ObjectiveHuntington disease (HD) is a fatal autosomal dominant, neurodegenerative condition characterized by progressively worsening motor and nonmotor problems including cognitive and neuropsychiatric disturbances, along with sleep abnormalities and weight loss. However, it is not known whether sleep disturbances and metabolic abnormalities underlying the weight loss are present at a premanifest stage.MethodsWe performed a comprehensive sleep and metabolic study in 38 premanifest gene carrier individuals and 36 age‐ and sex‐matched controls. The study consisted of 2 weeks of actigraphy at home, 2 nights of polysomnography and multiple sleep latency tests in the laboratory, and body composition assessment using dual energy x‐ray absorptiometry scanning with energy expenditure measured over 10 days at home by doubly labeled water and for 36 hours in the laboratory by indirect calorimetry along with detailed cognitive and clinical assessments. We performed a principal component analyses across all measures within each studied domain.ResultsCompared to controls, premanifest gene carriers had more disrupted sleep, which was best characterized by a fragmented sleep profile. These abnormalities, as well as a theta power (4–7Hz) decrease in rapid eye movement sleep, were associated with disease burden score. Objectively measured sleep problems coincided with the development of cognitive, affective, and subtle motor deficits and were not associated with any metabolic alterations.InterpretationThe results show that among the earliest abnormalities in premanifest HD is sleep disturbances. This raises questions as to where the pathology in HD begins and also whether it could drive some of the early features and even possibly the pathology. Ann Neurol 2015;78:630–648
Purpose -The paper aims to ascertain the predictors of training effectiveness with special reference to the characteristics of trainers.Design/methodology/approach -Characteristics of trainers as obtained from the extant literature served as seven independent variables to predict training effectiveness, measured in terms of trainee satisfaction with the training programme. Data were collected by administering a structured questionnaire on employees selected through simple random sampling. A total of 80 responses were obtained and subjected to multiple regression analysis. Findings -Of the seven independent variables, only two, namely trainer's comfort level with the subject matter and trainer's rapport with trainees, were found to be the significant predictors of trainee satisfaction. Hence, the hypothesis that all seven independent variables are significant predictors of trainee satisfaction was partially proved.Originality/value -Training programmes should be designed keeping in mind the knowledge level of trainers and their interpersonal skills. The paper suggests some measures that a trainer may adopt for a better learning experience of the participants.
Wearable physical activity (PA) monitors have improved the ability to estimate free-living total energy expenditure (TEE) but their application during arduous military training alongside more well-established research methods has not been widely documented.This study aimed to assess the validity of two wrist-worn activity monitors and a PA log against doubly labeled water (DLW) during British Army Officer Cadet (OC) training. For 10 days of training, twenty (10 male and 10 female) OCs (mean ± SD: age 23 ± 2 years, height 1.74 ± 0.09 m, body mass 77.0 ± 9.3 kg) wore one researchgrade accelerometer (GENEActiv, Cambridge, UK) on the dominant wrist, wore one commercially available monitor (Fitbit SURGE, USA) on the non-dominant wrist, and completed a self-report PA log. Immediately prior to this 10-day period, participants consumed a bolus of DLW and provided daily urine samples, which were analyzed by mass spectrometry to determine TEE. Bivariate correlations and limits of agreement (LoA) were employed to compare TEE from each estimation method to DLW. Average daily TEE from DLW was 4112 ± 652 kcal·day −1 against which the GENEActiv showed near identical average TEE (mean bias ± LoA: −15 ± 851 kcal . day −1 ) while Fitbit tended to underestimate (−656 ± 683 kcal·day −1 ) and the PA log substantially overestimate (+1946 ± 1637 kcal·day −1 ). Wearable physical activity monitors provide a cheaper and more practical method for estimating free-living TEE than DLW in military settings. The GENEActiv accelerometer demonstrated good validity for assessing daily TEE and would appear suitable for use in large-scale, longitudinal military studies. K E Y W O R D Saccelerometry, army, doubly labeled water, physical activity, wearable technology
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