The increasing effects of light pollution on professional and amateur astronomy.

The starry sky has been a source of inspiration throughout human history. Astronomy has been a common element in all cultures and civilizations, being used to establish calendars, navigate and discover new lands, and drive numerous scientific and technical breakthroughs. This Review discusses how it is becoming increasingly difficult for professional and amateur astronomers to observe the night sky because of light pollution. Artificial light at night, radio interference, and the deployment of satellite constellations are all rapidly increasing and are having adverse impacts on astronomical observations, limiting scientific discoveries, cultural connections to the night sky, and opportunities presented by astrotourism. Potential mitigation strategies to preserve the night sky are discussed.

Reducing nighttime light exposure in the urban environment to benefit human health and society.

Nocturnal light pollution can have profound effects on humans and other organisms. Recent research indicates that nighttime outdoor lighting is increasing rapidly. Evidence from controlled laboratory studies demonstrates that nocturnal light exposure can strain the visual system, disrupt circadian physiology, suppress melatonin secretion, and impair sleep. There is a growing body of work pointing to adverse effects of outdoor lighting on human health, including the risk of chronic diseases, but this knowledge is in a more nascent stage. In this Review, we synthesize recent research on the context-specific factors and physiology relevant to nocturnal light exposure in relation to human health and society, identify critical areas for future research, and highlight recent policy steps and recommendations for mitigating light pollution in the urban environment.

Regulating light pollution: More than just the night sky.

Impacts on ecology, health, energy, and climate are critical.

Artificial night light alters ecosystem services provided by biotic components.

The global catastrophe of natural biodiversity and ecosystem services are expedited with the growing human population. Repercussions of artificial light at night ALAN are much wider, as it varies from unicellular to higher organism. Subsequently, hastened pollution and over exploitation of natural resources accelerate the expeditious transformation of climatic phenomenon and further cause global biodiversity losses. Moreover, it has a crucial role in global biodiversity and ecosystem services losses via influencing the ecosystem biodiversity by modulating abundance, number and aggregation at every levels as from individual to biome levels. Along with these affects, it disturbs the population, genetics and landscape structures by interfering inter- and intra-species interactions and landscape formation processes. Furthermore, alterations in normal light/dark (diurnal) signalling disrupt the stable physiological, biochemical, and molecular processes and modulate the regulating, cultural and provisioning ecosystem services and ultimately disorganize the stable ecosystem structure and functions. Moreover, ALAN reshapes the abiotic component of the ecosystem, and as a key component of global warming via producing greenhouse gases via emitting light. By taking together the above facts, this review highlights the impact of ALAN on the ecosystem and its living and non-living components, emphasizing to the terrestrial and aquatic ecosystem. Further, we summarize the means of minimizing strategies of ALAN in the environment, which are very crucial to reduce the further spread of night light contamination in the environment and can be useful to minimize the drastic impacts on the ecosystem.

The Effect of a Quality Improvement Intervention on Sleep and Delirium in Critically Ill Patients in a Surgical ICU.

BACKGROUND: Delirium is a deleterious condition affecting up to 60% of patients in the surgical ICU (SICU). Few SICU-focused delirium interventions have been implemented, including those addressing sleep-wake disruption, a modifiable delirium risk factor common in critically ill patients. RESEARCH QUESTION: What is the effect on delirium and sleep quality of a multicomponent nonpharmacologic intervention aimed at improving sleep-wake disruption in patients in the SICU setting? STUDY DESIGN AND METHODS: Using a staggered pre-post design, we implemented a quality improvement intervention in two SICUs (general surgery or trauma and cardiovascular) in an academic medical center. After a preintervention (baseline) period, a multicomponent unit-wide nighttime (ie, efforts to minimize unnecessary sound and light, provision of earplugs and eye masks) and daytime (ie, raising blinds, promotion of physical activity) intervention bundle was implemented. A daily checklist was used to prompt staff to complete intervention bundle elements. Delirium was evaluated twice daily using the Confusion Assessment Method for the Intensive Care Unit. Patient sleep quality ratings were evaluated daily using the Richards-Campbell Sleep Questionnaire (RCSQ). RESULTS: Six hundred forty-six SICU admissions (332 baseline, 314 intervention) were analyzed. Median age was 61 years (interquartile range, 49-70 years); 35% of the cohort were women and 83% were White. During the intervention period, patients experienced fewer days of delirium (proportion ± SD of ICU days, 15 ± 27%) as compared with the preintervention period (20 ± 31%; P = .022), with an adjusted pre-post decrease of 4.9% (95% CI, 0.5%-9.2%; P = .03). Overall RCSQ-perceived sleep quality ratings did not change, but the RCSQ noise subscore increased (9.5% [95% CI, 1.1%-17.5%; P = .02). INTERPRETATION: Our multicomponent intervention was associated with a significant reduction in the proportion of days patients experienced delirium, reinforcing the feasibility and effectiveness of a nonpharmacologic sleep-wake bundle to reduce delirium in critically ill patients in the SICU. TRIAL REGISTRY: ClinicalTrials.gov; No.: NCT03313115; URL: www.clinicaltrials.gov.