Tolkiens Middle Earth Essay Example For Students

Tolkiens Middle Earth Essay In a discussion of great literary minds of the twentieth century, there is one name that always stands out. J. R. R. Tolkiens classic story Lord of the Rings is the measuring block by which all other fictional works of the twentieth century are compared. His engrossing characters, beautiful descriptions, and intriguing plot have enraptured generations of avid readers. The most endearing quality of the epic is Tolkiens ingenious use of archetypes, most notably the quest hero. Frodo Baggins possesses all of the qualities of a quest hero: courage, loyalty, and an unwavering sense of duty and responsibility. Frodo possesses loyalty and a willingness to act under the direction of others who may know better than he, even when he doesnt understand what it is he is being asked to do. He agrees to keep the ring in his possession after Bilbo leaves the Shire, he even accepts Gandalfs demand that the never use it, even though he has seen Bilbo do so many times. Frodo even accepts the horrible t ask laid on him by Elrond to bring the ring to Mount Doom deep in the heart of Mordor, the one place that he should fear above all others. I will take the Ring, he said, though I do not know the way (Tolkien 324) Frodo is willing to take this responsibility on himself, he doesnt even realize that he has no idea where to even begin his task.The hobbit is undyingly loyal to his comrades, even when their own minds lead them astray. We will write a custom essay on Tolkiens Middle Earth specifically for you for only $16.38 $13.9/page Order now Boromir corners Frodo and proceeds to beg, demand, and then attempt to take the ring from him. Even though Frodo could have given in to Boromir, indeed he even wanted to be rid of his burden, he knew that the ring was his alone to bear, and that it would destroy the proud Boromir if he were to use it. He knows his place in the company, and he is determined to never let his companions down through his own weakness. Frodos strongest quality is his unnaturally strong sense of responsibility. Even when separated from the rest of the company, and with only his faithful friend Sam Gamgee at his side, Frodo presses on, finding a way into Mordor, something no sane person would ever want to do. No matter how desolate his situation became, no matter how hungry, tired and injured he was, Frodo never wavered from his goal. His face was grim set, but resolute. He was filthy, haggard, and pinched with weariness, but he cowered no longer, and his eyes were clear. I purpose to enter Mordor, and I knowno other way. Therefore I shall go this way, I do not ask anyone to go with me. (Tolkien 289)Frodo always swore to finish what he started. Gandalf put the ring into his care, so he believed that the destruction of the ring was his duty. He had to undertake this impossible quest for the good of a world that looked at his race as a joke of a species. Frodos own companion, his dearest friend Sam, eagerly wished for his master to turn away from his dreadful task. Sam begs and pleads with Frodo, does all he can to try and sway his master, always trying wanting to turn Frodo away from Mordor and certain death. But the determined hobbit will not be swayed, Heres the gate, and it looks to me as if thats about as far as we are ever going to get! (Tolkien 288) Still Frodo pressed on, he knew in his heart that he had to complete his quest, no matter the odds against him. .u81c00f95368eb6eebfc56f9e5d9eacb4 , .u81c00f95368eb6eebfc56f9e5d9eacb4 .postImageUrl , .u81c00f95368eb6eebfc56f9e5d9eacb4 .centered-text-area { min-height: 80px; position: relative; } .u81c00f95368eb6eebfc56f9e5d9eacb4 , .u81c00f95368eb6eebfc56f9e5d9eacb4:hover , .u81c00f95368eb6eebfc56f9e5d9eacb4:visited , .u81c00f95368eb6eebfc56f9e5d9eacb4:active { border:0!important; } .u81c00f95368eb6eebfc56f9e5d9eacb4 .clearfix:after { content: ""; display: table; clear: both; } .u81c00f95368eb6eebfc56f9e5d9eacb4 { display: block; transition: background-color 250ms; webkit-transition: background-color 250ms; width: 