Development of a Sleep Assessment Module in the Automated Self-Administered 24-Hour (ASA24) Dietary Assessment Tool: New Research Opportunities

Abstract Objectives To develop a sleep assessment module in ASA24 to capture self-reported sleep behavior as an optional enhancement to the ASA24 Dietary Assessment Tool for adults. Methods Multiple self-reported sleep assessment tools were considered in module development, including the National Sleep Foundation Sleep Diary, the Activities Completed over Time in 24-hours (ACT24), Munich Chronotype Questionnaire (MCTQ), and the Consensus Sleep Diary (CSD) Core. Priority was given to minimal need for adaptation, questionnaire length to reduce survey fatigue, incorporating plain language, and optimizing for implementation in 24 hour recalls (24HR) and food records. Researchers with expertise in meal timing and sleep were consulted for feedback on content and utility and programmers with expertise in survey design were consulted on implementation. Lastly, the online data collection process and ASA24 System's output data files were tested for accuracy. Results The ASA24 sleep module contains ten questions and can be administered immediately following dietary assessment. Eight CSD Core questions were adapted to assess time in bed, time trying to go to sleep, and length of time to fall asleep; number and duration of nocturnal awakenings; wake time and time out of bed for the day; and perceived sleep quality. Two questions were added to capture sleep quality and comparability of reported sleep to a usual night's sleep. For users completing a 24HR, the module includes two questions on time of awakening and sleep quality immediately preceding the first reported meal; all 10 sleep questions are asked for the sleep period immediately following the last meal (i.e., 12 questions total), allowing for assessment of the impact of diet on sleep. In contrast, a food record is completed on the same day users consume the food, and thus all sleep questions address the sleep window prior to the first meal; a single record can be used to assess the impact of sleep on diet. Consecutive days of records can also be collected to capture sleep pre- and post-eating windows. Conclusions The ASA24 sleep module can assess sleep timing and quality and will be available in Fall 2021. Researchers can soon leverage this novel resource to examine the association of sleep with timing of eating and other chrononutrition variables. Funding Sources This project has been funded by the NIH.

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Extent of sleep problems and relationship with severity of chronic pain using three validated sleep assessment tools

British Journal of Pain ◽

10.1177/20494637211054698 ◽

2021 ◽

pp. 204946372110546

Author(s):

Rachel Vaughan ◽

Helen F Galley ◽

Saravana Kanakarajan

Keyword(s):

Chronic Pain ◽

Sleep Quality ◽

Assessment Tool ◽

Sleep Problems ◽

Sleep Onset ◽

Assessment Tools ◽

Poor Sleep ◽

Pain Clinics ◽

Sleep Assessment ◽

Sleep Interference

Objective Chronic pain can impact on sleep, but the extent and nature of sleep problems in patients with chronic pain are incompletely clear. Several validated tools are available for sleep assessment but they each capture different aspects. We aimed to describe the extent of sleep issues in patients with chronic non-malignant pain using three different validated sleep assessment tools and to determine the relationship of sleep issues with pain severity recorded using the Brief Pain Inventory (BPI), a commonly used self-assessment tool in pain clinics. The BPI has a single question on the interference of pain on sleep and we also compared this with the validated sleep tools. Design Prospective, cross-sectional study. Setting Pain management clinic at a large teaching hospital in the United Kingdom. Subjects Adult patients (with chronic non-malignant pain of at least 3 months’ duration) attending clinic during a 2-month period. Methods Participants completed the Pittsburgh Sleep Quality Index (PSQI), the Pain and Sleep Questionnaire-3 (PSQ-3) and the Verran Snyder-Halpern (VSH) sleep scale, plus the BPI. Duration and type of pain, current medications and demographic data were recorded. Results We recruited 51 patients and 82% had poor sleep quality as shown by PSQIscores above five. PSQI ( p = 0.0002), PSQ-3 ( p = 0.0032), VSH sleep efficiency ( p = 0.012), sleep disturbance ( p = 0.0014) and waking after sleep onset ( p = 0.0005) scores were associated with worse BPI pain scores. BPI sleep interference scores concurred broadly with the validated sleep tools. Median [range] sleep duration was 5.5 [3.0–10.0] hours and was also related to pain score ( p = 0.0032). Conclusion Chronic pain has a marked impact on sleep regardless of the assessment tool used. The sleep interference question in the BPI could be used routinely for initial identification of sleep problems in patients with chronic pain.

