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Transwiki:Culture of Turkey

The culture of Turkey combines a heavily diverse and heterogeneous set of elements that have been derived from the Byzantine, Ottoman, European, Middle Eastern and Central Asian traditions. Turkey's former status as a multiethnic empire which, de facto until the loss of Libya to the Kingdom of Italy in 1912 (and de jure until the official loss of Egypt and Sudan to the British Empire in 1914, as a consequence of the Ottoman government's decision to join the First World War on the side of the Central Powers) spanned three continents: Europe, Asia and Africa. The present-day Republic of Turkey, which succeeded the Ottoman state in 1923, is still a transcontinental country that spans Europe and Asia.

The nation was modernized primarily by Mustafa Kemal Atatürk starting from 1923. As he transformed a religion-driven former Ottoman Empire into a modern nation-state with a strong separation of state and religion, a corresponding increase in the methods of artistic expression arose. During the first years of the republic, the government invested a large amount of resources into fine arts such as paintings, sculpture and architecture. This was done as both a process of modernization and of creating a cultural identity. Because of the different historical factors defining the Turkish identity, the culture of Turkey combines clear efforts to be "modern" and Western, with a desire to maintain traditional religious and historical values.

People
Turkish culture has undergone profound changes over the last century. Today, Turkey may be the only country that contains every extreme of Eastern and Western culture (along with many compromises and fusions between the two). The Ottoman system was a multi-ethnic state that enabled people within it not to mix with each other and thereby retain separate ethnic and religious identities within the empire (albeit with a dominant Turkish and Southern European ruling class). Upon the fall of the empire after World War I the Turkish Republic adapted a unitary approach, which forced all the different cultures within its borders to mix with each other with the aim of producing "Turkish" national and cultural identity. This mixing, instead of producing cultural homogenization, instead resulted in many shades of grey as the traditional Muslim cultures of Anatolia collided with (or had imposed upon them) the cosmopolitan modernity of Istanbul and the wider West.

Literature
Turkish literature is the collection of written and oral texts composed in the Turkish language, either in its Ottoman form or in less exclusively literary forms, such as that spoken in the Republic of Turkey today. Traditional examples for Turkish folk literature include the stories of Karagöz and Hacivat, Keloğlan, İncili Çavuş and Nasreddin Hoca, as well as the works of folk poets such as Yunus Emre and Aşık Veysel. The Book of Dede Korkut and the Epic of Köroğlu have been the main elements of the Turkish epic tradition in Anatolia for several centuries.

The two primary streams of Ottoman literature were poetry and prose. Of the two, the Ottoman Divan poetry, a highly ritualized and symbolic art form, was the dominant stream. The vast majority of Divan poetry was lyric in nature: either gazels or kasîdes. There were, however, other common genres, most particularly the mesnevî, a kind of verse romance and thus a variety of narrative poetry. The tradition of Ottoman prose was exclusively non-fictional in nature; as the fiction tradition was limited to narrative poetry.

The Tanzimat reforms of 1839–1876 brought changes to the language of Ottoman written literature, and introduced previously unknown Western genres, primarily the novel and the short story. Many of the writers in the Tanzimat period wrote in several different genres simultaneously: for instance, the poet Nâmık Kemal also wrote the important 1876 novel İntibâh (Awakening), while the journalist Şinasi is noted for writing, in 1860, the first modern Turkish play, the one-act comedy "Şair Evlenmesi" (The Poet's Marriage). Most of the roots of modern Turkish literature were formed between the years 1896 and 1923. Broadly, there were three primary literary movements during this period: the Edebiyyât-ı Cedîde (New Literature) movement; the Fecr-i Âtî (Dawn of the Future) movement; and the Millî Edebiyyât (National Literature) movement. The Edebiyyât-ı Cedîde (New Literature) movement began with the founding in 1891 of the magazine Servet-i Fünûn (Scientific Wealth), which was largely devoted to progress (both intellectual and scientific) along the Western model. Accordingly, the magazine's literary ventures, under the direction of the poet Tevfik Fikret, were geared towards creating a Western-style "high art" in Turkey.

Poetry

Poetry is the most dominant form of literature in modern Turkey.

The folk poetry as indicated above, was strongly influenced by the Islamic Sunni and Shi'a traditions. Furthermore, as partly evidenced by the prevalence of the still existent aşık/ozan tradition, the dominant element in Turkish folk poetry has always been song. The development of folk poetry in Turkish—which began to emerge in the 13th century with such important writers as Yunus Emre, Sultan Veled, and Şeyyâd Hamza—was given a great boost when, on 13 May 1277, Karamanoğlu Mehmet Bey declared Turkish the official state language of Anatolia's powerful Karamanid state;[4] subsequently, many of the tradition's greatest poets would continue to emerge from this region.

There are, broadly speaking, two traditions of Turkish folk poetries;

Much of the poetry and song of the aşık/ozan tradition, being almost exclusively oral until the 19th century, remains anonymous. There are, however, a few well-known aşıks from before that time whose names have survived together with their works: the aforementioned Köroğlu (16th century); Karacaoğlan (1606?–1689?), who may be the best-known of the pre-19th century aşıks; Dadaloğlu (1785?–1868?), who was one of the last of the great aşıks before the tradition began to dwindle somewhat in the late 19th century; and several others. The aşıks were essentially minstrels who travelled through Anatolia performing their songs on the bağlama, a mandolin-like instrument whose paired strings are considered to have a symbolic religious significance in Alevi/Bektashi culture. Despite the decline of the aşık/ozan tradition in the 19th century, it experienced a significant revival in the 20th century thanks to such outstanding figures as Aşık Veysel Şatıroğlu (1894–1973), Aşık Mahzuni Şerif (1938–2002), Neşet Ertaş (1943– ), and many others.
 * the aşık/ozan tradition, which—although much influenced by religion, as mentioned above—was for the most part a secular tradition;
 * the explicitly religious tradition, which emerged from the gathering places (tekkes) of the Sufi religious orders and Shi'a groups.

Ottoman Divan poetry was a highly ritualized and symbolic art form. From the Persian poetry that largely inspired it, it inherited a wealth of symbols whose meanings and interrelationships—both of similitude (مراعات نظير mura'ât-i nazîr / تناسب tenâsüb) and opposition (تضاد tezâd)—were more or less prescribed. Examples of prevalent symbols that, to some extent, oppose one another include, among others:

the nightingale (بلبل bülbül) — the rose (ﮔل gül) the world (جهان cihan; عالم ‘âlem) — the rosegarden (ﮔﻠﺴﺘﺎن gülistan; ﮔﻠﺸﻦ gülşen) the ascetic (زاهد zâhid) — the dervish (درويش derviş)

In the early years of the Republic of Turkey, there were a number of poetic trends. Authors such as Ahmed Hâşim and Yahyâ Kemâl Beyatlı (1884–1958) continued to write important formal verse whose language was, to a great extent, a continuation of the late Ottoman tradition. By far the majority of the poetry of the time, however, was in the tradition of the folk-inspired "syllabist" movement (Beş Hececiler), which had emerged from the National Literature movement and which tended to express patriotic themes couched in the syllabic meter associated with Turkish folk poetry.

The first radical step away from this trend was taken by Nâzım Hikmet Ran, who—during his time as a student in the Soviet Union from 1921 to 1924—was exposed to the modernist poetry of Vladimir Mayakovsky and others, which inspired him to start writing verse in a less formal style.

Another revolution in Turkish poetry came about in 1941 with the publication of a small volume of verse preceded by an essay and entitled Garip ("Strange"). The authors were Orhan Veli Kanık (1914–1950), Melih Cevdet Anday (1915–2002), and Oktay Rifat (1914–1988). Explicitly opposing themselves to everything that had gone in poetry before, they sought instead to create a popular art, "to explore the people's tastes, to determine them, and to make them reign supreme over art".[21] To this end, and inspired in part by contemporary French poets like Jacques Prévert, they employed not only a variant of the free verse introduced by Nâzım Hikmet, but also highly colloquial language, and wrote primarily about mundane daily subjects and the ordinary man on the street. The reaction was immediate and polarized: most of the academic establishment and older poets vilified them, while much of the Turkish population embraced them wholeheartedly. Just as the Garip movement was a reaction against earlier poetry, so—in the 1950s and afterwards—was there a reaction against the Garip movement. The poets of this movement, soon known as İkinci Yeni ("Second New"[22]), opposed themselves to the social aspects prevalent in the poetry of Nâzım Hikmet and the Garip poets, and instead—partly inspired by the disruption of language in such Western movements as Dada and Surrealism—sought to create a more abstract poetry through the use of jarring and unexpected language, complex images, and the association of ideas. To some extent, the movement can be seen as bearing some of the characteristics of postmodern literature. The best-known poets writing in the "Second New" vein were Turgut Uyar (1927–1985), Edip Cansever (1928–1986), Cemal Süreya (1931–1990), Ece Ayhan (1931–2002), and İlhan Berk (1918–).

Outside of the Garip and "Second New" movements also, a number of significant poets have flourished, such as Fazıl Hüsnü Dağlarca (1914– ), who wrote poems dealing with fundamental concepts like life, death, God, time, and the cosmos; Behçet Necatigil (1916–1979), whose somewhat allegorical poems explore the significance of middle-class daily life; Can Yücel (1926–1999), who—in addition to his own highly colloquial and varied poetry—was also a translator into Turkish of a variety of world literature; and İsmet Özel (1944– ), whose early poetry was highly leftist but whose poetry since the 1970s has shown a strong mystical and even Islamist influence.

