An effective exercise-based intervention for improving mental health and quality of life measures: a randomized controlled trial

The association between 'weekend warrior', regular exercise, and cognitive function in elderly individuals with and without depressive symptoms: A cross-sectional analysis from NHANES 2011-2014

BACKGROUND

While previous studies have suggested that both 'Weekend Warrior' (WW) and Regular Exercise (RE) patterns confer health benefits, the relationship between different types of physical activity (PA) and cognitive function (CF) in elderly individuals with and without depressive symptoms remains unclear.

METHODS

Our study leveraged the NHANES 2011-2014 dataset, focusing on older adults. We explore the relationship between PA and CF, stratifying by depressive status. Our statistical approach included multivariable regression analysis to identify relationships between PA levels and cognitive outcomes, along with advanced techniques such as smoothed curve fitting and threshold effect analysis to examine potential nonlinear associations and identify optimal PA pattern for cognitive health.

RESULTS

Analysis revealed a positive correlation between PA time and CF across all participants (β-depressive symptoms = 0.03, 95 % CI: 0.01-0.05; β-non-depressive symptoms = 0.01, 95%CI: 0.00-0.02). When comparing against the inactive, non-depressed participants partaking in WW showed improved cognitive scores (β-WW = 0.22, 95 % CI: 0.05-0.39), similar to those engaging in RE (β-RE = 0.15, 95 % CI: 0.09-0.21). However, among the depressed participants, significant cognitive improvements were observed in the RE (β-RE = 0.15, 95 % CI: 0.04-0.25), with the WW showing less definitive results (β-WW = 0.22, 95 % CI: -0.02-0.47).

LIMITATION

The cross-sectional nature limits causal inferences.

CONCLUSION

Our findings affirm the potential role of PA in enhancing CF among older subjects without depressive symptoms. However, only RE was associated with improved CF in those with depressive symptoms. These results are critical for crafting personalized PA guidelines to enhance cognitive health in the aging population.

Efficacy study comparing a CBT-I developed for shift workers (CBT-I-S) to standard CBT-I (cognitive behavioural therapy for insomnia) on sleep onset latency, total sleep time, subjective sleep quality, and daytime sleepiness: study protocol for a parallel group randomised controlled trial with online therapy groups of seven sessions each

BACKGROUND

Shift workers are at an increased risk of developing sleep disorders. The standard therapy recommended for sleep disorders is cognitive behavioural therapy for insomnia (CBT-I). Many of its interventions are based on a regular sleep and wake rhythm, which is difficult to apply for shift workers. We have therefore developed a new therapy manual specifically for shift workers (CBT-I-S), which should be more applicable to their needs. In particular, all interventions that require regularity have been removed, and instead, interventions that address factors that proved to be relevant to sleep in our preliminary study have been integrated. We now want to test this manual for its effectiveness.

METHODS

A randomised controlled trial with N = 142 will be conducted to compare two conditions: the newly developed therapy manual will be carried out in the experimental group, while cognitive behavioural therapy for insomnia will be employed in the standard group. Both treatments will be conducted online via MS Teams in a group setting with seven sessions each. Data will be collected at three measurement points (pre, post, 6-month follow-up) and analysed using linear mixed models. The study will investigate whether the two treatments have led to significant improvements in total sleep time, sleep onset latency, subjective sleep quality and daytime sleepiness in shift workers. It will also examine whether the new therapy manual is superior to standard therapy in shift workers and whether these effects are stable.

DISCUSSION

We assume that interventions designed to address depressive mood, anxiety, worry, rumination, dysfunctional thought patterns and attitudes towards sleep will also improve sleep. If this is indeed the case, these interventions could replace previous ones that require regularity. This could significantly improve the treatment of insomnia in shift workers.

TRIAL REGISTRATION

German Clinical Trials Registry DRKS DRKS00032086 . Registered on August 16, 2023.

Hypothalamic-Pituitary-Adrenal (HPA) Axis: Unveiling the Potential Mechanisms Involved in Stress-Induced Alzheimer's Disease and Depression

The hypothalamic-pituitary-adrenal (HPA) axis plays a pivotal role in the body's response to stress, orchestrating the release of glucocorticoids. In chronic scenarios, these glucocorticoids contribute to various neurological disorders, including Alzheimer's disease (AD) and depression. This abstract explores the potential mechanisms through which HPA axis dysregulation links stress-induced pathways to the pathogenesis of AD and subsequent depression. Chronic stress triggers prolonged HPA axis activation, resulting in elevated cortisol levels, which can lead to hippocampal atrophy, synaptic dysfunction, and neuroinflammation, recognized as key pathological features of AD. These alterations impair cognitive function and may exacerbate amyloid-beta plaque formation and tau hyperphosphorylation, hallmarks of AD. Concurrently, persistent cortisol elevation affects the prefrontal cortex and limbic structures, contributing to depressive symptoms. The interplay between chronic stress, HPA axis dysregulation, and neuroinflammation is crucial in understanding the comorbidity of AD and depression. Unveiling these mechanisms provides insights into potential therapeutic targets aimed at modulating the HPA axis and reducing stress-induced neurodegeneration, offering a dual benefit in managing both AD and depression. Further research is essential to elucidate the precise molecular pathways and develop effective interventions to mitigate the impact of chronic stress on brain health.

Corrigendum: What kind of intervention is effective for improving subjective well-being among workers? A systematic review and meta-analysis of randomized controlled trials

[This corrects the article DOI: 10.3389/fpsyg.2020.528656.].

Weight change and mental health status in a behavioral weight loss trial

BACKGROUND

Obesity, depression, and anxiety often co-occur, but research on weight change and mental health status is limited. This analysis examined how the mental component score (MCS-12) from the Short Form health survey changed over 24 months in weight loss trial participants with vs. without treatment seeking for affective symptoms (TxASx) and by weight change quintiles.

METHODS

Participants with complete data (n = 1163) were analyzed from enrollees in a cluster-randomized, behavioral weight loss trial in rural U.S. Midwestern primary care practices. Participants received a lifestyle intervention with different delivery models, including in-clinic individual, in-clinic group, or telephone group counseling visits. Participants were stratified by baseline TxASx status and 24-month weight change quintiles. Mixed models were used to estimate MCS-12 scores.

RESULTS

There was a significant group-by-time interaction at the 24-month follow-up. The largest 0-24 month increase in MCS-12 scores (+5.3 points [12 %]) was observed in participants with TxASx who lost the most weight during the trial, while the largest decrease in MCS-12 scores (-1.8 points [-3 %]) was observed in participants without TxASx who gained the most weight (p < 0.001).

LIMITATIONS

Notable limitations included self-reported mental health, the observational analytical design, and a largely homogenous source population, as well as the possibility of reverse causation biasing some findings.

CONCLUSIONS

Mental health status generally improved, particularly among participants with TxASx who experienced significant weight loss. Those without TxASx who gained weight, however, had a decline in mental health status over 24 months. Replication of these findings is warranted.

Mental health in relation to changes in sleep, exercise, alcohol and diet during the COVID-19 pandemic: examination of four UK cohort studies

BACKGROUND

Responses to the COVID-19 pandemic have included lockdowns and social distancing with considerable disruptions to people's lives. These changes may have particularly impacted on those with mental health problems, leading to a worsening of inequalities in the behaviours which influence health.

METHODS

We used data from four national longitudinal British cohort studies (N = 10 666). Respondents reported mental health (psychological distress and anxiety/depression symptoms) and health behaviours (alcohol, diet, physical activity and sleep) before and during the pandemic. Associations between pre-pandemic mental ill-health and pandemic mental ill-health and health behaviours were examined using logistic regression; pooled effects were estimated using meta-analysis.

