Chronobiology international
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Randomized Controlled Trial Clinical Trial
Bright light therapy for winter depression--is phase advancing beneficial?
Bright light is the recommended treatment for winter seasonal affective disorder (SAD). Previously we showed that the antidepressant effect of morning (but not evening) light was greater than placebo after 3 weeks of treatment. Here, we determined if the magnitude and direction of circadian rhythm phase shifts produced by the bright light in the previous study were related to the antidepressant effects. ⋯ So it does not appear that an abnormal phase angle can entirely account for the etiology of SAD. A majority (75%) of the responders by strict joint criteria had a phase angle within this range after treatment, so it appears that obtaining the ideal phase relationship may account for some, but not all of the antidepressant response. In any case, regardless of the mechanism for the antidepressant effect of morning light, it can be enhanced when patients sleep at the ideal circadian phase and reduced when they sleep at a more abnormal circadian phase.
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This cross-sectional exploratory study involved health care workers of various skill types and levels. We tested the hypothesis that the prevalence of diseases, sleep complaints, and insufficient time for nonprofessional activities (family, leisure, and rest) are higher among night than day workers. Data collection was carried out in two public hospitals using questionnaires and other forms. ⋯ These results can be related to the "social value of time," as evenings and nights are when families usually spend time together. The complexity of the professional life and the consequent heterogeneity of the group of workers under shift-work schemes confound the results. More in-depth study of the questions raised here demands a more sophisticated epidemiological treatment and larger sample size.
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Equity is a humanitarian issue that gained strength during the transition from the 20th to the 21st century due to the mounting global discussion and social crisis involving human rights, health, and work. This article aims at (1) introducing the concept of equity as it applies to work environments, particularly to situations involving demanding work schedules, (2) discussing the role of science in equity issues related to work, (3) introducing a new scientific society dedicated to working-time issues, and (4) presenting an overview of new research on working time and health as addressed by the series of manuscripts published in this special issue of Chronobiology International devoted to the XVIth International Symposium on Night and Shiftwork, held in Santos, Brazil, November 2003. The concept of equity has a political as a well as a scientific dimension. ⋯ The Working Time Society is a new scientific society that aims at promoting research into working time and health and offers practical advice on how to minimize adverse effects of working hours on workers' health and well-being. An updated view of the research on working times and health includes studies on the relationship between work schedules, worker health, and well-being; effects of night and shiftwork on the internal synchronization of circadian rhythms and laboratory and field interventions; new methods of investigation or new approaches in shift-work studies; and prediction of risks in night and shift work. Current tendencies of work organization contribute to the amplification of inequality across groups and populations, revealing that equity remains a challenge to achieve.
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To investigate the role of the circadian pacemaker in cortisol reactivity to a cold pressor challenge, 26 diurnally subjects participated in a constant-routine protocol and were divided into two groups. Group 1 started immediately after a monitored sleep period at 09:00 h, while group 2 started 12 h later. After 2 h of adaptation, a cold pressor test was presented every 3 h. ⋯ The pretest samples were considered to be base-rate measures and base-rate values as subtracted from post-test values were considered as reactivity measures. Both measures showed distinct Time-of-Day variations (respectively: F(7,168) = 16.92, p < 0.001, epsilon = 0.383; and F(7,175) = 8.01, p < 0.001, epsilon = 0.523). These findings are interpreted as evidence for the existence of an endogenous circadian periodicity underlying the sensitivity of the hypothalamus-pituitary-adrenal (HPA)-axis to acute stress.
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Effects of temperature and temperature changes on circadian clocks in cyanobacteria, unicellular algae, and plants, as well as fungi, arthropods, and vertebrates are reviewed. Periodic temperature with periods around 24 h even in the low range of 1-2 degrees C (strong Zeitgeber effect) can entrain all ectothermic (poikilothermic) organisms. This is also reflected by the phase shifts-recorded by phase response curves (PRCs)-that are elicited by step- or pulsewise changes in the temperature. ⋯ Temperature changes affect membrane properties, ion homeostasis, calcium influx, and other signal cascades (cAMP, cGMP, and the protein kinases A and C) (indirect effects) and may thus influence, in particular, protein phosphorylation processes of the clock mechanism. The temperature effects resemble to some degree those induced by light or by light-transducing neurons and their transmitters. In ectothermic vertebrates temperature changes significantly affect the melatonin rhythm, which in turn exerts entraining (phase shifting) functions.