Differences in Free-Living Patterns of Sedentary Behaviour between Office Employees with Diabetes and Office Employees without Diabetes: A Principal Component Analysis for Clinical Practice

Aims: To identify principal components of free-living patterns of sedentary behaviour in office employees with type 2 diabetes (T2D) compared to normal glucose metabolism (NGM) office employees, using principal component analysis (PCA). Methods: 213 office employees (n = 81 with T2D; n = 132 with NGM) wore an activPAL inclinometer 24 h a day for 7 consecutive days. Comparions of sedentary behaviour patterns between adults with T2D and NGM determined the dimensions that best characterise the sedentary behaviour patterns of office employees with T2D at work, outside work and at weekends. Results: The multivariate PCA technique identified two components that explained 60% of the variability present in the data of sedentary behaviour patterns in the population with diabetes. This was characterised by a fewer number of daily breaks and breaks in time intervals of less than 20 min both at work, outside work and at weekends. On average, adults with T2D took fewer 31 breaks/day than adults without diabetes. Conclusion: Effective interventions from clinical practice to tackle prolonged sedentary behaviour in office employees with T2D should focus on increasing the number of daily sedentary breaks.The study was funded by Fondo de Investigación Sanitaria, Instituto de Salud Carlos III (PI17/01788), the Spanish Ministry of Science and Innovation (DEP2021-37169), grant Jose Luís Torres from redGDPS Foundation (redgdps/BJLTB/02/2022), the predoctoral research grant Isabel Fernández 2020 from the Spanish Society of Family and Community Medicine (semFYC) and another grant from the Càtedra Autonomous University of Barcelona (UAB)—Novartis for research in Family and Community Medicine. The funders had no role in the design, analysis, data interpretation or writing of the manuscript

Impacto de una intervención educativa nutricional para pacientes en hemodiálisis medido mediante la escala Malnutrición Inflamación y la bioimpedancia eléctrica

Introducción: Los pacientes en hemodiálisis pueden presentar alteraciones en su composición corporal, para ello las unidades de nefrología cuentan con herramientas, como son la bioimpedancia y la escala “Malnutrition Inflamation Score” para prevenir, detectar y diagnosticar estados de desnutrición. Objetivos: Evaluar el impacto de una intervención educativa sobre el estado nutricional de los pacientes en hemodiálisis, medido mediante la escala Malnutrición Inflamación y la bioimpedancia. Material y Método: Estudio cuasiexperimental realizado en 48 pacientes sometidos a hemodiálisis. Se analizaron variables sociodemográficas y clínicas, de composición corporal de los pacientes en dos mediciones, mediante bioimpedancia y escala de malnutrición MIS. Los pacientes que presentaron una puntuación de la escala MIS≥6 recibieron una intervención nutricional, evaluándolos nuevamente a los 6 meses. Resultados: La media de edad fue de 69,9±13,6 años, 29 (60,41%) eran hombres. Los pacientes llevaban en tratamiento con hemodiálisis una mediana de tiempo de 24(P25:10,3-P75:59,3) meses. Los pacientes que presentaron valores de la escala MIS≥6 fueron 24(50%), recibiendo la intervención educativa. En los pacientes que no recibieron la intervención el resultado MIS empeoró a los 6 meses (3,4 vs 5,4, p=0,002). Conclusiones: Aquellas personas que no recibieron una intervención educativa empeoraron sus resultados nutricionales frente a quienes si la recibieron. Cabe destacar la importancia de utilizar de forma sistematizada instrumentos validados, como la bioimpedancia y la escala MIS, para hacer un seguimiento del estado nutricional de los pacientes en hemodiálisis

Effectiveness of a healthcare-based mobile intervention on sedentary patterns, physical activity, mental well-being and clinical and productivity outcomes in office employees with type 2 diabetes: study protocol for a randomized controlled trial