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The Role of Digital Maturity Assessment in Technology Interventions with Industrial Internet Playground

Electronics ◽

10.3390/electronics10101134 ◽

2021 ◽

Vol 10 (10) ◽

pp. 1134

Author(s):

Annabeth Aagaard ◽

Mirko Presser ◽

Tom Collins ◽

Michail Beliatis ◽

Anita Krogsøe Skou ◽

...

Keyword(s):

Assessment Tool ◽

Digital Transformation ◽

Assessment Tools ◽

Manufacturing Companies ◽

Digital Interventions ◽

Maturity Assessment ◽

Industrial Internet ◽

Digital Development ◽

Key Dimensions ◽

The Impact

The use of digital technologies such as Internet of Things and advanced data analytics are central in digitally transforming manufacturing companies towards Industry 4.0. Success cases are frequently reported, and there is clear evidence of technology interventions conducted by industry. However, measuring the impact and effect of such interventions on digital maturity and on the organizational adoption can be challenging. Therefore, the research aim of this paper is to explore how the combination of the different methods of Industrial Internet Playground (IIP) pilots, Shadow Infrastructure (SI) and digital maturity assessment can assist in conducting and documenting the technical, as well as organisational, impact of digital interventions. Through an elaborate literature review of existing digital maturity assessment tools and key dimensions in digital transformation, we have developed a digital maturity assessment tool (DMAT), which is presented and applied in the paper to identify digital development areas and to evaluate and document the effects of digital interventions. Thus, the paper contributes with new knowledge of how the IIP pilot and SI combined with digital maturity assessment can support effective, transparent and documented digital transformation throughout an organisation, as explored through theory and a practice case.

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Effect of Manual Data Cleaning on Nutrient Intakes using the Automated Self-Administered 24-Hour Dietary Assessment Tool (ASA24)

Current Developments in Nutrition ◽

10.1093/cdn/nzab005 ◽

2021 ◽

Author(s):

Yasmine Y Bouzid ◽

Joanne E Arsenault ◽

Ellen L Bonnel ◽

Eduardo Cervantes ◽

Annie Kan ◽

...

Keyword(s):

Energy Intake ◽

Assessment Tool ◽

Data Cleaning ◽

Dietary Assessment ◽

Assessment Tools ◽

Energy Requirements ◽

Nutrient Intakes ◽

Significant Difference ◽

Before And After ◽

Total Fat

Abstract Background Automated dietary assessment tools such as ASA24® are useful for collecting 24-hour recall data in large-scale studies. Modifications made during manual data cleaning may affect nutrient intakes. Objectives We evaluated the effects of modifications made during manual data cleaning on nutrients intakes of interest: energy, carbohydrate, total fat, protein, and fiber. Methods Differences in mean intake before and after data cleaning modifications for all recalls and average intakes per subject were analyzed by paired t-tests. Chi-squared test was used to determine whether unsupervised recalls had more open-ended text responses that required modification than supervised recalls. We characterized food types of text response modifications. Correlations between predictive energy requirements, measured total energy expenditure (TEE), and mean energy intake from raw and modified data were examined. Results After excluding 11 recalls with invalidating technical errors, 1499 valid recalls completed by 393 subjects were included in this analysis. We found significant differences before and after modifications for energy, carbohydrate, total fat, and protein intakes for all recalls (p < 0.05). Limiting to modified recalls, there were significant differences for all nutrients of interest, including fiber (p < 0.02). There was not a significantly greater proportion of text responses requiring modification for home compared to supervised recalls (p = 0.271). Predicted energy requirements correlated highly with TEE. There was no significant difference in correlation of mean energy intake with TEE for modified compared to raw data. Mean intake for individual subjects was significantly different for energy, protein, and fat intakes following cleaning modifications (p < 0.001). Conclusions Manual modifications can change mean nutrient intakes for an entire cohort and individuals. However, modifications did not significantly affect correlation of energy intake with predictive requirements and measured expenditure. Investigators can consider their research question and nutrients of interest when deciding to make cleaning modifications.