Prose

The style of the current novelists can be traced back to the "Young Pens" (Genç Kalemler) journal in the Ottoman period. Young Pens was published in Selanik under Ömer Seyfettin, Ziya Gökalp and Ali Canip Yöntem. They covered the social and political concepts of their time with the nationalistic perspective. They were the core of a movement which became known as the "national literature."

With the declaration of the Turkish Republic in 1923, Turkish literature became interested in folkloric styles. This was also the first time since the 19th century that Turkish literature was escaping from Western influence and began to mix Western forms with other forms. During the 1930s, Yakup Kadri Karaosmanoğlu and Vedat Nedim Tor published Kadro, which was revolutionary in its view of life.

Stylistically, the early prose of the Republic of Turkey was essentially a continuation of the National Literature movement, with Realism and Naturalism predominating. This trend culminated in the 1932 novel Yaban (The Wilds) by Yakup Kadri Karaosmanoğlu. This novel can be seen as the precursor to two trends that would soon develop: social realism, and the "village novel" (köy romanı). The social realist movement was led by the short-story writer Sait Faik Abasıyanık. The major writers of the "village novel" tradition were Kemal Tahir, Orhan Kemal, and Yaşar Kemal. In a very different tradition, but evincing a similar strong political viewpoint, was the satirical short-story writer Aziz Nesin. Other important novelists of this period were Ahmet Hamdi Tanpınar and Oğuz Atay. Orhan Pamuk, winner of the 2006 Nobel Prize in Literature, is among the innovative novelists, whose works show the influence of postmodernism and magic realism. Important poets of the Republic of Turkey period include Ahmet Haşim, Yahya Kemal Beyatlı and Nâzım Hikmet (who introduced the free verse style). Orhan Veli Kanık, Melih Cevdet Anday and Oktay Rifat led the Garip movement; while Turgut Uyar, Edip Cansever and Cemal Süreya led the İkinci Yeni movement. Outside of the Garip and İkinci Yeni movements, a number of other significant poets such as Fazıl Hüsnü Dağlarca, Behçet Necatigil and Can Yücel also flourished.

Orhan Pamuk is a leading Turkish novelist of post-modern literature. His works have been translated into more than twenty languages. He is the recipient of major Turkish and international literary awards, such as the 2006 Nobel Prize in Literature.

Early Ottoman period (1299–1326)
With the establishment of the Ottoman Empire, the years 1300–1453 constitute the early or first Ottoman period in architecture, when Ottoman art was in search of new ideas. This period witnessed three types of mosques: tiered, single-domed and subline-angled mosques. The Hacı Özbek Mosque (1333) in İznik, the first important center of Ottoman art, is the first example of an Ottoman single-domed mosque.

Bursa period (1326–1437)
The domed architectural style evolved from Bursa and Edirne. The Ulu Cami (Holy Mosque) in Bursa was the first Seljuk mosque to be converted into a domed one. Edirne (Adrianople) was the Ottoman capital between 1365 and 1453, when Istanbul (Constantinople) became the new capital, and it is here that we witness the final stages in the architectural development which culminated in the construction of the great mosques of Istanbul. The buildings constructed in Istanbul during the period between the Turkish conquest of the city in 1453 and the construction of the Istanbul Bayezid II Mosque are also considered works of the early period. Among these are the Fatih Mosque (1470), Mahmut Paşa Mosque, the tiled palace and Topkapı Palace. The Ottomans integrated mosques into the community and added soup kitchens, theological schools, hospitals, Turkish baths and tombs.

Classical period (1437–1703)
During the classical period, mosque plans changed to include inner and outer courtyards. The inner courtyard and the mosque were inseparable. The master architect of the classical period, Mimar Sinan, was born in 1492 in Kayseri and died in Istanbul in the year 1588. Sinan started a new era in world architecture, creating 334 buildings in various cities. Mimar Sinan's first important work was the Şehzade Mosque, completed in 1548. His second significant work was the Süleymaniye Mosque and the surrounding complex, built for Suleiman the Magnificent. The Selimiye Mosque in Edirne was built during the years 1568-74, when Sinan was in his prime as an architect. The Rüstem Pasha Mosque, Mihrimah Sultan Mosque, Ibrahim Pasha Mosque, and the Şehzade Mosque, as well as the türbes (mausoleum) of Suleiman the Magnificent, Roxelana and Selim II are among Sinan's most renowned works. Most classical period designs used the Byzantine architecture of the neighboring Balkans as its base, and from there, ethnic elements were added, creating a different architectural style.

Examples of Ottoman architecture of the classical period, aside from Turkey, can also be seen in the Balkans, Hungary, Egypt, Tunisia and Algiers, where mosques, bridges, fountains and schools were built.

Westernization period (1703–1876)
During the reign of Ahmed III (1703–1730) and under the impetus of his grand vizier İbrahim Paşa, a period of peace ensued. Due to the close relations between the Ottoman Empire and France, Ottoman architecture began to be influenced by the Baroque and Rococo styles that were popular in Europe. Interestingly, a style that was very similar to Baroque was developed by the Seljuk Turks, according to a number of academics. Examples of the creation of this art form can be witnessed in the Divriği Hospital and Mosque, which is a UNESCO world heritage site, as well as in the Sivas Çifte Minare, Konya İnce Minare museums and many other buildings from the Seljuk period in Anatolia. It is often called the "Seljuk Baroque portal." From here it emerged again in Italy, and later grew in popularity among the Turks during the Ottoman era. Various visitors and envoys were sent to European cities, especially to Paris, to experience the contemporary European customs and life. The decorative elements of the European Baroque and Rococo influenced even the religious Ottoman architecture. On the other hand, Mellin, a French architect, was invited by a sister of Sultan Selim III to Istanbul and depicted the Bosporus shores and the seaside waterfront mansions called yalı. During a thirty-year period known as the Tulip period, all eyes were turned to the West, and instead of monumental and classical works, villas and pavilions were built around Istanbul. However, it was about this time when the construction on the Ishak Pasha Palace (1685–1784) in Eastern Anatolia was going on.

Tulip period (1703–1757)
Beginning with this period, the upper class and the elites in the Ottoman empire started to use the open and public areas frequently. The traditional, introverted manner of the society began to change. Fountains and waterside residences such as the Aynalıkavak Kasrı became popular. A water canal (other name is Cetvel-i Sim) and a picnic area (Kağıthane) were established as recreational areas. Although the Tulip period ended with the Patrona Halil uprising, it became a model for attitudes of Westernization. During the years 1720–1890, Ottoman architecture deviated from the principles of classical times. With Ahmed III's deposition, Mahmud I took the throne (1730–1754). It was during this period that Baroque-style mosques were starting to be constructed.

Baroque period (1757–1808)
Circular, wavy and curved lines are predominant in the structures of this period. Major examples are the Nur-u Osmaniye Mosque, Zeynep Sultan Mosque, Laleli Mosque, Fatih Tomb, Laleli Çukurçeşme Inn, Birgi Çakırağa Mansion, Aynalıkavak Palace, and the Selimiye Barracks. Mimar Tahir (also known as Mehmed Tahir Ağa) was the important architect of this period.

Empire period (1808–1876)
Nusretiye Mosque, Ortaköy Mosque, Sultan Mahmud's Tomb, Galata Lodge of the Mevlevi Dervishes, Dolmabahçe Palace, Beylerbeyi Palace, Sadullah Pasha Yalı and the Kuleli Barracks are the important examples of this style, developed parallel with the Westernization process. Architects from the Balyan family were the leading ones of the time. This period was marked by buildings of mixed Neo-Classical, Baroque, Rococo and Empire styles, such as the Dolmabahçe Palace, Dolmabahçe Mosque and Ortaköy Mosque.

Late Ottoman period (1876–1922)
Pertevniyal Valide Sultan Mosque, Şeyh Zafir Group of Buildings, Haydarpaşa School of Medicine, Duyun-u Umumiye Building, Istanbul Title Deed Office, large Post Office buildings such as the Merkez Postane (Central Post Office) in Istanbul's Sirkeci district, and the Harikzedegan Apartments in Laleli are the important structures of this period when an eclectic style was dominant. Raimondo Tommaso D'Aronco and Alexander Vallaury were the leading architects of the time.

Republic of Turkey period (since 1923)
In the first years of the republic, Turkish architecture was influenced by Ottoman architecture, in particular during the First National Architectural Movement. However, from the 1930s, architectural styles started to differ from traditional architecture, also as a result of an increasing number of foreign architects being invited to work in the country, mostly from Germany and Austria. The Second World War was a period of isolation, during which the Second National Architectural Movement emerged. Similar to Fascist architecture, the movement aimed to create modern but nationalistic architecture.

Starting from the 1950s, isolation from the rest of the world started to diminish, leading to Turkish architects being increasingly inspired by their counterparts in the rest of the world. However they were constrained by the lack of technological infrastructure or insufficient financial resources till the 1980s. Thereafter, the liberalization of the economy and the shift towards export-led growth, paved the way for the private sector to become the leading influence on architecture.