RESULTS

Worse mental health was related to adverse health behaviours; effect sizes were largest for sleep, exercise and diet, and weaker for alcohol. The associations between poor mental health and adverse health behaviours were larger during the May lockdown than pre-pandemic. In September, when restrictions had eased, inequalities had largely reverted to pre-pandemic levels. A notable exception was for sleep, where differences by mental health status remained high. Risk differences for adverse sleep for those with the highest level of prior mental ill-health compared to those with the lowest were 21.2% (95% CI 16.2-26.2) before lockdown, 25.5% (20.0-30.3) in May and 28.2% (21.2-35.2) in September.

CONCLUSIONS

Taken together, our findings suggest that mental health is an increasingly important factor in health behaviour inequality in the COVID era. The promotion of mental health may thus be an important component of improving post-COVID population health.

Is cognitive behavioral therapy for insomnia (CBTi) efficacious for treating insomnia symptoms in shift workers? A systematic review and meta-analysis

Shift workers commonly report insomnia symptoms. Cognitive behavioral therapy for insomnia (CBTi) is the first line treatment for insomnia, however efficacy in shift workers is not well understood. This systematic review and meta-analysis evaluates existing trials of CBTi in shift working populations. A systematic literature search was conducted across seven electronic databases (n = 2120). Fifty-two full-text articles were reviewed and of these, nine studies (across ten publications with a total of 363 participants) were deemed suitable for inclusion. Heterogeneity was considerable between studies, with variability in study design, style and delivery of intervention, and follow-up times. Small sample sizes were common and attrition was high. Some studies modified aspects of CBTi for use in shift workers, while others were limited to psycho-education as part of larger intervention studies. Mean differences (MD) pre and post CBTi were modest for both the insomnia severity index (ISI; MD: -3.08, 95% CI: -4.39, -1.76) and the Pittsburgh sleep quality index (PSQI; MD: -2.38, 95% CI: -3.55, -1.21). Neither difference was of a magnitude considered to reflect a clinically significant improvement. Tailored approaches to CBTi are needed for shift workers to improve efficacy, ideally including co-production with workers to ensure interventions meet this population's needs.

Physical Activity and Daily Stress Processes in Older Adulthood

OBJECTIVES

Older adults who are physically active report lower levels of stress. Less is known about the links between physical activity and exposure and reactivity to stressful events in daily life. The current study examined within-person associations between actigraphy-assessed daily physical activity and exposure and affective reactivity to naturally occurring interpersonal stressors.

METHOD

Older adults (N = 180) from the Daily Experiences and Well-being Study completed ecological momentary assessments (EMAs) every 3 hr for 5-6 days where they reported negative affect throughout the day and interpersonal tensions at the end of the day. They also wore Actical accelerometers to capture physical activity.

RESULTS

Older adults reported greater numbers of interpersonal stressors on days when they spent less time being sedentary and engaged in more light physical activity. On days when older adults experienced more interpersonal stressors, they reported higher levels of negative affect, but this association was attenuated when they were more physically active that day.

DISCUSSION

Physical activity may bolster older adults' capabilities to manage affective responses to interpersonal stressors in a more successful way. These findings underscore the importance of assessing physical activity and stressful events in daily life and have implications for both physical and psychological well-being.

A computational predictor of the anaerobic mechanical power outputs from a clinical exercise stress test

We previously were able to predict the anaerobic mechanical power outputs using features taken from a maximal incremental cardiopulmonary exercise stress test (CPET). Since a standard aerobic exercise stress test (with electrocardiogram and blood pressure measurements) has no gas exchange measurement and is more popular than CPET, our goal, in the current paper, was to investigate whether features taken from a clinical exercise stress test (GXT), either submaximal or maximal, can predict the anaerobic mechanical power outputs to the same level as we found with CPET variables. We have used data taken from young healthy subjects undergoing CPET aerobic test and the Wingate anaerobic test, and developed a computational predictive algorithm, based on greedy heuristic multiple linear regression, which enabled the prediction of the anaerobic mechanical power outputs from a corresponding GXT measures (exercise test time, treadmill speed and slope). We found that for submaximal GXT of 85% age predicted HRmax, a combination of 3 and 4 variables produced a correlation of r = 0.93 and r = 0.92 with % error equal to 15 ± 3 and 16 ± 3 on the validation set between real and predicted values of the peak and mean anaerobic mechanical power outputs (p < 0.001), respectively. For maximal GXT (100% of age predicted HRmax), a combination of 4 and 2 variables produced a correlation of r = 0.92 and r = 0.94 with % error equal to 12 ± 2 and 14 ± 3 on the validation set between real and predicted values of the peak and mean anaerobic mechanical power outputs (p < 0.001), respectively. The newly developed model allows to accurately predict the anaerobic mechanical power outputs from a standard, submaximal and maximal GXT. Nevertheless, in the current study the subjects were healthy, normal individuals and therefore the assessment of additional subjects is desirable for the development of a test applicable to other populations.

Restricted cafeteria feeding and treadmill exercise improved body composition, metabolic profile and exploratory behavior in obese male rats

The aim of this study was to evaluate, in male Long-Evans rats, whether a restricted-cafeteria diet (CAFR), based on a 30% calorie restriction vs continuous ad libitum cafeteria (CAF) fed animals, administered alone or in combination with moderate treadmill exercise (12 m/min, 35 min, 5 days/week for 8 weeks), was able to ameliorate obesity and the associated risk factors induced by CAF feeding for 18 weeks and to examine the changes in circadian locomotor activity, hypothalamic-pituitary-adrenal (HPA) axis functionality, and stress response elicited by this dietary pattern. In addition to the expected increase in body weight and adiposity, and the development of metabolic dysregulations compatible with Metabolic Syndrome, CAF intake resulted in a sedentary profile assessed by the home-cage activity test, reduced baseline HPA axis activity through decreased corticosterone levels, and boosted exploratory behavior. Both CAFR alone and in combination with exercise reduced abdominal adiposity and hypercholesterolemia compared to CAF. Exercise increased baseline locomotor activity in the home-cage in all dietary groups, boosted exploratory behavior in STD and CAF, partially decreased anxiety-like behavior in CAF and CAFR, but did not affect HPA axis-related parameters.

The Relationship between Physical Activity and Health-Related Quality of Life (HINT-Eight) in Middle-Aged Korean Women

The purpose of this study was to provide basic data on health by examining the effect of HINT-eight on the physical activity of middle-aged Korean women using secondary data from the 2019 KNHANES. The subjects were 1,428 middle-aged women aged 45-64. Multiple regression was performed to verify the relationship between physical activity and HINT-eight. Following confirmation of the association between HINT-eight and physical activity, it was found that the subdomains of QOL, such as stair climbing, vitality, work, sleeping, and happiness, were connected to physical activity. Stair climbing positively affected physical activity, education level, and grip strength and negatively affected age. Pain positively affected education level and grip strength and negatively affected age. Vitality positively affected physical activity, monthly household income, and grip strength. Working positively affected education level, monthly household income, and grip strength and negatively affected age. Depression positively affected monthly household income. Memory and sleep positively affected education level and negative effect on age. Happiness positively affected physical activity and monthly household income. In this study, physical activity was found to have an effect on various factors of QOL. Physical activity in middle age is an important influencing factor on the QOL in old age; to improve the QOL in older adult, it is necessary to make efforts to improve physical activity in middle age.

Bicycle ergometer exercise during hemodialysis and its impact on quality of life, aerobic fitness and dialysis adequacy: A pilot study

BACKGROUND

Chronic kidney disease patients on hemodialysis commonly have a worse quality of life (QoL) due to complications of the disease and dialysis procedure. Physical exercise has emerged as a strategy to improve this scenario. The objective of this study was to evaluate the effect of an intradialytic aerobic exercise program on QoL and aerobic fitness in hemodialysis patients.

