What is kinesthetic memory?

Introduction

Movement is central to sustaining life and fostering learning. Humans learn by kinesthetic, visual, or auditory methods, known as modalities, of processing sensory information. Each learning style engages a specific part of the brain to acquire, process, and store data. Educators develop teaching objectives compatible with students’ learning styles. Although the majority of people, approximately 65 percent, tend to learn best with visual memory, and 20 percent learn best through auditory memory, the 15 percent of humans who function best with kinesthetic memory usually retain information longer according to Bettina Lankard Brown for the Educational Resources Information Center (1998).

Kinesthetic memories are primarily stored in the cerebellum. This part of the brain has less risk for injury than the neocortex and hippocampus, which are involved in visual and auditory learning processes. Although kinesthetic memory is basic to the motions involved in writing, it is often ineffective for people attempting to comprehend academic topics. Kinesthetic types of learning are more suitable for mastering physical movements in sports and dance and in performance control such as playing instruments or singing.

Kinesthetic memory is fundamental to motor activity. Muscles in people and animals recall previous movements according to how body parts such as joints, bones, ligaments, and tendons interact and are positioned. This innate memory of relationships and sequences is the basis of motor skills such as writing or riding a bicycle. Because the brain relies on kinesthetic memory, it does not have to concentrate on how to move body parts. Instead, the brain can be focused for more complex thought processes and enhancement or refinement of movements.

Proprioception, the unconscious knowledge of body placement and a sense of the space it occupies, benefits from kinesthetic memory. Bodies are able to coordinate sensory and motor functions because of proprioception so that reflexes in response to stimuli can occur. These innate motor abilities help most organisms to trust that their bodies will behave as expected.

People have been aware of elements of kinesthetic memory since the late nineteenth century. Teacher Anne Sullivan used tactile methods to teach Helen Keller words. Keller, who was blind, deaf, and mute, touched objects, and kinesthetic sensations guided her to remember meanings. Educators have recognized the merits of kinesthetic learning to assist students, both children and adults, with reading difficulties. Kinesthetic memory has also been incorporated into physical therapies.

Measuring Memory

Kinesthetic memory is crucial for people to function proficiently in their surroundings. Measurement of kinesthetic memory is limited by clinical tools and procedures. Researchers are attempting to develop suitable tests to comprehend the role of kinesthetic memory in maintaining normal motor control for physical movement. Psychologists Judith Laszlo and Phillip Bairstow designed a ramp device that measures motor development and kinesthetic acuity in subjects’ upper extremities but not in specific joints. Kinesthetic acuity is how well people can describe the position of their body parts when their vision is obscured.

Some investigators considered Laszlo and Bairstow’s measurement method insufficient to examine some severely neurologically impaired patients, and it was revised to gauge nervous system proprioceptive deficiencies. Researchers at the University of Michigan-Flint’s Physical Therapy Laboratory for Cumulative Trauma Disorders adjusted ramp angles of laboratory devices in an attempt to create a better kinesthetic testing tool.

Kinesthetic studies examine such variables as gender and age and how they affect perception and short- and long-term kinesthetic memory. Results are applied to create more compatible learning devices and techniques that enhance information retention and recollection. Researchers sometimes assess how vibration of tendons and muscles or anesthesia of joints affects movement perceptions. Studies evaluate how kinesthetic stimuli affect awareness of size, length, and distance.

Kinesthetic memory tests indicate that kinesthetic performance varies according to brain characteristics and changes. Some tests involve tracing patterns at intervals during one week. Subjects are evaluated for how accurate their perceptions and memory of the required movements are from one testing session to the next. Such studies have shown that as people age, their kinesthetic memory capabilities decline. Mental health professionals seek treatment for brain injuries that result in ideomotor apraxia, a memory loss for sequential movements, and ideational apraxia, the breakdown of movement thought.

Intellectual Applications

Some educational specialists hypothesize that people with dyslexia
might lack sufficient kinesthetic memory to recognize and form words. Some dyslexia treatments involve strengthening neural pathways with physical activity to reinforce kinesthetic memory. As a result, some processes become instinctive and the brain can concentrate on understanding academic material and behaving creatively.

Teachers can help students acquire cursive handwriting skills by practicing unisensory kinesthetic trace techniques. Touch is the only sense students are permitted to use with this method, which develops kinesthetic memory for future writing. Blindfolded students trace letters with their fingers in a quiet environment. They repeat these hand and arm movements to form letters, then words. Muscular memories of these movements and body positions improve motor control for writing.

Kinesthetic-tactile methods are applied with some visual and auditory learning styles. In 1943 Grace Fernald introduced her method, VAKT, which used visual, auditory, kinesthetic, and tactile tasks simultaneously during stages of tracing, writing, and pronouncing. Margaret Taylor Smith established the Multisensory Teaching Approach (MTA). Beth Slingerland created the Slingerland Approach, which integrates all sensory learning styles, including kinesthetic motor skills.

Memorization is a fundamental part of musical activities. Singers rely on kinesthetic memory of throat muscles to achieve their desired vocal range and performance. Musicians develop kinesthetic memory skills by practicing pieces without visual cues to avoid memory lapses due to performance anxiety. Panic or nervousness can disrupt kinesthetic memories unless performers develop methods to deal with their fears or excitement.

Studies indicate that kinesthetic memory provokes signals that influence people’s memory. In particular, one study investigated how cues acquired during a learning process affect how people retain memories. Researchers focused on how people interacted with computers, specifically how the use of a pointing device, such as a mouse, and touchscreens affected retention of information viewed on computer screens. Pressing touchscreens, for instance, to control information contributed to increased spatial memory.

Body Intelligence

Kinesthetic memory guides children to develop control over their bodies. Jay A. Seitz, of York College/City University of New York, emphasizes that conventional intellectual assessments of children ignore bodily-kinesthetic intelligence. He argues that kinesthetic education, particularly in the mastery of aesthetic movements, is essential to balance traditional Western formal education, which focuses on cognitive linguistic and logical-numerical skills. Many educators consider those skills superior to other means of expressing intelligence. Seitz states that kinesthetic skills such as those developed by dance have significant cognitive aspects that can enhance academic curricula and children’s intellectual growth.

Jean Piaget
stressed that movement is an important factor in children’s early learning development. Infants’ sensorimotor experiences provide foundational knowledge for speech. Harvard University professor Howard Gardner built on Piaget’s premise by focusing on how people become skilled in coordinating their movements, manipulating items, and managing situations competently, what he terms bodily kinesthetic intelligence.

Kinesthetic memory is one of three main cognitive skills associated with bodily kinesthetic intelligence. Muscle memory allows people to use their bodies artistically to perform desired motion patterns, imitate movements, and create new nonverbal physical expressions. Motor logic and kinesthetic awareness supplement kinesthetic memory and regulate neuromuscular organization and presentation in such physical forms as rhythmic movement sequences and posture. Muscles and tendons have sensory receptors that aid kinesthetic awareness.

Seitz investigated how people use gestures to think and to express themselves. He emphasized that movement is the product of intellectual activity and can be recorded in kinesic language such as choreography, which describes dance sequences. Seitz conducted a qualitative and quantitative analysis of formal and informal dance classes to determine how children use kinesthetic sense and memory and motor logic to learn increasingly complicated dance routines. He noted that children aged three to four years have awareness of movement dynamics such as rhythm and balance.

After being taught simple choreography such as a butterfly-shaped pattern, children were asked to repeat the pattern five minutes later for a kinesthetic memory test. They were also asked to demonstrate a possible final gesture to a pantomime, such as pretending to throw a ball, as a motor logic test. The children were also shown pictures of people, structures, or items and asked to use their bodies to show what movements they associated with the images. All tests were videotaped to assess how children copied, created, or finished movements or the degree to which they failed.

Some children who lack motor skill competence have developmental coordination disorder (DCD), which was first classified in the fourth edition of the
Diagnostic and Statistical Manual of Mental Disorders
(1994, DSM-IV) and is included in the fifth edition, DSM-5. Authorities disagree whether DCD is caused by kinesthetic or visual perceptual dysfunction. Some tests reveal that children who have DCD might not kinesthetically rehearse memories they acquire visually. Laszlo and Bairstow developed kinesthetic sensitivity tests to assess subjects’ motor skills in processing information such as the position and movement of limbs. Kinesthetic perceptual problems result in clumsy movements. Therapists advocating the kinesthetic training approach encourage children to practice movements and develop better body awareness to refine motor skills.

Therapy

Kinesthetic memory contributes to physical fitness and the prevention of injuries. Researchers in the fields of kinesiology and biomechanics study how people move and incorporate kinesthetic concepts. Many athletes participate in Prolates, or progressive Pilates, which is a kinesthetically based conditioning program designed to achieve balance of muscle systems and body awareness of sensations and spatial location. Prolates practitioners view the human body as a unified collection of connected parts that must smoothly function together to achieve coordination, flexibility, and efficiency and to reduce stress.

