ObjectiveThe objective of this study was to pool, harmonise and re-analyse national accelerometer data from adults in four European countries in order to describe population levels of sedentary time and physical inactivity.MethodsFive cross-sectional studies were included from England, Portugal, Norway and Sweden. ActiGraph accelerometer count data were centrally processed using the same algorithms. Multivariable logistic regression analyses were conducted to study the associations of sedentary time and physical inactivity with sex, age, weight status and educational level, in both the pooled sample and the separate study samples.ResultsData from 9509 participants were used. On average, participants were sedentary for 530 min/day, and accumulated 36 min/day of moderate to vigorous intensity physical activity. Twenty-three percent accumulated more than 10 h of sedentary time/day, and 72% did not meet the physical activity recommendations. Nine percent of all participants were classified as high sedentary and low active. Participants from Norway showed the highest levels of sedentary time, while participants from England were the least physically active. Age and weight status were positively associated with sedentary time and not meeting the physical activity recommendations. Men and higher-educated people were more likely to be highly sedentary, while women and lower-educated people were more likely to be inactive.ConclusionsWe found high levels of sedentary time and physical inactivity in four European countries. Older people and obese people were most likely to display these behaviours and thus deserve special attention in interventions and policy planning. In order to monitor these behaviours, accelerometer-based cross-European surveillance is recommended.Electronic supplementary materialThe online version of this article (doi:10.1007/s40279-016-0658-y) contains supplementary material, which is available to authorized users.

BackgroundOffice-based workers typically spend 70–85% of working hours, and a large proportion of leisure time, sitting. High levels of sitting have been linked to poor health. There is a need for fully powered randomised controlled trials (RCTs) with long-term follow-up to test the effectiveness of interventions to reduce sitting. This paper describes the methodology of a three-arm cluster RCT designed to determine the effectiveness and cost-effectiveness of the SMART Work & Life intervention, delivered with and without a height-adjustable desk, for reducing daily sitting.Methods/designA three-arm cluster RCT of 33 clusters (660 council workers) will be conducted in three areas in England (Leicester; Manchester; Liverpool). Office groups (clusters) will be randomised to the SMART Work & Life intervention delivered with (group 1) or without (group 2) a height-adjustable desk or a control group (group 3). SMART Work & Life includes organisational (e.g., management buy-in, provision/support for standing meetings), environmental (e.g., relocating waste bins, printers), and group/individual (education, action planning, goal setting, addressing barriers, coaching, self-monitoring, social support) level behaviour change strategies, with strategies driven by workplace champions. Baseline, 3, 12 and 24 month measures will be taken. Primary outcome: Objectively measured daily sitting time (activPAL3). Secondary outcomes: objectively measured sitting, standing, stepping, prolonged sitting and moderate-to-vigorous physical activity time and number of steps at work and daily; objectively measured sleep (wrist accelerometry). Adiposity, blood pressure, fasting glucose, glycated haemoglobin, cholesterol (total, HDL, LDL) and triglycerides will be assessed from capillary blood samples. Questionnaires will examine dietary intake, fatigue, musculoskeletal issues, job performance and satisfaction, work engagement, occupational and general fatigue, stress, presenteeism, anxiety and depression and sickness absence (organisational records). Quality of life and resources used (e.g. GP visits, outpatient attendances) will also be assessed. We will conduct a full process evaluation and cost-effectiveness analysis.DiscussionThe results of this RCT will 1) help to understand how effective an important simple, yet relatively expensive environmental change is for reducing sitting, 2) provide evidence on changing behaviour across all waking hours, and 3) provide evidence for policy guidelines around population and workplace health and well-being.Trial registrationISRCTN11618007. Registered on 21 January 2018.