MATERIAL AND METHODS

These are a secondary analysis of clinical trial data previously published in which hemodialysis patients were randomized into "bike group" (using an adapted exercise bicycle) or "control group" (usual care). The exercise sessions lasted 45 min (5 min of warm-up, 35 min of moderate-intensity and 5 min of cool-down) three times/week for three months. The QoL domains were assessed using the SF-36 QoL questionnaire. Aerobic fitness was evaluated using the 6-min walk test (6MWT). Circulating cytokines, biochemical parameters and Kt/V were also assessed.

RESULTS

Nine patients completed three months of exercise (5 men, 44 ± 11 years), and nine were in the control group (6 men, 44 ± 14 years). In the bike group, there was a trend to improve the physical role domain (p = 0.06) regarding QoL, an improvement in the 6MWT (p = 0.02), and in the Kt/V (p = 0.03) after three months. There was a positive correlation between the general health domain and Kt/V (r = 0.691; p = 0.003) and an inverse correlation between the physical functioning domain and plasma TNF-α levels (r = -0.514; p = 0.04).

CONCLUSIONS

12 weeks of intradialytic aerobic exercise was enough to benefit hemodialysis patients' quality of life, aerobic fitness, and quality of dialysis.

CLINICALTRIALS

gov id: NCT04375553.

No Evidence for a Boost in Psychosocial Functioning in Older Age After a 6-Months Physical Exercise Intervention

The beneficial effects of physical exercise on physical health and cognitive functioning have been repeatedly shown. However, evidence of its effect on psychosocial functioning in healthy adults is still scarce or inconclusive. One limitation of many studies examining this link is their reliance on correlational approaches or specific subpopulations, such as clinical populations. The present study investigated the effects of a physical exercise intervention on key factors of psychosocial functioning, specifically well-being, stress, loneliness, and future time perspective. We used data from healthy, previously sedentary older adults (N = 132) who participated in a 6-month at-home intervention, either engaging in aerobic exercise or as part of a control group who participated in foreign language-learning or reading of selected native-language literature. Before and after the intervention, comprehensive cardiovascular pulmonary testing and a psychosocial questionnaire were administered. The exercise group showed significantly increased fitness compared to the control group. Contrary to expectations, however, we did not find evidence for a beneficial effect of this fitness improvement on any of the four domains of psychosocial functioning we assessed. This may be due to pronounced stability of such psychological traits in older age, especially in older adults who show high levels of well-being initially. Alternatively, it may be that the well-documented beneficial effects of physical exercise on brain structure and function, as well as cognition differ markedly from beneficial effects on psychosocial functioning. While aerobic exercise may be the driving factor for the former, positive effects on the latter may only be invoked by other aspects of exercise, for example, experiences of mastery or a feeling of community.

Physical Activity under Stress: A Perspective of HAPA and Individual Differences

Aims: Physical activity is an effective way for people to cope with stress. However, people often decrease their physical activity in response to stressors. Therefore, we aimed to understand the relationship between perceived stress and physical activity from an outcome expectancies perspective and investigated the moderating role of future orientation in this relationship. Methods: This study recruited 425 students who completed a three-wave survey at six-week intervals. A moderated mediation model was used to examine the mediating effects of outcome expectancies and the moderating effects of future orientation. Results: The results indicated that outcome expectancies mediated the relationship between perceived stress and physical activity. This relationship was moderated by future orientation. In particular, the mediating effects were significant for people with a high future orientation, but not for those with a low future orientation. Conclusion: Our results demonstrate the adaptive function of future orientation in response to general stress. Importantly, the link between perceived stress and reduced physical activity could be mitigated by encouraging people to focus on future consequences. Future studies should consider developing intervention strategies that help those struggling with stressful contexts.

A Differential Threshold of Breakfast, Caffeine and Food Groups May Be Impacting Mental Well-Being in Young Adults: The Mediation Effect of Exercise

Diet and exercise are known to influence mental health. However, the interaction between diet, dietary practices, and exercise and its impact on the mood of young adults (YA) is poorly understood. YA are inherently at risk for mental distress. They tend to consume a low-quality diet and are generally active. The purpose of the study was to assess these relationships through validating causal loop diagrams (CLD) that describe these connections by using a system dynamic (SD) modeling methodology. Adults 18-29 years were invited to complete the Food-Mood questionnaire. The anonymous questionnaire link was distributed to several institutional listservs and via several social media platforms targeting young adults. A multi-level analysis, including machine learning techniques, was used to assess these relationships. The key findings were then built into gender based CLD, which suggest that a differential repertoire may be needed to optimize diet quality, exercise, and mental well-being. Additionally, a potential net threshold for dietary factors and exercise may be needed to achieve mental well-being in young adults. Moreover, our findings suggest that exercise may boost the enhancing effect of food groups on mental well-being and may lessen the negative impact of dietary impediments of mental well-being.

The effect of scapular strengthening exercise using elastic band on balance and quality of life in the old people

The old people are weakened and misaligned due to aging, and their balance and quality of life are reduced. We investigated that the effect of scapular strengthening exercise on balance and quality of life in the old people. A scapular strengthening exercise was applied to the experimental group, and the general conditioning exercise was applied to the control group for 40 min per session, 5 times a week, for a total of 4 weeks. As a result, the static balance and Y-balance test performance improved in the experimental group (P<0.05). The physical function and mental health, and general health of 36-item Short Form health survey improved in the experimental group (P<0.05). Therefore, the scapular strengthening exercise could be suggested as an intervention method that could improve the balance and quality of life of the old people.

Customization of Diet May Promote Exercise and Improve Mental Wellbeing in Mature Adults: The Role of Exercise as a Mediator

Diet, dietary practices and exercise are modifiable risk factors for individuals living with mental distress. However, these relationships are intricate and multilayered in such a way that individual factors may influence mental health differently when combined within a pattern. Additionally, two important factors that need to be considered are gender and level of brain maturity. Therefore, it is essential to assess these modifiable risk factors based on gender and age group. The purpose of the study was to explore the combined and individual relationships between food groups, dietary practices and exercise to appreciate their association with mental distress in mature men and women. Adults 30 years and older were invited to complete the food–mood questionnaire. The anonymous questionnaire link was circulated on several social media platforms. A multi-analyses approach was used. A combination of data mining techniques, namely, a mediation regression analysis, the K-means clustering and principal component analysis as well as Spearman’s rank–order correlation were used to explore these research questions. The results suggest that women’s mental health has a higher association with dietary factors than men. Mental distress and exercise frequency were associated with different dietary and lifestyle patterns, which support the concept of customizing diet and lifestyle factors to improve mental wellbeing.

Universal and Selective Interventions to Prevent Poor Mental Health Outcomes in Young People: Systematic Review and Meta-analysis

BACKGROUND

Much is not known about the efficacy of interventions to prevent poor mental health outcomes in young people by targeting either the general population (universal prevention) or asymptomatic individuals with high risk of developing a mental disorder (selective prevention).

METHODS

We conducted a PRISMA/MOOSE-compliant systematic review and meta-analysis of Web of Science to identify studies comparing post-test efficacy (effect size [ES]; Hedges' g) of universal or selective interventions for poor mental health outcomes versus control groups, in samples with mean age <35 years (PROSPERO: CRD42018102143). Measurements included random-effects models, I2 statistics, publication bias, meta-regression, sensitivity analyses, quality assessments, number needed to treat, and population impact number.

RESULTS

295 articles (447,206 individuals; mean age = 15.4) appraising 17 poor mental health outcomes were included. Compared to control conditions, universal and selective interventions improved (in descending magnitude order) interpersonal violence, general psychological distress, alcohol use, anxiety features, affective symptoms, other emotional and behavioral problems, consequences of alcohol use, posttraumatic stress disorder features, conduct problems, tobacco use, externalizing behaviors, attention-deficit/hyperactivity disorder features, and cannabis use, but not eating-related problems, impaired functioning, internalizing behavior, or sleep-related problems. Psychoeducation had the highest effect size for ADHD features, affective symptoms, and interpersonal violence. Psychotherapy had the highest effect size for anxiety features.