100%; opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #95A5A6; } .u81c00f95368eb6eebfc56f9e5d9eacb4:active , .u81c00f95368eb6eebfc56f9e5d9eacb4:hover { opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #2C3E50; } .u81c00f95368eb6eebfc56f9e5d9eacb4 .centered-text-area { width: 100%; position: relative ; } .u81c00f95368eb6eebfc56f9e5d9eacb4 .ctaText { border-bottom: 0 solid #fff; color: #2980B9; font-size: 16px; font-weight: bold; margin: 0; padding: 0; text-decoration: underline; } .u81c00f95368eb6eebfc56f9e5d9eacb4 .postTitle { color: #FFFFFF; font-size: 16px; font-weight: 600; margin: 0; padding: 0; width: 100%; } .u81c00f95368eb6eebfc56f9e5d9eacb4 .ctaButton { background-color: #7F8C8D!important; color: #2980B9; border: none; border-radius: 3px; box-shadow: none; font-size: 14px; font-weight: bold; line-height: 26px; moz-border-radius: 3px; text-align: center; text-decoration: none; text-shadow: none; width: 80px; min-height: 80px; background: url(https://artscolumbia.org/wp-content/plugins/intelly-related-posts/assets/images/simple-arrow.png)no-repeat; position: absolute; right: 0; top: 0; } .u81c00f95368eb6eebfc56f9e5d9eacb4:hover .ctaButton { background-color: #34495E!important; } .u81c00f95368eb6eebfc56f9e5d9eacb4 .centered-text { display: table; height: 80px; padding-left : 18px; top: 0; } .u81c00f95368eb6eebfc56f9e5d9eacb4 .u81c00f95368eb6eebfc56f9e5d9eacb4-content { display: table-cell; margin: 0; padding: 0; padding-right: 108px; position: relative; vertical-align: middle; width: 100%; } .u81c00f95368eb6eebfc56f9e5d9eacb4:after { content: ""; display: block; clear: both; } READ: The Importance of Education to My Life EssayProbably Frodos most heroic quality is his inhuman, or rather, inhobbit courage. Again and again he presses on in the face of danger. Whether under attack by one of the nazgul, the giant spider Shelob, or the obsessed Smeagol, Frodo perseveres. He always manages to defeat or escape from certain death, carrying on his all-important task. Frodos quest changes him in this respect. At the beginning of his journey, Frodo appears as nothing but a scared little hobbit, grateful for Aragorns protection. By the time of his struggle with Gollum on Mount Doom, he feels

Use of language in A View from the Bridge essays

Use of language in A View from the Bridge essays The device for depicting Italian and Sicilian immigrants enables miller to make them more or less articulate in English. Only Alfieri is a properly articulate, educated speaker of American English: for this reason he can explain Eddies actions to the audience, but not to Eddie, who does not really speak his language. Eddie uses a naturalistic Brooklyn slang quicker for more quickly, stole for stolen and so on. His speech is simple, but at the start of the play is more colourful, as he tells Catherine she is walkin wavy and as he calls her Madonna. Miller uses epigrammatical style in some of Alfieris speeches. For example at the beginning of the play where Alfieri says: A lawyer means the law, and in Sicily, from where their fathers came, the law has not been a friendly idea since the Greeks were beaten. Miller shows that Alfieri is well educated and that he has a full historical background of his ancestors and how they were treated before his time. All of Alfieris speeches are soliloquy as he disrupts the play at certain periods and enlightens the audience with the story himself. Miller also creates asides in Alfieris speeches, where in the stage directions, the light fades on the scene and onto him on his desk as he gives a speech directed only to the audience he goes out of the department. The lights go down, as they rise on Alfieri.. This method however, enhances the secrecy of particular moments in the play (Alfieris interpretations of Eddies feelings). Antithesism is used in Alfieris opening speech at the beginning of the play where he says; and my practice is entirely unromantic. This signifies to the audience how he feels towards his job that it is the total opposite to romantic and towards the law in particular. To conclude, his dealings with longshore ...

