text:
User talk:41.113.223.244

Welcome!
Hello, and welcome to Wikibooks! Thank you for your contributions so far. I hope you like the place and decide to stay.

You don't have to log in to read or edit articles on Wikibooks, but if you wish to acquire additional privileges, you can simply  [ create a named account] . It's free, requires no personal information, and lets you:
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If you edit without using a named account, your (41.113.223.244) is used to identify you instead.

By the way, please make sure to sign and date your talk page comments with four tildes (~~~~).

Happy editing! Aranya (discuss • contribs) 13:04, 5 September 2020 (UTC)

title: User talk:41.113.223.244


text:
User:Davedeezi/Collections/Math study

 * A-level Mathematics
 * CLEP College Algebra
 * GCSE Mathematics
 * HSC Extension 1 and 2 Mathematics
 * IB Mathematics (HL)
 * IB Mathematics SL
 * IB Maths Studies
 * Intermediate 2 Mathematics
 * Leaving Certificate Mathematics
 * Numerical Methods Qualification Exam Problems and Solutions (University of Maryland)
 * RHIT MA113
 * UMD Analysis Qualifying Exam
 * UMD PDE Qualifying Exams
 * UMD Probability Qualifying Exams
 * VCE Mathematical Methods
 * VCE Specialist Mathematics

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

title: User:Davedeezi/Collections/Math study


text:
Module:Gallery

-- This module implements

local p = {}

local templatestyles = 'Template:Gallery/styles.css' local yesno = require('Module:Yesno')

local function trim(s) return mw.ustring.gsub(mw.ustring.gsub(s, '%s', ' '), '^%s*(.-)%s*$', '%1') end

local tracking, preview

local function checkarg(k,v) if k and type(k) == 'string' then if k == 'align' or k == 'state' or k == 'style' or k == 'caption' or k == 'title' or			k == 'width' or k == 'height' or k == 'lines' or k == 'whitebg' or k == 'class' or			k == 'mode' or k == 'footer' or k == 'perrow' or k == 'noborder' or k == 'showfilename' or			k:match('^alt%d+$') or k:match('^%d+$') then -- valid elseif k == 'captionstyle' then if not v:match('^text%-align%s*:%s*center[;%s]*$') then table.insert(tracking, '') end else -- invalid local vlen = mw.ustring.len(k) k = mw.ustring.sub(k, 1, (vlen < 25) and vlen or 25) k = mw.ustring.gsub(k, '[^%w\-_ ]', '?') table.insert(tracking, '') table.insert(preview, '"' .. k .. '"') end end end

function p.gallery(frame) -- If called via #invoke, use the args passed into the invoking template. -- Otherwise, for testing purposes, assume args are being passed directly in. local origArgs = (type(frame.getParent) == 'function') and frame:getParent.args or frame -- ParserFunctions considers the empty string to be false, so to preserve the previous -- behavior of, change any empty arguments to nil, so Lua will consider -- them false too. local args = {} tracking, preview = {}, {} for k, v in pairs(origArgs) do   	if v ~= '' then args[k] = v   		checkarg(k,v) end end if (args.mode or ) == 'packed' and (args.align or ) == '' then args.align = 'center' end

local tbl = mw.html.create('div') tbl:addClass('mod-gallery') if args.state then tbl :addClass('mod-gallery-collapsible') :addClass('collapsible') :addClass(args.state) end if args.style then tbl:cssText(args.style) else tbl:addClass('mod-gallery-default') end if args.align then tbl:addClass('mod-gallery-' .. args.align:lower) end if args.class then tbl:addClass(args.class) end if args.title or args.caption then tbl:tag('div') :addClass('title') :tag('div') :wikitext('' .. (args.title or args.caption) .. '') end local gargs = {} gargs['class'] = 'nochecker' .. (args.noborder and '' or ' bordered-images') gargs['widths'] = tonumber(args.width) or 180 gargs['heights'] = tonumber(args.height) or 180 gargs['style'] = 'line-height:1.35em' gargs['perrow'] = args.perrow gargs['mode'] = args.mode gargs['showfilename'] = args.showfilename if yesno(args.whitebg or 'yes') then gargs['class'] = gargs['class'] .. ' whitebg' end local gallery = {} local imageCount = math.ceil(#args / 2)

for i = 1, imageCount do		local img = trim(args[i*2 - 1] or '') local caption = trim(args[i*2] or '') local alt = trim(args['alt' .. i] or '') if img ~= '' then table.insert(gallery, img .. (alt ~=  and ('|alt=' .. alt) or ) .. '|' .. caption ) end end tbl:tag('div') :addClass('main') :tag('div') :wikitext(				frame:extensionTag{ name = 'gallery', content = '\n' .. table.concat(gallery,'\n'), args = gargs}				) if args.footer then tbl:tag('div') :addClass('footer') :tag('div') :wikitext('' .. args.footer .. '') end

local trackstr = (#tracking > 0) and table.concat(tracking, ) or  if #preview > 0 and frame:preprocess( "" ) == "" then trackstr = tostring(mw.html.create('div')			:addClass('hatnote')			:css('color','red')			:tag('strong'):wikitext('Warning:'):done			:wikitext('Unknown parameters: ' .. table.concat(preview, '; '))) end return frame:extensionTag{ name = 'templatestyles', args = { src = templatestyles} } .. tostring(tbl) .. trackstr end

return p

title: Module:Gallery


text:
Template:Gallery/styles.css

/* */ @media all and (max-width:720px) { .mod-gallery { width:100% !important; } } .mod-gallery { display:table; } .mod-gallery-default { background:transparent; margin-top:.3em; } .mod-gallery-center { margin-left:auto; margin-right:auto; } .mod-gallery-left { float:left; } .mod-gallery-right { float:right; } .mod-gallery-none { float:none; } .mod-gallery-collapsible { width:100%; } .mod-gallery .title, .mod-gallery .main, .mod-gallery .footer { display:table-row; } .mod-gallery .title>div { display:table-cell; text-align:center; font-weight:bold; } .mod-gallery .main>div { display:table-cell; } .mod-gallery .footer>div { display:table-cell; text-align:right; font-size:80%; line-height:1em; } .mod-gallery .title>div *, .mod-gallery .footer>div * { overflow:visible !important } .mod-gallery .gallerybox img { background:none !important; } .mod-gallery .bordered-images .thumb img { border:solid #eaecf0 1px; } .mod-gallery .whitebg .thumb { background:#fff !important; }

title: Template:Gallery/styles.css


text:
Module:Multiple image

-- implements template:multiple image local p = {}

local autoscaledimages local nonautoscaledimages

local function isnotempty(s) return s and s:match( '^%s*(.-)%s*$' ) ~= '' end

local function removepx(s) return tostring(s or ''):match('^(.*)[Pp][Xx]%s*$') or s end

local function getdimensions(s, w, h)	if tonumber(w) and tonumber(h) then nonautoscaledimages = true return tonumber(w), tonumber(h) end local file = s and mw.title.new('File:' .. mw.uri.decode(mw.ustring.gsub(s,'%|.*$',''), 'WIKI')) file = file and file.file or {width = 0, height = 0} w = tonumber(file.width) or 0 h = tonumber(file.height) or 0 autoscaledimages = true return w, h end

local function renderImageCell(image, width, height, link, alt, thumbtime, caption, textalign, istyle) local root = mw.html.create('')

local altstr = '|alt=' .. (alt or '') local linkstr = link and ('|link=' .. link) or '' local widthstr = '|' .. tostring(width) .. 'px' local thumbtimestr = ''

if isnotempty( thumbtime ) then thumbtimestr = '|thumbtime=' .. thumbtime end

local imagediv = root:tag('div') imagediv:addClass('thumbimage') imagediv:cssText(istyle) if( height ) then imagediv:css('height', tostring(height) .. 'px') imagediv:css('overflow', 'hidden') end imagediv:wikitext('') if isnotempty(caption) then local captiondiv = root:tag('div') captiondiv:addClass('thumbcaption') if isnotempty(textalign) then captiondiv:addClass('text-align-' .. textalign) end captiondiv:wikitext(caption) end return tostring(root) end

local function getWidth(w1, w2) local w	if isnotempty(w1) then w = tonumber(w1) elseif isnotempty(w2) then w = tonumber(w2) end return w or 200 end

local function getPerRow(pstr, ic) -- split string into array using any non-digit as a dilimiter local pr = mw.text.split(pstr or '', '[^%d][^%d]*') -- if split failed, assume a single row if (#pr < 1) then pr = {tostring(ic)} end -- convert the array of strings to an array of numbers, -- adding any implied/missing numbers at the end of the array local r = 1 local thisrow = tonumber(pr[1] or ic) or ic	local prownum = {} while( ic > 0 ) do		prownum[r] = thisrow ic = ic - thisrow r = r + 1 -- use the previous if the next is missing and -- make sure we don't overstep the number of images thisrow = math.min(tonumber(pr[r] or thisrow) or ic, ic) end return prownum end

local function renderMultipleImages(frame) local pargs = frame:getParent.args local args = frame.args local width = removepx(pargs['width'] or '') local dir = pargs['direction'] or '' local border = pargs['border'] or args['border'] or '' local align = pargs['align'] or args['align'] or (border == 'infobox' and 'center' or '') local capalign = pargs['caption_align'] or args['caption_align'] or '' local totalwidth = removepx(pargs['total_width'] or args['total_width'] or '') local imgstyle = pargs['image_style'] or args['image_style'] local header = pargs['header'] or pargs['title'] or '' local footer = pargs['footer'] or '' local imagegap = tonumber(pargs['image_gap'] or '1') or 1 local perrow = nil local thumbclass = { ["left"] = 'tleft', ["none"] = 'tnone', ["center"] = 'tnone', ["centre"] = 'tnone', ["right"] = 'tright' }

