A service evaluation of the North East Essex Diabetes Service (NEEDS).

Improving outcomes and the integration of diabetes care for adults is a National Health Service ambition. In north east Essex, United Kingdom, an innovative interprofessional community-based diabetes service (North East Essex Diabetes Service (NEEDS)) was developed to provide a single point of access and continuity of care across an integrated, interprofessional care pathway. The aim was to evaluate how NEEDS was embedded into Primary Care, and gain insight into how it works from the perspective of staff delivering the service and from those receiving care.

'It's about collaboration': a whole-systems approach to understanding and promoting movement in Suffolk.

Background: Population-levels of physical activity have remained stagnant for years. Previous approaches to modify behaviour have broadly neglected the importance of whole-systems approaches. Our research aimed to (i) understand, (ii) map, (iii) identify the leverage points, and (iv) develop solutions surrounding participation in physical activity across an English rural county.

Conceptualizing Sleep Satisfaction: A Rapid Review.

Good, satisfying, sleep is a key indicator and determinant of health and wellness. However, there is no consensus about how to define and measure good sleep. The present research aimed to define sleep satisfaction through the extant literature and disentangle it from sleep quality, a conceptually similar construct.

Attitudes towards air quality during outdoor exercise amongst habitual exercisers.

The effects of air pollution on health outcomes are well-established. However, little is known about perceptions of air pollution and how it may influence exercise behaviours. The aim of this study was to understand the perceived importance of air pollution during planned exercise, and where relevant, explore how those perceptions may differ between those living in different locations.

Tackling physical inactivity and inequalities: implementing a whole systems approach to transform community provision for disabled people and people with long-term health conditions.

Background: Physical inactivity is a global public health priority. There are known health and well-being consequences of being inactive, and the benefits of being physically active are well established. However, there are persistent inequalities when it comes to how physically active people are, with disabled people, people living with long-term health conditions, and people residing in areas of socio-economic deprivation being particularly affected.

Planning engagement with web resources to improve diet quality and break up sedentary time for home-working employees: A mixed methods study.

As home working becomes more common, employers may struggle to provide health promotion interventions that can successfully bridge the gap between employees' intentions to engage in healthier behaviors and actual action. Based on past evidence that action planning can successfully encourage the adoption of healthier behaviors, this mixed-methods study of a web-based self-help intervention incorporated a randomized planning trial that included quantitative measures of engagement and follow-up qualitative interviews with a subsample of participants. Participants either (a) selected a movement plan for incorporating a series of 2-min exercise videos into their work week to break up sedentary time and a balanced meal plan with recipe cards for a week's lunches and dinners or (b) received access to these resources without a plan.

Knee extensor force control as a predictor of dynamic balance in healthy adults.

Background: Previous research has demonstrated that force control in various muscles of the lower limb (measured according to the magnitude of force fluctuations) explains significant variance in static balance. Given the dynamic nature of many functional activities and sports, assessment of balance and its determinants under dynamic conditions is of importance.

Research Question: Does muscle force control explain significant variance in dynamic balance, as measured using the Y balance test (YBT)?

Methods: YBT performance and knee extensor muscle force control were measured in 28 healthy participants.

Development of a self-report measure to assess sleep satisfaction: Protocol for the Suffolk Sleep Index (SuSI).

Good sleep is essential for health but there is no consensus on how to define and measure people's understanding of good sleep. To date, people's perceptions of a good night's sleep have been, almost exclusively, conceptualized under the lens of sleep quality, which refers to characteristics of good sleep, such as such as ease and time needed to fall asleep, hours of sleep, and physical symptoms during sleep and upon awakening. A related, yet different construct, sleep satisfaction, refers to about one's sleep experience and has, to date, received little attention.

The Effect of Breaking Up Sedentary Time with Calisthenics on Neuromuscular Function: A Preliminary Study.