GEOGRAPHIES OF SUSTAINABLE FOOD Essay Example | Topics and Well Written Essays - 1250 words - 1

GEOGRAPHIES OF SUSTAINABLE FOOD - Essay Example Sustainable food system refers to a mutual set of sustainable food production processing, distribution, consumption and waste management with an aim of enhancing environmental economics and global social health. It is for this reason that farmers and consumers often partner in developing food sustainability projects in order to achieve a stable family farm base for a nutritious, adequate and affordable diet, create food and agricultural policies to promote food sustainability base (Robinson 113). Challenges confronting global food system The world’s rapid population increase calls for more demand of food amid changing consumption patterns and food scarcity. This is one of the biggest challenges facing the world’s global food system. The current century has experienced stunning statistics on population increase expectations with the population expected to rise by 1.4 billion people. This rise in population calls for close to 50 % increase in demand of food. It is shockin g to note that with this rise in population consumption patterns continue to get complicated. The cost of production has gone up as well leading to production of fewer quantities than before. In this regard, the global food system must be managed sustainably in the next decade in order to increase food production level to cater for the increase. To meet this demand the use of technology has become inevitable. However, the use of technology has received a worldwide uproar on safety matters owing to the use of synthetic fertilizers and pesticides in production. But, can universal food security be assured without the use of fertilizers and pesticides? Sustainable production of secure food can be achieved by reducing distortions in configuration of the global food market and the environment. Although many countries in developed and developing countries have large junks of unused land resources, they do not grow enough food to feed their populations. Such land resource does not only rema in untapped but also ecologically vulnerable. This is a big challenge to food sustainability. In addition to this, insolvency of the earth’s natural resources through consumption of resources beyond the earth’s production capability has led to complete depletion of the earth’s scarce resources. The other challenge affecting global food system is inequitable distribution of production resources, lack of employment or underemployment. This has rendered a greater percentage of population unable to feed their families and dependants. It has also challenged food production due to the inability to till land for production of food leading to over-reliance of foreign funding and relief food (Wilson 2). If more people were to be funded in the agricultural sector, it would mean more food availability and money to buy food. This is because agriculture is a solution to food and employment challenges. Therefore, countries with a culture of importing food from other countries tend to encourage high rate of unemployment since a culture of importing discourages agricultural activities. This is because importation marginalizes people forcing them to destroy resource base to sustain their livelihood. It is vital for agricultural resource base to be maintained because it contributes to good husbandry and sustainable management while easing rural-urban migration and in combating poverty. Measures of a

Teaching English in elementary schools in Saudi Arabia Literature review

Teaching English in elementary schools in Saudi Arabia - Literature review Example The reason is that variables involved in the development process cover those areas that this paper is interested in – the demographics of the young learners (at what age children usually learn English), the teaching content (such as how religion can be integrated in the instruction), teaching methodologies, perceived problems that are unique to Saudi children and their solutions, among others. Literature on the demographics of young learners in Saudi Arabia is quite scarce. This is more so in the field of ESL or what in identifying studies that actually investigated the beginning age of ESL learners in the country. There are researchers, however, who have mentioned some information and pertinent facts regarding this matter in their wider discourse of either English learning in the Middle East or as part of the wider profile of Saudi Arabia. An excellent example is Abir’s (1993) insights on the issue. He stated, for instance, that â€Å"the standard of education in the urban centres catering to the Saudis of middle-class background is on the whole relatively low,† and that â€Å"memorising is still the backbone of the system, while standard of English†¦ is uneven and often very poor.† (p. ... (Bingham, p. 435) Beginners are usually assessed according to their English language competency and currently they have more than 600 students coming from both expatriates and Saudis alike. Similar international schools roughly adopt the same standards. Meanwhile, the national average of new learners is glaringly different. Wilson, for example, wrote that based on statistics, Saudi children start learning at a later age but that enrolment is increasing rapidly because of extensive support from the government. (p. 106) In addition public elementary schools are usually late in introducing ESL as opposed to the private schools like in the case of Jeddah Prep & Grammar School, which has been established by British and Dutch expatriates. According to Abdan (2002), elementary students should be introduced to English in elementary school because public elementary school students are presently underexposed to the language since English is not part of the national curriculum. (p. 265-266) The benefits of introducing English to young learners, preferably to be integrated in the elementary education curriculum have been cited and proven by numerous studies. These benefits are explained in various arguments ranging from the social, cultural to psychological. According to Nikolov and the European Centre for Modern Languages (2007), young children can benefit from early language learning in the same way as older pupils do. In their research, they found that majority of teachers have been surprised to find how quickly young children pick-up English. (p. 26) It is for this reason why, in America, immigrants immediately send their children to school to learn English as part of the faster strategy to assimilate in the society. (Welch

