A cluster analysis of physical activity profiles and resilience in intensive care nurses

PurposeLimited evidence exists regarding a group of nurses' physical activity patterns and association with resilience. Less is known about the physical activity health paradox in nurses (the positive health effects of leisure time physical activity vs the negative health effects of occupational physical activity). This study aimed to explore the profiles of intensive care nurses' physical activity behaviours and associations with resilience, following a developed study-specific job demands–recovery framework.Design/methodology/approachA cross-sectional study was conducted with intensive care unit (ICU) nurses to explore their physical activity profiles and associations with resilience. The Connor-Davidson Resilience Scale 25 (CD-RISC 25) was used to assess resilience, and accelerometry was utilised to record participants' four-day activity (two workdays, two non-workdays). Hierarchical cluster analysis was employed to define groups of nurses by activity behaviours.FindingsParticipants (N = 93) were classified as low actives (n = 19), standers (n = 36), sitters (n = 31) and movers (n = 7). During two 12-h shifts, movers had the highest mean level of dynamic standing and the lowest mean level of sitting. During two non-workdays, movers had the highest mean level of walking as well as the lowest mean level of sitting and sleep time.Originality/valueThe uniqueness of this study was that it analysed ICU nurses' physical activity profiles and associations with resilience using identified clusters. However, the small number of participants limited this study's ability to determine significant relationships between resilience and the grouped physical activity profiles.

Diabetes Self-Management Education and Association With Diabetes Self-Care and Clinical Preventive Care Practices

Purpose: The purpose of the study is to assess self-reported receipt of diabetes education among people with diabetes and its association with following recommended self-care and clinical preventive care practices. Methods: We analyzed data from the 2017 and 2018 Behavioral Risk Factor Surveillance System for 61 424 adults (≥18 years) with self-reported diabetes in 43 states and Washington, DC. Diabetes education was defined as ever taking a diabetes self-management class. The association of diabetes education with self-care practices (daily glucose testing, daily foot checks, smoking abstention, and engaging in leisure-time physical activity) and clinical practices (pneumococcal vaccination, biannual A1C test, and an annual dilated eye exam, influenza vaccination, health care visit for diabetes, and foot exam by a medical professional) was assessed. Multivariable logistic regression with predicted margins was used to predict the probability of following these practices, by diabetes education, controlling for sociodemographic factors. Results: Of adults with diabetes, only half reported receiving diabetes education. Results indicate that receipt of diabetes education is associated with following self-care and clinical preventive care practices. Those who did receive diabetes education had a higher predicted probability for following all 4 self-care practices (smoking abstention, daily glucose testing, daily foot check, and engaging in leisure-time physical activity) and all 6 clinical practices (pneumonia vaccination, biannual A1C test, and an annual eye exam, flu vaccination, health care visit, and medical foot exam). Conclusions: The prevalence of adults with diabetes receiving diabetes education remains low. Increasing receipt of diabetes education may improve diabetes-related preventive care.

Trends of central obesity and associations with nutrients intake and daily behaviors among women of childbearing age in China

Background Obesity among women of childbearing age has becoming an important public health concern. We aimed to describe the trends of central obesity among Chinese women of childbearing age from 2004 to 2011 and to examine its associations with nutrients intake and daily behaviors. Methods Longitudinal data were derived from the China Health and Nutrition Survey. Participants consisted of 2481 women aged 15–44 years old. WC (Waist circumference) and WHtR (Waist to height ratio) were adopted as indicators of central obesity. Generalized linear mixed model was performed to analyze the associations of nutrients intake and daily behaviors with central obesity. Results From 2004 to 2011, the prevalence of central obesity among Chinese women of childbearing age increased from 21.6 to 30.7% (WC as indice) or from 22.8 to 32.6% (WHtR as indice) (both p < 0.001). Protein intake above the AMDR (Acceptable macronutrient distribution range) (OR = 1.21, 95% CI 1.05–1.39, p < 0.01) and non-participation in LTPA (Leisure time physical activity) (OR = 1.45, 95% CI 1.17–1.80, p < 0.001) were risk factors for high WC, and the latter was also associated with high WHtR (OR = 1.36, 95% CI 1.10–1.67, p < 0.01). For those women who had high WC & high WHtR, the impacts of protein intake and LTPA became stronger, especial LTPA (OR = 1.53, 95% CI 1.21–1.94, p < 0.001). Age-stratified analyses found that non-participation in LTPA was key factor for central obesity in 15–34 age group, while protein intake above the AMDR was pronounced in the 35–44 age group. Conclusions Non-participation in LTPA and protein intake above the AMDR were significant contributors of central obesity, which could be intervention targets to deal with the growing trend of central obesity among women of childbearing age.

Functional status, mood state, and physical activity among women with post-acute COVID-19 syndrome

Objectives: While organ-specific pathophysiology has been well-described in SARS-CoV-2 infection, less is known about the attendant effects on functional status, mood state and leisure-time physical activity (PA) in post-acute COVID-19 syndrome. Methods: A case-control design was employed to recruit 32 women (n = 17 SARS-CoV-2; n = 15 controls) matched on age (54 +/- 12 years), body mass index (27 +/- 6 kg/m2), smoking status, and history of cardiopulmonary disease. Participants completed a series of assessments including the Modified Pulmonary Functional Status and Dyspnea Questionnaire (PFSDQ-M), Profile of Mood States (POMS), and Godin-Shephard Leisure-Time PA. Results: SARS-CoV-2 participants exhibited poorer functional status (p = 0.008) and reduced leisure-time PA (p = 0.004) compared to controls. Significant between-group differences were also detected for the POMS total mood disturbance with sub-scale analyses revealing elevated tension, confusion, and lower vigor among SARS-CoV-2 participants (all p-values < 0.05). The number of SARS-CoV-2 symptoms (e.g.,loss of taste / smell, muscle aches etc.) were associated (r = 0.620, p = 0.008) with confusion. Conclusion: The sequela of persistent SARS-CoV-2 symptoms elicit clear disturbances in functional status, mood state, and leisure-time PA among women with post-acute COVID-19 syndrome.