CONCLUSION

Universal and selective preventive interventions for young individuals are feasible and can improve poor mental health outcomes.

Combined Chair-Based Exercises Improve Functional Fitness, Mental Well-Being, Salivary Steroid Balance, and Anti-microbial Activity in Pre-frail Older Women

Introduction

Regular exercise has long been shown to positively impact the immune system responsiveness and improve mental well-being (MWB). However, the putative links between biomarkers of mental health and immune efficiency in exercising subjects have been scarcely investigated. The aim of this study was to verify the effect of a 14-week combined chair-based exercise program (CEP) on salivary steroid hormones and anti-microbial proteins, functional fitness, and MWB indexes in pre-frail older women.

Methods

The participant women (82.8 4.6 years old; n = 32) were randomly divided into the exercising group (CEP, n = 17) and the non-exercising control group (CG, n = 15). The pre/post assessment included: (1) salivary anti-microbial proteins lysozyme; (Lys) and immunoglobulin-A (IgA); (2) salivary steroid hormones of testosterone (TT) and cortisol (COR); (3) functional fitness (gait speed, hand grip strength, and static balance); (4) MWB questionnaires (happiness, depression state, satisfaction with life, and stress).

Results

Significant differences with large Cohen's (d) effect sizes were found on increased salivary TT (p < 0.05; d = 0.60) after exercise intervention. The results revealed a decrease in IgA levels after CEP (p < 0.01, d = 0.30). The increase in subjective happiness levels (p < 0.05, d = 0.30) and decrease of stress perception (p < 0.01, d = 2.60) and depressive state (p < 0.05, d = 0.30) were found after intervention in the CEP group. Robust statistical differences in gait speed (p < 0.05; d = 0.60) and balance tests (p < 0.05; d = 0.80) were also found in the CEP group. In control, COR increased moderately (p < 0.05; d = 0.65) while no changes were found for the other indicators. Correlation analyses showed inter-dependence between pre-post variations of MWB, biochemical indexes, and fitness function (e.g., COR inverse correlation with hand grip strength and balance tests).

Conclusion

The CEP program was able to improve functional-fitness performance, decrease feelings of stress, and increase happiness. The CEP also induced clinically relevant hormonal and immune responses, which suggests that chair exercises that combine muscular strength, balance, and gait speed training are promising interventions to improve physical and mental health of older pre-frail adults.

The Importance of Nature Exposure and Physical Activity for Psychological Health and Stress Perception: Evidence From the First Lockdown Period During the Coronavirus Pandemic 2020 in France and Germany

Objective: This cross-sectional questionnaire-based study aims to compare physical activity and nature exposure levels between people living in France and Germany during the lockdown. Furthermore, the secondary aim is to observe the relationship between perceived stress, psychological health, physical activity, and nature exposure in Germany and France during the coronavirus disease 2019 (COVID-19)-related lockdown of April/May 2020. Methods: The study includes 419 participants who have completed the Perceived Stress Scale 10, the World Health Organization Quality of Life-BREF, the Godin-Shephard Leisure-Time Physical Activity Questionnaire, the modified Nature Exposure Scale, and complementary questions related to the lockdown period from April 19 to May 11, 2020. Multiple regression models were constructed to evaluate the relationship of nature exposure and physical exercise with overall stress perception and psychological health in France and Germany when considering a broad range of covariates. Results: Exposure to nature during the lockdown (ηp 2 = 0.034, p < 0.001), amount of physical activity ηp 2 = 0.014, p < 0.001), and psychological health (ηp 2 = 0.041, p < 0.001) were greater in German compared with French participants. Godin Index and Nature Exposure Scale total score were both inversely correlated to stress perception and positively correlated to psychological health. The stress and psychological health regression models explained 10% of the results' variance. Physical activity (Godin Index) was a significant for both models. Nature Exposure Scale total score was a significant predictor only for psychological health. When including all significant covariates, the regression models explained 30.7% for the perceived stress and 42.1% for the psychological health total overall variance. Conclusion: Physical activity and nature exposure are significant predictors of psychological health. Even though both variables are associated with stress perception, only physical activity is a significant predictor of stress perception. Our results suggest that physical activity and nature exposure were key factors to go through the lockdown period in France and Germany.

Mediating Effect of Perceived Stress on the Association between Physical Activity and Sleep Quality among Chinese College Students

BACKGROUND

While physical activity has been reported to positively affect stress and sleep quality, less is known about the potential relationships among them. The present study aimed to investigate the mediating effect of stress on the association between physical activity and sleep quality in Chinese college students, after controlling for age, nationality, and tobacco and alcohol use.

PARTICIPANTS

The sample comprised 6973 college students representing three Chinese universities.

METHODS

Physical activity, perceived stress, and sleep quality were respectively measured using the International Physical Activity Questionnaire-Short Form (IPAQ-SF), Perceived Stress Scale-10 Items (PSS-10), and Pittsburgh Sleep Quality Index (PSQI).

RESULTS

Mediating effects of perceived stress on the association between physical activity and sleep quality were observed in males and females, with 42.4% (partial mediating effect) and 306.3% (complete mediating effect) as percentages of mediation, respectively.

CONCLUSION

The results of this study may provide some suggestions that physical activity could improve sleep by aiding individuals in coping with stress and indicate that stress management might be an effective non-pharmaceutical therapy for sleep improvement.

What Kind of Intervention Is Effective for Improving Subjective Well-Being Among Workers? A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Objectives: This study aimed to conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) to improve subjective well-being (SWB), including evaluative, hedonic, and eudemonic well-being, and the mental component of quality of life (QOL) of working population. Methods: A literature search was conducted, using PubMed, Embase, PsycINFO, and PsycARTICLES. Eligible studies included those that were RCTs of any intervention, conducted among healthy workers, measured SWB as a primary outcome, and original articles in English. Study characteristics, intervention, outcomes, and results on SWB outcomes were extracted by the investigators independently. After a brief narrative summarizing and classifying the contents of the interventions, the included outcomes were categorized into each aspect of SWB (evaluative, hedonic, and eudemonic well-being, and the mental component of QOL). Finally, the characteristics of the effective interventions for increasing each aspect were summarized, and the pooled effect of interventions on SWB was investigated by a meta-analysis. Publication bias was investigated by drawing a funnel plot and conducting Egger's test. Results: From the 5,450 articles found, 39 met the inclusion criteria for the systematic review. The interventions included in this review were classified into six categories (physical activity, ergonomics, psychological, environmental, multicomponent intervention, and others). The meta-analysis from 31 studies showed that the pooled effect of included interventions on SWB was significantly positive (standardized mean difference (SMD) = 0.51; standard error (SE) = 0.10). A funnel plot showed there were extremely large or small SMDs, and Egger's test was significant. Thus, we conducted sensitivity analysis, excluding these extreme SMDs, and confirmed that the estimated pooled effect was also significantly positive. Subgroup analyses for separate types of interventions showed the effects of psychological interventions (e.g., mindfulness, cognitive behavioral based approach, and other psychological interventions) were also significantly positive. Conclusion: The current study revealed the effectiveness of interventions for increasing SWB. Specifically, psychological interventions (e.g., mindfulness, cognitive behavioral based approach, and other psychological interventions) may be useful for improving SWB.

Effects of a work-related stress model based mental health promotion program on job stress, stress reactions and coping profiles of women workers: a control groups study

BACKGROUND

Work-related stress and its detrimental effects on human health have rapidly increased during the past several years. It causes many different stress reactions, related diseases and unhealthy behavior among workers, but especially women workers. Thus, the aim of this study was to examine the effects of the work-related stress model based Workplace Mental Health Promotion Programme on the job stress, social support, reactions, salivary immunoglobulin A and Cortisol levels, work absenteeism, job performance and coping profiles of women workers.

