Daytime Activity Research Articles

Rest-Activity Rhythm Patterns and Physical Functional Performance in Community-Dwelling Older Men

Sleep and activity patterns have been linked to physical performance in older adults. Traditional parametric models of 24-hour activity rhythms fail to adequately capture specific diurnal sleep and wake patterns; functional principal components analysis (fPCA) is a non-parametric approach that addresses this limitation. Using fPCA, we modeled accelerometry data from n = 2,960 participants in the Osteoporotic Fractures in Men (MrOS) ancillary sleep study (mean age 77y) and examined cross-sectional associations with gait speed and grip strength measurements. Lower daytime activity (expected difference = -0.049 [-0.072, -0.028] m/s), increased sleep duration and a reduced midday dip in activity (-0.015 [-0.035, 0.006] m/s) were modestly associated with worsening gait speed. A modest association between both later sleep and wake times and increased sleep duration with worsening grip strength outcomes was observed (-1.11 [-1.90, -0.32] kg). Specific daily activity patterns may serve as predictive biomarkers for changing physical function in aging populations.

You can tell it works - Experiences from using the VIPS practice model in primary healthcare.

Person-centred care is a philosophy rather than a method ready for implementation and utilization in daily clinical work. Internationally, few methods for person-centred care have been widely adopted in clinical dementia care practice. In Norway, the VIPS practice model is one that is commonly used for the implementation and use of person-centred care in primary healthcare. Nursing home physicians, managers and leaders in the municipalities, care institutions and domestic nursing care services were eligible for inclusion if their workplace had implemented and used the VIPS practice model for a minimum of 12months. Individual interviews were conducted via Facetime, Skype or telephone and analysed with qualitative content analysis. In all, 20 respondents were included: one manager of health and care services in the municipality, six managers and leaders working in domestic care or daytime activity centres and 10 managers/leaders and three physicians working in nursing homes. Two global categories emerged: category 1: Change in staff's professional reasoning with two sub-categories: (a) an enhanced professional level in discussions and (b) a change in focus from task to person; and category 2: Changes in the clinical work, with three sub-categories: (a) effective interventions, (b) a person-centred work environment and (c) changes in cooperation between stakeholders. Regular use of the VIPS practice model appeared to change the work culture for the benefit of both service users and frontline staff. Increased cooperation between frontline staff, nurses, physicians and next of kin was described. Staff were more focused on the needs of the service users, which resulted in care interventions tailored to the needs of the individual with dementia, loyalty to care plans and fewer complaints from next of kin.

Knowledge, Attitudes and Perceptions Regarding Endemic Vivax Malaria in Inhabitants and Patients in Two Cities of Northern Gyeonggi-do, Korea, 2020.

An understanding of the knowledges, attitudes and perceptions of different populations is key for public health policy makers. Here, a survey was performed on knowledge, attitudes, and perceptions about malaria diagnosis, prevention, control, and treatment. The 407 survey participants included both uninfected inhabitants and patients from 2 cities (Gimpo- and Paju-si) of Northern Gyeonggi-do, known as high-risk areas for vivax malaria. We used community-based study design and non-probability sampling method using the primary data. Association between variables were tested using χ2-tests. In general, the information on malaria reported by the participants in this study was unsystematic and included inaccurate details. The knowledge of malaria symptoms, identified as headache, chills and fever, was high, but the surveyed community lacks knowledge of the specific medications used for malaria treatment, with a large number of respondents having no knowledge of any form of medication. Survey questions with high correct answer rates included questions about easy treatment of malaria in Korea, the high daytime activity of malaria-borne mosquitoes, and the infection risk posed by outdoor activities. However, a large portion of the respondents was unable to provide simple medical and biological information about the disease. This study aimed to comprehensively evaluate the knowledge, attitude, and practical behavior of the surveyed community with respect to malaria and the implications reported here could be applicable to other malaria endemic areas in Korea.