-- find all the nonempty images local imagenumbers = {} local imagecount = 0 for k, v in pairs( pargs ) do		local i = tonumber(tostring(k):match( '^%s*image([%d]+)%s*$' ) or '0') if( i > 0 and isnotempty(v) ) then table.insert( imagenumbers, i)			imagecount = imagecount + 1 end end

-- sort the imagenumbers table.sort(imagenumbers)

-- create an array with the number of images per row perrow = getPerRow(dir == 'vertical' and '1' or pargs['perrow'], imagecount)

-- compute the number of rows local rowcount = #perrow

-- store the image widths and compute row widths and maximum row width local heights = {} local widths = {} local widthmax = 0 local widthsum = {} local k = 0 for r=1,rowcount do		widthsum[r] = 0 for c=1,perrow[r] do			k = k + 1 if( k <= imagecount ) then local i = imagenumbers[k] if( isnotempty(totalwidth) ) then widths[k], heights[k] = getdimensions(pargs['image' .. i], pargs['width' .. i], pargs['height' .. i]) else widths[k] = getWidth(width, pargs['width' .. i]) end widthsum[r] = widthsum[r] + widths[k] end end widthmax = math.max(widthmax, widthsum[r]) end

-- make sure the gap is non-negative if imagegap < 0 then imagegap = 0 end

-- if total_width has been specified, rescale the image widths if( isnotempty(totalwidth) ) then totalwidth = tonumber(totalwidth) widthmax = 0 local k = 0 for r=1,rowcount do			local koffset = k			local tw = totalwidth - (3 + imagegap) * (perrow[r] - 1) - 12 local ar = {} local arsum = 0 for j=1,perrow[r] do				k = k + 1 if( k<= imagecount ) then local i = imagenumbers[k] local h = heights[k] or 0 if (h > 0) then ar[j] = widths[k]/h heights[k] = h					else ar[j] = widths[k]/100 end arsum = arsum + ar[j] end end local ht = tw/arsum local ws = 0 k = koffset for j=1,perrow[r] do				k = k + 1 if( k<= imagecount ) then local i = imagenumbers[k] widths[k] = math.floor(ar[j]*ht + 0.5) ws = ws + widths[k] if heights[k] then heights[k] = math.floor(ht) end end end widthsum[r] = ws			widthmax = math.max(widthmax, widthsum[r]) end end

-- start building the array of images, if there are images if( imagecount > 0 ) then -- compute width of outer div local bodywidth = 0 for r=1,rowcount do			if( widthmax == widthsum[r] ) then bodywidth = widthmax + (3 + imagegap) * (perrow[r] - 1) + 12 end end -- The body has a min-width of 100, which needs to be taken into account on specific widths bodywidth = math.max( 100, bodywidth - 8);

local bg = pargs['background color'] or '' -- create the array of images local root = mw.html.create('div') root:addClass('thumb') root:addClass('tmulti') -- root:addClass('tmulti-sandbox') root:addClass(thumbclass[align] or 'tright')

if( align == 'center' or align == 'centre' ) then root:addClass('center') end if( bg ~= '' ) then root:css('background-color', bg) end

local div = root:tag('div') div:addClass('thumbinner') div:css('width', tostring(bodywidth) .. 'px') :css('max-width', tostring(bodywidth) .. 'px') if( bg ~= '' ) then div:css('background-color', bg) end if( border == 'infobox' or border == 'none') then div:css('border', 'none') end -- add the header if( isnotempty(header) ) then div:tag('div') :addClass('trow') :tag('div') :addClass('theader') :css('text-align', pargs['header_align']) :css('background-color', pargs['header_background']) :wikitext(header) end -- loop through the images local k = 0 for r=1,rowcount do			local rowdiv = div:tag('div'):addClass('trow'); for j=1,perrow[r] do				k = k + 1 if( k <= imagecount ) then local imagediv = rowdiv:tag('div') imagediv:addClass('tsingle') if bg ~= '' then imagediv:css('background-color', bg); end if ((imagegap > 1) and (j < perrow[r])) then imagediv:css('margin-right', tostring(imagegap) .. 'px') end local i = imagenumbers[k] local img = pargs['image' .. i]					local w = widths[k] imagediv:css('width', tostring(2 + w) .. 'px') :css('max-width', tostring(2 + w) .. 'px') imagediv:wikitext(renderImageCell(img, w, heights[k], pargs['link' .. i], pargs['alt' .. i], pargs['thumbtime' .. i], pargs['caption' .. i], capalign, imgstyle)) end end end -- add the footer if( isnotempty(footer) ) then local falign = string.lower(pargs['footer_align'] or args['footer_align'] or 'left') falign = (falign == 'centre') and 'center' or falign div:tag('div') :addClass('trow') :css('display', (falign ~= 'left') and 'flow-root' or 'flex') :tag('div') :addClass('thumbcaption') :css('text-align', (falign ~= 'left') and falign or nil) :css('background-color', pargs['footer_background']) :wikitext(footer) end return tostring(root) end return '' end

function p.render( frame ) autoscaledimages = false nonautoscaledimages = false

return frame:extensionTag {name = 'templatestyles', args = {src = 'Multiple image/styles.css', wrapper = ".tmulti"}} .. renderMultipleImages( frame ) -- .. (autoscaledimages and  or ) -- .. (nonautoscaledimages and  or ) end

return p

title: Module:Multiple image


text:
Template:Multiple image/styles.css

/* this is a block */ .thumbinner { display: flex; flex-direction: column; }

.trow { display: flex; flex-direction: row; clear: left; flex-wrap: wrap; width: 100%; box-sizing: border-box; }

/* this is a cell */ .tsingle { margin: 1px; float: left; }

.theader { clear: both; font-weight: bold; text-align: center; align-self: center; background-color: transparent; width: 100%; }

.thumbcaption { background-color: transparent; }

.text-align-left { text-align: left; }

.text-align-right { text-align: right; }

.text-align-center { text-align: center; }

@media all and ( max-width: 720px ) { .thumbinner { /* not !important usage can be removed when these are no longer inline styles inside Template:Multiple image and media query using min-width is introduced */ width: 100% !important; box-sizing: border-box; max-width: none !important; align-items: center; }	.trow, .trow * { justify-content: center; }	.tsingle { /* not !important usage can be removed when these are no longer inline styles inside Template:Multiple image and media query using min-width is introduced */ float: none !important; max-width: 100% !important; box-sizing: border-box; }	.trow > .thumbcaption { text-align: center; } }

title: Template:Multiple image/styles.css


text:
User talk:2401:4900:3B2A:7596:B857:F3FF:FE97:8803

--Synoman Barris (discuss • contribs) 16:42, 5 September 2020 (UTC)


text:
User talk:Great Brightstar

Belated welcome
Welcome to Wikibooks, Great Brightstar!

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You do not need technical skills to contribute. You can easily change most books. Please introduce yourself, and let us know what interests you.

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 * Need to rename a page? Use the move tab (is available once your account is 4 days old - until then, ask for help).
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 * Please fill in the edit summary and preview your edits before saving.
 * Sign your name on discussion pages by typing ~~~~
 * User scripts can make many tasks easier. Look at the Gadgets tab of my preferences; check off the boxes for the scripts you want, and hit save!

Hi I know you've been here for quite awhile, but were never welcomed, so here it is. Cheers -- Jules (Mrjulesd) 17:11, 5 September 2020 (UTC)

Queries
Hi, I have some queries:

1. Is Module:Gallery all your own work? If it is imported from elsewhere it should have attribution to source, or ideally imported via the process at Help:Importing.

2. According to the   parameter was removed. Is this intentional? It seems that transclusions call this parameter.

-- Jules (Mrjulesd) 17:21, 5 September 2020 (UTC)

 * It looks as if Module:Gallery is a slight modification of Wikipedia's w:Module:Gallery. --Pi zero (discuss • contribs) 18:01, 5 September 2020 (UTC)

 * Yes, this module is based on source codes from Wikipedia with some small improves I made in Wikimedia Commons, the new source codes has good flexibility among desktop and mobile views (i.e. responsive web design). Currently this module used <gallery> tag as backend, which doesn't has similar parameter, so the new source code no longer support  parameter, but provides   parameter, which can be used to specify number of gallery boxes per line. -- Great Brightstar (discuss • contribs) 15:49, 8 September 2020 (UTC)

 * If you still want  parameter, there are some technical challenges to resolve in the module, however I'm out of idea: 1. Count number of images inserted in the template gallery; 2. Generate appropriate break point into proper position.
 * -- Great Brightstar (discuss • contribs) 16:22, 8 September 2020 (UTC)

