in mood and behavior (P < 0.001) and the illumination experienced indoors (P < 0.001). Greater seasonal changes (P < 0.001) and poor illumination indoors (P = 0.0035) were associated with more severe mental ill-being.</p> <p>Conclusion</p> <p>The routinely emerging seasonal changes in mood and behavior are associated with the HRQoL and mental well-being. Better illumination indoors might alleviate the season-bound symptoms and thereby enhance the HRQoL and mental well-being.</p

Experienced Poor Lighting Contributes to the Seasonal Fluctuations in Weight and Appetite That Relate to the Metabolic Syndrome

We tested which environmental, social, lifestyle, and health related factors of the individual contribute to the seasonal variations in mood and behavior and whether these influence the risks of the metabolic syndrome and major depressive disorder, both conditions having a high prevalence in industrialized populations. 5480 individuals, representative of the general population aged 30 and over in Finland, were assessed for metabolic syndrome using the ATP-III criteria, gave a self-report of seasonal variations in mood and behavior, and were interviewed for mood, anxiety, and alcohol use disorders using the DSM-IV criteria. The seasonal variations in mood and behavior have a metabolic factor composed of weight and appetite, and greater loadings on this factor increased the risk of metabolic syndrome (odds ratio of 1.18, 95% confidence interval of 1.10 to 1.26). Self-reports of lighting experienced as poor at home contributed to scores on the metabolic factor (t = 4.20, P < .0001). Lighting conditions and their dynamics may serve as a measure for intervention in order to influence the seasonal metabolic signals and in the end to prevent the metabolic syndrome

Effect of natalizumab on disease progression in secondary progressive multiple sclerosis (ASCEND). a phase 3, randomised, double-blind, placebo-controlled trial with an open-label extension

Background: Although several disease-modifying treatments are available for relapsing multiple sclerosis, treatment effects have been more modest in progressive multiple sclerosis and have been observed particularly in actively relapsing subgroups or those with lesion activity on imaging. We sought to assess whether natalizumab slows disease progression in secondary progressive multiple sclerosis, independent of relapses. Methods: ASCEND was a phase 3, randomised, double-blind, placebo-controlled trial (part 1) with an optional 2 year open-label extension (part 2). Enrolled patients aged 18–58 years were natalizumab-naive and had secondary progressive multiple sclerosis for 2 years or more, disability progression unrelated to relapses in the previous year, and Expanded Disability Status Scale (EDSS) scores of 3·0–6·5. In part 1, patients from 163 sites in 17 countries were randomly assigned (1:1) to receive 300 mg intravenous natalizumab or placebo every 4 weeks for 2 years. Patients were stratified by site and by EDSS score (3·0–5·5 vs 6·0–6·5). Patients completing part 1 could enrol in part 2, in which all patients received natalizumab every 4 weeks until the end of the study. Throughout both parts, patients and staff were masked to the treatment received in part 1. The primary outcome in part 1 was the proportion of patients with sustained disability progression, assessed by one or more of three measures: the EDSS, Timed 25-Foot Walk (T25FW), and 9-Hole Peg Test (9HPT). The primary outcome in part 2 was the incidence of adverse events and serious adverse events. Efficacy and safety analyses were done in the intention-to-treat population. This trial is registered with ClinicalTrials.gov, number NCT01416181. Findings: Between Sept 13, 2011, and July 16, 2015, 889 patients were randomly assigned (n=440 to the natalizumab group, n=449 to the placebo group). In part 1, 195 (44%) of 439 natalizumab-treated patients and 214 (48%) of 448 placebo-treated patients had confirmed disability progression (odds ratio [OR] 0·86; 95% CI 0·66–1·13; p=0·287). No treatment effect was observed on the EDSS (OR 1·06, 95% CI 0·74–1·53; nominal p=0·753) or the T25FW (0·98, 0·74–1·30; nominal p=0·914) components of the primary outcome. However, natalizumab treatment reduced 9HPT progression (OR 0·56, 95% CI 0·40–0·80; nominal p=0·001). In part 1, 100 (22%) placebo-treated and 90 (20%) natalizumab-treated patients had serious adverse events. In part 2, 291 natalizumab-continuing patients and 274 natalizumab-naive patients received natalizumab (median follow-up 160 weeks [range 108–221]). Serious adverse events occurred in 39 (13%) patients continuing natalizumab and in 24 (9%) patients initiating natalizumab. Two deaths occurred in part 1, neither of which was considered related to study treatment. No progressive multifocal leukoencephalopathy occurred. Interpretation: Natalizumab treatment for secondary progressive multiple sclerosis did not reduce progression on the primary multicomponent disability endpoint in part 1, but it did reduce progression on its upper-limb component. Longer-term trials are needed to assess whether treatment of secondary progressive multiple sclerosis might produce benefits on additional disability components. Funding: Biogen