Background: Prolonged sedentary time is associated with an increased incidence of chronic disease including type 2 diabetes mellitus (DM2). Given that occupational sedentary time contributes signifcantly to the total amount of daily sedentariness, incorporating programmes to reduce occupational sedentary time in patients with chronic disease would allow for physical, mental and productivity benefts. The aim of this study is to evaluate the short-, medium- and long-term efectiveness of a mHealth programme for sitting less and moving more at work on habitual and occupational sedentary behaviour and physical activity in ofce staf with DM2. Secondary aims. To evaluate the efectiveness on glycaemic control and lipid profle at 6- and 12-month follow-up; anthropometric profle, blood pres‑ sure, mental well-being and work-related post-intervention outcomes at 3, 6 and 12months. Methods: Multicentre randomized controlled trial. A sample size of 220 patients will be randomly allocated into a control (n=110) or intervention group (n=110), with post-intervention follow-ups at 6 and 12months. Health professionals from Spanish Primary Health Care units will randomly invite patients (18–65 years of age) diagnosed with DM2, who have sedentary ofce desk-based jobs. The control group will receive usual healthcare and information on the health benefts of sitting less and moving more. The intervention group will receive, through a smartphone app and website, strategies and real-time feedback for 13weeks to change occupational sedentary behaviour. Variables: (1) Subjective and objective habitual and occupational sedentary behaviour and physical activity (Workforce Sit‑ ting Questionnaire, Brief Physical Activity Assessment Tool, activPAL3TM); 2) Glucose, HbA1c; 3) Weight, height, waist circumference; 4) Total, HDL and LDL cholesterol, triglycerides; (5) Systolic, diastolic blood pressure; (6) Mental well being (Warwick-Edinburgh Mental Well-being); (7) Presenteeism (Work Limitations Questionnaire); (8) Impact of work on employees´ health, sickness absence (6th European Working Conditions Survey); (9) Job-related mental strain (Job Content Questionnaire). Diferences between groups pre- and post- intervention on the average value of the vari‑ ables will be analysed. Discussion: If the mHealth intervention is efective in reducing sedentary time and increasing physical activity in ofce employees with DM2, health professionals would have a low-cost tool for the control of patients with chronic disease.The study was funded by Fondo de Investigación Sanitaria, Instituto de Salud Carlos III (PI17/01788) and the predoctoral research grant Isabel Fernández 2020 from the Spanish Society of Family and Community Medicine (semFYC). The funders had no role in the design, analysis, data interpretation or writing of the manuscript

Monitoring sedentary patterns in office employees: validity of an m-health tool (Walk@Work-App) for occupational health.

OBJECTIVE: This study validated the Walk@Work-Application (W@W-App) for measuring occupational sitting and stepping. METHODS: The W@W-App was installed on the smartphones of office-based employees (n=17; 10 women; 26±3 years). A prescribed 1-hour laboratory protocol plus two continuous hours of occupational free-living activities were performed. Intra-class correlation coefficients (ICC) compared mean differences of sitting time and step count measurements between the W@W-App and criterion measures (ActivPAL3TM and SW200Yamax Digi-Walker). RESULTS: During the protocol, agreement between self-paced walking (ICC=0.85) and active working tasks step counts (ICC=0.80) was good. The smallest median difference was for sitting time (1.5seconds). During free-living conditions, sitting time (ICC=0.99) and stepping (ICC=0.92) showed excellent agreement, with a difference of 0.5minutes and 18 steps respectively. CONCLUSIONS: The W@W-App provided valid measures for monitoring occupational sedentary patterns in real life conditions; a key issue for increasing awareness and changing occupational sedentariness

An mHealth Workplace-Based “Sit Less, Move More” Program: Impact on Employees’ Sedentary and Physical Activity Patterns at Work and Away from Work

Background: Most workplace interventions that aim to reduce sedentary behaviour have 38 focused on employees’ sedentary patterns at-work but less have focused on understanding the 39 impact beyond working time. The aim of this study was to evaluate the impact of a 13-week m-40 health workplace-based ‘sit less, move more’ intervention (Walk@WorkApp; W@W-App) on 41 physical activity (PA) and sitting in desk-based employees at-work and away from work. Methods: Participants (n = 141) were assigned by hospital to an intervention group (IG; used the W@W-App; n = 90) or an active comparison group (A-CG; monitored occupational activity; n = 51). The W@W-App, installed on the participants´ own smartphones, provided real-time feedback for occupational sitting, standing, and stepping, and gave access to automated strategies to sit less and move more at work. Changes between groups were assessed for total sitting time, sedentary bouts and breaks, and light and moderate-to-vigorous PA (activPAL3TM; min/day) between the baseline and after program completion. Results: Compared to the A-CG, employees that used the W@W-App program increased their number of daily breaks and the time spent on short sedentary bouts (<20 min, p = 0.047) during weekends. Changes in shortest sedentary bouts (5–10 min) during weekends were also statistically significant (p < 0.05). No changes in workday PA or sitting were observed. Conclusion: Desk-based employees seemed to transfer the W@W-App program knowledge outside of work. Evaluating the impact of workplace (mHealth-based or not) interventions at work but also away from work would provide a better understating of the impact of such interventions.This research was funded by Spanish Ministry of Science and Innovation, grant number DEP2012-3716