More than sleep and wake disturbances: An actigraphic study showing the sleep-wake pattern dysregulation in epilepsy

ObjectiveThis study aimed to assess the sleep-wake pattern in patients with epilepsy compared to controls. MethodsPatients with epilepsy and controls underwent a 14-day actigraphic recording to evaluate the rest-activity cycle. A sleep medicine interview was performed to exclude conditions interfering with the sleep-wake cycle in both patients and controls. Patients presenting seizures during the actigraphic recording were excluded. Daytime activity, nocturnal sleep, and non-parametric circadian rhythm activity (NPCRA) were analysed. ResultsTwenty-two patients (mean age 49.5 ± 19.84 years; 50% female) and 17 controls were included. Patients showed lower sleep efficiency and longer sleep latency than controls. NPCRA analysis showed lower inter-daily stability and higher intra-daily variability in patients, who also presented lower daytime activity and a longer central phase measure (CPM) than controls. ConclusionsPatients showed a significant alteration of the sleep-wake pattern, featured by lower synchronization and higher fragmentation of the rest-activity rhythm. Moreover, patients showed a delayed CPM compared with controls, corresponding to an evening chronotype tendency. Nocturnal sleep alteration and lower daytime activity were also evident. Therefore, patients with epilepsy present an alteration of the sleep-wake pattern and clinicians should increase their awareness about circadian rhythmicity dysregulation in epilepsy.

Timing of objectively-collected physical activity in relation to body weight and metabolic health in sedentary older people: a cross-sectional and prospective analysis.

Little is known about the impact of timing as opposed to frequency and intensity of daily physical activity on metabolic health. Therefore, we assessed the association between accelerometery-based daily timing of physical activity and measures of metabolic health in sedentary older people. Hourly mean physical activity derived from wrist-worn accelerometers over a 6-day period was collected at baseline and after 3 months in sedentary participants from the Active and Healthy Ageing study. A principal component analysis (PCA) was performed to reduce the number of dimensions (e.g. define periods instead of separate hours) of hourly physical activity at baseline and change during follow-up. Cross-sectionally, a multivariable-adjusted linear regression analysis was used to associate the principal components, particularly correlated with increased physical activity in data-driven periods during the day, with body mass index (BMI), fasting glucose and insulin, HbA1c and the homeostatic model assessment for insulin resistance (HOMA-IR). For the longitudinal analyses, we calculated the hourly changes in physical activity and change in metabolic health after follow-up. We included 207 individuals (61.4% male, mean age: 64.8 [SD 2.9], mean BMI: 28.9 [4.7]). Higher physical activity in the early morning was associated with lower fasting glucose (-2.22%, 95% CI: -4.19, -0.40), fasting insulin (-13.54%, 95%CI: -23.49, -4.39), and HOMA-IR (-16.07%, 95%CI: -27.63, -5.65). Higher physical activity in the late afternoon to evening was associated with lower BMI (-2.84%, 95% CI: -4.92, -0.70). Higher physical activity at night was associated with higher BMI (2.86%, 95% CI: 0.90, 4.78), fasting glucose (2.57%, 95% CI: 0.70, 4.30), and HbA1c (2.37%, 95% CI: 1.00, 3.82). Similar results were present in the prospective analysis. Specific physical activity timing patterns were associated with more beneficial metabolic health, suggesting particular time-dependent physical activity interventions might maximise health benefits.

Nighttime behavior and the length of social relationships in male Asian elephants

ABSTRACT To evaluate elephant welfare, it is important to understand their use of time both during day and night. The length of social relationships can influence how much time they spend in different activities. We assessed daytime and nighttime activity budgets of male Asian elephants at Denver Zoo and examined how length of relationships influenced nighttime behavior. Using scan sampling we investigated activity budget and proximity to a conspecific, and used General Estimating Equations to compare them across day and night and across new and established dyads at night. During daytime, elephants spent significantly more time exhibiting affiliative and agonistic behaviors, and in proximity to a conspecific, and less time resting, compared to night. Overnight, the odds of resting were significantly lower in new social dyads compared to established dyads, and new dyads spent more time exhibiting agonistic behavior and in proximity to a conspecific compared to established dyads. Our study suggests that male elephants at Denver Zoo have developed strong relationships and highlights the importance of systematically observing elephants overnight so that managers make decisions that improve animal welfare.