 * OK thanks for your explanation. I suppose the change shouldn't cause too many problems. I have updated Module:Gallery with a null edit to provide attribution. -- Jules (Mrjulesd) 16:40, 8 September 2020 (UTC)
 * Sorry I made a mistake while I replied you last time. I was misunderstood the use of  parameter, maybe I have never noticed that when I edit articles with this template. If you still want that you need to write an algorithm for gallery text areas into module page. --Great Brightstar (discuss • contribs) 12:10, 17 September 2020 (UTC)
 * Well it doesn't seem like a hugely important parameter. I think the idea was to provide consistent spacing between rows of images. We can see how it goes I suppose. Jules  (Mrjulesd) 12:56, 17 September 2020 (UTC)

title: User talk:Great Brightstar


text:
User talk:2401:4900:38CE:A2B4:C429:EC78:45E:90D9

--Synoman Barris (discuss • contribs) 19:19, 5 September 2020 (UTC)


text:
User:Alexkachanov/Collections/JLPT N4

 * JLPT Guide/JLPT N4 Vocabulary/Row A

title: User:Alexkachanov/Collections/JLPT N4


text:
User:Alexkachanov/Collections/JLPT N4 Vocabulary

JLPT N4 Vocabulary

 * JLPT Guide/JLPT N4 Vocabulary/Row A
 * JLPT Guide/JLPT N4 Vocabulary/Row Ka
 * JLPT Guide/JLPT N4 Vocabulary/Row Sa
 * JLPT Guide/JLPT N4 Vocabulary/Row Ta
 * JLPT Guide/JLPT N4 Vocabulary/Row Na
 * JLPT Guide/JLPT N4 Vocabulary/Row Ha
 * JLPT Guide/JLPT N4 Vocabulary/Row Ma
 * JLPT Guide/JLPT N4 Vocabulary/Row Ya
 * JLPT Guide/JLPT N4 Vocabulary/Row Ra
 * JLPT Guide/JLPT N4 Vocabulary/Row Wa


text:
Exercise as it relates to Disease/Childhood Activity for lifelong mental health

The following is a critical analysis of the journal article “Lower levels of physical activity in childhood associated with adult depression” by F.N. Jacka et al (2011) as published in the Journal of Science and Medicine in Sport.

What is the background to this research?
The health benefits of partaking in even modest amounts of physical activity have been widely known for many years. Through an improved energy balance an enhanced body composition is achieved as well as changes in glucose levels, lipid profiles, blood pressure and inflammation among many others. From these improvements comes a reduced risk of developing cardiovascular disease, diabetes, respiratory diseases and several forms of cancer. The links between physical activity and improved health have been shown in both adults and children and as such many governments now produce guidelines surrounding physical activity goals such as that produced by the Department of Health’

As well as having short term health benefits children who are physically active have been shown to be more active later in life further increasing the health benefits.

In addition to physical health, physical activity has also been shown to have great benefits to mental health. In studies involving both adults and children evidence has suggested that increased physical activity may lead to reduced depressive symptoms in the short term. As such this may have prevent the onset of depression as well as provide relief for those experiencing symptoms.

However despite this research little is know of the long term protective effects of physical activity on depression. This study looks to fill this gap of knowledge and potentially reduce the growing burden of mental health on society.

Where is the research from?
‘Dr Felice Jacka’ led her team of highly experienced,Victoria based researchers in this study. The authors specialise in a range of fields including. mental health, public health and epidemiology.Although several authors had received funding for research the providers had no role in designing, conducting or analysing this study. The ethics for this study were approved by Barwon Health.

As this study used data from the larger Geelong Osteoporosis Study (GOS) participants were male and female between 20–96 and located within the Barwon Statistical Division.

What kind of research was this?
As a part of larger epidemiology research this cross sectional study looked specifically at the link between childhood physical and adult depression.

As this was a cross sectional study information was able to be assessed across a wide range of society with little cost to researcher or disruption to participants. However as this is simply an insight into the correlations at a particular point in time causation and other influencing factors are not assessable and therefore further research is needed to fully understand the mechanism of the relationship.

Additionally as the surveys in most cross sectional studies (including this research) are self reported by participants some elements of social desirability bias may be present. Also as the data collected is often historical in nature societal viewpoint and education may shift altering the potential data collected.

What did the research involve?
The research conducted in this study was collected as a part of the larger GOS involving initially women and extending to men of all adult ages in the Barwon District of Victoria. Among other surveys in the study participants completed questionnaires on physical activity(PA) and depression according to the following schedule.

As no new or original data was collected for this study this could be seen as an entry level approach to this field of research. When seen as such the methodology was well approached as it was cheap, non invasive and provided information on a wide range of Australian society. However as the questionnaires used retrospective self reporting many results may be inaccurate due to memory faults and social desirability bias. Additionally, reporting on depression was conducted using DSM-IV self reporting rather than clinical diagnosis, which would have given a more accurate result.

What were the basic results?
Through careful analysis of reported childhood physical activity levels and self reported incidences of depression the authors found some common patterns. Both men and women in this study who reported low levels of physical activity in childhood were 35% more likely to report depression in adulthood. This finding supports the theory that childhood physical activity has impacts on lifelong mental health as well as physical.

Although the findings of this study show some support to their hypothesis the authors point that due to the study type requiring retrospective self reporting the study is clearly limited. Additionally they note that while physical activity may have some effect on mental health later in life there are many other factors not accounted for in this study which may be of influence including genetic predisposition and personality types. The authors suggest further research in this area using more alternate, more controlled research methods.

What conclusions can we take from this research?
Despite the previously noted limitations of this study involving self reporting and childhood recall a moderate link can be seen between childhood activity and adult mental health, in particular depression. As noted by the authors a more detailed study is required to fully understand this effect. Little research has been published in this area due to the long time period required for full results.

The 2014 study by McKercher and colleagues goes some way to assess the links between the maintenance of childhood activity into adulthood and depressive symptoms, finding a that reduced activity increased prevalence of depression in men. This study reduced recall bias by using a previous data set and following up with this population group later in life.

Practical advice
Although not entirely conclusive in its links between childhood physical activity and adult depression this study was not suggesting children need to participant in extraordinary levels of activity for future protection. It is currently advised that children aged 5-17 aim for at least 60 minutes of moderate to vigorous activity daily. This is known to benefit the child’s physical health, current mental health, cognitive abilities as well as aid them socially.

Habits made in childhood, especially surrounding activity have life long effects and this study show yet another reason why meeting these guidelines is so important.

Further information/resources
If you or someone you know is struggling with depression or other aspects of mental health the following offer information and services dedicated to helping those in need;

‘Beyond Blue’

‘Black Dog Institute’

‘Lifeline’

For ideas to get yourself and those around you active see the ‘Find Your 30’ by SportAus


text:
Exercise as it relates to Disease/How knee osteoarthritis in older adults can be improved from home

This page is a critical analysis of "The Efficacy of Home Based Progressive Strength Training in Older Adults with Knee Osteoarthritis: A Randomised Controlled Trial" by Baker et al (2001).

What is the background for this research?
Osteoarthritis is a irreversible, chronic, and progressive condition occurring when joint cartilage wears down, typically due to ageing, obesity, or joint related injuries. It is the most common joint disease in adults around the world and occurs in the hands, hips, and spine, but most commonly in the knee. The estimated lifetime risk for knee osteoarthritis is 47% in women and 40% in men, with between 19-28% of adults actually exhibiting the condition.

The study aims to test how strengthening the musculature acting on the knees, particularly the quadriceps, affects the clinical signs and symptoms of knee osteoarthritis. Previous research has concluded that quadriceps weakness is the greatest predictor of lower limb functional limitation and that strengthening the quadriceps improves pain and function of those with knee osteoarthritis. However, those same studies showed little, to no, strength gains in the participants. Improving strength, psychological well-being, or maintaining cartilage integrity have been stated to have potential beneficial effects on knee osteoarthritis, but are yet to be evaluated. Therefore, this study aims to fill this gap in knowledge through testing these pathways and their benefits when the goal of the program is to actually improve strength.

This research is important due to the potential real world application of a home-based strength program for elderly adults, as an exercise program like the one in the study can be easily accessed and replicated by all those suffering from knee osteoarthritis.

Where is the research from?
The baseline and final tests were completed at the Jean Mayer USDA Human Nutrition Research Centre on Ageing at Tufts University. It was also partly supported by grants from the Arthritis Foundation, American Federation of Ageing Research, Life Fitness Academy, The Farnsworth Trust Medical Foundation, Brookdale Foundation, USDA Cooperative Aggreement-58-1950-9-001, and National Institutes of Health Grant AR20613. However, there is no evidence of bias from such organisations.

All six authors have previous research on topics revolving around osteoarthritis, nutrition, exercise programs, cartilage damage, and pain management.

What kind of research was this?
The study was a randomised controlled trial (RCT) where participants were placed in either a home-based exercise program (intervention group) or a home-based nutrition program (control group). The participants were blinded to the active intervention and the results of both groups were compared.

The use of a RCT provides reliable evidence regarding the effectiveness of the intervention when compared to other study types (e.g. cohort study, cross-sectional study, case-control study). This is because other study types only find correlations between groups, rather than conclusive evidence like a RCT.

What did the research involve?
The research in this study involved elderly adults who were randomly placed in either the intervention or control group. Eligibility criteria for these participants included:
 * ≥55 years old
 * BMI ≤40kg/m2
 * Pain on one or more days of the past month during walking, going up/down stairs, standing upright, or in bed,
 * Radiographic evidence of knee osteoarthritis
 * Cleared to exercise
 * No inflammatory arthritis
 * Had not participated in a exercise program within the last six months

There were 56 potential participants, however due to withdrawals during the treatment period, only 38 participants completed the full intervention.

