Writing in Britain and Ireland, c. 400 to c. 800

No abstract available

Airborne concentration and deposition of trace metals and metalloids in an urban area downwind of a manganese alloy plant

The evaluation of the content of metals and metalloids in particulate matter (PM) and in atmospheric deposition in areas impacted by local industries is essential from an environmental and health risk perspective. In this study, the PM10 levels and atmospheric deposition fluxes of potentially toxic metals and metalloids were quantified at three urban sites of the Cantabrian region (northern Spain), located at different distances downwind of a Mn alloy plant. The content of Mn, V, Fe, Ni, Cu, Zn, As, Mo, Cd, Sb and Pb in PM10 and in the water-soluble and insoluble fractions of the deposition was determined by ICP-MS. Among the studied elements, the highest concentrations in PM10 and deposition rates were found for Mn, Fe, Zn and Pb, associated with the Mn alloy industry, and for Cu, related to non-exhaust traffic emissions. The levels of Mn, Fe, Zn and Pb in PM10 were higher in autumn, when the most frequent winds blow from the S-SW, whereas their highest deposition rates were found in winter and autumn, which are characterized by high monthly average precipitations. The water-soluble fraction of the atmospheric deposition of most metals increased with distance from the Mn alloy plant. The highest water-soluble fractions were found for Ni (72%), Zn (62%), Cu (60%) and Mn (49%). These results will be useful for the health risk assessment of the metal exposure associated with Mn alloy plants, as well as for the evaluation of the metal burden to soil, water and ecosystems related to this industrial activity.This work was financially supported by the Spanish Ministry of Economy and Competitiveness (MINECO) through the CTM2013-43904R Project. Ana Hernández-Pellón would like to thank the Ministry of Economy and Competitiveness (MINECO) for the FPI grant awarded, reference number BES-2014-068790

Pilot study of Lokomat versus manual-assisted treadmill training for locomotor recovery post-stroke

<p>Abstract</p> <p>Background</p> <p>While manually-assisted body-weight supported treadmill training (BWSTT) has revealed improved locomotor function in persons with post-stroke hemiparesis, outcomes are inconsistent and it is very labor intensive. Thus an alternate treatment approach is desirable. Objectives of this pilot study were to: 1) compare the efficacy of body-weight supported treadmill training (BWSTT) combined with the Lokomat robotic gait orthosis versus manually-assisted BWSTT for locomotor training post-stroke, and 2) assess effects of fast versus slow treadmill training speed.</p> <p>Methods</p> <p>Sixteen volunteers with chronic hemiparetic gait (0.62 ± 0.30 m/s) post-stroke were randomly allocated to Lokomat (n = 8) or manual-BWSTT (n = 8) 3×/wk for 4 weeks. Groups were also stratified by fast (mean 0.92 ± 0.15 m/s) or slow (0.58 ± 0.12 m/s) training speeds. The primary outcomes were self-selected overground walking speed and paretic step length ratio. Secondary outcomes included: fast overground walking speed, 6-minute walk test, and a battery of clinical measures.</p> <p>Results</p> <p>No significant differences in primary outcomes were revealed between Lokomat and manual groups as a result of training. However, within the Lokomat group, self-selected walk speed, paretic step length ratio, and four of the six secondary measures improved (<it>p </it>= 0.04–0.05, effect sizes = 0.19–0.60). Within the manual group, only balance scores improved (<it>p </it>= 0.02, effect size = 0.57). Group differences between fast and slow training groups were not revealed (<it>p </it>≥ 0.28).</p> <p>Conclusion</p> <p>Results suggest that Lokomat training may have advantages over manual-BWSTT following a modest intervention dose in chronic hemiparetic persons and further, that our training speeds produce similar gait improvements. Suggestions for a larger randomized controlled trial with optimal study parameters are provided.</p

Systematic review of the validity and reliability of consumer-wearable activity trackers