This exercise program develops the mind-body relationship with movement visualization and concentration skills practice so people can instinctively sense how to fix athletic problems using appropriate muscles instead of repeatedly rehearsing mechanics. Prolates requires participants to achieve control of their center of gravity during diverse movements, thus refining kinesthetic memory. Athletes automatically adjust their physical stance when details about muscles are conveyed to the brain by proprioceptors, which are enhanced by Prolates.

Aquatic proprioceptive neuromuscular facilitation (PNF) is a movement therapy. This treatment helps fibromyalgia sufferers learn appropriate movement patterns to replace damaging behaviors such as clenching teeth, raising shoulders, and other excessive and unconscious muscle contractions and tensions that people use to deal with chronic pain and emotional stimuli. They also learn more efficient breathing techniques.

Erich Fromm encouraged the use of visual kinesthetic dissociation (V/KD), which is a therapy designed to help patients attain detachment from kinesthetic memories acquired traumatically, through physical abuse or rape. Therapists initiate V/KD by asking patients to act as observers, not participants, as though they are watching a movie, not acting in it, as they recall the traumatic experiences in their imagination. By paying attention to visual and auditory cues, patients gradually release kinesthetic memories. Sometimes, therapists ask the patients to play the scenes backward to reinforce nonkinesthetic memories and develop sensations of being empowered and competent.

Bibliography

Crawley, Sharon J. Remediating Reading Difficulties. 6th ed. New York: McGraw, 2012. Print.

Floyd, R. T. Manual of Structural Kinesiology. 18th ed. New York: McGraw, 2012. Print.

Jamison, Lynette, and David Ogden. Aquatic Therapy Using PNF Patterns. Tucson: Therapy Skill Builders, 1994. Print.

Laszlo, Judith I., and Phillip J. Bairstow. Perceptual Motor Behavior: Developmental Assessment and Therapy. New York: Praeger, 1985. Print.

Messing, Lynn, and Ruth Campbell, eds. Gesture, Speech, and Sign. Oxford: Oxford UP, 2004. Print.

Seitz, Jay A. “I Move . . . Therefore I Am.” Psychology Today 26.2 (1993): 50–55. Print.

Sheets-Johnstone, Maxine. "Kinesthetic Memory: Further Critical Reflections and Constructive Analyses." Body Memory, Metaphor, and Movement. Eds. Sabine C. Koch, Thomas Fuchs, Michela Summa, and Cornelia Muller. Vol. 84. Amsterdam: Benjamins, 2012. 43–72. Print.

Wing, Alan M., Patrick Haggard, and J. Randall Flanagan, eds. Hand and Brain: The Neurophysiology and Psychology of Hand Movements. San Diego: Academic, 1996. Print.

What is testicular torsion?

Causes and Symptoms

Testicular torsion is most commonly found in infants, adolescents, or young adult males. Roughly half of the cases occur in the early hours of the morning, and cases usually occur on the left side rather than the right. The condition can occur during sleep, rest, game playing, or hard physical activity, but it is more likely to be caused by direct injury. Testicular torsion may also result if the testicle is unusually mobile within its covering in the scrotum because of inadequate connective tissue.

Testicular torsion makes itself known by pain of varying degrees either in the lower part of the abdomen or in the scrotum itself. The pain intensifies rapidly and is occasionally accompanied by nausea as the testicle becomes swollen and very tender and the scrotal skin becomes discolored. A diagnosis can be made by physical examination.

Treatment and Therapy

Immediate treatment of testicular torsion is necessary. The testicle must be untwisted immediately and blood flow restored to the testicle, the epididymis, and other structures. Otherwise, complete blockage of the blood supply (ischemia) for six hours or more may result in gangrene (tissue death) of the testicle. Even a partial loss of circulation can produce atrophy.

Manual untwisting should be followed by surgery within six hours of the onset of symptoms to ensure that the torsion has been undone successfully and that there is no recurrence. An incision is made in the scrotal skin, and the testicle is secured to the scrotum by small stitches. If irreversible damage has been done, the testicle must be removed. The other testicle, which usually remains capable of producing active sperm, is also anchored to prevent torsion on that side. Prompt surgery generally ensures a complete recovery.

Bibliography:

Behrman, Richard E., Robert M. Kliegman, and Hal B. Jenson, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia: Elsevier/Saunders, 2011.

Montague, Drogo K. Disorders of Male Sexual Function. Chicago: Year Book Medical, 1988.

Rajfer, Jacob, ed. Urologic Endocrinology. Philadelphia: W. B. Saunders, 1986.

Rifkin, Matthew D., and Dennis L. Cochlin. Imaging of the Scrotum and Penis. Florence, Ky.: Taylor & Francis, 2002.

Swanson, Janice M., and Katherine A. Forrest. Men’s Reproductive Health. New York: Springer, 1984.

Taguchi, Yosh, and Merrily Weisbord, eds. Private Parts: An Owner’s Guide to the Male Anatomy. 3d ed. Toronto: McClelland & Stewart, 2003.

“Testicular Torsion.” Urology Care Foundation, Jan. 2011.

What is general adaptation syndrome (GAS)?

Introduction

Stress
is the rate of wear and tear, in particular the strain on the nervous system, in an organism. It is the sum of all adaptive reactions in the body and manifests itself by a specific syndrome that consists of all the nonspecifically induced changes within the individual.

Adaptive reactions, or adaptation, are the processes by which the organism adjusts itself to changed circumstances. A syndrome is a group of symptoms usually appearing together in a disease. Nonspecific changes are those that involve many organs of the body and can be induced by a variety of causal factors. Nevertheless, the form in which these changes appear is quite specific: It is the general adaptation syndrome (GAS), first described by Hans Selye in the 1950’s. The explanation of this seeming contradiction lies in the fact that stress produces two kinds of change: one that is nonspecifically caused and appears in a nonspecific form, called the primary change; and one that, although nonspecifically caused, is specific in form, the secondary change called general adaptation syndrome.

Stages

The general adaptation syndrome is composed of three stages. The first is the alarm reaction, in which the body arms itself for defense against an aggression (such as a bacterial or viral infection, physical damage, or a strong nervous stimulus) but has had no time to adjust itself to the new condition. The second is the stage of resistance, in which the body succeeds in adapting itself to the condition. The third is the stage of exhaustion, in which the body’s resistance breaks down with the loss of its adaptive response, a development that can lead to death.

There are three main signs of the first (alarm reaction) stage: an enlargement of the cortex (outer layer) of the adrenal glands; a degeneration of the thymus gland (located in the front of the chest, playing an important role in defense against infections) and the lymphatic system (the vessels that carry the lymph, or white blood, and the lymph nodes, including the spleen and tonsils); and the appearance of gastrointestinal (stomach and gut) ulcers.

In the second (resistance) stage, the body is at its highest level of adaptation, above the normal range, and the body organs return to their normal state. The adrenals, which in the first stage completely discharged their hormones, again accumulate large amounts of hormones. In the last (exhaustion) stage, the adrenals again lose their secretions and the other organs degenerate even more; the body’s resistance drops to below-normal levels. Although the third stage can lead to death, this is not necessarily the outcome. Often a person undergoes all three stages only to recuperate at the end. A marathon runner goes through all stages of the general adaptation syndrome and, although completely exhausted at the end of the race, regains strength after only a few hours of rest.

The adrenal glands have an important role in the general adaptation syndrome. These are two little glands, each sitting on top of one of the kidneys. The gland is composed of an outer part, or cortex, and a core, or medulla. The cortex is subdivided into layers, one of which manufactures the so-called mineralocorticoids, aldosterone and desoxycorticosterone (DOCA), which have a role in electrolyte (salt) metabolism and have a proinflammatory effect in the body; the second layer secretes the glucocorticoids, cortisol and cortisone, which play a role in sugar metabolism and have an anti-inflammatory effect. Inflammation is a local defense mechanism of the body; the anti-inflammatory hormones suppress this defensive weapon. They also promote the spread of infections and the formation of gastrointestinal ulcers. In spite of this apparent antagonism between the two types of cortical hormones, their effects are absolutely necessary for the body to resist aggression. If the adrenal glands are damaged to a degree that they can no longer produce these hormones, then, without treatment, death is inevitable. In contrast, the hormones secreted by the medullary part of the adrenal gland, epinephrine (also known as adrenaline) and norepinephrine, are not absolutely necessary for survival because they are also produced by nerve endings in other parts of the body.

Agents and Effects

Any agent that attacks the body will induce both specific and nonspecific effects. These are direct effects, such as a burn wound, and indirect effects, which are of two kinds: one that triggers the proinflammatory mechanism, inducing it to fight the damage, and one that triggers the anti-inflammatory mechanism, which limits the extent of the damage. The system is actually a bit more complex than this; another component, the so-called conditioning factors, must be taken into account.

