text:
Exercise as it relates to Disease/Exercise as a treatment for drug addiction

Roessler KK. Exercise treatment for drug abuse-A Danish pilot study. Scand J Pub Health. 2010 Aug;38(6):664-9.

What is the background to this research?
Australia has a culture which views the abuse of drugs as not overtly harmful to health. This outlook fosters a society that normalises substance misuse and thereby exposes potential addicts to a higher risk of drug addiction. Drug addiction is a significant problem for public health in Australia, with wide social and economic costs. The estimated cost of drug abuse on the Australian economy is $8.2 billion per year. The Australian government focuses less on treatment, prevention, and harm reduction, and more on law enforcement in an effort to combat our drug problem. Despite these efforts, Australia has still recorded more than 2000 drug induced deaths each year for the past five years, and drug deaths are outpacing population growth, implying that our budget split is ineffective. We are in need of evidence to support changes in policy that focus more on prevention and treatment, like Portugal, who saw drug related deaths drop by 80% after extensive policy change.

Exercise has been proposed as a treatment for drug addiction because of its positive effects on health, the possibility to reduce withdrawal symptoms, enhance mood , reduce anxiety and induce reward signalling in the brain. There is a lack of research in this area with well-designed exercise interventions with many participants. The research article by Roessler investigated the use of an exercise intervention as treatment for drug addiction, providing insight into the effectiveness of exercise as treatment for drug addiction and the prospect of conducting more research in the area.

Where is the research from?
This study was conducted in Denmark by Professor Roessler and was published in 2010. Although social climate differs to Australia, Denmark has approximately half the drug induced deaths of Australia (44 deaths/million people compared to 85 deaths/million people ). Therefore, their research has potential use in Australia. Roessler is well published in the area of exercise and substance abuse and this article was published in the Scandinavian Journal for Public Health, which is ranked with its impact factor in the top 71% of journals worldwide. The Scandinavian Journal for Public Health requires all articles to declare whether there is conflict of interest and where any funding came from, but this is not available to read about in the public version of Roessler’s article.

What kind of research was this?
The study design was an uncontrolled and nonrandomised intervention, which greatly reduces the validity of the results. As such, the level of evidence from studies of this design are considered low. Despite this, as a pilot study, it provides preparation and theory development for a larger scale intervention with an improved study design.

What did the research involve?
The method for the study was as follows: The author acknowledges that the methodology of the study was weak. Utilising self-report measures to track drug use increases the risk of social desirability and recall bias effecting the results. Additionally, the exercise sessions were run by the same person over the intervention, which may have made them a social support for the participants and hence influenced participants behaviour towards the exercise sessions. The participants were aware they were being studied, which may have induced the Hawthorn effect (where participants change their behaviour because they aware they are being studied). The participants also had the chance to increase the duration of the intervention beyond the standard eight weeks, which means results could be attributed more to participants who exercised over a longer or shorter intervention span than others.
 * 60 people attending a local drug addiction treatment centre were recruited for the study by workers at the centre. 38 were included in the study.
 * VO2max, the European Addiction Severity Index questionnaire (EASI), and qualitative focused interviews about sense of body and self-confidence were tested before and after the intervention.
 * Participants exercised under the instruction of a university level fitness trainer for two hours, three times a week, for at least eight weeks. The sessions used weight training and exercise bikes and the goal of sessions was to increase maximal oxygen intake.
 * One year after the intervention, 23 participants took part in a follow up interview.

What were the basic results?
Important results from the study were as follows:
 * Answers from the EASI indicated that fewer participants had the urge to use drugs (65% pre intervention compared to 47% post intervention) and fewer participants had a weakened ability to control their substance abuse (47% pre intervention compared to 18% post intervention).
 * In the qualitative interviews, participants described how they felt they suffered less from withdrawal symptoms.
 * At the one year follow up interview, five participants stated they were free of substance abuse, 10 said they had reduced intake of drugs and the rest stated no changes in their drug addiction.

The author acknowledges that changes described in the results may be due to other factors. Considering the poor study design and the evidence suggesting that results from uncontrolled studies, such as Roessler’s, may over-estimate intervention effects, conclusions drawn from this study on the effect of exercise as treatment for drug addiction should be interpreted with caution.

What conclusions can we take from this research?
Whilst conclusions drawn from Roessler’s study must be interpreted with caution, the positive results, albeit offering only low quality evidence, bring attention to a possible area of further research. Roessler’s study produced effects in line with other studies with a similar design , and since publication, more studies with a controlled, randomised design have been conducted   , showing positive results in reducing substance misuse in drug addicts. The future of treatment for drug addiction is looking promising and research in this area can hopefully contribute to policy change for managing Australia’s drug problem.

Practical advice
In conjunction with studies released since Roessler’s  it may be suggested that exercise can be utilised as a treatment for drug addiction. A good place to start may be with three sessions per week, each comprised of a five-minute warm up, 30 minutes of moderate intensity aerobic training, 15 minutes of weight training and a five-minute cool down. Medical clearance and having an exercise physiologist oversea the sessions is recommended, as this population may have existing cardiovascular damage which may put them at a higher risk of cardiovascular events when exercising. Starting an exercise program at a low load and progressing slowly may help reduce risk of cardiovascular events.

Further information/resources
For a review on exercise as treatment for drug addiction, click here.

There is no shame in struggling with addiction - it is a chronic disease that affords just as much respect, dignity and support as other chronic illnesses (cancer, diabetes etc). For resources on help with drug addiction in Australia, click here.


text: Category:Book:Culinary Arts/Templates

license: Creative Commons - Attribution Share-Alike - https://creativecommons.org/licenses/by-sa/4.0/

title: Category:Book:Culinary Arts/Templates


text:
Exercise as it relates to Disease/Treating osteosarcopenia through high-intensity resistance training. Is it the Holy Grail of treatment options?

This is a summary and critique of the journal article "Effects of High-Intensity Resistance Training on Osteopenia and Sarcopenia Parameters in Older Men with Osteosarcopenia—One-Year Results of the Randomized Controlled Franconian Osteopenia and Sarcopenia Trial (FrOST)." by Wolfgang Kemmler, Matthias Kohl, Michael Fröhlich, Franz Jakob, Klaus Engelke, Simon von Stengel and Daniel Schoene.

What is the background to this research?
Osteosarcopenia is a syndrome which describes the co-existence of both and. Both are chronic health conditions and are most commonly associated with ageing. In simple terms, osteoporosis is a condition where bones have become brittle and more likely to fracture, whereas sacropenia is defined as the loss of muscle mass, strength and function. The combination of these two conditions significantly increases the risk of falls, fractures and mortality rates when compared to either condition alone.

There is a significant body of evidence to support the use of in patients with sarcopenia and it has been shown to have an important protective role in the development of osteoporosis. Yet, the evidence supporting it's use a treatment for reversing osteoporosis is not as strong.

The authors of this study argued previous research trials into the efficacy of resistance exercise as a treatment for osteoporosis contained several limitations (eg: short study duration and different aspects of exercise program design). Further to this, they cited a lack of research in male populations and in individuals with osteosarcopenia.

Where is the research from?
The research presented in this paper is from the Franconian Osteopenia and Sarcopenia Trial or FrOST study. It was published in the Journal of Bone and Mineral Research. The lead author of the study, Wolfgang Kemmler, is a Professor at Friedrich-Alexander-University of Erlangen-Nürnberg in the Faculty of Medicine. He is a widely published author and his main areas of research include investigating the effects of different types of exercise on bone mineral density and body composition in different populations.

The research was supported by Kieser Training, a strength training company which provided the gym facilities and supervised participants.

What kind of research was this?
The study was a clinical exercise study with a stratified randomised and balanced parallel group design. Participants in the study were allocated to either an exercise or control group (no exercise) and the design of the study ensured participants with different levels of skeletal muscle mass were equally represented in both the exercise and control groups. No stratification/grouping to account for differences in bone mineral density was mentioned.

What did the research involve?
Participants for this study were recruited based on their participation in a previous study, the Franconian Sarcopenic Obesity (FranSO) study. They were all men aged 72 years or older who lived in community-based dwellings and who had osteosarcopenia. There were a number of additional eligibility criteria which are listed in full in the original paper.

Participants were allocated to either an exercise or control group. To control for differences in diet and the potential impact it might have on the outcomes being measured, both groups received dietary supplementation of protein, Vitamin D and calcium over the 12 months of the study. The exercise group undertook a 12 month supervised resistance training program two times a week. The training program was machine based and undertaken at a centrally located gym. The exercise program itself was comprehensive, consisting of 5 phases of 8 to 12 week blocks, with up to 18 exercises programmed per session.

The following table outlines the primary and secondary outcome measures used in the study.

What were the basic results?
After 12 months of exercise the following were observed:

Primary Outcome: Secondary Outcome/s:
 * Bone mineral density at the lumbar spine was maintained in the exercise group while it decreased in the control group, resulting in a significant difference between the two groups.
 * Skeletal muscle mass index increased significantly in the exercise group and decreased in the control group.
 * Bone Mineral density at the hip did not change significantly in either the exercise or control group.
 * The maximum dynamic strength of the hip and leg extensors was significantly higher for exercise group when compared to the control group.

What conclusions can we take from this research?
Overall, this was a robust long term study which demonstrated resistance training can have the following benefits in elderly men with osteosarcopenia:
 * help to maintain bone mineral density of the lumbar spine;
 * increase skeletal muscle mass; and
 * improve strength at the hip / leg extensors.

However, it's important to note the benefits of resistance training for elderly populations with sarcopenia is well established and are reflected in clinical guidelines for treatment of sarcopenia. Furthermore, the study found the lumbar bone mineral density of the exercise group was maintained, meaning they would still be defined as having osteopenia / osteoporosis. This suggests resistance exercise by itself was not enough to reverse osteoporosis in this population.

Practical advice
Resistance training is an effective treatment option for sarcopenia and is an important tool for the prevention of osteopenia / osteoporosis.