The Apollo Group, Inc Case Study Example | Topics and Well Written Essays - 1000 words

The Apollo Group, Inc - Case Study Example Unlike other universities, UOP is a for-profit institution. Synopsis of the Situation The University of Phoenix catered to the working adults who wanted to continue their education. It was one of the first institutions to target this growing market. They are considered the giant in the industry and as such have earned $2.5 billion in revenues in 2006. While many colleges employed full-time faculty members, UOP hired working professionals as teachers. The success of the Apollo Group emanates from the fact that they were able to tap an unserved niche in the market, that is, the working adults. Key Issues The key issues of the case are the growing demand for online education not only in the US but also in the developing countries, the need to open up new local campuses and the need to improve the existing technology that UOP utilizes. Define the Problem The problem presented in the case is how to change the reputation of UOP from a â€Å"diploma mill† establishment to one which i s offers accredited degree programs and an institution that will introduce new undergraduate and graduate degree programs that will meet the needs of both the adult working population and the traditional collegiate market. Alternative Solutions There are several solutions that may be adapted by UOP namely: Use the media to give information about programs that they offer, the competence of their faculty members and the academic system that they use Highlight the low cost of tuition as compared to other colleges Create tie-ups with large corporations to encourage their employees to enroll at UOP; discounts may be given to corporations which enrolls a certain number of their workers at UOP Advertise through the internet to capture foreign markets and increase its student population Put emphasis on the concept of offering quality education at schedules that are accessible even to working adults Need to invest more on latest technology available for educational institutions especially wi th regards to online education Selected Solution to the Problem The selected solution to the problem is a combination of all the alternative solutions presented above. UOP cannot just rely on a single solution to its problems. It should improve its course and program offerings and hire more competent faculty members. It is also essential that UOP keep abreast with the latest technological advancements in the industry. After improving on the said aspects, it must allocate the necessary funds to come up with an advertising strategy that will improve its reputation by highlighting its unique selling point and emphasizing the quality of its education. Implementation The solutions suggested would take several months to implement. The first step to do is to research on the latest technology available for online education. This is of utmost importance because several schools are already offering online programs and if UOP does not adapt the latest technology, they might not be able to reta in its market leadership. The next step is to beef up its marketing to other developing countries. This should be done because in case they lose their leadership in the US market, the foreign market can augment any decline in enrollment in the local market. Expanding overseas is the way to go for online education. Hand in hand with marketing to the foreign market, UOP must recruit new faculty members to maintain the ratio of students to

The congenital heart disease

The congenital heart disease Does an Exercise Program following Cardiac Surgery for Congenital Heart Defects improve a Childs Cardiopulmonary Response to Exercise and Increase Exercise Tolerance? Introduction   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Paediatric Cardiac Problems are prevalent throughout the world with 1.5 million new cases diagnosed each year. Congenital Heart Disease (CHD) is the most common diagnosis of heart problems at birth. Between four and nine per one thousand live births each year are diagnosed with the condition (Draper 2008). In 2007, 989 live births were recorded of babies with cardiovascular abnormalities (National Statistics 2007). Congenital Heart Disease is an umbrella term which encompasses all heart defects that are present when a child is born. The child may have one or multiple defects at birth which can either be detected by a scan ante-natally or are diagnosed soon after birth. Although the diagnosis of CHD is now becoming easier, some diagnoses of the condition do not happen till later on in life. Statistics show that around 60% of congenital heart disease are diagnosed in babies aged from birth to one year, 30% in children aged one to fifteen, and 10% in adul thood (16 years and over) (BHF 2003). Many common conditions include a Ventricular Septal Defect (VSD), an Atrial Septal Defect (ASD), Pulmonary Artery Stenosis, Tetralogy of Fallot (TOF) (Fig. 1) and Transposition of the Great Arteries (TGA) (Fig. 2). Congenital Heart Disease is now not just a problem of the child, many people with the condition are now living into