The home-based exercise program included seven exercises, including bodyweight squats and step-ups, and knee extensions/flexions, hip extensions, and hip abductions/adductions with ankle weights. The squats and step-ups had three and four progressions respectively, meaning the exercises increased in difficulty with technique changes rather than load increases. Whereas the other exercises progressed with heavier ankle weights. Each participant performed two sets of twelve repetitions, three times per week for each exercise. The intensity of each exercise was determined using a modified 10 point Borg scale rating of perceived exertion (RPE). Participants began with an RPE of 3-5 until proper form was achieved, then increasing to RPE 8 for the remainder of the intervention. Patients were visited twice a week in the first three weeks, once in the fourth, and then once every two weeks from thereon.

The nutrition program included keeping a food log on three nonconsecutive days every two weeks, which were evaluated with each home visit. Additionally, specific nutritional goals were set each visit, e.g. increasing fruit and vegetable intake.

The methodology used had both strengths and weaknesses. The weaknesses lie in the sample size being small, and the risk of food log inaccuracies. Due to the nature of knee osteoarthritis and high-intensity exercise, the selection criteria had to be specific to avoid harm to the participants, and explains the small sample size. Additionally, food log inaccuracies are unavoidable due to potential errors in self-reporting and a low number of recorded days. The strengths are using an RPE system, not progressing until proper form was learned, and employing steady progression for each exercise, allowing for individualised and safe development for each participant.

What were the basic results?
Pain, physical function, knee extension 1 repetition maximum (1RM), knee flexion 1RM, leg press 1RM, and quality of life factors were measured both at baseline and after the four-month intervention.

NOTE: Pain and physical function were measured using the Western Ontario/McMaster Universities Osteoarthritis Index (WOMAC), where higher scores indicate worse pain or function.

Findings show that strength training greatly improved all measures compared to the control group. Not seen in the table, but there were improvements in quality of life factors, including social functioning, mental health, bodily pain, vitality, general emotional health, and walking self-efficacy.

The implications of their findings were not over emphasised as the conclusions made by the authors are supported and can be comparable to previous studies (mentioned in the report), although limitations are acknowledged. The authors interpreted the benefits of their intervention as almost entirely a result of increased muscular strength, however they do believe that psychological factors also play a role in pain management and the mechanisms in which increased muscular strength improve knee osteoarthritis are still inconclusive.

What conclusions can we take away from this research?
The study proves that high-intensity, at-home, progressive strength training programs can improve the physical function, pain, self-efficacy, and the quality of life of elderly adults with knee osteoarthritis through increasing muscular strength. However, since osteoarthritis cannot be reversed, only managed, four months is a relatively short period of time when considering sufferers will be managing pain and function for years, and as such, long term adherence and benefits of a strength program are yet to be evaluated. Thus, the long term benefits of a strength program needs further investigation before proper judgement is made. Nevertheless, the findings are still extremely promising due to the number of lifestyle related aspects that improved as muscular strength increased.

Practical advice
The research shows that a home-based, strength training program can have significant effects on knee osteoarthritis. A program like the one in the study can be easily replicated by elderly adults due to minimal required equipment and the simplicity of the exercises. Although, it is important to be cleared by a health professional prior to beginning exercise (via an ESSA pre-exercise screening tool) and proper form needs to be learnt before increasing intensity to reduce the risk of harm. Furthermore, exercise should be ceased if any pain or discomfort occurs at any stage. Once these considerations are met, a home-based strength program can be achieved by those suffering from knee osteoarthritis.

Further information
For further information on osteoarthritis, please visit:
 * 1) Mayo Clinic - Osteoarthritis: https://www.mayoclinic.org/diseases-conditions/osteoarthritis/symptoms-causes/syc-20351925
 * 2) What is knee osteoarthritis?: https://www.arthritis-health.com/types/osteoarthritis/what-knee-osteoarthritis#:~:text=Knee%20osteoarthritis%20is%20a%20condition,from%20joint%20friction%20and%20impact.
 * 3) The effect of dynamic versus isometric resistance training on pain and functioning among adults with osteoarthritis of the knee: https://doi.org/10.1053/apmr.2002.33988
 * 4) Cost-effectiveness of aerobic and resistance exercise in seniors with knee osteoarthritis: http://doi.org/10.1097/00005768-200009000-00002


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User:U3181120uc

Using Wikibooks to complete an assignment

title: User:U3181120uc


text:
Transportation Geography and Network Science/Morphology

Morphology, in the context of transportation geography, is better known as urban morphology which emerged as a topic resulting from the combined works of geography, architecture, sociology and urban planning. It studies the evolution and current transformations of urban forms, as well as the understanding its components (which include buildings, streets and parks to name a few) and their interactions. These interactions include both between the individual components as well as between the components and the urban form itself. Examples of urban forms range from cities, towns and villages though is not limited to this list as urban forms are defined as areas settled by humans. Since urban morphology involves the extensive study of spatial patterns of land-use, it serves useful for: urban design and planning as well as many traffic and transportation models which depend on land-use.

Perspectives
Historically, urban morphology existed as a topic fragmented between different disciplines before it evolved into an interdisciplinary field of study through platforms such as on the 'International Seminar on Urban Form'. Urban morphology was developed from the British Morphological School, the Italian Typological School and the French Versailles School from where the different disciplines of geography, architecture and sociology respectively were able to provide a perspective on a subject related to all of them. Hence, in urban morphology the development of the urban form is approached through the analysis of social and economic forces affecting them. Other approaches have included understanding (the urban form of) cities within the discipline of the spatial sciences through the construction of spatial dynamics models.

Geography
From the British Morphological School, geographer M.R.G Conzen is associated with developing the plan analysis which uses historical maps to understand the evolution of a town or city. Conzen introduced the method with a case study of the English town Alnwick. Implications of the method provide insight into land-use patterns and building forms. Considering a town plan as being comprised of its elements - a street network, plots and buildings - Plan Analysis uses unique combinations of these elements, called plan-units, to divide a town into regions of homogeneous morphology. This and other similar case studies for other European cities and towns provided the foundation for much of the conceptual framework for urban morphology. Expanding upon the urban morphological element of streets, from a geographic perspective the discussion on streets is important to identify street patterns in urban areas with the development of the classification system (or typology) of streets by type. For a towns and cities, degrees of regularities between different street layouts have been used as a means of classification. Other means of classification include deciding the configuration of the street layout - for example grid, axial plan and radial plan - for a town or city to visual spatial patterns. However, this classification method draws criticism for its simplistic reduction (sometimes misleading) of the complexity of the morphology of street patterns; urban street patterns tend to be composite. Urban street layouts embed the social and economic (also in some cases political) causes that have developed them in the past. Thus, looking at street layouts from a sole design point of view misses the understanding of how it has been shaped and renders it difficult to view its morphological characteristics. This, in part, is what motivates and highlights the usefulness of using Conzenian concepts of plan-units.

Architecture and Sociology
During the transformation stage of any urban landscape, the role of the agents who are in the position of influencing the physical shape of the urban form must be considered. Other than the developers and urban planners, architects play a significant role as having their ideas realized on the scale of the urban form, as well as be involved in the design and configuration of parts of urban areas. This is evidenced in the history of the urban morphology, with the development of the map by Giambattista Nolli for Rome which leads to the formalisation of the 'figure-ground theory': representing urban areas with solid masses and open voids. Another important architectural theory is the 'linkage theory' which aims to construct a 'network of lines' connecting the elements of an urban area. In this context, this refers to the arrangement of streets, pedestrian ways and other linear open spaces. Since the urban form is developed by humans one may expect that the urban form reflects a particular set of historical, social and cultural values. This forms the basis of the one of the main architectural theories, 'Place Theory', which imprints the contemporary societal values to physical environment,. Through the reflection of societal values one is lead to the idea of how the urban form design can be (and has) illustrate an aesthetic reflecting on ideas from religion (such as in the case of ‘the inward city ‘ and ‘nested city’). Within the architectural discipline, it should be mentioned that designs for the urban form have centred around a transport system. Examples of which include: the Star where a large city has a highly dense and used centre with transit lines radiating (from the centre); and the Linear City where the city (with its economic activities and residencies) is distributed along continuous transport line.

Spatial Analytics
Understanding the evolution of the urban form also involves analytical methods - Geographic Information System (GIS), Cellular Automaton and agent-based models - by considering the urban form as a spatial structure. These perspectives leads creates new avenues of approaching evolution of urban form by involving the phenomenon of fractals into the conceptual framework for urban forms. The urban form is studied through different scales to better analyse the activity distribution which impacts the urban form. Many static equilibrium models are able to model the urban form since the urban structure with employment and population distribution is inputted into the model which illustrates morphological characteristics. The dynamic models based on cellular automata are able to generate processes (in the urban form) which illustrate features of agglomeration and bottom-up development from simulated urban areas. Results generated from simulated growths of cities from single seeds exhibit fractal patterns similar to real cities. However, there is a hidden assumption of the spatial patterns scaling through time that does not capture phenomena of radical societal changes such as in technology. This highlights a limitation within cellular automaton that could be addressed in the future. Another application of the tools within spatial analytics enables the urban form to be modelled as networks of human settlement encompassing a space where people are (in)directly connected to each other. A result of the application was a relationship between the levels of self-organisation (within cities) and the degree of network connectivity (relative to the network's spatial density). A unique feature of this relationship exhibited is how there is a minimum degree of network connectivity required to generate a level of self-organisation sufficiently large for the urban form to function as a metropolis. Increasing network connectivity achieves the functioning of a metropolis but renders the network redundant and inefficient, while decreasing the network connectivity does not achieve the performance of a metropolis.

