Innovation in the occupational health physician profession requires the development of a work collective to improve the efficiency of MSD prevention

Given the ageing population of occupational health physicians and the deteriorating situation of employee health, reforms targeting the multi-disciplinary nature of occupational health are currently being drawn up. These are of great concern to doctors in terms of the future of occupational health, notably with regard to changing medical practices. The objective of this study is to explore the actual practices of occupational health physicians within the framework of MSD prevention in France. By analysing the activity of occupational health physicians, we could gain a better understanding of the coordination between those involved in OHS with the ultimate goal being to improve prevention. Based on an analysis of peer activity, this method made it possible to push beyond pre-constructed discourse. According to activity theories, it is through others that the history and controversies of a profession can be grasped and skills developed. The results produced by these collective discussions on activity analysis contributed to establish a collective point of view about the important aspects of their profession that need defending and the variations in professional genre in relation to the current reforms, notably.     

Aging in Place at Home Through Environmental Support of Physical Activity: An Interdisciplinary Conceptual Framework and Analysis

This article presents a conceptual framework to link issues of health, services, physical activity, and environment to help older adults age in place in their own homes, which may reduce the demands on society to provide institutional long-term care. Using environments to promote physical activity has received attention by researchers, but its impact on aging-in-place at home has been largely ignored. This article interprets and synthesizes existing studies on aging-in-place in relation to health and services, contributions of physical activity to health and service accessibility, and environmental support of physical activity. The conceptual framework can serve as the core construct to address gaps in previous research and as a tool to refine practical targets for policies and interventions aimed at promoting healthy aging.     

Exploring the role of gender norms in nutrition and sexual health promotion in a piloted school-based intervention: The Philadelphia Ujima™ experience

Perceptions of masculinity and femininity influence behaviors and can be identified in young children and adolescents (Brannon, 2004). Thus, adolescents’ engagement in health risk or promoting behaviors is influenced by perceptions of masculinity and femininity and the differences in expectations, norms and responsibilities for girls and boys (WHO, 2007). Girls and boys have different needs, and gender-based interventions that consider similarities as well as differences are needed. A gender-based nutrition and sexual health promotion program was developed and piloted by the Philadelphia Ujima Coalition in a high school setting. To explore the gender differences in adolescents’ perceptions of the influence of gender norms on weight, nutrition, physical activity, and sexual health and the implication of these differences in future gender-integrated health promotion programming for youth, a content analysis of student and facilitator debriefing forms were implemented for the participating schools. The content analysis was used to identify central themes, concepts gained, and overall impact of the intervention sessions. Overall, gender norms influence healthy eating practices and activity through influencing perceptions of body type in adolescents. Gender norms also influence sexual activity and decision making through influencing perceptions of beauty, masculinity, femininity, pressures and popular concepts related to sexual activity. Thus, interventions that address gender may more effectively promote health and wellness in adolescents.     

A proposal for a new screening paradigm and tool called Exercise Assessment and Screening for You (EASY)

The Exercise Assessment and Screening for You (EASY) is a tool developed to help older individuals, their health care providers, and exercise professionals identify different types of exercise and physical activity regimens that can be tailored to meet the existing health conditions, illnesses, or disabilities of older adults. The EASY tool includes 6 screening questions that were developed based on an expert roundtable and follow-up panel activities. The philosophy behind the EASY is that screening should be a dynamic process in which participants learn to appreciate the importance of engaging in regular exercise, attending to health changes, recognizing a full range of signs and symptoms that might indicate potentially harmful events, and becoming familiar with simple safety tips for initiating and progressively increasing physical activity patterns. Representing a paradigm shift from traditional screening approaches that focus on potential risks of exercising, this tool emphasizes the benefits of exercise and physical activity for all individuals.     

A pilot intervention to promote walking and wellness and to improve the health of college faculty and staff

There is a need to investigate novel interventions that promote worksite physical activity and wellness. OBJECTIVE: The authors' purpose in this study was to evaluate the effectiveness of a 12-week walking program supplemented with a pedometer, computer educational program, and weekly e-mails. METHODS: College faculty and staff participated in a one-group pre-posttest study to determine whether the 12-week walking intervention had an effect on body mass index (BMI), blood pressure, blood glucose, and cholesterol. The authors also determined participant-perceived wellness effects. RESULTS: The authors observed differences between baseline and follow-up in BMI (p = .024), blood glucose (p = .06), and total cholesterol (p = .09). The program had a moderate effect on fitness, mood, health awareness, nutrition, and health. CONCLUSIONS: It is incumbent that experts develop innovative worksite physical activity and wellness programs. A pedometer-monitored walking program is one way that a worksite health initiative can improve the health and wellness of its employees and simultaneously reduce health-care costs.     