CVD risk from prolonged occupational sitting attenuated by additional physical activity – Evidence from a prospective cohort of 481,688 Asian adults

BackgroundFor the first time, the 2020 WHO guidelines on physical activity recommend reducing sedentary behaviors due to their health consequences. Less is known on the effect of prolonged occupational sitting, especially in the context of low physical activity engagement.This study aims at quantifying cardiovascular risk associated with prolonged occupational sitting and determining the additional amount of physical activity that may be needed to attenuate it.MethodsA cohort comprising 481,688 participants in a health surveillance program in Taiwan was followed between 1996 and 2017, collecting data on occupational sitting time, leisure-time physical activity (LTPA) habits, lifestyle, and metabolic parameters. The all-cause and expanded cardiovascular disease (CVD + diabetes mellitus + kidney disease) mortality associated with three occupational sitting volumes (mostly sitting, alternating sitting and non-sitting, mostly non-sitting) was analyzed applying multivariate Cox regression models to calculate the hazard ratios (HRs) for all participants and by subgroups, including five levels of LTPA. Deaths in the first two years of follow-up were excluded to avoid reverse causality.ResultsThe study recorded 26,257 deaths during a mean follow-up period of 12.85 years. Individuals mostly sitting at work had a higher mortality risk than those mostly non-sitting, both from all causes (HR: 1.16, 95% CI: 1.11-1.20) and from expanded CVD (HR:1.46, 95% CI:1.35-1.58), after adjusting for gender, age, education, smoking, drinking, and body mass index. Individuals alternating sitting and non-sitting at work did not experience increased risk for all-cause mortality, compared to individuals mostly non-sitting at work (HR: 1.01, 95% CI: 0.97-1.05), but did experience higher risk of deaths due to expanded CVD (HR: 1.13, 95% CI: 1.04-1.23). Individuals engaged in low (15-29 min/day) or no (<15 min/day) LTPA, who mostly sit at work, would need to increase their LTPA by 15 and 30 minutes respectively to reduce their risk of mortality to that of similarly inactive individuals who mostly do not sit at work.ConclusionsAs part of modern lifestyles, prolonged occupational sitting is considered normal and has not received due attention, even though its deleterious effect has been largely proved. Alternating sitting and non-sitting at work, as well as an extra 15 to 30 min/day of LTPA, can attenuate the harms of prolonged occupational sitting. Thus, emphasizing the associated harms and suggesting workplace system changes could help the society to de-normalize this common behavior, similarly to the process of de-normalizing smoking.

All are equal, but some are more equal than others: social determinants of leisure time physical activity through the lens of intersectionality

Background To date, no research has investigated social determinants of leisure time physical activity through the lens of intersectionality in a low- and middle-income country. Therefore, the aim of this study was to explore the intersectionality in leisure time physical activity in a nationwide sample of Brazilian adults. Methods Data from the Brazilian National Health Survey conducted in 2013 were analysed (N = 58,429). Prevalence of sufficient leisure time physical activity (150+ minutes per week in moderate-to-vigorous physical activity) was estimated according to gender, racial identity, education and income, and according to multiple combinations of these sociodemographic characteristics (i.e., multiple jeopardy index). Results The prevalence of sufficient leisure time physical activity was 22.9% (95%CI: 22.3 to 23.6). Overall, the prevalence of sufficient leisure time physical activity was highest among men, individuals with white skin colour, and among those in the highest group of education and income. Among men, white, with a university degree and in the highest quartile of income (3% of the population), the prevalence of sufficient leisure time physical activity was 48%. Among non-white women with low education and low income (8.1% of the population), the prevalence of sufficient leisure time physical activity was 9.8%. Conclusion Informed by the theory of intersectionality, findings of this study have shown that intersections of gender, racial identity and socioeconomic position of the Brazilian society strongly influence leisure time physical activity at the individual level. Targeted interventions to increase leisure time physical activity should address the complexities of social status intersections.

Associations between Physical Activity and Academic Competence: A Cross-Sectional Study among Slovenian Primary School Students

Physical activity has beneficial effects on overall academic performance in children. However, there is a lack of evidence regarding how the individual characteristics of physical activity interact with other confounding variables of academic competence. Leisure-time physical activity with potential confounders—such as developmental, behavioral, family, and school factors, predicting overall, mathematical, and reading academic competence—was studied in a random sample of 1520 Slovenian primary school students in grades 4–6 (51.9% female; mean age = 10.4 years; SD = 0.93). A structured self-reported questionnaire was used to gather data on the children’s leisure-time physical activity and social-demographic variables, while academic competence was measured by teachers using the SSRS Academic Competence Evaluation Scale. The findings showed that children engage in physical activity most days a week, with moderate-intensity and unorganized activities. It was predicted that engaging in physical activity would lead to an increase in academic performance by 4.2% in males (p = 0.002) and 3.2% in females (p = 0.024), but after fully adjusting the model for controlling confounding variables, the prediction increased to 81.1% in females and 84.1% in males (p < 0.001). The frequency and intensity of physical activity, the absence of digital games, and attending sports clubs seem to have the most beneficial effects in terms of academic competence in school children, among other relevant confounders mediating in this complex relationship.