Work-related Activity Research Articles

Clinical determinants of physical activity and sedentary behaviour in individuals with schizophrenia.

Modifiable lifestyle factors such as physical activity (PA) have ameliorative effects on commonly reported health conditions in schizophrenia like cardiovascular diseases and diabetes. Similarly, reduction in sedentary behaviour (SB) promotes better physical health. However, engaging individuals with schizophrenia in PA and less SB can be challenging because of symptoms of schizophrenia. The aims of the present study are (i) to examine the profiles of PA and SB in individuals with schizophrenia; and (ii) to identify their respective clinical determinants. 157 individuals with schizophrenia were recruited. PA and SB were examined via the Global Physical Activity Questionnaire (GPAQ). Psychopathology was assessed using the Positive and Negative Syndrome Scale (PANSS). Potential clinical predictors of PA and SB were identified via univariate regression analyses and subsequently included in the final multiple regression models for PA and SB respectively. 63.7% met the WHO PA guidelines. Work-related activity was the largest domain specific contribution towards PA. Mean duration of SB was approximately 9 h and about 57.3% reported at least 8 h or more of SB daily. Positive symptom was associated with engagement in PA and reduced duration of SB. Negative symptom was associated with greater SB. With emerging evidence of deleterious health effects of SB independent of PA, it is important to monitor SB in individuals with schizophrenia, particularly those presenting with negative symptoms. While the lack of treatment response for negative symptoms remains a challenge, effort should be made to reduce duration of SB.

Using in-Vehicle Data Monitors to Reduce Risky Driving among Sales Representatives

Driving is the riskiest work-related activity in the European Union, including the UK. One promising approach for improving work-related driver safety is through the use of In-Vehicle Data Monitors...

Physical activity profile of the Iranian population: STEPS survey, 2016

BackgroundInsufficient physical activity (IPA) is one of the leading causes of premature mortality through the increased burden of non-communicable diseases. From 1990 to 2017, the percentage of low physical activity attributable disability-adjusted life years (DALY) increased globally by 1.5 times and 2-fold in Iran, causing more than 1.2 million deaths worldwide and 18,000 deaths in Iran in 2017. Reports suggest that Iran, a developing middle-income country, suffers from a high level of IPA. Socioeconomic and cultural alterations along with the country’s developments expose the population to IPA risk. We aimed to describe IPA prevalence in Iran’s adult population, categorized by demographics, geographical region, and activity domains to assess the present pattern of physical inactivity and its domains in the country.MethodsIn 2016, in order to represent Iran’s adult population, adult participants (n: 30541) from 30 provinces were selected using systematic proportional to size cluster sampling. Physical activity (PA) was assessed via the Global Physical Activity Questionnaire, calculating the Metabolic Equivalent of Task (MET) value in minutes per week for work, recreation, and transport domains. Insufficient physical activity (IPA) was defined according to WHO’s recommendation (less than 600 METs per week). Adjusted odds ratios of IPA associates for sociodemographic, lifestyle related variables, and metabolic risk factors were reported.ResultsA high prevalence of IPA was seen in the total population (54.7%, 95%CI: 54.0–55.3) with a considerable difference between the two genders (males: 45.3% (95%CI: 44.3–46.3); females: 61.9% (95%CI: 61.0–62.7)). Work-related activity was the domain with the greatest percentage of total PA, whereas, both genders lacked recreational activities. In our findings, being female, a housekeeper, younger and living in urban areas were significantly associated with higher levels of IPA. Moreover, insufficient fruit and vegetable consumption, lack of alcohol consumption, having a personal vehicle, and finally, having a medical history of diabetes were significantly associated with the presence of IPA in our population. Among the study population, 33.6% (95%CI: 33.0–34.2) had at least 4 h of sedentary behavior in a typical day.ConclusionsWidespread IPA among the Iranian adult population is of major concern. In our findings, we observed a considerable gap in the prevalence and pattern of IPA between the two genders. Additionally, IPA was associated with living in urban areas, unhealthy lifestyle habits and a history of other metabolic risk factors. Thus, a prompt initiative for population-specific actions should be taken.