Further information/resources
Exercise and Sports Science Australia (ESSA) position statement on exercise prescription for the prevention and management of osteoporosis

Osteoporosis Australia

Centers for Disease Control and Prevention: Growing Stronger - Strength Training for Older Adults

Physical activity guidelines for older adults (Australia)


text:
Oberon/A2/BIOS.V24.Mod

MODULE V24; (** AUTHOR "AFI"; PURPOSE "V24/RS-232 driver" *) (** Supports a maximum of 8 COM serial ports at speeds up to 115'200 BPS. 	No longer compatible with ETH Native Oberon. 	The I/O base address and the IRQ corresponding to each COM port must be 	declared in Aos.Par, except that COM1 and COM2 are declared by default 	with their standard values 		COM1="3F8H,4" 		COM2="2F8H,3" 	and must be specified if these values do not apply to a particular machine. 	Bluebottle operates in 32-bit addressing mode and cannot interrogate 	the base address by accessing the port directly in BIOS. 	The ports are numbered in the order of appeareance in Aos.Par, starting from 0 	and are named logically starting from COM1. 	Includes a facility to determine the UART type and a facility to trace the data. 	References: 			Serial and UART Tutorial by Frank Durda 			"http://freebsd.org/doc/en_US.ISO8859-1/articles/serial-uart" 			"http://www.lammertbies.nl/comm/info/RS-232_uart.html" * * History: * *	14.06.2006	Adapted to changes in Serials.Mod (staubesv) *	26.06.2006	ClearMC, SetMC & GetMC procedure bodies made exclusive, performance counters implemented (staubesv) *) IMPORT SYSTEM, Objects, Machine, Streams, Commands, KernelLog, Serials; CONST 	MaxPortNo = 8;	(* Up to 8 serial ports supported *) 	BufSize = 1024; 	(* Port registers *) 	(* RBR = 0;	 Select with DLAB = 0 - Receive Buffer Register - read only 							Select with DLAB = 1 - Baud Rate Divisor LSB *) 	IER = 1;	(* Select with DLAB = 0 - Interrupt Enable Register - R/W 						 Select with DLAB = 1 - Baud Rate Divisor MSB *) 	IIR = 2;	(* Interrupt Identification Register - read only *) 	FCR = 2;	(* 16550 FIFO Control Register write only *) 	LCR = 3;	(* Line Control Register - R/W *) 	MCR = 4;	(* Modem Control Register -  R/W *) 	LSR = 5;	(* Line Status Register -  read only*) 	MSR = 6;	(* Modem Status Register - R/W *) 	SCR = 7;	(* Scratch Register - R/W *) 	(** Modem control lines *) 	DTR* = 0;  RTS* = 1;	(** output *) 	Break* = 2;	(** input/output - Bit 6 in LCR *) 	DSR* = 3;  CTS* = 4;  RI* = 5;  DCD* = 6;	(** input *) 	ModuleName = "V24"; 	Verbose = TRUE; TYPE 	RS232Port = OBJECT (Serials.Port); 		VAR 			baseaddr, irq, maxbps: SIGNED32; 			buf: ARRAY BufSize OF CHAR; 			head, tail: SIGNED32; 			open, ox16: BOOLEAN; 			diagnostic: SIGNED32; 		PROCEDURE &Init*(basespec, irqspec : SIGNED32); 		BEGIN 			baseaddr := basespec; 			irq := irqspec; 			open := FALSE; ox16 := CheckOX16PCI954(basespec); 			IF ox16 THEN 				maxbps := 460800 			ELSE 				maxbps := 115200 			END 		END Init; 		PROCEDURE Open*(bps, data, parity, stop : SIGNED32; VAR res: INTEGER); 		BEGIN {EXCLUSIVE} 			IF open THEN 				IF Verbose THEN KernelLog.String(ModuleName); KernelLog.String(": "); KernelLog.String(name); KernelLog.String(" already open"); KernelLog.Ln; END; 				res := Serials.PortInUse; 				RETURN 			END; 			SetPortState(bps, data, parity, stop, res); 			IF res = Serials.Ok THEN 				open := TRUE; 				head := 0; tail:= 0; 				charactersSent := 0; charactersReceived := 0; 				(* install interrupt handler *) 				Objects.InstallHandler(HandleInterrupt, Machine.IRQ0 + irq); 				Machine.Portout8((baseaddr) + IER, 01X);	(* Enable receive interrupts *) 				IF Verbose THEN KernelLog.String(ModuleName); KernelLog.String(": "); KernelLog.String(name); KernelLog.String(" opened"); KernelLog.Ln END; 			END 		END Open; 		(** Send a single character to the UART. *) 		PROCEDURE SendChar*(ch: CHAR; VAR res : INTEGER); 		VAR s: SET; 		BEGIN {EXCLUSIVE} 			IF ~open THEN res := Serials.Closed; RETURN; END; 			res := Serials.Ok; 			REPEAT	(* wait for room in Transmitter Holding Register *) 				Machine.Portin8((baseaddr) + LSR, SYSTEM.VAL(CHAR, s))	(* now send that character *) 			UNTIL 5 IN s; 			Machine.Portout8((baseaddr), ch); 			INC(charactersSent); 		END SendChar; 		(** Wait for the next character is received in the input buffer. The buffer is fed by HandleInterrupt *) 		PROCEDURE ReceiveChar*(VAR ch: CHAR; VAR res: INTEGER); 		BEGIN {EXCLUSIVE} 			IF ~open THEN res := Serials.Closed; RETURN END; 			AWAIT(tail # head); 			IF tail = -1 THEN 				res := Serials.Closed; 			ELSE 				ch := buf[head]; head := (head+1) MOD BufSize; 				res := diagnostic; 			END 		END ReceiveChar; 		(** On detecting an interupt request, transfer the characters from the UART buffer to the input buffer *) 		PROCEDURE HandleInterrupt; 		VAR n: SIGNED32; ch: CHAR; s: SET; 		BEGIN {EXCLUSIVE} 			LOOP	(* transfer all the data available in the UART buffer to buf *) 				Machine.Portin8((baseaddr) + IIR, ch); 				IF ODD(ORD(ch)) THEN EXIT END;	(* nothing pending *) 				diagnostic := 0; 				Machine.Portin8((baseaddr) + LSR, SYSTEM.VAL(CHAR, s));	(* Inspect if error *) 				IF (7 IN s) OR (1 IN s) THEN	(* Establish a diagnostic of the error *) 					IF (1 IN s) THEN diagnostic := Serials.OverrunError; 					ELSIF (2 IN s) THEN diagnostic := Serials.ParityError 					ELSIF (3 IN s) THEN diagnostic := Serials.FramingError 					ELSIF (4 IN s) THEN diagnostic := Serials.BreakInterrupt 					END; 				END; 				Machine.Portin8((baseaddr), ch);	(* Receive a character from the UART - baseaddr points to RBR *) 				n := (tail+1) MOD BufSize; 				IF n # head THEN buf[tail] := ch; tail := n END; 				INC(charactersReceived); 			END; 		END HandleInterrupt; 		PROCEDURE Available*: SIZE; 		BEGIN {EXCLUSIVE} 			RETURN (tail - head) MOD BufSize 		END Available; 		(* Set the port state: speed in bps, no. of data bits, parity, stop bit length. *) 		PROCEDURE SetPortState(bps, data, parity, stop : SIGNED32; VAR res: INTEGER); 		CONST TCR = 2; 		VAR s: SET; tcr: SIGNED32; 		BEGIN 			IF (bps > 0) & (maxbps MOD bps = 0) THEN 				IF (data >= 5) & (data <= 8) & (parity >= Serials.ParNo) & (parity <= Serials.ParSpace) & 						(stop >= Serials.Stop1) & (stop <= Serials.Stop1dot5) THEN 					IF ox16 THEN 						IF bps <= 115200 THEN 							tcr := 0 						ELSE 							tcr := 115200*16 DIV bps; 							ASSERT((tcr >= 4) & (tcr < 16)); 							bps := 115200 						END; 						IF ReadICR(baseaddr, TCR) # CHR(tcr) THEN 							WriteICR(baseaddr, TCR, CHR(tcr)) 						END 					END; 					bps := 115200 DIV bps; 					(* disable interrupts *) 					Machine.Portout8((baseaddr)+LCR, 0X);	(* clear DLAB *) 					Machine.Portout8((baseaddr)+IER, 0X);	(* Disable all interrupts *) 					(* clear latches *) 					Machine.Portin8((baseaddr)+LSR, SYSTEM.VAL(CHAR, s)); 					Machine.Portin8((baseaddr)+IIR, SYSTEM.VAL(CHAR, s)); 					Machine.Portin8((baseaddr)+MSR, SYSTEM.VAL(CHAR, s)); 					Machine.Portout8((baseaddr)+FCR, 0C1X);	(* See if one can activate the FIFO *) 					Machine.Portin8((baseaddr)+IIR, SYSTEM.VAL(CHAR, s));	(* Read how the chip responded in bits 6 & 7 of IIR *) 					IF s * {6,7} = {6,7} THEN	(* FIFO enabled on 16550 chip and later ones *) 						Machine.Portout8((baseaddr) + FCR, 47X)	(* 16550 setup: EnableFifo, CLRRX, CLRTX, SIZE4 *) 					ELSIF s * {6,7} = {} THEN	(* Bits 6 and 7 are always zero on 8250 / 16450 chip *) 						Machine.Portout8((baseaddr) + FCR, 0X) 					ELSE KernelLog.String("Not prepared to deal with this COM port situation");	(* This case should not exist *) 					END; 					(* set parameters *) 					Machine.Portout8((baseaddr) + LCR, 80X);	(* Set the Divisor Latch Bit - DLAB = 1 *) 					Machine.Portout8((baseaddr), CHR(bps));	(* Set the Divisor Latch LSB *) 					Machine.Portout8((baseaddr)+1, CHR(bps DIV 100H));	(* Set the Divisor Latch MSB *) 					(* Prepare parameters destined to LCR data, stop, parity *) 					CASE data OF	(* word length *) 						   5: s := {} 						| 6: s := {0} 						| 7: s := {1} 						| 8: s := {0,1} 					END; 					IF stop # Serials.Stop1 THEN INCL(s, 2) END; 					CASE parity OF 						   Serials.ParNo: 						| Serials.ParOdd: INCL(s, 3) 						| Serials.ParEven: s := s + {3,4} 						| Serials.ParMark: s := s + {3,5} 						| Serials.ParSpace: s := s + {3..5} 					END; 					(* Finalize the LCR *) 					Machine.Portout8((baseaddr)+LCR, SYSTEM.VAL(CHAR, s));	(* DLAB is set = 0 at the same time *) 					(* Set DTR, RTS, OUT2 in the MCR *) 					Machine.Portout8((baseaddr)+MCR, SYSTEM.VAL(CHAR, {DTR,RTS,3})); (*					Machine.Portout8((baseaddr)+IER, 01X);	*) 					res := Serials.Ok 				ELSE res := Serials.WrongData (* bad data/parity/stop *) 				END 			ELSE res := Serials.WrongBPS (* bad BPS *) 			END 		END SetPortState; 		(** Get the port state: state (open/closed), speed in bps, no. of data bits, parity, top bit length. *) 		PROCEDURE GetPortState*(VAR openstat : BOOLEAN; VAR bps, data, parity, stop : SIGNED32); 		CONST TCR = 2; 		VAR savset, set: SET; ch: CHAR; 		BEGIN {EXCLUSIVE} 			(* get parameters *) 			openstat := open; 			Machine.Portin8((baseaddr) + LCR, SYSTEM.VAL(CHAR, savset)); 			set := savset + {7}; 			Machine.Portout8((baseaddr) + LCR, SYSTEM.VAL(CHAR, set));	(* INCL the Divisor Latch Bit - DLAB = 1 *) 			Machine.Portin8((baseaddr)+1, ch); 			bps := ORD(ch); 			Machine.Portin8((baseaddr), ch); 			IF (bps = 0 ) & (ch = 0X) THEN 			ELSE 				bps := 115200 DIV (100H*bps + ORD(ch)) 			END; 			IF ox16 THEN 				ch := ReadICR(baseaddr, TCR); 				IF (ch >= 04X) & (ch < 16X) THEN 					bps := bps*16 DIV ORD(ch) 				END 			END; 			Machine.Portout8((baseaddr)+LCR, SYSTEM.VAL(CHAR, savset));	(* Reset the Divisor Latch Bit - DLAB = 0 *) 			Machine.Portin8((baseaddr)+LCR, SYSTEM.VAL(CHAR, set)); 			IF set * {0, 1} = {0, 1} THEN data := 8 			ELSIF set * {0, 1} = {1} THEN data := 7 			ELSIF set * {0, 1} = {0} THEN data := 6 			ELSE data := 5 			END; 			IF 2 IN set THEN 				IF set * {0, 1} = {} THEN stop := 3 				ELSE stop := 2 				END; 			ELSE stop := 1 			END; 			IF set * {3..5} = {3..5} THEN parity := 4 			ELSIF set * {3,5} = {3,5} THEN