Objectives To evaluate the effectiveness of an intervention, with and without a height adjustable desk, on daily sitting time, and to investigate the relative effectiveness of the two interventions, and the effectiveness of both interventions on physical behaviours and physical, biochemical, psychological, and work related health and performance outcomes. Design Cluster three arm randomised controlled trial with follow-up at three and 12 months. Setting Local government councils in Leicester, Liverpool, and Greater Manchester, UK. Participants 78 clusters including 756 desk based employees in defined offices, departments, or teams from two councils in Leicester, three in Greater Manchester, and one in Liverpool. Interventions Clusters were randomised to one of three conditions: the SMART Work and Life (SWAL) intervention, the SWAL intervention with a height adjustable desk (SWAL plus desk), or control (usual practice). Main outcomes measures The primary outcome measure was daily sitting time, assessed by accelerometry, at 12 month follow-up. Secondary outcomes were accelerometer assessed sitting, prolonged sitting, standing and stepping time, and physical activity calculated over any valid day, work hours, workdays, and non-workdays, self-reported lifestyle behaviours, musculoskeletal problems, cardiometabolic health markers, work related health and performance, fatigue, and psychological measures. Results Mean age of participants was 44.7 years, 72.4% (n=547) were women, and 74.9% (n=566) were white. Daily sitting time at 12 months was significantly lower in the intervention groups (SWAL −22.2 min/day, 95% confidence interval −38.8 to −5.7 min/day, P=0.003; SWAL plus desk −63.7 min/day, −80.1 to −47.4 min/day, P<0.001) compared with the control group. The SWAL plus desk intervention was found to be more effective than SWAL at changing sitting time (−41.7 min/day, −56.3 to −27.0 min/day, P<0.001). Favourable differences in sitting and prolonged sitting time at three and 12 month follow-ups for both intervention groups and for standing time for the SWAL plus desk group were observed during work hours and on workdays. Both intervention groups were associated with small improvements in stress, wellbeing, and vigour, and the SWAL plus desk group was associated with improvements in pain in the lower extremity, social norms for sitting and standing at work, and support. Conclusions Both SWAL and SWAL plus desk were associated with a reduction in sitting time, although the addition of a height adjustable desk was found to be threefold more effective. Trial registration ISRCTN Registry ISRCTN11618007 .

Quantifying sitto-stand and stand-to-sit transitions in free-living environments using the activPAL thigh-worn activity monitor. Gait and Posture, 73, pp. 140-146.

Purpose: Sedentary behaviour (SB) is associated with a number of adverse health outcomes.Studies that have used accelerometers to define sedentary time tend to use a threshold of <100 counts per minute (cpm) for classifying SB; however, this cut-point was not empirically derived for adults. It is not known whether accelerometer cut-points for SB differ depending on the context in which it occurs. We aimed to: 1) empirically derive an optimal threshold for classifying SB, using the cpm output from the ActiGraph GT3X+, compared to the sedentary classification from the activPAL3™; and 2) ascertain whether this varied by day of the week and in working time versus non-working time.Methods: A convenience sample of 30 office-based university employees (10 males, 20 females; age 40.47±10.95 years; BMI 23.93±2.46 kg/m2) wore the ActiGraph GT3X+ and activPAL3™ devices simultaneously for seven days. Data were downloaded in one minute epochs and non-wear time was removed. Generalised estimating equations were used to make minute by minute comparisons of sedentary time from the two devices, using sitting from the activPAL3™ as the criterion measure. Results:After data reduction participants provided on average 11 hours 58 minutes of data per day. The derived cut-points from the models were significantly higher on a Saturday (97cpm) compared to weekdays (60cpm) and Sunday (57cpm). Derived cpm for sedentary time during working time were significantly lower compared to non-working time (35)(36)(37)(38)(39)(40)(41)). Compared to the 100cpm and 150cpm thresholds, the empirically derived cut-points were not significantly different in terms of area-under-thecurve, but had lower mean bias for each day of the week and for working and non-working times. Conclusion:Accelerometer cut-points for SB can depend on day and also domain, suggesting that the nature of sitting differs depending on the context in which sedentary time is accrued.