Conditioning factors are agents or situations that themselves have no independent effects; however, they can modify the response to a particular stimulus. There are external and internal conditioning factors. The external ones comprise, for example, geographical, social, and nutritional factors, whereas the internal conditioning factors are those determined by genetics and previous experiences.

Based on this information, the sequence of events that occurs when a stressor (a stress inducer) acts on an individual may be summarized as follows: The brain senses the stimulus and sends messages to the adrenal medulla, inducing it to release epinephrine, and to the pituitary gland, inducing it to release adrenocorticotropic hormone (ACTH). Epinephrine has two effects: It acts on the pituitary gland, increasing the secretion of ACTH, and it acts on most of the body tissues, increasing their rate of activity. The heart rate, breathing rate, and blood pressure are increased, as well as the blood sugar level. All these changes prepare the organism for fight or flight. ACTH, in the meantime, reaches the adrenal cortex and induces the secretion of anti-inflammatory hormones. Simultaneously, proinflammatory hormones are released. Both types act on the tissues affected directly by the stressor and also have a systemic effect on the whole body, inducing the general adaptation syndrome. The particular type and degree of response are modulated by the conditioning factors.

Stress and Disease

Disease
could be defined as an alteration, as a result of a changed environment, of the structure and function of tissues that interferes with their ability to survive. To produce a disease, two types of factors are necessary: environmental, or external, factors; and the response of the organism, or internal factors. The discovery that stress elicits a specific response, the general adaptation syndrome, made it possible to apply exact measurements to the state of stress and its consequences (stress-induced diseases). Although the general adaptation syndrome has a defensive purpose in the body because it promotes adaptation to new conditions, an excess of adaptive hormones can induce untoward symptoms, that is, cause disease. This aspect of stress, that adaptive reactions can themselves become harmful, is one of the most important characteristics of the phenomenon. It made physicians realize that there are many diseases that are not caused by specific agents such as microorganisms, toxic chemicals, or injuries, but rather by the response of tissues to these aggressors (stressors). An example of this type of disease is an allergy such as hay fever or hives. It was found that the inflammation of the nasal passages, eyes, or skin is caused by the tissues reacting against chemicals contained in pollen or in some foods. The body fights these reactions with glucocorticoids (anti-inflammatory hormones) secreted by the adrenal cortex. This discovery, that adrenal glucocorticoids have anti-inflammatory and antiallergic effects, was immediately applied in clinical medicine to treat very grave diseases such as arthritis and asthma. The glucocorticoids proved to be lifesaving in these cases.

As the phenomenon of stress is primarily produced by a strain on the nervous system, it seemed reasonable to look into the role of the general adaptation syndrome in nervous and mental diseases. It became clear that what is called maladaptation can be the cause of a nervous breakdown or even outright mental disease. This realization led physicians to search for the connection between psychological maladjustments and bodily diseases. The result was the foundation of the medical specialty called psychosomatic medicine. It is known that what is called “executive disease”—that is, gastrointestinal ulcers and high blood pressure, sometimes accompanied by a nervous breakdown—is induced by the inability to adjust to a new situation, by an exceptionally heavy workload, or by fear of responsibility and an inability to make decisions. Psychosomatic medicine attempts to elucidate the way in which maladaptation causes disease as well as the way in which it influences aging and the degenerative diseases of old age, in particular, coronary heart disease and cancer. It is known that chronological age is not the same as physiological age. That is, a fifty-year-old person, from the point of view of tissue integrity and function, may be much older than a seventy-year-old person whose tissues are still in good functioning order. The underlying causes of these individual differences are based in an individual’s differential response to stressful situations.

As an outgrowth of the study of stress and the GAS, two subfields of research opened up: the psychology of stress and psychophysiology. The study of stress psychology implies that human behavior is affected by biological mechanisms that appear to be a common heritage of all mammals. The aim of the study would be to enable people to control their emotions and, thus, their behavior. This would be of obvious benefit in the rehabilitation of persons who come in conflict with the law because of their violent behavior and, possibly, would allow society to reduce violent crimes. Psychophysiology, which was founded as a separate branch of psychology in 1960, studies psychological or behavioral variables with their respective physiological responses. For example, one of the major preoccupations of psychophysiology is the study of biofeedback, or the control by subjects of their own heart rates or brain function. There is great interest in biofeedback studies, because it is hoped that psychosomatic disturbances could be treated successfully by this technique. In 1949, researchers studied two groups of patients: one group that had recurring head and neck pains, and another that complained of cardiovascular (heart) symptoms. When the researchers administered painful stimuli to the two groups, the members of each group reported an increased intensity in its particular symptoms, although they had been well before the test. The researchers concluded that psychosomatic disorders are caused by the exaggerated response of a particular physiological system, characteristic for the individual. This phenomenon has been named symptom specificity.

History of Stress Research

In ancient Greece, the father of medicine, Hippocrates, taught that in every diseased body there is a natural force that fights the disease from within. Later, in eighteenth century England, John Hunter stated that every injury has the tendency to produce the means for a cure. That is, the concept of being sick includes a battle between the aggressor and the defense mechanisms of the body. Rufus of Ephesus, a Greek physician, around the year 100 c.e. discovered that high fever had a beneficial effect on the progression of many illnesses. This fact was rediscovered by a nineteenth century Viennese psychiatrist, Julius Wagner von Jauregg, who tried to alleviate the mental disease of patients in the last stage of syphilis. In 1883, he observed that the symptoms improved markedly when the patients contracted typhoid fever. Subsequently, he introduced the treatment with malaria and achieved spectacular results, but without knowing the reason for the cure.

The great French physiologist Claude Bernard, in the nineteenth century, taught that a characteristic of living organisms is their ability to maintain a constant internal environment in spite of significant fluctuations in the external conditions in which they live. Walter Bradford Cannon, at Harvard University, gave this phenomenon the name “ homeostasis.” He also coined the term “emergency reaction” to describe the immediate functional changes occurring in the body as a consequence of stressful stimuli. When the homeostatic mechanisms of the body fail to maintain the constancy of the internal medium, disease and eventually death ensue. Although all these findings converged in the treatment of disease by nonspecific means, it was a Viennese physician, Selye, who formulated a scientific theory of the “syndrome of being sick,” or, in other words, the concept of stress and of the general adaptation syndrome.

Selye, who was born in Vienna but immigrated to Canada, discovered in 1936 that the physical response to stress could cause disease and even death. He detected the effects of stress when he injected ovarian extracts into laboratory rats. He found that the extract induced enlargement of the adrenal cortex, shrinkage of the thymus gland, and gastric ulcers. Selye realized that it was the stress caused by the impurities in the extract that induced the characteristic changes. He extrapolated his findings to humans and stated that stress could initiate disease and cause death. In 1950, he published The Physiology and Pathology of Exposure to Stress, in which he gave a detailed description of the general adaptation syndrome concept.

In the beginning, the medical establishment was reluctant to accept the idea that hormones could have a role in the causation of nonspecific aspects of disease; until that time, hormones were known to act only on specific target tissues. They caused disease either by too little or too much of a particular hormone. For example, a lack of growth hormone resulted in dwarfism, whereas too much of the same created a giant. Selye, however, postulated general hormonal effects that transcended their known immediate action on target tissues. Another, unjustified, criticism of his theory was that he attributed too great a role to the hormonal system, neglecting the part played by the nervous system. These criticisms did not hold up in the long run, and Selye’s teachings on stress and the general adaptation syndrome were in the end accepted by medical and physiological researchers.

Bibliography

Kahn, Ada P., ed. The Encyclopedia of Stress and Stress-Related Diseases. 2d ed. New York: Facts On File, 2005. Print.

Khazan, Inna Z. The Clinical Handbook of Biofeedback: A Step by Step Guide for Training and Practice with Mindfulness. Chichester: Wiley-Blackwell, 2013. Print.

Marks, David, Michael Murray, Brian Evans, and Emee Vida Estacio. Health Psychology: Theory Research, and Practice. 3rd ed. London: Sage, 2011. Print.

Romas, John A., and Manoj Sharma. Practical Stress Management: A Comprehensive Workbook for Managing Change and Promoting Health. 5th ed. San Francisco: Pearson, 2009. Print.

Sapolsky, Robert. Why Zebras Don’t Get Ulcers: An Updated Guide to Stress, Stress-Related Diseases, and Coping. New York: Freeman, 1998. Print.

Seaward, Brian L. Managing Stress: Principles and Strategies for Health and Well-being. 7th ed. Sudbury: Jones, 2012. Print.

Selye, Hans. The Stress of Life. Rev. ed. New York: McGraw-Hill, 1978. Print.

Wulsin, Lawson R. Treating the Aching Heart: A Guide to Depression, Stress, and Heart Disease. Nashville: Vanderbilt UP, 2007. Print.