adulthood. It is predicted that by 2010, 185,000 people will be living in the UK with CHD (Deanfield (BHF) 2003). Treatment for Congenital Heart Conditions has changed rapidly over the last 50 years. Now surgical management is needed in most cases however some defects will either resolve themselves or require medication. Surgical treatment has changed in recent times, fewer patients are requiring open heart surgery and more are receiving a catheterisation technique. Around 3,100 operations and 725 interventional cardiac catheterisations are performed each year on babies and children with CHD (BHF 2003). The effects of surgical interventions on cardiopulmonary function have been thoroughly researched in the past. The studies have concluded that surgery does improve lung and cardiac function and reduces secondary complications (Picchio 2006). Exercise is widely known as the best treatment for most musculoskeletal problems but its effects on the cardiopulmonary system has only recently been researched into (Cullen 1991). Pulmonary and Cardiac Rehabilitation have now been shown to have an effect in adults but the research into paediatric rehabilitation classes is not widely known about. Other studies have looked at exercise training or a cardiac rehabilitation programmes following surgery and the effect of this on the patients exercise tolerance. I am going to use this review to assess these studies which look at both cardiac rehabilitation programmes and also levels of exercise tolerance following surgery. I want to discuss whether there are any gaps in the knowledge base surrounding the effects of exercise in cardiac surgery of paediatrics. I also want to conclude whether the assumption that exercise is positive, can be correctly justified. Method After deciding a topic I was able to start researching into the background area of paediatric cardiology. I started by using a combination of terms including, Exercise, Sports, Physical Activity, Paediatrics, Children, Post-Cardiac Surgery, Congenital Heart Disease, Congenital Heart Defects and Cardiac Rehabilitation. The search pages I found highlighted articles of relevance and then I used the link to related articles to find the studies (see appendix 1). I also searched on individual journal websites including, Paediatric Cardiology and Cardiology in the Young. I used databases such as Pubmed, Medline, Ovid, Sciencedirect and Springerlink to read abstracts of articles and decide their relevance to my review. I then selected the most relevant and used excel to compile a table where I could easily see the differences in the studies under headings (see appendix 4). The studies I am looking at are all based on paediatrics and are randomised controlled trials dating from 1981 to 2009. Although some of the studies are nearly thirty years old, they hold some strong evidence compared to present day studies and therefore I have not discounted older studies from this review. Other reviews have assessed whether exercise has an impact on cardiopulmonary performance and have been shown that an exercise rehabilitation class does provide benefits in cardiopulmonary performance and exercise capacity. Some of the studies that are being reviewed however are concluding with insignificant findings. The reviews have stated that research lacks long-term effects of training and also a clear understanding as to which exercise type is best (Tomassoni 1996). In this review I will try look at newer studies and see if the areas of knowledge that were found to be omitted after previous reviews have now been researched into. Review of Studies Firstly I am going to discuss the testing of the participants. All of the studies completed two exercise tests to assess the participants ability before and after either the cardiac rehabilitation program or surgery. Exercise testing is very difficult to reproduce. Many studies have problems with ensuring the test is accurate and reliable and many struggle, causing results and testing to be different and therefore not comparable. If the results are not accurate and cannot be compared to other studies the results can cause a change in average results and therefore may mislead readers into a false positive result. Each of the studies used either a treadmill test or a cycle ergometer to test their participants cardiopulmonary function and exercise tolerance. Using these two tests is the most common technique of testing function as it is very reliable. (Washington 1994) All studies used a specific protocol outlined in the Washington Guidelines with all of the studies using a treadmill test with five of the thirteen studies using Bruces protocol. Bruces protocol is where the grade of exercise is increased every 3 minutes until the participant has reached their maximum capacity and cannot continue. The bicycle ergometer tests are where the participants are required to cycle continuously at approximately 50-60rpm where the grade of exercise is increased by 10-20 watts/ minute every three minutes. This is also completed until the participant can no longer continue (Washington 1994). Exercise testing using a treadmill or a cycle ergometer causes problems because the task they are undertaking in the test are is not functional and do not relate to daily tasks. Running and cycling is functional but not to that grade of exhaustion. Many children normally will stop an exercise when they are tiring and will never push themselves to the level that these exercise tests are pushing them. The tasks are also not fun for the participants and I feel that it should be fun otherwise children will get bored. This is the same with the intervention as well and the programmes should be child orientated and individual to each child. Outcome Measures are the basis to the results of a study and therefore its effectiveness. A lack of certain outcome measures may show large flaws in a study as many can be used to assess different parts of function and physiological activities. In the studies looking at the effects of cardiovascular surgery, there were a limited number of outcome measures that were looked at. Sarubbi (2000) only looked at heart rate and blood pressure as outcome measures and this limits results. The main outcome measures were heart rate, blood pressure and maximum work rate in all the studies. These outcome measures although very limited are values that help us to understand cardiovascular activities. Other helpful measures would have been oxygen saturations, which only Rhodes studies (2005/6) looked into. Saturations are helpful to assess whether a change in heart rate or blood pressure affects saturations or whether a change in these may be due to a ventilation problem. (Rivers 2001) The outcome measures of the cardiac rehabilitation studies are all different but all have similarly looked at exercise capacity after the intervention. This is shown by all the studies using VO2 as a measure and that all the participants improved their VO2 maximum to allow for a greater exercise capacity. The only study that did not prove an increase in VO2 max was Goldbergs study (1981) which only showed an improvement in maximum work rate. This could have been due to the date in which the study was undertaken. This was one of the earlier studies done in 1981 and therefore technology may not have been as accurate or as reliable as some of the later studies done since 2000. However Goldbergs study was the one that had the most intervention time of all the studies with exercise of up to 45 minutes completed on alternate days with a strict regime to increase grade of exercise over the 6 weeks. This leads me to believe that maybe it was inappropriate testing or inaccurate technology tha t changed the results of the study as previous reviews have shown that an increase in exercise time has shown to have positive effects on health. As technology has developed since the early eighties, this may be why more accurate testing is used and therefore making results more positive to the outcome we wish. Another problem in trials of this sort is compliance. Compliance is always an issue when completing studies (Burke 1997). Initially recruiting people to participate is difficult and many people with either choose not to participate or may drop-out early in the study. Many people will not participate because of exercise testing being too invasive or because of geographical implications as the distance to the base of the study being an issue. Some of the studies had large drop-out rates with almost 30% decrease in patients initially viable for the treatment plan and those who undertook the tests in the study (Arvidsson 2009). I think this could be explained by that the studies involved child participants that are less compliant to long term programmes and who tire easily to an activity. Also due to the nature of the surgery that they have all completed, many parents will be protective over their children and be pushing the participants exercise tolerance will make many parents worried about their childs health. Much of this can be avoided by specifically explaining the procedures and answering any questions that the parent or participant may have to educate them that this a treatment plan and is not going to hinder their childs recovery or health. Also intervention time is a major issue when looking at trials. Some may be days long and others have follow-ups of years once the intervention has finished. The studies that focus on Cardiac rehabilitation all have various time scales of their intervention with the shortest program being six weeks (Goldberg 1981) and the longest around twenty weeks (Opocher 2005). The difference in timescale and the different number of sessions that the participants attend makes it difficult to assess whether it is the content of the program that affects the patients or whether just exercising over a longer, more sustained period of time effects the participants in the same way. I think studies that look at different contents of treatment programmes but have a fixed intervention time may be beneficial in deciding the aim of this review. When looking at the studies, all of the cardiac rehabilitation programs only assess the patients exercise performance straight after the program and only one study looks at the effects of the program long term. Rhodes et al 2005 firstly looked at the immediate effect of a cardiac rehabilitation program and then in 2006 did another study looking at the same participants of the previous study six months after the original program. The studies that look at exercise capacity before and after surgery also do not look at the effects of the cardiovascular system in response to exercise on a long term scale. Long term effects are the best indicator to say that function and exercise capacity has improved (Miller 2005). Sociodemographics of the subjects in a study are also important to review as to its involvement in accuracy of results. Different age ranges or male to female ratios cause studies to be inaccurate in trying to generalise the population group. Many of the studies had a very large age range within their participant groups with the largest difference being 17.6 years in Marino et als study in 2005. I feel that the exercise difference between a seven year old is very different to that of a twenty-four year old. I feel that a large age range is used to increase subject numbers. Male: Female ratios are also important and that a large majority in these studies had male participants. The biggest ratio of male to female was in Opochers (2005) study where there were nine male participants and only one female participants. The best ratio of male: female was either Moalla (2006) study with 44 males and 39 females. This is important as I believe men and women react differently to exercise. Subject numbers is also a large problem with these studies. Due to most of the studies only looking at the children that have had surgery in their trust or hospital they have decreased their subject numbers and none of the studies look at the effects on large number of subjects on a national scale. The studies that looked at cardiac rehabilitation all have subject numbers under 16 which is a very big limitation. The only studies that have larger numbers are the ones that look at exercise capacity after surgery. By having participants that are only from the immediate area of the study base also means you do not get a generalised view of everyone nationally and you may not cover different children from different backgrounds socially and economically and so may have different attitudes to rehabilitation, treatment and self-management. Studies with participants that are not generalised to their population group can therefore produce a bias result to that specific population group. Also having different backgrounds of participants is important in assessing their compliance and what individual exercise programme they should be given. Having a specific age range is particularly important as many of the subjects may be inappropriate for the programme due to their age. Some of the subjects may be too young and using subjects that are under six years old would be inappropriate due to the subjects being too young to understand the instructions of the study. Using older subjects may also cause different results as their bodies have had longer to regain independent function and the body has had time to compensate for a lack in cardiopulmonary function. I think it is important to keep variables as succinct as possible and trials should be able to based on one variable alone and truly work on whether surgery or exercise has a n effect on that variable independently. Effects of Cardiac Rehabilitation The studies looking at cardiac rehabilitation all have an exercise programme set up for their patients either at home (Moalla 2006) or in an outpatient setting (Ruttenberg 1983). These sessions ranging in therapy time from one hour alternate days to one hour once a week, all show an increase in either cardiopulmonary performance or in exercise tolerance. This shows that a rehabilitation programme is appropriate for these patients and does have a positive effect on the participants life. Rhodes studies (2005/6) had the greatest effect on the patients final outcome. Not only did most of the testing result in significant effects but the large range of outcome measures used means that we can assess not only the cardiovascular performance of the participant but also look at the pulmonary effects of the exercise and their effects of the heart and the cardiac system. What we can also see from this review is that the cardiac rehabilitation programmes are becoming more significant in results as the studies get newer. This is a good indicator that current programmes are being effective in their rehabilitation (Opocher 2005, Rhodes 2005/6, Moalla 2006) and that newer techniques and more knowledge on exercise has lead to better run classes which not only improve results more consistently than the older studies and that the effects from an initial programme can also be maintained for 6months after intervention (Rhodes 2006). Effects of Cardiovascular Surgery Two of the studies looking at effects of surgery only have exercise testing after the surgery. The study by Arvidsson only used the number of sports sessions a week that the participant goes to after the surgery. Therefore a direct comparison between their before and after the surgery ability cannot be done and so the study is only looking at their sports participation after surgery and not the effects of the surgery. However these studies do show that after surgery childrens exercise tolerance increases to the level that healthy participants are achieving (Zaccara 2003) and they are participating in equal amounts of sports participation following surgery (Arvidsson 2009) Future ideas In future studies, long term effects of cardiac rehabilitation should be researched, with a follow-up test of a least a year after their rehabilitation to see if the participant is now more active. I also think a control group should be used in the study to look at the effects of non-surgical patients that also participate in cardiac rehabilitation. This is to assess whether the improvement seen during cardiac rehabilitation is not just a response to any exercise and that if a child went back to normality and participating in sports then they will just be as exercise tolerant as children who do not have CHD. Also I would suggest that an exercise programme for the patients that is more functional but also fun and exciting for the patient should be used to increase compliance and also enjoyment for the participants and their parents. Conclusion In conclusion, Cardiac surgery is a commonly used form of reducing congenital heart defects and has been shown by these studies that the surgery does have an improvement on the patients cardiopulmonary performance. I have also found that a cardiac rehabilitation programme is beneficial for paediatric patients after cardiac surgery for congenital heart defects. References/ Bibliography Arvidsson, D (2009) Physical Activity, sports participation and aerobic fitness in children who have undergone surgery for congenital heart defects. Acta Paediatrica 98 pp. 1475-1482 Balfour, I. (1991) Pediatric Cardiac Rehabilitation. AJDC- Volume 145 pp. 627-630 Bradley, L. (1985) Effect of Intense Aerobic Training on Exercise Performance in Children After Surgical Repair of Tetralogy of Fallot or Complete Transposition of the Great Arteries. The American Journal of Cardiology Volume 56 pp.816-818 Burke, L. (1997) Compliance with cardiovascular disease