Evaluating the performance of LBSM data to estimate the gross domestic product of China at multiple scales: A comparison with NPP-VIIRS nighttime light data

Regional economic development evaluation is essential for understanding social and environmental issues. Although the nighttime light (NTL) data have been proved to be effective in economic estimation, it cannot reflect the human activities that occur during the daytime. Recently, with the widespread use of smart mobile devices, the location based social media (LBSM) data are increasingly being used as a proxy for real-time human activities. However, little work was carried out to explore the potential of LBSM data in estimating economic development at different scales in China. This study filled this gap by evaluating the effectiveness of Tencent user density (TUD) data, a typical type of LBSM data in China, in Gross Domestic Product (GDP) modeling at the provincial, municipal, and county scales. In this study, we employed holiday and non-holiday TUD sample data to simulate the annual TUD data, and compared it with the new generation NTL data, NPP/VIIRS images. The results showed that although the simulated annual TUD data does not perform better than NPP/VIIRS-NTL data in provincial and municipal GDP estimation, it outperforms NPP/VIIRS-NTL data at the county scale. More importantly, the simulated annual TUD data are much more powerful and reliable than NPP/VIIRS-NTL data in underdeveloped areas with complex terrain, such as the Northwest and Southwest China, as well as in more developed areas with separation of work and housing, such as the North China and South China. This is mainly because TUD data can reduce the impact of natural factors such as terrain on data collection as well as reflect both daytime and nighttime human activities. This study confirmed that the LBSM-TUD data is a potential and promising data source for economic modeling in small scale areas of China, which will help to support China's regional economic evaluation.

The actigraphic documentation of circadian sleep-wake rhythm dysregulation in myotonic dystrophy type 1

Study objectivesThe present study aimed at identifying the sleep-wake rhythm in patients with myotonic dystrophy type 1 (DM1) compared to healthy controls. MethodsPatients with genetic diagnosis of DM1 and healthy controls underwent a 7-day actigraphic recording and filled out a daily sleep diary to evaluate the sleep-wake rhythm. All participants underwent a physical and neurological examination to exclude conditions interfering with the sleep-wake cycle. Daytime activity, nocturnal sleep, and non-parametric circadian rhythm activity (NPCRA) were analysed. ResultsTwenty-nine patients affected by DM1 were included in the present study and were compared to 16 controls. Considering nocturnal actigraphic data, DM1 patients showed a longer time in bed, sleep period time, actual sleep time, and sleep latency compared to controls. Central phase measurement was significantly longer in DM1 patients than controls. At NPCRA analysis patients showed a lower degree of regularity in the activity-rest pattern compared to controls. Moreover, DM1 patients showed reduced motor activity during daytime and a lower synchronization of the rest-activity rhythm than controls. ConclusionsThis study documented that patients with DM1 not only present the impairment of nocturnal sleep, but also show a dysregulation of the sleep-wake circadian rhythm; moreover, reduced amplitude of the circadian rhythmicity was also evident in comparison to controls, probably in relation to the reduced diurnal motor activity of patients. These findings add further evidence to the already documented sleep impairment and excessive daytime sleepiness in DM1 patients.

Diel metabolic patterns in a migratory oceanic copepod

Diel vertical migration of zooplankton profoundly impacts the transport of nutrients and carbon through the water column. Despite the acknowledged importance of this active flux to ocean biogeochemistry, these contributions remain poorly constrained, in part because daily variations in metabolic rates are not considered or are modeled as simple functions of temperature. To address this uncertainty, we sampled the subtropical copepod Pleuromamma xiphias at 4- to 7-h intervals throughout the daily migration and measured rates of oxygen consumption, ammonium excretion, fecal pellet production and metabolic enzyme activity. No significant patterns were detected in rates of oxygen consumption or ammonium excretion for freshly caught animals over the diel cycle. Fecal pellet production was highest during mid-night, consistent with several hours of feeding near the surface. Surface feeding resulted in fecal pellet production at depth in the morning, providing direct evidence that active flux of particulate organic carbon occurs in this region. Electron transport system activity was highest during the afternoon, contrary to our prediction of reduced daytime metabolism. Activity of both glutamate dehydrogenase and citrate synthase increased during early night, reflecting higher capacity for excretion and aerobic respiration, respectively. Overall, these results show that activities of metabolic enzymes vary during diel vertical migration. The surprising observation of elevated afternoon enzyme activity coupled with daytime fecal pellet and ammonium production suggests that additional characterization of the daytime activity of migratory zooplankton is warranted.

Loneliness in older adult mental health services during the COVID-19 pandemic and before: Associations with disability, functioning and pharmacotherapy.