Proposing a model for promoting Children's Health in Early Childhood Education and Care Settings

This pilot study was conducted in one early childhood pre-school nursery setting in an area of high deprivation in England to explore the under-researched area of how practitioners promote the health of children. The research used an original tool, Child Health Promotion: A Toolkit for Early Childhood Education and Care Practitioners, containing a 5 Step Programme as a model to guide practitioners in identifying and implementing a health promotion activity. The findings will help to set the onward agenda for a larger scale study which will foreground the voices of practitioners and highlight the role that ECEC practitioners can play in promoting the health of children.     

Physical activity and cognitive-health content in top-circulating magazines, 2006-2008

Physical activity may promote cognitive health in older adults. Popular media play an important role in preventive health communication. This study examined articles discussing associations between physical activity and cognitive health in top-circulating magazines targeting older adults. 42,753 pages of magazines published from 2006 to 2008 were reviewed; 26 articles met inclusion criteria. Explanations regarding the link between physical activity and cognitive health were provided in 57.7% of articles. These explanations were generally consistent with empirical evidence; however, few articles included empirical evidence. Physical activity recommendations were presented in 80.8% of articles; a wide range was recommended (90-300 min of physical activity per wk). Socioeconomic status and education level were not mentioned in the text. Results suggest an opportunity for greater coverage regarding the role of physical activity in promoting cognitive health in popular media. Magazine content would benefit from including more empirical evidence, culturally sensitive content, and physical activity recommendations that are consistent with U.S. guidelines.     

The impact of early occupational choice on health behaviors

Occupational choice is a significant input into workers’ health investments, operating in a manner that can be either health-promoting or health-depreciating. Recent studies have highlighted the potential importance of initial occupational choice on subsequent outcomes pertaining to morbidity. This study is the first to assess the existence and strength of a causal relationship between initial occupational choice at labor entry and subsequent health behaviors and habits. We utilize the Panel Study of Income Dynamics to analyze the effect of first occupation, as identified by industry category and blue collar work, on subsequent health outcomes relating to obesity, alcohol misuse, smoking, and physical activity in 2005. Our findings suggest blue collar work early in life is associated with increased probabilities of obesity, at-risk alcohol consumption, and smoking, and increased physical activity later in life, although effects may be masked by unobserved heterogeneity. The weight of the evidence bearing from various methodologies, which account for non-random unobserved selection, indicates that at least part of this effect is consistent with a causal interpretation. These estimates also underscore the potential durable impact of early labor market experiences on later health.     

Mitigation of musculoskeletal problems and body discomfort of agricultural workers through educational intervention

Farming is a physically arduous occupation that places farm workers' at potential risk of musculoskeletal disorders, which has been observed to impose a greater impact on their health. Each activity in agriculture brings about certain stress and strain on bones and muscles leading to work-related musculoskeletal disorders which can lead to several permanent diseases and disabilities. The purpose of analyzing musculoskeletal problems among male and female workers engaged in agriculture was to know about the risk factors dangerous to health so that interventions can be planned for mitigating them thereby increasing the efficiency of work. Educational intervention included audio-visual aids as well as printed literature. It was hoped that awareness of these factors through dissemination of information would contribute at preventing hazards amongst farmers and their families. The results revealed that the workers reported very severe to severe pain in low back while performing agricultural activities. Weeding was the most strenuous activity for females and threshing crop for males. Training and education on MSDs through educational intervention proved that the knowledge of the farm workers could be enhanced and can help reduce risk of many musculoskeletal problems. It can be help in empowering the community and mitigate MSDs in agriculture.     

Physical activity, genes, and lifetime predisposition to chronic disease

This mini-review summarizes the main associations between physical activity and chronic diseases and discusses the basic concepts related to the role of genetic factors in studies evaluating the effects of physical activity/exercise therapy on chronic disease prevention/treatment during the life course. Many observational cohort studies have shown that high physical activity during young adulthood or middle age is associated with reduced later life morbidity, mobility limitations and mortality. Physical activity or exercise therapy has a positive effect on health via many disease-specific mechanisms. The most consistent finding of the various randomized controlled studies conducted to date is that aerobic/functional capacity and/or muscle strength can be improved by exercise training among patients with different chronic diseases. Genes are known to play a role in chronic disease predisposition and to contribute to physical fitness levels, physical activity participation and ageing. Physical fitness, physical activity and health outcomes may be partly due to underlying genetic factors that have a favourable effect on all these traits (genetic pleiotropy). This means that in observational studies, the relationship between baseline activity and the later occurrence of diseases may not be interpreted entirely as causal. Increased knowledge on the role of nuclear genome, mitochondrial genome, epigenetics, telomeres and regulation of gene expression will increase our understanding of their relationships with physical activity and morbidity.     