parity := 3 			ELSIF set * {3,4} = {3,4} THEN parity := 2 			ELSIF set * {3} = {3} THEN parity := 1 			ELSE parity := 0 			END; 		END GetPortState; 		(** Clear the specified modem control lines. s may contain DTR, RTS & Break. *) 		PROCEDURE ClearMC*(s: SET); 		VAR t: SET; 		BEGIN {EXCLUSIVE} 			IF s * {DTR, RTS} # {} THEN 				Machine.Portin8((baseaddr) + MCR, SYSTEM.VAL(CHAR, t)); 				t := t - (s * {DTR, RTS});	(* modify only bits 0 & 1 *) 				Machine.Portout8((baseaddr) + MCR, SYSTEM.VAL(CHAR, t)) 			END; 			IF Break IN s THEN 				Machine.Portin8((baseaddr) + LCR, SYSTEM.VAL(CHAR, t)); 				EXCL(t, 6);	(* break off *) 				Machine.Portout8((baseaddr) + LCR, SYSTEM.VAL(CHAR, t)) 			END 		END ClearMC; 		(** Set the specified modem control lines. s may contain DTR, RTS & Break. *) 		PROCEDURE SetMC*(s: SET); 		VAR t: SET; 		BEGIN {EXCLUSIVE} 			IF s * {DTR, RTS} # {} THEN 				Machine.Portin8((baseaddr) + MCR, SYSTEM.VAL(CHAR, t)); 				t := t + (s * {DTR, RTS});	(* modify only bits 0 & 1 *) 				Machine.Portout8((baseaddr) + MCR, SYSTEM.VAL(CHAR, t)) 			END; 			IF Break IN s THEN 				Machine.Portin8((baseaddr) + LCR, SYSTEM.VAL(CHAR, t)); 				INCL(t, 6);	(* break on *) 				Machine.Portout8((baseaddr) + LCR, SYSTEM.VAL(CHAR, t)) 			END 		END SetMC; 		(** Return the state of the specified modem control lines. s contains the current state of DSR, CTS, RI, DCD & Break Interrupt. *) 		PROCEDURE GetMC*(VAR s: SET); 		VAR t: SET; 		BEGIN {EXCLUSIVE} 			s := {}; 			Machine.Portin8((baseaddr) + MSR, SYSTEM.VAL(CHAR, t));	(* note: this clears bits 0-3 *) 			IF 4 IN t THEN INCL(s, CTS) END; 			IF 5 IN t THEN INCL(s, DSR) END; 			IF 6 IN t THEN INCL(s, RI) END; 			IF 7 IN t THEN INCL(s, DCD) END; 			Machine.Portin8((baseaddr) + LSR, SYSTEM.VAL(CHAR, t));	(* note: this clears bits 1-4 *) 			IF 4 IN t THEN INCL(s, Break) END 		END GetMC; 		PROCEDURE Close*; 		VAR s: SET; 		BEGIN {EXCLUSIVE} 			IF ~open THEN 				IF Verbose THEN KernelLog.String(ModuleName); KernelLog.String(": "); KernelLog.String(name); KernelLog.String(" not open"); KernelLog.Ln; END; 				RETURN 			END; 			REPEAT	(* wait for last byte to leave *) 				Machine.Portin8((baseaddr)+LSR, SYSTEM.VAL(CHAR, s)) 			UNTIL 6 IN s;	(* No remaining word in the FIFO or transmit shift register *) 			tail := -1;	(* Force a pending Receive to terminate in error. *) 			(* disable interrupts *) 			Machine.Portout8((baseaddr) + IER, 0X); 			(* remove interrupt handler *) 			Objects.RemoveHandler(HandleInterrupt, Machine.IRQ0 + irq); 			open := FALSE; 			IF Verbose THEN KernelLog.String(ModuleName); KernelLog.String(": "); KernelLog.String(name); KernelLog.String(" closed"); KernelLog.Ln; END; 		END Close; 	END RS232Port; PROCEDURE ReadICR(baseaddr, index: SIGNED32): CHAR; 	CONST SPR = 7; ICR = 5; ICREnable = 6; 	VAR ch: CHAR; BEGIN 	Machine.Portout8((baseaddr) + SPR, 0X); 	Machine.Portout8((baseaddr) + ICR, SYSTEM.VAL(CHAR, {ICREnable})); 	Machine.Portout8((baseaddr) + SPR, CHR(index)); 	Machine.Portin8((baseaddr) + ICR, ch); 	Machine.Portout8((baseaddr) + SPR, 0X); 	Machine.Portout8((baseaddr) + ICR, 0X); 	RETURN ch END ReadICR; PROCEDURE WriteICR(baseaddr, index: SIGNED32; ch: CHAR); 	CONST SPR = 7; ICR = 5; BEGIN 	Machine.Portout8((baseaddr) + SPR, CHR(index)); 	Machine.Portout8((baseaddr) + ICR, ch) END WriteICR; PROCEDURE CheckOX16PCI954(baseaddr: SIGNED32): BOOLEAN; 	CONST ID1 = 8; ID2 = 9; ID3 = 10; REV = 11; BEGIN 	RETURN (baseaddr >= 1000H) & (ReadICR(baseaddr, ID1) = 016X) & (ReadICR(baseaddr, ID2) = 0C9X) & 		(ReadICR(baseaddr, ID3) = 050X) & (ReadICR(baseaddr, REV) = 001X) END CheckOX16PCI954; PROCEDURE ShowModule(out : Streams.Writer); BEGIN 	out.String(ModuleName); out.String(": "); END ShowModule; (** Scan the installed serial ports and determine the chip type used *) PROCEDURE Scan*(context : Commands.Context); VAR i: SIGNED32; port: RS232Port; serialPort : Serials.Port; portstatus: SET; found : BOOLEAN; 	PROCEDURE DetectChip(baseaddr: SIGNED32); 	VAR ch: CHAR; 	BEGIN 		context.out.String(" Detected UART  "); 		Machine.Portout8((baseaddr) + FCR, 0C1X);	(* See if one can activate the FIFO *) 		Machine.Portin8((baseaddr) + IIR, ch);	(* Read how the chip responded in the 2 most significant bits of IIR *) 		Machine.Portout8((baseaddr) + FCR, 00X);	(* Deactivate the FIFO *) 		CASE ASH(ORD(ch), -6) OF 		   0: Machine.Portout8((baseaddr) + SCR, 0FAX);	(* See if one can write in the SCR *) 				Machine.Portin8((baseaddr) + SCR, ch); 				IF ch = 0FAX THEN 					Machine.Portout8((baseaddr) + SCR, 0AFX); 					Machine.Portin8((baseaddr) + SCR, ch); 					IF ch = 0AFX THEN 						context.out.String("16450, 8250A") 					ELSE 						context.out.String("8250, 8250-B, (has flaws)") 					END 				ELSE	(* No SCR present *) 					context.out.String("8250, 8250-B, (has flaws)") 				END 		| 1: context.out.String("Unknown chip") 		| 2: context.out.String("16550, non-buffered (has flaws)") 		| 3: IF CheckOX16PCI954(baseaddr) THEN 					context.out.String("OX16PCI954") 				ELSE 					context.out.String("16550A, buffer operational") 				END 		END 	END DetectChip; BEGIN 	ShowModule(context.out); context.out.String("Serial port detection and inspection:"); context.out.Ln; 	found := FALSE; 	FOR i := 1 TO Serials.MaxPorts DO 		serialPort := Serials.GetPort(i); 		IF (serialPort # NIL) & (serialPort IS RS232Port) THEN 			port := serialPort (RS232Port); found := TRUE; 			IF port.baseaddr # 0 THEN (* Port has a valid base address *) 				context.out.String(port.name); context.out.String(": "); context.out.Hex(port.baseaddr, 10); context.out.Char("H"); context.out.Int(port.irq, 4); 				DetectChip(port.baseaddr); 				port.GetMC(portstatus); 				IF CTS IN portstatus THEN context.out.String(" - CTS signals the presence of a DCE / Modem") END; 				context.out.Ln 			END 		END; 	END; 	IF ~found THEN context.out.String("No COM port found."); context.out.Ln; END; END Scan; (** Set the essential port operating parameters as specified in Aos.Par 		If omitted, default standard values are assigned to COM1 and COM2 *) PROCEDURE Install*(context : Commands.Context); VAR i: SIGNED32; p : SIZE; name, s: ARRAY 16 OF CHAR; BASE, IRQ: SIGNED32; port : RS232Port; BEGIN 	FOR i := 0 TO MaxPortNo-1 DO 		COPY("COM ", name); 		name[3] := CHR(ORD("1") + i); 		Machine.GetConfig(name, s); 		p := 0; 		BASE := Machine.StrToInt(p, s); 		IF s[p] = "," THEN 			INC(p); IRQ := Machine.StrToInt(p, s) 		END; 		IF (i = 0) & (BASE = 0) THEN BASE := 3F8H; IRQ := 4 END;	(* COM1 port default values *) 		IF (i = 1) & (BASE = 0) THEN BASE := 2F8H; IRQ := 3 END;	(* COM2 port default values *) 		IF BASE # 0 THEN 			NEW(port, BASE, IRQ); 			(* Check the presence of a UART at the specified base address *) 			Machine.Portin8((port.baseaddr) + MCR, s[0]); 			IF ORD(s[0]) < 32 THEN	(* Bits 7..5 of the MCR are always 0 when a UART is present *) 				(* Register this RS232Port with an identical index in Serials.registeredSerials array *) 				Serials.RegisterOnboardPort (i+1, port, name, "Onboard UART"); 				IF context # NIL THEN 					ShowModule(context.out); context.out.String("Port "); context.out.String(name); context.out.String(" installed."); context.out.Ln; 				END; 			ELSE 				IF context # NIL THEN 					ShowModule(context.out); context.out.String("No UART present at address specified for "); 					context.out.String(name); 					context.out.Ln 				END; 			END 		END 	END; END Install; PROCEDURE Init*; (* compatibility with windows ... *) BEGIN END Init; END V24. V24.Install ~		System.Free V24 ~ V24.Scan ~ Example Aos.Par information (typical values usually assigned to the 4 first serial ports)   COM1="3F8H,4"   COM2="2F8H,3"   COM3="3E8H,6"   COM4="2E8H,9" ~ In Bluebottle, the generalization of the serial port support lead to the following adjustments: New low-level module V24.Mod -> V24.Obx is completely new. 	A new object-oriented driver supporting up to 8 serial ports (COM1 .. COM8) at speeds up to 	115'200 BPS. No longer compatible with ETH Native Oberon. 	The I/O base address and the IRQ corresponding to each COM port must be declared in Aos.Par, 	which contains configuration data, except that COM1 and COM2 are declared by default 	with their standard values, as used on most machines 		COM1="3F8H,4" 		COM2="2F8H,3" 	These two ports must be declared only in the case that the indicated standard do not apply. 	Bluebottle operates in 32-bit addressing mode and it is not possible to interrogate the base address 	by accessing the port directly in BIOS. 	The port information is registered in the order of appearance in Aos.Par and the ports are: 	- named from the user's viewpoint starting from COM1 by name and 1 by number and 	- numbered internally starting from 0 	The module includes the facilities 	- to verify that the ports declared in Aos.Par exist effectively 	- to determine the UART chip type used by the ports 	- to detect the presence of a modem 	- to trace the data stream (in the next update round) 	Error detection and handling during the reception have been improved, but the reception is 	not error prone anyway. Very low-level module using a serial port KernelLog.Mod -> KernelLog.Obx 	Offers the possibility of tracing the boot process on another machine connected via a serial port 	without the assistance of any other V24 support mentioned in this context. 	Like V24.Mod, it collects the base address of the available serial ports from Aos.Par 	and the port is selected from this list by reading the TracePort value in Aos.Par 	In the original version the port base address was hard-coded in the module. 	The module produces only an outgoing data stream. Modified low-level module Aos.V24.Mod -> V24.Obx 	In the earlier Bluebottle versions, this module offered the low-level serial port support. 	It is now an application module exploiting V24.Obx. Consequently, it is much simpler 	although it offers all the functionality of its predecessor. 	Backward compatibility with the original version is thus provided for client modules. 	New developments should avoid using it and make use of the enhanced V24.Obx.

