This study compared the cardiorespiratory responses of eight healthy women (mean age 30.25 years) to submaximal exercise on land (LTm) and water treadmills (WTm) in chest-deep water (Aquaciser). In addition, the effects of two different water temperatures were examined (28 and 36 degrees C). Each exercise test consisted of three consecutive 5-min bouts at 3.5, 4.5 and 5.5 km x h(-1). Oxygen consumption (VO2) and heart rate (HR), measured using open-circuit spirometry and telemetry, respectively, increased linearly with increasing speed both in water and on land. At 3.5 km x h(-1) VO2 was similar across procedures [chi = 0.6 (0.05) l x min(-1)]. At 4.5 and 5.5 km x h(-1) VO2 was significantly higher in water than on land, but there was no temperature effect (WTm: 0.9 and 1.4, respectively; LTm: 0.8 and 0.9 l x min(-1), respectively). HR was significantly higher in WTm at 36 degrees C compared to WTm at 28 degrees C at all speeds, and compared to LTm at 4.5 and 5.5 km x h(-1) (P < or = 0.003). The HR-VO2 relationship showed that at a VO2 of 0.9 l x min(-1) x HR was higher in water at 36 degrees C (115 beats x min[-1]) than either on land (100 beats min[-1]) or in water at 28 degrees C (99 beats x min[-1]). The Borg scale of perceived exertion showed that walking in water at 4.5 and 5.5 km x h(-1) was significantly harder than on land (WTm: 11.4 and 14, respectively; LTm: 9.9 and 11, respectively; P < or = 0.001). These cardiorespiratory changes occurred despite a slower cadence in water (the mean difference at all speeds was 27 steps/min). Thus, walking in chest-deep water yields higher energy costs than walking at similar speeds on land. This data has implications for therapists working in hydrotherapy pools.

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Background: There is good evidence from studies conducted in a single-centre research setting for the efficacy of graded motor imagery (GMI) treatment, a complex physiotherapy intervention, to reduce pain in long-standing complex regional pain syndrome (CRPS). However, whether GMI is effective in clinical practice is not established. Aim: To establish whether GMI is effective in clinical practice. Methods: We undertook a prospective audit of GMI treatment at two UK centres with a special interest in the management of patients with CRPS. All patients received GMI, in conjunction with a range of other 'best practice' physical and psychological interventions. Results: The patients' average pain intensities did not improve with treatment [centre 1: n = 20, pre-post numeric rating scale (NRS) difference 0.6 [confidence interval (CI) -0.3 to 1.5]; centre 2: n = 12, pre-post NRS difference 0.2 (CI: -0.9 to 1.2)]. Patients at centre 1 reported significant functional improvement. Improved performance on left/right judgement replicated in both centres seen in the clinical trials. Conclusions: The failure of our real-world implementation of GMI suggests that better understanding of both the GMI methodology and its interaction with other treatment methods is required to ensure that GMI research results can be translated into clinical practice. Our results highlight challenges with the translation of complex interventions for chronic pain conditions into clinical practice.

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Abstract. The Fine Resolution Atmospheric Multi-pollutantExchange model (FRAME) was applied to model the spatial distribution of reactive nitrogen deposition and air concentration over the United Kingdom at a 1 km spatial resolution. The modelled deposition and concentration data were gridded at resolutions of 1 km, 5 km and 50 km to test the sensitivity of calculations of the exceedance of critical loads for nitrogen deposition to the deposition data resolution. The modelled concentrations of NO 2 were validated by comparison with measurements from the rural sites in the national monitoring network and were found to achieve better agreement with the high resolution 1 km data.High resolution plots were found to represent a more physically realistic distribution of reactive nitrogen air concentrations and deposition resulting from use of 1 km resolution precipitation and emissions data as compared to 5 km resolution data. Summary statistics for national scale exceedance of the critical load for nitrogen deposition were not highly sensitive to the grid resolution of the deposition data but did show greater area exceedance with coarser grid resolution due to spatial averaging of high nitrogen deposition hot spots. Local scale deposition at individual Sites of Special Scientific Interest and high precipitation upland sites was sensitive to choice of grid resolution of deposition data. Use of high resolution data tended to generate lower deposition values in sink areas for nitrogen dry deposition (Sites of Scientific Interest) and higher values in high precipitation upland areas. In areas with generally low exceedance (Scotland) and for certain vegetation types (montane), the exceedance statistics were more sensitive to model data resolution.

The NERC and CEH trade marks and logos ('the Trademarks') are registered trademarks of NERC in the UK and other countries, and may not be used without the prior written consent of the Trademark owner. Wet deposition of nitrogen and sulphur was found to decrease more slowly than the emissions reductions rate.This is attributed to a number of factors including increases in emissions from international shipping and changing rates of atmospheric oxidation. The modelled time series was extended to a 50 year period from 1970 to 2020. The modelled deposition of SO x , NO y and NH x to the UK was found to fall by 87%, 52% and 25% during this period. The percentage of the United Kingdom surface area for which critical loads are exceeded is estimated to fall from 85% in 1970 to 37% in 2020 for acidic deposition and from 73% to 49% for nutrient nitrogen deposition. The significant reduction in land emissions of SO 2 and NO X focuses further attention in controlling emissions from international shipping. Future policies to control emissions of ammonia from agriculture will be required to effect further significant reductions in nitrogen deposition.