Institutional contexts and mortality: the case of Peru

Increasingly, attention is being given to institutional contexts to explain differential demographic and health outcomes. Regional inequality in terms of economic development, social institutions, and health services leads to regional disparities in health outcomes, especially infant mortality. The author uses linked data from population and economic censuses, government agencies, and health surveys on 24 Peruvian provinces to explore how differential economic development and institutional contexts influence health outcomes. Regional inequities based on rural population, subsistence activity, women's illiteracy, monthly income, gross domestic product, medical care, and health facilities are compared, with a cluster analysis identifying institutional contexts which have internal similarities. These contexts are able to discriminate differences in infant mortality. The analysis demonstrates that infant mortality in Peru varies systematically with social, economic, and medical contexts. Economic development, income and subsistence levels, women's literacy, and the amount of medical care and public health services influence health outcomes. It is clear that understanding such regional inequities can help explain disparities in health outcomes.     

The prevalence of physical activity maintenance in a sample of university students: a longitudinal study

The health and financial costs of physical inactivity are staggering. Few researchers have assessed the prevalence of physical activity at the level needed to gain health benefits. OBJECTIVE: The author's purpose in this longitudinal study was to assess the prevalence of university students who maintained physical activity at the level necessary for health gains for at least 1 month. PARTICIPANTS: University students (N = 392) from 2 campuses participated in this 1-month study. METHODS: The author administered a survey to the same group of students at baseline and 1 month later to assess the prevalence of students who met and maintained the physical activity guideline for health (PAGH). RESULTS: Thirty-five percent of students maintained the PAGH for 1 month. CONCLUSION: The majority of students in this study were insufficiently physically active. Given that insufficient physical activity may lead to serious health concerns, interventions are needed to improve activity maintenance in this population.     

Performance indicators of work activity

The measurement of performance is a current topic in the management of people in companies, used as a parameter of effectiveness of processes and operations of production. The methods and models of the indicators of current use in the production have concentrated in the assessment of people's performance as determinative resource of the organizational success in the search for the competitiveness. Associated with the classic indicators of performance assessment of the production proceeding, other indicators are used in the assessment of risks and hazards, however with methods focused in the tasks, without connection with the real work activity. The present article explores literature on the models of performance measurement in use in companies and a field research to understand how companies interpret and use indicators that relate health and work, to direct future studies on the subject. Regarding the literature review, one can see that health indicators can be basically divided into two major groups: the legal and managerial indicators. When conducting case studies, it can be realized that companies do not have precisely the concept of health indicator, or were unable to define which of the indicators could be considered indicators of health, considering that absenteeism was the indicator mentioned by the four companies.     

The influence of the tasks characteristics in physical performance and psychosocial aspects of workers

The work and life conditions have influence on the health and life quality of workers. Physically active persons can demonstrate a life style that are and affect the physical performance, psychosocial aspects and work capacity. The purpose of this study was to investigate the physical activity level and work capacity in different tasks characteristics, one with more physical exertion and other with more cognitive exertion. A total of 193 workers from an institution of higher education and 457 workers from a metallurgical industry participated in the current study. All participants completed the International Physical Activity Questionnaire (IPAQ-short) and Work Ability Index (WAI). The results indicated that both groups were classified as having high level of physical activity while only few of them were considered sedentary (less than 27%). However, the group of metallurgical workers had greater indices (82%) than the workers from higher education institution (74%). Overall, the workers reported their work ability as moderate to excellent, suggesting that overall they are satisfied with their working and health conditions. It can be concluded that even though workers performed tasks with different demands (cognitive versus physical), they demonstrated similar level of physical activity as well as work ability.     

Physical and psychological outcomes of a supported physical activity program for older carers

This study evaluated health benefits of a supported physical activity program for 116 older carers (mean age 64.4 [SD = 7.9], 85% women). Participants undertook a 6-month center-based physical activity program (strength training, yoga, or Tai Chi). Eighty-eight participants (76%) completed the program. Multivariate repeated-measures ANOVA identified overall significant improvement postintervention (p = .004). Univariate analyses revealed significant improvements for balance, strength, gait endurance, depression, and SF-36 (physical component; p < .05). There was no change in the Zarit Carer Burden Scale (p > .05). Change in performance scores did not differ significantly between those with higher and lower attendance at classes, although there was significantly greater improvement in gait endurance and balance (p < .05) in those attending classes run twice weekly than in those attending once-weekly classes. In conclusion, a carer physical activity program, providing additional carer support to facilitate participation, can achieve high levels of involvement by carers and significant health benefits.     