Cinema

Turkish film directors have won numerous prestigious awards in the recent years. Nuri Bilge Ceylan won the Best Director Award at the 2008 Cannes Film Festival with the film Üç Maymun. This was the fourth time that Ceylan received an award at Cannes, following the awards for the film Uzak (which was also nominated for the Golden Palm) at the festival of 2003 and 2004, and the film İklimler (also nominated for the Golden Palm) at the 2006 Cannes Film Festival. These three films, along with the other important works of Ceylan such as Kasaba (1997) and Mayıs sıkıntısı (1999) have also won awards at the other major international film festivals; including the Angers European First Film Festival (1997 and 1999), Ankara Film Festival (2000), Antalya Golden Orange Film Festival (1999, 2002 and 2006), Bergamo Film Meeting (2001), Berlin Film Festival (1998), Brothers Manaki Film Festival (2003), Buenos Aires International Festival of Independent Cinema (2001), Cannes Film Festival (2003, 2004 and 2006), Chicago Film Festival (2003), Cinemanila Film Festival (2003), European Film Awards (2000), Istanbul Film Festival (1998, 2000, 2003 and 2007), Mexico City Film Festival (2004), Montpellier Mediterranean Film Festival (2003), San Sebastián Film Festival (2003), Singapore Film Festival (2001), Sofia Film Festival (2004), Tokyo Film Festival (1998) and the Trieste Film Festival (2004).

More recently Semih Kaplanoğlu won the Golden Bear in the 60th Berlin International Film Festival with his Honey (2010 film); the third and final installment of the "Yusuf Trilogy", which includes Egg and Milk. This was the second time a Turkish film wins the award; first one being Susuz Yaz by Metin Erksan in 1964.

Turkish film director Fatih Akın, who lives in Germany and has dual Turkish-German citizenship, won the Golden Bear Award at the 2004 Berlin Film Festival with the film Head-On. The film won numerous other awards in many international film festivals. Fatih Akın was nominated for the Golden Palm and won the Best Screenplay Award at the 2007 Cannes Film Festival; as well as the Golden Orange at the 2007 Antalya Film Festival; the Lino Brocka Award at the 2007 Cinemanila Film Festival; the Best Screenwriter award at the 2007 European Film Awards; the Best Direction, Best Screenplay and Outstanding Feature Film awards at the 2008 German Film Awards; the Best Feature Film and Best Screenplay awards at the 2008 RiverRun Film Festival; the 2008 Bavarian Film Award; and the Lux Prize by the European Parliament, with the film The Edge of Heaven. Other important films of Akın, such as Kurz und schmerzlos (1998), Im Juli (2000), Solino (2002), and Crossing the Bridge: The Sound of Istanbul (2005) won numerous awards.

Another famous Turkish film director is Ferzan Özpetek, whose films like Hamam (1997), Harem suaré (1999), Le Fate Ignoranti (2001), La finestra di fronte (2003), Cuore Sacro (2005) and Saturno contro (2007) won him international fame and awards. The film La finestra di fronte (2003) was particularly successful, winning the Best Film and Scholars Jury awards at the 2003 David di Donatello Awards, the Crystal Globe and Best Director awards at the 2003 Karlovy Vary International Film Festival, the 2003 Silver Ribbon for Best Original Story from the Italian National Syndicate of Film Journalists, the Festival Prize at the 2004 Foyle Film Festival, the Audience Award at the 2004 Rehoboth Beach Independent Film Festival, and the Canvas Audience Award at the 2004 Flanders International Film Festival.

Sports
The traditional Turkish national sport has been the Yağlı güreş (Oiled Wrestling) since Ottoman times. The annual international yağlı güreş (oiled wrestling) tournament that's held in Kırkpınar near Edirne is the oldest continuously running, sanctioned sporting competition in the world, having taken place every year since 1362.

The most popular sport in Turkey is football. Turkey's top teams include Fenerbahçe, Galatasaray and Beşiktaş. In 2000, Galatasaray cemented its role as a major European club by winning the UEFA Cup and UEFA Super Cup. Two years later the Turkish national team finished third in the 2002 FIFA World Cup Finals in Japan and South Korea, while in 2008 the national team reached the semi-finals of the UEFA Euro 2008 competition.

Other mainstream sports such as basketball and volleyball are also popular. Turkey hosted the 2010 FIBA World Championship international basketball tournament. The men's national basketball team finished second in Eurobasket 2001; while Efes Pilsen S.K. won the Korać Cup in 1996, finished second in the Saporta Cup of 1993, and made it to the Final Four of Euroleague and Suproleague in 2000 and 2001. Turkish basketball players have also been successful in the NBA. In June 2004, Mehmet Okur won the 2004 NBA Championship with the Detroit Pistons, becoming the first Turkish player to win an NBA title. Okur was selected to the Western Conference All-Star Team for the 2007 NBA All-Star Game, also becoming the first Turkish player to participate in this event. Another successful Turkish player in the NBA is Hidayet Türkoğlu, who was given the NBA's Most Improved Player Award for the 2007–2008 season, on April 28, 2008. Women's volleyball teams such as Eczacıbaşı, Vakıfbank Güneş Sigorta, and Fenerbahçe Acıbadem have been the most successful by far in any team sport, winning numerous European championship titles and medals.

Motorsports have become popular recently, especially following the inclusion of the Rally of Turkey to the FIA World Rally Championship calendar in 2003, and the inclusion of the Turkish Grand Prix to the Formula One racing calendar in 2005. Other important annual motorsports events which are held at the Istanbul Park racing circuit include the MotoGP Grand Prix of Turkey, the FIA World Touring Car Championship, the GP2 Series and the Le Mans Series. From time to time Istanbul and Antalya also host the Turkish leg of the F1 Powerboat Racing championship; while the Turkish leg of the Red Bull Air Race World Series, an air racing competition, takes place above the Golden Horn in Istanbul. Surfing, snowboarding, skateboarding, paragliding, and other extreme sports are becoming more popular every year.

International wrestling styles governed by FILA such as Freestyle wrestling and Greco-Roman wrestling are also popular, with many European, World and Olympic championship titles won by Turkish wrestlers both individually and as a national team. Another major sport in which the Turks have been internationally successful is weightlifting; as Turkish weightlifters, both male and female, have broken numerous world records and won several European, World and Olympic championship titles. Naim Süleymanoğlu and Halil Mutlu have achieved legendary status as one of the few weightlifters to have won three gold medals in three Olympics.

Turkey hosted the 2005 Summer Universiade in İzmir and will host the 2011 Winter Universiade in Erzurum.

Cuisine
Turkish cuisine inherited its Ottoman heritage which could be described as a fusion and refinement of Turkic, Kurdish, Arabic, Greek, Armenian and Persian cuisines. Turkish cuisine also influenced these cuisines and other neighbouring cuisines, as well as western European cuisines. Ottomans fused various culinary traditions of their realm with influences from Middle Eastern cuisines, along with traditional Turkic elements from Central Asia such as yogurt. The Ottoman Empire indeed created a vast array of technical specialities. It can be observed that various regions of the Ottoman Empire contain bits and pieces of the vast Ottoman dishes. Taken as a whole, Turkish cuisine is not homogenous. Aside from common Turkish specialities which can be found throughout the country, there are also region-specific specialities. The Black Sea region's cuisine (northern Turkey) is based on corn and anchovies. The southeast—Urfa, Gaziantep and Adana—is famous for its kebabs, mezes and dough-based desserts such as baklava, kadayıf and künefe. Especially in the western parts of Turkey, where olive trees are grown abundantly, olive oil is the major type of oil used for cooking. The cuisines of the Aegean, Marmara and Mediterranean regions display basic characteristics of Mediterranean cuisine as they are rich in vegetables, herbs and fish. Central Anatolia is famous for its pastry specialities such as keşkek (kashkak), mantı (especially of Kayseri) and gözleme.

The name of specialities sometimes includes the name of a city or a region (either in Turkey or outside). This suggests that a dish is a speciality of that area, or may refer to the specific technique or ingredients used in that area. For example, the difference between Urfa kebab and Adana kebab is the use of garlic instead of onion and the larger amount of hot pepper that kebab contains.

title: Transwiki:Culture of Turkey


text: World Stamp Catalogue/Germany/Stamps of the Deutsche Bundespost Berlin

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User:James2472003

Two men were seriously ill they occupied the same room in the hospital. One of them was lying on the bed near the only window in the room. Every day he was allowed to spend some times sitting on his bed to help draining the fluid from lungs. The other man was forced to spend all his days. Flat on his back, they talked a lot about their life, families, jobs, vacations, every time, when the first man was sitting by his window , he described in details all that he saw outside the window His roommate always looked for those moments, when his world was broadened and brightened up by the world outside Amazing views of a park with a beautiful lake could be seen from the window of their room everyone played among ducks and swans. Couples walked arm in arm colorful flowers. Also the stunning city skyline could be seen. When the man by the window had been thoroughly describing all that was happening outside the window. His roommate would close his eyes and imagine all the beautiful scene of life that were told to him. One night the man whose bed was near the window, died peacefully during sleep and his tommate was very sad After some times when the nurse came to visit him he asked if he could be moved next to the window the nurse agreed and kindly made the switch. When she left the man slowly and painfully popped himself up on one elbow and took the first look at the world outside. He was stunned. The window faced a blank wall When the nurse came to visit him the next time he told her about the beautiful things outside the wall that hod roommate described him. The nurse replied that his roommate was a blind man Probably he just tries to encourage you.

title: User:James2472003


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User:KarenFennescey

Hi there! :) My name is Luann, I'm a student studying Creative Writing from North Johnston, Great Britain.

title: User:KarenFennescey


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text: User talk:Lixue1212

title: User talk:Lixue1212


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Tahitian/Greetings

 * Aroha : greet
 * 'ia ora na 'oe (singular)
 * 'ia ora na 'orua (dual)
 * 'ia ora na 'outou (plural) : Hello
 * 'ia ora na, e aha te huru? : Hello, how are you?
 * Maita'i : good
 * Maita'i vau, māurūru : Fine thanks
 * Maita'i roa: very good
 * Maita'i ri'i : not bad
 * 'o Hina vau : I'm Hina.
 * 'ia ora na tātou : hi everyone.
 * Happy birthday : 'ia 'oa'oa 'oe i tō 'oe mahana fānaura'a
 * Happy christmas : 'ia 'oa'oa i teie noera

Phrases

 * Good weekend! : 'ia maita'i te hope'ara'a hepetoma!

title: Tahitian/Greetings


title: User:Lixue1212/sandbox


text:
Exercise as it relates to Disease/Correlation amongst physical activity and lung health in patients with cystic fibrosis

This is a critique of the research article by Jane Scheneiderman, supervised by Felix Ratjen: Longitudinal Relationship between Physical Activity and Lung Health in Patients with Cystic Fibrosis (CF), from the educational research journal. This critical elaboration was written as an assignment for the University of Canberra, unit Health Disease and Exercise.