ObjectivesLoneliness is associated with psychiatric morbidity. Restrictions placed on the population during the first COVID‐19 lockdown may have disproportionately affected older adults, possibly through increasing loneliness. We sought to investigate this by examining loneliness in referrals to mental health of older adults (MHOA) services during the first UK COVID‐19 lockdown.MethodsReferrals to MHOA services from a large South London catchment area were identified for the 16‐week period of the UK lockdown starting in March 2020 and for the corresponding period in 2019. A natural language processing algorithm identified loneliness in the patients' records. We applied logistic regression models adjusted for age, gender, ethnicity and diagnosis, to examine associations of loneliness in the study population.Results1991 referrals were identified, 56.9% of whom were female, with a mean age of 77.9 years. Only 26.9% occurred during the 2020 lockdown, but with a higher prevalence of loneliness (22.0 vs. 17.7%, p = 0.028). In the whole sample, loneliness was associated with non‐accidental self‐injury (Odds ratio [OR]: 1.65), depressed mood (OR: 1.73), psychotic symptoms (OR: 1.65), relationship problems (OR: 1.49), problems with daytime activities (OR: 1.36), and antidepressant use (OR: 2.11). During lockdown, loneliness was associated with non‐accidental self‐injury (OR: 2.52), problem drinking or drug‐taking (OR 2.33), and antidepressant use (OR 2.10).ConclusionsLoneliness is associated with more severe symptoms of affective illness, worse functional problems and increased use of antidepressant medication in older adults. During lockdown, loneliness in referrals to MHOA services increased and was associated with increased risk‐taking behaviour. Loneliness is a potential modifiable risk factor for mental illness, and efforts to minimise it in older adults should be prioritised as we emerge from the pandemic.

Rest activity rhythms characteristics of breast cancer women following endocrine therapy.

Rest-activity rhythm (RAR) disruptions are frequently associated with chemotherapy in breast cancer (BC), but they are less known in BC with endocrine therapy (ET). The aim of this ancillary study was to characterize the RAR and estimated sleep characteristics from actigraphy in BC patients either treated (ET+) or untreated with ET (ET-), compared to healthy controls (HC) and using a cross-sectional design. Eighteen ET+, 18 ET-, and 16 HC completed questionnaires and wore wrist actigraphs at home for 2 weeks. Parametric and nonparametric RAR, sleep parameters, and quality of life were compared between groups (p < .05). BC groups presented lower daytime activity than HC according to RAR analysis (mesor and M10 parameters). Compared to HC, ET- had lower inter-daily stability and ET+ had greater sleep complaints. Compared to ET-, ET+ had lower sleep efficiency, more time awake, and higher activity levels at night, as assessed with actigraphy. Our results suggest an effect of cancer independent of treatment on RAR in BC, highlighting the need for further investigation of this topic. In contrast, sleep as assessed with actigraphy seems modified only during ET which matches with patients' sleep complaints. Further longitudinal studies would aid in confirming the latter hypothesis.

Sleep: The price we pay for higher order cognition

Sleep-wake neurocircuitry has demonstrated a number of changes associated with the aging process. For example, reductions in noradrenergic tone result in diminished monoamine-mediated wakefulness. There is also evidence of breakdown of the circadian rhythm due, in part, to conditions such as cataracts or macular degeneration, but also to age-related changes in the suprachiasmatic nucleus, the location of the body’s “master clock” housed in the hypothalamus. The consequence of reduced circadian amplitude is less-consistent periods of sleeping/waking across the 24-hour day, with resultant increased nighttime and decreased daytime activity. However, in healthy elder populations there appears to be more day-to-day consistency in sleep-wake patterns, despite the diminished strength of the circadian rhythmicity. Sleep–wake and circadian disturbances in neurodegenerative disease are secondary to pathological degeneration of primary brain regions important for regulating the sleep–wake and circadian cycles. Common proteins associated with neurodegenerative processes – amyloid β, tau, and α-synuclein – accumulate as a consequence of normal neuronal activity, but unhealthy sleep patterns may also contribute to neurodegeneration through sleep’s role in the clearance of the toxic consequences of neuronal activity during sleep. With the recent description of the brain’s extensive perivascular glymphatic system, facilitating clearance of such metabolic byproducts most effectively in slow wave sleep, the connection between sleep and neural/glial health is beginning to crystalize. As such, the finding that clearance of potentially neurotoxic substances (such as amyloid β and tau) is hindered by sleep deprivation and/or disruption has implications for human neurodegenerative disease pathogenesis.