What did Ruth, Bronia and Jan do to stop the farmer from handing them over to the burgomaster?

As they made their way through Bavaria, the children made a stopover on a farm and decided to spend the night in a barn on the farm. The farmer discovered them in the morning as they slept. He threatened to hand them over to the burgomaster, who was in charge of repatriating Polish refugees back to their home country. The children had no option but to negotiate for their release without information reaching the burgomaster.

They offered to work on the farm as compensation for their initial stay at the barn. The farmer agreed to the offer, and his wife welcomed the children to stay. She prepared a meal for the children, and later different chores were assigned to them. The arrangement helped them evade the Burgomaster. However, the children were later discovered, and an order for their repatriation was issued. The farmer rescued the children from repatriation, by arranging for their escape down a river using his old canoes.

What is sterilization?

Indications and Procedures

Sterilization, of either a woman or a man, is a permanent method of surgical contraception

that is used to render a couple incapable of conceiving children. Female sterilization involves the blockage or removal of the Fallopian tubes, the ovaries, or the uterus. Male sterilization involves the interruption of the vas deferens, the pathway of sperm from the testicles. The vas deferens may be reconnected, while many of the sterilization procedures performed on women are considered irreversible. Although the most frequently utilized types of female sterilization possess the potential for reversal at a later date, attempted reversals are often unsuccessful. Therefore, a woman choosing this type of contraception should be quite sure that she does not want another child. By the beginning of the twenty-first century, sterilization was the most prevalent form of contraception worldwide, with an estimated one hundred million women choosing the procedure. In the United States, approximately 700,000 women are sterilized
each year. One reason that female sterilization is a popular form of contraception with women is because it represents a onetime effort that is usually both simple and the cause of only mild side effects. Another advantage of sterilization over the use of birth control pills is its high success rate: Less than a tenth as many sterilized women will become pregnant (as a result of improperly performed or incomplete procedures) as will women who rely on birth control pills for their contraception. The use of condoms, diaphragms, and all the other barrier pregnancy prevention devices are even less effective than birth control pills.

Before considering the various aspects of sterilization, it is useful to describe the female reproductive system
and its biological operation. This organ system consists of two ovaries connected to paired Fallopian tubes that open up into the uterus. The entire system passes through a monthly menstrual cycle that is controlled by the female hormones progesterone and the estrogens. During each menstrual cycle, an ovary produces one egg (sometimes more) in a graafian follicle. The egg then enters one of the Fallopian tubes, which carries it to the uterus. If an egg is fertilized, it then implants in the endometrial tissue that lines the interior of the uterus and subsequently develops into an embryo.

Egg formation and uterus preparation for implantation are controlled by the female hormones. Once an egg implants, the uterus is kept in a state that optimizes pregnancy with the production of progesterone and related hormones, first by the corpus luteum (originally the graafian follicle that yielded the egg) and then by the placenta that forms from commingled uterine and fetal tissue. In the absence of fertilization, the menstrual cycle continues, most of the endometrium breaks down into the monthly menstrual flow, and the process begins over again.

Menstruation stops between forty-five and fifty-five years of age in most women, causing them to undergo a process called the menopause. After hundreds of repeated menstrual cycles since puberty, the graafian follicles stop producing eggs. Cessation of the menstrual cycle means that female hormone production stops almost entirely. Therefore, the menopause is accompanied by gradual atrophy of the sex organs and possible related symptoms, including hot flashes, depression, and irritability. When ovariectomy or hysterectomy is performed to achieve sterilization, these symptoms of the menopause may be induced prematurely.

For pregnancy to occur, then, a woman must have at least one functional ovary that produces eggs, an intact and operational Fallopian tube to transport the egg, and a functional uterus. The surgical methods that are used for sterilization must, therefore, make one of these reproductive organs nonfunctional. Most often, sterilization cuts and then blocks or removes the Fallopian tubes. Such interruption of the Fallopian tubes is the preferred form of female sterilization surgery for three reasons. First, these operations are relatively minor surgical procedures and are unlikely to be very risky. In addition, premature menopausal symptoms are not produced because the menstrual cycle continues. Finally, when carried out appropriately, interruption of the Fallopian tubes can sometimes be reversed if the patient changes her mind as a result of altered marital arrangements, lifestyle, or financial circumstances.

In many cases, a 1-centimeter to 1.5-centimeter section in the middle of each Fallopian tube is removed surgically or burned away via electrocoagulation. Alternatively, plastic or metal clips are used to close off each tube, or similar tube closure is effected by making a loop in each Fallopian tube and closing it off with a tight plastic ring or band.

Very frequently, the method that is used to damage the Fallopian tubes is a form of surgery called a laparoscopic procedure. The patient is given a general anesthetic, a very small incision is made close to the navel, and a flexible lighted tube—a laparoscope—is inserted into the incision. The laparoscope is equipped with fiber optics and enables an examining physician to see into the abdominal (peritoneal) cavity. Visibility of the Fallopian tubes and the other abdominal organs with laparoscopic examination is enhanced by pumping harmless carbon dioxide gas or nitrous oxide gas into the abdomen, to distend it. This process is called pneumoperitoneum.

After laparoscopic examination identifies the operation site in the peritoneal cavity, the surgical tools for cauterization, cutting, banding, and other aspects of interrupting the Fallopian tubes are passed through the laparoscope, and the chosen surgical interruption procedure is carried out. An entire laparoscopic procedure often takes less than thirty minutes, which is one of the reasons for its great popularity. In addition, women who choose to undergo such surgery can usually go home in a few hours and are fully recovered after only one to two days of postoperative bed rest, followed by a week or so of curtailed physical and sexual activity.

Despite the popularity of the laparoscopic procedure for sterilization, some physicians prefer to carry out sterilization by use of a larger surgical incision through which the tubes are altered directly. Despite the larger size of the incision, the physicians who use this method believe that it is safer and more sure of success and that it has a greater potential for reversibility.

Other methods for sterilization through Fallopian tube surgery are culdoscopy and chemical means. Culdoscopy, in which an optical instrument and surgical tools reach the Fallopian tubes through the uterus, has a somewhat lower success rate than do the laparoscopic procedure and the direct method. Chemical methods for tubal closure have also been attempted and are not viewed as viable because of a low success rate and frequent, serious postoperative complications.

The other avenues available for sterilization are ovariectomy (removal of the ovaries) and hysterectomy (removal of the uterus). Both of these types of sterilization surgery are much more serious and risky. In addition, ovariectomy and hysterectomy are totally irreversible. Ovariectomy, a more complicated procedure than the one inactivating the Fallopian tubes, is usually utilized only when both ovaries are diseased. This procedure produces an early menopause because most of a woman’s female hormones are made by the ovaries’ graafian follicles.

Hysterectomy is the most uncommon form of female sterilization because it requires even more extensive surgery and can have fatal complications. While the operation is sometimes carried out when a woman has completed her desired family, most hysterectomies are curative. They are performed in cases of very severe and widespread endometriosis and in the presence of other serious gynecological problems.

An alternative available to couples is sterilization of the male partner. This type of surgery, a vasectomy
, is quite simple, brief, and relatively painless and only rarely results in physical or psychological complications. In addition, after vasectomy only one-tenth of a percent of involved couples experience undesired pregnancies. Vasectomy has no effect on sexual desire or male hormone production. It is also relatively easy to reverse such surgery, if so desired later in life. Consequently, the method has become quite popular. In the United States, for example, it was estimated in the early twenty-first century that approximately 500,000 men undergo this sterilization surgery each year.

Vasectomy involves the surgical interruption of the tube—the vas deferens—through which sperm leave the testicle. Vasectomy is carried out after identifying the position of each tube and injecting it with a local anesthetic. A one-inch-long incision is made in the scrotum, each tube is cut near its middle, a small piece of the tube is removed to keep the cut ends apart, and all the ends are closed with sutures, by cauterization, or with metal or plastic clips.

Vasectomy has a short recovery period and does not stop ejaculation during postoperative intercourse. It is important to note, however, that azoospermia (a lack of sperm in the ejaculate) is achieved only after six to fifteen postoperative ejaculations. Therefore, to ensure sterility, it is critical that the condition of azoospermia has been achieved before the patient carries out intercourse without using condoms or other protective measures. After two consecutive sperm counts indicate azoospermia, unprotected intercourse is deemed safe.

Uses and Complications

The most popular method of female sterilization is to block or damage both Fallopian tubes so that eggs cannot pass through them to the uterus. In some cases, the tubes are removed completely. While removal ensures successful sterilization, it is irreversible and considered too drastic by women who might someday wish to reverse the operation. Several popular alternatives to removal are the methods that interrupt the tubes, retaining the potential for reversal at a later date. Women undergoing this type of surgery are warned, however, that such reversal may be impossible.

When the Fallopian tubes are damaged but not entirely closed off, they may reconnect and cause an ectopic pregnancy

, in which a fertilized egg implants in one of the tubes and begins to grow into a fetus. Ectopic pregnancy can be fatal to the pregnant woman, and when identified, it is corrected by surgical removal of the fetus. Although the cause of this problem is not clear, there is some thought that alteration of the interior wall of the tube or slowed passage of an egg through the tube may be the causative agent. Fortunately, ectopic pregnancy is relatively uncommon.

Whether the laparoscopic method or the direct approach is utilized, the best time to carry out female sterilization is at the end of a menstrual cycle; at this time, early pregnancies cannot be compromised. It is advised that the patient discontinue intercourse and the use of birth control pills for at least a month prior to the surgery. The cessation of intercourse eliminates the chance of unexpected pregnancy at the time of surgery, while stopping the use of birth control pills decreases the possibility of blood-clotting problems.

The complications of all types of Fallopian tube surgery can include internal bleeding, blood-clotting problems, injury to the intestines and the other abdominal organs, and abnormal postoperative menstrual cycles. It is estimated, however, that these complications occur in less than 1 percent of patients. A more frequent problem is the difficulty of restoring fertility by reconnecting the Fallopian tubes (with only a 20 to 40 percent success rate).

Hysterectomy is never a highly recommended female sterilization operation. Rather, it is used mostly in those cases where other uterine health problems are sufficiently severe to make the process sensible. These problems may include recurrent and heavy vaginal bleeding, severe endometriosis, and chronic pelvic inflammatory disease (PID). This extensive surgery results in a high rate of complications and a significant number of deaths.

A woman may seek sterilization when she is having an abortion or soon after giving birth to an undesired child. Such a decision, perhaps made hastily at a time of intense emotional stress, is not advisable. It is essential that a sterilization operation be performed only after careful reflection. Divorce or the death of a spouse and subsequent remarriage may cause a sterilized woman regret should she desire more children.

Severe psychological problems for both the patient and her family may accompany female sterilization. Therefore, it is highly recommended that these women, their families, and both partners in married couples consult a gynecologist and a psychological counselor before proceeding with female sterilization surgery.

In contrast to the complications associated with female sterilization, with vasectomy a day of bed rest and a week of avoidance of all strenuous physical activity usually produce complete recovery. Health complications occur in less than 5 percent of vasectomy patients. In addition, these problems are usually minor and almost never lead to fatalities. Skin discoloration, swelling, and oozing of clear fluid from the scrotum incision are common symptoms immediately following the surgery, but they spontaneously disappear as the healing process continues. Less frequently, inflammation and a condition called sperm granuloma can occur when sperm leak out of the cut portion of the vas deferens closest to the testicle. A granuloma produces severe inflammation, pain, and swelling. When this condition does not subside spontaneously, the granuloma must be removed surgically.

Perspective and Prospects

While surgical sterilization was first described in the nineteenth century, it was not widely available for contraception until the 1920s, nor did it become popular immediately. Though voluntary sterilization began slowly in the 1950s, its use accelerated until it became a popular form of fertility control in the industrial and developing nations of the 1970s.

A source of discontent with the sterilization techniques that are available is their total or poor reversibility when fertility reinitiation is desired later in life. This discontent has occurred because, with passing time, an unexpectedly large segment of sterilized men and women have come to regret their decisions regarding sterilization. All hysterectomies and Fallopian tube removals are forever irreversible, and a low reversibility rate is seen even in the two most popular—and potentially reversible—sterilization methodologies: Fallopian tube interruption and vasectomy.

Consequently, the development of sterilization surgery has been directed toward devising methods that will enable much larger incidences of reversibility, where desired. One direction has been to expand the understanding of Fallopian tube and vas deferens anatomy and functionality. Particularly useful results obtained include the realization that destruction of the nerves that control the operation of these organs can make the recovery of fertility incomplete or impossible even when excellent corrective surgery reverses the original interruption of continuity. This discovery has led to the development of more sophisticated interruption surgery that is less likely to damage the vas deferens or Fallopian tube nerve integrity. Some improvement of the reversibility of these operations has been obtained in this manner, but the overall results are still far from satisfactory.

Consequently, many other surgical techniques have been attempted, including the placement of removable plugs in the Fallopian tubes or of tiny, faucet-like valves in the vas deferens that allow or stop the ejaculation of sperm. Other useful methods to ensure reversible sterilization may include hormones, vaccines against eggs and sperm, and chemical treatments. It is hoped that improved antifertility methodologies will be developed that combine more reversible surgical sterilization, vaccines, chemicals, and various contraceptives.

Bibliography

Ammer, Christine. The New A to Z of Women’s Health: A Concise Encyclopedia. 6th ed. New York: Checkmark Books, 2009.

Connell, Elizabeth B. The Contraception Sourcebook. Chicago: Contemporary Books, 2002.

Denniston, George C. Vasectomy. Victoria, B.C.: Trafford, 2002.

Health Library. "Tubal Ligation—Laparoscopic Surgery." Health Library, April 22, 2013.

Health Library. "Vasectomy." Health Library, October 26, 2012.

Mastroianni, Luigi, Jr., Peter J. Donaldson, and Thomas T. Kane. Developing New Contraceptives: Obstacles and Opportunities. Washington, D.C.: National Academy Press, 1990.

Parker, James N., and Philip M. Parker, eds. The Official Patient’s Sourcebook on Vasectomy. [N. p.]: ICON Group, 2007.

Sherwood, Lauralee. Human Physiology: From Cells to Systems. 8th ed. Belmont, Calif.: Brooks/Cole Cengage Learning, 2013.

Storck, Susan. "Sterilization Surgery—Making a Decision." MedlinePlus, February 26, 2012.

Wigfall-Williams, Wanda. Hysterectomy: Learning the Facts, Coping with the Feelings, and Facing the Future. New York: Michael Kesend, 1986.

How can I write a diary extract about arriving at the old house in the forest in "The Listeners"?

Walter de la Mare's poem "The Listeners" is written in the third person, with a narrative viewpoint limited to the perceptions and thoughts of "the Traveller" in the beginning, but expanding towards the end of the poem to include a description of the "listeners'" actions (or more precisely, inactions). Your main choice in writing this assignment is point of view.

The obvious point of view is that of the Traveller, but there are other possibilities. You could take a creative approach and write from the point of view of the Traveller's horse, who also is arriving at the house and probably does not enjoy a long journey in the dark through the forest, where he risks breaking an ankle or leg on tree roots or animal burrows. The horse is introduced as patiently waiting while the Traveller does his errand:

And his horse in the silence champed the grasses

Of the forest’s ferny floor:

You also could try writing from the viewpoint of the listeners or of the bird that flies out of the turret in the fifth line, who has a bird's eye view of the entire scene:

And a bird flew up out of the turret,

Above the Traveller’s head....

Whichever viewpoint you choose, you should write in the first person and recount the events in chronological order. 

What was the Freedmen's Bureau?

The Freedmen’s Bureau was created after the Civil War ended to help the former slaves. The former slaves had little experience with freedom. Many of them had been born into slavery. They had no idea how to provide for their basic necessities since their master handled these needs. Being free was a new experience for many former slaves.

The Freedmen’s Bureau was created to help the former slaves adjust to freedom. The Freedmen’s Bureau provided the former slaves with food, clothing, and medical care. The Freedmen’s Bureau helped the former slaves establish schools for their kids. The Freedmen's Bureau helped them get jobs, get fair wages, and sometimes get transportation to their jobs. Later on, the Freedmen’s Bureau got more power by being able to prosecute people who violated the rights of former slaves. Special courts were established to for this purpose.

The purpose of the Freedmen’s Bureau was to help the former slaves adjust to being free. It was able to do this after the Civil War ended and during Reconstruction.

What is cartilage?

Structure and Functions

Cartilage shapes the skeleton before bone formation begins in the embryo and persists in certain areas of the human skeleton during adulthood. It supports and protects body parts and acts as a shock absorber for the bones. Cartilage is a specialized nonvascular and nonlymphatic supporting tissue without a nerve supply containing cellular components, extracellular components, and water. The extracellular content consists of a dense matrix of collagen and elastin fibers and a proteoglycan-rich extracellular matrix (ECM). Chondrocytes are specialized cartilage cells. They produce the ECM, become embedded within it, and maintain their ECM under homeostatic conditions. In the adult, cartilage is a tough but flexible tissue present in the skeletal and respiratory system and the ear, where its main function is structural support. The thoracic skeleton has costal cartilages. In the respiratory system, cartilage supports airway shape and ensures its openness. Cartilage keeps the external ear open in order for sound waves to reach the internal ear canal.

There are three kinds of cartilage: hyaline cartilage, fibrocartilage, and elastic cartilage. Each type has different properties that perform a particular function at that unique site and dictate the type and depth of the stresses that it can withstand. The most prevalent of them is hyaline cartilage, which is strong and made of a shiny bluish-white translucent type II collagen. In joints, hyaline cartilage is the articular cartilage that covers the end bones, providing the smooth articular surface of joints and resilience by transferring loads applied to it. Hyaline cartilage prevents possible harmful stress impact to the bone and offers a low-friction bearing surface permitting free joint movement, which is essential for locomotion. It is found in the larynx, ear, nasal septum, and sternum and between the ribs. The nonarticular cartilage includes the elastic cartilage and fibrocartilage. Fibrocartilage contains type I collagen and is found in persistent stress areas such as the meniscus and intervertebral discs. The elastic cartilage includes a network of elastin fibers that gives great flexibility while enabling repeated bending to parts of the nose, ear, epiglottis, and trachea.

The interaction of water with the ECM gives cartilage its biomechanical properties, hence its cushioning function. The water content allows load-dependent deformation of the cartilage tissue while providing nutrition, facilitating lubrication, and producing a low-friction surface against other cartilage or bones.

Disorders and Diseases

Disruption to cartilage homeostasis—as a result of genetic disorders, inflammation, malignancy, or stressful biomechanics to the tissue—compromises this well-organized structure. Therefore, tissue damage might significantly affect a patient’s quality of life, since it is difficult to restore or duplicate cartilage after it has been weakened or worn away. The homeostatic mechanisms of cartilage are essential to sustain a healthy, balanced tissue when disease or injury occurs. Therefore, joint degeneration and pain takes place at the articular cartilage when homeostasis is broken. Breathing problems are present when cartilage of the airways is affected. Cosmetic, hearing, or smelling problems might arise if cartilage of the ear or nose are involved.

Some of the most common cartilage medical conditions are osteoarthritis, costochondritis, achondroplasia, spinal disk herniation, relapsing polychondritis, tumors, and articular cartilage injury. Most of these conditions may not emerge until later in life. Yet, it is possible for young athletes participating in high-demand sports such as basketball, football, or soccer to damage their cartilage and suffer from long-lasting cartilage injuries.

Osteoarthritis (OA) is the noninflammatory degeneration of the articular cartilage. Cartilage around bones becomes thin or completely worn out, producing a bone-to-bone joint, decreasing joint motion, and causing pain. OA is mainly a result of wear and tear, and its treatment might include lifestyle modification, patient education, physical therapy, exercise, or invasive surgery such as arthroplasty. Costochondritis, the inflammation of costal cartilages, causes chest pain. Its treatment includes anti-inflammatory medications, rest, or local heat or ice. Achondroplasia is a genetic disorder in which chondrocyte proliferation is reduced during childhood, causing dwarfism. Presently, there is no treatment for achondroplasia. Cartilage deterioration of the ears, nose, throat, joints, or rib cage is characteristic in relapsing polychondritis. Its etiology is not well known, but it might be an autoimmune disease, in which the body’s immune system targets and destroys its own cartilage tissues within the body. Immunosuppressants are used to treat this condition. During spinal disk herniation, cartilage malfunction causes an asymmetric compression within the intervertebral disk, producing a herniation of its soft content that compresses nearby nerves and results in back pain. Pain medications, rest, physical therapy, or weight control might alleviate symptoms. Surgery is considered only if there is neurological deficit. Tumors formed in cartilage can be either malignant (chondrosarcoma) or benign (chondroma). Surgery is the main treatment, but it is based on the location or severity of the cancer. Articular cartilage injury results either after one direct impact to the knee, from a series of minor injuries over time, or after a pivot on a bent knee causing a meniscus tear. Damage can be mild to severe, and treatment might be nonsurgical or surgical. Recommended conservative measures include exercises to develop muscle strength around the knee, weight loss, shock-absorbing insoles, or hyaluronic acid injections to enhance joint lubrication and reduce biomechanical abrasion.

Perspective and Prospects

The first recorded acknowledgment of cartilage has been traced to Aristotle in the fourth century BCE; in the second century BCE, the medical works of the famous Roman physician Galen briefly described cartilage. In 1543, Andreas Vesalius
included an influential chapter on cartilage on his anatomy book De humani corporis fabrica (On the workings of the human body). Two hundred years later, in 1743, Scottish anatomist and surgeon
William Hunter
stated that “an ulcerated cartilage is a troublesome disease that once destroyed, it is never recovered.”

In the first decade of the twenty-first century, despite novel therapies, medications treating symptoms associated with cartilage damage, or surgical interventions, Dr. Hunter’s 1743 statement still remains valid. No universal method or therapy has been discovered that has the ability to repair or induce new cartilage growth resembling native cartilage in structure and functional load bearing. The vascular phase of any bodily tissue repair mechanism is essential to achieve tissue healing, but cartilage is a nonvascular structure without a blood supply to promote the healing process. Therefore, the repair capacity of cartilage is very limited when it is injured. It is known that cartilage will be restored if direct mechanical injury to the matrix does not damage the cells and they are able to resynthesize new ECM. However, the biomechanical damage of chondrocytes and matrix from trauma will result in only some degree of repair dependent on age, size, and depth of injury or mechanical misalignment of the joint.

Established procedures that can improve clinical symptoms include lavage, shaving and debridement, or marrow stimulation techniques (abrasion arthroplasty and microfracture). A second group of procedures aimed to restore the cartilage surface comprises autologous chondrocyte implantation and osteochondral autograft/allograft transplantation. Knowledge about the cartilage matrix composition, such as the identification of molecular markers in synovial
fluid or serum, can be applied to track changes in cartilage metabolism and to evaluate cartilage damage. Other novel therapies integrate the latest molecular biology methodologies with tissue engineering within transplantation surgery, with the aim of achieving reconstruction of the integrity of the cartilage surface and thus allowing patients to live an unconstrained, pain-free life.

Bibliography

Benedek, T. G. “A History of the Understanding of Cartilage.” Osteoarthritis and Cartilage 14, no. 3 (March, 2006): 203–9.

Bhosale, Abhijit M., et al. “Articular Cartilage: Structure, Injuries, and Review of Management.” British Medical Bulletin 87 (August, 2008): 77–95.

Buchanan, W. W. “William Hunter (1718–1743).” Rheumatology (Oxford) 42, no. 10 (October, 2003): 1260–61.

Dam, Erik B., et al. “Identification of Progressors in Osteoarthritis by Combining Biochemical and MRI-Based Markers.” Arthritis Research and Therapy 11, no. 4 (July, 2009): R115.

Firestein, Gary S., et al., eds. Kelley’s Textbook of Rheumatology. 8th ed. Philadelphia: Elsevier, 2008.

Goldring, M. B., et al. “Cartilage Homeostasis in Health and Rheumatic Diseases.” Arthritis Research and Therapy 11, no. 3 (May, 2009): 224.

International Cartilage Repair Society. "What Is Cartilage?" International Cartilage Repair Society, 2013.

MedlinePlus. "Cartilage Disorders." MedlinePlus, June 7, 2013.

Samuels, J., et al. “Osteoarthritis: A Tale of Three Tissues.” Bulletin for the NYU Hospital for Joint Diseases 66, no. 3 (2008): 244–50.

Seibel, M. J., P. Robin Simon, and John P. Bilezikian, eds. Dynamics of Bone and Cartilage Metabolism. 2d ed. San Diego, Calif.: Academic Press, 2006.

Thorstensson, Carina A., et al. “Help-Seeking Behaviour Among People Living with Chronic Hip or Knee Pain in the Community.” BMC Musculoskeletal Disorders 10 (December, 2009): 153–63.

UCSF Medical Center. "Cartilage Repair." University of California San Francisco, 2013.

What literary techniques are used and what are the effects of these techniques in Sonnet CXVI (116) by William Shakespeare?

Shakespeare's Sonnet 116 is about the definition of true love. While it is not as inventive as some of his other sonnets, the images and metaphors it contains effectively establish the idea that true love is ever-lasting. The sonnet begins by defining what love is not with a paradox, "love is not love." He then continues to define what love is not by repeating words "Which alters when it alteration finds, /Or bends with the remover to remove." These lines mean that love does not change when it encounters changes or alter itself when one is unfaithful. These lines are effective ways to introduce the poem because they pull the reader in by providing a sense of paradox, or the opposite of what's expected, and repeat words that have slightly different meanings each time they are used.

Shakespeare's sonnet begins almost with a series of riddles about what love is not and then turns to what love is by using a series of effective metaphors: "O no; it is an ever-fixed mark, /That looks on tempests, and is never shaken." In these lines, he compares love to a lighthouse that is not destroyed by storms, and then Shakespeare compares love to a star that guides each "bark," or ship. The poet then says that even Time, with "his bending sickle," or trademark scythe, cannot change love, even though Time can affect love and make it look older. The use of Time is a well-known image in Shakespeare's poems and other poems of the era. In the final couplet (which ends all sonnets): "If this be error and upon me proved,/ I never writ, nor no man ever loved," Shakespeare claims the truth of what he's said and sets up a very powerful inverse. He says that if he's wrong, no one was ever in love. Since this statement can't be true (someone has loved), he must be right, and the last couplet establishes the truth of what he's said.

What is altruism in population genetics?

Reproductive Success = Survival

If evolutionary outcomes in a Darwinian world are described as natural economies, then individual reproduction is the currency of these economies and of natural selection. Given both naturally occurring genetic variation among individuals and a certain environmental dynamic, it follows that some individuals will be better adapted to locally changing environments than others. Such differential adaptation is expressed as a difference in the frequency with which individual genes pass into future generations. This simple scenario fulfills the genetic definition of evolution—change in allele frequencies in natural populations—by explaining environmental influences on these changes. Note that this argument emphasizes, as its central postulate, the importance of individual reproduction rather than simple survival. Survival of the fittest is therefore more properly viewed as the differential propagation of genes.

A challenge to such a scenario is the paradox of altruism. Altruism is defined as any behavior that benefits another at a cost to the altruist. Charles Darwin
himself suggested that this problem was a “special difficulty . . . which at first appeared . . . insuperable, and actually fatal to [the] whole theory” of natural selection. The individual who pushes siblings from the track as he himself is killed by the rushing locomotive is an altruist; the colony sentinel that issues an alarm call to her cohort to take cover, despite the risk of drawing the attention of an approaching predator, is also acting altruistically. These behaviors make no sense in Darwin’s economy, since they appear to decrease the likelihood of individual reproduction—unless, as W. D. Hamilton suggested in the early 1960s, Darwinian success is not limited to the success of individual bodies harboring particular genes but may be extended to include the reproductive success of relatives who share genes with the altruist. Hamilton defined inclusive fitness as the sum of an individual’s own fitness plus the influence that individual has on the fitness of relatives. According to Hamilton, kin selection is the evolutionary mechanism that selects for behaviors that increase the inclusive fitness of altruists. Even though there are potential costs to altruistic behavior, the evolutionary economy of an altruist operates in the black because actors profit (beyond associated costs) by helping others who share their genes. The bottom line is that altruists increase their inclusive fitness through the reproduction of others.

Argument for Kin Selection

One of the best arguments for kin selection is the social structure of certain groups of insects, including the Hymenoptera (ants, bees, and wasps). A unique system of sex determination (haplodiploidy) in which females are diploid and males are haploid predisposes some group members to behave altruistically. In certain bees, for example, the queen is diploid and fertile. Worker bees are female, diploid, and sterile. Drones are male, developed from unfertilized eggs, and haploid. Such a situation makes for unusual patterns of genetic relationship among hive members. In diploid systems, the genetic relation between parents and offspring and among offspring is symmetrical. Offspring receive half their genetic complement from their mother and half from the father; sons and daughters are related to each parent by one-half and full sibs (siblings) are related to each other by one-half. In the haplodiploid system such genetic relationships are asymmetric. Drones are haploid and receive half of the queen’s genome. Workers are diploid and share 100 percent of their paternal genes and, on average, half of their maternal genes with their sisters. Sisters of the same father are therefore related to each other by three-quarters; however, research conducted after Hamilton published his groundbreaking theory indicates that queens may mate with as many as twenty different drones, resulting in the sister bees being only one-third related. In this economy, it makes sense that workers should act altruistically to assist the queen in the production of sisters. What would appear to be purely altruistic acts, on the part of workers, result in greater inclusive success than if the workers had reproduced themselves. In contrast, drones contribute little to community welfare and serve only to fertilize the queen. Note that in this system there is no conscious decision on the part of workers not to reproduce; their sterility is an inherent part of this unusual system of sex determination.

A Test of Predictions

One prediction made by the kind of kin selection described above is that, assuming the queen produces male and female offspring in equal proportion, female workers should invest three times the energy in caring for sisters than they do for brothers. Because queens are related to both male and female offspring equally, one would predict that eggs are equally divided between the sexes. Because workers are related to their sisters by as much as three-fourths and to their brothers by one-fourth, one would predict that they should invest three times the energy in care of eggs eventually yielding sisters than they do in the care of eggs eventually yielding brothers. Remarkably, it has been shown that certain worker ants are able to identify and then selectively care for eggs containing sisters. Kin recognition has also been studied in the house mouse, Mus musculus domesticus, and in some cases individuals, can distinguish full sibs from half sibs on the basis of their major histocompatibility complexes
(glycoproteins important in immune system function). The specific MHC type is fairly unique for each mouse, but related individuals will have similar patterns and share some specific MHC glycoproteins. MHC glycoproteins are found in mouse urine, and individuals can distinguish these molecules by smell. Consistent with the foregoing hypothesis, the degree of female altruism toward the offspring of close relatives was predicted by the degree of relation based on MHC type and type recognition.

Analyses by theoretical biologists Martin A. Nowak, Corina E. Tarniţă, and Edward O. Wilson, published in a 2010 Nature article, showed no mathematical difference between kin selection theory and classic natural selection theory and suggested that natural selection could itself account for eusocial behaviors (living in groups where only a select few mate) when those behaviors confer evolutionary advantages. Their work ignited controversy within the scientific community, with many defending kin selection and attacking Nowak, Tarnita, and Wilson's methods. Wilson has long espoused the theory of group selection, in which evolutionary demands apply not only to the individual but also to the social group, not merely the individual. According to this theory, altruism is based on association rather than genetic relatedness. Debate continues over which theoretical model best fits the evidentiary reality.

Maternal Altruism

Altruism may be observed in a variety of natural systems in which groups comprise individuals who share a high degree of genetic relatedness. A classic example of this sort occurs with Belding’s ground squirrels. Males tend to disperse from colonies, while females remain to create highly related maternal groups. Members of such maternal groups demonstrate altruistic behaviors such as alarm calling to warn relatives of danger. Although truly altruistic in the sense that alarm callers may incur risk of personal injury or death, they can be reasonably assured of breaking even in this economy as long as their genes live on in the bodies of those they have saved by their actions.

Reciprocal Altruism

It would seem that altruism based on inclusive fitness would be precluded by human social organization. Scientists have predicted, however, that reciprocal altruism should exist in systems characterized by a high frequency of interaction among member individuals and life spans long enough to allow the recipients of altruistic acts to repay altruists. Note that the theoretical basis for the existence of reciprocal altruism differs from that for kin selection and that any system in which evidence for reciprocity is found must necessarily include the development of a complex web of sophisticated social interaction. Such systems would be expected to foster traits expressing the panoply of human emotion and the development of certain moral architectures and group cohesion.

Likewise, some social science researchers propose that emotional reward is the underlying motivation for altruism. They argue that empathy and compassion based on emotional attachment trigger altruistic behavior when one individual witnesses another's needs. This hypothesis thus relates more closely to Wilson's group selection theory of association-based altruism than to Hamilton's inclusive fitness.

The Altruistic Gene

Research suggests that multiple genes may play a role in altruistic behaviors. A 2011 Social Cognitive and Affective Neuroscience study indicated an association between the Val/Val and Val/Met variants of the COMT gene and prosocial behavior such as donating earnings to charity. According to the authors, the prevalence of these variations differs among ethnic groups and that 75 percent of Caucasians carry one or the other of them. In 2012, a study published in Molecular Psychiatry found that variations in the dopamine receptor gene DRD4 are associated with self-reported altruism. Investigations into the influence of these and other genes on prosocial behavior remain ongoing.

Key Terms




altruism


:

behavior that benefits others at the evolutionary (reproductive) cost of the altruist




evolution

:

a change in the frequency of alleles resulting from the differential reproduction of individuals




haplodiploidy

:

a system of sex determination in which males are haploid (developing from unfertilized eggs) and females are diploid





inclusive fitness


:

an individual’s total genetic contribution to future generations, comprising both direct fitness, which results from individual reproduction, and indirect fitness, which results from the reproduction of close relatives





kin selection


:

an evolutionary mechanism manifest in selection for behaviors that increase the inclusive fitness of altruists




maternal altruism

:

altruism on the part of mothers toward offspring as well as between and among members of groups comprising closely related females





natural selection


:

a process whereby environmental factors influence the survival and reproductive success of individuals; natural selection leads to genetic changes in populations over time




reciprocal altruism

:

mutual exchange of altruistic acts typically associated with highly cohesive social groups





Bibliography

Anacker, K, et al. "Dopamine D4 Receptor Gene Variation Impacts Self-Reported Altruism." Molecular Psychiatry 18.4 (2013): 402–3. PDF file.

Buck, Ross. "Communicative Genes in the Evolution of Empathy and Altruism." Behavior Genetics 41.6 (2011): 876–88. PDF file.

Dugatkin, Lee Alan. The Altruism Equation: Seven Scientists Search for the Origins of Goodness. Princeton: Princeton UP, 2006. Print.

Eaton, Kristi. "Is There an Altruism Gene?." Greater Good: The Science of a Meaningful Life. The Greater Good Science Center, U of California, Berkeley, 26 Jan. 2011. Web. 28 July 2014.

Freeman, Scott, and Jon C. Herron. “Kin Selection and Social Behavior.” Evolutionary Analysis. 5th ed. Boston: Pearson, 2014. Print.

Gilbert, Natasha. "Altruism Can Be Explained by Natural Selection." Nature. Macmillan, 25 Aug. 2010. Web. 28 July 2014.

Gould, Stephen Jay. “So Cleverly Kind an Animal.” Ever Since Darwin. New York: Norton, 1973. Print.

Hrdy, Sarah Blaffer. Mothers and Others: The Evolutionary Origins of Mutual Understanding. Cambridge: Belknap, 2011. Print.

Johnson, Eric Michael. "The Good Fight." Scientific American. Nature America, 9 July 2012. Web. 28 July 2014.

Keltner, Dacher. Born to Be Good: The Science of a Meaningful Life. New York: Norton, 2009. Print.

Keltner, Dacher, Jason Marsh, and Jeremy Adam Smith, eds. The Compassionate Instinct: The Science of Human Goodness. New York: Norton, 2010. Print.

Volpe, E. Peter, and Peter A. Rosenbaum. “Natural Selection and Social Behavior.” Understanding Evolution. 6th ed. Boston: McGraw, 2000. Print.

What does Thorin vow to do anyone who withholds the Arkenstone in The Hobbit?

Thorin vows to get revenge on anyone who keeps the stone from him.

The Arkenstone is very important to Thorin.  It is his birthright.  To him it is the most valuable jewel of all of the dwarves’ riches hidden in the mountain.  It hurts him deeply that the dragon has it.  It is one of the reasons he wants to go into the Lonely Mountain to get it.

"The Arkenstone! The Arkenstone!" murmured Thorin in the dark, half dreaming with his chin upon his knees. "It was like a globe with a thousand facets; it shone like silver in the firelight, like water in the sun, like snow under the stars, like rain upon the Moon!" (Ch. 12)

When the dwarves do take the mountain, Bilbo finds the stone.  He knows what it is from the description, but he does not tell Thorin immediately.  He thinks he can use the stone to negotiate with the elves and men who are at a standoff with the dwarves. 

Bilbo becomes concerned about Thorin’s reaction to the stone being missing.  He worries about dragon-sickness, or the dwarves’ reactions to the gold, specifically Thorin’s.  The longer Bilbo holds out, the more worried he gets.  He knows that Thorin will be very, very angry if he tells him he has had it this whole time.

"For the Arkenstone of my father," he said, "is worth more than a river of gold in itself, and to me it is beyond price. That stone of all the treasure I name unto myself, and I will be avenged on anyone who finds it and withholds it." (Ch. 16)

Poor Bilbo feels bad about withholding the jewel from Thorin, even though he is also a little nervous about the fact that Thorin has vowed revenge on anyone who withholds the stone.  When Thorin finds out he is mad, and threatens to throw Bilbo off the mountain.

What is the relationship between stress and smoking?

Stress Responses

Stress is a natural, reactive response involving physical and psychological changes that helps the body adapt to a variety of events and exposures. Stress responses trigger the hypothalamic-pituitary axis (HPA), which regulates multiple hormones simultaneously and connects their actions to chemicals in the nervous system.

During an acute stress event, hormonal and chemical fluctuations facilitate tension in the body; epinephrine, also known as adrenaline, and cortisol peak and cause increased heart rate and blood pressure, sweating, muscle tension, headache, and rapid respiration. Cortisol guides an inflammatory response and can counteract immune system functions.

Acute stress is useful when these processes activate the body’s defenses or increase the adrenaline necessary to overcome a challenge. However, neurochemical responses can result in psychological changes that can lead to short- and long-term emotional instability and anxiety. With chronic stress exposure, deeper problems develop: excessive stimulation of cortisol release causes obesity, heart disease, depression, and other chronic diseases. Chronic stress increases the likelihood that a person will turn to substance abuse in an attempt to counteract the body’s hyper-reactive state; drug and food abuse can relieve immediate psychological anxiety through dopamine release but cannot stop the long-term physical or psychological damages of stress.

Nicotine and Stress

Smoking physically stresses the body immediately and in the long term, worsening other conditions and increasing anxiety. When inhaled nicotine enters the bloodstream, the HPA is triggered to release epinephrine and cortisol—the same physical response to everyday stressors. Thus, heart rate, respiratory rate, and blood pressure all increase after nicotine use.

Tolerance to the nicotine effect on the HPA builds as smoking continues; although the physical effects wane, the levels of cortisol and epinephrine in the body remain high with chronic HPA activation. The result is a blunted natural stress reaction that prevents the body from responding appropriately to other stressors.

Nicotine also increases glucose secretion and prevents insulin release, causing chronically high blood sugar concentrations that stress organ functions. Oxidative stress reactions to nicotine throughout the body cause damage to cells and change cellular DNA (deoxyribonucleic acid), which impairs the immune response, worsens existing diseases, and increases inflammation.

In the central nervous system, nicotine use is rewarded by an apparent and immediate relief of anxiety through neurochemical changes. When tobacco is inhaled, nicotine enters the brain within ten seconds to stimulate dopamine, acetylcholine, and norepinephrine. Through these actions, nicotine quickly induces pleasure, improves mood, and enhances concentration and focus. Each cigarette provides hundreds of rapidly fleeting nicotine hits that in turn cause short bursts of euphoria. The subjective psychological boost hides the physical impairment and is short lived as the body develops tolerance to the fleeting neurologic highs.

Although smokers generally believe that nicotine reduces their stress, the repeated dopamine stimulation provides negative reinforcement of cigarette use. Chronic smoking leads to the compulsion of greater use to try to minimize the anxiety that results from lower dopamine levels when the nicotine effect wears off between cigarettes.

Stress Fuels Nicotine Addiction

Smoking and nicotine addiction
are aggravated by additional, outside sources of stress, as smokers report higher cigarette use during times of known external stressors. In addition, the body of a smoker develops chronic physical health problems from nicotine damage that facilitate stress responses.

Smokers claim to have more psychological stress than nonsmokers, and stress is provided as a reason for smoking because of its apparent relaxing effects. However, no empiric evidence supports a consistent difference in stress between smokers and nonsmokers until after smoking begins. Nicotine heightens baseline stress between cigarette use, and smokers only attain normal, lower stress signals when cigarettes are used.

Stress is a vital body mechanism for protection, but it contributes to smoking addiction and the frequency of relapse, as smokers use nicotine to relieve immediate sensations of anxiety. When nicotine is chronically present, the nervous system and HPA adapt to it as a stressor, even more nicotine is needed to respond to daily stress.

Stress itself increases the craving for nicotine as tolerance builds, and anxiety encourages drug-seeking behavior. As the central nervous system adapts to frequent and repeated norepinephrine and dopamine stimulation, more nicotine is necessary to obtain the same pleasure, focus, and stress-relief responses. Relief of stress is harder to achieve as smoking continues. Thus, stress increases the amount, frequency, duration, and intensity of cravings for nicotine.

Withdrawal from nicotine is probably the best example of the connection between stress and smoking habits. Although physical withdrawal from nicotine can cause increased appetite and headaches, the psychological reactions of withdrawal are the key causes of stress and ultimate nicotine dependence. Irritability, attention problems, sleep disturbances, and tobacco cravings are common and are a sign of the damaging changes from smoking, not proof of nicotine’s stress-relieving effects.

Without the rapid and repeated bursts of nicotine, anxiety and physical stress become evident. Nicotine abstinence breaks the cycle of stress-induced smoking and smoking-induced stress, but it ultimately requires learning new coping skills to manage stress.

Bibliography

Cougle, J. R., et al. “The Role of Comorbidity in Explaining the Associations between Anxiety Disorders and Smoking.” Nicotine and Tobacco Research 12 (2010): 355–64. Print.

Mendelsohn, C. “Women Who Smoke: A Review of the Evidence.” Australian Family Physician 40 (2011): 403–7. Print.

“Psychological Stress and Cancer: Questions and Answers.” Cancer.gov. Natl. Cancer Inst., 29 Apr. 2008. Web. 8 Apr. 2012.

Richards, J. M., et al. “Biological Mechanisms Underlying the Relationship between Stress and Smoking: State of the Science and Directions for Future Work.” Biological Psychology 88.1 (2011): 1–12. Print.

Wang, Wendy, and Paul Taylor. “Smokers Can’t Blow Off Stress.” Pew Research Center Social & Demographic Trends. Pew Research Center, 8 Apr. 2009. Web. 9 Nov. 2015.