title: Oberon/A2/BIOS.V24.Mod


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Exercise as it relates to Disease/Enhancing aerobic and anaerobic fitness in asthmatic children

Counil F, Varray A, Matecki S, Beurey A, Marchal P, Voisin M et al. Training of aerobic and anaerobic fitness in children with asthma. The Journal of Pediatrics. 2003;142(2):179-184. DOI: 10.1067/mpd.2003.83

What is the background to this research?
This paper evaluates improvements in aerobic and anaerobic fitness in asthamatic children after a training protocol designed to target both energy systems. Asthma is a chronic inflammatory condition affecting the airways. In 2013, the disorder affected 1 in 7 children and 1 in 15 adults in the United States. The majority of studies looking at exercise capacity in asthmatic people published prior to 2002 have been from an aerobic energy system point of view. The authors reported that a training effect on the anaerobic component of fitness has not been demonstrated in patients with asthma, and that all current training protocols are designed to improve aerobic fitness. Tolerable exercise protocols, both aerobic and anaerobically focussed, are important for people with asthma. There is a large amount of self-limitation of physical activity (PA) in asthmatic people due to unpleasant feelings associated with exercising, such as dyspnea and exercise-induced bronchospasm (EIB). Despite this, regular PA is recognised as being beneficial for asthmatics as it improves both cardiorespiratory health and muscular conditioning. It has been reported that equal decreases in maximal aerobic and anaerobic capacity exist in this population indicating that there is a need to increase both aspects of fitness.

Where is the research from?
The article was published in The Journal of Pediatrics in 2002. The research was conducted by a team from University of France Montpellier, Faculty of Sport Science. Service de Pédiatrie (the pediatric department) and Service d'Exploration Fonctionnelle Respiratoire (the exploration of respiratory function service) at Arnaud de Villeneuve Hospital were also involved. The head author, Francois-Pierre Counil, is a part of the Department of Pediatrics at Sherbrooke University and has many publications of research in respiratory, pulmonology and sports medicine.

What kind of research was this?
The study was a randomised controlled trial (RCT). At the time of the study (2002), only a few other controlled studies were available on the effects of endurance training in children with asthma. Some studies showed improvements in VO 2 max , maximal aerobic power (MAP)  , and anaerobic threshold , other studies showed no improvements. Being a RCT, the level of evidence should be reliable as the participants were randomly placed into either an exercising group or a control group. RCTs are considered to be the gold standard for determining the efficacy of a treatment protocol and the safety for the participants. They also ensure a low level of systematic error and provide a very high level of evidence regarding the effectiveness of the proposed protocol.

What did the research involve?
The study involved 16 male children who were recruited from two inpatient pulmonary rehabilitation clinics in Font Romeu, France. The participants had 3 sessions/week over 6 weeks. Each session involved 45min of continuous cycling, and every 4min they performed a 1min sprint at load corresponding to each subject’s individual MAP (recorded during an initial VO 2 max test). All sessions were supervised by a trainer and a pulmonologist to ensure the participants performed the exercises safely and correctly. The method used in the study is sound and a similar program has been used previously. However, it may have been more advantageous to undertake two different training modalities; one directly designed to improve aerobic fitness and another to improve anaerobic fitness. As well as this, increasing the length of the program from 6 weeks to 16 weeks may yield more reliable results. The study is limited in that only 16 children were recruited. The children were aged 10-16y/o, indicating that they would have been at very different stages of development, resulting in very different responses to training. Past studies have reported inconclusive evidence about aerobic response in children pre puberty.

What were the basic results?
The training protocol resulted in significant increases from baseline in the exercise group for: No significant changes were found in the control group for any of the tested variables. The researchers reported that both aerobic and anaerobic fitness can be improved in asthmatic children by using an exercise protocol that involves bouts of both high and moderate-low intensity workloads. However, there may be an overemphasis on the improvement to the anaerobic fitness of the participants as the only anaerobic parameter that significantly increased post-intervention was peak power. Neither the maximal breaking mass the subject could theoretically handle (Fo), nor the maximal cycling velocity theoretically obtained if Fo=0 (Vo) increased after the training protocol. Therefore, it is more likely that improvements in anaerobic fitness are not as great as improvements in aerobic fitness using the protocol implemented in this study. In order to further improve anaerobic fitness above just peak power, a specific protocol should be implemented that targets anaerobic fitness directly. For example, high intensity interval training (HIIT), or a resistance-based training program.
 * VO 2 max
 * Maximal aerobic power (MAP)
 * Maximum heart rate (HR max )
 * Peak power

What conclusions can we take from this research?
From the results, it can be seen that aerobic-based training in asthmatic children makes significant improvements in their aerobic fitness. However more data is needed to assess significant improvements in anaerobic fitness as the only aspect to improve in the study was peak power. For example, evaluating lactate thresholds and implementing a resistance-based protocol may be more informative about improvements to the anaerobic capacity of asthmatic children. A study duration including both male and females would also make the findings more applicable to a wider population group. These findings align with a more recent study from 2007 that also found improvements in power outputs and VO 2 max. This study involved two exercise sessions per week for 16 weeks. Each session included 30min of aerobic exercise followed by 30min of resistance-based exercise. The study concluded that exercise improves the quality of life and EIB in asthmatic children. However, another study reported no significant improvements in lung function (measured using FEV 1 ) after a 6 week exercise intervention (3 x 40min sessions/week), but did report improvements in clinical symptoms and quality of life (measured using the Paediatric Allergic Disease Quality of Life Questionnaire).

Practical advice
Exercise Recommendations Cycling Resistance Cautions
 * For those with no or little history of PA, include a build-up period over 8 sessions of low intensity.
 * Once tolerable, increase the duration and intensity, aiming for 40-45min of moderate intensity.
 * To train both aerobic and anaerobic systems, high intensity "sprints" can be added in every 4-5min of moderate intensity cycling.
 * Upper and lower body resistance based exercise can be performed with free weights.
 * Literature suggests 3 sets of 15 repetitions per exercise.
 * Caution should be taken for those with severe asthma when considering beginning a PA program as those involved in the study were classified as having only mild-moderate asthma.

Further information/resources
Helpful links
 * What happens in your airways when you have asthma
 * Exercise and Asthma
 * Asthma Australia
 * Exercise-induced asthma
 * 11 Ways to Encourage Your Child to be more Physically Active


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Exercise as it relates to Disease/Group exercise treatment for military veterans with post-traumatic stress disorder

This WikiBook is a critical analysis of the research article "Veterans Group Exercise: A randomised pilot trial of an Integrative Exercise program for veterans with post-traumatic stress" by Goldstein et al., (2018)

This analysis was conducted as an assessment for Health Disease and Exercise (8340) at the University of Canberra.

Research Background
Post-Traumatic Stress Disorder (PTSD) can be defined as a chronic psychological condition developed following exposure to a traumatic event or experience, that involves actual or threat of death or serious injury. The prevalence of PTSD amongst military veterans has increased in the last decade following the Middle Eastern conflicts in Iraq and Afghanistan, with current estimates ranging from 15% in Vietnam War veterans, to 5-20% of those who served in Iraq and Afghanistan. These figures also don't take into account approximately 20% of returning servicemen and women who don't receive Post-Deployment Health Assessments. Estimations are often disputed and vary largely, due to the rate of underreporting and failure to seek treatment, as well as difficulty establishing a firm diagnosis.