The Relationship Between The Physical Strain Of Walking And Daily Activity Time In Individuals With Slowly Progressive Neuromuscular Diseases

<h3>Research Objectives</h3> To investigate the physical strain of walking and its relationship with daily activity time in individuals with neuromuscular diseases (NMD). <h3>Design</h3> Observational study. <h3>Setting</h3> Data were collected from multiple research projects at the Department of Rehabilitation Medicine at the Amsterdam UMC, location AMC. <h3>Participants</h3> Thirty-one adults with post-polio syndrome (N = 11), Charcot-Marie-Tooth disease (N = 12) and other slowly progressive NMD (N = 8) participated (age: 59.9 ± 14.3). <h3>Interventions</h3> Steady state oxygen consumption during comfortable 6-minute walking (VO2walk), peak oxygen uptake (VO2peak) during maximal cycle ergometry, and heart rate and step count during 7 consecutive days were assessed. <h3>Main Outcome Measures</h3> Physical strain was defined as the ratio of VO2walk and VO2peak (in %). Daily activity time was expressed as average daily step count and time spent in moderate (40-60% heart rate reserve) to vigorous (>60% heart rate reserve) physical activity (MVPA). Regression analyses assessed the relationships between physical strain, VO2walk, and VO2peak with daily activity time. <h3>Results</h3> Participants walked 8262 ± 3403 steps and physical strain during walking was 64% ± 15%. Physical strain was inversely related to step count (r2=.26, p=0.004), while VO2peak was positively related to step count (r2=.20, p=0.013) and inversely related to MVPA (r2=.14, p=0.040). The other relations were not significantly correlated. <h3>Conclusions</h3> Physical strain of walking is high in patients with slowly progressive NMD compared to able-bodied individuals (27% ± 6%) [1], approximating vigorous exercise intensities. People with a higher physical strain take less steps daily. People with lower VO2peak take less steps daily, while spending more time in MVPA. The small proportions of explained variance indicate that more factors play a role in daily activity. <h3>Author(s) Disclosures</h3> None.

Simulating the impacts of interregional mobility restriction on the spatial spread of COVID-19 in Japan

A spatial susceptible–exposed–infectious–recovered (SEIR) model is developed to analyze the effects of restricting interregional mobility on the spatial spread of the coronavirus disease 2019 (COVID-19) infection in Japan. National and local governments have requested that residents refrain from traveling between prefectures during the state of emergency. However, the extent to which restricting interregional mobility prevents infection expansion is unclear. The spatial SEIR model describes the spatial spread pattern of COVID-19 infection when people commute or travel to a prefecture in the daytime and return to their residential prefecture at night. It is assumed that people are exposed to an infection risk during their daytime activities. The spatial spread of COVID-19 infection is simulated by integrating interregional mobility data. According to the simulation results, interregional mobility restrictions can prevent the geographical expansion of the infection. On the other hand, in urban prefectures with many infectious individuals, residents are exposed to higher infection risk when their interregional mobility is restricted. The simulation results also show that interregional mobility restrictions play a limited role in reducing the total number of infected individuals in Japan, suggesting that other non-pharmaceutical interventions should be implemented to reduce the epidemic size.

The consequences of COVID-19 lockdown for formal and informal resource utilization among home-dwelling people with dementia: results from the prospective PAN.DEM study