The ageing process results in reduced neuromuscular function. This alongside prolonged sedentary behaviour is associated with decreased muscle strength, force control and ability to maintain balance. Breaking up sedentary time with regular bouts of physical activity has numerous health benefits, though the effects on neuromuscular function are unknown.

Operationalization of One Health Burnout Prevention and Recovery: Participatory Action Research-Design of Nature-Based Health Promotion Interventions for Employees.

Burnout is, besides a global, complex phenomenon, a public health issue with negative consequences on personal, organizational, social, and economic levels. This paper outlines the co-design of a novel Nature-based Burnout Coaching intervention, called NABUCO. Due to the complexity of burnout, we propose a One Health approach in healthcare, educational and governmental pilot organizations, to deliver guidelines and protocols for prevention and recovery of burnout.

Can Simulated Green Exercise Improve Recovery From Acute Mental Stress?

This exploratory study enhances previous research into green exercise and addresses a gap in the research by exploring the contribution of individual and combined senses in the recovery of mood and stress after a psychological stressor, whilst rigorously controlling exercise intensity. The hypotheses were: (i) recovery of mood and stress from a state of psychological stress would be greater following simulated green exercise compared to rest, (ii) green exercise would facilitate better recovery than exercise alone, (iii) these effects would remain 10 min following intervention, and (iv) visual stimuli alone would enhance recovery from a state of psychological stress compared to sound. Fifty participants were randomly assigned to one of five groups: REST, exercise, exercise with nature sounds, exercise with nature visual and exercise with nature sound and visual.

The Development of Three Questionnaires to Assess Beliefs about Green Exercise.

Green exercise is physical activity that takes place in the presence of natural environments. Despite the promising evidence of the benefits, little is known about how individuals' thoughts and feelings influence participation in green exercise and subsequent outcomes. The aim of the current research was to develop questionnaires using the Theory of Planned Behaviour as a framework that could both directly and indirectly assess attitudes, subjective norms and perceived behaviour control, along with intention toward green exercise.

Development and Validity of the Rating-of-Fatigue Scale.

Objective: The purpose of these experiments was to develop a rating-of-fatigue (ROF) scale capable of tracking the intensity of perceived fatigue in a variety of contexts.

Methods: Four experiments were carried out. The first provided the evidential basis for the construction of the ROF scale.

Effect of breaking up sedentary time with callisthenics on endothelial function.

Periods of prolonged sitting impairs endothelial function in lower limb conduit arteries, which is attenuated with physical activity breaks. The effect of activity breaks on upper limb arteries has not been examined. This study assessed changes in brachial artery endothelial function following either a prolonged sitting period or breaking up this sedentary time by performing sets of callisthenics exercises.

A cross-sectional study examining predictors of visit frequency to local green space and the impact this has on physical activity levels.

Background: Lack of physical activity (PA) is a growing public health concern. There is a growing body of literature that suggests a positive relationship may exist between the amount of local green space near one's home and PA levels. For instance, park proximity has been shown to predict PA levels amongst certain populations.

Influences of Green Outdoors versus Indoors Environmental Settings on Psychological and Social Outcomes of Controlled Exercise.

This study addressed a methodological gap by comparing psychological and social outcomes of exercise in green outdoors versus built indoors settings, whilst rigorously controlling exercise mode and intensity. The hypotheses were that greater improvements or more desirable values for directed attention, mood, perceived exertion, social interaction time, intention for future exercise behaviour and enjoyment would be associated with outdoors compared to indoors exercise. Following a baseline session, paired participants completed two conditions of 15 min of cycling on an ergometer placed outside in a natural environment and inside in a laboratory setting in a randomized, counter-balanced order.

A Lunchtime Walk in Nature Enhances Restoration of Autonomic Control during Night-Time Sleep: Results from a Preliminary Study.