Influence on Transportation
The evolution of the urban form (distribution of the employment and population in the urban area) is affected by processes of urban development through economic agglomeration. The overall effect on land-use within urban areas impacts how transport systems are used. Examples of which can be seen in the studies of patterns of metropolitan forms in the US where cities have low development densities and decentralised land-uses, thus encouraging the use of cars. While the opposite (high development density and centralised land-use), which is more prevalent in Europe, encourages the modes of walking and bicycle. These examples also allude to the idea of how effective designs of urban forms can address traffic problems. Hence, suggestions have been made for traffic policies to be based on population characteristics and spatial structure of cities at different stages. Within metropolitan areas there are 4 main types of spatial network structures to consider: A significant process that has shaped transportation system within the urban landscape has been urbanisation - population shifts from rural to urban areas. Features of which have been imprinted onto the urban form through the concentration of activities on different scales: when it occurs relative to the entire urban area it is centralisation; but a focus within a part of an urban area refers to clustering. The urban spatial structure can be abstracted with network elements of nodes representing centre of economic activities (transportation facilities of train stations and airports) and linkages between the centres. It should be noted that nodes and linkages also illustrate the accessibility and mobility (of the urban transport system) which contribute to the evolution of the urban form. Limitations in the transport technology, historically, manifest much of the motivations for centralisation of activities at urban central areas due to the unavailability of cars and restricting people within urban areas to rely on walking as the main transportation mode. Due to the inefficiency of walking (as a mode) in achieving urban mobility, in the past many spatial structures of cities were highly compact and accessible; many cities in Europe and East Asia still retain similar structures. Additionally, the evolution of the urban form points to the influence transport technologies have on the urban form. A phenomenon exemplifying this are the new clusters that emerged in the periphery of urban areas, preempting the poly-centric form many urban areas have adopted with high car use.
 * Completely Motorised Network: a large automobile-oriented network (with a land-use density ranging between low and average) of high-capacity highways while the public transit system is present with a minor function within the network. The network is to symbolise urban efficiency and designed to allow ease of movement between any 2 locations. E.g. North American Cities of Los Angeles and Dallas after 1950.
 * Weak Centre: a moderately dense (in terms of land-use) network of concentric patterns where many centres along the periphery connected by ring roads compete with the central business district for economic activity. At the centre of the network is where the central business district is located, better accessed by car but connected by a transit service which is under-used and underfunded. E.g. cities such as Melbourne and San Francisco at the beginning of the 20th century.
 * Strong Centre: A highly dense network which is highly accessible by a high-capacity transit system responsible for serving the mobility requirements to generate the economic productivity in the central urban area. The radial and ring roads as well as high costs associated to the central business district motivates secondary centres to emerge away from the district along the ring roads. E.g. cities with high commercial and financial centres especially in the 19th century such as in Paris.
 * Traffic Limitation: Networks where traffic control and modal preference strategies are implemented. Its central urban area, served by a transit system, limits car use within it as part of a congestion management policy. The 'funnel effect' is illustrated through the use of individual transportation (car) relative to one's distance to the central area: decreasing as one moves towards central area while increasing as one moves towards the periphery. While the opposite illustrated by collective transportation (transit) use: increasing as one moves towards the central urban area but decreasing as one moves towards the periphery. Additionally, interfaces are present within the transportation system between suburbs and central area allowing access between individual and collective transportation modes (car and transit), and between high and low capacity collective transportation modes (bus and rail). E.g. Cities with such spatial structures may include Singapore and Hong Kong.


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Exercise as it relates to Disease/Can physical function and mental health of brain cancer survivors be improved by exercise?

This Wikipedia page is a critical analysis of the paper: Exercise Improves Physical Function and Mental Health of Brain Cancer Survivors: Two Exploratory Case Studies.

What is the background to this research?
Brain cancer can be classified into two different type of tumours. Benign tumour meaning unlikely to spread and malignant tumour meaning likely to spread to other regions of the brain and spinal cord. Malignant brain cancer can be challenging due to its poor prognosis and unpredictability. The treatment is intensive through surgery, radiation therapy and chemotherapy. Treatment is associated with physical impairment, cognitive dysfunctions e.g. decreased memory and also compromised psychological well-being Research into interventions is important as it can help to improve quality of life and reduce the negative effects of treatment.

The study assessed exercise as an intervention to improve the physical function and mental health of brain cancer survivors. Physiological and psychological measures were taken to provide clinical outcomes. This study is one of very few that aims to assess exercise and brain cancer survivors, as earlier studies have assessed current patients. The measure/procedure of this study are also highly thorough compared to others, as it assesses both aerobic and resistance exercise and psychosocial measures.

Where is the research from?
The study was published by in 2014 by Integrative Cancer Therapies. It was written and researched by GT Levin, KM Greenwood, F Singh and D Tsio. The research of this study was conducted by:

GT. Levin has performed other research on the topics of mental health, cancer and exercise.His is experience in this area of research is extensive and significant. By including multiple researchers and institutions, it can be assumed the procedure and processes of the study are of high quality and the results are valid.
 * 1) University of Calgary, AB, Canada
 * 2) Edith Cowan University, Perth, WA, Australia
 * 3) Capital Medical University, Beijing, PRC
 * 4) St John of God Hospital, Subiaco, WA, Australia
 * 5) Cumming School of Medicine

What kind of research was this?
This is an exploratory case study on two female participants and both are brain cancer survivors. The participants were diagnosed with different types of brain cancer and were at different stages of their recovery and care. With an exercise program as the intervention, the study explores if exercise can improve the physical function and mental health of the participants. The participants also met the other inclusion criteria of the study.

What did the research involve?
Limitations of the research:
 * Two female participants took part in an exercise program . 2 x 20 minutes of aerobic training and 2 x 40 minutes of resistance training with a qualified exercise physiologist per week .Also additional self-managed aerobic session per week.
 * Physiological and psychosocial measures recorded at baseline, 6 and 12 weeks.
 * Aerobic measures: oxygen consumption (VO2 ml/kg/min) and heart rate (BPM).
 * Resistance measures: 1 repetition maximum (RM) for a chest press and leg press (kg).
 * Total body lean and fat mass: dual energy X-ray absorptiometry (DEXA) scan (% body fat).
 * Psychosocial measures: questionnaires measured quality of life, depression, anxiety, satisfaction with life, etc.

 * This study was small, consisting of two people and were both females . This study did not include people of different ages, genders, socioeconomical backgrounds.
 * Included self-reported aerobic session and psychosocial questionnaires therefore there may be bias.
 * This study is a short-term exercise program . A long-term study following the participants over multiple months or years may determine permanent adherence to the program and further clinical outcomes.
 * It is difficult to compare the participants exercise outcomes as they had different diagnosis and at different stages of their treatment and care.
 * Study lacked a controlled variable. Both participants were at different activity levels before baseline testing, the additional session was self-managed therefore bias may be involved and they also had different diagnosis of brain cancer.

What were the basic results?

 * Improvement in cardiovascular efficiency shown by lower heart and reduction in 400-metre walk time.
 * Upper body maximal strength increased by 17% and lower body strength increased by 48%.
 * Reduction in mental health questionnaires scores showing reduced feelings of depression, anxiety and total distress.

The results table below shows the key tests performed and the differences when comparing baseline to measures after 12-weeks of exercise training.

↑: Increase from baseline testing to 12 weeks testing ↓: Decrease from baseline testing to 12-week testing

What conclusions can we take from this research?
This study provides evidence supporting other research that using exercise as an intervention reduces negative consequences of brain cancer and its treatment. Other supporting exercise intervention research includes by Cormie and colleagues: The Potential Role of Exercise in Neuro-Oncology and additionally The Brain Cancer Fact Guide provided by the Cancer Council. This study shows specifically aerobic training coupled with resistance training should be considered to become a part of the standard care of brain cancer survivors as the participants showed positive links between exercise and improved physical function. Significant improvements occurred to the participants mental health seen through the The Hospital Anxiety and Depression Scale. Other current research reinforce this studies findings as they have shown exercise to improve mental health of brain cancer patients. Additionally, a longer term and a larger cohort with different genders, ages, socioeconomical backgrounds may also increase the validity of the outcomes of this type of study.

Practical advice
With respect to the limitations of this study, brain cancer survivors are recommended to perform 80-100 minutes of aerobic exercise and additionally 2-3 resistance sessions (80 minutes) per week to benefit from improved physical function and mental health. . The exercise mode and intensity should be prescribed as dose response to ensure safety.

Longer-term studies and further evidence, in comparison to this case study, may find exercise programs used as apart of the standard supportive care for brain cancer survivors to reduce the negative cognitive, physical and emotional effects and improve survivor outcomes.

Further information/resources

 * 1) Cure Brain Cancer Foundation: https://www.curebraincancer.org.au/page/7/about-brain-cancer
 * 2) Cancer Council – Understanding Brain Tumours: https://www.cancer.org.au/assets/pdf/understanding-brain-tumour-booklet
 * 3) Australian Government Cancer Australia: https://www.canceraustralia.gov.au/affected-cancer/cancer-types/brain-cancer/statistics
 * 4) Brain Foundation Australia: https://brainfoundation.org.au/brain-tumour-cancer/
 * 5) The Potential Role of Exercise in Nero-Oncology: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4389372/
 * 6) Role of physical exercise in reducing depression and improving mental health in cancer survivors: https://ro.ecu.edu.au/cgi/viewcontent.cgi?article=2415&context=theses


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User:Jcubic

Hi, my name is Jakub T. Jankiewicz and I'm web developer with focus on JavaScript.