Background: Baby wipes have been shown to be safe and effective in maintaining skin integrity when compared to the use of water alone. However, no previous study has compared different formulations of wipe. The aim of the BaSICS study was to identify any differences in incidence of irritant diaper dermatitis (IDD) in infants assigned to three different brands of wipe, all marketed as suitable for neonates, but which contained varying numbers of ingredients. Methods: Women were recruited during the prenatal period. Participants were randomly assigned to receive one of three brands of wipe for use during the first eight weeks following childbirth. All participants received the same nappies. Participants reported their infant's skin integrity on a scale of 1e5 daily using a bespoke smartphone application. Analysis of effect of brand on clinically significant IDD (score 3 or more) incidence was conducted using a negative binomial generalised linear model, controlling for possible confounders at baseline. Analysts were blind to brand of wipe. Results: Of 737 women enrolled, 15 were excluded (admitted to neonatal intensive care, premature or other infant health issues). Of the 722 eligible babies, 698 (97%) remained in the study for the full 8-week duration, 24.6% of whom had IDD at some point during the study. Mothers using the brand with the fewest ingredients reported fewer days of clinically significant nappy rash (score3) than participants using the two other brands (p Z 0.002 and p < 0.001). Severe IDD (grades 4 and 5) was rare (2.4%).

Background: Actively commuting to and from work can increase moderate-to-vigorous physical activity (MVPA) and increase adherence to physical activity (PA) guidelines; however, there is a lack of evidence on the contribution of mixed-mode commutes and continuous stepping bouts to PA. Many commuting studies employ the use of self-reported PA measures. This study objectively determined the contribution of MVPA during commuting to total MVPA, using cadence to define MVPA, and explored how the length of stepping bouts affects adherence to PA guidelines. Methods: Twenty-seven university staff wore an activPAL™ activity monitor for seven days and kept an activity diary. The activPAL™quantified MVPA and bouts duration and the activity diary collected information about commute times and the modes of commute. Twenty-three participants with at least four days of data were included in the final analysis. Results: The median total time per day spent in MVPA was 49.6 (IQR: 27.4–75.8) minutes and 31% of the total time was accumulated during commuting (median = 15.2 minutes; IQR: 4.11–26.9). Walking and mixed-mode commuters spent more time in MVPA (37.6 and 26.9 minutes, respectively), compared to car commuters (5.8 minutes). Seventeen out of the 23 participants achieved more than 30 minutes of MVPA per day, with five achieving this in their commute alone. A significant positive association was found between commute time spent in MVPA and total MVPA (p < .001). Conclusion: Commuting can be a major contributor to total MVPA, with the mode of commute having a significant role in the level of this contribution to total MVPA.

Working environments have in recent times become less physical with the increase in sedentary, computer-based occupations. Sedentary time is known to be associated with a number of health-related outcomes, including obesity, heart disease, diabetes, cardiometabolic risk factors, some cancers and early mortality, independent of physical activity. There is limited research that has examined sedentary time and physical activity and associations with musculoskeletal conditions, despite these being responsible for the majority of work-related ill health and days absent from work.The validity and practicality of objective and subjective techniques to measure physical behaviour have been widely reported; however, there is no gold standard that is valid, accurate, reliable and also practical. Self-reported methods can be practical and low-cost, but are subject to recall and social desirability bias; whereas objective devices, such as accelerometers, can be expensive, but allow for information on intensity, frequency and duration of activity to be measured.The Health Survey for England 2008 used both subjective and objective measures of physical activity: they found that 39% of men and 29% of women were meeting the recommended levels of physical activity when asked via a questionnaire. In comparison, when physical activity was objectively measured using an accelerometer, it was found that only 6% of men and 4% of women met these targets.Wearable technologies, including research grade accelerometers (e.g. activPAL™) and consumer wearables (e.g. FitBit), are increasingly being used in research, not only to measure physical behaviours but may also be useful in facilitating and monitoring behaviour change. This work will present an overview of wearable technologies used in research, what they can (and can't) measure, and in particular their application in musculoskeletal research.Disclosure of InterestNone declared