METHODS

This study had a "pre-test post-test non-equivalent control groups" design and included 70 women workers (35 in each study group) selected by randomized sampling from two factories. The programme was delivered as an intervention including 12 weeks of follow-up. Reminder messages, videos, and WhatsApp texts were used at the follow-up stage. The research measurements were; the assessment form, the Brief Job Stress Questionnaire, the Brief Coping Profile Scale, salivary ELISA kits, and a self-reported check-list.

RESULTS

There were no differences in sociodemographic characteristics, general health or working conditions between the Intervention and control groups(p > .05). Three months after the intervention, there was a significant decrease in job stress(p ≤ .001), physical and mental reactions' scores(p ≤ .001) and work absenteeism(p < .05), and there was an increase in job performance(p < .05), social support(p ≤ .001) among the intervention group. The programme showed positive effects on coping profiles(p < .05). After the intervention salivary-cortisol and IgA levels showed a statistically significant decrease(p < .05). A majority of effect sizes were very large (ηp2 > .14).

CONCLUSIONS

Work-ProMentH was found to be effective and useful in job stress management and promotion of effective coping profiles. It enables its users to holistically assess worker stress and to plan and examine intervention programmes via a systematic approach. There is a need for more empirical studies that may support the data of the present study, but it is thought that the intervention can be maintained for the long-term. We recommend that occupational health professionals at workplaces should consider using this model-based cost-effective intervention, which seems easy and practical to apply in real-life situations.

TRIAL REGISTRATION

ISRCTN registration ID: ISRCTN14333710 (2020/10/03, retrospective registration).

Exercise interventions for the prevention of depression: a systematic review of meta-analyses

BACKGROUND

Exercise may be a promising target for depression interventions. However, evidence for a beneficial effect of exercise interventions on the prevention of depression differs substantially across different studies.

METHODS

A systematic search was performed up to July 2018 using PubMed, Embase, PsycINFO, and Cochrane. Articles were included if a meta-analysis of randomized controlled trials was performed that examined the effect of exercise interventions on the onset of depression or depressive symptoms in the general population. Meta-analyses focusing on treatment of diagnosed depression were excluded. Two authors independently screened the articles and graded the quality of included meta-analyses using AMSTAR 2.

RESULTS

Eight meta-analyses were included that showed little overlap in 134 included studies. All meta-analyses reported on depressive symptoms rather than onset of depression. Five of these were rated as moderate quality and three of low quality. Six meta-analyses found significant effects, and two found non-significant effects of exercise interventions in reducing depressive symptoms in children, adolescents, adults and the elderly (effect sizes ranging from - 0.10 to - 0.81). Scarce evidence did not allow to draw conclusions about the role of sex and characteristics of exercise on depression. However, some findings suggest that low intensity exercise was as effective as high intensity exercise. Heterogeneity among primary studies was high, likely caused by differences in study quality and exercise characteristics.

CONCLUSIONS

The evidence from this study suggests that exercise interventions have a beneficial effect on depressive symptoms in the general population across a wide age-range.

Association between type of exercise and health-related quality of life in adults without activity limitations: a nationwide cross-sectional study

BACKGROUND

Exercise is known to be associated with health-related quality of life (HRQoL), however, evidence on the association between type of exercise and HRQoL in the general population is limited. We performed this study to investigate the association of exercise types and their combinations with HRQoL in Korean adults.

METHODS

We analyzed data from 13,437 adults aged ≥19 years without activity limitations who had participated in the 5th Korea National Health and Nutrition Examination Survey 2010-2012. As per the American College of Sports Medicine guideline, exercise types were categorized into eight groups: walking (W), flexibility (F), resistance (R), W + F, W + R, F + R, and W + F + R exercise groups and a non-exercise group. The European Quality of Life-5 Dimension (EQ-5D) index and the European Quality of Life Visual Analogue Scale (EQ-VAS) were used to assess HRQoL.

RESULTS

The mean age of participants was 42.8 ± 0.2 years. The proportion of participants in the non-exercise group was the highest (34.7%); among the exercise groups, the walking group was the most prevalent (16.9%) and the W + R group was the least (1.2%). In analysis of covariance, the mean EQ-5D index in W (0.875), W + F (0.878), F + R (0.877), and W + F + R (0.876) groups was significantly higher compared with that in non-exerciser group (0.869) (p < 0.05). The mean EQ-VAS score in the W (64.064), F (64.427), W + F (65.676), F + R (65.811), and W + F + R (67.110) groups was higher than that in the non-exercise group (62.396) (p < 0.05). No difference was observed between R and W + R groups and non-exercise group with regard to the EQ-5D index and EQ-VAS score.

CONCLUSIONS

The W (for 30 min at least five times a week), W + F, F + R (at least two days a week), and W + F + R groups showed higher HRQoL than the non-exercise group. This study may be helpful in the development of public exercise interventions, which could help enhance HRQoL in adults.

Relationship of workplace exercise with work engagement and psychological distress in employees: A cross-sectional study from the MYLS study

We investigated the relationship between workplace exercise and psychological distress, and work engagement, both of which are factors related to the mental health and work productivity of employees. Data from the Meiji Yasuda Lifestyle study, collected from July 2017 through December 2017, were used. Data from an annual health checkup and questionnaire were collected from the Meiji Yasuda Shinjuku Medical Center in Tokyo, Japan. The 1321 participants (mean age: 50.8 ± 9.5 years, rate of female: 68.2%, rate of white-collar workers: 64.7%) were divided into three groups based on the frequency of performing workplace exercise: less than once, once or twice, and three or more times a week. Vigor of work engagement and psychological distress were assessed using the Utrecht Work Engagement Scale and Kessler Psychological Distress Scale (K6). Logistic regression analyses were performed to examine relationships between workplace exercise frequencies and work engagement or psychological distress. Demographic variables, health behaviors, health status, work characteristics, and objectively measured physical activity and sedentary behavior were adjusted for odds ratio (OR) and 95% confidence interval (95% CI). Participants who performed workplace exercise once or twice and three or more times a week showed a significantly higher OR (OR = 1.93, 95% CI = 1.00-3.71, p = 0.049, OR = 1.63, 95% CI = 1.23-2.15, p = 0.001, respectively) for vigor of work engagement. Neither groups of workplace exercise showed a significant OR for psychological distress even when adjusted for covariates. The practice of workplace exercise is positively and independently related to vigor of work engagements of physical activity and sedentary behavior, and the association was observed regardless of the frequency of once or twice, or three or more times a week. Workplace exercise, however, does not correlate with psychological distress. Our findings indicated that workplace exercise at least once or twice a week could have practical implications for the enhancement of vigor of work engagement, especially among white-collar workers.

Effects of morning vs. evening combined strength and endurance training on physical performance, sleep and well-being

The aim of the present study was to examine how combined strength and endurance training in the morning and evening influences the adaptations in strength and endurance performance, perception of time management, psychological well-being and sleep. The combined training period lasted for 24 weeks and the participants were divided into the morning training (MG, n = 18), evening training (EG, n = 24) and control groups (CG, n = 10). Isometric leg press force (iLP), maximal oxygen consumption (VO₂max), sleep behavior, fatigue, time management, motivation, self-esteem and health-related quality of life (HRQoL) were assessed. Morning to evening difference in iLP was observed in both MG and EG at Pre and Post, with higher force values in the evening, but not for VO₂max. iLP force increased significantly in EG in the morning (p < 0.001) and evening (p = 0.010). VO₂max increased in MG and EG both in the morning (both p < 0.001) and in the evening (MG: p < 0.001; EG: p = 0.003). Participants of the present study slept 7-8 h per night and the self-reported sleep duration, get-up time and the average time to go to bed were similar between the groups and did not change from Pre to Post. From HRQoL dimensions, the score for bodily pain decreased in MG (p = 0.029) and significant between-group differences were observed for Pre-Post changes in MG and EG (p = 0.001) as well as between MG and CG (p < 0.001). In vitality, a significant between-group difference was observed for Pre to Post changes in MG and EG (p = 0.014). Perception of time management decreased in EG (p = 0.042) but stayed unchanged for MG and CG. For the intrinsic motivation to participate, significant between-group differences were observed for MG and EG (p = 0.033) and between MG and CG (p = 0.032) for Pre to Post changes. Self-esteem improved in MG (p = 0.029) and EG (p = 0.024). The present combined strength and endurance training program performed in the morning and in the evening led to similar improvements in strength and endurance performance. Training in the morning or in the evening did not disrupt the already good sleep behavior and it was able to further increase the self-esteem. Although training in the morning hours may leave more time for free time activities or social life (i.e. family and friends) compared to the evening training, it might be more challenging to stay motivated to participate in prolonged training programs in the morning hours.

