Active work, passive leisure? Associations between occupational and non-occupational physical activity on weekdays.

Research from recent years reports that physical inactivity is a major risk factor for global mortality. Several societal trends in the last decades are likely to have contributed to the increasing prevalence of sedentary lifestyles. Physical activity throughout the day has become much less self-evident and much more a matter of personal effort. Its presumed discretionary character made leisure the time par excellence to compensate for daily inactivity in non-discretionary time. The historical dichotomy of leisure and paid work led to a large body of research assessing the association between occupational and non-occupational physical activity, almost always equated with leisure time physical activity. This study investigates the relationship between occupational and non-occupational physical activity and adds to existing knowledge by breaking down non-occupational physical activity to physical activity in different non-occupational domains of life. Using Belgian time-use data from 2013 coupled with metabolic equivalent of task scores, reveals no direct association between occupational physical activity and physical activity in the domains of leisure, household work and family care, and transport on weekdays after controlling for sociodemographic characteristics. The association between women's occupational physical activity and physical activity in household work and family care is the sole exception. The results suggest that a holistic, naturalistic approach to physical activity taking into account that individuals have to synchronize needs other than paid work (e.g. reproductive and social productive needs) with the institutional and cultural temporal structures of the society they live in, is more appropriate.

Labelling of end-of-life decisions by physicians.

OBJECTIVES: Potentially life-shortening medical end-of-life practices (end-of-life decisions (ELDs)) remain subject to conceptual vagueness. This study evaluates how physicians label these practices by examining which of their own practices (described according to the precise act, the intention, the presence of an explicit patient request and the self-estimated degree of life shortening)they label as euthanasia or sedation. METHODS: We conducted a large stratified random sample of death certificates from 2007 (N=6927).The physicians named on the death certificate were approached by means of a postal questionnaire asking about ELDs made in each case and asked to choose the most appropriate label to describe the ELD. Response rate was 58.4%. RESULTS: In the vast majority of practices labelled as euthanasia, the self-reported actions of the physicians corresponded with the definition in the Belgian euthanasia legislation; practices labelled as palliative or terminal sedation lack clear correspondence with definitions of sedation as presented in existing guidelines. In these cases, an explicit life-shortening intention by means of drug administration was present in 21.6%, life shortening was estimated at more than 24 h in 51% and an explicit patient request was absentin 79.7%. DISCUSSION: Our results suggest that, unlike euthanasia,the concept of palliative or terminal sedation covers abroad range of practices in the minds of physicians. This ambiguity can be a barrier to appropriate sedation practice and indicates a need for better knowledge of the practice of palliative sedation by physicians.