prevention strategies: A review of the research. Annals of Behavioural Medicine. Volume 19, number 3, pp. 239-263 Cullen, S. (1991) Exercise in Congenital Heart Disease. Cardiology in the Young; 1: pp. 129-135 Deanfield J. (2003) Congenital Heart Disease Statistics (accessed on 8/11/09) British Heart Foundation Statistics Database www.heartstats.org disease participate in sport and in which kind of sport? Journal Of Cardiovascular Medicine, 7: pp. 234-238 Draper, Dr. Richard (2008) Congenital Heart Disease in Children (accessed on 3/11/09) http://www.patient.co.uk/doctor/Congenital-Heart-Disease-(CHD)-in-Children.htm ECHO (Evelina Childrens Heart Organisation) (accessed on 15/11/2009) http://www.echo-evelina.org.uk/ Goldberg, B. (1981) Effects of Physical Training on Exercise Performance of Children Following Surgical Repair of Congenital Heart Disease. Pediatrics Vol. 68 No.5 pp. 691-699 http://graphics8.nytimes.com/images/2007/08/01/health/adam/18088.jpg http://graphics8.nytimes.com/images/2007/08/01/health/adam/8807.jpg Marino, B. (2006) Exercise Performance in children and adolescents after the Ross procedure. Cardiology in the Young 16: 40-47 Miller, T. (2005) Exercise rehabilitation of paediatric patients with cardiovascular disease. Progress in Paediatric Cardiology Volume 20, pp. 27-37 Minamisawa, S. (2001) Effect of Aerobic Training on Exercise Performance in Patients After the Fontan Operation. The American Journal of Cardiology Volume 88 pp. 695-699 Moalla, W. (2006) Effect of exercise training on respiratory muscle oxygenation in children with congenital heart disease. European Journal of Cardiovascular Prevention and Rehabilitation 13: 604-611 National Statistics (2007) Congenital anomaly Statistics Notifications. Office for National Statistics. Series MB3, no.22 Opocher, F. (2005) Effects of Aerobic Exercise Training in Children After the Fontan Operation. The American Journal of Cardiology Vol. 95 pp.150-152 Picchio F. (2006) Can a child who has been operated on for congenital heart Rhodes J. (2006) Sustained Effects of Cardiac Rehabilitation in Children with serious Congenital Heart Disease. Paediatrics Volume 118:3 pp.586-592 Rhodes, J. (2005) Impact of Cardiac Rehabiliation on the Exercise Function of Children with Serious Congenital Heart Disease. Pediatrics Volume 116:6 pp.1339-1345 Rivers, E. (2001) Central venous oxygen saturation monitoring in the critically ill patient. Current Opinion in Critical Care. Volume 7, issue 3, pp. 204-211 Ruttenberg, H. (1983) Effects of Exercise Training on Aerobic Fitness in Children after Open Heart Surgery. Pediatric Cardiology Vol. 4, No. 1, pp. 19-24 Sarubbi, B. (2000) Exercise Capacity in Young Patients after Total Repair of Tetralogy of Fallot. Paediatric Cardiology 21: 211-215 Tomassoni, T. (1996) Role of exercise in the management of cardiovascular disease in children and youth. Medicine Science in Sports Exercise. Volume 28(4), pp 406-413 Washington RL. Et al. (1994) Guidelines for exercise testing in the pediatric age group. Journal of the American Heart Association. Volume 90;pp. 2166-2179 Zaccara, A. (2003) Cardiopulmonary Performances in Young Children and Adolescents Born with Large Abdominal Wall Defects. Journal of Pediatric Surgery Volume 38;3 pp 478-481

Role of Mutated Gene in the Evolution of Large Brained, Small-Jawed Hum

Role of Mutated Gene in the Evolution of Large Brained, Small-Jawed Humans The debate with-in the anthropology field has been heated over the evolution of the human and the events that have lead us to where we are now. One of the major questions that is debated is how did we, humans-large brained and small jawed, evolve from primates-large jawed and small brained. Interestingly enough, this debate is now being directed from outside the field; by biologists and plastic surgeons. On march 25, 2004, Doctors Stedman (and others) published their findings in Nature (VOL 428) under the title Myosin gene mutation correlates with anatomical changes in the human lineage. Their findings point to the gene myosin and its mutated form MYH16 and that the mutation that toke place some 2.4 million years ago as a major step in the development of a larger brain that we now as humans have. In this paper I aim to outline what they have discovered and point out some of the controversy surrounding the findings. It is not my goal to understand how the gene functions, but to rely on accepted judges conclusions that the gene is mutated but I will explain what this can say about the formation of bone structure. What the researchers found centers on the MYH16 mutation and the original myosin gene, a protein that builds strong muscular jaws. Myosin is a protein that works with other proteins to contract muscles, more importantly jaw muscles. The mutation of myosin, MYH16, causes a weaker bite. In their experiments they looked at macaque monkey and human genes to determine how this mutation worked. They found that the gene myosin only worked in the muscles of the head used for chewing and biting. The difference between the two subjects was... ...ary Source: Stedman, Hansell, et. al. Myosin Gene Mutation Correlates with Anatomical Changes in the Human Lineage. Nature, Vol 428, March 28, 2004. The Nature Publishing Group. www.nature.com/nature Secondary Sources: Associated Press. Gene Mutation Said Linked to Evolution. http://abcnews.go.com/wire/Living/ap20040324_1105.html Hopkin, Michael. Jaw-Dropping Theory of Human Evolution. http://www.nature.com/nsu/040322/040322-9.html Kreeger, Karen. Myosin Mutant Points to Human Origins. http://www.eurekalert.org/pub_releases/2004-03/uopm-mmp032204.php Ananthaswamy, Anil. Early Humans Swapped Bite for Brain. http://www.newscientist.com/news/news.jsp?id=ns99994817 Reuters. Scientists: Humans traded jaw strength for big brains. http://edition.cnn.com/2004/TECH/science/03/24/science.brains.reut/index.html