La continuidad de cuidados desde el hospital de agudos: resultados

ResultsAbstractObjective: To describe the profile of patients treated by a Continuity of Care Manager in anacute-care center during the first six months of its activity, as well as the profile of patientstreated and the resource allocation.Method: A prospective cross-sectional study was conducted on patients with complex careneeds requiring continuity of care liaison, and who were attended by the Continuity of CareNurse during the period from October 2013 to March 2014. Patient characteristics, their socialenvironment and healthcare resource allocation were registered and analyzed.Results: A total of 1,034 cases of demand that corresponded to 907 patients (women 55.0%; age80.57 ± 10.1; chronic 47.8%) were analyzed, of whom 12.2% were readmitted. In the multiva-riate model, it was observed that the variables associated with readmission were polypharmacy(OR: 1.86; CI: 1.2-2.9) and fall history prior to admission (OR: 0.586; CI: 0.36-2-88).Conclusions: Patients treated by a Continuity of Care Nurse are over 80 years, with comorbidi-ties, geriatric syndromes, complex care, and of life needs, to whom an alternative solution tohospitalization is provided, thus preventing readmissions

Quality of Life and Social Support of People on Peritoneal Dialysis: Mixed Methods Research

Although some study has been made into quality of life in patients with peritoneal dialysis, little is known about how this relates to social support. The aim of this paper was to study health-related quality of life, perceived social support and the experiences of people receiving peritoneal dialysis. A cross-sectional study was conducted using quantitative and qualitative methodologies, between June 2015 and March 2017. Fifty-five patients receiving peritoneal dialysis were studied. The most affected quality of life dimensions were the effects of the disease, the burden of the disease, occupational status, sleep and satisfaction. The physical component of the quality of life questionnaire was negatively associated with the number of hospital admissions over the previous year (p = 0.027) and positively associated with social support (p = 0.002). With regard to the mental component, age (p = 0.010) and social support (p = 0.041) were associated with a better quality of life. Peritoneal dialysis, while not a panacea, is experienced as being less aggressive than hemodialysis, allowing greater autonomy and improved perceived health. Greater symptomology corresponded to worse quality of life and to perceiving the disease as a burden. Patients had to adapt to the new situation despite their expectations. Social support was observed to be a key factor in perceived quality of life

An mHealth workplace-based “Sit less, move more” program: impact on employees’ sedentary and physical activity patterns at work and away from work

Background: Most workplace interventions that aim to reduce sedentary behaviour have 38 focused on employees’ sedentary patterns at-work but less have focused on understanding the 39 impact beyond working time. The aim of this study was to evaluate the impact of a 13-week m-40 health workplace-based ‘sit less, move more’ intervention (Walk@WorkApp; W@W-App) on 41 physical activity (PA) and sitting in desk-based employees at-work and away from work. Methods: Participants (n = 141) were assigned by hospital to an intervention group (IG; used the W@W-App; n = 90) or an active comparison group (A-CG; monitored occupational activity; n = 51). The W@W-App, installed on the participants´ own smartphones, provided real-time feedback for occupational sitting, standing, and stepping, and gave access to automated strategies to sit less and move more at work. Changes between groups were assessed for total sitting time, sedentary bouts and breaks, and light and moderate-to-vigorous PA (activPAL3TM; min/day) between the baseline and after program completion. Results: Compared to the A-CG, employees that used the W@W-App program increased their number of daily breaks and the time spent on short sedentary bouts (<20 min, p = 0.047) during weekends. Changes in shortest sedentary bouts (5–10 min) during weekends were also statistically significant (p < 0.05). No changes in workday PA or sitting were observed. Conclusion: Desk-based employees seemed to transfer the W@W-App program knowledge outside of work. Evaluating the impact of workplace (mHealth-based or not) interventions at work but also away from work would provide a better understating of the impact of such interventions.Ministerio de Ciencia e Innovación (España) | Ref. DEP2012-3716