Veterans suffering from PTSD often experience symptoms of functional impairment and an overall decreased quality of life. PTSD has been associated with higher lifetime prevalence of other negative health outcomes, in particular, circulatory, digestive, musculoskeletal, nervous system, respiratory and infectious diseases, and is also a major risk factor for cardiovascular disease. Aside from physiological health outcomes, PTSD is known to increase the prevalence of other psychological conditions with sufferers 3-5 times more likely to also suffer from depression. Anxiety, sleep disturbance and substance abuse/dependence are also more commonly associated with PTSD. Based on statistics, returned veterans in the United States account for 20% of suicide figures, with those in the 18–24 years age bracket are now 4x more likely than their non-serving peers, further highlighting the need for greater intervention into Veteran PTSD

Traditional treatments of Post-Traumatic Stress Disorder typically include either pharmacotherapy or psychotherapy, or a combination of both. Medicated intervention is most commonly through the use of anti-depressants, or similar, to treat the patient. Cognitive-behaviour therapy is the most commonly utilised from of psychotherapy when treating PTSD, and has been shown to be more effective than any other method of non-drug treatment. Published in 2007, the Australian Guidelines for the Treatment of Adults with Acute Stress Disorder and PTSD state that exercise may be helpful in managing the symptoms of Post-Traumatic Stress Disorder, and are an effective part of a general self-care program

Where is this research from?
This research was a randomised pilot study conducted to assess the effects of a group exercise program on symptom severity and quality of life in Military Veterans suffering from Post-Traumatic Stress Disorder. As this is a relatively small sample size (n=47), and the nature of the research, the primary intention is to assess the protocols for validity for further research.

Participants in this study were determined to have met the criteria for current or partial PTSD, as outlined by the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders. The Diagnostic and Statistical Manual of Mental Disorders is considered to be the gold standard in diagnosing mental health conditions including PTSD.

The primary author of this research, Lizabeth A. Goldstein, is an Assistant Professor at the University of California, San Francisco. She is extensively published in Post-Traumatic Stress Disorder, Cognitive Behaviour Therapies, as well as a range of other psychological conditions. The research was overseen by Dr. Thomas Neylan, resident professor of the Department of Psychiatry at the University of California, San Francisco. Amongst his other roles, Dr. Neylan is the Director of the Post-Traumatic Stress Disorders (PTSD) Clinic and the Stress and Health Research Program at the San Francisco Veterans Affairs Medical Centre.

What did the research involve?
The research was conducted on a veteran population (n=47), aged 18–69 (M=46.8). The participants - mostly male (81%) - were first screened following the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition)(DSM - IV) to establish the status of their PTSD - current (n=42) or partial (n=5). Participants were then randomised into their research groups - 21 to undertake the Integrated Exercise Program (IE) and the remaining 26 to remain in a monitor only Waitlist Control Group (WL). Participants from both groups underwent pre-screening through a number of methodologies, to establish baseline prior to the research commencing. Pre-screening included a previous medical history, completion of the Physical Activity Readiness Questionnaire and more targeted assessments to determine particular characteristics associated with each participants PTSD. Each of these assessments was then to be followed up at the conclusion of week 4, week 8 and week 12 - the end of the research period. Targeted assessments consisted of;

 * Structured Clinical Interview for DSM-IV - structured interview assessment used to determine participants diagnostic status, is considered to have good reliability and validity.
 * Clinician-Administered PTSD Scale (CAPs) - structured interview assessment used to assess the frequency and intensity of the participants PTSD-related symptoms. Severity scores are assigned to each symptom, and scores are then totalled 0 - 136 with a higher score indicative of more severe symptoms. The CAPs assessment has been established to provide good test-retest reliability and consistency.
 * World Health Organisation Quality of Life (WHOQOL - BREF) - self-reporting assessment determining quality of life in physical and psychological health, shown to have a good level of reliability and validity.
 * Feasibility and Acceptability Questionnaire - self-reporting assessment completed by IE participants following the conclusion of exercise program, based on overall treatment impression, content of intervention and length of intervention. Responses gathered on a scale of 1 - 5.
 * Godin Leisure-Time Exercise Questionnaire - self-reporting assessment completed by IE and WL participants weekly. Shows good reliability and validity, based on comparisons with maximum oxygen consumption (VO2Max) and body fat.

The Integrated Exercise (IE) participants began their research protocols following all of the pre-screening assessments. The IE protocols followed three-1 hour group training sessions per week, across a 12-week period for the entirety of the study. Exercise intervention consisted of a combination of aerobic training, strength training with free weights and resistance bands, as well as yoga movements conducted following one new mindfulness principle introduced on a weekly basis. Each exercise session was approached on a full-body basis, working all major muscle groups but through varying durations and intensities to reduce the effects of delayed onset muscle soreness (DOMs).

What were the basic results?
The research highlighted particular areas of effectiveness of the exercise intervention in its treatment of PTSD, its symptoms and the quality of life of participants. On average, IE participants recorded a reduction of 30.64 on the CAPs assessment, compared with an average of 14.77 in the WL group. This difference in CAPs scores indicates the successful reduction of symptoms in the IE group, when compared to WL. Based on the WHOQOL - BREF data, both physical and psychological, there is further reason to suggest validity of the group exercise intervention, as physical data was significantly greater, and psychological had also improved.

The participants that completed the entire exercise intervention reported high levels of satisfaction overall. Each participant reported perceived benefit from treatment, learning new skills and techniques, and overall the experience of the intervention in a group setting was engaging and enjoyable.

What conclusions can we take from this research?
Based on the research, there is evidence to suggest benefit in group exercise intervention as a treatment for Post-Traumatic Stress Disorder in Military Veterans. The improvements in symptom severity and quality of life amongst the participants indicates there is a need for further supporting research in this area, but the results of this pilot study show positive signs for its effectiveness as an alternative to traditional pharmacotherapy or psychotherapy. There is enough scope in this research to consider further study, in a larger population. Exercise in a group setting may help to breakdown barriers and stigma associated with PTSD.

Further research into the viability of group exercise as a treatment for PTSD in Veterans is required, in a larger population sample. As the research conducted was a pilot study, the small sample size only gives a brief indication as to the success of the intervention. Furthermore, heavy reliance on self reporting data, a lack of physiological testing, and comparison to an "inactive" group restricts the overall validity.

Practical Advice
Due to the lack of practical recommendations in the research, and the limited information regarding PTSD and exercise for Military Veterans available, the primary source of practical advice would be considered to follow Physical Activity Guidelines, as prescribed for general populations. The Integrated Exercise Program in the research, although briefly outlined, doesn't specify amount, modality and structure of each type of exercise so as such, recommendations for exercise based on the information provided cannot be concluded.

Further information / resources
For further information and reading on Post-Traumatic Stress Disorder in Veterans, please consider the links below;
 * PTSD Treatment for Veterans: What's Working, What's New and What's Next
 * Department of Veterans Affairs, Australia
 * Soldier On, Australia


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User talk:AGG EP

Welcome
Welcome to Wikibooks, AGG EP!

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-- Jules (Mrjulesd) 08:46, 3 September 2020 (UTC)

title: User talk:AGG EP


text:
User:P37307

I am Paul Chambers

title: User:P37307


text:
Exercise as it relates to Disease/Effectiveness of eccentric strength exercise in individuals after a stroke

This is a critique of the research article: Folkerts MA, Hijmans JM, Elsinghorst AL, Mulderij Y, Murgia A, Dekker R. Effectiveness and feasibility of eccentric and task-oriented strength training in individuals with stroke. NeuroRehabilitation. 2017;40(4):459-71.

What is the background to this research?
A stroke is a cardiovascular event where the blood supply to the brain is interupted. Individuals can be left paralysed or disabled with 40% having these lifestyle impediments. In 2015 Australia recorded around 36,700 strokes which equates around to 100 incidents a day. This condition has had one of Australia's highest mortality rates with 5.2% of all deaths resultant of a stroke.

This article focusses on how stroke can be caused by lifestyle factors such as obesity, high blood pressure, and physical inactivity whist improving quality of life post-stroke. Lifestyle factors are becoming more prevalent with predictions of more than a million people to have effects of strokes by 2050 especially when 80% of these could be prevented. A successful strength-based program to aid in rehabilitation from a stroke is important to allow a better quality of life. These programs are targeted at improving the range of motion of joints, strength of the muscles to aid in everyday tasks and coordination.

Where is the research from?
This study was undertaken at the University of Groningen Medical Center, Netherlands and was then published in the international, multidisciplinary journal Neurorehabilitation

This article was Mireille Folkerts first publication as a Ph.D. candidate. She has now published multiple studies in heat stresses on the human body. Juha Hijmans has published multiple studies from 2005 to 2020 on biomechanics and injuries within the body during exercise. The other authors all work at the University of Groningen with each specialising in a different area of exercise and health sciences.

What kind of research was this?
This research is a crossover randomised controlled trial assessing whether eccentric strength training (EST) or task orientated strength training (TOST) is more beneficial. Each of the eleven participants was observed over 10 weeks and completed both EST and TOST. A randomised controlled study is designed to eliminate bias and less risk of systematic error. This study design is ranked a level II for grades of evidence with level I been the best. This is due to lower subject numbers being present within this study, greater subject numbers would increase significance.

What did the research involve?
Eleven individuals were selected from the criteria which included:
 * Understanding of the Dutch language
 * A clinical diagnosis of a stroke
 * At least 6 months post-stroke with the ability to make the rehabilitation clinic
 * Reduced arm function had been reported by a physician
 * Mini-mental state examination for no cognitive impairment

Method

The individuals selected were split into two groups, one group doing EST for the first four weeks and the other group doing TOST. Each group switched over in week six and did the opposite training for the next four weeks. Baseline results were taken before commencement, week five, and week ten. The EST consisted of using lightweight dumbbells and resistance bands going through multiple muscle actions at the shoulder, elbow, and wrist. The TOST had participants use a bilateral upper limb movement based computer game where they held a weighted handlebar for 30 minutes going through different upper body movements. These were completed three times a week, once at the clinic to assess whether progression can be made and twice at home which is self-reported.

Limitations

As apart of the study, individuals had to self-report their participation and results twice a week at home. Potentially subjects could have avoided exercises whilst unsupervised potentially leading to an underestimation of how effective the strength tasks are. Underestimation can also have occurred from the action research arm test (ARAT) where subjects can max out this test which may lead to inaccuracies in their results. Future research incorporating more subjects in their data may allow for a different study design. This can truly show whether task orientated, eccentric strength or a combination of both is more effective.

