Alerting effects of light in healthy individuals: a systematic review and meta-analysis

Light plays an essential role in psychobiological and psychophysiological processes,such as alertness.The alerting effect is influenced by light characteristics and the timing of interventions.This meta-analysis is the first to systematically review the effect of light intervention on alertness and to discuss the optimal protocol for light intervention.In this meta-analysis,registered at PROSPERO(Registration ID:CRD42020181485),we conducted a systematic search of the Web of Science,PubMed,and PsycINFO databases for studies published in English prior to August 2021.The outcomes included both subjective and objective alertness.Subgroup analyses considered a variety of factors,such as wavelength,correlated color temperature(CCT),light illuminance,and timing of interventions(daytime,night-time,or all day).Twenty-seven crossover studies and two parallel-group studies were included in this meta-analysis,with a total of 1210 healthy participants(636(52%)male,mean age 25.62 years).The results revealed that light intervention had a positive effect on both subjective alertness(standardized mean difference(SMD)=-0.28,95%confidence interval(CI):-0.49 to-0.06,P=0.01)and objective alertness in healthy subjects(SMD=-0.34,95%CI:-0.68 to-0.01,P=0.04).The subgroup analysis revealed that cold light was better than warm light in improving subjective alertness(SMD=-0.37,95%CI:-0.65 to-0.10,P=0.007,I2=26%)and objective alertness(SMD=-0.36,95%CI:-0.66 to-0.07,P=0.02,I2=0).Both daytime(SMD=-0.22,95%CI:-0.37 to-0.07,P=0.005,I2=74%)and night-time(SMD=-0.32,95%CI:-0.61 to-0.02,P=0.04,I2=0)light exposure improved subjective alertness.The results of this meta-analysis and systematic review indicate that light exposure is associated with significant improvement in subjective and objective alertness.In addition,light exposure with a higher CCT was more effective in improving alertness than light exposure with a lower CCT.Our results also suggest that both daytime and night-time light exposure can improve subjective alertness.

Telehealth interventions to reduce management complications in type 1 diabetes:A review

Type 1 diabetes is a chronic illness with a high burden of care.While effective interventions and recommendations for diabetes care exist,the intensive nature of diabetes management makes compliance difficult.This isespecially true in children and adolescents as they have unique psychosocial and diabetes needs.Despite the development of effective in-person interventions targeting improving self-management and ameliorating psychosocial difficulties there are still a number of barriers to implementing these interventions,namely time,cost,and access.Telehealth interventions allow for the dissemination of these interventions to a broader audience.Self-management and psychosocial telehealth interventions are reviewed with a special emphasis on mobile phone and internet based technology use.While efficacy has been demonstrated in a number of telehealth interventions with improved cost effectiveness over inperson interventions,many challenges remain including high participant attrition and difficulties with receiving reimbursement for services rendered.These and other challenges are discussed with recommendations for researchers and telehealth providers provided.