Validity and reliability of the Work-related Physical Activity Questionnaire for assessing intensity-specific physical activity and sedentary behavior in the workplace

We developed the Work-related Physical Activity Questionnaire (WPAQ) to measure occupational physical activity, including sedentary behavior and sedentary breaks (interruptions of prolonged sedentary behavior), during work. This study aimed to examine the WPAQ's reliability and criterion validity using an accelerometer. To examine criterion validity, 97 full-time factory workers (male: 89.7%) wore a triaxial accelerometer while working and completed the WPAQ. The questionnaire inquired about participants' normal work activities and the proportion of sitting, standing, walking, and heavy labor engaged in during work. In calculating time spent in each behavior, the proportion of each occupational activity was multiplied by the total minutes of work. Duration of uninterrupted sitting time was also measured. For reliability, the same questionnaire was administered twice (median test-retest interval: 9 days) to another convenient sample of 54 participants. Spearman's ρ was used to assess validity and intraclass correlation coefficients (ICCs) and Cohen's kappa with quadratic weighing were used to assess reliability. The criterion validity of occupational sitting time measured by the WPAQ was moderate (Spearman's ρ for sedentary behavior: 0.69) based on comparison with accelerometer data. Significant positive correlations were found for standing (ρ = 0.66) and walking (ρ = 0.39) between the WPAQ and accelerometer data, though not for heavy labor. A moderate but significant correlation (ρ = 0.27) was found for sedentary breaks. Test-retest reliability for all items was adequate (ICC = 0.59-0.79 for occupational sedentary behavior and physical activities, and Cohen's kappa with quadratic weighting = 0.84 for sedentary breaks). The WPAQ has acceptable properties for measuring workers' activities, including sedentary breaks. Reduced physical activity, increased time spent in sedentary behaviors, and fewer sedentary breaks during working time are all associated with adverse health outcomes. Though some occupational exposure to these activities might be unavoidable, the WPAQ may be a practical tool for assessing them.

Trends in Adherence to the Physical Activity Guidelines for Americans for Aerobic Activity and Time Spent on Sedentary Behavior Among US Adults, 2007 to 2016

The updated 2018 Physical Activity Guidelines for Americans (PAG) reaffirmed key recommendations regarding aerobic activity in the 2008 edition and recently introduced health risks of sedentary behaviors and their association with physical activity. To examine the concurrent changing trends in adherence to the PAG for aerobic activity and time spent on sedentary behavior in US adults from 2007 to 2016. This study used data from a series of cross-sectional, nationally representative surveys on adults 18 years or older from the National Health and Nutrition Examination Surveys from 2007 to 2016. Data analysis was performed from September 1, 2018, to March 31, 2019. Duration, frequency, and intensity of leisure-time, work-related, and transportation-related aerobic activity were ascertained by a standardized questionnaire and summed as minutes per week. Adherence to the PAG for aerobic activity was defined as engaging in at least 150 minutes a week of moderate-intensity or 75 minutes a week of vigorous-intensity aerobic physical activity or an equivalent combination of moderate- and vigorous-intensity aerobic physical activity. Time spent on sedentary behavior was estimated by hours spent sitting on a typical day. Among 27 343 participants 18 years or older (13 630 [52.0%] female; 14 628 [66.6%] non-Hispanic white), the weighted adherence rate to the PAG for aerobic activity was 65.2% (95% CI, 62.3%-68.2%) in 2015-2016, with no significant change from 2007-2008 (63.2%; 95% CI, 60.2%-66.1%) to 2015-2016 (P = .15 for trend). Time spent on sedentary behavior significantly increased over time from a weighted mean (SE) of 5.7 (0.3) hours per day in 2007-2008 to 6.4 (0.2) hours per day in 2015-2016 (P < .001 for trend). The weighted proportion of people not adhering to the PAG for aerobic activity and reporting long sedentary time (>6 hours per day) increased from 16.1% (95% CI, 14.4%-17.8%) in 2007-2008 to 18.8% (95% CI, 17.7%-20.0%) in 2015-2016. The findings suggest that the adherence rate to the PAG for aerobic activity in US adults has not improved since the release of the first edition in 2008 but that time spent on sedentary behavior has significantly increased over time. Further nationwide efforts appear to be warranted to not only promote physical activity but also reduce sedentary time in the United States.

