Impact of Indoor Overheating on Physiological Strain in Individuals With Schizophrenia
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 入组人数
- 10
- 试验地点
- 1
- 主要终点
- Core temperature (Peak) during daylong exposure to indoor overheating
研究概览
简要总结
Schizophrenia is a severe mental illness affecting approximately 24 million people worldwide and is associated with more than double the all cause mortality risk of the general population. Emerging evidence demonstrates that elevated temperatures acutely worsen mental health symptoms and significantly increase the risk of heat related morbidity and mortality. For people living with schizophrenia, prolonged exposure to heat can exacerbate psychiatric symptoms, impair judgment and decision making, and reduce the ability to engage in protective behaviors such as increasing hydration, reducing clothing, improving ventilation, or seeking cooler environments. As a result, individuals with schizophrenia may experience higher rates of heat related illness. To date our understanding of heat exposure effects in individuals with schizophrenia remains incomplete, hindering the development of evidence-based strategies to protect them.
Thus, the primary objective of this exploratory study is to gather preliminary data on the effects of indoor overheating on physiological responses (core body temperature and cardiovascular function), cognitive performance (attention, working memory, and reaction time), and mood in adults with schizophrenia. Specifically, we will assess whether maintaining indoor conditions at the upper recommended temperature limit for older adults (26°C, 45% relative humidity [RH]; PMID: 38329752) is sufficient to mitigate physiological strain compared with exposure to a hot indoor environment (36°C, 45% RH) representative of non-air-conditioned homes during extreme heat events in individuals with schizophrenia. In both conditions, the individual will remain seated at rest while wearing light clothing (t shirt and shorts), with the exception of performing 15 minutes of stepping exercise (4-4.5 METS) each hour (excluding the lunch period) to reflect typical daily activities of daily living.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Crossover
- 主要目的
- Basic Science
- 盲法
- Single (Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 85 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •English or French speaking.
- •Ability to provide informed consent.
- •Individuals with and without schizophrenia or schizoaffective disorder.
排除标准
- •Endurance exercise training (greater than 3 sessions of vigorous exercise training per week for 30 minutes or more)
- •Restrictions to physical activity
- •Any history of diagnoses for other psychiatric disorders deemed to make participation in the study inadvisable.
研究组 & 干预措施
Exposure to indoor temperature upper limit of 26°C
Participants exposed daylong (6 hours) to an indoor temperature maintained at 26°C and 45% relative humidity (humidex equivalent of 29).
干预措施: Simulated exposure to indoor overheating (Other)
Exposure to hot indoor environment of 36°C
Participants exposed daylong (6 hours) to an indoor temperature maintained at 36°C and 45% relative humidity (humidex equivalent of 45).
干预措施: Simulated exposure to indoor overheating (Other)
结局指标
主要结局
Core temperature (Peak) during daylong exposure to indoor overheating
时间窗: End of 6 hour daylong exposure
Peak core (indexed by visceral temperature) temperature (15 min average) during exposure. Visceral temperature is measured continuously throughout the 6 hour exposure to the simulated indoor overheating.
Core temperature (AUC) during daylong exposure to indoor overheating
时间窗: End of 6 hour daylong exposure
Areas under the curve (AUC) of visceral temperature during the 6 hour exposure to the simulate indoor overheating.
Core temperature end of daylong exposure to indoor overheating
时间窗: End of 6 hour daylong exposure
Visceral temperature measured at hour 6 of exposure to indoor overheating (15-min average).
Mean skin temperature (Peak) during daylong exposure to indoor overheating
时间窗: End of 6 hour daylong exposure
Peak mean skin temperature (15 min average) during exposure. Mean skin temperature as calculated from skin temperature measured across 7 body regions is measured continuously throughout the 6 hour exposure to the simulated indoor overheating.
Mean skin temperature (AUC) during daylong exposure to indoor overheating
时间窗: End of 6 hour daylong exposure
Areas under the curve (AUC) of mean skin temperature as calculated over 7 body regions during the 6 hour exposure to the simulate indoor overheating.
Mean skin temperature end of daylong exposure to indoor overheating
时间窗: End of 6 hour daylong exposure
Mean skin temperature measured over 7 body regions at hour 6 of exposure to indoor overheating (15-min average).
Heat rate (Peak) during daylong exposure to indoor overheating
时间窗: End of 6 hour daylong exposure
Peak heart rate (15 min average) during exposure. Heart rate is measured continuously throughout the 6 hour exposure to the simulated indoor overheating.