My contribution

 * Scheme Programming

title: User:Jcubic


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User:Cosmonaut Kitten

Hi, I'm Cosmonaut Kitten.

こんにちは、私はコズモノートキテンです.

Saluton, mi estas Cosmonaut Kitten.

title: User:Cosmonaut Kitten


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User talk:Maxthore

Siri
I'm bored what should I do? Maxthore (discuss • contribs) 19:56, 6 September 2020 (UTC)

title: User talk:Maxthore


text:
User talk:41.113.87.165

--Synoman Barris (discuss • contribs) 19:56, 6 September 2020 (UTC)

title: User talk:41.113.87.165


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Exercise as it relates to Disease/How vigorous-intensity exercise is associated with an increase in mental health

What is the background of this research?
The background of the research was in stress experienced at university and how it related to stress related mental disorders along with how they can lead to many mental health problems such as depression, higher burnout rates, augmented sleep complaints, anxiety or even panic attacks. This study pointed out a recent systematic review of studies of depression prevalence at universities and showed that university students have a prevalence rate of poor mental health of 31% and more so showed there's was a 50% rate of student with mental health symptoms. The main focus of this study however was identifying if vigorous intensity physical activity lead to a noticeable decrease in stress symptoms, depression rates and better sleeping patterns. The study used the American Collage of Sports medicine vigorous exercise intensity recommendations which is equal to or greater than 3x20min of vigorous physical activity per week and compared it to students that didn't meet these recommendations and therefore only did moderate physical activity.

Where is the research from?
This research was based out of the department of Sport, Exercise and Health within the University of Basel in Basel Switzerland. Along with the Psychiatric Hospital of the University of Basel, Centre for Affective, Stress and Sleep Disorders, also is Basel Switzerland

What kind of research was this?
This article was a cross-sectional study design due to it not having a control group but rather comparing multiple population groups at specific times. Which in this study can be seen as comparing vigorous activity group to the moderate activity group within the three questioning periods.

What did the research involve?
This study involves using a very small cohort of 42 university students with poor mental health, high stress levels and poor sleep. Then seeing if meeting the American College of Sports Medicine's vigorous-intensity exercise recommendation increased their overall mental health compared to people who may have had moderate activity or none. To track physical activity the participants were taught how to correctly use accelerometers then proceeded to wear them on their hips during the day to track activity. Stress was recorded via a simple self-perceived stress scale. Assessing the severity of depressive symptoms was done by the German version of the Beck Depression Scale. Sleep complaints were assessed via The Insomnia Severity Index and sleep pattern was assessed by the use of a portable sleep-EEG to give participants the ability to sleep at home in comfort. All of these measured are proven to be statistically reliable and were a good choice for the basis of this study.

What were the basic results?
The study showed that participants above the ASCM's vigorous intensity guidelines slept better, had lowered stress levels, had fewer depressive symptoms with a lower self-perception of overall stress compared to those who did not meet the guidelines. It also shows that the participants that met the moderate physical activity guidelines also saw better mental health and stress levels just not to the same extent. However, this study only used a very small sample size of 42 and just let the participants go on their own daily life without a proper control group. This lead to only 19 participants representing the studies findings of meeting the vigorous activity guidelines and the other 23 meeting the moderate physical activity guideline (MPA). This small sample size showed that 10% reported mild or moderate depression symptoms. However, the study didn't contain an inactive or low activity group which may have shown a lot more important data when compared to the VPA or MPA group, this is turn may skew the results. A 2010 study looking at physical activity and mental health in student used three trial groups, them being highly active, medium level of activity and a low-none level of activity. This study showed a much greater gap when comparing low to high whereas this study just compared moderate to vigorous which shows a much smaller gap.

What conclusions can we take from this research?
This research does certainly show that vigorous intensity exercise is better for mental health, stress levels and sleep compared to moderate level exercise. And more so demonstrates that intensity is the key not just to cardiovascular health but to mental health as well and that high-intensity exercise doesn't require a lot of time out of your week, something as simple as ACSM's recommended 3 x 20 minute vigorous intensity sessions a week is enough. However, the sample size was very small and although it did show improvements more study is needed with a larger cohort and an inactive group to provide comparison to. The inclusion of an inactive group in this study may make an extremely good case for the MPA group. Showing that vigorous intensity is better than moderate intensity but moderate may still show significant increases in mental health, stress and sleep when compared to an inactive/ low physical activity group of participants.

Practical advice
All you need to meet the vigorous activity guidelines is as simple as three 20 minute sessions a week of high intensity exercise. This 60 minutes of exercise alone results in better cardiovascular health, better mental health, lower stress levels and better sleep. It's highly achievable and has many benefits even when done to the minimum level of 60 minutes a week.

Further information/resources

 * For information on the Australian Department of Health's physical activity guidelines visit: https://www1.health.gov.au/internet/main/publishing.nsf/Content/health-pubhlth-strateg-phys-act-guidelines#npa1864
 * Multiple mental health helplines can be found on health directs website to help answer any mental health questions at: https://www.healthdirect.gov.au/mental-health-helplines
 * A great multi-study analysis on how dosage of green exercise is also great at improving mental health can be found at: https://pubs.acs.org/doi/abs/10.1021/es903183r
 * The Website verywellfit provides great explanations into what vigorous intensity exercise is, how it can be measured and some good examples of how you can do it yourself. This website can be found at: https://www.verywellfit.com/what-is-vigorous-intensity-exercise-3435408


text: User talk:JarrodPhillips11

title: User talk:JarrodPhillips11


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Exercise as it relates to Disease/Maximal strength training used to target strength, balance and walking, in individuals with Multiple Sclerosis

This is a critique of the research article: Karpatkin H, Choen E, et.al. The Effect of Maximal Strength Training on Strength, Walking, and Balance in People with Multiple Sclerosis: A Pilot Study" [internet]. Multiple Sclerosis International, Hindawi, vol. 2016, Article ID 5235971, 6 pages, 2016.

The critique was an assignment for the unit; Health, Disease and Exercise at University of Canberra, Semester 2, 2020.

Background to research
Multiple Sclerosis (MS) is a progressive, chronic disease, which affects the central nervous system. This leads to impaired mobility of an individual. People are diagnosed with MS between 20 and 40 years of age, however young children can also be diagnosed.

Previous studies have been conducted to investigate the effects of resistance training on mobility deficits, in individuals with MS. It was not examined as to whether or not maximal strength training (MST) had an impact on mobility measures, in those with MS.

The study focused on two topics:
 * 1) To examine the effects that low, MST had on endurance walking and balance, in those with MS.
 * 2) To examine the effects that MST had on fatigue.

This study is important as it was hypothesised that if individuals with MS showed signs of improvement in their mobility and did not have an increase in their level of fatigue, then clinicians could safely and effectively incorporate MST into their rehabilitation programs. The null hypothesis states that there is no relationship between MST and improved mobility, and that MST increases fatigue levels.

Research
The research was a noncontrolled, nonrandomized Pilot study, which was approved by the relevant institutional Review Board. A Pilot study is a small-scale test, used to evaluate the feasibility of a main, larger study. Pilot studies are undertaken to ensure that researchers do not launch a larger study, without having adequate knowledge of the methods proposed. This aims to reduce the occurrence of flaws in a larger, main study.

All 8 participants were recruited from a local, multidisciplinary MS clinic. Each participant had to have a definitive diagnosis of MS, be at least 18 years old and could walk freely for 6 minutes, either with or without the help of an assistive device. All the authors in this study are Physical Therapists, some with different certifications and specialities. For example, the first two authors are:
 * 1) Herb Karpatkin:, who has been specialising in MS since 1993.
 * 2) Evan T. Cohen, who is a Neurologic Certified Specialist.

It is important that the authors in this study are Physical Therapists, but it is even more effective to have people that specialise in Neurology and MS. The reason being, is that extra knowledge can be provided, to help one another better understand the results of the study.

The authors also declare that they had no competing interests. Therefore, there are no organisational/ sponsorship links are perceived as a conflict of interest/bias, from the findings in this study.

Methods of Study
The study was conducted over 8 weeks, with the MST intervention occurring twice a week. The method is as follows:

Balance:
 * Measured using the Berg Balance Scale (BBS), through the assessment of 14 tasks of varying difficulty.

Fatigue: Baseline Testings:
 * Measured using the Fatigue Severity Scale (FFS). This is an effective tool, as it is a widely used, valid and reliable measurement tool.
 * 1RM
 * BBS
 * 6-minute walking test (6MWT)

Warm-up: Main assessment: Cool-down:
 * 5 min, no resistance cycle ergometer, at a comfortable pace
 * Then 5 minutes of seated resting
 * 5 repetition, horizontal leg press warm-up, at 50% of their 1RM.
 * Then 90 second rest
 * 4 sets, 4 reps per set at 85-95% of their 1RM, for each leg.
 * 90 second break between each set.
 * A timing model which has been used in previous MST studies was incorporated into this current study, where participants had to perform a concentric contraction, then followed by a more controlled, slow eccentric contraction.
 * 5-minute cycle ergometer cooldown, same as the warm-up.