Work-Related Mental Fatigue, Physical Activity and Risk of Insomnia Symptoms: Longitudinal Data from the Norwegian HUNT Study

ABSTRACT Objective/Background To examine the prospective association between work-related mental fatigue and risk of insomnia symptoms, and if leisure time physical activity modifies this association. Participants A total of 8,464 women and 7,480 men who participated in two consecutive surveys of the Norwegian HUNT study. Methods The study comprises longitudinal data on persons who were vocationally active and without insomnia symptoms at baseline in 1995–1997. We used a modified Poisson regression model to calculate adjusted risk ratios (RRs) with a 95% confidence interval (CI) for insomnia symptoms at follow-up in 2006–2008 associated with work-related mental fatigue and leisure time physical activity at baseline. Results Women and men who always experienced mental fatigue after a workday had RRs of insomnia symptoms of 2.55 (95% CI 1.91–3.40) and 2.61 (95% CI 1.80–3.78), respectively, compared to workers who never or seldom had this experience. There was no strong modifying effect of leisure time physical activity on this association, but workers who always experienced mental fatigue had a RR of insomnia symptoms of 3.17 (95% CI 2.28–4.40) if they reported low physical activity and a RR of 2.52 (95% 1.89–3.39) if they reported high physical activity. Conclusion This study shows that work-related mental fatigue, caused by high cognitive workload, is a strong risk factor for insomnia symptoms. There was no clear modifying effect of leisure time physical activity but workers who experienced excessive work-related fatigue accompanied by low physical activity had the highest risk of insomnia symptoms.

The Effect of Environmental Changes on Hospital Employee Walking Duration

PURPOSE: Employee health is known to be associated with work-related physical exertion. The objectives of this study were to assess the effect on employee daily steps taken by transitioning a free-standing rehabilitation hospital to a larger facility and to compare step count differences across age, sex, and occupations. METHODS: Data from personal fitness devices linked to an employer-sponsored wellness program assessed the number of steps taken in two specific months (July and November) in the year prior to and in the year following the move to a rehabilitation facility three-times the size of the original. Participant data were only included for those enrolled in the program in these specific months pre- and post-move. Daily step counts accounted for activity both during and outside of work. RESULTS: Participants (n=70) had significantly less average daily steps for both July (9708 steps vs. 8008 p=0.02) and November (8839 vs. 7779 p=0.006) following the move to the new rehabilitation facility. Groups with significant step reduction included women compared to men (p=0.03), those aged 21-35 years (p=0.03), and the occupations of health care assistants (HCAs) and nursing (p=0.01), for both months. However, medical providers (physicians and nurse practitioners) had a trend towards increased step counts, regardless of age group or sex. CONCLUSION: Transitioning a rehabilitation facility to a larger building does not necessarily lead to increased employee work-related physical activity. In our study, the transition to a larger facility was associated with a reduction in employee daily steps taken with relation to age, gender, and occupation. These findings may reflect strategic planning within the new workspace, which optimizes efficiency specifically for nurses and HCAs, allowing occupational duties to be confined to a smaller area. This could lead to employees having less daily work-related physical exertion, although this will be investigated further in future studies.

A Flexor Digitorum Superficialis Tenodesis Technique for Surgical Treatment of Finger PIP Joint Volar Plate Chronic Avulsion.

Background: Chronic, post-traumatic, avulsion of the proximal interphalangeal (PIP) joint volar plate represents a disabling lesion. The purpose of this report is to describe a flexor digitorum superficialis (FDS) tenodesis using a mini-bone anchor inserted into the proximal phalanx, and its clinical outcome. Methods: 15 patients with chronic post-traumatic hyperextension instability of the PIP joint were treated surgically. From the first post-operative day patients were invited to start an early gradual joint active motion, wearing an extension block splint. Forty days after surgery, clinical evaluations were carried out, including: joint stability, pain and range of motion (ROM). The use of a circumferential splint was recommended for two further months, avoiding strenuous manual activities. The range of motion, time lost at work and the functional results were recorded six months after surgery. Results: At last follow up, 7 of the 13 reviewed patients presented an excellent functional recovery, with complete resolution of pain and stability with attainment of ROM comparable to the contralateral finger. The others 6 patients obtained good results, with remission of the functional impairment and pain, with either residual hyperextension or flexion contracture. There was one case of recurrence consecutively to a premature traumatic work-related activity. Conclusions: The FDS tenodesis via a bone anchor, combined with early active PIP joint protected motion, was shown in this study to be effective and reliable.