Seasonal Changes in Mood and Behavior Are Linked to Metabolic Syndrome

BACKGROUND: Obesity is a major public health problem worldwide. Metabolic syndrome is a risk factor to the cardiovascular diseases. It has been reported that disruptions of the circadian clockwork are associated with and may predispose to metabolic syndrome. METHODOLOGY AND PRINCIPAL FINDINGS: 8028 individuals attended a nationwide health examination survey in Finland. Data were collected with a face-to-face interview at home and during an individual health status examination. The waist circumference, height, weight and blood pressure were measured and samples were taken for laboratory tests. Participants were assessed using the ATP-III criteria for metabolic syndrome and with the Seasonal Pattern Assessment Questionnaire for their seasonal changes in mood and behavior. Seasonal changes in weight in particular were a risk factor of metabolic syndrome, after controlling for a number of known risk and potential confounding factors. CONCLUSIONS AND SIGNIFICANCE: Metabolic syndrome is associated with high global scores on the seasonal changes in mood and behavior, and with those in weight in particular. Assessment of these changes may serve as a useful indicator of metabolic syndrome, because of easy assessment. Abnormalities in the circadian clockwork which links seasonal fluctuations to metabolic cycles may predispose to seasonal changes in weight and to metabolic syndrome

Genetic Markers of Toxicity From Capecitabine and Other Fluorouracil-Based Regimens: Investigation in the QUASAR2 Study, Systematic Review, and Meta-Analysis

Fluourouracil (FU) is a mainstay of chemotherapy, although toxicities are common. Genetic biomarkers have been used to predict these adverse events, but their utility is uncertain

The Science Performance of JWST as Characterized in Commissioning

This paper characterizes the actual science performance of the James Webb Space Telescope (JWST), as determined from the six month commissioning period. We summarize the performance of the spacecraft, telescope, science instruments, and ground system, with an emphasis on differences from pre-launch expectations. Commissioning has made clear that JWST is fully capable of achieving the discoveries for which it was built. Moreover, almost across the board, the science performance of JWST is better than expected; in most cases, JWST will go deeper faster than expected. The telescope and instrument suite have demonstrated the sensitivity, stability, image quality, and spectral range that are necessary to transform our understanding of the cosmos through observations spanning from near-earth asteroids to the most distant galaxies.Comment: 5th version as accepted to PASP; 31 pages, 18 figures; https://iopscience.iop.org/article/10.1088/1538-3873/acb29

