The Effect of Route Choice in Children's Exposure to Ultrafine Particles Whilst Walking to School.

Children walking to school are at a high risk of exposure to air pollution compared with other modes because of the time they spend in close proximity to traffic during their commute. The aim of this study is to investigate the effect of a walker's route choice on their exposure to ultrafine particles (UFP) on the walk to school. During morning commutes over a period of three weeks, exposure to UFP was measured along three routes: two routes were alongside both sides of a busy arterial road with significantly higher levels of traffic on one side compared to the other, and the third route passed through quiet streets (the background route). The results indicate that the mean exposure for the pedestrian walking along the background route was half the exposure experienced on the other two routes. Walkers on the trafficked side were exposed to elevated concentrations (>100,000 pt/cc) 2.5 times longer than the low-trafficked side. However, the duration of the elevated exposure for the background route was close to zero. Public health officials and urban planners may use the results of this study to promote healthier walking routes to schools, especially those planned as part of organized commutes.

Manipulative therapy (Feldenkrais, massage, chiropractic manipulation) for neck pain.

Neck pain is an extremely common symptom with many possible etiologies. A substantial number of patients are turning to complementary and alternative medicine (CAM). Low-quality evidence supports the beneficial effects of CAM. Feldenkrais, massage therapy, and spinal manipulation are discussed in detail. Complications are generally benign and self-limited, although occasional catastrophic consequences have been documented. Despite the favorable opinion many rheumatologists have of some CAM therapy, many patients are not disclosing CAM use to their medical providers. By expressing interest, asking questions, and taking a shared-decision-making approach, providers can encourage disclosure and provide valuable input.

Complementary and alternative treatment for neck pain: chiropractic, acupuncture, TENS, massage, yoga, Tai Chi, and Feldenkrais.

Of the multitude of treatment options for the management of neck pain, no obvious single treatment modality has been shown to be most efficacious. As such, the clinician should consider alternative treatment modalities if a modality is engaging, available, financially feasible, potentially efficacious, and is low risk for the patient. As evidence-based medicine for neck pain develops, the clinician is faced with the challenge of which treatments to encourage patients to pursue. Treatment modalities explored in this article, including chiropractic, acupuncture, TENS, massage, yoga, Tai Chi, and Feldenkrais, represent reasonable complementary and alternative medicine methods for patients with neck pain.