What is the Background to this research
Cystic fibrosis is a chronic, life limiting, incurable lung disease, which causes severe health consequences to respiratory and digestive tracts. This disease is caused by mutation in CF transmembrane conductance regulator, with caucasians being the most genetically predisposed. Disruptions to cardiorespiratory function by CF limits daily physical activity. Furthermore, the suppressed immune system often limits the patient to staying in carefully monitored indoor environments

Habitual physical activity (HPA) is of importance for reduction of CF severity amongst the young population. HPA is considered as any physical activity which limits sedentary periods, and improves overall health. Such as walking, free play periods, any activity of the lower intensity and it’s less structured than training programs, furthermore HPA will improve overall health, strength, and aerobic capacity of the patients. Primary focus on aerobic training will enhance the cardiovascular system, resulting in increased lung capacity, better Iron absorption and enhancement of the mucus clearance. Consistency in aerobic fitness development will diminish further progression of the chronic disease throughout the lifespan. This research is conducted on a mixed gender group, aged 7–17 and obtained baseline FEV1, Habitual Activity Estimation Scale and stage 1 aerobic cycle ergometer test scores in this group. This provides information on changes in lung capacity and physical activity participation changes following exercise intervention over nine years.

Where is the Research from
The author of this study is Jane Schneiderman, Exercise Physiologist/Registered Kinesiologist at the Hospital for Sick Children in Toronto. Jane is an assistant professor in the department of Kinesiology and Physical Education at the University of Toronto. Her career in the Exercise Medicine Lab at the Clinical Research Centre is to research the effect of physical activity interventions on cystic fibrosis pathophysiology. She works to correlate Exercise Medicine into the diagnosis and treatment of the patients. Jane’s supervisor for this research was Flix Ratjen, division chief of paediatric respiratory medicine at the Hospital for Sick Children, professor of paediatrics at the University of Toronto, and Senior Scientist at the Research institute in the Translational Medicine research program. Felix Ratjen is co-leading the CF centre at Sick Kids and Medical Director of the Clinical Research Unit.

What kind of research was this
This study is based on a randomised controlled trial, 212 patients were monitored over 9 years. They would randomly participate in physical activities of varying intensities, with no structured grouping being presented by the author. This questions the validity of the study, as it is not known what intensities of activity have the best outcomes. It is also not known if some participated in more activity than others. There is also no control group, meaning it cannot be determined if outcomes were due to the interventions or factors of the hospital. Moreover, it is not stated what happened to participants who would have become adults during the study, and whether they were included in the results or not.

What did the research involve
212 patients with cystic fibrosis aged 7–17 years old from the two hospitals, the Hospital for Sick Children and Montreal Children’s Hospital. Interventions were based on the regular stimulation of the cardiovascular system through any sort of physical exercising. Patients with current additional acute medical conditions, such as increased cough and sputum production, malaise, fever and/or physical participation inability, were not included in the research until they were eligible. Based on this research, the decision to exclude any of the other acute or chronic diseases except CF will provide more accurate results. The results of this study may not be reliable as there was no control group meaning it can not be known if results were caused by the intervention or other factors in the hospital.

Methods of study
In the period of nine years, data collection was undertaken quarterly on the 212 study patients. The rule of exclusion of all patients with an acute disease was practiced, which led into the variable result outcomes. Radical measures of excluding patients should be criticised as all patients with CF are more susceptible to disease, therefore it should be considered in studies. Anthropometric measures were assessed, monitoring changes in body mass index, weight and eventually height. Pulmonary function testing using spirometry, however, specificity of the assessments were not outlined, therefore it is unknown if the procedures were consistent. Furthermore, dates of assessments were not outlined in this research.

Habitual Activity Estimation Scale was monitored at each quartile, on a typical weekday after the two week periods. Total activity was monitored, data was collected from one weekday, on every second week. It is unknown how much activity they were achieving relative to the recommended guidelines of 30 to 60 minutes of daily moderate to vigorous physical activity. Aerobic cycle ergometer test stage 1 was also conducted annually to determine peak oxygen consumption. Overall results were recorded, but specific results for different ages, or individuals were not given.

What were the basic results
The outcome of this study would indicate that any physical activity has a positive influence on the patient’s cardiovascular health. Thus, CF patients who are engaged in the physical activity would experience less respiratory function decline over the lifespan, compared to non active patients. This study indicates that aerobic activity interventions of any intensity would result with reduction of the disease’s progress. However, the methodology of the study means it is not known which frequency, intensity, time and type of exercise is optimal for the participants. All that can be taken is simply that some sort of physical activity has positive outcomes.

What conclusions can we take from this research
Increased physical activity/reduced sedentary time has profound health benefits on sufferers of cystic fibrosis. In this study, detailed specificities of the training programs were not presented, limiting specific information on intensities/duration of exercise. Research should be constructed more precisely to determine the optimal type, intensity and duration of exercise for individuals with cystic fibrosis.

Practical advice
CF requires an incorporated treatment approach in the specialised CF clinics, and a huge scope of non-medical and pharmaceutical therapies are required for the optimal patient’s outcomes. Increased regular aerobic activities would diminish the disease progression through the lifespan, further study needs to be done for more constructed training interventions.

Further information/resources
https://pubmed.ncbi.nlm.nih.gov/31226098/ https://pubmed.ncbi.nlm.nih.gov/15463875/


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Exercise as it relates to Disease/Effect of physical activity and weight gain in obese pregnant women

This Wikibooks page is a critique of the research article "Exercise Training and Weight Gain in Obese Pregnant Women: A Randomised Controlled Trial (ETIP Trial)" by Garnæs, Mørkved, Salvesen and Moholdt (Jul. 2016).

This page was created as an assignment for the unit Health, Disease and Exercise at the University of Canberra (Sep. 2020).

What is the background to this research?
Gaining weight during pregnancy is normal, yet the amount of weight gained is important for the long-term health of both the mother and the baby. Recent studies suggest that approximately one-third (32%) gained the recommended amount of weight during pregnancy; whereas, the majority of women were outside the recommended guidelines (48% too much and 21% too little). The ideal amount of weight is based on the mother's body mass index (BMI) before falling pregnant. For example, overweight/obese women should gain less throughout pregnancy than someone who is underweight/normal. Consequently, women that are already an unhealthy weight and further gain too much while being pregnant, increase the risk of numerous health complications such as; preeclampsia, gestational diabetes mellitus (GDM) and caesarean birth.

The present study being critiqued, aims to determine if regular physical activity in overweight/obese pregnant women could reduce gestational weight gain (GWG) and hence prevent other negative health complications. The study also compared the effects of exercise across 30 different measures including but not limited to; blood pressure, blood measurements, skinfold thickness and body composition. Since maternal obesity is related to GWG and GDM, there is a significant demand to evaluate whether prescribing exercise training programs to overweight/obese pregnant women could considerably decrease the risk of detrimental health complications for future pregnancies.

Where is the research from?
The authors of this study are Kirsti Krohn Garnæs (researcher), Siv Mørkved (professor), Øyvind Salvesen (associate professor) and Trine Moholdt (researcher) from the University of Science and Technology in Norway (NTNU). The content of the study is likely to be of high-quality as all participating scientists have extensive knowledge on the effects of exercise on the human body as well as specialising in female research, particularly on the reproductive system. The Norwegian Fund for Post-Graduate Training in Physiotherapy as well as The Liaison Committee between the Central Norway Regional Health Authority partnered with the NTNU were the main organisations for funding and supporting this study. With this being said, it was specifically noted that there was no conflict of interest/bias as the sponsors had zero input in the way the study was designed, how the data was collected and analysed, the decision to publish the article nor the preparation of the manuscript.

What kind of research was this?
This study was conducted as a randomised controlled trial (RCT), meaning participants were randomly assigned to one of two possible groups. One being the experimental group receiving the intervention being tested and the other the control group receiving conventional treatment. The expected difference between the experimental and control group for this research design is the outcome variable being studied, in this case the effect of physical activity.

What did the research involve?
Methods used for this research were taken from the previous study protocol Exercise Training in Pregnancy for Obese Women (ETIP): Study Protocol for a Randomised Controlled Trial; however, the following changes were made to predominately increase recruitment into the trial; body composition measurement, extension for baseline testing and inclusion as well as lowering BMI criteria.

This was a single centre study consisting of 91 pregnant women with a BMI of ≥ 28 kg/m2. Participants were then randomly assigned to either the exercise group or control group.

Exercise group

 * Weekly 3 x 60 minute supervised hospital sessions (35 minutes of moderate intensity cardio followed by 25 minutes of strength training)
 * Weekly 1 x 50 minute at home program (35 minutes of endurance training followed by 15 minutes of strength training)
 * Standard maternity care

Control group

 * Standard maternity care

All physiological assessments were conducted at pregnancy 12–18 weeks, then again at 34–37 weeks and lastly on delivery day.

The main limitation of this trial was the reduced statistical power. The study aimed to recruit a total of 150 participants as opposed to the 91 they received which could have been a result of the recruitment criteria, time frame as well as the population demographic. In addition, it was noted that only 50% of the participants in the exercise group performed the exercise training program making it extremely difficult to interpret data and detect any possible effects in the intervention. This should be considered when analysing the results.

What were the basic results?
Overall, the research concluded that women in the intervention group gained 10.5 kg on average (towards the end of pregnancy); whereas, the control group only gained 9.2 kg on average. Upon examining the populations average BMI, the amount of weight gained throughout pregnancy could be considered 'healthy' when comparing with other normative data. It was also evident towards the end of the last trimester, fewer women in the exercise group had GDM and their diastolic/systolic blood pressure was lower compared to those in the control group. All other measures tested showed no apparent differences between the two groups.

Unfortunately, the study found no changes in GWG between women assigned to an exercise program to those just receiving standard maternity care. Therefore, the effectiveness of prescribing exercise training programs to overweight/obese pregnant women to prevent GWG and GDM is still unclear and further studies are required.

What conclusions can we take from this research?
According to this study, implementing exercise to specifically reduce GWG and GDM in overweight/obese pregnant women has little to no effect. This implies that both endurance and strength training followed by standard maternity care is just as effective as maternity care alone. The methodology and recruitment process for the study question the validity of the findings as the trail consisted of fewer participants than initially expected with only 50% complying to the described protocol. With these inconsistencies, it is unclear whether exercise alone would produce similar results if participants correctly adhered to the intervention program proposed. Likewise, exercise weight loss programs have been proven to be effective, especially when adopting a balanced diet.

In future, studies should aim to incorporate different forms of exercise followed by appropriate nutrition to help encourage overall health and weight loss in overweight/obese pregnant women. Other factors including demographics, predisposition for health conditions, previous pregnancies and how these factors could influence the effect of GWG or the likelihood of developing GDM in already unhealthy women. Not only physical measures should be considered, but physiological parameters such as the link between depression and weight gain should further be explored.

Practical advise
Exercise programs are an effective way for losing weight; however, results are subjective and rely on self-motivation. Unfortunately, it seems that overweight/obese pregnant women lack the ability and desire to change their lifestyle as illustrated by the compliance rate of this study. Before becoming pregnant, it is recommended that women consult their general practitioner (GP) for a pre-pregnancy check-up. From there, any potential risks for the mother and baby are discussed as well as any medical concerns that need to be addressed such as weight loss. Even though weight is a sensitive topic for some, it is advised that women fall within a healthy BMI before conceiving. Not only does this protect the mother's health and prevent complications during birth, but also the baby's well-being.

Further information/resources

 * The Women's weight gain guideline
 * Complications associated with obesity in pregnancy
 * Healthline strategies to safely lose weight while expecting
 * Pregnancy approved exercises


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Exercise as it relates to Disease/Determinants of physical activity in obese and non-obese children

What is the background to this research?

 * US children and adolescents had shown an increase in prevalence of obesity at an alarming rate in this study. Between the 10 years of the second (1976–1980) and third (1988-1991) administration of the National Health and Nutrition Examination Survey (NHANES), the prevalence of obesity among children aged 6–11 years and adolescents aged 12–17 years (based on age- and gender-specific 95th percentile body mass index (BMI) cut-off points) increased from 6 to 10.7% and 4.8 to 10.7%.

 * Reports at the time had confirmed similar increases in the prevalence of obesity among pre-schoolers and infants. This rising trend had also been linked to represent a critical public health problem

 * Obese children and adolescents were found to be more at risk for adult obesity and were more likely than their counterparts to experience significant short-term health problems such as hyperlipidaemia, hypertension, glucose intolerance and orthopaedic complications.

 * The adverse social consequences of childhood and adolescent obesity may have long-lasting negative effects on self-esteem, body image and economic mobility. Thus, presenting a real-world issue caused by obesity in children.

Where is the research from?

 * The research was approved by the University of South Carolina Institutional Review Board and was published on the July 6, 2001 in the International Journal of Obesity.

What kind of research was this?

 * The research was a cross-sectional study aimed to compare PA patterns and the hypothesized psychosocial and environmental determinants of PA in an ethnically diverse sample of obese and non-obese middle school children.

What did the research involve?

 * The research involved one-hundred and thirty-three non-obese and fifty-four obese sixth grade children with a mean age of 11.4 +/- 0.6.

 * Obesity status was determined using the age-, race- and gender-specific 95th percentile for BMI from NHANES – 1.

 * Objective measurements were collected of PA over a 7-day period using the Computer Science and Applications Inc. (CSA) 7164 accelerometer: total daily counts; daily moderate (3–5.9 METs) physical activity (MPA); daily vigorous physical activity (≥6 METs; VPA); and weekly number of 5, 10 and 20 min bouts of moderate-to-vigorous physical activity (≥3 METs, MVPA).

 * Self-report measures were collected of PA self-efficacy; social influences regarding PA, beliefs about PA outcomes; perceived PA levels of parents and peers, access to sporting and/or fitness equipment at home, involvement in community-based PA organizations; participation in community sports teams; and hours spent watching television or playing video games.

What were the basic results?

 * Compared to their non-obese counterparts, obese children exhibited significantly lower daily accumulations of total counts, MPA and VPA as well as significantly fewer 5, 10- and 20-min bouts of MVPA.

 * Obese children reported significantly lower levels of PA self-efficacy, were involved in significantly fewer community organizations promoting PA and were significantly less likely to report their father or male guardian as physically active

Critique

 * S.G. Trost, L.M Kerr, D.S. Ward, R.R. Pate all contribute to the makings of this research. Trost, from the School of Human Movement Studies, The University of Queensland assessed the validity and inter-instrument reliability of the CSA 7164 activity monitor in children aged 10–14.

 * The main authors Kerr and Pate from the Department of Exercise Science, School of Public Health, University of South Carolina, and Ward from the School of Public Health, University of North Carolina at Chapel Hill. Trost, Ward, and Pate are all highly regarded individuals at their respective schools, nationally, and internationally with each having multiple accounts of published work. In researching, there was little information found on Kerr and cannot comment on their reputation/background.

 * The subjects for this study were 187 sixth grade students from four randomly selected middle schools in Columbia, South Carolina. Disadvantages of random selection include the time needed to gather the full list of the population, retrieving and contacting the list via the schools, and bias that could occur when the sample set is not large enough to adequately represent the full population.

 * The objective of the article was to compare in an “ethnically diverse sample”, however, in the methodology, only seem to state male and female African Americans rather than any other ethnicities such as Chinese American or Latin American etc.

 * The authors findings can be found appropriate due to the objective nature of their measurements using instruments such as the CSA 7164 activity monitors.

 * Non-monitored activities were given PA scores and were calculated with and without the inclusion of self-reported participation in swimming, cycling and weight training. Inclusion of these data resulted in no changes to the mean MPA and VPA scores and were not included in the analyses.

 * The nature of this study precluded from inferring a causal relationship between PA and obesity status. Thus, the lower activity profile exhibited by the obese children relative to their counterparts may have been the consequence of obesity and not the cause of it.

 * Although alarming to find that approximately 30% of the sixth-grade sample could be classified as obese, the modest sample size of the obese group precluded their ability to conduct sex-specific analyses.

 * Due to logistic concerns, the study included a relatively small number of determinant variables and did not collect direct data from parents. Therefore, future studies should expand the list of determinants to include physical self-perception variables such as social physique anxiety and body attractiveness; and more comprehensive measures of parental and peer support/ encouragement for physical activity.

What conclusions can we take from this research?

 * The results are consistent with the hypothesis that physical inactivity is an important contributing factor in the maintenance of childhood obesity.

 * Interventions to promote PA in obese children should endeavour to boost self-efficacy perceptions regarding exercise, increase awareness of, and access to, community PA outlets, and increase parental modelling of PA

 * Considering the critique, it is believed a different sampling technique should be undertaken, including multiple ethnicities and have all PA monitored rather than relying on some aspects of self-reporting.

Practical advice

 * Given the study findings and the critique multiple considerations can be made for sound practical advice. Advice such as using a different selection process to increase efficiency, inclusion of more ethnicities to adhere to the objectives, calculating all PA into the analyses rather than factoring into only MPA, VPA and MVPA and not relying on self-report figures to do so. Having sex-specific figures as a separate study to incorporate into the data, and finally, increase logistic parameters to be able to collect more data from direct sources.

Further information/resources
https://www1.health.gov.au/internet/main/publishing.nsf/Content/child-and-youth-health-1

https://www.understood.org/en/friends-feelings/child-social-situations/sports/how-to-get-your-child-involved-in-sports

https://www.mdanderson.org/publications/focused-on-health/tips-to-get-kids-to-exercise.h17-1589046.html


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User:Sd.healthstudent

Exercise as it relates to Disease/Improving executive functions in children with autism spectrum disorder through mixed martial arts
This book is a critique on the study “promoting executive functioning in children with autism spectrum disorder through mixed martial arts training” studied by the authors Janice N. Phung and Wendy A. Goldberg (2019).

What is the background to this research?
Autism spectrum disorder affects about 1 in every 100 to 110 people. This is a neurodevelopmental disorder that alters these individuals social and behavioural development, affecting their approach to interact with their environment as well as other people. ASD is a chronic disorder and to this day, has no cure. Those who are diagnosed with ASD face difficulties in managing executive functions of the brain and therefore enhancing these skills leading to poor displays of planning abilities and/or cognitive flexibility. The main EFs depend on three brain functions including: 1) Working memory, which is the ability to contain and utilise information that is learnt over short periods of time. 2) Cognitive flexibility, where the brain can readily transfer or prolong attention as response to different requests or rules in certain situations. And lastly 3) Self-control, allowing the inhibition of impulsive responses or actions . On the other hand, there are also complex EFs, which involve more planning, problem solving, reasoning and verbal and nonverbal fluency. EFs are developed throughout childhood and continue to increase complexity and depth as age increases. Children with ASD have a hindered progress of EFs and tend to exhibit deficient planning abilities and cognitive flexibility in particular.

Physical activity in previous studies have proven to be beneficial in boosting executive functioning skills perhaps through the increase of neurochemical activity in the neural system. This neural activity allows for the activation of EFs. In a study done by, they discovered that moderate to lower intensity exercise generated optimal levels of neural activity. The proposed exercise mode of martial arts training has been chosen as it not only meets the optimal level of exercise intensity but also the importance of self-disciple, through behavioural emotional and cognitive control. Traditional martial arts highlights character development as well as self-control. Mixed martial arts, deriving from Jeet Kune Do, consists of many diverse techniques and elements coming from 20 different martial arts, proposes many ways of benefiting children with ASD through the enhancement of EFs. Each child with ASD has many differing strengths and weaknesses, and through the MMA intervention each of these can be catered to and targeted to become better. Moreover, as MMA is delivered as a traditional class rather than modernised and focused on sport and physical conditioning, there is an increased emphasize on character development as well as self-control with the addition of physical conditioning and fitness. Skills that are learned from this training can be generalized and adapted in order to be universally used through different situations and contexts.

Abbreviations
ASD - Autism spectrum disorder

TD - Typically developing

EFs - Executive functions

Where is this research from?
The Journal of Autism and Developmental Disorders published by Springer online June 2019.

What kind of research was this?
This research involved a randomized controlled trial study investigating the effectiveness of mixed martial arts as an intervention to enhance executive functions in children with autism spectrum disorder. Randomized controlled trial studies analyse the outcome variable being the martial arts training for the children for this case using common and trusted statistical tools.

What did the research involve?
'''Participants ''' The study involved n=34 children aged 8-11 years old with a clinical diagnosis of ASD. Participants were from a departmental database who had already consented to be contacted for studies or contacted the research team through an exclusive online survey.

Measures

A series of testing in order to distinguish where the participants intellectual and executive functioning state as well as the severity of their condition were held pre and post the intervention. These tests involved: lifetime social communication questionnaire, autism diagnostic observation schedule-second edition, Wechsler abbreviated scale of intelligence-second edition, behaviour inventory of executive function-2nd edition and finally the hearts & flowers test. Results from these tests equalled to low average from the participants as a whole indicating a moderate to high severity of the disorder.

Interventions

The participants were randomly assigned to either the MMA intervention group or the waitlist control group. The intervention duration was 13 weeks with the participants of the MMA intervention required to attend training twice a week. These classes ran for 45 minutes with a class plan designed by experienced instructors also dealing teaching other students with disabilities. On the other hand, waitlist control group participants did not participate in MMA training.

MMA Intervention 13-week curriculum

Weeks 1-4 = Punching/ kicking on mitts / kicking pads

Weeks 5-8 = Glove drills and grappling with partner taking turns of attacking and defending

Weeks 9-13 = Glove drills and grappling with partner taking turns of attacking and defending

Class plan

'''5 minutes Bow-in'''

-	Line up

-	Attention to instructor

-	Bow as respect to instructor

-	Meditation

''' 15 minutes Warm up'''

-      Jogging

-	Footwork

-	Stretching

'''20 minutes

Main activity '''

-	Increasing complexity throughout duration of intervention

-	Practising with TD students -	A combination of striking and defenses

'''5 minutes

Cool down'''

-	Social game

-	Line up

-	Attention to instructor

-	Bow as respect to instructor

-	High-five as acknowledgement to other students

What conclusions can we take from this research?
The study’s findings propose that the traditional MMA style has beneficial results as an intervention for enhancing EFs due to its high suitability for children with ASD. Although martial arts is a very under looked sport, it has many to offer for the development of any children’s wellbeing. Not only does it physically condition but it also incorporates and emphasizes character development and discipline. These are qualities that children can use as a baseline to build on to succeed and become confident within themselves and further develop independence. With the complexity of martial art forms and combination activities, the children are able to optimally stimulate neural activity and increase executive functions. From there they are able to use skills gained universally throughout their daily lives and with the addition of being able to defend themselves confidently in dangerous situations.

Practical Advice
For health care professionals or parents seeking alternate therapies for children with autism spectrum disorder, it is worthwhile to introduce and train children who are diagnosed in martial arts. Preferably traditionally taught martial arts in particular. From this study, training children with ASD in mixed martial arts will not only incorporate physical conditioning improving the children’s fitness but will also assist in neural development, as this sport will optimally stimulate neurochemical activity which can lead to executive functional enhancement. Skills gained through training in MMA, can also be universal and can be used in different contexts, boost the children’s confidence as well as independence through the increased self-discipline, character development and the knowledge of self-defence.

Further Information/Resources

 * Executive functions
 * Journal of Autism and Developmental Disorders
 * MMA and benefits for ASD
 * MMA and benefits for ASD

title: User:Sd.healthstudent


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Exercise as it relates to Disease/Exercise and respiratory training on patients with chronic pulmonary hypertension

This is a critique of the research article Effect of Exercise and Respiratory Training on Clinical Progression and Survival in Patients with Severe Chronic Pulmonary Hypertension (2011).

This is an assignment for the unit of Health, Disease and Exercise for the University of Canberra.

What is the background to this research?
Pulmonary hypertension (PH) increases vascular loading on the right ventricle, which can cause electrical, mechanical and structural changes to the heart and lungs. This allows for ventricular interdependence, resulting in the unloading of the left ventricle. It is an uncommon disorder of unknown medical causes, characterized by an increase in pulmonary artery pressure and vascular resistance, often leading to failure of the right ventricle of the heart.

The definition for PH was developed in the 1998 World Health Organization meeting. PH is most commonly associated with respiratory system disorders and is classified as a pulmonary artery mean pressure, at rest, of 20mmHg or greater and is commonly due to an increase in pulmonary vascular resistance.

Physical capacity and quality of life (QoL) are often restricted for patients with pulmonary PH. Specific medical treatment options partnered with an exercise respiratory training program result in an increased exercise capacity and overall QoL for these individuals.

The aim of this study was to determine whether the benefits of exercise and respiratory training on physical capacity and QoL can be applied to a larger cohort of patients, and if an exercise program is a viable long term therapy for PH patients.

Where is the research from?
The research was conducted at the Centre of Pulmonary Hypertension, Thoracic Clinic, University Hospital in Heidelberg, Germany. This particular group of PH patients had been referred from nine different medical centres.

All patients provided written informed consent to participate in this study, which was approved by the University of Heidelberg’s Ethics Committee.

What kind of research was this?
The prospective study investigated 58 patients with severe chronic PH and right heart failure between January 2003 and April 2007, including the follow-up time of 24±12 months. The participants received respiratory training and exercise in addition to disease-targeted medication.

Inclusion criteria of participants:

 * Aged 18–80 years old
 * Classified as WHO functional class II-IV
 * Had to be stable and compensated with appropriate medical therapy at least 3 months prior to the beginning of the study

Some patients were removed from the study during the 3 month period prior to the study. The exclusion criteria of participants included:
 * Failing the baseline tests
 * Change in medication during the 3 months
 * Listed for lung transplantation

What did the research involve?
Patients were prescribed with an exercise program to partake in, for at least 15 weeks. For the first 3 weeks, all patients remained in hospital and completed the exercises in controlled, supervised conditions. At the end of the third week, patients were discharged and returned home, receiving an individualized program and a bicycle ergometer to continue the prescribed exercise.

The exercise program included:
 * Daily interval bicycle ergometer training at low workloads
 * Daily walking
 * Resistance training of single muscle groups using 0.5–1 kg dumbbells
 * Respiratory training 5 days a week
 * Psychological training to improve patients' perception of physical ability and understanding limitations

The patients' oxygen saturation and heart rate were continuously monitored throughout the exercise training and were used to adjust the intensity of the training. The program was closely monitored by physical therapists and physicians for the first 3 weeks and the amount of training at home was supervised by phone calls every 2–4 weeks after discharge.

Patients were clinically assessed at baseline, after the 3 month period, as well as 3 and 15 weeks after the commencement of exercise, followed by regular clinical visits or phone calls for 24±12 months.

The clinical assessments included:
 * A 6-minute walking test (6MWT) performed in a large hall under standardized conditions
 * Health-related QoL test, performed by the Short-Form Health Survey (SF-36)

Changes in WHO functional classification, Borg dyspnea index (6 - no exertion, 20 - maximal exertion) and gas exchange were also analyzed over the 15 week program.

What were the basic results?
It was concluded by the authors of this journal that the tests conducted at the end of the 15 week exercise program proved that:

 * There was an increase in the 6-minute walking distance of 96±61 metres, which was a greater value than that achieved with medical therapy
 * The patients resting heart rate was significantly reduced
 * QoL parameters were also improved. All patients reported that they had improved awareness of their physical abilities and limitations
 * Exercise capacity, peak oxygen uptake, anaerobic workload threshold, maximum heart rate and systolic pulmonary artery pressure improved at rest for all patients, suggesting a reduction in right ventricular work
 * The mean WHO functional class significantly improved

The researchers of this study acknowledged the time to clinical worsening and the deterioration in functional class of some of the participants during the exercise program. However, the training itself was well tolerated and there were no adverse effects or progression of symptoms in any participant.

What conclusions can we take from this research?
It has been demonstrated that carefully monitored exercise and respiratory training as a supplement to appropriate medical therapy can improve the 6-minute walking distance as well as QoL in patients suffering severe PH.

Exercise and respiratory training with PH is an effective but not completely harmless additional therapy, even in patients with severe diseases, and all exercise should be closely monitored. Many similar studies also suggest that low-dose exercise and respiratory training as a supplement to medical therapy is safe in a closely supervised setting and it may improve the exercise capacity and QoL of patients with many forms of PH.

Further research is required to determine whether exercise and respiratory training can increase the survival rate for PH patients. The only prospective, randomized trials to demonstrate a favorable impact on mortality in PH patients have been performed using continuous intravenous epoprostenol (a short-acting vasodilator of the blood vessels in the heart and lungs and an inhibitor of platelet aggregation ).

Practical advice
Participating in any form of physical activity has implications for a typically healthy individual, but this is particularly enhanced when a disease or health issue becomes evident.

Many patients that suffer severe PH as a result of COPD have an additional cause of pulmonary pressure elevation including, left ventricular disease, pulmonary embolism or sleep apnoea. This particular population of patients suffered from PH associated with a variety of different conditions. These additional health issues require individualized medication and treatment based on the patient and their medical history. This may imply that exercise and respiratory training could have adverse effects on certain patients.

A limitation of this study was the gender bias. The population consisted of 42 women and only 16 men. Another possible limitation would be the overall size of the population (n=58). Although, in the article it was mentioned that, to date (2011), there is no data available in a larger patient cohort for this particular type of research.

Further information and resources
The following websites provide useful information, fact sheets and support for patients with PH in regards to exercise:

 * Pulmonary Hypertension Association - Exercise Guidelines
 * National Organization for Rare Disorders - PH
 * Lung Foundation Australia - Rehabilitation Toolkit
 * St Vincent's Hospital, Heart Health


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Exercise as it relates to Disease/Exercise interventions for arthritis sufferers

This article is a critique of the research paper The effects of strength and endurance training in patients with rheumatoid arthritis (Strasser, B. et al. 2010).

What is the background to this research?
Rheumatoid arthritis (RA) is a chronic inflammatory disease that seriously impacts quality of life in general, and has links to several comorbidities, including cardiovascular disease, diabetes and some cancers.

Since chronic inflammation is a factor in the development of cardiovascular disease (CVD) and type 2 diabetes, and is a key symptom in RA patients, it follows that RA patients will be at greater risk of developing these diseases than the general population.

Regular physical activity has long been associated with reduced risk of developing CVD, diabetes and some cancers through its anti-inflammatory effect. The issue for RA patients is that the common symptoms of RA, e.g. joint pain, and conservative treatment approaches, e.g. rest, discourage physical activity. This leads to muscle loss, reduced muscle strength and endurance capacity, and subsequent loss of physical function and quality of life. It can also contribute to increased risk of developing comorbidities.

While it has been suggested that there is a link between medications prescribed for RA and the onset of some comorbidities in RA patients, there remains a strong case for using exercise to alleviate the risk of developing these diseases, potentially more so than for the general “healthy” population.

The researchers in this study hypothesised that a combination of strength and endurance training could assist in alleviating some of the symptoms of RA. This, in turn, could improve quality of life and reduce the likelihood of several other comorbidities often associated with RA.

Where is the research from?
The study was conducted by a group of Austrian researchers, drawing on RA patients from the Rheumatology Unit at Wilhelminen Hospital, Vienna. Members of the research group have undertaken extensive research over several years into various forms of arthritis, CVD, diabetes and other life threatening medical conditions, as well as the role of physical activity in treatment of these conditions. The researchers’ individual areas of interest and expertise combine to suggest a well-balanced and well-informed approach to this investigation. The lead researcher, Professor Barbara Strasser, has been cited more than 2000 times since 2015, lending credibility to her research expertise.

The research was published on 8 October 2010 in Clinical Rheumatology, the Journal of the International League of Associations for Rheumatology and can be viewed online at https://link.springer.com/10.1007/s10067-010-1584-2.

What kind of research was this?
The research was conducted as a randomised control trial (RCT). RCT is widely considered the gold standard of comparative research, making it the ideal choice for this study. The main benefit of this type of research is that it eliminates any bias the researchers may have, for example, allocating patients with less serious RA symptoms to the test group if the selection was not randomised. It is also best suited to accurately determining cause and effect, one of the main aims of this study.

What did the research involve?
Forty patients clinically diagnosed with RA were randomly assigned to a supervised combined strength and endurance training program (19 women, one man) conducted over six months; or a control group (17 women, three men) who did not undertake any strength or endurance training during the same six month period. Prior to commencement, medical history was noted and clinical examination undertaken. The clinical examination included:
 * echocardiography,
 * blood pressure,
 * blood analysis,
 * current medications,
 * clinical health status,
 * functional ability,
 * stress test,
 * muscle strength,
 * body weight,
 * fat mass, and
 * lean body mass.

The combined strength and endurance training group completed two sessions of strength based training on non-consecutive days of the week. The sessions involved a 10 minute warm up comprising stretching exercises. The strength component of the session included structured training to achieve hypertrophy over the six month duration of the program, targeting major muscle groups. Progressions were individualised for participants but followed the same sets and repetitions pattern. The endurance training component was undertaken on a cycle ergometer and comprised two sessions per week, with intensity controlled by maintaining 60% of the VO2max of participant, as calculated at the start of the study.

The control group completed stretching exercises twice a week, without additional resistance. They were permitted to continue recreational physical activity that didn’t involve strength or systematic endurance training.

What were the basic results?
The researchers concluded that “Long term training appears to be effective in reducing disease activity and associated pain and was found to have no deleterious effects.”

General health (30%) and functional ability (18%) improved as a result of the strength and endurance program. Overall, the combination of strength and endurance training resulted in benefits in all areas for RT patients. Disease activity (p=0.06) and pain (p=0.05) were reduced after the six month training period; general health (p=0.04) and functional ability (p=0.06) improved; cardio respiratory endurance improved significantly (10%, p<0.001); strength increased (average 14%); lean body mass increased, and body fat (p<0.05) decreased.

In the control group, there were no significant changes in any of the same measures.

What conclusions can we take from this research?
In simple terms, this research supports the use of combined strength and endurance training to improve quality of life and reduced likelihood of common comorbidities for RA patients. Testing parameters were extensive and contributed to the capacity to draw valid conclusions.

The researchers acknowledged that the study had limitations around limited numbers (only 75% of the starting participants completed the strength and endurance program) and no follow up assessment of the participants post the six month study period. They also suggested further research is required into the impact of ongoing exercise programs for RA patients. However, this research and other investigations into physical activity for RA patients, specifically strength and endurance training, conducted at around the same time and subsequently, further support this modality as a valid option for RA patients.

Practical advice
Reassure patients : Physical activity programs including strength and endurance training are not only safe for RA patients, but can provide considerable health and lifestyle benefits. However, many RA patients may be fearful of embarking on an exercise program. Therefore, a major consideration for any practitioner working in this area is reassuring the patient that strength and endurance programs are safe with RA.

Monitor and tailor programs : Given the variable nature of RA symptoms, exercise programs should be closely monitored and tailored to the abilities and limitations of the individual.

Collaborate with relevant professionals : It has been suggested that programs to increase physical activity for RA patients should be developed in collaboration with physiotherapists or rheumatology healthcare practitioners. This may well be valid for advanced or complicated cases, however with education and professional development, it is reasonable and potentially more practical for knowledgeable and accredited exercise professionals to take on the development and management of strength and endurance programs for RA patients, while maintaining collaboration with those patients’ existing health care support workers.

Further information/resources
Further information on the value of, and advice on, exercise for RA patients can be found via the following links:

https://reumanetnl.nl/wp-content/uploads/2020/03/Metsios-2020-The-effects-of-exercise-on-cardiovascular-disease-risk-factors-and-cardiovascular-physiology-in-rheumatoid-arthritis.pdf

https://www.rheumatoidarthritis.org/living-with-ra/exercise/

https://arthritisaustralia.com.au/managing-arthritis/living-with-arthritis/physical-activity-and-exercise/exercise-and-ra/


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Exercise as it relates to Disease/Effectiveness of physical fitness through virtual reality in individuals with intellectual and developmental disability

This wikibook's page is a critique of the research article "Improving physical fitness of individuals with intellectual and developmental disability through a Virtual Reality Intervention Program" by Meir Lotan Shira Yalon-Chamovitz and Patrice Weiss 2009.

What is the background to this research?
The aim of the research was to investigate the effectiveness of video capture virtual reality (VR) to enhance the physical fitness levels of individuals with intellectual and developmental disability (IDD). Individuals with IDD have been shown to have lower levels of physical fitness when compared to peers without IDD. This commonly occurs due to the passive lifestyle, low motivational levels exhibited, psychological and/or physiological factors. Previous case studies relating to VR devices stated that motivational levels were high due to participant enjoyment leading to more engagement. This research takes a broader approach to other factors such as social, emotional and cognitive development, as well as the individual’s interests. For this to occur it requires the intervention to be highly motivational. As some fitness tests require supplementary requirements such as specialised equipment and/or trained individuals, these complexities may be exchanged for alternative fitness tests more favourable to the setting such as VR.

Where is the research from?
Meir Lotan is an expert professor in the physical therapy field, with numerous published papers on a variety of health subjects including medicine, neuroscience, biochemistry and genetics. Lotan has completed similar studies across the years and this research is just one into those concerned with IDD. His 2006 study began researching how to improve physical activity in adolescents with intellectual disability, followed by the currently analysed study with an additional follow up study published in 2010 as ‘Virtual reality as means to improve physical fitness of individuals at a severe level of intellectual and developmental disability’ with the same team.

What kind of research was this?
Researchers undertook an observational study to monitor how individuals with IDD responded to physical fitness with the use of VR in comparison to a control group. This study also had an additional goal to determine whether the motivational effect found in previous studies could be achieved with a reduced number of trained staff and specialised equipment, so more of these individuals can increase their level of physical fitness in the comfort of their own space. Other studies differ due to methodology however a large portion support evidence of a positive correlation between the use of VR in improving physical fitness in those with IDD.

What did the research involve?
The participants were divided into two, thirty person groups both with approximately half that utilise wheelchairs and half that are utilising walker aids. One of these were a control group while the other group was the experimental group. Participants of each group were then enrolled into three, thirty-minute sessions per week over a span of 5-6-week for the length of the program. A preintervention test was performed a week before commencing the program. An included 10 min break was done before the start of the program once the participant arrived at the room. After the second session, the participants could choose their favourite games for the remainder of the program. The methodology was an acceptable approach due to limiting the factors of external stimuli. This was shown by the designated room of the participants resident which they would feel less anxious about and with the same 2 occupational therapy students and physiotherapist supervisor. The choice of game was also set by the individual having their preference of game for most of the test period. The test also allowed for a pre and post intervention test with non-overloading three, thirty-minute sessions per week with breaks to regulate anxieties about testing. However, the recruitment of these individuals did not account for those that still are able bodies that do not rely upon mobility aids. The study also did not account for those who are under the age of 30 or 18 when the disability is most diagnosed.

What were the basic results?
The results showed that the Modified Cooper test had the most growth. There was a significant difference in the pre-post measurements of the wheelchair users and those with walking aids when compared separately. The Total Heart Beat Index (THBI) also showed the post intervention of the research group walkers users dropped significantly from 53.5+/- 57.0 to 31.3 +/- 27.9, while those from the research group with a wheelchair aid dropped from 8.1+/-13.0 to 3.9+/-3 however still a significant result.

*These values are taken at the mean ± S.D.

The researchers interpreted the results as a positive increase in physical fitness from the research group in relation to the control group. This was evidently shown by the results in the Modified Cooper Test. The researchers did not over-emphasis their findings, though through their discussion the results were compared to the population that did not have IDD.

What conclusions can we take from this research?
This study has been a significant boost to the insight in how we can adapt modern technology to increase the physical fitness of those with IDD. With the ever-growing support for VR, there can be further refinements made to cater for higher levels of engagement, thus leading to a larger increase in the physical fitness levels of those with IDD. While the idea of VR is a great gateway to increasing physical fitness of those with IDD, more support is required for the types of activities readily available. Those with IDD could ascertain a much better level of physical fitness if the activities are engaging and cater to those utilising this system.

Practical advice
Further research into the engagement of physical fitness for those with IDD is required to be completed more as an individual case study rather than grouped together based on having IDD. Other case studies regarding those with IDD and their levels of physical fitness have skewed towards more positive results with higher levels of engagement. Further focus on the enjoyment of these activities carried out by the individuals should correlate to higher engagement and physical fitness. To motivate these individuals with IDD, there must be more pre-screening questionnaires to gage the individual’s preference towards types of VR and or physical fitness to improve their engagement levels.

Further information/resources

 * Center For Disease Control And Prevention
 * Virtual Reality Institute of Health and Exercise
 * Oculus Game “Supernatural” Example
 * Oculus Where to Purchase


text: User talk:59.10.34.231

title: User talk:59.10.34.231


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Exercise as it relates to Disease/Adherence to physical activity in young people with Type 1 diabetes

What is the background to this research?
Type 1 diabetes is an auto-immune condition in which the immune system is activated to destroy the cells in the pancreas which produce insulin(2). This health concern affected 20,700 children and young adults (aged 0–24) in Australia 2018(4). Due to the inability to produce their own insulin, problems may occur while exercising including the risk of hypoglycaemia (condition in which your blood glucose level is lower than normal) or hyperglycaemia (cause their blood glucose levels to increase)(2). These fluctuations of glucose levels can also cause fear towards physical activity which is a primary barrier for individuals with type 1 diabetes(5). This is problematic, especially with children and adolescents as physical activity plays a key role in the management of type 1 diabetes as well as their development(6). Considering these risks and barriers the article aims to investigate time spent exercising, adherence to the program for a safe exercise and ability of young people with diabetes to take appropriate measures to reduce potential risks(1).

Where is the research from?
This research was based at the Regional Centre for the management of diabetes in childhood of the University of Parma, Parma, Italy, however the individuals conducting the study used a variety of different facilities including Children’s Hospital and the General Hospital of Parma(1). The article had several authors including Maurizio Vanelli and Giovanni Chiari, both working at Department of Clinical and Experimental Medicine, University of Parma and have a combined 206 publications(1). Their skills and expertise include diabetes mellitus, blood glucose and nutrition(1). The other authors (Chiara Gelmetti, Anna Bernardini, Brunella Iovane, Rosa Vitale, Maria Katrin Errico) all have an affiliation with the University of Parma and have a combined 41 publications(1).

What kind of research was this?
A mixed research was used to complete the study as it included both qualitative and quantitative data. At the beginning of the research quantitative data was collected from the participants including age, sex, weight, height, BMI, duration of disease, mean HbA1c value(1). During the study both qualitative and quantitative data was collected including weekly time spent for physical activity, the type of exercise usually performed and the measures taken to reduce exercise risks have been collected by a structured questionnaire(1).

What did the research involve?
The study involved a random selection of 91 type 1 diabetes mellitus (50 boys, 41 girls), aged between 10-18 years and have had diabetes longer then 6 months without any association with chronic diseases (1). The clients age, sex, weight, height, BMI, duration of disease, mean HbA1c value were recorded and then an interview commenced to determine the clients(1): Apart from the initial interview/questionnaire, the information provided about the method of the study was minimal creating confusion and a misunderstanding of the process used in the study. However, it was mentioned that the patients glycated haemoglobin was taken every 3 months and in the follow up, guidelines were provided to perform a safe exercise e.g. avoid exercise during peak insulin action and consider reducing insulin dose when exercise is anticipated(1).
 * Weekly time spent for physical activity at school or in the spare time
 * The type of exercise usually performed
 * The measures taken to reduce exercise risks, in particular changes in insulin and food intake before and after exercise.

What were the basic results?
The mean of the HbA1c values collected from the 91 individuals over preceding 6 months was 8.4 ± 0.2%(1). However the study discovered that children that exercised less then 60 minutes a week had a mean HbA1c level higher then children exercising 120-360 minutes or 360-480 minutes a week as shown in the table below(1). This was then taken a step further and the physical activity was split into two categories competitive sports (soccer and volleyball) and spare time (walking and skating). The results found that children attending a competitive sport (at least 360 min per week) had a better glycemic control (HbA1c = 7.39 ± 0.6)(1). Throughout the study individuals did suffer from hyperglycaemia and hypoglycaemia episodes. Hypoglycaemia was recorded in 37.7% of individuals, higher then hypoerglycaemia(1). This was spread evenly throughout competitive sports and spare time. However only 50% of patients were using safe procedures including(1): Overall the results supported physical activity benefits individuals with type 1 diabetes however there was no information about safety procedures helping individuals avoid hyperglycaemia and hypoglycaemia episodes.
 * 29% monitored blood glucose levels before exercise
 * 41% monitored blood glucose levels after exercise
 * 30% monitored blood glucose levels before and after exercise
 * 32% of patients referred to change insulin dose according to blood glucose levels

What conclusions can we take from this research?
Overall the study was a success however the aim was not 100% fulfilled. The authors were successful in gathering a correlation that an increase in the amount of minutes exercised each week is beneficial towards individuals with type 1 diabetes and does decrease HbA1c levels. However they only reported that individuals should use safe practices to avoid hyperglycaemia and hypoglycaemia episodes and didn't go into detail which safe practices were effective.

Practical advice
During the interviewing stage the questionnaire was positive to receive information about the patients however the reliability of it is questionable due to the children and adolescence may not be 100% honest. The numbers received for the minutes participated in physical activity may have been unreliable as well due to dishonesty from patients however the results demonstrate a reasonable trend to rule this out. The method needed more detail to it as well due to confusion in what happened after the interviews. Finally more detail needed in the results in which safe practices were beneficial to the patients.

Further information/resources
Listed below are several links beneficial to individuals with type 1 diabetes:
 * Diabetes Austraila
 * Health direct
 * jdrf