Long-term exposure to ambient fine particulate matter and incidence of diabetes in China: A cohort study

BackgroundDiabetes caused substantial economic and health burden worldwide. However, the associations between air pollution and diabetes incidence were rarely reported in the developing countries, especially in China with relatively high PM2.5 concentrations. ObjectivesA cohort-based study was conducted to assess the diabetes incidence associated with long-term exposure to ambient PM2.5. MethodsWe collected individual health data and risk factors from the project of Prediction for Atherosclerotic Cardiovascular Disease Risk in China (China-PAR Project) from 15 provinces over China. Diabetes was defined as fasting glucose levels ≥7.0 mmol/L at the follow-ups and/or the use of insulin or oral hypoglycemic agents and/or diagnosed medical history of diabetes during 2004 to 2015. Individual-level PM2.5 exposures were estimated from satellite-based PM2.5 concentrations (10 km spatial resolution) during the study period. Cox proportional hazards models with random intercepts of each cohort and region were employed to estimate the diabetes incidence attributable to PM2.5, after the adjustment for age, gender, body mass index, smoking status, education, work-related physical activity level, hypertension, urbanicity, county-level averaged years of education, and long-term levels of temperature and relative humidity. ResultsA total of 88,397 subjects were analyzed with 580,928 person-years of follow-up after 2004, among which 6439 new cases of diabetes were observed. The mean age of the subjects was 51.7 years at baseline. For an increase of 10 μg/m3 in long-term PM2.5 exposure, the multivariable-adjusted percent increase in the diabetes incidence was estimated to be 15.66% (95% confidence interval: 6.42%, 25.70%). The adverse effects of PM2.5 were larger among females, rural subjects, non-smokers, normotensives, subjects younger than 65 years and subjects with body mass index <25 kg/m2. ConclusionsOur findings provided evidence for the association of long-term exposure to PM2.5 with diabetes incidence in China. A sustained improvement of air quality will benefit the reduction for diabetes epidemic in China.

Nursing-Related Smartphone Activities in the Italian Nursing Population: A Descriptive Study.

In this study, we describe smartphone-related activities for nurses' work and nonwork purposes; analyzed the differences between smartphone use and nurses' age, gender, and working environment; and observed the influences that personal digital devices have on nurses' performance. We conducted a cross-sectional and correlational study. A convenience sample of nurses was recruited, composed of 256 nurses, mostly women (74.6%) younger than 30 years of age (59%). This study showed that the most frequent work-related smartphone activity was searching for work-related drug references. Smartphones also helped nurses reduce work-related stress and improve unit cohesion and teamwork. Younger nurses and male nurses were more likely than female nurses to use their digital devices during healthcare activities. In addition, 42% of nurses reported that they were distracted by the use of smartphones. If smartphones are used properly, they are certainly helpful tools for improving patient safety and enabling communication among healthcare staff. Otherwise, smartphones can constitute an important source of distraction and endanger patient safety.

Improving Physical Activity among Residents of Affordable Housing: Is Active Design Enough?

Physical inactivity increases risk of chronic disease. Few studies examine how built environment interventions increase physical activity (PA). Active design (AD) utilizes strategies in affordable housing to improve resident health. We assessed how AD housing affects PA among low-income families in Brooklyn, New York. Participants were recruited at lease signings in 2016 from a new AD apartment complex and two recently renovated comparison buildings without AD features. Eligibility included age ≥18 years with no contraindications to exercise. Anthropometric data were collected. PA was self-reported using the Recent and Global Physical Activity Questionnaires. Smartphone users shared their tracked step. Data collection was repeated one year after move-in. All data were analyzed using SPSS. Eighty-eight eligible participants completed the initial questionnaire (36 AD and 52 from 2 comparison buildings) at baseline (T0). There were no differences between AD and comparison cohorts in: stair use, PA, sitting time or, mean waist-to-hip ratio (WHR) at T0. However, the AD cohort had a lower baseline BMI (27.6 vs. 31.0, p = 0.019). At one-year follow-up (T1), 75 participants completed our survey including a 64% retention rate among those who previously completed the T0 questionnaire. Among T0 questionnaire respondents, mean daily steps increased at T1 among AD participants who moved from an elevator building (∆6782, p = 0.051) and in the comparison group (∆2960, p = 0.023). Aggregate moderate work-related activity was higher at T1 in the AD building (746 vs. 401, p = 0.031). AD building women reported more work-related PA overall but AD men engaged in more moderate recreational PA. Living in an AD building can enhance low-income residents’ PA. More research with objective measures is needed to identify strategies to sustain higher PA levels and overall health.