Abstract Background Consumer-wearable activity trackers are electronic devices used for monitoring fitness- and other health-related metrics. The purpose of this systematic review was to summarize the evidence for validity and reliability of popular consumer-wearable activity trackers (Fitbit and Jawbone) and their ability to estimate steps, distance, physical activity, energy expenditure, and sleep. Methods Searches included only full-length English language studies published in PubMed, Embase, SPORTDiscus, and Google Scholar through July 31, 2015. Two people reviewed and abstracted each included study. Results In total, 22 studies were included in the review (20 on adults, 2 on youth). For laboratory-based studies using step counting or accelerometer steps, the correlation with tracker-assessed steps was high for both Fitbit and Jawbone (Pearson or intraclass correlation coefficients (CC) > =0.80). Only one study assessed distance for the Fitbit, finding an over-estimate at slower speeds and under-estimate at faster speeds. Two field-based studies compared accelerometry-assessed physical activity to the trackers, with one study finding higher correlation (Spearman CC 0.86, Fitbit) while another study found a wide range in correlation (intraclass CC 0.36–0.70, Fitbit and Jawbone). Using several different comparison measures (indirect and direct calorimetry, accelerometry, self-report), energy expenditure was more often under-estimated by either tracker. Total sleep time and sleep efficiency were over-estimated and wake after sleep onset was under-estimated comparing metrics from polysomnography to either tracker using a normal mode setting. No studies of intradevice reliability were found. Interdevice reliability was reported on seven studies using the Fitbit, but none for the Jawbone. Walking- and running-based Fitbit trials indicated consistently high interdevice reliability for steps (Pearson and intraclass CC 0.76–1.00), distance (intraclass CC 0.90–0.99), and energy expenditure (Pearson and intraclass CC 0.71–0.97). When wearing two Fitbits while sleeping, consistency between the devices was high. Conclusion This systematic review indicated higher validity of steps, few studies on distance and physical activity, and lower validity for energy expenditure and sleep. The evidence reviewed indicated high interdevice reliability for steps, distance, energy expenditure, and sleep for certain Fitbit models. As new activity trackers and features are introduced to the market, documentation of the measurement properties can guide their use in research settings

Examining Courtesy Stigma in Siblings of People with Down Syndrome

The purpose of this study was to determine whether siblings of people with Down syndrome face courtesy stigma, a stigma acquired as a result of an association with a person from a stigmatized group. The central hypothesis was that the majority of people who have a sibling with Down syndrome face courtesy stigma during both adolescence and adulthood. The data supports this hypothesis, showing that 76% of respondents reported courtesy stigma as adolescents and 62% reported courtesy stigma as adults. The levels of courtesy stigma reported were higher in adolescence than adulthood. However, the overall levels of courtesy stigma reported by all respondents were low, and participants reported strongly positive relationships with their siblings with Down syndrome despite experiencing courtesy stigma. Other findings of this study include a positive correlation between aberrant behaviors on the part of the individual with Down syndrome and higher levels of courtesy stigma reported by their siblings and an increase in courtesy stigma when the sibling with Down syndrome also has a comorbid condition, such as autism or a lack of verbal communication skills. Due to a small participant population, this study was unable to establish whether the amount of courtesy stigma experienced by siblings of people with Down syndrome has changed together with our society's attitudes toward people with intellectual disabilities over the past several decades

Accuracy of 2 activity monitors in detecting steps in people with stroke and traumatic brain injury

Background. Advances in sensor technologies and signal processing techniques provide a method to accurately measure walking activity in the home and community. Activity monitors geared toward consumer or patient use may be an alternative to more expensive monitors designed for research to measure stepping activity. Objective. The objective of this study was to examine the accuracy of 2 consumer/patient activity monitors, the Fitbit Ultra and the Nike+ Fuelband, in identifying stepping activity in people with stroke and traumatic brain injury (TBI). Secondarily, the study sought to compare the accuracy of these 2 activity monitors with that of the StepWatch Activity Monitor (SAM) and a pedometer, the Yamax Digi-Walker SW-701 pedometer (YDWP).Design. A cross-sectional design was used for this study. Method. People with chronic stroke and TBI wore the 4 activity monitors while they performed the Two-Minute Walk Test (2MWT), during which they were videotaped. Activity monitor estimated steps taken were compared with actual steps taken counted from videotape. Accuracy and agreement between activity monitor estimated steps and actual steps were examined using intraclass correlation coefficients (ICC [2,1]) and the Bland-Altman method. Results. The SAM demonstrated the greatest accuracy (ICC [2,1] =.97, mean difference between actual steps and SAM estimated steps=4.7 steps) followed by the Fitbit Ultra (ICC [2,1] =.73, mean difference between actual steps and Fitbit Ultra estimated steps = - 97 steps), the YDWP (ICC [2,1] =.42, mean difference between actual steps and YDWP estimated steps= -28.8 steps), and the Nike+ Fuelband (ICC [2,1] =.20, mean difference between actual steps and Nike+ Fuelband estimated steps =-66.2 steps). Limitations. Walking activity was measured over a short distance in a closed environment, and participants were high functioning ambulators, with a mean gait speed of 0.93 m/s. Conclusions. The Fitbit Ultra may be a low-cost alternative to measure the stepping activity in level, predictable environments of people with stroke and TBI who can walk at speeds \u3e0.58 m/s. © 2014 American Physical Therapy Association