Heart rate (AUC) during daylong exposure to indoor overheating
时间窗: End of 6 hour daylong exposure
Areas under the curve (AUC) of heart rate during the 6 hour exposure to the simulate indoor overheating.
Heart rate end of daylong exposure to indoor overheating
时间窗: End of 6 hour daylong exposure
Heart rate measured at hour 6 of exposure to indoor overheating (15-min average).
Systolic blood pressure during daylong exposure to indoor overheating
时间窗: At the start (hour 0) and end of 6 hour daylong exposure
Systolic blood pressure measured in triplicate via automated oscillometry (\~60 seconds between measures).
Diastolic blood pressure during daylong exposure to indoor overheating.
时间窗: At the start (hour 0) and end of 6 hour daylong exposure
Diastolic blood pressure measured in triplicate via automated oscillometry (\~60 seconds between measures).
Reaction time during daylong exposure to indoor overheating (cognitive function).
时间窗: At the start (hour 0) and end of 6 hour daylong exposure
Participants will be provided with a tablet device with the Sway Medical testing platform for the assessment of reaction time. Participants will be asked to initiate a movement of the device in response to a visual cue.
Impulse control during daylong exposure to indoor overheating (cognitive function).
时间窗: At the start (hour 0) and end of 6 hour daylong exposure
Participants will be provided with a tablet device with the Sway Medical testing platform for the assessment of impulse control. Participants will be asked to respond to both "go" and "no-go" visual cues. In response to the "go" cue, participants will initiate a movement of the device.
Memory recall during daylong exposure to indoor overheating (cognitive function).
时间窗: At the start (hour 0) and end of 6 hour daylong exposure
Participants will be provided with a tablet device with the Sway Medical testing platform for the assessment of memory recall. Participants complete both a delayed recall test and a working memory test.
CDC 4-Stage Balance Test during daylong exposure to indoor overheating (postural stability).
时间窗: At the start (hour 0) and end of 6 hour daylong exposure
To assess postural stability, participants hold a tablet to their chest, then auditory cues guide participants through four consecutive stances, feet side by side, instep of one foot touching the big toe of the other foot, tandem stand with one foot in front of the other, heel touching toe, and stand on one foot. The balance assessment will be evaluated based on movement detected by an accelerometer integrated into the hardware of the tablet device (Sway Medical Inc).
Executive function during daylong exposure to indoor overheating (cognitive function).
时间窗: At the start (hour 0) and end of 6 hour daylong exposure
Participants will be provided with a tablet device with the Sway Medical testing platform for the assessment of executive function. Participants will complete the Cued Stroop test, in which they are presented a sequence of congruent, neutral and incongruent color-word tasks.
BTrackS Balance Assessment during daylong exposure to indoor overheating (postural stability).
时间窗: At the start (hour 0) and end of 6 hour daylong exposure
To assess postural stability, participants will be asked to stand on a BTracks force plate with their feet spread out to shoulder width, hand on their hips and eyes closed. The assessment will comprise of four trials (one practice trial) lasting 20 seconds in length and 20 seconds between trials. Center of pressure (COP) vector data along vertical (y) and horizontal (x) axes will be summed for the total path excursion length (cm) during each trial
Hydration status during daylong exposure to indoor overheating
时间窗: At the start (hour 0) and end of 6 hour daylong exposure
Hydration status measured via assessing the urine specific gravity of a urine sample.
Fluid consumption during daylong exposure to indoor overheating
时间窗: At end of 6 hour daylong exposure
Average hourly fluid consumption calculated by weighing participant water intake at the start and end of each hour of exposure (normalized to the exposure duration).
Fluid loss during daylong exposure to indoor overheating
时间窗: At end of 6 hour daylong exposure
Fluid loss calculated as the change in body mass during each exposure presented as a percentage of baseline body mass (corrected for food consumption).
Thermal sensation scale during daylong exposure to indoor overheating
时间窗: At the start (hour 0) and end of 6 hour daylong exposure
Thermal sensation assessed via an ordinal scale (How hot do you feel?) ranging from "extremely hot" to "neutral".
Thermal sensation 2 scale during daylong exposure to indoor overheating
时间窗: At the start (hour 0) and end of 6 hour daylong exposure
Thermal sensation assessed via an ordinal scale ("How do you feel?") ranging from "hot" to "cold" (midpoint: neutral)
Thermal comfort scale during daylong exposure to indoor overheating
时间窗: At the start (hour 0) and end of 6 hour daylong exposure
Thermal comfort assessed via an ordinal scale ("How comfortable does your body temperature feel?") ranging from "very uncomfortable" to "comfortable".