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Nocturnal Sleep–Wake Parameters of Adolescents at Home Following Cancer Chemotherapy

Biological Research For Nursing ◽

10.1177/1099800411408414 ◽

2011 ◽

Vol 14 (3) ◽

pp. 236-241 ◽

Cited By ~ 3

Author(s):

Amy J. Walker ◽

Kyle P. Johnson ◽

Christine Miaskowski ◽

Vivian Gedaly-Duff

Keyword(s):

Sleep Duration ◽

Cancer Chemotherapy ◽

Sleep Onset ◽

Sleep Diary ◽

Nocturnal Sleep ◽

Wake Time ◽

Targeted Interventions ◽

Time In Bed ◽

Wrist Actigraphy ◽

At Home

Purpose: The purpose of this descriptive, longitudinal study was to describe objective nocturnal sleep–wake parameters of adolescents at home after receiving chemotherapy in the hospital or outpatient clinic and explore differences in sleep variables by age, gender, and corticosteroid use. Methods: We collected 7 days of wrist actigraphy and sleep diary data from 48 adolescents (10–19 years) who were receiving cancer chemotherapy for a primary or secondary cancer or a relapse. The actigraphic sleep variables included rest interval (i.e., time in bed), sleep onset, sleep offset, sleep duration, total sleep time (TST), wake after sleep onset (WASO), and %WASO. Results: Of the 48 adolescents, 38 had at least five nights of scored actigraphy and were included in analyses. Older (13–18 years) adolescents went to bed later and had fewer minutes of TST than younger adolescents (10–12 years). Exploratory analyses revealed no differences between adolescents who were taking oral corticosteroids (i.e., prednisone, dexamethasone) and those who were not or between males and females. Conclusion: These adolescents had sleep durations that met or exceeded the recommended sleep duration for their age groups but experienced significant WASO. Further research is needed to estimate sleep needs of adolescents during chemotherapy and determine factors that contribute to nocturnal wake-time so that targeted interventions can be designed to improve sleep quality.

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Sleep Patterns of Resident Physicians and the Effect of Heartfulness Meditation

Annals of Neurosciences ◽

10.1177/09727531211039070 ◽

2021 ◽

pp. 097275312110390

Author(s):

Jayaram Thimmapuram ◽

Robert Pargament ◽

Sonya Del Tredici ◽

Theodore Bell ◽

Deborah Yommer ◽

...

Keyword(s):

Sleep Quality ◽

Sleep Onset ◽

Onset Time ◽

Assessment Tools ◽

Sleep Diary ◽

Poor Sleep ◽

Sleep Patterns ◽

Sleep Quantity ◽

Resident Physicians ◽

Improve Sleep Quality

Background: Medical residents are vulnerable to poor sleep quality due to intense work shifts and academic load. Studies objectively quantified with sleep quantity and quality among resident physicians are limited. Meditation techniques have been shown to improve sleep but are rarely studied in this population. The aim of the present study is to evaluate sleep patterns of internal medicine residents and the effect of a structured Heartfulness meditation program to improve sleep quality. Methods: A total of 36 residents participated in a pre–post cohort study from January 2019 through April 2019. Sleep was monitored during a one-week outpatient rotation with two validated assessment tools, namely consensus sleep diary and actigraphy. After four intervening weeks, when the residents returned to the same rotation, Heartfulness meditation was practiced and the same parameters were measured. At the end of the study period, an anonymous qualitative feedback survey was collected to assess the feasibility of the intervention. Results: All 36 residents participated in the study (mean age 31.09 years, SD 4.87); 34 residents (94.4%) had complete pre–post data. Consensus sleep diary data showed decreased sleep onset time from 21.03 to 14.84 min ( P = .01); sleep quality and restfulness scores increased from 3.32 to 3.89 and 3.08 to 3.54, respectively ( P < .001 for both). Actigraphy showed a change in sleep onset time from 20.9 min to 14.5 min ( P = .003). Sleep efficiency improved from 83.5% to 85.6% ( P = .019). Wakefulness after initial sleep onset changed from 38.8 to 39.9 min ( P = .682). Sleep fragmentation index and the number of awakenings decreased from 6.16 to 5.46 ( P = .004) and 41.71 to 36.37 ( P = .013), respectively. Conclusions: Residents obtained nearly 7 h of sleep during outpatient rotation. Findings suggest a structured Heartfulness meditation practice to be a feasible program to improve subjective sleep onset time and several objective measures among resident physicians.

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Rethinking the Use of Mobile Apps for Dietary Assessment in Medical Research

Journal of Medical Internet Research ◽

10.2196/15619 ◽

2020 ◽

Vol 22 (6) ◽

pp. e15619 ◽

Cited By ~ 1

Author(s):

Wael Khazen ◽

Jean-François Jeanne ◽

Laëtitia Demaretz ◽

Florent Schäfer ◽

Guy Fagherazzi

Keyword(s):

Medical Research ◽

Assessment Tool ◽

Mobile Apps ◽

Dietary Assessment ◽

Ease Of Use ◽

Assessment Tools ◽

Dietary Behaviors ◽

Mobile Technologies ◽

Eating Occasions ◽

Dietary Data

Food intake and usual dietary intake are among the key determinants of health to be assessed in medical research and important confounding factors to be accounted for in clinical studies. Although various methods are available for gathering dietary data, those based on innovative technologies are particularly promising. With combined cost-effectiveness and ease of use, it is safe to assume that mobile technologies can now optimize tracking of eating occasions and dietary behaviors. Yet, choosing a dietary assessment tool that meets research objectives and data quality standards remains challenging. In this paper, we describe the purposes of collecting dietary data in medical research and outline the main considerations for using mobile dietary assessment tools based on participant and researcher expectations.

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286 Pilot Sleep During Brazil-to-China COVID-19 Humanitarian Mission Flights Compared to Biomathematical Predictions of Sleep

SLEEP ◽

10.1093/sleep/zsab072.285 ◽

2021 ◽

Vol 44 (Supplement_2) ◽

pp. A114-A115

Author(s):

Jaime Devine ◽

Caio Garcia ◽

Audrey Simoes ◽

Jake Choynowski ◽

Marina Guelere ◽

...

Keyword(s):

Sleep Quality ◽

Intraclass Correlation ◽

Correlation Coefficients ◽

Sleep Time ◽

Prediction Algorithm ◽

Sleep Diary ◽

Flight Period ◽

Paired Samples ◽

Time In Bed ◽

Scheduling Tool

Abstract Introduction n response to the COVID-19 pandemic, Azul Airlines organized and conducted five separate humanitarian missions to China between May and July, 2020. Each mission consisted of 4 flight legs between 11-15 hours long crewed by a team of 8 pilots. Each pilot was given a 9-hour sleep opportunity during the flight period. Prior to conducting the missions, a sleep-prediction algorithm (AutoSleep) within the Sleep, Activity, Fatigue, and Task Effectiveness (SAFTE) model Fatigue Avoidance Scheduling Tool (FAST) was used to predict in-flight time in bed (TIB) and total sleep time (TST). During missions, pilots wore a wrist actigraph and completed a sleep diary. These analyses compare the accuracy of SAFTE-FAST AutoSleep predictions against pilots’ sleep diary and actigraphy from Azul’s COVID-19 humanitarian missions. Methods Pilots wore a sleep-tracking actigraphy device (Zulu Watch, Institutes for Behavior Resources), and reported the TIB and sleep quality of their in-flight rest periods using a sleep diary. Diary TST was estimated from TIB and sleep quality. AutoSleep, diary, and actigraphy measures were compared using paired samples t-tests. Agreement was compared using intraclass correlation coefficients (ICC). Results Twenty (n=20) pilots flying across 5 humanitarian missions provided sleep diary and actigraphy data. AutoSleep predictions of TIB (235±20 minutes) and TST (193±16 minutes) were significantly lower than diary (TIB: 330±123, t=6.80, p≤0.001; TST: 262±108, t=5.60, p≤0.001) and comparable to actigraphy (TIB: 246±127, t=0.78, p=0.43; TST: 212±113, t=1.59, p=0.12). ICC values were >0.90, indicating excellent agreement, for TIB (0.94) and TST (0.91). Conclusion Biomathematical predictions of in-flight sleep during unprecedented humanitarian missions were in agreement with actual sleep patterns during flights. These findings indicate that biomathematical models may retain accuracy even under extreme circumstances like the COVID-19 pandemic. Pilots may overestimate the amount of sleep that they receive during extreme flights-duty periods, which could constitute a fatigue risk. Support (if any) NA

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Probing the question order effect while developing a chemistry concept inventory

Chemistry Education Research and Practice ◽

10.1039/c5rp00228a ◽

2017 ◽

Vol 18 (1) ◽

pp. 45-54 ◽

Cited By ~ 2

Author(s):

Molly A. Undersander ◽

Travis J. Lund ◽

Laurie S. Langdon ◽

Marilyne Stains

Keyword(s):