Ténodèse par mini-ancre du flexor digitorum superficialis pour les déformations en hyperextension de l’articulation IPP dans l’arrachement chronique de la plaque palmaire. Technnique originale

As a result of a severe sprain, the avulsion of the volar plate can lead to instability of the PIP joint. This lesion causes a finger hyperextension disabling deformity, which lead to pain and functional restriction. A late diagnosis is not infrequent and the volar plate is usually retracted or thinned, thus a functional repair has to be researched. With this goal Littler conceived a flexor digitorum superficialis tenodesis in 1959. The purpose of this report is to describe a modified Littler's technique for the correction of chronic, traumatic joint hyperextension. 15patients with a diagnosis of chronic post-traumatic hyperextension instability of the PIP joint were treated surgically in three years. The flexor sheath was incised between the A1 and A2 pulleys. The ulnar slip of the FDS was cut as proximally as possible. A minibone anchor was then placed at the centre of the P1 in a slight sidelong proximal-to-distal direction. The FDS slip was sutured to the anchor, carefully tensioning it so that the PIP joint was approximately 5–10° short of full physiological extension. The wound was covered with a slight dressing and a temporary orthoses was applied dorsally, leaving the flexion motion free. Postoperatively patients were invited to start an early gradual finger active motion, wearing an extension block splint. Forty days after surgery, clinical outpatient evaluations were carried on to evaluate joint stability, pain, range of motion. The use of an annular splint was recommended for two further months, avoiding strenuous manual activities. Two patients were lost at follow-up. At six months after surgery, 13 patients were revalued. The range of motion, time lost from work and the functional results were recorded. At last follow up, 7 of the 13 reviewed patients presented an excellent functional recovery, equivalent to complete resolution of the hyperextension and pain, attainment of ROM comparable to the contralateral finger and a stable joint. Others 6 patients obtained as well good results, with remission of the functional impairment and pain, but a residual moderate joint hyperextension or a slight PIP joint flexion contracture was observed. A case of recurrence was recorded, consecutively to a premature traumatic work-related activity. The average time lost from work was equal to 24 days. The FDS tenodesis via a bone anchor combined with early active PIP joint protected motion resulted in this trial to be effective and reliable over time.

Behavioural risk factors associated with ischemic heart disease among population attending selected cardiac hospitals of Kathmandu, Nepal

Background and Aims: Ischemic Heart Disease (IHD) is the number one cause of morbidity and mortality among the in-patient of different cardiac hospital of developing countries like Nepal. The prevalence of IHD is high with significant associated risk factors that include tobacco use, history of hypertension, family history and age. Though IHD can cause life-threatening conditions like myocardial infarction, yet it is preventable disease. The objective of the study was to study the risk factors associated with ischemic heart diseases among population attending selected cardiac hospitals of Kathmandu.Methods: Hospital- based pair matched case-control was conducted among the patients with IHD at Manmohan Cardiothoracic Vascular and Transplant Centre (MCTVC) and Shahid Gangalal National Heart Center (SGNHC). Non- random purposive sampling technique was applied and sample size was calculated as 105 (35 cases and 70 controls). Case and control were matched with age (Å} 2 years) and sex from the same hospitals. Ethical approval was taken from Institutional review board, Institute of medicine. Informed consent was obtained prior to information collection, after explaining about the purpose of the study to the entire participants. Only interested participants were included in the study. Confidentiality of the subject was ensured by collecting data in separate private room. Univariate associations between the risk factors and IHD under study was assessed by applying Chi-Square test and Fisher’s exact test and expressed as odds ratios with 95% confidence intervals. To assess the strength of association, the odds ratio was calculated.Results: 88.6% cases and 90% controls participants were of age 41 years and above and IHD was more common in male (60%) than female (40%). The participants who were not doing work-related moderate-intense activity are twice more likely to have IHD compared to controls (OR=2.276, p=0.049), similarly, hypertensive are two times (OR=2.276, p=0.049), obese are more than two times (OR=2.44, p=0.045), and participants with high waist to hip ratio are almost three times more likely to suffer from IHD (OR=2.88, p=0.013).Conclusions: The current smoking, physical inactivity, hypertension and waist to hip ratio tend to be the significant risk factors of IHD. Minimizing exposure to the identified risk factors can prevent burden of complex and expensive IHD treatment.