Indicated Prevention Interventions in the Workplace for Depressive Symptoms: A Systematic Review and Meta-analysis

CONTEXT

Depressive symptoms are highly prevalent and cause substantive morbidities and loss of functioning among employees. Depression may be prevented at its early stages. However, there is a paucity of information regarding indicated preventive interventions for depression among employees. The objective of this review is to examine the effectiveness of indicated interventions for the reduction of depressive symptoms in the workplace.

EVIDENCE ACQUISITION

A systematic review and meta-analysis of articles published between January 2000 and September 2017 was conducted using major electronic databases, including PubMed/MEDLINE, PsycINFO, EMBASE, SOCINDEX, and ABI/ProQuest. Studies were selected based on a set of predefined inclusion criteria. Primary outcome measures were depressive symptomatology, and the interventions were preventive in nature. Studies were pooled based on the intervention type and the effect size was measured using the standardized mean difference.

EVIDENCE SYNTHESIS

A computer and hand search of the literature yielded 4,462 papers, from which 16 trials were identified to be suitable for meta-analysis. Eight of 16 studies reported significant effects for workplace preventive interventions targeting depressive symptoms in which six were cognitive behavioral therapy (CBT)-based interventions and two were non-CBT-based interventions. Small to medium effect sizes were found for both CBT- and non-CBT-based interventions (standardized mean difference= -0.44, 95% CI= -0.61, -0.26, I²=62.1% and standardized mean difference= -0.32, 95% CI= -0.59, -0.06, I²=58%, respectively).

CONCLUSIONS

This review demonstrates that indicated interventions can significantly reduce the level of depressive symptoms among workers. The implementation of evidence-based workplace interventions should consequently be considered to prevent the development of depressive symptoms among employees.

The effect of the type of physical activity on the perceived stress level in people with activity limitations

The purpose of this study was to investigate the effect of the type of physical activity that people with activity limitations participate in on their perceived stress level. We analyzed the data of the Korean National Health and Nutrition Examination Survey (KNHANES) conducted annually from 2007 to 2015. The subjects of the study were adults aged 19 or older who had activity limitations. The data analysis was done using the SPSS ver. 18.0 program, and complex sampling design frequencies analysis and logistic regression analysis were conducted. The statistical significance level was set at P<0.05. The results of this study are as follows: First, in the case of males with activity limitations, the odds ratio (OR) for the perceived stress level for those who participated in walking exercise compared to those who did not was 0.707 (95% confidence interval [CI], 0.535–0.934; P<0.05). Second, for males with activity limitations, the OR for the perceived stress level for those who participated in walking exercise for 5 days or more compared to the nonparticipation group was 0.630 (95% CI, 0.472–0.841; P<0.05). Third, for females with activity limitations, the OR for the perceived stress level for those who participated in flexibility exercise compared to those who did not was 0.869 (95% CI, 0.727–1.039; P<0.05). Fourth, for females with activity limitations, the OR for the perceived stress level for those who participated in flexibility exercise for 5 days or more compared to the nonparticipation group was 0.672 (95% CI, 0.539–0.838; P<0.05).

Decreasing Physical Inactivity in the Veterans Health Administration Employee Population

OBJECTIVE

The aim of this study was to describe a comprehensive approach to decrease physical inactivity in the Veterans Health Administration (VHA) employee population.

METHODS

The approach included (1) initiatives to decrease physical inactivity in the workplace; (2) two operational surveys to assess system-wide service provision; and (3) two national employee surveys.

RESULTS

From 2010 to 2012, 86 employee fitness centers were completed in VA medical centers. A grants program (2010 to 2015) funded smaller projects designed to decrease physical inactivity in the workplace. Projects involved the provision of equipment to decrease sedentary behaviors, including stability balls, treadmill and sit-to-stand desks, stairwell projects, and funding for on-site fitness classes, bicycle racks, and outdoor par courses and walking paths among others.

CONCLUSIONS

A comprehensive approach to decrease physical inactivity in VHA employees was successful. Overall, self-reported, age-adjusted physical inactivity in VHA employees decreased from 25.3% in 2010 to 16.1% in 2015.

The roles of health culture and physical environment in workplace health promotion: a two-year prospective intervention study in China

BACKGROUND

To understand the potential influencing factors on the effectiveness of workplace health promotion interventions and examine whether workplace health culture and physical environment can mediate the relationship between workplace health promotion and intervention effectiveness.

METHODS

A total of 719 participants from 10 Chinese government agencies were recruited for a prospective self-controlled trial. Questionnaires, qualitative interviews, and direct observation were used for the baseline evaluation, process evaluation, and effectiveness evaluation. Based on the results of the need assessment and risk assessment at each workplace, a two-year comprehensive health intervention was conducted by each workplace. Health outcomes including self-rated health (SRH) and mental health were measured at baseline and 24 months. Health culture was measured at 24 months. Physical environment and intervention implementation were measured at 12 months and 24 months.

RESULTS

Compared with the baseline, the means of SRH and mental health increased significantly by 0.302 and 2.698, respectively. The SRH scores were different before and after intervention; furthermore, the differences varied by workplace. Health culture mediated the relationship between intervention implementation and intervention effectiveness, including SRH and mental health improvement, but physical environment did not. Physical environment quality was significantly negatively correlated with SRH improvement and mental health improvement. Under the relatively high-quality interventions with scores higher than 4.047 or 4.151 (out of 5), better health culture may led to greater SRH and mental health improvements.

CONCLUSIONS

Health culture may mediate the relationship between intervention implementation and intervention effectiveness, whereas physical environment does not seem to mediate this relationship. Under relatively high-quality interventions, a better health culture may lead to more positive improvements in SRH and mental health. Future studies will need to examine the physical environment as a moderating effect rather than mediating effect.

TRIAL REGISTRATION

This study was retrospectively registered in Chinese Clinical Trial Registry.

TRIAL REGISTRATION NUMBER

ChiCTR-OOC-16010059 . Date of registration: Dec 1, 2016.

Role and Value of the Corporate Medical Director

: The role of the corporate medical director (CMD) has evolved over the last 300 years since Ramazzini first identified diseases of Italian workers in the early 1700s. Since then, there has been a gradual blurring of the boundaries between private and workplace health concerns. Today's CMD must have intimate knowledge of their corporation's industry and the businesses that they support, particularly the occupational and environmental programs that comply with all local, state, and/or national standards and regulations. Leading companies not only measure compliance with such standards but also may hold programs to their own internal corporate global standards even if these go beyond local government requirements. This document will explore in greater depth the strength and importance that the CMD brings to the business operations to support a healthy, engaged, and high performing workforce. Part 1 describes the role and value of the CMD, while Part 2 provides collective wisdom for the new CMD from current and past highly experienced CMDs.