Epidemiological data of seasonal variation in mood and behaviour

The aim of this study was to measure seasonal variation in mood and behaviour. The dual vulnerability and latitude effect hypothesis, the risk of increased appetite, weight and other seasonal symptoms to develop metabolic syndrome, and perception of low illumination in quality of life and mental well-being were assessed. These variations are prevalent in persons who live in high latitudes and need balancing of metabolic processes to adapt to environmental changes due to seasons. A randomized sample of 8028 adults aged 30 and over (55% women) participated in an epidemiological health examination study, The Health 2000, applying the probability proportional to population size method for a range of socio-demographic characteristics. They were present in a face-to-face interview at home and health status examination. The questionnaires included the modified versions of the Seasonal Pattern Assessment Questionnaire (SPAQ) and Beck Depression Inventory (BDI), the Health Related Quality of Life (HRQoL) instrument 15D, and the General Health Questionnaire (GHQ). The structured and computerized Munich Composite International Diagnostic Interview (M-CIDI) as part of the interview was used to assess diagnoses of mental disorders, and, the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATPIII) criteria were assessed using all the available information to detect metabolic syndrome. A key finding was that 85% of this nationwide representative sample had seasonal variation in mood and behaviour. Approximately 9% of the study population presented combined seasonal and depressive symptoms with a significant association between their scores, and 2.6% had symptoms that corresponded to Seasonal Affective Disorder (SAD) in severity. Seasonal variations in weight and appetite are two important components that increase the risk of metabolic syndrome. Other factors such as waist circumference and major depressive disorder contributed to the metabolic syndrome as well. Persons reported of having seasonal symptoms were associated with a poorer quality of life and compromised mental well-being, especially if indoors illumination at home and/or at work was experienced as being low. Seasonal and circadian misalignments are suggested to associate with metabolic disorders, and could be remarked if individuals perceive low illumination levels at home and/or at work that affect the health-related quality of life and mental well-being. Keywords: depression, health-related quality of life, illumination, latitude, mental well-being, metabolic syndrome, seasonal variation, winter.Tämän tutkimuksen aiheena oli mielialassa ja käyttäytymisessä ilmenevän vuodenaikaisvaihtelun merkitys terveydelle. Tämä kaamosoireilu altistaa metaboliselle oireyhtymälle, jonka ilmaisimena kaamosoireet voisivat toimia osana terveystarkastuksia. Kaamosoireet johtuvat elimistön sisäisen kellon rytmihäiriöistä. Kaamosoireita voi lievittää ja ehkäistä paitsi liikunnalla myös valolla. Elimistön sisäistä kelloa tahdistava valaistus saattaisi edistää painonhallintaa ja edelleen ehkäistä metabolista oireyhtymää. Yleisvalaistuksen kohentaminen saattaisi lisäksi vaikuttaa myönteisesti niin terveyteen liittyvään elämänlaatuun kuin henkiseen hyvinvointiin. Tutkimuksen lähdeaineistona käytettiin Terveys 2000 -tutkimusta. Sen 30-vuotiaita ja sitä vanhempia suomalaisia edustavaan otokseen kuului 8028 henkilöä. Heistä 5480 haastateltiin kasvokkain, minkä jälkeen heidän terveydentilansa tutkittiin ja he vastasivat muokatun vuodenaikaiskyselyn (Seasonal Pattern Assessment Questionnaire), muokatun mielialakyselyn (Beck Depression Inventory), geneerisen terveyteen liittyvän elämänlaatukyselyn (15D) ja henkisen pahoinvointikyselyn (General Health Questionnaire) kysymyksiin. Mielenterveyden häiriöiden diagnosoimiseksi käytettiin strukturoitua menetelmää (Munich Composite International Diagnostic Interview), ja metabolisen oireyhtymän määrittämiseksi käytettiin National Cholesterol Education Program Adult Treatment Panel III:n mukaisia kriteerejä. Tämä tutkimus osoitti, että 85 sadasta suomalaisesta kokee mielialansa ja käyttäytymisensä toistuvasti vaihdelleen vuodenaikojen mukaan. Kolmella sadasta nämä kaamosoireet ovat olleet siinä määrin vakavia, että he hyötyisivät hoidosta. Yhdeksällä sadasta oli tutkimustalvena yhtaikaa sekä vakavia masennusoireita että vakavia kaamosoireita, ja jos aiempien tutkimusten havainnot siitä, että joka kymmenes tällainen henkilö sairastaa kaamosmasennusta, pätevät tähän tutkimukseen, niin kaamosmasennuksen esiintyvyys suomalaisilla on 9 tuhannesta. Vakavien kaamosoireiden esiintyminen suurensi riskin samanaikaisten vakavien masennusoireiden ilmenemiselle yli kolminkertaiseksi. Niin kaamosoireet kuin masennusoireet vallitsivat tasaisesti maassamme. Kaamosoireista erottui kaksi faktoria: metabolinen faktori ja mielenterveyden faktori. Edelliseen lukeutuivat painossa ja ruokahalussa ilmenevät vuodenaikaisvaihtelut. Kaamosoireiden vahva latautuminen vuodenaikaisvaihtelun metaboliselle faktorille suurensi metabolisen oireyhtymän vaarasuhteen 1.2-kertaiseksi ja selittyi merkitsevästi osaltaan myös huonoksi koetusta kodin yleisvalaistuksesta käsin. Etenkin painon toistuva vuodenaikaisvaihtelu osoittautui metabolisen oireyhtymän uudeksi riskitekijäksi jo tunnettujen riskitekijöiden huomioimisen jälkeenkin. Heikompi terveyteen liittyvä elämänlaatu selittyi merkitsevästi niin kaamosoireilla kuin huonoksi koetulla yleisvalaistuksella ja ne selittivät merkitsevästi myös suurempaa henkistä pahoinvointia vielä tunnettujen riskitekijöiden huomioimisen jälkeenkin. Elimistön sisäisen kellon toiminnasta syntyvissä vuodenaikaisvaihteluissa ja vuorokausirytmeissä ilmenevät rytmihäiriöt saattavat johtaa metabolisiin häiriöihin. Nämä metaboliset häiriöt voivat edelleen pahentua niukan valaistuksen seurauksena mutta toisaalta lievittyä valoaltistuksen avulla. Siten sisäisen kellon rytmihäiriöt ja valo vaikuttavat terveyteemme, mikä ilmenee muun muassa terveyteen liittyvässä elämänlaadussa ja henkisessä hyvinvoinnissa. Avainsanat: elämänlaatu, hyvinvointi, kaamosoire,leveyspiiri, masennustila, metabolinen oireyhtymä, valaistus, vuodenaik

Protective and risk factors of metabolic syndrome in the Finnish population aged over 30 years (the univariate models).

<p>Protective and risk factors of metabolic syndrome in the Finnish population aged over 30 years (the univariate models).</p