BackgroundCOVID-19 isolated home-dwelling people with dementia (PwD) from home care services, respite care, and daytime activities. We aimed to investigate the consequences of these restrictions on informal (family, friends) and formal (homecare staff) resource utilization among co-residing (e.g., spouses) and visiting caregivers (e.g., children).Methods105 PwD (≥65 years old) and their caregivers were included in the prospective PANdemic in DEMentia (PAN.DEM) study, which was initiated when the ongoing stepped-wedge, cluster randomized LIVE@Home.Path trial (N = 438) was temporarily halted due to the pandemic. Primary outcome was change in resource utilization assessed by the Resource Utilization in Dementia Care (RUD) instrument in pre- (12 Dec. 2019 to 11 Mar. 2020) and during the lockdown periods (20 April 2020 to 15 May 2020). Degree of cognitive impairment was assessed by Mini-Mental Status Examination (MMSE), and physical functioning and independent living skills by Physical Self-Maintenance Scale and Lawton Instrumental Activities of Daily Living Scale. Associations between informal and formal care utilization, socio-demographics, and clinical variables were assessed by descriptive statistics and Ordinary Least Squares models (OLS).ResultsMean age for PwD was 81.8 years; 61% were female; 45.6% lived alone, and the mean MMSE score was 20.8 (SD ± 3.7). PwD with co-residents (44%) were younger (78.4 years) than those who were living alone (84.5 years; P < 0.001). During the first 2 months of lockdown, PwD missed on average 20.5 h of formal care in a month (P < 0.001) leading to an approximately 100% increase in informal care, which was particularly pronounced in personal hygiene (6.9 vs. 11.4 days in a month, P < 0.001) and supervision (9.2 vs. 17.6 days in a month; P < 0.001). Visiting caregivers increased by 1.9 days (SD ± 11.5), but co-residing caregivers increased their number of days providing ADL by approximately 7 days per month (β = 6.9; CI, 0.39–13.1, P < 0.05) after adjusting for PwD and caregiver demographics and clinical variables. Decrease in home nursing care was particularly visible for PwD living alone (− 6.1 vs. -1.3 h per month, P = 0.005). Higher cognitive function (β = − 0.64, CI, − 1.26 – 0.02, P = 0.044) was associated with reduction in home nursing service during the lockdown.ConclusionThe care situation for PwD changed dramatically in the early phase of the COVID-19 pandemic, especially for those living alone who received less support from homecare services and visiting caregivers. For future crises and the forthcoming post-pandemic period, health authorities must plan better and identify and prioritize those in greatest need.Trial registrationClinicalTrials.gov; NCT04043364.

Dutch Forensic Flexible Assertive Community Treatment: Operating on the Interface Between General Mental Health Care and Forensic Psychiatric Care.

In the Netherlands, Forensic Flexible Assertive Community Treatment (ForFACT) is used as a specialized form of outpatient intensive treatment. This outreaching type of treatment is aimed at patients with severe and long lasting psychiatric problems that are at risk of engaging in criminal behavior. In addition, these patients often suffer from addiction and experience problems in different areas of their life (e.g., financial debt, unemployment, or lack of daytime activities). The aim of this exploratory study was to gain more insight into the characteristics of the ForFACT patient population. More knowledge about these patients may enhance the effectiveness of ForFACT and therefore (further) reduce the risk of recidivism. Data on 132 ForFACT patients were gathered by studying electronic patient records, criminal records, and by conducting semi-structured interviews with practitioners and patients. Additionally, as part of a cognitive screening, two screening instruments were conducted to gain insight into intelligence and possible mild cognitive impairments. This article gives a broad description of the ForFACT patient population, including demographic data and context variables, diagnostics, recidivism risk and offense history, and aspects related to care. Furthermore, several recommendations are given to further improve ForFACT. Based on the results it can be concluded that the ForFACT patient population shows a high degree of diversity in complex care needs and responsivity issues. Therefore, this article highlights the necessity for ForFACT to collaborate with other mental health institutions, as well as probation officers, and forensic or criminal justice institutions. Moreover, it is important to continually check the inclusion and exclusion criteria when admitting patients to ForFACT, and to examine whether ForFACT is still the most adequate care for patients or if they need to be referred. In addition, the results emphasize the importance of cognitive screening for forensic outpatients. Finally, this study zooms in on the interface between forensic psychiatric care and general mental health care.

Association between physical activity and activity space in different farming seasons among rural Lao PDR residents

BackgroundSoutheast Asia is experiencing a health transition, where non-communicable diseases (NCD) are exceeding communicable diseases. Despite NCDs accounting for roughly 60–85% of deaths in the region, many developing Southeast Asian countries are beginning to address the impacts of a physically inactive lifestyle for the first time. Our study aims to bridge this gap by objectively measuring physical activity in rural Lao PDR to reveal the association among physical activity, activity space, and seasonal variation.MethodsMultiple waves of survey data were collected in Songkhon District, Lao PDR between March 2010 and March 2011. Adults aged between 18 and 65 were recruited (n = 48). A portable GPS recorded participants’ activity and farmland locations and an accelerometer recorded participants’ physical activity level and daily steps for seven consecutive days. Using a directional distribution tool in ArcGIS 10.5, the activity space area of each participant in each wave was calculated. Concurrently, participants recorded time spent on each daytime activity. Linear mixed models with the fixed effects as the observations from different waves and the random effects as individual participants were developed to identify factors associated with areas of activity space and counts of daily steps, respectively.ResultsA total of 48 respondents aged between 19 and 57 took part in the study. Half of the participants were females. Walking was found to be the most frequent travel mode. Females were physically less active, with a smaller activity space, and were more overweight than the males in the study. Participants were physically less active during the off-farming seasons.ConclusionsFindings contribute to the surveillance of risk factors needed to create healthy living environments. Our research is also one of the first to use empirical evidence demonstrating seasonal variations of rural residents’ activities in mainland Southeast Asia.