A Role for Exercise in Attenuating Unhealthy Food Consumption in Response to Stress

It is well established that both acute and chronic stress can be detrimental to health and wellbeing by directly increasing the risk of several chronic diseases and related health problems. In addition, stress may contribute to ill-health indirectly via its downstream effects on individuals’ health-related behaviour, such as promoting the intake of unhealthy palatable foods high in fat and sugar content. This paper reviews (a) the research literature on stress-models; (b) recent research investigating stress-induced eating and (c) the potential physiological and psychological pathways contributing to stress-induced eating. Particular attention is given to (d) the role of physical exercise in attenuating acute stress, with exploration of potential mechanisms through which exercise may reduce unhealthy food and drink consumption subsequent to stressor exposure. Finally, exercise motivation is discussed as an important psychological influence over the capacity for physical exercise to attenuate unhealthy food and drink consumption after exposure to stressors. This paper aims to provide a better understanding of how physical exercise might alleviate stress-induced unhealthy food choices.

Assessment of dietary factors, dietary practices and exercise on mental distress in young adults versus matured adults: A cross-sectional study

The importance of the diet in modulating mental health is uncovering as many dietary factors have been described to alter brain chemistry. Brain maturation may not complete until the age of 30 which may explain the differential emotional control, mindset, and resilience between young adults and matured adults. As a result, dietary factors may influence mental health differently in these two populations.

OBJECTIVES

To study dietary intake, dietary practices and exercise in young adults (YA) (18-29 years) versus matured adults (MA) (30 years and older) in relation to mental distress. Another aim was to assess whether mental well-being potentially stimulates healthy eating, healthy practices, and exercising.

METHODS

An anonymous internet-based survey was sent through social media platforms to different professional and social group networks. Best-fit models were constructed using the backward regression analysis to assess the relationship between dietary variables, exercise, and mental distress in YA versus MA.

RESULTS

YA mood seems to be dependent on food that increases availability of neurotransmitter precursors and concentrations in the brain (such as frequent meat consumption and exercise, respectively). However, MA mood may be more reliant on food that increases availability of antioxidants (fruits) and abstinence of food that inappropriately activates the sympathetic nervous system (coffee, high glycemic index, and skipping breakfast).

DISCUSSION AND CONCLUSION

Level of brain maturation and age-related changes in brain morphology and functions may necessitate dietary adjustments for improving mental well-being.

Association between Style of Living and General Health in Suburban Women: A Cross-sectional Study in South East of Iran

INTRODUCTION

In developing countries, suburban population is increasing. However, their health issues are rarely considered in studies. Socioeconomic and environmental factors in their neighbourhood can affect their lifestyle and health. Compared to men, women have fewer social resources and are more susceptible to an unfavourable environment, in general.

AIM

To investigate the association between lifestyle and general health status in suburban women.

MATERIALS AND METHODS

This correlation, cross-sectional study assessed the lifestyle and general health, among suburban women living in Shirabad neighbourhood, Zahedan, Iran. Randomized one stage cluster sampling was used and 132 people participated in the study. Lifestyle Questionnaire (LSQ) and General Health Questionnaire-28 (GHQ-28) were used for data collection. For data analysis, descriptive statistical methods, Pearson's correlation coefficient and multivariate regression analysis were performed.

RESULTS

Mean score of LSQ was 100.23±20.45 and mean GHQ-28 score was 28.46±16.41. There was a significant negative relationship between lifestyle and GHQ-28 total score (r=-0.619, p=0.01). Multivariate regression analysis showed that among predictor variables, education, sports and fitness and psychological health components had a significant relationship with GHQ-28 (p<0.001, p=0.01, p=0.002 respectively).

CONCLUSION

This study demonstrated that suburban women have poor lifestyle and health status. Also, it showed a significant relationship between education, sports and fitness and psychological health components and health. As a result, implementation of programs to modify lifestyle especially in the field of sports and improving the educational level could be useful in promoting women's health.

Sintomas osteomusculares e qualidade de vida em costureiras do município de Indaial, Santa Catarina

RESUMO Os problemas de saúde decorrentes da relação de trabalho têm se tornado um fenômeno mundial. O objetivo deste estudo foi avaliar os sintomas osteomusculares e a qualidade de vida em profissionais do ramo da costura no município de Indaial (SC). Trata-se de um estudo de natureza transversal com abordagem quantitativa. A amostra foi constituída por 118 costureiras de 48 empresas que responderam a três questionários: um sociodemográfico, outro de sintomas osteomusculares e um de qualidade de vida. Das costureiras avaliadas, 71,1% apresentaram sintomas osteomusculares nos últimos sete dias e 88,1% nos últimos doze meses. A região corporal mais afetada de acordo com a maioria dos relatos foi a dos ombros (18,6%) e as causas de afastamento foram as dores dorsais e lombares (cada uma correspondendo a 19,1% dos casos). O domínio de qualidade de vida mais comprometido foi o estado geral de saúde (57,03±16,08), seguido pelos de vitalidade (58,89±17,65), dor (60,53±22,28), saúde mental (66,81±19,19), aspectos emocionais (67,72±38,29), aspectos físicos (73,94±32,91), aspectos sociais (75,63±23,10) e capacidade funcional (77,16±19,19). Percebe-se que quanto maior o escore de qualidade de vida, menor o número de regiões anatômicas com dor. A associação de medidas preventivas ao trabalhar, como períodos de micropausas, atenção para posturas corretas e ginástica laboral, podem influenciar a redução de dor e prevenção de doenças, como também aprimorar a qualidade de vida.

Effect of Lavender Oil Aroma in the Early Hours of Postpartum Period on Maternal Pains, Fatigue, and Mood: A Randomized Clinical Trial

BACKGROUND

Busy care providers focus on the serious complications of postpartum period. This issue causes the seemingly trivial complications, such as mother's pains, fatigue, and psychological status, to be less taken into account. The study aimed to determine the effect of lavender oil aroma in the early hours of postpartum period on maternal pains, fatigue, and mood in primiparous mothers.

METHODS

This randomized clinical trial was conducted on 56 participants; 29 in intervention group and 27 in control group. The intervention group received lavender oil in three doses during the first 24 h after delivery. Sesame oil was used in the control group. Intensity of pain, fatigue, and distress level was measured by visual analog scale before and after the interventions. Besides, mood status was assessed through the positive and negative affect schedule.

RESULTS

The mean age of all the participants was 23.88 ± 3.88 years. After the first intervention and also in the tomorrow morning assessment, significant differences were found between the two groups regarding perineal pain (P = 0.004, P < 0.001), physical pain (P < 0.001), fatigue (P = 0.02, P < 0.001), and distress scores (P < 0.001). In addition, significant differences were found concerning the mean scores of positive (P < 0.001) and negative (P = 0.007, P < 0.001) moods between the two groups after the interventions. Repeated measures analyses showed that the two groups were significantly different over time in all the evaluated variables.

CONCLUSIONS

Lavender oil aromatherapy starting in the first hours of postpartum period resulted in better physical and mood status compared to nonaromatic group.

Person-directed, non-pharmacological interventions for sleepiness at work and sleep disturbances caused by shift work

BACKGROUND

Shift work is often associated with sleepiness and sleep disorders. Person-directed, non-pharmacological interventions may positively influence the impact of shift work on sleep, thereby improving workers' well-being, safety, and health.

OBJECTIVES

To assess the effects of person-directed, non-pharmacological interventions for reducing sleepiness at work and improving the length and quality of sleep between shifts for shift workers.

SEARCH METHODS

We searched CENTRAL, MEDLINE Ovid, Embase, Web of Knowledge, ProQuest, PsycINFO, OpenGrey, and OSH-UPDATE from inception to August 2015. We also screened reference lists and conference proceedings and searched the World Health Organization (WHO) Trial register. We contacted experts to obtain unpublished data.

SELECTION CRITERIA

Randomised controlled trials (RCTs) (including cross-over designs) that investigated the effect of any person-directed, non-pharmacological intervention on sleepiness on-shift or sleep length and sleep quality off-shift in shift workers who also work nights.

DATA COLLECTION AND ANALYSIS

At least two authors screened titles and abstracts for relevant studies, extracted data, and assessed risk of bias. We contacted authors to obtain missing information. We conducted meta-analyses when pooling of studies was possible.