Physical Activity in Relation to Sleep Among Community-Dwelling Older Adults in China.

This cross-sectional study was conducted to describe the physical activity and sleep in 290 community-dwelling Chinese older adults and to examine the association between physical activity and poor sleep outcomes. Almost half of the samples were poor sleepers. The majority of the samples regularly participated in walking, some household activity, and light sports, yet only a small portion were involved in work-related activity or in strenuous sports. A greater level of overall physical activity (odds ratio = 0.79; 95% confidence interval = [0.73, 0.86]), leisure-time exercise (odds ratio = 0.77; 95% confidence interval = [0.68, 0.85]), and household activity (odds ratio = 0.66; 95% confidence interval = [0.56, 0.78]) were associated with reduced likelihood of being poor sleepers and other poor sleep outcomes, independent of covariates including age, sex, education, family income, the number of children, drinking, and sleep hygiene. Future larger-scale studies that incorporate both objective and subjective measures are needed to further examine the association and to explore the effects of different types of activity on sleep and other well-beings in older adults.

The Work Disability Functional Assessment Battery (WD-FAB): Development and validation review

Comprehensive, efficient assessment of work-related activity limitations is imperative to government disability programs and clinicians working with patients experiencing work limitations. This article describes the development and initial validation of a newly developed instrument: the Work Disability Functional Assessment Battery (WD-FAB). The WD-FAB characterises physical and mental function across 8 key dimensions related to work: Basic Mobility; Upper Body Function; Fine Motor Function; Community Mobility; Mood & Emotions; Resilience & Sociability; Self-Regulation; and Cognition & Communication. The WD-FAB draws upon a pool of over 300 items to generate scores for all 8 scales in under 15 minutes. WD-FAB scores allow direct comparisons between individuals with self-reported activity limitations and sex- and age-matched adults. Future research with the WD-FAB in both the US and Europe has potential implications for enhancing disability assessment methodologies within the context of disability determination and insurance medicine systems.

Physical Activity Patterns and Risk of Type 2 Diabetes and Metabolic Syndrome in Middle-Aged and Elderly Northern Chinese Adults

The main aim of this study is to quantitatively describe the status of physical activity and evaluate its levels in a rural population and to investigate the association between the quantifiable physical activity and type 2 diabetes and metabolic syndrome. In total, 2076 participants aged over 40 years were included in a cross-sectional analysis. Physical activity status and the contributions of different types of activity were evaluated. The association between social behaviors and physical activities was analyzed. In addition, the impact of physical activities on type 2 diabetes mellitus and metabolic syndrome was also analyzed by logistic regression. Approximately half of the total activity in rural areas consisted of work-related activity (49.3%) followed by commuting (30.2%) and recreational activity (20.5%). In rural areas, the prevalence of physical activity levels was 28.6% for low levels, 47.3% for moderate levels, and 24.1% for high levels. Educational level showed a significant negative association with the physical activity level. Lower physical activity shows a strong and significant association with type 2 diabetes and metabolic syndrome. In conclusion, insufficient physical activity among rural people over 40 years old increases the risk of type 2 diabetes and metabolic syndrome. Population-wide and individualized guidelines for physical activities especially recreational physical activities should be developed.

Recovery Colleges; how effective are they?

PurposeRecovery Colleges are education-based mental health resources, utilising practitioner and lived experience expertise, promoting skills to enhance student independence. The purpose of this paper is to evaluate the impact of engagement with a Recovery College in Northern England on student wellbeing.Design/methodology/approachFeedback questionnaires were analysed from 89 students attending the Recovery College. Short Warwick-Edinburgh Mental Wellbeing Scale (SWEMBS) and “Empower Flower” (a measure of personal resources) data for 56 students were compared pre- and post-attendance at courses.FindingsThe SWEMBS and Empower Flower indicated improvements in wellbeing and personal resources pre- to post-attendance at Recovery College courses. Satisfaction with the service was high. Students saw the service as unique, accepting and enabling. Students noted they developed a sense of hope, confidence and aspirations. They related this to practical changes, e.g. increasing work-related activity and decreasing service use.Research limitations/implicationsThis research suggests that there is a need for further evaluation of the unique contribution that Recovery Colleges can make to mental wellbeing, and the mechanisms involved in promoting the process of recovery.Practical implicationsThe Recovery College may be a cost-effective way to provide a supportive recovery-orientated environment which promotes students’ ability to build self-confidence and skills, enabling them to connect with others and progress towards independence and valued goals. This complements more traditional mental health services.Originality/valueThis paper reports on an area of mental health development where there is very limited research, adding valuable data to the literature.