What were the basic results?
After ten weeks the researchers found positive trends in strength through the shoulder and elbow. The EST-TOST group had the most significant benefits in muscle function however, no significant differences between the two groups in strength. Abbreviations: HHD=Handheld Dynamometer; P=p-value; ES=Effect size; T0=Testing prior to intervention; T2=Final testing.

The researchers reported one participant dropped out of the study due to lack of motivation to continue. Overall strength and upper body mobility was improved in patients post-stroke. This was seen in both sets of groups no matter the sequence of training. The researchers emphasise that task-orientated function has helped to increase the functional ability of the upper limbs when it is preceded by strength training. All other statements made were supported by other studies and statistics stating EST has benefits on the overall strength. One aspect they understand is that further research is required to determine what order works best between EST and TOST preferably with more participants.

What conclusions can we take from this research?
This study is a useful resource for rehabilitation professionals or physiotherapists who work with stroke patients. It gives an insight in how to return some quality of life back through better movement. The researchers have shown what muscle actions have been successful in strengthing the muscles and improving joint movement. Research supports EST as an effective method of resistance training however, most of these articles are on gait and lower body movements. Further research is required on upper body strength and function in stroke patients.

Practical advice
For any stroke patient having impaired motor function, seeking out someone specialised in rehabilitation or physiotherapy may improve muscular function through a strength-based program. The program should consist of lightweight dumbbells, resistance bands, or bodyweight exercises to improve coordination. Two sets of five repetitions should be used for heavier loads while three sets of fifteen repetitions are beneficial for lighter loads. These recommendations will encourage strength and muscular endurance benefits as well as neuromuscular control. Performing these under supervision would be recommended for safety. Trying to build-up to the recommended amounts of 150 minutes of physical activity a week can help prevent any extra lifestyle diseases that may occur from the effects of stroke. Trying to exercise as much as possible will help to provide a better quality of life whilst reducing the chance of further strokes.

Further information/resources
General Stroke Information

Australian Stroke Data

Eccentric Strength Improving Lower Body Mobility

Exercise Tips Post-Stroke

Basic Exercise Ideas Post-Stroke


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User:Sociomi

Audiowavegeek covers the technical aspects of the audio equipment, upcoming trends, audio improvement guides, and in-depth review of the music-related products and technology. Consider this as your go-to site for anything audio.

title: User:Sociomi


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User:Synoman Barris/Twinkle.js

Use the settings in the panel below to customize Twinkle to suit your personal preferences.

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User talk:1.186.178.109

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title: User talk:1.186.178.109


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Wikijunior:Africa/Algeria

Algeria is a country in Northern Africa. Algiers is the country's biggest city. Algeria is the tenth-largest country in the world, and the largest by area in the African Union and the Arab world, while having one of the largest military forces in Africa and the largest defence budget.

Geography
Algeria has a coast on the Mediterranean Sea. A large portion of central and southern Algeria is covered by the Sahara Desert. The Sahara Desert is a vast desert stretching across most of North Africa. It is not very habitable, with only an extremely small amount of people living in it, despite its extreme size.

title: Wikijunior:Africa/Algeria


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Wikijunior:Africa/Angola

Namibia is a country in southern Africa. Luanda is the country's capital city. It is the seventh-largest country in Africa. Its currency is known as Kwanza.

People
.

title: Wikijunior:Africa/Angola


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Wikijunior:Africa/Benin

Benin is a country in Western Africa. Its currency is known as West African CFA franc.

Geography
Benin covers an area of 114,763 square kilometres (44,310 sq mi).

Economy
The economy of Benin is dependent on subsistence agriculture, cotton production, and regional trade. Cotton accounts for 40% of the GDP and roughly 80% of official export receipts.Growth in real output has averaged around 5% in the past seven years, but rapid population growth has offset much of this increase. Inflation has subsided over the past several years. Benin uses the CFA franc, which is pegged to the euro.

People
The official language of Benin is French, with several indigenous languages such as Fon, Bariba, Yoruba and Dendi also being commonly spoken. The largest religious group in Benin is Roman Catholicism, followed closely by Islam, Vodun (commonly referred to as Voodoo outside the country) and Protestantism. Benin is a member of the United Nations, the African Union, the Economic Community of West African States, the Organisation of Islamic Cooperation, the South Atlantic Peace and Cooperation Zone, La Francophonie, the Community of Sahel–Saharan States, the African Petroleum Producers Association and the Niger Basin Authority.

title: Wikijunior:Africa/Benin


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Wikijunior:Africa/Burkina Faso

Burkina Farso is a landlocked country in West Africa. It covers an area of around 274,200 square kilometres (105,900 sq mi) and is surrounded by six countries. Its currency is known as West African CFA franc.

title: Wikijunior:Africa/Burkina Faso


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Wikijunior:Africa/Burundi

Burundi is a landlocked country in East Africa. is a landlocked country in the Great Rift Valley where the African Great Lakes region and East Africa converge.Its currency is known as the Burundian Franc.

People
Sources estimate the Christian population at 80–90%, with Roman Catholics representing the largest group at 60–65%. Protestant and Anglican practitioners constitute the remaining 15–25%. An estimated 5% of the population adheres to traditional indigenous religious beliefs. Muslims constitute 2–5%, the majority of whom are Sunnis and live in urban areas

title: Wikijunior:Africa/Burundi


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Wikijunior:Africa/Cameroon

Cameroon is a country in West Africa. At 475,442 square kilometres (183,569 sq mi), Cameroon is the world's 53rd-largest country.

People
Cameroon is home to over 250 native languages spoken by nearly 25 million people. The official languages of Cameroon are French and English, the official languages of former colonial French Cameroons and British Cameroons respectively. Its religious population consists of 70.7% Christians and 24.4% Muslims. It is governed as a Unitary presidential republic and has good relations with the major powers of France, the United Kingdom and China.

title: Wikijunior:Africa/Cameroon


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Wikijunior:Africa/Cape Verde

Cape Verde officially the Republic of Cabo Verde, is an island country in the central Atlantic Ocean. Cape Verde is a stable semi-presidential representative democratic republic. It is among the most democratic nations in Africa, ranking 26th in the world, according to the 2018 Democracy Index.

title: Wikijunior:Africa/Cape Verde


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Wikijunior:Africa/Congo

Republic of Congo also known as Congo-Brazzaville, the Congo Republic or simply either Congo or the Congo is a country located in the western coast of Central Africa.

History
The region was dominated by Bantu-speaking tribes at least 3,000 years ago, who built trade links leading into the Congo River basin. Congo was formerly part of the French colony of Equatorial Africa. The Republic of the Congo was established on 28 November 1958 and gained independence from France in 1960. It was a Marxist–Leninist state from 1969 to 1992, under the name People's Republic of the Congo. The sovereign state has had multi-party elections since 1992, although a democratically elected government was ousted in the 1997 Republic of the Congo Civil War, and President Denis Sassou Nguesso, who first came to power in 1979, has ruled for 35 of the past 40 years.

title: Wikijunior:Africa/Congo


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Wikijunior:Africa/Djibouti

Djibouti officially the Republic of Djibouti, is a country located in the Horn of Africa in East Africa.

People
Djibouti is a multi-ethnic nation with a population of over 921,804 inhabitants (the smallest in mainland Africa). French and Arabic are the country's two official languages. About 94% of residents adhere to Islam,[1] which is the official religion and has been predominant in the region for more than a thousand years. The (Issa clan) and Afar make up the two largest ethnic groups. Both speak the Cushitic branch of the Afroasiatic languages

title: Wikijunior:Africa/Djibouti


title: User:Eddiem0710/Template/PageHeader


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User:U3177024

Hi there, My name is Lil Whitfeld, I am 22 years of age and I am currently studying Exercise Physiology and Rehabilitation at the University of Canberra.

'''Background: I Have completed my education up to year 12 and have no progressed onto a bachelors degree (stated above). I am also a dance teacher and employee at a real estate company.

'''Interests: I enjoy exercise, dancing, sunshine as well as socialising with my family and friends.

'''Wikibooks Projects: https://en.wikibooks.org/w/index.php?title=Exercise_as_it_relates_to_Disease/Effects_of_diet_and_exercise_intervention_for_patients_with_type_2_diabetes&action=edit&redlink=1

title: User:U3177024


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Exercise as it relates to Disease/Effects of diet and exercise intervention for patients with type 2 diabetes

This paper is a critique on the article: Vanninen E, Uusitupa M, Siitonen O, Laitinen J, Länsimies E. Habitual physical activity, aerobic capacity and metabolic control in patients with newly diagnosed type 2 (non-insulin-dependent) diabetes mellitus: effect of 1-year diet and exercise intervention. Diabetologia. 1992 Apr 1;35(4):340-6.

This is an assignment created for the unit 'Health Disease and Exercise' at the University of Canberra. Semester 2, 2020

What is the background to this research?
Self-report data collected from 2017 to 2018, revealed that 5.3% of Australians over the age of 18 (and inclusive) had Type 2 diabetes. This value equates to almost 1 million people diagnosed and furthermore, approximately 16,700 associated deaths.

Supporting literature has shown that exercise is beneficial for Type 2 diabetes patients. With regular exercise, 3x< per week, there is an increased insulin resistance effect coupled with an enhanced glucose tolerance post-exercise. If sustained, exercise can also increase high-density lipoprotein (HDL) cholesterol, and reduce low-density lipoprotein (LDL) cholesterol. High levels of LDL can be dangerous as they are associated with atherosclerosis.

During the time period of this study, there was limited evidence of large studies on habitual physical activity in patients with Type 2 diabetes, and its effects. Furthermore, education on diet, physical activity and diabetes in general was near to none in the affected population. Therefore, the present study aimed to investigate the effects of a 1-year intensified diet and exercise intervention on obese, Type 2 diabetics. There was a strong focus on assessing the effects of aerobic capacity and its implications on metabolic function, as well as compliancy to exercise in the selected participants.

Where is the research from?
The intervention group of this study visited the outpatient centre at the Department of Medicine, Kuopio University Hospital where they were treated. The conventional group completed their treatment at the community clinics from which they were referred in Kuopio, Finland. Participants were referred if they were between 40 and 64 years inclusive and had a fasting blood glucose level >6.7 mmol/l. As the highest prevalence of Type 2 diabetes in Finland is from the ages of 55–59, the selected age range for this study is adequate. However, ages 64–75 years are closely followed, perhaps showing a need to increase the selected age range.