Strengths

 * All participants came from the same, multidisciplinary MS clinic
 * All participants had a definitive diagnosis of MS
 * All authors are Physical Therapists, with some specialising in MS and Neurology
 * Uses the FFS test, which is a widely used, effective measurement tool
 * Looks at other studies which investigates Neural drive and how this correlates with the findings
 * A timing model was incorporated, which has been used in previous MST studies

Limitations

 * Non-controlled and Non-randomized study, which can limit the generalisations that can be made
 * Other studies and literature around resistance training programs for those with MS, mainly target intensities which rarely exceed 70% of 1RM. This may be that heavier loads could lead to complications around neurogenic fatigue.
 * Only 8 participants in this study. The recommended number of participants in a Pilot study is a minimum of 12. Therefore, data results may not be as accurate, due to a smaller sample population.

As with all Pilot studies, a follow-up study with a larger sample size must be undertaken, to support and confirm the results.

Results
Results showed:
 * MST had quite a significant impact on strength, on both the right and left leg, between pre-tests and post-tests, demonstrating a greater increase in leg press strength
 * The FFS scores showed minimal effect of MST on fatigue levels throughout the protocol
 * There was an average of a 46m improvement in the 6MWT. Averages were taken and analysed from the results, for each variable.
 * The was an improvement in the BBS results
 * From the results, a P value of <0.05 was determined. This means that the null hypothesis was rejected, so therefore MST did not increase fatigue levels, and there is a relationship between MST and improvement in mobility.

Conclusions
Individuals with MS have an increased risk of falls, as their balance is impaired. Their walking endurance is also reduced. The results in this study provide evidence that MST may be a feasible means of improving mobility issues, however implications are not over emphasised. An improvement in the 6MWT, strongly suggests that there are improvements in walking endurance, which is quite an important finding. The BBS improved by 5.3 points in this assessment, which therefore demonstrates a significant improvement in balance and mobility. FFS scores were not high, which is another important finding, as this demonstrates how MST was handled well by all the participants, without instigating high fatigue levels. Another study was conducted in 2016, which assessed the effects that MST had on wheelchair propulsion, work economy. The results from that study also supported the findings in this study, as both showed improvements in mobility, as a result of MST.

The authors also investigated how MST impacts Neural Drive. MST works by increasing muscle motor recruitment and neural drive. This increases muscle activation, which therefore improves motor recruitment, coordination, strength and mobility.

Future Studies Suggestions

 * Participants could undergo a follow-up assessment, every 3 months to see whether MST improvements were sustained or not.
 * A greater range of lower extremity resistance training could be incorporated. Greater improvements may be identified in functional measures, as a result of this
 * Mobility assessments could incorporate characteristics of power, which could measure more direct effects of lower extremity resistance training in MS
 * Investigate sex differences, in response to resistance training

Practical Advice
If you or someone you know has MS, it might be beneficial to consult with a health professional or a rehabilitation clinician, to determine if it is safe to incorporate MST into rehabilitation programs. There are a variety of assessments, such as those discussed in this article, which could be incorporated, such as: Results from this study support MST for individuals with MS, to improve mobility without an increase in fatigue levels.
 * Leg Press
 * 6MWT
 * Mini-BESTest
 * FSS
 * 1RM
 * Plantar flexion

Further Readings/Insights
If you are interested in further information and readings, please refer to the links below:
 * Maximal Bench Press Strength Training
 * Strength Training to improve Gait in MS
 * MS: Effects of Strength Training on Mobility
 * Sex differences in response to resistance training
 * MST and Enhanced Neural Drive


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User talk:27.147.201.137

--Synoman Barris (discuss • contribs) 07:24, 7 September 2020 (UTC)

title: User talk:27.147.201.137


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English-Hanzi/Worn joints can cause neck pain

Worn joints can cause neck pain. Just like other joints of the body, the neck joints will gradually wear out with age. Arthritis can cause the cushion between the spinal bones of the neck to worsen. Then, the body forms bone spurs, which affect joint movement and cause pain.

磨损的关节会导致颈部疼痛. 就像身体的其他关节一样，颈部关节会随着年龄的增长而逐渐磨损. 关节炎会导致颈椎骨之间的缓冲变差. 然后，身体形成骨刺，影响关节运动并引起疼痛.


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User:Grace.Ronnfeldt

I'm Grace Ronnfeldt, a Student at the University of Canberra. I am currently in my second year studying a Bachelor of Exercise Physiology and Rehabilitation.

For one of my assignments in the Health, Disease and Exercise Unit, I am required to create a WikiBook and Critique a Study based on Physical Activity and its link with Disease.

Exercise as it relates to Disease

title: User:Grace.Ronnfeldt


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User:Grace.Ronnfeldt/sandbox

Exercise as it relates to Disease/ Pilates based intervention for Post-Menopausal Women living with Osteoporosis.

This is a critique of the research article: N. Kucukcakir et al. Effects of Pilates exercises on pain, functional status and quality of life in women with Post-Menopausal Osteoporosis. Journal of Bodywork and Movement Therapies (2013) 17, 204-211

The critique was written as assignment in the Unit; Health, Disease and Exercise at University of Canberra, September 2020.

What is the background to this research
The Study's objective is to assess the effects of Pilates Based exercise on pain, functional status and wellbeing in postmenopausal women suffering from Osteoporosis (OP). OP is 'the most common metabolic bone disease' with symptoms causing a significant detrimental effect on patients functionality and quality of life. As OP causes the bones to become weak and brittle, bone fracture is very common and contributes to risk of mortality. The main goal for OP prevention, treatment and management is to increase muscular strength, bone mineral density and balance in the older population, especially post menopausal women as well as education amongst these factors. In doing so, N. Kucukcakir et al. incorporate Pilates, as a measure to improve these outcomes. Although Pilates has been utilised as an important part in sport training, chronic low back pain , musculoskeletal disease and balance and quality of life in the elderly population , it hasn't been studied to specifically target the ever-growing issues of bone health on the ageing population and in particular, post-menopausal women.

Where is the research from?
The authors Lale Altan and Nimet Korkmaz, whom took part in this study, also designed another study alongside Umit Bingol and Berna Gunay, on the 'Effect of Pilates training on people with Fibromyalgia syndrome. The study took place in 2009 and shared a very similar approach to the Pilates training on Osteoporosis Study conducted years later. The article incorporates ideas from its previous studies on Pilates and its effects on Musculoskeletal Disorders and have transferred this knowledge onto its effects on a more targeted population of postmenopausal Women with OP. This supports the positive findings that Atlan found on patients with Musculoskeletal Disorders such as Fibromyalgia and Ankylosing Spondylitis.

What kind of research was this?
The study uses a randomised controlled, single blind study allowing no experimental bias when testing the subjects to take place. The person allocating the groups didn’t participate in any patient evaluation at any stage of the study, adopting a strategic approach to prevent any external factors to dictate the study’s results.

The diagnosis of the condition was measured through DEXA which is known to be a commonly used source. The procedure was well set out, starting with a flow chart detailing the enrolment process of participants. Sub-headings of 'pain, six-minute walk test, sit-to-stand test, quality of life assessment and number of falls', gives details of the tests that took place at baseline and the one-year mark of intervention involvement. The six-minute walk test and sit-to-stand test are objective measures that assess lower body endurance and are reliable in that they are well known to be associated with vertebral fracture development and falls Alongside measuring physical outcomes, the study used quality of life assessments to subjectively evaluate the individuals mental state, as this has been proven to be significantly affected with diagnosis of OP. As functionality decreases and therefore independence with OP, it is important to gauge the participants emotional state and how they rate their quality of life with improvement.

What did the research involve?
Participants were selected based on their age and diagnosis. They had to be aged between 45-65years and diagnosed with postmenopausal Osteoporosis. Subjects meeting the above criteria underwent a DEXA scan and those with a 'Bone Mineral Density score of less than -2.5 in the lumbar or femur region was valid for the study'. Participants were randomly allocated into two groups, either Group 1; Pilates based, or Group 2; Home Exercise based. Prior to the program commencing, all participants undertook baseline testing consisting of Visual Analogue Scale (VAS), to determine pain levels, a six-minute walk test, sit-to-stand test and 2 quality of life questionnaires. The intervention took place over a year. Group 1 took part in supervised sessions, twice a week which included 'postural education, focusing on a neutral position, sitting exercises, stretching exercises and proprioceptive and respiratory training' with the use of exercise balls and bands throughout the sessions. Meanwhile, Group 2 were shown exercises by a physiotherapist such as 'thoracic extension exercises and were required to be performed for 3 sets of 20 reps'. Check ins occurred for the Home-Exercise Group to ensure exercises were being performed and correctly. After the 1 year of program intervention, the same tests at baseline were measured and recorded for improvement and comparison.

The sample group of 70 people is relatively small, with each group having 35 participants. A small group limits the study’s ability to apply its findings to the whole population group of Post-menopausal women with OP. Another limiting factor is that there was no control group to compare the full effects of the intervention to, unlike the Study completed by Oksuz and Unal. As both groups were exercising and it had already been known that exercise had shown beneficial effect, it doesn’t provide context for how much the program had effect. The study doesn’t specify how or where the sample was selected from, but tests were performed to ensure eligibility criteria was met.