Assessment Tool ◽

Order Effect ◽

Assessment Tools ◽

Concept Inventory ◽

Order Effects ◽

First Year ◽

First Semester ◽

Question Order ◽

First Year University ◽

The Impact

The design of assessment tools is critical to accurately evaluate students' understanding of chemistry. Although extensive research has been conducted on various aspects of assessment tool design, few studies in chemistry have focused on the impact of the order in which questions are presented to students on the measurement of students' understanding and students' performance. This potential impact has been labeled the question order effect in other literature and may be considered as a threat to the construct validity of the assessment tool. The set of studies described in this article tested whether question order effects were present within a concept inventory on acid-based chemistry. In particular, we tested whether the order of two conceptually isomorphic questions, one pictorial and one verbal, affected students' performance on the concept inventory. Two different versions of the inventory were developed and collected from students enrolled in the second semester of first-year university chemistry courses (general chemistry;N= 774) at two different institutions and to students enrolled in the first semester of organic chemistry (N= 163) at one of the two institutions. Students were further divided in two groups based on their self-reported level of effort in answering the concept inventory. Interviews were also conducted with a total of 19 students at various stages of the studies. Analyses of differences in students' responses to the two versions of the inventory revealed no question order effect in all settings. Implications for instructors and researchers are provided.

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ICT-FLAG: a web-based e-assessment platform featuring learning analytics and gamification

International Journal of Web Information Systems ◽

10.1108/ijwis-12-2016-0074 ◽

2017 ◽

Vol 13 (1) ◽

pp. 25-54 ◽

Cited By ~ 8

Author(s):

David Gañán ◽

Santi Caballé ◽

Robert Clarisó ◽

Jordi Conesa ◽

David Bañeres

Keyword(s):

Learning Analytics ◽

Assessment Tool ◽

Reference Model ◽

Assessment Tools ◽

Web Based ◽

Ongoing Research ◽

Content Type ◽

Analysis And Design ◽

Software Methodology ◽

The Impact

Purpose The purpose of this paper is to present an innovative web-based eLearning platform called ICT-FLAG that provides e-assessment tools with general-purpose formative assessment services featuring learning analytics and gamification. Design/methodology/approach The paper reports on the technical development of the platform driven by the Reference Model for Open Distributed Processing software methodology, which guides the platform construction, including the analysis and design steps. Findings The ICT-FLAG platform is technically tested by integrating it into a real e-assessment tool. Results are positive in terms of functional and non-functional aspects as well as user’s satisfaction on usability, emotional state, thus validating the platform as a valuable educational tool. Research limitations/implications Because of the chosen technical paper as article type, validation of the impact of the ICT-FLAG platform in the learning process is not provided. Ongoing research with this platform is to measure the learning outcomes of its use in a real context of eLearning. Practical implications The paper shows implications of the main technical issues and challenges encountered during the integration of the ICT-FLAG platform with external eLearning tools, involving relevant aspects of interoperability, security, modularity, scalability, portability and so on. Originality/value This platform can fill the gap of many e-assessment systems, which currently do not have built-in analytical and gamification tools for learning, thus providing them with the experience to improve the quality of education and learning.

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Assessing sleep quality in older adults: A comparison of three measurement approaches

Innovation in Aging ◽

10.1093/geroni/igaa057.3256 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 882-882

Author(s):

Amy Berkley ◽

Patricia Carter

Keyword(s):

Older Adults ◽

Sleep Quality ◽

Assessment Tool ◽

Sleep Problems ◽

Adult Population ◽

Sleep Onset ◽

Self Report ◽

Sleep Onset Latency ◽

Wrist Actigraphy ◽

Sleep Assessment

Abstract Discrepancies between subjective and objective sleep measures have been reported for some time; however, it is critical to consider the implications of inaccurate or incomplete sleep assessment for frail older adults who are struggling to maintain independence. To compare sleep assessment methods, we collected objective sleep measurements (via wrist actigraphy), subjective measures via self-report sleep surveys (Pittsburgh Sleep Quality Index; Insomnia Severity Index, Sleep Hygiene Index), and qualitative data through semi-structured audio-recorded interviews, from 8 older adults who self-reported sleep problems while living in a retirement community in southwestern US. Participants’ objective sleep (Total Sleep Time, Sleep Onset Latency, Wake After Sleep Onset, and Sleep Efficiency) and qualitative narratives were congruent, but self-report measures failed to capture several unique sleep problems identified in the sample. Disordered sleep in older adults has been linked to increased incidence of falls, depression and anxiety, cognitive impairment, institutionalization, and mortality, but traditional sleep assessment instruments, designed for the general adult population, fail to capture many of the experiences and causes that are unique to older adults. functioning. A sleep assessment tool designed to measure older people’s sleep experiences could provide more accurate and sensitive data.

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