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6 DESIGN 6.4.1 Target group Primary, the average subject is a young adult female with AN stage 1-3, only one out of ten is male. It is a changing group of patients, including 12 girls at a time. The length of stay can range from a few months to a year or more. Personalised lighting would be the best solution, but it is very diffi- cult, as the patients have different needs according to mental stability, level of depression, seasonality score, diurnal type and mean melatonin rhythm etc. (Putilov, Donskaya and Verevkin, 2015) The scope of the following CL concept will thus be determined by the common denominator and metrics will be evaluated against the ones proposed by Barroso et al, 2014. (Barroso, Simons and De Jager, 2014) Secondary, the CR of the 24-hour staff should be supported. In PCBA ED 55, the staff works in three shifts: 7-15, 15-23 and 23-7, and an emphasis should be on the ones working in rotating nigh-shifts. ALAN can cause side effects, when experiencing shift work and circadian disruption over longer periods of time, can lead to cancer. (Schernhammer et al., 2001; Pauley, 2004; Figueiro, Rea and Bullough, 2006; Kamali and Abbas, 2012) 6.4.2 Biological clock The rising and setting of the sun will reset the human circadian clock, unless the timer is influenced by other factors, such as artificial light, food, muscle activity or social contact. As a combination of the daily schedule and the location in the Northern hemisphere, the light stimuli from the natural light will not be enough to reset the biological clock in the patients. They spend most time inside and the artificial light and light-emitting- screens will continuously disrupt their circadian rhythm at night. If the ar- tificial lighting has to serve as the main Zeitgeber, the illuminance has to be significantly higher than current standards suggest. [section 3.3.6] BLT is commonly used as light box with up to 10.000 lux for 30-60min in the early morning. [section 2.6.1] This therapy can be part of a morning routine, reading or answering email, but findings suggest that similar results can be obtained with lower light levels at longer duration. A minimum of 400lx at eyelevel, should be emitted for ~2h in the morning, ~8.5h after Melatonin onset, for resetting, as findings suggest that exposure to light peaks, like BLT for resetting of the biological clock is preferable in the morning. A blue light peak at 460nm will induce higher chance of a successful phase shift, as well as intermitted light pulses. (Rimmer et al., 2000; Zeitzer et al., 2000; Terman et al., 2001; Lockley, Brainard and Czeisler, 2003)This could be explained by an overweight in people with peak activity in the afternoon and a soci- ety build for people with a morning peak. Four different chrono-types has been determined (Putilov, Donskaya and Verevkin, 2015) and there is a small tendency towards disrupted Melatonin rhythms in AN, but no significant chrono-type was found. [section 3.3.2] Master thesis · MSc Lighting Design · Pernille Bech-Larsen · Fall 2017 82PDF Image | Healing with light
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