Walking within nature (Green Exercise) has been shown to immediately enhance mental well-being but less is known about the impact on physiology and longer lasting effects. Heart rate variability (HRV) gives an indication of autonomic control of the heart, in particular vagal activity, with reduced HRV identified as a risk factor for cardiovascular disease. Night-time HRV allows vagal activity to be assessed whilst minimizing confounding influences of physical and mental activity.

Occlusion of sight, sound and smell during Green Exercise influences mood, perceived exertion and heart rate.

This study's aim was to identify the relative contribution of sight, sound and smell to the Green Exercise effect. It was hypothesised that visual occlusion while exercising in a natural environment would have the greatest diminishing effect on perceived exertion and mood compared to auditory and olfactory occlusion. Twenty-nine healthy participants were randomly assigned to one of the three groups: visual (n = 10), auditory (n = 9) and olfactory occlusion (n = 10).

Energy expenditure and heart rate response to breaking up sedentary time with three different physical activity interventions.

Background And Aims: Prolonged sedentary behaviour is associated with increased cardiovascular disease risk and decreased energy expenditure (EE). Workplace interventions breaking up sedentary time have increased EE but the cardiovascular responses are unknown. The practicalities of these interventions, such as required costs and workplace adaptations, are questioned.

A repeated measures experiment of school playing environment to increase physical activity and enhance self-esteem in UK school children.

School playtime provides daily opportunities for children to be active outdoors, but only makes small contributions to physical activity (PA) requirements. Natural environments facilitate unstructured PA and children report a preference for play in nature. Thus, play on the school field might encourage children to be more active during playtime.

Walks4Work: assessing the role of the natural environment in a workplace physical activity intervention.

Objectives: The primary aim of this study was to examine the impact of physical activity (PA) in the natural environment (eg, "green exercise") on resting autonomic function in the Walks4Work intervention. A secondary aim was to assess the feasibility of Walks4Work in terms of adherence, change in PA levels, and cardiovascular health parameters.

Methods: In an 8-week randomized control trial, 94 office workers in an international company were allocated to one of three groups: control, nature (NW), or built (BW) lunchtime walking route.

The great outdoors: how a green exercise environment can benefit all.

The studies of human and environment interactions usually consider the extremes of environment on individuals or how humans affect the environment. It is well known that physical activity improves both physiological and psychological well-being, but further evidence is required to ascertain how different environments influence and shape health. This review considers the declining levels of physical activity, particularly in the Western world, and how the environment may help motivate and facilitate physical activity.

Viewing nature scenes positively affects recovery of autonomic function following acute-mental stress.

A randomized crossover study explored whether viewing different scenes prior to a stressor altered autonomic function during the recovery from the stressor. The two scenes were (a) nature (composed of trees, grass, fields) or (b) built (composed of man-made, urban scenes lacking natural characteristics) environments. Autonomic function was assessed using noninvasive techniques of heart rate variability; in particular, time domain analyses evaluated parasympathetic activity, using root-mean-square of successive differences (RMSSD).

The validity of the ActiPed for physical activity monitoring.

The ActiPed (FitLinxx) is a uniaxial accelerometer, which objectively measures physical activity, uploads the data wirelessly to a website, allowing participants and researchers to view activity levels remotely. The aim was to validate ActiPed's step count, distance travelled and activity time against direct observation. Further, to compare against pedometer (YAMAX), accelerometer (ActiGraph) and manufacturer's guidelines.

Walks4work: rationale and study design to investigate walking at lunchtime in the workplace setting.

Background: Following recruitment of a private sector company, an 8 week lunchtime walking intervention was implemented to examine the effect of the intervention on modifiable cardiovascular disease risk factors, and further to see if walking environment had any further effect on the cardiovascular disease risk factors.

Methods: For phase 1 of the study participants were divided into three groups, two lunchtime walking intervention groups to walk around either an urban or natural environment twice a week during their lunch break over an 8 week period. The third group was a waiting-list control who would be invited to join the walking groups after phase 1.