What were the basic results?
The results were summarised and for the Pilates group, all parameters showed significant improvements at the completion of one year from baseline (p<0.001). The results exhibited a significant improvement in all evaluation parameters for the Pilates Group at the completion of the one year. All parameters bar the pain, functional and mental health questionnaires, showed a statistically significant improvement for the Home-Based Exercise group also. When both groups were compared to each other, the Pilates circumstance displayed more improvement in all areas of testing (p<0.05). The results were displayed and compared in table format which enabled all mean values to be displayed. Comparison of the 2 groups at pre-treatment, supported the findings in post-treatment, as all results weren’t significant in difference. Table 2 and 3 present the data on ‘differences in post-treatment evaluation parameters in comparison with pre-treatment values after 1 year’ for both Pilates and Home-Based Exercise Groups respectively. Table 4 provides comparison of the percentage of the 2 groups from pre to post-treatment, displaying the difference the intervention has caused amongst the conditions.

What conclusions can we take from this research?
It has been proven in more recent research by S. Oksuz and E. Unal (2016) that clinical pilates improves OP symptoms of kinesiophobia, pain, functional status and quality of life. This similar study incorporated a pilates experimental group and control group over a period of 6 weeks with the pilates group receiving 3 physiotherapist lead sessions per week, however, the control group received no intervention. 14 well-known, reliable tests were used to assess pain, functional state and mental health and wellbeing. All evaluated parameters exhibited significantly greater improvements (p<0.05) in the pilates group compared to the control group in post-intervention results. This supports the findings of N. Kucukcakir et al.’s (2012) study that Pilates post intervention scores also revealed significant improvements compared to the home based exercise study.

Practical advice
Although Pilates has been shown to improve functionality and quality of life for those already diagnosed with OP, little to no research has been provided for Pilates to be used as a preventative measure for predisposed conditions. An outcome of Menopause is its detrimental loss in bone mineral density and therefore already places women aged between 45-65years in a high risk category in developing this condition. As pilates is a low impact form of activity, it is ideal for patients whom are already suffering with low bone mineral density and movement, however, it could be argued that a higher intensity exercise be more beneficial for those with normal functionality about to go through menopause. Therefore, other considerations for study investigation could include assessing the benefits of Pilates prior to menopause or if other high intensity exercise intervention would be of more benefit for this target population. A study by Kannus et al., involving the beneficial effects of sport and physical activity participation on bone mineral density, suggests that 'activity should be carried out prior to and during the post-menopausal stages which is critical for bone mineral density loss'. This is supported by their findings in tennis players with significantly improved bone mineral density in the dominant extremities of their bodies. Considering the population is becoming more sedentary, identifying if pilates, a low intensity activity, is beneficial during this crucial time period, would be important to decrease rates of the disease or at least the severity of the condition.

Further information/resources

 * https://www.osteoporosis.org.au/
 * www.premiersportsmedicine.com.au/virtual-pilates-online/
 * https://www.researchgate.net/effectclinicalpilatesonkinesiophobia_osteoporosis.pdf

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Exercise as it relates to Disease/Strength and endurance training in the treatment of advanced lung cancer

The following is a critique of the research paper 'Strength and endurance training in the treatment of lung cancer patients in stages IIIA/IIIB/IV'.

What is the background to this research?
Lung cancer (LC) is the most commonly diagnosed form of cancer and is the leading cause of cancer-related deaths worldwide. LC is extremely deadly as it is rarely detected in its early stages due to the inability to externally examine the organs, with physical symptoms only manifesting once the cancer has reached an advanced stage. Unfortunately in its advanced stages LC is irresectable therefore palliative chemotherapy is prescribed to slow the spread of the cancer and/or reduce associated symptoms. However, the side effects of chemotherapy have a significant impact on the physical activity levels of patients - with a lack of exercise rapidly progressing muscular atrophy, therefore reducing the patients ability to perform daily activities resulting in a diminished quality of life (QOL).

Although other literature highlights the importance of exercise programs in the recovery of those with operable LC, there is little research surrounding the benefits of exercise programs for those receiving palliative treatment for the inoperable disease. This research therefore fills the gap by examining ‘the feasibility and effects of a specially designed treatment protocol for advanced LC patients on the patient’s QOL and their ability to be independent in activities of daily living during the time patients received palliative chemotherapy’. Given the commonness of lung cancer, this research is extremely important as it could improve the QOL for the millions of people around the world receiving palliative care for the disease.

Where is this research from?
This study was predominantly conducted by researchers from the Vivantes Clinic in Neukoelln, Germany – with these authors belonging to the Departments of Internal Medicine, Hematology and Oncology; Internal Medicine, Pulmonology and Infectiology; and Radiology. All authors involved in this study are highly experienced, each involved in many published studies surrounding exercise and its impact on physical conditions and diseases.

What kind of research was this?
This research was conducted as a randomised control trial (RCT). This form of study is considered to be the highest level of evidence as RCT’s are ‘designed to be unbiased and have less risk of systematic error’.

What did the research involve?
This study involved 46 participants aged 18 years and over, who had been diagnosed with LC in stage IIIA/IIIB/IV and were receiving an inpatient palliative platinum-based chemotherapy treatment at the Vivantes Klinikum Neukoelln/Berlin. A computer program was used to randomly place participants in either the intervention (IG) or control group (CG), with the IG beginning with the participants first day of chemotherapy and ending after their third cycle of chemotherapy.

Base-line and end of study measures
All participants from both the IG and CG were tested pre and post IG using the following tests:
 * The Barthel Index – The primary outcome measure used to evaluate patient’s independence in daily tasks.
 * European Organization for Research and Treatment of Cancer QOL Questionnaire Core-30 – The secondary outcome measure used to evaluate patients QOL.
 * 6-Minute Walk Test & Staircase walking (amount of steps) – Used to test patient endurance capacity.
 * Biceps curl, triceps extension, bridging, abdominal exercise (maximum number of reps) – Use to test patient strength.

Breathing Techniques
Breathing techniques were used in both the IG and CGs and included the active cycle of breathing technique (ACBT).

IG
The IG group completed endurance training and breathing techniques five days a week and strength training every other day.

Endurance The endurance training consisted of two separate exercises, a 6 minute walk in the hallway (5 days a week) and a 2 minute stair walk. In the hallway walk, the training intensity was determined using the Modified Borg Scale (MBS) and a pre-calculated heart rate reserve (HRR), with participants training anywhere from 50-60% of HRR. In the stair walk, each participant had 2 minutes to walk up and down as many stairs as possible, with the amount of stairs walked in the time period recorded.

Strength In each strength training session, the participant completed three sets (1 minute rest in-between) at 50% of their pre-determined maximum rep range of each of the following; a bridging exercise, abdominal exercise, bicep curl exercise and triceps extension exercise, with the arm exercises completed using a medium resistance Thera-band.

CG
The CG only received conventional physiotherapy. Therefore, the participants received controlled breathing techniques and/or manual therapy techniques which included massage and muscle stretching, distraction and traction, and joint manipulation and mobilisation.

Methodological review
This study has a good RCT methodology, with a computer being used to randomly assign participants to either group - therefore removing the chance for any bias to occur. The exclusivity of participants accepted into this study also ensures any outcome is due only to the variable (exercise), for example, LC patients suffering other conditions such as cardiovascular diseases were excluded. This study does however have its limitations, one of which being that only 29 of the initial 46 participants completed the trial. 10 of those who dropped out of the trial did so due to non-compliance, therefore leading to the question of whether the methodology was too intense for some.

What were the basic results?
This study found significant improvements in the IG across all tests, with the key results as follows:
 * There was a significant difference between both groups in the Barthel Index post-intervention. The IG had was significantly more independent in daily activities post-intervention, whilst CG was significantly worse.
 * There was a significant difference between both groups in the QOL measures, with IG significantly improving physical functioning; haemoptysis; pain in arms/shoulders; peripheral neuropathy and cognitive functioning.
 * The strength and endurance significantly improved in the IG post-intervention (even after three rounds of chemotherapy), and there was a significant decrease in dyspnoea amongst the IG during sub-maximal walking activities.

Results review
The authors of this study appropriately interpreted the results, establishing through significant statistical differences between the IG and CG the training program has had a positive impact on the patients independence in carrying out daily tasks and the patients strength and endurance, with single factors relating to QOL also improved.

What conclusions can we take from this research?
It can be concluded from this study that LC patients receiving palliative chemotherapy treatment should also undergo a physical activity intervention in order to counteract the inability to complete daily tasks and diminished QOL associated with advanced LC and chemotherapy. This conclusion aligns with other research relating to physical activity interventions in the palliative treatment of other forms of advanced cancer.

Practical advice
Those involved in prescribing palliative treatment for advanced LC patients should consider the patients ability to perform endurance and strength based exercises and if possible implement some combination of these exercises as part of the patients treatment plan. However, given the health risks that accompanies advanced LC and chemotherapy, exercise training programs should only be prescribed and supervised by a trained health professional.

Further information/sources
https://www.cancer.org.au/cancer-information/types-of-cancer/lung-cancer
 * Further information regarding LC from the Cancer Council:

https://www.cancer.org.au/cancer-information/after-a-diagnosis/coping-with-a-cancer-diagnosis
 * If you have been diagnosed with cancer and need support:

https://www.cancer.org.au/assets/pdf/caring-for-someone-with-cancer#_ga=2.255355019.2040694170.1599448859-2041275608.1568335855
 * If someone you know has been diagnosed with cancer: