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Exercise as it relates to Disease/Is a combination of strength and endurance training effective for postmenopausal females suffering from fibromyalgia?

This page is a critique of the research article: 'Effects of Concurrent Strength and Endurance Training on Physical Fitness and Symptoms in Postmenopausal Women With Fibromyalgia: A Randomized Controlled Trial' by Valkeinen H, Alén M, Häkkinen A, Hannonen P, Kukkonen-Harjula K, Häkkinen K.

Critique was undertaken as an assignment for the unit Health, Disease, and Exercise (8340) at the University of Canberra, during Semester 2 of 2022.

What is the background to this research?
Fibromyalgia syndrome (FMS) is a chronic rheumatic condition that causes individuals to experience widespread pain, fatigue, mental distress and often abnormal processing of pain. It impacts 2% to 5% of the population (the majority are females) and has no known cause or cure. American College of Rheumatology (ACR) published an article investigating the quality of life of fibromyalgia patients. ACR concluded that quality of life decreased from 8.6 out of 10 to 4.8 out of 10, through questionaries conducted by FMS patients. The European Alliance of Associations for Rheumatology (EULAR) reviewed management recommendations for FMS in 2016. EULAR concluded that aerobic and strength training are effective non-pharmacological methods for managing FMS symptoms. Current guidelines for exercise prescribe include:

 * Highly individualised program.
 * Low-intensity training.
 * Progressive overload is slow and aims toward a moderate intensity level.

However, there is insufficient evidence on which forms of exercise are best and whether a combination of exercise types would be a more effective management method .The ‘Effects of Concurrent Strength and Endurance Training on Physical Fitness and Symptoms in Postmenopausal Women with Fibromyalgia: A Randomised Controlled Trial’ investigates the effectiveness of concurrent strength and endurance training as an exercise intervention to improve FMS patients’ symptoms and overall physical fitness. This knowledge would advance the understanding of exercise prescriptions for FMS patients and the extent of the impact.

Where is the research from?
This peer-reviewed article was published in the Archives of Physical Medicine and Rehabilitation volume 89, issue 9, owned by the American congress of rehabilitation medicine (ACRM). ACRM is a private organisation that aims to share updated, accurate research in rehabilitation. Therefore, articles must be credible and limited bias to be published. ACRM is sponsored by numerous reputable organisations, including the American Stroke Association, decreasing the bias. All authors have been involved in several peer-reviewed projects. This experience increased the reliability of the study.

The small specific sample group reduces the ability to generalise the study to FMS patients with other health issues such as obesity, which is typical for FMS patients. Furthermore, the lab environment increases the difficulty of applying to hospital settings, decreasing generalising capacity.

What kind of research was this?
This study is a randomised control trial (RCT), excellent for identifying a significant difference between using concurrent endurance and strength training or no exercise prescription for managing symptoms relating to FMS. Limitations in how concurrent exercise interventions are practical occur to due this RCT format. The size of this RCT have created a level two of evidence. The level of evidence can be improved through numerous RCTs or increased sample size. The 26 participants in this study were all females above 50 years old without any other chronic illnesses that could impact results, such as cardiovascular disease and diabetes. All participants had not been involved in an exercise intervention already. Participants were separated randomly into the training or control group.

What did the research involve?
Participants in the training group had to complete a 21-week training program (table 2) that alternated two strength training and one aerobic training, followed by one strength training and two aerobic training. Sufficient rest periods between sessions were vital not to aggravate FMS patients' symptoms. Strength sessions were all supervised, and endurance sessions were supervised once a week. Physical fitness and perceived wellbeing were tested before the study and on weeks 7, 14 and 21. Aerobic testing was completed first, and strength testing seven days after. These tests include:

 * Grip
 * Isometric leg extension
 * Concentric leg extension
 * Elbow flexionTrunk flexion and extension
 * Perceived symptoms during aerobic exercise testing
 * Heart rate
 * VO2Walking pace for 10 minutes
 * Time to climb ten steps without support
 * Stanford HAQ

The methodology for this study has excellent measures to reduce bias, appropriate tests for physical fitness and reliable perceived pain questionnaire. The structure is similar to articles reviewed in Current Pain and Headache Reports review 'Exercise Therapy for Fibromyalgia ', which are high standard meta-analyses or RCT. Increasing rest time during muscular strength tests would improve reliability of results as fatigue would decrease performance in tests.

What were the basic results?
The training group had significant improvements in the aerobic workload (p=0.001), work duration (p=0.001), concentric leg extension (p=0.034 and pain perceived decreased (p=0.038) . Other aspects of physical fitness had positive trends of improvement. However, they were not significant. Other elements of well-being reported through the HAQ had no significant progress . Researchers of this study interpreted the results with a more positive perspective, typically explaining positive changes in areas tested, but the p-value indicated was not significant. Researchers are implying there is potential for concurrent training to be a management treatment for FMS patients, but it needs more research . The small sample size decreases the accuracy, producing more inconclusive results.

What conclusions can we take from this research?
This investigation indicated that with concurrent training, FMS patients could improve physical fitness in aspects of workload, work time and some parts of muscular strength. Symptoms of FMS did not worsen. Fatigue and pain changed in a positive direction. Throughout the study, numerous tests had insignificant results leading to inconclusive results. Therefore, there is a potential that concurrent training may not be beneficial management of FMS symptoms. Strength training in other RCTs has found more promising improvements in overall well-being. For example, Current Pain and Headache Reports review 'Exercise Therapy for Fibromyalgia ', indicated high positive impact on physical function and mental wellbeing. Whereas, concurrent training had positive impacts in these aspects. Potentially strength training may be more effective in treatment management than a combination of training formats at one time. Comparison of different exercise interventions is required to further understand the most effective method and further research into concurrent training to produce more conclusive evidence. The methodology of this investigation is effective but the small sample size decreases the ability to generalise study.

Practical advice

 * Exercise interventions have a positive impact on individuals suffering from FMS.

 * Concurrent training significantly improves fatigue, pain, concentric leg extension strength and aerobic capacity.

 * Strength training improves the well-being of patients to a greater extent than contemporary training interventions, but aerobic fitness is not impacted.

 * A trained physiotherapist or physiologist should supervise the exercise. Exercise should be low intensity to avoid injury or worsening of symptoms.

 * Tailoring of the program should consider all diseases with the FMS, such as cardiovascular disease.

Further information/resources

 * American College of Rheumatology: https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Fibromyalgia
 * National Institute of Arthritis and musculoskeletal and Skin Diseases: https://www.niams.nih.gov/health-topics/fibromyalgia
 * Arthritis Australia: https://arthritisaustralia.com.au/managing-arthritis/living-with-arthritis/physical-activity-and-exercise/exercise-and-fibromyalgia/


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User:Rubixthenoob

Hi I'm Rubixthenoob. I'm a normal being with ASD disorder.

Weight:80kgs/175ibs

Height:6ft 1 1/4in/1.86m

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

title: User:Rubixthenoob


text:
User:Rubixthenoob/sandbox

Hi, I have ASD Disorder, i'm a grown up.

Weight:80kgs/175ibs

Height:6ft 1 and 1/4in/1.86m

title: User:Rubixthenoob/sandbox


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Exercise as it relates to Disease/Can increased participation in physical activity reduce the risk of developing type 2 diabetes?

The following article is a critical analysis of 'A National Effort to Prevent Type 2 Diabetes: Participant-Level Evaluation of Centres for Disease Control National Diabetes Prevention Program' by Elizabeth K.Ely (2017).

What is the background to this research?
The impact diabetes has on the United States health care system is vast and costly with an estimated 29 million American adults diagnosed with diabetes. According to the American Diabetes Association it is estimated that approximately 86 million adults experience high blood glucose levels linked to prediabetes but not high enough to warrant a diagnosis. High blood glucose levels can not only increase the risk of developing type 2 diabetes but increase the risk of developing heart disease and/or stroke. Physically inactive or overweight or obese individuals also have an increased risk of developing diabetes. The aim of the study was to evaluate participant-level results from the first 4 years of implementation of the national diabetes prevention program and how increased physical activity participation can reduce the risk of developing type 2 diabetes.

Where is the research from?
The research was conducted in the Division of Diabetes Translation, Centres for Disease Control and prevention in Atlanta, United States. The article was also guided by the Hubert Department of Global Health, Rollins school of public health, Emory University in Atlanta, United States. The Data used in the research came from participants of the National Diabetes Prevention Program. The study was funded mainly by the Centres for Diabetes Control. It was partially funded by the Georgia Centre for Diabetes Translation Research and the National Institute of Diabetes and Digestive and Kidney Diseases.

The following authors contributed to the study concept and design, conducted and statistical analysis, and contributed to the interpretation and discussion of data and editing.

 * Elizabeth K. Ely
 * Stephanie M. Gruss
 * Elizabeth T. Luman
 * Edward W. Gregg
 * Mohammed K. Ali
 * Kunthea Nhim
 * Deborah B. Rolka
 * Ann L. Albright

What kind of research was this?
The research article is an evaluation and continuation of analysis based off the core data provided in the randomised controlled trial conducted by the Centres for Disease Control National Prevention Program. The article was designed to support the original Diabetes Prevention Programs findings. Randomised controlled trials have minimal bias and provide a high level of evidence. Evaluation is used to understand the specific issues within a study to ensure practicality for real-world settings. It also assesses the strengths and areas of improvement for the study. However, there are some limitations to the study. Physical activity was reported by the participants which could create bias from individuals over reporting. Also due to not having glycemic markers, the study was unable to provide additional information on whether weight loss will continue to decrease the risk of developing diabetes.

What did the research involve?
The primary study included 14,747 eligible participants aged 18 years or older. The average age of the participants was 55.1 years old and 19.7% were male and 80.3% were female. To be eligible for the study participants had to have an increased risk of developing diabetes. To determine eligibility participants were asked to participate in a blood-based test resulting in high blood glucose levels, have a history of gestational diabetes mellitus, or score on the Centres of diabetes control or American Diabetes Association as having increased risk of developing diabetes. The diabetes prevention program consisted of sessions conducted by coaches. Each session's objective was to provide information regarding diabetes, recommend physical activities and offer feedback to the participants. Program attendance was based on the total number of sessions the person attended during the 12-month program. The participants were encouraged to attend a minimum of four sessions. Sex, age, race/ethnicity, baseline BMI and eligibility category, average initial weight, and average number of days in the program were recorded. A two-sample t test was employed to measure the difference in participants baseline weight and the number of days they contributed to the program. Number of months in the program was calculated as the number of days from first session attended to last session attended. Physical activity was also calculated based on the number of minutes recorded each week. It was suggested that individuals participate in moderate to vigorous physical activity for at least 150 minutes per week.

What were the basic results?
The main findings in the study were:

 * 75% of participants were discovered to have obesity and 22.5% were overweight.
 * Participants reported an average of 152 minutes of physical activity a week throughout the study.
 * Median body weight loss usually increased as the number of sessions attended increased.
 * Significantly less females reached the 5% weight loss goal compared to men.
 * The average weight loss percentage was 4.2%.
 * 35.5% of participants achieved the >5% weight loss goal.

What conclusions can we take from this research?

 * Participants that persisted with the program were more successful than participants who quit early. For example, with each additional session attended the participants lost an average 0.31% of their body weight. This suggests that increased participation in physical activity has a positive relationship with weight loss.
 * A large portion of participants are not participating in the whole program suggesting that the current study lacks engagement.
 * Limitations to the study are identifying individuals at risk of developing diabetes and engaging them to participate in diabetes prevention programs.

Practical advice
It would be beneficial for participants to break up long periods of sedentary behaviour as individuals that experience large periods of sedentary behaviour have an increased risk of weight gain or developing diabetes and other chronic diseases. Obesity is a major risk factor for diabetes because it causes insulin resistance and b cell impairment. Encouraging individuals to participate in sporting teams and exercise groups will increase participation and keep their engagement. It is also important for physical activity to work around your lifestyle. For example, do you have more free time at night or in the morning.

Further information/resources
Additional organisations in the United States and Australia supporting individuals with diabetes and working to prevent diabetes nationwide.

[https://www.cdc.gov/diabetes/prevention/index.html#:~:text=The%20National%20Diabetes%20Prevention%20Program,risk%20of%20type%202%20diabetes. https://www.cdc.gov/diabetes/prevention/index.html#:~:text=The%20National%20Diabetes%20Prevention%20Program,risk%20of%20type%202%20diabetes.]

https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/in-depth/diabetes-prevention/art-20047639

https://www.niddk.nih.gov/

https://www.diabetesaustralia.com.au/for-health-professionals/key-diabetes-organisations/


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title: Template:Colorf


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Exercise as it relates to Disease/The benefits of exercise in older adults with Idiopathic Pulmonary Fibrosis

This page explores the article ‘Exercise Training-Based Pulmonary Rehabilitation Program Is Clinically Beneficial for Idiopathic Pulmonary Fibrosis’ by Vainshelboim B, Oliveira J, Yehoshua L, Weiss I, Benjamin D, Fruchter O, Kramer O.

What is the background to this research?
Idiopathic Pulmonary Fibrosis (IPF) is a chronic and progressing interstitial lung disease (ILD) with unknown aetiology. Usually affecting older adults and characterised as;

 * Impaired gas exchange and ventilatory capacity
 * Hypoxemia

 * Progressive worsening of dyspnea and lung function
 * Exercise intolerance

Individuals suffering from this disease are less physically active and more breathless, resulting in reduced functional capacity and quality of life (QOL). There is no current treatment for this disease however, interventions can be implemented to slow progression.

Exercise training (ET), a major component of pulmonary rehabilitation can help manage the effects of respiratory diseases. The implementation of ET has shown significant improvement in functional capabilities however, more research into this topic is required to draw definitive connections.

The aim of this intervention was to determine the effects of an ET program for pulmonary rehabilitation on; exercise tolerance, functional capacity, pulmonary function, dyspnea and QOL.

Where is the research from?
This research was conducted in Israel at the Pulmonary Institute of the Rabin Medical Centre located at Beilinson Hospital. The article was published in Respiration: International Journal of Thoracic Medicine in 2014. This journal is an open access, peer reviewed journal indexed in PubMed and Science Citation Index Expanded (SCIE). It focused on respiratory, lung, heart, oesophageal, and mediastinal diseases.

The primary author of this article, Dr Baruch Vainshelboim has a Ph.D in Clinical Exercise Physiology and Pulmonary Rehabilitation. He has published 145 peer-reviewed scientific papers, received several reputed awards and funding for his academic efforts.

What kind of research was this?
The study was conducted as a randomised control trial (RTC). The intervention evaluated the clinical and physiological outcomes of a 12-week ET program on individuals with IPF. RTC’s are used to measure the effectiveness of an intervention, or treatment, where participants are recruited and randomly assigned to either the intervention or the placebo group. This randomisation significantly reduces bias and offers an effective technique to explore the cause-effect relationship between an intervention and the outcome.

What did the research involve?
Patient Recruitment and Selection

Patients from the Pulmonary Institute of the Rabin Medical Centre diagnosed with IPF, based on the American Thoracic Society (ATS) and European Respiratory Society (ERS) criteria, were recruited for the intervention. A clinical assessment on their medical history and IPF risk factors was performed with exclusion criteria being;

 * - severe comorbid illnesses
 * - unstable cardiac disease
 * - neurological/orthopaedic contraindications for ET
 * - exacerbation of IPF
 * - participation in a pulmonary rehabilitation within 12 months prior to recruitment

A co-ordinator, uninvolved in-patient assessment or treatment randomised the 34 participants.

The ET group (n=18) participated in two, weekly, 60-minute supervised sessions over a 12-week period whilst continuing with care in the outpatient pulmonary rehabilitation program. The control group (n=16) did not participate in the ET program and continued with regular medical care in the outpatient pulmonary rehabilitation program.

The exercise program was broken up into two six-week progressive blocks.

Block 1 * When beginning the program exercise was performed in intervals of five minutes followed by one minute of passive rest, for five repetitions. Progression included an additional one minute of work, to each exercise interval, until participants reached 15 minutes of continuous exercise.

Block 2

In block two the duration of aerobic training was increased to 20 minutes of continuous aerobic endurance training. Intensity was increased to 60–70% of peak WR in cycling and 80–90% of individual average walking speed for treadmill walking. Stair climbing within the hospital for 3–5 minutes was added to each session. Resistance and flexibility training were maintained however, resistance sessions were altered to two sets of 10–12 repetitions with 45 seconds of rest.

Assessment

All participants were assessed at baseline and within 1-week post intervention. The assessment consisted of;

 * 1) 1. Pulmonary Function Tests
 * 2) 2. Cardiopulmonary Exercise Test (CPET)
 * 3) 3. 6MWD Test
 * 4) 4. 30-Second Chair-Stand Test of Leg Strength
 * 5) 5. Dyspnea questionnaire using the medical research council (mMRC) scale criteria for dyspnea evaluation
 * 6) 6. QOL questionnaire using a validated St. George's Respiratory Questionnaire (SGRQ)

During all sessions participants were periodically monitored for blood pressure, SpO2, heart rate and symptoms. Supplementary oxygen was provided for patients on request or if SpO2 fell below 88% during exercise.

What were the basic results?
The intervention was completed by 32 of the 34 recruited participants, with an overall adherence rate of 90%. There were no differences between the intervention and control group in terms of patient characteristics, co-morbidities, physiological and clinical parameters, or medication at baseline.

The results from this study determined that the implementation of a supervised ET program in those with IPF resulted in improved:

 * - Exercise tolerance (ΔVO2 peak)
 * - Functional capacity (Δ6MWD)
 * - Leg strength (Δ30-second chair-stand test)
 * - Pulmonary function (ΔFVC%)
 * - Ventilatory response (ΔVO2 peak)
 * - Dyspnea (ΔmMRC)
 * - QOL (ΔSGRQ)

A worsening trend in the progression of IPF was observed in the control group.

What conclusions can we take from this research?
This intervention provides strong evidence that a short-term ET program can clinically improve several IPF manifestations and result in a better QOL. ET interventions should therefore be considered as standard care for IPF patients.

There were some limitations to this study. Sample size was only small which may have resulted in low statistical power. All recruited subjects had moderate pulmonary restriction meaning that these findings therefore cannot be extrapolated to those with a more severe progression of IPF.

Practical advice
Whilst IPF is not a treatable or preventable disease there are steps that can be taken to mitigate the effects of moderate IPF and assist in reducing the rate of progression.

Exercise pre-screening is essential and constant monitoring of variables such as BP and SpO2 is imperative when exercising to establish risk level. During exercise individuals with IPF should always be supervised.

Supplementary O2 can be used to assist individuals to complete the training session if SpO2 is low.

Further information/resources
[https://pubs.acs.org/doi/full/10.1021/acsptsci.2c00050 1. New and promising research into the treatment of IPF]

[https://web.archive.org/web/20220623112428id_/https://www.e-trd.org/upload/pdf/trd-2022-0053.pdf 2. IPF as a complication of COVID-19]

[https://pubmed.ncbi.nlm.nih.gov/35805179/ 3. Review: Regeneration or Repair? The Role of Alveolar Epithelial Cells in the Pathogenesis of IPF]


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Exercise as it relates to Disease/Prevalence of anxiety and depression for team sport athletes in comparison to individual sport athlete

=
This article is a critique of; Pluhar, E., McCracken, C., Griffith, K., Christino, M., Sugimoto, D., Meehan, W. Team Sport Athletes May be Less Likely to Suffer Anxiety or Depression than Individual Sport Athletes. Journal of Sports Science & Medicine [Internet]. 2019 Sept 1 [2022 Sept 10}. 18(3): 490-496. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6683619/ =====

What is the background to this research?
Exercise’s effects on mental health has been studied extensively and shown to have positive effects on not only physical but mental wellbeing. For example, a 2011 meta-analysis showed significant improvements for adolescents who engaged in physical activity to experience less depressed and anxious feelings,. This study went an approach further and analysed if playing individually or playing in a team had an effect on depression and anxiety prevalence in a youth population. This study is importance as depression and anxiety in young people in Australia is increasing. In 2014, 1 in 5 people aged 11-17 had either high or very high levels of psychological distress,. Therefore, these findings are relevant and highlight the importance of the type of exercise especially in youth populations for their mental wellbeing.

Where is the research from?
This study was conducted using 756 athletes at the Micheli Sports Injury and Prevention centre from 2013-2018 in Boston,. The data was analysed under the Oregon State University. The full list of authors and their credentials were provided in the article. The article was published in the Journal of Sports Science and Medicine in 2019. This is an easily accessible and credible publishing agency with many other reputable and peer reviewed sources.

What kind of research was this?
This study was conducted as a cross sectional study; meaning that the data was observed and taken at one single point in time. The data was only taken from participants aged 18years and younger. P-values of <0.05 or a 95% confidence interval that did not cross 1 were defined as statistically significant,. As 756 athletes were sampled the large population group used means reliable information can be concluded. There was only a slightly higher rate of females in the population at 56% so differences seen among gender can be considered. The method of this article was unclear in how the data was specifically taken and if any bias was present. They defined their selection of individual athletes as; athletes that did not require another person to compete with (not including opponent),. Team sport athletes were defined as any athlete that competed in any team sports throughout any season,. Anxiety and depression had to be clinically diagnosed, but also self-reported by the individual,. This therefore eliminated any self-diagnosis factors that would lead to non-valid results.

What did the research involve?
The method for this cross-sectional study was limited in their requirements for participants and how they specially gathered their research, The participants had to be at the sports injury centre and from the ages of 11-18. They were asked to document their reason for playing, time spent training, use of alcohol and intensity of exercise. The researches also recorded each athlete’s body mass index (BMI), gender and age. The athlete then self-reported any clinically diagnosed depression and anxiety. The article does not mention if they had to provide medical proof of this mental health status but it is assumed as it is mentioned repeatedly, they had to be diagnosed by a medical professional. This is reliable to ensure that those reported with mental health disorders are correct but there is also a limitation that some individuals suffering with anxiety and/or depression have not been diagnosed and for potentially many different reasons unable to access the required help. The research also went from 2013-2018, this had both positives and negatives to the final outcome. A negative effect of this is that over this 5-year period some of the athletes may have developed these mental health issues as they got older as the mean age was 13.5 years and pre-pubescent children just starting puberty would undergo many more emotional changes,. A positive however, is that the 5 year long collection period of data ensured a very large sample to compare reliable data.

What were the basic results?
The 756 participants had a mean age of 13.5 ± 2.5years and 56% were females with 44% males.

Table 1 shows the percentages of athletes suffering from anxiety or depression. Individual at 13% (p<0.01) and for team 7% (p<0.01).

Table 2 shows other risk factors potentially related to the higher depression and anxiety rates seen in graph 1. This helps highlight other potential preventative issues relating to poor mental health in young adults. More team sport athletes drank alcohol at 9% compared to individual sport athletes at 7%. It was also more likely for team athletes to be engaging in sport for fun (79%) then for goal orientated reason (21%). Individual athletes were lower at 70% for fun reasons and 30% for goal orientated reason.

What conclusions can we take from this research?
Current research and this study suggest that youth who engage in physical activity through team sports have lower levels of self-reported and clinically diagnosed anxiety and depression,. Although this particular study lack specificity in their method, the goal and research conclusions were strong and related to the introduction and extensively measured anxiety, depression and risk factors over the large population sample. The introduction and discussion of the article highlighted the importance of this study and provided similar literature that showed the positive effects of sport on mental health. It also suggested reasons as to why individual sport holds higher levels of mental health problems. The increased accountability and shame or guilt after loses in induvial athletes would b a contributing factor. The lack of social activity and relationship building also has been shown to be a limitation for playing sport individually,.

Other factors analysed were the reasons for playing their chosen sport, a slightly higher proportion of individual athletes had goal-related reasons. This can suggest more pressure is put onto themselves and their schedule may be less balanced with other social and academic activities.

Practical advice
Therefore, some research including this article has shown that playing a team sport can be better for adolescent’s wellbeing due to factors linked to higher social and psychological behaviours. There is an added relationship and factor of belonging when engaged in team sports, although this is also reliant on positive relationships with teammates and coaches. However, exercise and sport in general as an adolescent will decrease the risk of developing depression and anxiety. This is proven in many studies and even this sample of young athletes used in this article as overall 8% of the adolescences reported suffering from anxiety or depression,. This is lower than the U.S average at the time in 2019,.

Further information/resources
For more information and support please review:

Anxiety and Depression Support; https://www.beyondblue.org.au/

Guide and Reference for Adolescence Physical Activity; https://www.health.gov.au/health-topics/physical-activity-and-exercise/physical-activity-and-exercise-guidelines-for-all-australians/for-children-and-young-people-5-to-17-years


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User:Shiger1

Born and live for over 30 year in Barcelona (Catalunya), I've learn Catalan & Spanish in my Scholarship days, and migrate to England to learn properly English.

Live is a Short journey to experience things, to grow, and to leave a legacy from our knowledge to the coming generations.

[Català]

Orgullos d' haver nascut i viscut mes de 30 anys a la bellisima ciutat de Barcelona. Vaig estudiar i aprendre Català i Castellà simultaneament a l'escola. Vaig marxar cap Anglaterra, per aprendre bè l' Angles.

La vida es un curt viatge per aprendre i experimentar les coses, i deixarne un legat a les futures generacions dels nostres coneixements adquirits.

Salut! (aka; Cheers)

title: User:Shiger1


text:
Exercise as it relates to Disease/The feasibility of high-intensity interval training and moderate-intensity continuous training on Crohn’s Disease patients

This Wikibooks page is a critical appraisal of the research article "High-intensity interval training and moderate-intensity continuous training in adults with Crohn's disease: A pilot randomised controlled trial" by Tew. G.A. et.al (2019). From the BMC Gastroenterology.

What is the Background to this Research?
Crohn’s disease (CD) is an inflammatory bowel disease that impacts the patient’s immune system from functioning effectively, and produces an inflammatory response in the digestive tract walls, causing symptoms such as abdominal pain and diarrhoea. CD patients also suffer from bone mineral loss and therefore are included into the moderate to high risk factor for individuals exercising. Exercise is recommended as it can help patient’s cope with symptomatic issues such as fatigue, inflammation, and mental health, whilst lowering their Crohn's Disease Activity Index (CDAI).

There are controversies surrounding the topic of exercise involving Crohn’s disease patients as they provide a moderate to high risk. It was outlined as too high of a level of intensity of exercise may cause heartburn and diarrhoea and other acute gastrointestinal bleeding issues, and is particularly prevalent in endurance runners.

This paper entails the feasibility of two exercise modules test Crohn’s disease patients exercising at a high-intensity interval training (HIIT) level and at a moderately-intense continuous training (MICT) level. Relating to current research, it investigates how intense and how much exercise a Crohn’s disease patient can do without exacerbating their symptoms. This research provides insight and a reliable foundation for future expansions of research into exercise with Crohn’s disease patients, as current research predominantly reflects low-intensity exercise.

Where is the Research From?
This research article was published by the reputable journal publisher, BMC Gastroenterology. Although, it is a reasonably new source, this journal is highly accepted as a reputable peer-reviewed source and covers technology, gastroenterology, and the medicines categories.

Recruitment was taken from 3 private hospitals in England. The exercise modules were conducted at the University of Winchester by Garry.A. Tew. The data was analysed at the University of New York, York’s Trials Unit. The paper was funded by the Living with IBD Research Programme at Crohn’s and Colitis UK, and research continued for as long as they were funded for. It was noted that the source of funding had no influence on the outcome and analysis of the results.

The authors have a distinguished background. Specifically, Professor Garry.A Tew who has 86 research papers, investigating the effects of exercise-based programs on specific communities or health diseases. Professor Tew’s fellow co-authors; Dr Leighton, Dr Bottoms, Dr Carpenter, Dr Anderson have done 3 other papers which embark on further research into Crohn’s disease and the effectiveness and quality of life from exercising with CD.

What Kind of Research Was This?
This research article is stated as a three-arm pilot randomised trial. Participants were randomly assigned to the High-intensity interval group, moderate-intensity continuous group, and parallel, a usual-care as the continuous group to standardise results collected. A pilot study is the necessary preliminary trial to then further expand upon to a randomised controlled trial which is the gold standard of studies. Due to the delivery of the programs, it would be evident to the participants which intervention they were in. Other pilot trial investigations found correlations of lean mass generation with high and moderate exercise, correlations of higher quality of life , and without exacerbating any symptoms and placing their CDAI in a critical state. .

The authors disclosed that there were no conflicts of interests.

What Did the Research Involve?
The trial consisted of 53 participants clinically diagnosed with Crohn's disease and were randomised into 3 separate programs via a statistician from the Yorks Trials Unit. Participants were to complete 28 or 38 minute sessions 3 times a week over the course of 12 weeks. All exercise trials took place on a cycle ergometer. The high intensity and moderate intensity programs both started off with a 5-minute warm up at 15% peak power output (PPO) (determined via baseline cardiopulmonary testing), with a 3-minute cool down session also at 15% PPO. Heart rate and peak oxygen uptake (POU) was recorded throughout the trial to identify PPO. The methodology could have been reduced to a 2-arm study, to limit difficulty of recruiting participants.

There were several limitations to this research paper:

 * Sample size was limited
 * Physical activity was self-reported
 * Endoscopies weren’t used to evaluate the degree of inflammation in the gastrointestinal tract
 * No blinded allocation for follow up procedures

What Were the Basic Results?
The HIIT in comparison to the MICT have both provided insight to being beneficial for Crohn’s disease patients to partake in both activities. Peak oxygen uptake was significantly improved in the HIIT program (2.4 mL/kg/min increase) in contrast to the MICT program (0.7mL/kg/min increase) when tested for the baseline to 3 retest protocol. Maximum heart was 92% for HIIT and 68% for MICT. The CDAI score decreased for HIIT participants and increased slightly for the MICT, however both scores are still considered as asymptomatic remission. Majority of patients reported that their intervention improved the quality of their life without causing CD symptoms and inflammation. There were also statements made how the trial motivated them to continue with the regime. There were a couple of adverse-events that were due to the exercise interventions. It was reported that their CDAI scores were increased in disease activity, which returned back to the baseline measure within 1 week.

What Conclusions Can We Take From This Research?
The High-intensity interval and moderate-intensity continuous training programs have been found to be correlated with improving patients quality of life, peak oxygen uptake, and lowering their CDAI score. Participants were able to maintain their results with the 3-month follow up procedure. This study also provided strong statistical evidence for the HIIT group providing better results than the MICT group as they were able to increase their peak oxygen uptake whilst decreasing they CDAI score. The control group didn't provide much information other than context for the study, therefore using a 2-arm study would be beneficial for future studies. There unfortunately were adverse effects during the trial, however information was provided that it was a combination of the participants medications and the program that potentially caused issues, therefore, the consideration of how safe this program is should be researched further in larger sample-sized settings.

Practical Advice
For future research, investigating patients that have no previous and current history of private institute benefits as healthcare is not accessible to all and therefore, a different will not be provided with the same level of care as patients in private hospitals. Adverse effects of exercise should be expanded upon in research as exercise can affect individuals on specific medications or stages of CD. It would be beneficial if a randomised controlled trial further expanded upon the safety of higher intensities of exercise on CD patients as several participants were interested in doing variations of high-intensity exercises. Strength training has been correlated with providing a feasible and safe option for management of symptoms within CD patients.

Further Information/Resources
For further information on management of Crohn's disease using physical activity please read the following:

 * 1) Progressive resistance training improves muscle strength in women with inflammatory bowel disease and quadriceps weakness
 * 2) P026 Relations between physical activity, diet, and body composition in paediatric patients with inflammatory bowel disease
 * 3) Moderate endurance and muscle training is beneficial and safe in patients with quiescent or mildly active Crohn’s disease
 * 4) Randomised clinical trial: combined impact and resistance training in adults with stable Crohn’s disease.


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Exercise as it relates to Disease/Diabetes and the benefits of physical activity

Paper: Kriska, A.M., Edelstein, S.L., Hamman, R.F., Otto, A., Bray, G.A., Mayer-Davis, E.J., Wing, R.R., Horton, E.S., Haffner, S.M., and Regensteiner, J.G. (2006) Physical Activity in Individuals at Risk for Diabetes: Diabetes Prevention Program Med Sci Sports Exercise 38(5): 826-832

What is the background to this research?
Diabetes is worldwide health concern and is currently identified as the world’s fastest growing chronic health condition. In 2015, it was estimated that 1 in 11 adults had diabetes (over 415 million people), 12% of global health expenditure was diabetes related, and every 6s a person dies from diabetes. In Australia alone, approximately 120,000 per year are diagnosed with diabetes, the estimated annual cost impact is $14.6 million, with diabetes the biggest challenge to the health system. Health related complications associated with diabetes include blindness, amputation, heart disease, and kidney disease.

Where is the research from?
The research was conducted by Diabetes Prevention Program (DPP) Research Group, of the George Washington University. The DPP is funded by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and set up to conduct clinical trials on issues relating to diabetes and diabetic populations.

What kind of research was this?
This research was conducted as a randomised clinical trial of diabetes prevention, with data collected from 27 centres across the United States of America (USA) over a 4-year period. Focusing on interventions with the potential to delay the onset of diabetes, a total of 3234 overweight individuals ≥ 25 years old (mean age 50.6 ± 10.7 years) of diverse ethnicity (45% from ethnic or racial groups) with elevated fasting glucose levels and IGT were recruited to participate. Other inclusion criteria included body mass index value ≥ 24 kg.m-2, ability to walk ¼ mile in 10 min, and fasted plasma glucose concentration of 95-125 mg.dL-1 and 140-199 mg.dL-1 post a 75g oral glucose tolerance test (OGTT).

The DPP research concentrated on a diet and exercise lifestyle intervention or treatment with metformin, a drug that works to help restore the body’s response to insulin by decreasing the amount of blood sugar the liver produces and that the intestines or stomach absorb, with participants randomly assigned to receive different treatments.

What did the research involve?
The purpose of this study was to examine: 1) physical activity and measures of obesity and glucose intolerance via three different physical activity questionnaires, 2) activity levels of a cohort of participants at risk of developing diabetes against a broader sample of participants with impaired glucose tolerance (IGT).

The study evaluated baseline, self-reported levels of leisure activity using three physical activity questionnaires. The three questionnaires used to quantify the amount of leisure physical activity/exercise, incorporated reporting periods of 7 days to 1 year.

- Low-Level Physical Activity Recall (LOPAR; past 7 d) - modified version of a 7-day physical activity recall validated for use in population with low levels of regular physical activity. Included assessment of all forms of physical activity, including occupational, leisure and home, with leisure activity being the focus. Total energy expenditure was quantified in terms metabolic equivalents (METs) and the of number of hours spent completing very light (1.0-1.5 METs), light (2-3 METs), moderate (3-5 METs) and heavy (≥ 6 METs) activities.

- Third National Health and Nutrition Examination Survey (NHANES III; past month) - questionnaire that asked if participants had engaged in specific activities (ie. walking, jogging, bike riding, swimming, aerobics, dancing, calisthenics, gardening, weightlifting) or other exercise, sports or physically active hobbies. Leisure activity was quantified as times per month with duration or intensity data not collected.

- Modifiable Activity Questionnaire (MAQ; past year) - occupational and leisure activities with leisure activity the main focus of this study. Questionnaire included a comprehensive list of leisure activities developed from pilot work and shown to be reliable and valid through evaluations with activity monitors, field-based fitness testing, and assessments of energy expenditure (doubly labelled water method). Participants reported leisure activities undertaken as well as an estimate of frequency and duration. Relative intensity for each activity was calculated in terms of METs and reported as MET-hours per week. Energy expenditure at rest was represented as 1 MET, and 10 METs equated to ten times resting energy expenditure.

What were the basic results?
Significant correlations were reported for leisure activity data across all three surveys, although stronger relationships were found between MAQ and NHANES III when compared to the LOPAR.

Results from this study were generally consistent with previous literature. Results are best explained under key variables:

Gender / Age / Ethnicity - across all three surveys, men more physically active than women; older participants more active than younger ages, with most active group ≥ 60 years; physical activity varied by ethnicity; women and men less active in the DPP cohort compared to NHANES III for most ages and ethnicities; however, when matched for impaired glucose tolerance the DPP cohort were more active than participants NHANES III subgroup.

BMI / Waist: Hip Ratio / Blood Glucose - inconsistent results for association between physical activity and fasting or post load glucose values; physical activity estimates from MAQ and NHANES III significantly and inversely associated with BMI, waist: hip ratio, fasting and 75g OGTT insulin measures, fasting plasma proinsulin and amount of glucose attached to haemoglobin (HbA1c) for men and women; LOPAR was significantly and inversely correlated with fasting and 30 min post insulin in men only; DPP women and men less active compared to NHANES III for BMI.

Influence of Time - physical activity reported via MAQ and LOPAR questionnaires was not strongly related. Whilst shorter surveys are thought to be less influenced by recall bias, assessments over a longer period are believed to better reflect typical behaviours and be less influenced by changes in health, time pressures and weather. Previous studies have found that the average of four weekly recalls showed a stronger relationship with past year activity comparted to a one-off recall.

Leisure Information / Intensity of Activities - MAQ and NHANES III were more closely related as both assessed frequency of popular moderate- to high-intensity leisure activities, whereas LOPAR assessed larger range of intensities including daily living and hours spent sleeping and in very light and light activities.

DPP Cohort vs NHANES III - activity levels for DPP participants were greater than NHANES III participants that had impaired glucose tolerance; this may be influenced by study inclusion criteria and that the NHANES III cohort was a random sample of general population whereas DPP was volunteer sample committed to an intervention study.

What conclusions can we take from this research?
The three questionnaires, whilst different, provided an insight into physical activity behaviours for participants at risk of developing diabetes compared to general USA population. Participants at risk of developing diabetes were less physically active than the general population however, when matched for impaired glucose tolerance they were more active than participants in the NHANES III subgroup. This is likely an effect of being in a study and being observed and monitored.

Physical activity was adversely affected by measures of obesity whereby participants with higher BMI and waist: hip ratio were less active.

Self-reporting of physical activity can present chances for participant bias and over-reporting of data however, surveys conducted over longer periods of time can better capture normal activity behaviours. Surveys that include detailed or specific questions and are restricted to specific activity intensities are likely to provide improved and more valid results.

Practical advice
Results from this study and other resources, support the premise that people at risk of developing diabetes should partake in regular physical activity of various forms and intensities. Physical activity can help insulin and weight management, lower blood pressure and reduce risk of stress and heart disease and should be prescribed in a controlled manner. Establishing positive activity habits earlier in life is recommended to help address, reduce and aid the fight against diabetes.

Application of results from this study to other populations needs to consider variables including gender, age, ethnicity, anthropometry and glucose tolerance.

Further information/resources
-       https://www.diabetes.ca/en-CA/health-care-providers/clinical-practice-guidelines/chapter-10#panel-tab_FullText

-       Diabetes & Exercise Safety, Flood, Lisa MSN, RN, CS; Constance, Ann MA, RD, CDE

-       https://www.ndss.com.au/living-with-diabetes/health-management/exercise/

References

1.   Diabetes Globally (2022) Diabetes Australia

< https://www.diabetesaustralia.com.au/about-diabetes/diabetes-globally/ >

2.   Diabetes in Australia (2022) Diabetes Australia < https://www.diabetesaustralia.com.au/about-diabetes/diabetes-in-australia/

3.   Metformin (2022) Mayo Foundation for Medical Education and Research

< https://www.mayoclinic.org/drugs-supplements/metformin-oral-route/side-effects/drg-20067074?p=1#:~:text=Metformin%20is%20used%20to%20treat,where%20it%20can%20work%20properly >

4.   Rosenman, R., Tennekoon, V, and Hill, L.G. (2011) Measuring bias in self-reported data. Int J Behav Healthc Res. Oct; 2(4): 320–332

< https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4224297/ >

5.    Physical activity (2022) National Diabetes Services Scheme

< https://www.ndss.com.au/living-with-diabetes/health-management/exercise/ >


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Exercise as it relates to Disease/The effectiveness of Yoga therapy and aerobic exercise on people with Schizophrenia

What is the background to this research?
State anxiety, psychological stress, and negative wellbeing are known to be common responses and co-morbidities individuals on the Schizophrenia spectrum. The poor management of these responses work cyclically with the exacerbation of Schizophrenic symptoms. Davy Vancampfort and his accompanying cohort completed a randomized comparative trial to evaluate acute changes in these psychological responses after single sessions of Yoga therapy and aerobic exercise, accompanied with a controlled condition.

There have been copious amounts of studies investigating how particular types of PA, including Yoga and aerobic exercise, impact numerous psychological and physiological health outcomes of Schizophrenia. Exercise has long been known to improve both acute and chronic levels of anxiety and stress in the general population. However, this study is the first to demonstrate large effect sizes in transient reductions in state anxiety, psychological stress, and increases in subjective wellbeing for individuals with Schizophrenia. The research constructs on solid foundations, with some practical implications for add-on physiotherapy treatment. However the topic requires further research investigating other components of underlying physiological, psychological, and behavioural mechanisms and outcomes.

Where is the research from?
In Kortenberg, Belgium a cohort of patients with Schizophrenia or Schizoaffective disorder of an acute inpatient care unit of the University Psychiatric Centre of Kortenberg were invited to participate in the study. Published fairly recently, in 2010, the study was collectively conducted by eight authors, Davy Vancampfort et al.,. Vancampfort is a reputable Belgium Physiotherapist with vast skills and expertise, and numerous published research, much alike his co-authors. The process of authorization of this paper involved approval through the Ethical Committee of the University of Psychiatric Centre, in accordance with the principles of the declaration of Helsinki. The declaration is a highly regarded statement outlining ethical principles involved in research of human subjects which has long been adopted by the World Medical association. The authors also report no conflicts of interest and were solely responsible for the content and writing of the paper.

What kind of research was this?
This study construct was a randomized controlled trial conducted over an 8-month period. Patients with Schizophrenia and Schizoaffective disorder participated in three within-subject conditions, Yoga therapy, aerobic exercise, and a control condition used for a comparative purpose of the study. A randomized control trial is a high regarded baseline as it is the only study design that assesses cause-effect relationships between the intervention and outcome. Because it was a with-in subject design there was no effects of individual variation, however, there would have been potential for a carry-over effect without the reduced bias due to the randomisation of the condition order.

Sample size

 * Participants initially recruited (n=57)
 * Excluded/non-compliant participants (n=17)
 * Anxiety disorder (n=1)
 * Substance dependence (n=5)
 * Neuromuscular disorder (n=2)
 * Did not agree to participate (n=5)
 * Did not complete test conditions (n=2)
 * Participants included in final analysis (n=40)
 * Males (n=22)
 * Females (n=18)

Conditions
The study was investigating comparative effects of a single bouts of two different types of exercise, with one control condition. In one week, the participants undertook the Yoga and aerobic exercise sessions to get used to the environment and protocol. The week after the exercise conditions were performed in a randomly assigned order, with a physiotherapist present, on a one-one basis on consecutive days, at the same hour. Questionnaires were completed after the sessions without the Physiotherapist present.

30 minute Hatha Yoga therapy session (n=40)

 * Cardiovascular warming up- 5 min
 * Abdominal breathing exercises - 5 min
 * Asanas
 * Tadasana (mountain posture) - 3 min
 * Vrikshasana (tree posture) - 3 min
 * Bidalasana (cat posture) - 3 min
 * Bhujangasana (cobra posture) - 3 min
 * Apanasana (knees to chest posture) - 3 min
 * Relaxation technique (Shavasana) - 5 min

20 minute Aerobic exercise (n=40)

 * Electronically braked bicycle ergometer
 * Self selected intensity with heartrate feedback

20 minute control condition (n=40)

 * Sat quietly in a room with personal and/or supplied reading material
 * Physiotherapist present

Assessment of methodology
Methodological limitations developed from the amount of individuals who were excluded or voluntarily didn't participate. These high drop out rates and small sample size increased the risk of selection bias as the individuals who chose to participate likely already had interest and knowledge of the benefits of PA. However, the excluded criteria was necessary to prevent outlying data and a with-in subject design doesn't always require large sample size. There was no investigation of the physiological or psychological mechanisms potentially responsible for improved responses, limiting a more evidence based outcome and introducing the potential for other determinants of the result.

What were the basic results?
The analysis of State anxiety, psychological stress, and positive wellbeing all identified significant effect sizes from both the Yoga therapy and aerobic exercise conditions, compared with the no-exercise control conditions. There were no significant differences between the exercise conditions for each psychological response however. These findings support the claim that single bouts of exercise can have a positive transient effect on State anxiety, Psychological stress, and subjective wellbeing for the participants.

What conclusions can we take from this research?
The research did conclude with significant effect sizes that single bouts of exercise such as Yoga therapy and aerobic exercise have transient effects on several psychological responses in the participants. The study design is highly regarded to prevent bias and assessment of a cause-effect relationship. This has some practical implications for physiotherapy as a form of treatment for this population, however, as there is limited research (when published), which requires more investigation into the underlying mechanisms that improve these responses and the limitations of generalisability.

Practical advice
This research poses exercise adherence as a generalisability limitation, a result of the clinical population's characteristics. Anxiety, wellbeing and stress are common co-morbidities in individuals with Schizophrenia. Because mental illness, and Schizophrenia in particular, is often so debilitating, there is often a lack of adherence to PA, notable in the large drop out rate, leading to the cyclic deterioration of psychological and physiological health and diagnosed co-morbidities. A result of numerous economic, social, behavioural, and environmental determinants. Providing interesting choice of type and content of PA, monitoring intently, while ensuring specialisation to each individual can improve these limitations. For individuals not in direct care of psychiatric institutions, it can pose even more difficult for the prescription of exercise. Coordinating the advertisement of PA programs through individual's GPs, psychiatrists, and other forms of individual healthcare is a consideration to encourage PA for these external settings.

Further information/resources

 * A brief intervention to improve exercising in patients with schizophrenia: a controlled pilot study with mental contrasting and implementation intentions (MCII)
 * Yoga therapy for Schizophrenia
 * Aerobic exercise and yoga improve neurocognitive function in women with early psychosis
 * Co-morbidities of mental disorders and chronic physical diseases in developing and emerging countries: a meta-analysis


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Exercise as it relates to Disease/Effects of 12 weeks of aerobic exercise combined with resistance training on neurocognitive performance in obese women

What is the background to this research?
Obese or overweight is defined as abnormal or excessive fat accumulation that presents a risk to health. . Previously there have been no further studies conducted on how the long-term effects of an exercise intervention on deficits in inhibitory control in obese individuals. Inhibitory control is defined as the suppression of goal-irrelevant stimuli and behavioral responses. . It is widely believed that the prefrontal cortex (PFC) serves as a source of inhibitory control over other brain areas. The inhibitory control plays a key role in body weight regulation. Compared to a normal healthy adult, obese adults tend to have more excitation when responding to food cues in the brain. It is also stated that obese people appear to show lower dopamine D2 receptors which could potentially heighten the chances of making someone overindulge. Exercise plays a key role in not only continuing to be healthy but can also be effective in improving problems that relate to inhibitory control. Therefore, the aim of the research study was to examine the effect of 12 weeks of a combination of aerobic and resistance exercise on behavioural and cognitive electrophysiological performance involving cognitive interference inhibition in obese individuals.

Where is the research from?
This study was conducted in Taiwan. It was advertised on a local radio station and posted in a local newspaper. The researchers based the criteria of obesity on the western Pacific Regional Office of the World Health Organization for Asian populations. Healthy obese women with a body mass of > 25.0 kg/m2 were recruited as the participants of the study. Only female participants were recruited because the effects of exercise on cognitive degeneration is assumed to be gender-dependent.

What kind of research was this?
The research conducted was a randomised clinical trial. Participants were randomly assigned to either the exercise group or the control group. The outcome of the intervention was to determine if 12 weeks of aerobic exercise combined with resistance exercise in obese women affects their neurocognitive function.

What did the research involve?
Thirty-two obese women were recruited to participate. These women were randomly divided into two groups: the exercise group and the control group. All volunteers were asked to participate in the Stroop task with electrophysiological signals being collected whilst performing the task. The data was collected prior to the 12-week intervention and subsequently after as well. VO2 max, muscular strength, and body fat percentage were all assessed as well, this was done a week before and after the intervention. Volunteers in the exercise group were asked to engage in 30 minutes of moderate to high-intensity aerobic exercise combined with resistance exercise. The exercise group did 5 sessions per week for the 12 weeks. The control group was asked to continue with their daily lifestyle doing no exercise during the intervention time. Female adults suffering from obesity show problems in cognitive interference inhibition when performing the Stroop task. Therefore one of the measures was to perform a Stroop task. P2, N2, and P3 event-related potential were also forms of measures ideal for inhibitory control. P2 is a wave that refers to the positive deflection peaking around 100-250 msec after the stimulus. N2 Is a negative deflection peaking at about 200 msec after the presentation of a stimulus. P3 is a positive component occurring around 300–600 ms post-stimulus, is associated with inhibition processing or motivation-related attentional engagement. The three ERP components have been demonstrated to effectually differentiate cognitive electrophysiological performance in obese and normal-weight individuals when performing cognitive tasks involving inhibitory control.

What were the basic results?
The results of the study revealed that the 12-week exercise intervention did not enhance the behavioural indices. The exercise group showed significantly shorter N2 and P3 waves and more P2 and P3 waves. The participants when compared to the control group had significantly improved in total fat percentage and level of physical fitness.

What conclusions can we take from this research?
These findings suggested that 12 weeks of aerobic exercise combined with resistance exercise in obese women affects cognitive function broadly, but not specifically in terms of inhibitory control. The percentage of decreased trunk fat may play a potential facilitating role in inhibition processing in obesity.

Practical advice
Obesity in adults can increase health complications. Risks include cardiovascular disease, type 2 diabetes, and psychological disorders. This paper allows exercise scientists to create plans and diversity that will help them better accumulate to people's conditions. this paper also allows scientists to gain a better understanding of cognitive control in various types of bodies. If the goal is to use exercise to reduce the health risks of obesity, exercises, specifically aerobic and resistance training, should be incorporated of used to lessen the risk.


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Exercise as it relates to Disease/What are the most effective exercise recommendations for promoting physical activity among postpartum mothers?

What is the background to this research?
In 2013, Emily L Mailey and Wei-Wen Hsu conducted research into exercise in postpartum mothers. The research compared how effective a postpartum mother's behaviour to exercise changes if it was conducted through structured exercise recommendations or through a generalised physical activity recommendation. Due to previous research examining mainly exercise as a general concept during the first 12 months postpartum, this research contributes to the specific exercise reschemes that can be put in place (1) in comparison to general physical activity. This study also conducts a 6-month follow-up post intervention to determine and compare if the effects were maintained (1). During the first 12 months of the transition into motherhood, evidence shows that physical activity remarkably declines (2). Other studies have backed this up showing that a high percentage of mothers who were physically active and meeting the national physical activity recommendations no longer hit this targets after giving birth (3) By understanding how we can improve the effect of behaviour towards physical activity in postpartum mothers and encouraging their engagement in physical activity provides an array of benefits including (4):

-       improved cardiovascular health,

-       improved energy levels,

-       restore muscle strength,

-       weight loss,

-       improved psychological well-being.

Due to these declines in physical activity in this population, it is critical to explore ways we can effectively promote and encourage these physical activities.

Where is the research from?
There were 79 postpartum females, who were between the 6 weeks and 12 months phase, who were assessed for eligibility of the research. These participants had to gain approval from a physician for safety reasons post childbirth. 62 of these participants were recruited from multiple sources, although mainly from a university email list. The participants were split into 2 groups; 1 group (25 participants) was the specific exercise recommendations, and 1 group (24 participants) was the general physical activity recommendations.

The authors of this research have conducted previous as well as more recent studies regarding physical activity in similar sedentary populations who aren’t meeting current national physical activity recommendations. This is their first research published relating to postpartum mothers and physical activity.

The authors of this research paper received funding from Kansas State University Small Research Grant and declared no conflicts of interest between the findings, the research, and the publication (1). This research was published in 2019 on the Journal of Health Psychology (1).

What kind of research was this?
This study implements a randomised control test, comparing the 2 groups in the effectiveness of specific exercise recommendations to general physical activity recommendations. There was no significant demographic difference between these 2 groups.

Participants indicated availability (e.g., weekends vs weekdays), and based on availability, was randomly assigned with other mothers with a similar timetable. These grouping were then randomly assigned by a random number generator into the 2 intervention groups.

What did the research involve?
All participants went through baseline measurements, which the information was gathered by an accelerometer that was worn for a week by each participant. The participants then proceeded to participate in 3 group workshops that lasted 1.5-hours across 2 months. After these 2 months, participants were given an accelerometer to wear for a week and complete questionnaires online. Once 6-months post research workshops, participants were asked to wear the accelerometer for a week and complete questionnaires online again. Both comparative groups received the same questionnaire.

I believe this methodology wasn’t the most effective approach to monitor the participants behaviour to physical activity both during the research and for the future. Due to the workshops being group ones, they had to schedule based on the maximum number of participants that could attend. It could have been more effective if a smaller group or individual methods were used, tracked by an accelerometer or smart watch, so that more session could have been conducted throughout the research period.

Limitations in this methodology is the quality of information gathered throughout the accelerometer in the weeks post workshop period as they could conduct more than their normal physical activity to give dishonourable data. This trustworthiness is also a factor to consider in the online questionnaires.

What were the basic results?
The participants showed a significant increase in short-term physical activity post research workshop sessions. The generalised physical activity group showed an increase in their physical activity maintenance in their accelerometer information both in the first week post workshops and 6 months later.

The authors interpreted this result was due to the participants in the generalised group having more enjoyment in the activities as they were given the opportunity to participant in their preferred physical activities.

The authors mainly emphasis on how this research paper is just a baseline for further research into this topic. Due to this paper being one of the first to get into specifics of exercising in postpartum mothers, results and discussion mainly reflect on how they can improve and reduce limitation and decrease potential errors in data.

What conclusions can we take from this research?
Based on these findings, we can conclude that allowing participants to engage in physical activity that they genuinely enjoy and want to participant is a great way to encourage physical activity in postpartum mothers (5). Postpartum mothers have many barriers in their life both physically and psychologically, therefore regaining the confidence and motivation to participate in physical activity that they enjoy will be the best step to a positive long-term outcome (6, 7).

The specific exercise recommendation group should be an effective way to introduce physical activity as a beginning phase, as the gradual return to activity can be programmed and factored in. Sedentary populations have found success in this progressive programming for increasing physical activity (8), so if it could be used as a starter program to then integrate into general physical activity may be a beneficial approach.

Practical advice
Although general physical activity was successful in promoting exercise compared to a more specific approach, the research paper didn’t disclose any specific exercises or how to conduct them. Due to no specifics of return to physical activity post childbirth, consulting a doctor before exercising is highly recommended for clearance and guidance. Consulting an exercise physiologist is another great way to return safely to physical activity.

Further information/resources
For further information regarding postpartum exercise, see resources below:

- https://www.pregnancybirthbaby.org.au/safe-return-to-exercise-after-pregnancy

- https://www.acog.org/womens-health/faqs/exercise-after-pregnancy

For further information regarding health professionals and guidance, see resources below:

- https://epexercisephysiology.com.au/postnatal-strong/

- https://www.pregnancybirthbaby.org.au/your-body-after-having-a-baby


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Use to avoid substituting templates in signatures, which can be used to shorten the wikicode of long sigs. '''Do not use this template as an excuse to have an overly long signature! Use it only for complex text styling!''' Also make sure to include a link to your userpage or talkpage in the actual signature (not in the template) or pings won't work.

title: Template:Nosubst


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MATLAB Programming/Bonus Chapters/History of MATLAB

History of MATLAB
During the late 1970's and early 1980's, Cleve Moler develop mathematical software package during his tenure as mathematics professor in University New Mexico as supplement teaching tools for his Numerical Analysis course.

His motivation at that time is to let his student to write EISPACK and LINPACK without having to code in FORTRAN programming languages. For this version of MATLAB1.0, there is only 71 mathematics functions at the beginning (which are built out of EISPACK and LINPACK). Soon enough, the program package found its ways to other applied mathematics department around the USA. During this time, a student introduced MATLAB future co-founder, Jack Little. Jack Little had been in the graduate engineering program at Stanford and he adopted it for his own work.

In 1984, Cleve Moler co-founded MATLAB with Jack Little in California to commercialize and develop MATLAB. Jack Little suggested the creation of a commercial product based on MATLAB. He left his job and bought a Compaq® PC. Jack Little, together with Steve Banger spent 1.5 years to reprogram the MATLAB into C programming languages. Basically, the MATLAB version 1 is functioning like a matrix calculator and it is without any sophisticated features unlike today versions of MATLAB such as plotting, advance maths functions such as ODE, FFT, etc. PC-MATLAB made its debut in December 1984 at the IEEE Conference on Decision and Control in Las Vegas with some of most significant features such as functions, toolboxes, and graphics.


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User:Chemnerd1234

We are going to learn about bonds!

What are chemical bonds? How do they happen? Why do they happen?

A chemical bond is a bond that happens between 2 or more elements when the elements try to stabilize their electrons, depending on how many valence electrons an atom has in it, the more or less likely it is to bond with another atom.

There are three different types of bonds, ionic bonds, covalent bonds, and metallic bonds. Covalent bonds happen between non-metals, metallic bonds happen between metals, and ionic bonds happen between a metal and a non-metal.

There are 2 mayor properties that determine whether an atom can easily make a bond or not, these properties are electron affinity and ionization energy. Electron affinity is an atom’s ability to gain electrons, electron affinity increases in each element as you go up and right on the periodic table. Ionization energy is an atom’s ability to maintain or hold its electrons, it also increases in each element as you go up and to the right on a periodic table. Ex.

If I have an oxygen atom which has 8 electrons and 2 hydrogen atoms which both have 1 electron the hydrogen atoms are going to try to gain the electron they need to fill their outer shell by taking the electron from the oxygen, but because both the oxygen and the hydrogen have high electron affinity and high ionization energy they end up sharing electrons, to put it into perspective imagine 2 people with rocks in their hands and they both try to take the rocks from each other with the same strength, they will end up “sharing” the rocks because they are both pulling with the same strength, and so the result of the atoms interacting in this way creates H2O (Water)

To summarize what we have learned:

The purpose of bonds is to make an atom more stable (by filling it)

A covalent bond is between nonmetals both atoms have a high Ionization energy and electron affinity. Neither can steal electrons from the other, so they end up sharing electron. 2e makes one covalent bond. The bigger the atom the harder it is to grab the electron

Similarly, the bigger atoms tend to be more likely to lose an electron

Oppositely smaller atoms have an easier time grabbing electrons

In simpler terms smaller atoms also tend to gain electrons

Nonmetals try to gain electrons because they are smaller and able to steal them easier. They do this in an attempt to create an octet or a duet.

Ionic bonds means losing electrons not sharing electrons.

On a periodic table when going from left to right the I.E. and E.A increases whereas the atomic radius (The size) gets larger from right to left.

Increasing E.A and I.E also appears to increase when going down to up

The atomic radius means essentially the distance from the nucleus to the valence electron. The higher the atomic radius the bigger the atom and the lower the strength.

Electron Affinity is dependent upon the atomic size, nuclear charge, and electron configuration.

title: User:Chemnerd1234


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User:TawSAstudent

chemistry student

title: User:TawSAstudent


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Cultural travel

General education article; considers one of the options of non-standard travel around the planet, which is partly intersected with hobo tourism. Recommended for reading by all.

--- Cultural travel — the term is almost unknown, very rarely used in the true sense; in addition, it has nothing to do with the widely practiced Cultural tourism.

The following material explains the meaning of cultural travel, its basic principles, and also offers a short training course for those who wish to do it.

General information
Cultural Travel emphasizes experiencing life from within a foreign culture, rather than from the point of view of a temporary visitor. Cultural travelers leave their home environme nt at home, bringing only themselves and a desire to become part of the culture they visit. Cultural travel goes beyond exploration, and involves a complete transformation in way of life.

The concept was first used in 1977 by 21-year-old budget traveler Gary Langer as a way to describe a journey that requires a new level of understanding of foreign culture.

The term is often distorted and misused by travel agents, tour operators and international tourism organizations. Culture is primarily about people, not places or objects. Tourists are limited to impressions beyond the surface: visits to museums, ancient buildings and festivals do not give the same experience that true becoming part of the culture of another country.

Territorial research is a form of cultural travel that provides insight into various unknown and less discussed cultures. The knowledge of the foreign culture of the homebody part of the population depends on the travel notes of travelers, testifying to the seen in distant countries, rather than from official messages from abroad. The antithesis of cultural travel is tourism, that is trips, when people bring their home environment with them, wherever they go, and apply it to everything they see.

Respect for tradition
Cultural travel suggests that wanderer will look like a native inhabitant, without differentiating in clothing. In some countries, clothing standards contrast with foreign designs, fundamentally different from them. For example, the Pashtun costume and the pakol uses in Afghanistan; the shalwar kameez — in the countries of South Asia. In muslim states people wearing long robes and chalmas.

In many African and Asian countries where the official religion is Islam, men are allowed to enter the mosque during the day and sit relaxed, even eat and lie down (the floors of Muslim temples are usually paved with soft clean carpets), plunging into sleep. In European terms, it is unacceptable to take such actions in a holy tample. Another example is the wearing of the hiyab by women of all ages, nationalities and citizenship in Iran. The traveler should forget the tradition of his country and live by local canons.

Use of traditional cuisine in food
The features of the national cuisine are an integral part of the culture. A traveller practising cultural immersion should include traditional foods in their diet.

Some dishes of exotic countries may shock the foreigner. For example, in the Cambodian town of Skuon, fried tarantulas are eaten. In Phnom Penh, this exquisite dish is harder to find, which is not the case with more common food: fried in butter grasshoppers and cockroaches. In the Ecuadorian village of Pompeia (Orellana province), local people eat the charcoal-broiled larvae of the palm beetle. In Zambia, Zimbabwe and Malawi cook a variety of meals using Gonimbrasia belina caterpillars, — a delicacy that costs more than meat, while the daily food of the people of those countries is nshima, — a fresh dish of rice flour. In the Philippines, they eat ballut (boiled duck egg that has already formed a fruit) and deep-fried newborn chickens. In many countries of Africa, Asia, Oceania and Latin America, a variety of plantains dishes are served: it can be cooked as a boiled, deep fried or grilled.

Living in Aboriginal homes
A cultural traveller visiting the countries of the world, whenever possible, stay in the homes of the local population; if not given the opportunity, — uses accommodation designed for the indigenous poor. While staying with the natives, observing life and life, eating with the owners of traditional dishes, the traveler learns local customs. Indigenous people in small communities of developing countries will, in most cases, welcome the presence in their homes of an infrequent visitor from a distant country.

Practical examples
Many foreigners, including Russian travelers, getting to the territory of Indonesia by water route "Malacca — Dumai" from Malaysia, live with a local English teacher — Mr. Muchsin, owner of a private school, helping students to learn the basics of English. . Traveler Viktor Pinchuk, using the idea and experience of the practice from Muchsin, continued the lessons with the children in another school (no longer private), located in a tiny village near Lake Maninjau, independently initiating communication lessons.

Anton Krotov, who visited the Sudan with a group of like-minded people in 1999, writes: ''And imagine: the Russian village, say, Yazhilbitsy, and in one of the houses, at nightfall, knock and ask for a night (in broken Russian) five fat blacks with such Baulas... Our village old ladies will be bewildered. And here — quietly. You will knock on the house — you will be allowed, and what moves the master? interest, sincere joy, or an ancient custom of hospitality?''

And this is a description of living in the commune of the Papuans of the Province of Westerns Highlands, PNG from a book by the Russian traveler Viktor Pinchuk: ''The structure in which they live is similar to the Mongolian yurt: in the middle of the dark room, (no electricity. — Author), in the concrete niche in the evening they make a fire, in which they bake kau kau — local potatoes. Smoke escapes through the thatched roof. Unaccustomed hard to breathe, and outside it looks like a fire has started. Sleeping present (I counted five), on a special platform, which is built along the perimeter of the walls.''

The same author refers to his stay in a small Cuban village: ''According to the situation you can see that they live very poor: furniture at a minimum, household appliances are missing — only an old TV on the bedside table; the food is also not a lot They gave me a little jam of their own preparation. <...> In the evening I looked for a place in the corner under the wall, settling down for the overnight, but the owner stopped me. He took the sleeping mat from my hand and laid it on the bed: "You will sleep here".''

Gallery I
Photos from trips and expeditions of the Russian traveler Viktor Pinchuk

Gallery II
Videos from trips and expeditions of the Russian traveler Viktor Pinchuk

Materials in Wikisource project

 * Viktor Pinchuk  "Very tasty... spider!"
 * Viktor Pinchuk "The Crimean guru in Sumatra" (in ru)

authors: Виктор Пинчук

title: Cultural travel


text: Category:Book:Cultural travel

authors: Виктор Пинчук

title: Category:Book:Cultural travel


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Open Scholarship Press Collections

The Open Scholarship Press Collections feature four individual, book-length annotated bibliographies with analytical overviews covering key areas of open social scholarship: Community, Connection, Policy and Training. To view any of the collections, click the Wikibooks links below; print versions are also available via PediaPress at the links below as well.

Open social scholarship is the creation and dissemination of research and research technologies to a broad, interdisciplinary audience of specialists and non-specialists, in ways that are both accessible and significant to all groups (Implementing New Knowledge Environments Partnership, https://inke.ca/).

''These collections are accompanied by primers, curated volumes of essential reading in each of these areas as well, following an analytical overview. For these curated volumes, please see the Open Scholarship Press Curated Volumes. For an overview of the OSP and related projects, please see the Open Scholarship Press.''

Community: An Analysis and Annotated Bibliography in the Context of Open Social Scholarship

Alyssa Arbuckle (UVic), Caroline Winter (UVic), Jesse Kern (UBC), Vitor Yano (Concordia), Anna Honcharova (European Students’ Forum), Alan Colín-Arce (U Autónoma del Estado de México), Graham Jensen (UVic), and Ray Siemens (UVic), with Jon Bath (U Saskatchewan), Jon Saklofske (Acadia U), and the INKE and ETCL Research Groups

ISBN 9798210902801

This annotated bibliography draws together recent thinking and writing on the emergence and evolution of open, digital scholarship. The scan revolves around three core themes--public/community engagement, open social scholarship, and scholarly communication--but includes selections from topics as far reaching as public humanities to open data to knowledge mobilization.

The emergence and evolution of open, digital scholarship has shone a light on the possibilities for academic work beyond the real or perceived boundaries of postsecondary institutions. Academic research can now be produced, published, and shared in a way that extends past the hallowed halls of a long-established university or the compact shelves of that university’s library. The Open Access movement has been pivotal for the largescale reconsideration of who does and who should have access to the world’s research. Community-university partnerships and concerted knowledge translation and mobilization efforts have also formalized efforts to bring various publics together around issues of shared interest. The evolution of open access to open scholarship to open social scholarship is also representative of changing notions around the purpose and possibility of academic work.

Connection: An Analysis and Annotated Bibliography in the Context of Open Social Scholarship

Graham Jensen (UVic), Tyler Fontenot (Independent), Alan Colín-Arce (U Autónoma del Estado de México), Alyssa Arbuckle (UVic), Vitor Yano (Concordia), Anna Honcharova (European Students' Forum), Caroline Winter (UVic), and Ray Siemens (UVic), with the INKE and ETCL Research Groups

ISBN 9798210903815

This annotated bibliography gathers and synthesizes scholarship on the digital spaces, tools, and technologies that have increasingly facilitated open communication among researchers, organizations, and the public in the last few decades. In particular, it examines the possibilities and problems associated with “digital knowledge commons” or “digital research commons”—that is, digital spaces for publishing, sharing, and accessing information.

Examples of digital knowledge commons include Wikipedia as well as academic social networking sites such as Academia.edu and ResearchGate, which have now enabled millions of researchers to share information and connect with others online. Indeed, this latter form of knowledge commons has helped researchers share their work within and beyond their existing academic networks using sharing features that are familiar to users of Facebook, Twitter, and other popular commercial social networking sites. Although many of the works compiled in this bibliography compellingly outline the problems associated with academic social networking sites, and with social media more generally, the cumulative and overwhelming message of this body of work is nevertheless clear: it is difficult to overstate the impact of such platforms—and the rapidly changing technologies that enable them—on the present shape and future possibilities of academic research.

Policy: An Analysis and Annotated Bibliography in the Context of Open Social Scholarship
Caroline Winter (UVic), Alyssa Arbuckle (UVic), Jesse Thomas Kern (UVic), Vitor Yano (Concordia), Anna Honcharova (European Students' Forum), Tyler Fontenot (Independent), Graham Jensen (UVic), Alan Colin Arce (U Autónomo del Estado de México), and Ray Siemens (UVic), with Tanja Niemann (Érudit) and Lynne Siemens (UVic), and the INKE and ETCL Research Groups

ISBN 9798210902702

This annotated bibliography surveys current literature about open scholarship policy, offering a snapshot of the field of policy analysis and criticism. It does so with the goal of mapping the contours of this field and identifying the major critical pathways, recognizing that, as a snapshot, it cannot capture the entirety of the field in detail. In particular, questions about open scholarship policy include: How and to what extent does policy advance open scholarship? What effect does policy have on individuals and their work? How does policy affect open scholarly practices?

This resource builds upon the Open Scholarship Policy Observatory, a hub for information and resources related to all aspects of open scholarship that includes a collection of policy documents as well as policy analysis. It follows and reflects policy developments related to open scholarship in Canada and beyond, analyzing policy changes and their relevance to researchers, information professionals, librarians, faculty, and policymakers. Its roots in the Open Scholarship Policy Observatory lend this bibliography a Canadian focus and an interest in the humanities and social sciences (HSS), but it takes a broad view, considering open scholarship as an international and interdisciplinary movement. The term policy is already broad, and it is applied here broadly as well to encompass not only formal international, national, and institutional policy statements but also formal and informal policies about the issues and topics that constitute open scholarship and adjacent issues.

Training: An Analysis and Annotated Bibliography in the Context of Open Social Scholarship

Randa El Khatib (UTSC), Alan Colín-Arce (U Autónoma del Estado de México), Vitor Yano (Concordia), Anna Honcharova (European Students’ Forum), and Ray Siemens (UVic), with the INKE and ETCL Research Groups

ISBN 9798210902603

This annotated bibliography provides a snapshot of topics pertaining to training and pedagogy within the context of open social scholarship. More specifically, it frames the intersections between digital humanities pedagogy, public humanities, and open resources.

Embracing new media and digital technologies in higher education has caused a profound shift in training and pedagogy. The unprecedented access to education facilitated by the Internet has extended skills training and knowledge exchange beyond the confines of the university and lowered barriers for accessing education. At the same time, today’s digital economy requires additional training and skills to improve digital literacy, including the use of digital technologies for information-seeking and research purposes, as well as knowledge production and dissemination. These shifts pose several challenges for higher education, ranging from how digital training and pedagogy can be adopted in the classroom, curricula, and universities, to thinking about best practices for engaging and training active publics.

title: Open Scholarship Press Collections


text: Category:Book:Open Scholarship Press Collections


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I renamed it, but not totally sure if the name matches it well... Does anybody know of a better name for this one? 20:30, 13 September 2022 (UTC)

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(Would you like to provide feedback on this message?) Thanks for your contributions. 20:35, 13 September 2022 (UTC)

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