MAIN RESULTS

We included 17 relevant trials (with 556 review-relevant participants) which we categorised into three types of interventions: (1) various exposures to bright light (n = 10); (2) various opportunities for napping (n = 4); and (3) other interventions, such as physical exercise or sleep education (n = 3). In most instances, the studies were too heterogeneous to pool. Most of the comparisons yielded low to very low quality evidence. Only one comparison provided moderate quality evidence. Overall, the included studies' results were inconclusive. We present the results regarding sleepiness below. Bright light Combining two comparable studies (with 184 participants altogether) that investigated the effect of bright light during the night on sleepiness during a shift, revealed a mean reduction 0.83 score points of sleepiness (measured via the Stanford Sleepiness Scale (SSS) (95% confidence interval (CI) -1.3 to -0.36, very low quality evidence). Another trial did not find a significant difference in overall sleepiness on another sleepiness scale (16 participants, low quality evidence).Bright light during the night plus sunglasses at dawn did not significantly influence sleepiness compared to normal light (1 study, 17 participants, assessment via reaction time, very low quality evidence).Bright light during the day shift did not significantly reduce sleepiness during the day compared to normal light (1 trial, 61 participants, subjective assessment, low quality evidence) or compared to normal light plus placebo capsule (1 trial, 12 participants, assessment via reaction time, very low quality evidence). Napping during the night shiftA meta-analysis on a single nap opportunity and the effect on the mean reaction time as a surrogate for sleepiness, resulted in a 11.87 ms reduction (95% CI 31.94 to -8.2, very low quality evidence). Two other studies also reported statistically non-significant decreases in reaction time (1 study seven participants; 1 study 49 participants, very low quality evidence).A two-nap opportunity resulted in a statistically non-significant increase of sleepiness (subjective assessment) in one study (mean difference (MD) 2.32, 95% CI -24.74 to 29.38, 1 study, 15 participants, low quality evidence). Other interventionsPhysical exercise and sleep education interventions showed promise, but sufficient data to draw conclusions are lacking.

AUTHORS' CONCLUSIONS

Given the methodological diversity of the included studies, in terms of interventions, settings, and assessment tools, their limited reporting and the very low to low quality of the evidence they present, it is not possible to determine whether shift workers' sleepiness can be reduced or if their sleep length or quality can be improved with these interventions.We need better and adequately powered RCTs of the effect of bright light, and naps, either on their own or together and other non-pharmacological interventions that also consider shift workers' chronobiology on the investigated sleep parameters.

Association between regular physical exercise and depressive symptoms mediated through social support and resilience in Japanese company workers: a cross-sectional study

BACKGROUND

Regular physical exercise has been reported to reduce depressive symptoms. Several lines of evidence suggest that physical exercise may prevent depression by promoting social support or resilience, which is the ability to adapt to challenging life conditions. The aim of this study was to compare depressive symptoms, social support, and resilience between Japanese company workers who engaged in regular physical exercise and workers who did not exercise regularly. We also investigated whether regular physical exercise has an indirect association with depressive symptoms through social support and resilience.

METHODS

Participants were 715 Japanese employees at six worksites. Depressive symptoms were assessed with the Center for Epidemiologic Studies Depression (CES-D) scale, social support with the short version of the Social Support Questionnaire (SSQ), and resilience with the 14-item Resilience Scale (RS-14). A self-report questionnaire, which was extracted from the Japanese version of the Health-Promoting Lifestyle Profile, was used to assess whether participants engage in regular physical exercise, defined as more than 20 min, three or more times per week. The group differences in CES-D, SSQ, and RS-14 scores were investigated by using analysis of covariance (ANCOVA). Mediation analysis was conducted by using Preacher and Hayes' bootstrap script to assess whether regular physical exercise is associated with depressive symptoms indirectly through resilience and social support.

RESULTS

The SSQ Number score (F = 4.82, p = 0.03), SSQ Satisfaction score (F = 6.68, p = 0.01), and RS-14 score (F = 6.01, p = 0.01) were significantly higher in the group with regular physical exercise (n = 83) than in the group without regular physical exercise (n = 632) after adjusting for age, education, marital status, and job status. The difference in CES-D score was not significant (F = 2.90, p = 0.09). Bootstrapping revealed significant negative indirect associations between physical exercise and CES-D score through the SSQ Number score (bias-corrected and accelerated confidence interval (BCACI) = -0.61 to -0.035; 95 % confidence interval (CI)), SSQ Satisfaction score (BCACI = -0.92 to -0.18; 95 % CI), and RS-14 score (BCACI = -1.89 to -0.094; 95 % CI).

CONCLUSION

Although we did not find a significant direct association between exercise and depressive symptoms, exercise may be indirectly associated with depressive symptoms through social support and resilience. Further investigation is warranted.

Health-related quality of life among veterans in addictions treatment: identifying behavioral targets for future intervention

BACKGROUND

US veterans report lower health-related quality of life (HRQoL) relative to the general population. Identifying behavioral factors related to HRQoL that are malleable to change may inform interventions to improve well-being in this vulnerable group.

PURPOSE

The current study sought to characterize HRQoL in a largely male sample of veterans in addictions treatment, both in relation to US norms and in association with five recommended health behavior practices: regularly exercising, managing stress, having good sleep hygiene, consuming fruits and vegetables, and being tobacco free.

METHODS

We assessed HRQoL with 250 veterans in addictions treatment (96 % male, mean age 53, range 24-77) using scales from four validated measures. Data reduction methods identified two principal components reflecting physical and mental HRQoL. Model testing of HRQoL associations with health behaviors adjusted for relevant demographic and treatment-related covariates.

RESULTS

Compared to US norms, the sample had lower HRQoL scores. Better psychological HRQoL was associated with higher subjective social standing, absence of pain or trauma, lower alcohol severity, and monotonically with the sum of health behaviors (all p < 0.05). Specifically, psychological HRQoL was associated with regular exercise, stress management, and sleep hygiene. Regular exercise also related to better physical HRQoL. The models explained >40 % of the variance in HRQoL.

CONCLUSIONS

Exercise, sleep hygiene, and stress management are strongly associated with HRQoL among veterans in addictions treatment. Future research is needed to test the effect of interventions for improving well-being in this high-risk group.

Leisure time physical activity and subsequent physical and mental health functioning among midlife Finnish, British and Japanese employees: a follow-up study in three occupational cohorts

OBJECTIVES

The aim of this study was to examine whether leisure time physical activity contributes to subsequent physical and mental health functioning among midlife employees. The associations were tested in three occupational cohorts from Finland, Britain and Japan.

DESIGN

Cohort study.

SETTING

Finland, Britain and Japan.

PARTICIPANTS

Prospective employee cohorts from the Finnish Helsinki Health Study (2000-2002 and 2007, n=5958), British Whitehall II study (1997-1999 and 2003-2004, n=4142) and Japanese Civil Servants Study (1998-1999 and 2003, n=1768) were used. Leisure time physical activity was classified into three groups: inactive, moderately active and vigorously active.

PRIMARY OUTCOME MEASURE

Mean scores of physical and mental health functioning (SF-36) at follow-up were examined.

RESULTS

Physical activity was associated with better subsequent physical health functioning in all three cohorts, however, with varying magnitude and some gender differences. Differences were the clearest among Finnish women (inactive: 46.0, vigorously active: 49.5) and men (inactive: 47.8, active vigorous: 51.1) and British women (inactive: 47.3, active vigorous: 50.4). In mental health functioning, the differences were generally smaller and not that clearly related to the intensity of physical activity. Emerging differences in health functioning were relatively small.

CONCLUSIONS

Vigorous physical activity was associated with better subsequent physical health functioning in all three cohorts with varying magnitude. For mental health functioning, the intensity of physical activity was less important. Promoting leisure time physical activity may prove useful for the maintenance of health functioning among midlife employees.