Thirst sensation scale during daylong exposure to indoor overheating
时间窗: At the start (hour 0) and end of 6 hour daylong exposure
Thirst sensation assessed via an ordinal scale ranging from very, very thirsty to not thirsty at all.
Feel good scale during daylong exposure to indoor overheating
时间窗: At the start (hour 0) and end of 6 hour daylong exposure
Feel good scale assessed via an ordinal scale (How good do you feel?) ranging from "very good" to "very bad" (midpoint: neutral)
Activity levels (total steps taken) during daylong exposure to indoor overheating
时间窗: End of 6 hour daylong exposure
Activity levels, quantified by number of steps taken per hour and totaled for each 6 hour exposure, assessed via a wearable accelerometer worn on the wrist and hip.
Perceived exertion scale during daylong exposure to indoor temperature limit.
时间窗: At the start (hour 0) and end of 6 hour daylong exposure
Perceived exertional assessed via an ordinal scale ("How hard are you working?") ranging from "no exertional at all" to "maximal exertion"
次要结局
- Perceived exertion scale during daylong exposure to indoor temperature limit.(At the start (hour 0) and end of 6 hour daylong exposure)
- Activity levels (total steps taken) during daylong exposure to indoor overheating(End of 6 hour daylong exposure)
- Feel good scale during daylong exposure to indoor overheating(At the start (hour 0) and end of 6 hour daylong exposure)
- Thirst sensation scale during daylong exposure to indoor overheating(At the start (hour 0) and end of 6 hour daylong exposure)
- Thermal comfort scale during daylong exposure to indoor overheating(At the start (hour 0) and end of 6 hour daylong exposure)
- Thermal sensation 2 scale during daylong exposure to indoor overheating(At the start (hour 0) and end of 6 hour daylong exposure)
- Thermal sensation scale during daylong exposure to indoor overheating(At the start (hour 0) and end of 6 hour daylong exposure)
- Fluid loss during daylong exposure to indoor overheating(At end of 6 hour daylong exposure)
- Fluid consumption during daylong exposure to indoor overheating(At end of 6 hour daylong exposure)
- Hydration status during daylong exposure to indoor overheating(At the start (hour 0) and end of 6 hour daylong exposure)
- BTrackS Balance Assessment during daylong exposure to indoor overheating (postural stability).(At the start (hour 0) and end of 6 hour daylong exposure)
- Executive function during daylong exposure to indoor overheating (cognitive function).(At the start (hour 0) and end of 6 hour daylong exposure)
- CDC 4-Stage Balance Test during daylong exposure to indoor overheating (postural stability).(At the start (hour 0) and end of 6 hour daylong exposure)
- Heart rate end of daylong exposure to indoor overheating(End of 6 hour daylong exposure)
- Memory recall during daylong exposure to indoor overheating (cognitive function).(At the start (hour 0) and end of 6 hour daylong exposure)
- Impulse control during daylong exposure to indoor overheating (cognitive function).(At the start (hour 0) and end of 6 hour daylong exposure)
- Reaction time during daylong exposure to indoor overheating (cognitive function).(At the start (hour 0) and end of 6 hour daylong exposure)
- Diastolic blood pressure during daylong exposure to indoor overheating.(At the start (hour 0) and end of 6 hour daylong exposure)
- Systolic blood pressure during daylong exposure to indoor overheating(At the start (hour 0) and end of 6 hour daylong exposure)
- Heart rate (AUC) during daylong exposure to indoor overheating(End of 6 hour daylong exposure)
- Heat rate (Peak) during daylong exposure to indoor overheating(End of 6 hour daylong exposure)
- Mean skin temperature end of daylong exposure to indoor overheating(End of 6 hour daylong exposure)
- Mean skin temperature (AUC) during daylong exposure to indoor overheating(End of 6 hour daylong exposure)
- Mean skin temperature (Peak) during daylong exposure to indoor overheating(End of 6 hour daylong exposure)
- Core temperature end of daylong exposure to indoor overheating(End of 6 hour daylong exposure)
- Core temperature (AUC) during daylong exposure to indoor overheating(End of 6 hour daylong exposure)
- Profiles of Mood States (POMS) during daylong exposure to indoor overheating(At the start (hour 0) and end of 6 hour daylong exposure)
- Environmental Symptoms Questionnaire (ESQ) during daylong exposure to indoor overheating(At the start (hour 0) and end of 6 hour daylong exposure)
研究者
Glen P. Kenny
Full Professor, University Research Chair
University of Ottawa