Internet usage among undergraduate nursing students: A case study of a selected university in South Africa

Background: Globally, the internet is becoming an increasingly indispensable tool in academic institutions and the workplace. Nursing students are required to use the computer and the internet to search for information and to use various software, for which computer and internet literacy are essential. Despite becoming an important tool for teaching and learning, literature reflects an under-utilization of the internet in academic and non-academic settings for a number of reasons. This article explores the general internet usage of undergraduate nursing students at a selected university in South Africa.Methods: A quantitative, non-experimental, exploratory descriptive design was used, with 115 undergraduate nursing students participating in the study. Data was collected using a questionnaire survey after obtaining ethical clearance from the university’s ethics committee and were analysed descriptively.Results: The findings revealed that the internet was used for various purposes including; academic (96.5%); communication (82.6%), pleasure (71.3%), and work-related activity (53.9%). Facebook (77.4%) was the most commonly used social network. Constraints encountered in using Barriers to the use of the internet include restriction of access to certain sites (62.6%), very slow internet connection (55.7%), little training on how to use internet facilities (38.3%), and a limited number of computers (37.4%).Conclusions: Contrary to other studies, this study shows that students do use the internet for a number of reasons, and recommend structured support on how to use if for academic purposes.

Foreword

This study aimed to examine the prospective associations between total physical activity, leisure-time physical activity (LTPA), and domestic and work-related physical activity (DWPA) involving heavy physical labor, with all-cause mortality in patients with cardiovascular disease (CVD). A 7-year follow-up cohort design was used based on the data from the Taiwan 2005 National Health Interview Survey, which was linked to the 2005 to 2012 Taiwan National Health Insurance claims data. Multivariable Cox proportional hazard models were utilized to assess the associations between physical activity and all-cause mortality in 2,370 patients with CVD. Participants who achieved a volume of all physical activities of ≥1,000 kcal/week experienced lower risks of all-cause mortality than those who achieved less. Additionally, an inverse relation between LTPA and all-cause mortality was observed. Furthermore, participants who reported exertions (1 to 999 kcal/week) in DWPA had the lowest risk of all-cause mortality. This study provides evidence that patients with CVD who achieve at least a moderate volume of physical activity reduce their mortality risk. It also reveals that both LTPA and DWPA may be important contributors to the reduced risk of premature death among this clinical population.

Physical activity during work and leisure show contrasting associations with fear-avoidance beliefs: cross-sectional study among more than 10,000 wage earners of the general working population.

The association between different types of physical activity and fear-avoidance beliefs remains unclear. This study investigates the association between work-related and leisure-time physical activity with fear-avoidance beliefs in the general working population. Currently employed wage earners (n=10,427) from the 2010 round of the Danish Work Environment Cohort Study replied to questions about work, lifestyle and health. General linear models controlling for lifestyle, psychosocial work factors, education, pain, medication-use and chronic diseases tested associations of work-related and leisure-time physical activity (explanatory variables) with fear-avoidance beliefs (outcome variable, scale 0-100). The level of fear-avoidance was 41.7 (SD 27.3), 38.0 (SD 26.9) and 54.3 (SD 27.7) among the general working population, a subgroup of pain-free individuals, and a subgroup with back disease, respectively. In the general working population, the level of fear-avoidance among those with low, moderate and high physical activity during leisure were 47 [95% confidence intervals (CI) 45-49], 44 (95% CI 42-46) and 43 (95% CI 41-45), and physical activity at work were 40 (95% CI 39-42), 44 (95% CI 42-46) and 49 (95% CI 48-51), respectively. Individuals with back disease and a high level of physical activity at work showed the overall highest level of fear-avoidance whereas pain-free individuals with a low level of physical activity at work showed the overall lowest level of fear-avoidance. Physical activity during work and leisure shows contrasting associations with fear-avoidance beliefs. While high physical activity during leisure is associated with lower levels, high physical activity at work is associated with higher levels of fear-avoidance. The present results may reflect some deeply rooted negative beliefs about pain and work in the population. On the societal level, campaigns may be a possible way forward as these have shown to improve beliefs about musculoskeletal pain and work.