The percentage of adults (18-64yrs) reaching the guidelines for physical activity in Finland is currently 34%, with 76% of the population exhibiting sedentary behaviour per day. With a large amount of the population already not physically active, it may be difficult to encourage diabetic patients into regular bouts of exercise/physical activity. This statement is also taking into consideration that on average, females and males were classified as obese on observation of their BMI from this study.

The primary author of this study, Dr. Esko Vanninen, is a professor in the Department of Clinical Physiology and Nuclear Medicine in Kuopio, Finland. He has participated in multiple other studies that similarly investigate insulin-resistance or impaired glucose-control patients. However, these papers have no focus on exercise and its effects on insulin resistance or glucose control.

There is little to no conflicting evidence to that of the findings in this study. However, literature does show an increase in aerobic capacity in patients with Type 2 diabetes with supervised exercise programs, not self-administered.

What kind of research was this?
The design of this study was a randomised control trial (RCT) in which the participants were referred from physicians if they fit the selected criteria. This type of study can prevent any bias selection of participants, which may have altered the results. After elimination of participants due to various factors, only 78 were analysed for the results. As this number can be considered relatively low for the study, different factors such as sex, disease state, exercise history could have skewed the results. This would be considered a downfall to the design of this particular study.

What did the research involve?
After a 3-month diabetic education programme, participants were randomly divided into two groups, the intervention and conventional groups. The intervention group were instructed to visit the outpatient clinic every 2-months for a 12-month period. During these visits they received treatment from a physician, dietitian, and a specialised diabetes nurse. The professionals held a responsibility to motivate patients to exercise, educate them on diet as well as metabolic control. The conventional group did not visit any specialists, instead they attended the community health centres.

All participants used exercise records to note down their duration, intensity and mode of exercise (occupational and recreational) for the 12-month period. Self-report measures, such as the one used in this study, have shown to overestimate physical activity/exercise levels in other studies. Although this method is cost effective, it tests the reliability of the data presented in this study.

Even though there were 2-month check-ups in the intervention group, exercise was unsupervised during the entire 12-month period (except for the initial and post aerobic capacity test). This meant participants were to exercise with a goal of achieving a frequency of 3-4x/week, duration of 30-60 mins and mean heart rate of 110-140 bpm (for which they were not supplied with heart rate monitors). To improve the aerobic capacity of these participants, supervised exercise training may have induced this effect. Results would then have been similar to that of the supported literature noted in the introduction of the study.

As only baseline and 12-month (post-intervention) measures were taken for this study, there is no indication of acute-response to the intervention. Perhaps, this missing data could have provided further motivation for the participants, and a comparison of initial and post-treatment effects.

What were the basic results?
The intervention group reported a 14% increase in the men, and a 41% increase in the female's habitual physical activity at the end of the study. Compared to the conventional group, the men did not significantly increase their habitual physical activity. Aerobic capacity did not significantly improve in either groups, neither did the associated markers (serum-lipid profile). However, among the participants that did increase their VO2 max (n=37), there was also a greater increase in HDL-cholesterol levels than compared to the conventional group. There was a statistically significant inverse correlation between aerobic capacity and HbA 1c (marker for diabetes), even though aerobic capacity did not improve.

The researchers interpreted the results in a manner that was clearly demonstrated in the statistical findings. No over-emphasis on their findings was implied.

What conclusions can we take from this research?
Through thorough analysis of this research article, the main finding is that encouraging increases in habitual physical activity in Type 2 diabetics is not sufficient to improve aerobic capacity. Furthermore, intensified diet education did not induce a significant response in the participants to increase aerobic capacity. Although HDL-cholesterol levels increased and HbA 1c levels decreased with improved aerobic function, evidence is not sufficient enough to state that these metabolic changes are due to increases in aerobic capacity. Increases in physical activity and a reduction in sedentary time in general may have induced these responses, perhaps in conjunction with other variables (better diet, smoking habits, weight loss).

In a more recent review, structured aerobic exercise coupled with resistance exercise demonstrated the largest reduction in HbA 1c levels in Type 2 diabetics. Additionally, a combined effort of more than 150 minutes per week showed further reductions which is in align with the current recommendations of this study. Pedometer-registered physical activity in Type 2 diabetic patients for a short period (12-week intervention), showed an increase in aerobic capacity as well as positive changes to metabolic function and weight loss. Perhaps this method could be substituted for the self-report exercise logs utilised in this study in order to increase motivation for physical activity.

Practical advice
Regular physical activity is beneficial for patients with Type 2 diabetes as it has demonstrated an improvement in metabolic function (HbA 1c, HDL- cholesterol). With the use of pedometers, further increases in regular physical activity are administered. Aerobic capacity can be increased in these patients with supervised exercise sessions that also incorporate resistance training.

When combined, effective diet and exercise can improve serum lipid profiles in that of patients with Type 2 diabetes. These two methods can ultimately improve the quality of life in this affected population.

Further information/resources
The following links provide further information:

 * Relationship between pedometer‐registered activity, aerobic capacity and self‐reported activity and fitness in patients with type 2 diabetes
 * Physical activity advice only or structured exercise training and association with HbA1c levels in type 2 diabetes: a systematic review and meta-analysis
 * Exercise and Diabetes Mellitus
 * Diabetes Australia


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Wikijunior:Africa/Equatorial Guinea

Equatorial Guinea is a country located on the west coast of Central Africa, with an area of 28,000 square kilometres (11,000 sq mi). Formerly the colony of Spanish Guinea, its post-independence name evokes its location near both the Equator and the Gulf of Guinea. Equatorial Guinea is the only sovereign African state in which Spanish is an official language. As of 2015, the country had a population of 1,225,367.

Economy
On 1 January 1985, the country became the first non-Francophone African member of the franc zone, adopting the CFA franc as its currency. The national currency, the ekwele, had previously been linked to the Spanish peseta.

title: Wikijunior:Africa/Equatorial Guinea


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Wikijunior:Africa/Eritrea

Eritrea is a country in Eastern Africa, with its capital at Asmara.

People
Eritrea is a multi-ethnic country, with nine recognized ethnic groups in its population of around five and a half million. Eritrea has nine national languages which are Tigrinya language, Tigre, Afar, Beja, Bilen, Kunama, Nara, Saho. Tigrinya, Arabic, and English serve as the three working languages

title: Wikijunior:Africa/Eritrea


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User talk:72.36.63.190

--Synoman Barris (discuss • contribs) 06:23, 4 September 2020 (UTC)

title: User talk:72.36.63.190


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User talk:5.65.245.237

--Synoman Barris (discuss • contribs) 06:25, 4 September 2020 (UTC)

title: User talk:5.65.245.237


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Wikibooks:AutoWikiBrowser/Typos

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User talk:85.255.233.46

--Synoman Barris (discuss • contribs) 14:13, 4 September 2020 (UTC)

title: User talk:85.255.233.46


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User:Mbrickn

Intro
Howdy!

I mainly edit on:
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I occasionally also use:
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Here I'm mostly interested in updating and modernizing older content. I'm also interested in improving technology and culture articles.

My Workspace
Most of the stuff here isn't really relevant to most people, aside from User:Mbrickn/Wikibooks tips, and is basically my Wikibooks scratchpad. If you're interested in what I'm working on though, feel free to peruse.

To do

 * At some point I'd like to try a recipe for globi used at Saturnalia.
 * Tyrokafteri dip
 * Fix weird issues with Chip's Challenge/Printable version
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 * Fix printable version in Mega Man (classic series)
 * Lunar Lander PDP demo packin and Easter egg for history of video games Wikibook
 * Make strategy guide standardized box with logo, skill level, intended audience, etc. Not quite like infobox, but something similar.

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This is my WikiBooks user page. Other sites may copy contents from 𝒲𝒾𝓀𝒾𝒷ℴℴ𝓀𝓈, but I am almost certainly not affiliated with them. I have a template at the top of this section that explains it nicer, but in case that template is broken on the mirror, this footnote text should remain.

title: User:Mbrickn


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User:AGG EP

Background
I am currently studying Exercise Physiology and Rehabilitation.

Interests
Lifting weights, gardening and playing with my dogs.

Wikibooks projects
[https://en.wikibooks.org/wiki/Exercise_as_it_relates_to_Disease/Treating_osteosarcopenia_through_high-intensity_resistance_training._Is_it_the_Holy_Grail_of_treatment_options%3F Treating osteosarcopenia through high-intensity resistance training. Is it the Holy Grail of treatment options?]

title: User:AGG EP


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English-Hanzi/When hearing loss is the result of injury or damage to the outer or middle ear

When hearing loss is the result of injury or damage to the outer or middle ear, it is called conductive hearing loss.

当听力损失是外耳或中耳受伤或损坏的结果时，称为传导性听力损失.


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English-Hanzi/When deafness is the result of injury or damage to the inner ear

When deafness is the result of injury or damage to the inner ear, vestibulocochlear nerve, or brain, it is sensorineural hearing loss.

当耳聋是内耳，前庭耳蜗神经或大脑受伤或受损的结果时，则是感觉神经性听力损失.


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Exercise as it relates to Disease/Aerobic exercise versus mindfulness-based stress reduction for social anxiety

This is a critique of the article A randomized trial of MBSR versus aerobic exercise for social anxiety disorder, Published in the Journal of Clinical Psychology (2012)

What Is the Background to This Research?
Anxiety is the most common mental health condition in Australia with approximately 11% of the population experiencing social anxiety during their lifetime. Social anxiety disorder is characterised by excess worry during performance situations or social interactions and a focus on the perceived deficient aspects of one’s personality.

Traditional therapies such as pharmacotherapy and cognitive behavioural therapy are most common but some individuals are unresponsive or unable to access these treatments. This has led to a recent shift in the search for non-traditional therapies such as Mindfulness Based Stress Reduction (MBSR) and aerobic exercise.

There is very limited research on the effect of exercise on social anxiety disorder and findings from mixed samples of anxiety disorders cannot be generalised for specific disorders.

Where Is the Research From?
This research was conducted at Stanford University and was published in the Journal of Clinical Psychology. The research was financially supported by grants to author James Gross from the National Institute of Mental Health and the National Centre for Complementary and Integrative Health Care. This financial support is unlikely to have led to biases in the findings and the authors declared no conflicts of interest and no personal or financial affiliations.

Author James Gross is a Professor of Psychology and Director of the Stanford Psychophysiology Laboratory and has published several articles on psychology and psychiatric conditions both before and since publishing this article.

What Kind of Research Was This?
This research was a randomised trial with two control groups. The intervention groups were randomised but the control groups were not. This reduces the reliability of the data. A randomised controlled trial of both intervention and control groups would have provided more reliable results as this is the gold standard for evidence collection.

This study relied on self-reported data and this may have reduced the reliability and validity compared to measured data.