Depressive symptoms in patients with epilepsy and clinically associated features in a single tertiary center

Although depressive symptoms are the most common psychiatric comorbidity in epilepsy, they remain underestimated and untreated in a large proportion of patients. The purpose of this study was to evaluate depression severity and related clinical features in people with epilepsy using a well-reliable self-report index of mood, the Beck Depression Inventory-II (BDI-II). One-hundred seventeen adult patients with epilepsy were recruited from a tertiary epilepsy center and completed the BDI-II. A single-item analysis of the 21 questions of the BDI-II was computed and differences between women and men in each depressive symptom were evaluated. Correlation and regression analyses were used to identify clinical features associated with the severity of depression. Results showed gender differences in some items, with women reporting overall higher depression severity than men. The most common symptoms regarded domains of sleeping patterns, tiredness, and loss of energy. Regression evidence suggested that being female, having an epilepsy duration < 10 years, as well as being treated with psychotropic drugs and reporting generalized seizure, were associated with higher depression severity. Despite its cross-sectional nature, this study reinforces the importance of investigating and possibly treating depressive symptoms in adult patients with epilepsy, since they negatively impact well-being, daytime activities, and sleep. Further studies identifying pharmacological and non-pharmacological treatments for depression in epilepsy need to be planned.

Chronotype changes with age; seven-year follow-up from the Netherlands study of depression and anxiety cohort

BackgroundChronotype reflects an individual's optimal daily timing of sleep, activity, and cognitive performance. Previous, cross-sectional, studies have suggested an age effect on chronotype with later chronotypes in adolescents and earlier chronotypes in children and elderly. Additionally, later chronotypes have been associated with more depressive symptoms. Few studies have been able to study longitudinal associations between chronotype and age, while adjusting for depressive symptoms. MethodsChronotype was assessed twice with the Munich Chronotype Questionnaire 7 years apart in the Netherlands Study of Depression and Anxiety (T1: N = 1842, mean age (SD): 42.63 years (12.66)) and T2: N = 1829, mean age (SD) 50.67 (13.11)). The longitudinal association between change in age and change in chronotype was tested using a generalized estimated equation analysis adjusted for covariates (including level of depressive symptoms). Using age-bins of 5 years (age at T2), change in chronotype between T1 and T2 was analyzed with Linear Mixed Models. ResultsWe found a change towards an earlier chronotype with higher age (B (95% CI): -0.011 (-0.014–0.008), p < 0.001). For the age-bins, the difference in chronotype was significant for the 25–29 years age-bin. LimitationsThe sample did not include individuals younger than 19 years or older than 68 years. ConclusionsIn the whole sample chronotype changed towards becoming more morning-type over a period of 7 years, but this change was only significant for those aged 25–29 years. The study was performed in a large naturalistic cohort study with a wide age-range, including patients with a diagnosis of depressive and anxiety disorder and healthy controls.

Can Religiosity be Sensed with Satellite Data? An Assessment of Luminosity during Ramadan in Turkey

AbstractSocial scientists have long been interested in how religious beliefs and practices impact and are impacted by socio-political and economic processes. Most recently, scholarly attention has focused on the interplay between religiosity and local actors, events, and institutions. Until now, measures of religiosity have relied heavily on self-reports in surveys, but these cannot always be safely collected and tend to be costly. Even where available, survey-based measures may be too obtrusive and are rarely representative of sub-national units. Here, I propose an inexpensive method that uses satellite imagery to unobtrusively estimate religiosity across small geographic units. I hypothesize that night-lights are affected by the behavior of fasting Muslims during Ramadan, especially in places where daytime activities are otherwise unchanged (i.e., where there is no “day-night inversion”). I explore and confirm the validity of this measurement strategy in the Turkish case, using a series of high-quality surveys and electoral results, representing 973 administrative districts. I conclude with a discussion of the external validity of this method and an overview of the ethical concerns raised by the use of remote sensing to estimate religiosity, in the Muslim world and elsewhere.