Evaluating Occupant Light Exposure and Usage Patterns in an Inpatient Behavioral Health Unit.

OBJECTIVE: To (1) evaluate the use case for tunable lighting in inpatient behavioral health, (2) describe differences in staff lighting exposures between static and tunable lighting conditions using wearable sensors, and (3) document occupant lighting control usage patterns. BACKGROUND: Tunable lighting fixtures can vary the amount of light and spectral content, so have been offered as a way to address light and health considerations. Before we can understand potential health benefits of tunable lighting, it is helpful to understand how occupant exposures under tunable lighting differ from those under more traditional lighting systems. METHODS: Tunable lighting benefits and challenges for inpatient behavioral health were carefully detailed during design. Light exposure measurements were recorded at an old site with static fluorescent lighting and a new site with tunable light-emitting diode (LED) lighting. Behavioral health inpatient unit staff participants voluntarily wore a light measurement device to estimate light exposure. At the new site, controls usage data were recorded each time a button was pressed on a lighting control station. RESULTS: While general observations can be made about the data between sites, there is notable variation at both sites depending on the day and hour. Button press data revealed that occupants used the full capability of the tunable lighting system to support different activities and needs. CONCLUSION: Understanding the relationship between occupant well-being and light requires a holistic research approach including thoughtful design accounting for real-world constraints, detailed measurement of light exposure, and understanding how occupants interact and make use of new technology.

Nurses' Satisfaction With Patient Room Lighting Conditions: A Study of Nurses in Four Hospitals With Differences in the Environment of Care.

PURPOSE: The present study aims to contribute to current knowledge about nurses' perceived importance of lighting in patient rooms and to compare these perceptions across different ages, work shifts, (day and night), and environments of care (traditional and contemporary). BACKGROUND: Creating an environment of care in patient rooms that successfully balances energy efficiency concerns with the holistic needs of patients, families, and caregivers poses a major challenge for future lighting systems. This study adds to a growing evidence base on the effects of lighting on nurses' job performance, job satisfaction, and overall perceptions of the environment. METHOD: Survey responses from 138 participants working in medical-surgical units in four hospitals were analyzed using a mixed-methods approach, with three of the hospitals having lighting systems characterized as providing a traditional environment of care (TEC) and the other hospital having lighting systems characterized as providing a contemporary environment of care (CEC). RESULTS: No significant differences were found based on age or work shift, but several significant differences were found between participants working in the hospital with a CEC and those working in hospitals with a TEC. Participants from the hospital with a CEC lighting system consistently reported higher lighting quality, fewer patient complaints, and less need for supplemental lighting than the participants from the three hospitals with TEC lighting systems. CONCLUSION: The results of this study provide evidence that innovative lighting approaches and technologies are worth considering as an investment by hospital administrators looking to improve perceptions of the patient room environment.

Clinical Inquiry: Does caffeine intake during pregnancy affect birth weight?

No. Reducing caffeinated coffee consumption by 180 mg of caffeine (the equivalent of 2 cups) per day after 16 weeks' gestation doesn't affect birth weight. Consuming more than 300 mg of caffeine per day is associated with a clinically trivial, and statistically insignificant (less than 1 ounce), reduction in birth weight, compared with consuming no caffeine.

Clinical inquiry: is red-yeast rice a safe and effective alternative to statins?

In patients with known coronary artery disease and dyslipidemia (secondary prevention), therapy with red-yeast rice extract containing naturally-occurring lovastatin is associated with a 30% reduction in coronary heart disease (CHD) mortality and a 60% reduction in myocardial infarction (MI), similar to the effect of statin medications.

Clinical inquiry: which treatments relieve painful muscle spasms from a black widow spider bite?

Opioids relieve pain and benzodiazepines ease muscle spasms in most patients with latrodectism-widespread, sustained spasms-resulting from envenomation by a black widow spider.

Clinical Inquiry: Do any topical agents help prevent or reduce stretch marks?

No topical agent has been proven to prevent or reduce stretch marks. Randomized controlled trials show that cocoa butter doesn't prevent stretch marks ; neither does olive oil.

Clinical Inquiries: Does exercise alleviate symptoms of depression?

Yes. Exercise reduces patient-perceived symptoms of depression when used as monotherapy (strength of recommendation [SOR]: B, meta-analysis of randomized controlled trials [RCTs] with significant heterogeneity). It relieves symptoms as effectively as cognitive behavioral therapy (CBT) or pharmacologic anti-depressant therapy (SOR: B, meta-analysis) and more effectively than bright light therapy (SOR: B, meta-analysis). Resistance exercise and mixed exercise (resistance and aerobic) work better than aerobic exercise alone (SOR: B, meta-analysis). High-frequency exercise is more effective than low-frequency exercise (SOR: B, small RCT). "Mindful" exercise, which has a meditative focus, such as tai chi and yoga, also reduces symptoms of depression (SOR: B, systematic review of RCTs).