Reducing Funding Risk and Implementing a Fundraising Plan: A Case Study

Small nonprofit organizations in the health care and human services fields can find themselves frozen into a dependence on government funding. They run the risk of constricting their management choices and neglecting other potential funding sources. Often a fundamental shift in attitude is necessary in order to deemphasize service-based contracts and to transform private fundraising into a central activity of the business.     

Development of a logic model for a service learning,dog walking course for college students

Despite overwhelming evidence of the importance of physical activity, only 20% of US adults meet physical activity recommendations. A subsector of the population vulnerable to inactivity is college students. There is a disconnect between evidence-based physical activity programming and dissemination into college communities, which may be overcome through logic model development and evaluation. The purpose of this paper is to discuss logic model development for a service-learning, dog walking program for undergraduates. Participants were undergraduates (18–25 years). Process evaluations and observational data were used in a content analysis to determine major themes to create the logic model. A set of resources were needed to complete program activities, which led to short- and long-term outcomes. The overarching goal of the program is to improve the overall health status of college students and companion animals. This logic model may have significant public health impact as it can serve as a framework for universities wanting to develop, implement, and evaluate a service-learning, dog walking program for students.     

Binge drinking in female college students: the association of physical activity, weight concern, and depressive symptoms

As an initial step in building gender-specific binge drinking intervention programs, the authors investigated the relation of potentially modifiable factors (physical activity level, weight concern, and depressive symptoms) to binge drinking while controlling for the effects of previously established correlates of binge drinking (tobacco and marijuana use, GPA, and perception of peer alcohol use). Four-hundred-twelve college women completed an in-class survey. Multivariate analyses revealed that tobacco and marijuana use, GPA, and physical activity were significantly associated with binge drinking, whereas tobacco use and perception of peers' alcohol use were associated with more frequent binge drinking. The findings suggested that the variables associated with any binge drinking and frequency of binge drinking may differ and that binge drinking can be associated with positive health behaviors (ie, greater physical activity) as well as risky health behaviors (eg, tobacco use).     

Treatment of postmenopausal vaginal atrophy with 10-μg estradiol vaginal tablets

Postmenopausal estrogen deficiency can lead to symptoms of urogenital atrophy. Individuals with urogenital atrophy have symptoms that include vaginal dryness, vaginal and vulval irritation, vaginal soreness, pain and burning during urination (dysuria), increased vaginal discharge, vaginal odour, vaginal infections, recurrent urinary tract infections, pain associated with sexual activity (dyspareunia) and vaginal bleeding associated with sexual activity. Despite the frequency and effects of vaginal atrophy symptoms, they are often under-reported and, consequently, under-treated. Therefore, care of a menopausal woman should include a physical assessment of vaginal atrophy and a dialogue between the physician and the patient that explores existing symptoms and their effect on vulvovaginal health, sexuality and quality-of-life issues. The development of the ultra-low-dose 10-μg estradiol vaginal tablets is in line with the requirements of regulatory agencies and women's health societies regarding the use of the lowest effective hormonal dose. Because of its effectiveness and safety profiles, in addition to its minimal systemic absorption, the 10-μg estradiol vaginal tablet can offer greater reassurance to health-care providers and postmenopausal women with an annual estradiol administration of only 1.14 mg.     

Best practices for physical activity programs and behavior counseling in older adult populations

Physical activity offers one of the greatest opportunities for people to extend years of active independent life and reduce functional limitations. The purpose of this paper is to identify key practices for promoting physical activity in older adults, with a focus on older adults with chronic disease or low fitness and those with low levels of physical activity. Key practices identified in promotion activity in older adults include: (1) a multidimensional activity program that includes endurance, strength, balance, and flexibility training is optimal for health and functional benefits; (2) principles of behavior change, including social support, self-efficacy, active choices, health contracts, assurances of safety, and positive reinforcement, enhance adherence; (3) management of risk by beginning at low intensity but gradually increasing to moderate physical activity which has a better risk/benefit ratio should be the goal for older adults; (4) an emergency procedure plan is prudent for community-based programs; and (5) monitoring aerobic intensity is important for progression and for motivation. Selected content reviews of physical activity programming from major organizations and institutions are provided. Regular participation in physical activity is one of the most effective ways for older adults, including those with disabilities, to help prevent chronic disease, promote independence, and increase quality of life in old age.Publication Note All National Blueprint Publications are in the public domain and can be freely reproduced without copyright. This article has been previously published in Medicine Science and Sports and Exercise and the Journal of Aging and Physical Activity. Individuals or organizations who wish to publish National Blueprint articles should contact the National Blueprint Office for permission.