What Did the Research Involve?
Fifty-six adults diagnosed with social anxiety disorder were randomised to complete an 8-week intervention of either MBSR (n=31) or aerobic exercise (n=25) intervention. Two control groups were used for comparison of results, one healthy group of adults with no history of psychiatric problems (n=48) and a group of adults with untreated social anxiety disorder (n=29). These groups were all assessed using the same measures to ensure consistency. Participants were excluded if they had previously completed an MBSR course or undertook regular (≥3 times per week for ≥2 months) practice of meditation or exercise. There were no significant differences between the intervention and control groups at baseline.

Throughout the 8-week intervention the MBSR group participated in a weekly 2.5-hour group class, 1-day meditation retreat and daily home practice. The participants were trained in formal meditation practice and the instructors had an average of 15.7 years teaching experience.

The aerobic exercise group were provided a 2-month gym membership to a gym of the participants’ choice. Participants were required to complete at least two individual aerobic sessions at moderate intensity and one group aerobic session (not meditation or yoga) each week.

All participants of the intervention groups received a weekly phone call to monitor practice and address obstacles. Data about anxiety state was collected pre-intervention, immediately post-intervention and 3-months post-intervention. Participants also reported measures of clinical symptoms and well-being including measurement against the Kentucky Inventory of Mindfulness Scale.

There were several limitations of this study. The reliance on self-reported data may have led to biases or inaccurate reporting, reducing the validity of the results. This study required participants to contact the researchers to participate in the study. This may have discouraged potential participants with severe social anxiety from participating. It would be beneficial to include participants of a broad range of social anxiety disorder symptom levels as the results found may not be generalisable to the remainder of the population with social anxiety disorder due to its limited inclusion criteria. The untreated social anxiety disorder group used as a control was not randomised with the MBSR and aerobic exercise intervention groups. Randomisation of all participants with social anxiety disorder would have increased the reliability and validity of the results.

What Were the Basic Results?
Both interventions were associated with increased mindfulness when compared to the control groups. Comparison of the MBSR group to the untreated social anxiety disorder control showed a decrease in symptoms of social anxiety and perceived stress. Changes in depression, self-compassion and self-esteem were not statistically significant. Comparison of the aerobic exercise group to the untreated social anxiety disorder group showed a decrease in clinical symptoms of social anxiety as well as improved self-compassion. Differences in other measures were not statistically significant.

Both the MBSR and aerobic exercise interventions reduced some clinical symptoms of social anxiety and enhanced some measures of well-being both post-intervention and 3-months post-intervention. Differences between MBSR and aerobic exercise were not statistically significant. The results between the MBSR and aerobic exercise intervention groups were generally comparable and no conclusive results were found regarding the superior non-traditional treatment for social anxiety disorder.

What Conclusions Can We Take From this Research?
Based on the evidence provided, MBSR and aerobic exercise reduce clinical symptoms and improve well-being in people with social anxiety disorder. Neither intervention was successful in improving all aspects of social anxiety disorder. These treatment options are likely to be most effective when combined with traditional therapies such as pharmacotherapy or cognitive behavioural therapy. Further research is needed regarding the combination of traditional and non-traditional therapies for social anxiety disorder.

For people unresponsive or unwilling to undertake traditional therapies, non-traditional therapies may be effective. Subsequent research has suggested that individuals with lower pre-treatment anxiety may find greater improvements with MBSR and individuals with higher pre-treatment anxiety may find greater improvements with aerobic exercise. More recent research has suggested no significant effects of aerobic exercise on social anxiety and to date there is little to no research on the long-term benefits of non-traditional treatments for social anxiety disorder.

Practical Advice
People with social anxiety disorder may find some benefit in Mindfulness-Based Stress Reduction or aerobic exercise. People who experience social anxiety disorder or believe they may be affected, should speak to their GP or a qualified psychologist for individualised treatment which may include traditional or non-traditional therapies.

For individuals unable or unwilling to undertake traditional treatment, non-traditional therapies such as Mindfulness-Based Stress Reduction and aerobic exercise may be effective in reducing symptoms of social anxiety disorder.

Further Information/Resources
Beyond Blue

Anxiety Australia

Mindfulness in Australia

Australia Counselling – MBSR Course


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Exercise as it relates to Disease/Can home-based exercises help reduce knee pain?

This is a critique of the article "Home based exercise programme for knee pain and knee osteoarthritis: randomised controlled trial" KS thomas, et al (2002)

What is the background to this research?
Knee pain caused by knee osteoarthritis is the single most common cause of disability in older adults. The aim of this research was to determine if there would be a reduction in knee pain by simply introducing a 20 to 30-minute exercise intervention in people with knee pain. Although exercise is a common treatment for knee osteoarthritis, patients often seek the attention of physiotherapists. As knee pain is a common problem a less expensive more accessible treatment is ideal. Knee osteoarthritis is a result of the loss of articular cartilage typically found in elderly population. It can also result from wear and tear in the knee joint as people age or from abnormal concentration of force across the knee. Knee osteoarthritis is the most diagnosed type of arthritis and is only set to rise as life expectancy and obesity in people increases.

Where is the research from?
This research was conducted through two general practices in Nottingham where a postal survey was sent to male and females over the age of 45. The authors of the research had backgrounds in rheumatology and access to funding from the department of health.

What kind of research was this?
The research was a randomised controlled trial over two years. Participants were divided into four groups as follows: 1.	Three groups received an intervention:

a.	One group engaged in an exercise program;

b.	One group received a monthly telephone call; and

c.	One group received both an exercise program and a monthly telephone call.

2.	The fourth group received no intervention. Participants in the exercise and telephone call group and participants in the no intervention group were randomised to receive or not receive a placebo health food tablet.

What did the research involve?
The research involved participants aged 45 years old and over who were required to meet the following requirements: 1.	They had not had a total knee replacement, lower limb amputation or a permanent cardiac pacemaker;

2.	They provided informed consent; and

3.	Had experienced no knee pain within the previous week. 786 people were recruited for the research – 470 for the exercise group and 316 for the non-exercise group. A limitation of this group of people is that all participants were recruited from two family practices in Nottingham. This does not provide a broad representation of the population, noting that low socioeconomic status is associated with a higher risk of developing arthritis. While the research points to exercise as being beneficial in reducing knee pain, there are limitations to people’s ability to exercise. For example, a person’s socioeconomic status and environmental factors can influence and reduce their ability to exercise. The research was carried out over two years and the results recorded in six-month intervals. The participants who were assigned exercise intervention were required to perform a 30-minute exercise using both legs, increasing repetitions up to a maximum of 20 repetitions per leg. The programme was designed to strengthen the muscles around the knee and to increase range of motion. The authors did not go into detail about the exercises performed, stating only that the use of graded exercise bands was used. Having not stated the exact exercise interventions performed makes it difficult for the reader to understand and draw their own conclusion from the results.

What were the basic results?
Results were self-reported using a knee specific questionnaire from the Western Ontario and McMaster University (WOMAC) Osteoarthritis Index. The Osteoarthritis Index is based on pain, stiffness, and physical function. The pain score ranges from 0-20 with the higher score being more painful. The results showed the exercise intervention group did have an average of 12% reduced pain over the two-year period.

What conclusions can we take from this research?
The study was aimed at measuring the effect of prescribed home-based exercise on reducing knee pain in adults 45 years and older. There was a reduction in self-reported knee pain in exercise group compared with the non-exercise group. Although there was a reported reduction in pain, a large percentage of participants did not complete the two-year intervention with only 48.1% of the exercise group (226 people) completing the programme.

Practical advice
Aerobic and strength home based exercise can help manage and reduce knee pain. It is important to maintain a fit and healthy body to reduce immobility. Low impact aerobic exercises such as cycling, and walking are a great way for the elderly population to maintain fitness. Strength training for the muscles surrounding the knee joint is important for older people and in particular those with knee pain. Simple exercises such as sitting then standing (sit/stands – where the person sits on a chair, stands, and then sits on the chair until the desired amount of repetitions is reached) and leg crosses can be beneficial and performed in a safe manner. Leg crosses require the person to sit on the edge of a table, bed or seat. The person then crosses their ankles with straight legs and pushes their front leg backwards and the back leg forward until the thigh muscles become tense. This exercise can be held for one minute and then the person may rest for two minutes, and then the exercise repeated a further two times before switching legs.

Further information/resources
https://www.arthritis.org/home

https://www.versusarthritis.org/about-arthritis/conditions/osteoarthritis-of-the-knee/


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User talk:27.63.133.142

--Synoman Barris (discuss • contribs) 06:29, 5 September 2020 (UTC)

title: User talk:27.63.133.142


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User talk:2401:4900:5179:92B9:1:0:CFA9:1850

--Synoman Barris (discuss • contribs) 06:41, 5 September 2020 (UTC)


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User talk:WereSpielChequers

Belated welcome
Welcome to Wikibooks, WereSpielChequers!

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Hi I know you've been here for quite awhile, but were never welcomed, so here it is. cheers -- Jules (Mrjulesd) 08:53, 5 September 2020 (UTC)
 * Thanks, glad to meet someone active in WikiBooks. WereSpielChequers (discuss • contribs) 10:54, 5 September 2020 (UTC)

A new proposal
Hi, there is currently a proposal at Wikibooks:Reading room/Proposals for non-admins to be given the ability of    and. Since you’ve been an active user on Wikibooks for the last thirty day, I thought you might join in by giving feedback/opinion or amendments. Thank you so much for your time Synoman Barris (discuss • contribs) 12:57, 14 September 2020 (UTC)

title: User talk:WereSpielChequers


text:
Cookbook:Chicken Gyros

Chicken

 * 1 clove garlic
 * Smoked paprika
 * Salt
 * Pepper
 * Olive oil
 * 1.3 pounds (~590 grams) chicken breast, diced

Serving

 * Pita bread
 * Olive oil

 * Fries
 * Tzatziki
 * Fry sauce
 * Onion
 * Tomato

Chicken

 * 1) Grate the garlic clove, then combine with the paprika, olive oil, salt, and pepper.
 * 2) Mix the chicken into the marinade. If desired, let marinate.
 * 3) Cook the chicken in a non-stick skillet until the chicken is golden and cooked through.

Serving

 * 1) Put some of the prepared chicken on a warm pita bread and wrap like a burrito. If you like, you can also put some french fries, fry sauce, tzatziki sauce, onions, and/or tomatoes.

title: Cookbook:Chicken Gyros


text:
User talk:106.205.180.255

--Synoman Barris (discuss • contribs) 12:36, 5 September 2020 (UTC)

title: User talk:106.205.180.255