Food in the Mediterranean Essay Example | Topics and Well Written Essays - 2000 words

Food in the Mediterranean - Essay Example The Mediterranean cuisine is particularly suited for workers who are looking for an alternative to the cafeteria or vending machines at work. Discussion Mediterranean food is considered, by Martha Rose Shulman, to be the â€Å"World’s healthiest cuisine,† which is why her book, Mediterranean Light is subtitled â€Å"Delicious Recipes from the World’s Healthiest Cuisine† (Shulman, 1989). Shulman states that part of the reason why the region’s food is so healthy is because the food is prepared with fresh ingredients. This is due to the fact that many of the countries in the Mediterranean region are poor countries, so the cuisine reflects the fact that the citizens in those countries take advantage of what nature has to offer, as opposed to eating processed foods. Thus, they are more apt to â€Å"live off the land,† and their recipes reflect this ethos. Moreover, Shulman states that part of the reason why the food is so healthy is because of the ingredients – for instance, olive oil is a staple in many of the dishes in Italy and Spain, and olive oil is thought to reduce bad cholesterol in the people who consume this kind of oil on a regular basis. Vegetables also form a focus in this kind of food, including tomatoes, eggplant, peppers, potatoes, zucchini, cucumbers, artichokes, sweet peas and beans. These are all known to be very healthful ingredients as well. The fruits which are a part of the cuisine are also healthy, and they include figs, melons, peaches and apricots. These dishes are also centered around lean protein, such as rabbit, chicken and fish. Shulman also praises the Mediterranean cuisine because of the flavor that it receives from the fresh, wholesome ingredients and herbs. Because the herbs are so pungent – common herbs include parsley, basil, rosemary, thyme, sage, coriander and mint, along with a lot of garlic – the cuisine is flavorful without adding a lot of sodium and fat. Other in gredients which are used in the Mediterranean, including Parmesan Cheese, are so flavorful that a little goes a long way. Even the desserts in Shulman’s book, such as fruit enhanced with honey and lemon, are healthy and low-sugar (Shulman, 1989). Shulman’s book consists of food from throughout the Mediterranean, so she has recipes from Morocco, Egypt, Tunisia, Libya, Algeria, Greece, Italy, Spain, France, and the Middle East. The website â€Å"AroundSicily.com† zeroes in on Italian food, and the benefits of this kind of cuisine. This website states that Italian food, true Italian food, centers on fresh ingredients, such as fruits, vegetables, whole grains, olive oil, dairy products, fish, poultry, eggs and moderate amounts of wine. This website states that a typical Italian breakfast consists of yogurt, milk or coffee; snacks are fruits and juices; lunch is a pasta and salad; and dinner consists of fish, meat or chicken with a vegetable side dish. Pizza, the Ita lian dish that many non-Italians consider to be a staple, is only consumed sparingly in Italy, with most Italians eating this once a week (AroundSicily.com). Nestle (1995) is particularly concerned with Mediterranean food, and its current status of being somewhat of a lost art. She states that the Mediterranean people show the rate of chronic diseases to be the lowest in the world, with some of the highest life expectancies in the world. For instance, Nestle notes that the Cretes subsist on a diet of olives, cereal grains, wild

Tuning Out to be Heard Loud and Clear Essay Example for Free

Tuning Out to be Heard Loud and Clear Essay There is a reason TVs and radios come with an on-off switch, so people can use them. TV and radio are as commercial as any other industry, and they should be.   Preserving the people’s interest in available public broadcasting by presenting information in a balanced manner is a nice ideal, but ultimately a foolish one if you want to maintain a free and capitalistic society.   It is drafted in The First Amendment to the U.S. Constitution that â€Å"Congress shall make no law.    .   .   abridging the freedom of speech, or of the press.† Yet in 1949 the Fairness Doctrine was enacted which stifled this right.   It was a point of much controversy in broadcasting for nearly 40 years until it was repealed in 1987, but now there are discussions about re-enacting it.   The FCC should not require radio and television to comply with the Fairness Doctrine if they want to maintain the rights of U.S. citizens. At their core, radio and television are forms of entertainment.   One of the initial arguments of the Fairness Doctrine was that there were a limited number of frequencies available to license and that â€Å"there are many fewer broadcast licenses than people who would like to have them† (Rendall, 2005). Following that rationale there are a number of different entertainment venues people would like to operate, but they are limited by space or money or the abundance of that business present in their community.   Television and radio aren’t essential to life; they are a luxury, a form of entertainment and should be viewed as such. It is true that they also act in an informative and educational way, but it is and should be at the discretion of the broadcaster what to publish, just as it is and should be at the discretion of the recipient whether or not to tune in.   Radio and television may be available to the public, but stations/ frequencies are owned and operated by corporations.   What they offer will be driven by public interest in so much as the public will disengage if it doesn’t like what is available. Particularly with the advent of cable/ satellite television and digital radio the possibilities for viewers are virtually endless.   In 1984 the Supreme Court in FCC v. League of Women Voters concluded that the â€Å"scarcity rationale underlying the doctrine was flawed and that the doctrine was limiting the breadth of public debate† (Thierer, 1993).   Ultimately broadcasting is just another sellable product.   Mark Fowler, the FCC chair appointed by Regan in the 80s was quoted as saying, ‘The perception of broadcasters as community trustees should be replaced by a view of broadcasters as marketplace participants.’ To Fowler, television was ‘just another appliance—it’s a toaster with pictures,’ and he seemed to endorse total deregulation) ‘We’ve got to look beyond the conventional wisdom that we must somehow regulate this box.’ (Rendall, 2005). Fowler is right; it is not a broadcaster’s responsibility acting as a mouthpiece for entertainment, providing a marketable product that we have to ‘buy’ into, to act in the community interest.   Eventually the broadcaster will respond to community interest because they are the audience and essentially determine what is played on the air by their willingness to engage, but it is not a broadcaster’s responsibility to do so.   Government should not be regulating available information because broadcasting is a consumer driven market. The only discrepancy would be if we were talking about national or local government owned stations.   In the special case of those, it is in the best interest of citizens to have a balanced stream of information available particularly in a democratic political system.   Those stations would be used to inform and should be objective and/ or balanced because citizens would be using them as trusted unbiased resources.   However all other ‘public’ broadcasting sources currently available are privately owned by corporations and are and should be exclusively market driven to protect our right to free speech. It is interesting that PBS the touted public broadcasting station was generated out of a demand from citizens to create just such a network of more balanced and educational information.   It was created and driven by the market and is funded primarily by its viewers (it does get some government grant funding and private grant funding for programming), so it is clear that tuning out or more to the point demanding alternate forms of entertainment (ultimately even PBS is still a just an alternate form of entertainment) works and there is no need for regulations. The Fairness Doctrine addresses more specifically the coverage of political or current social issues. The Fairness Doctrine had two basic elements: It required broadcasters to devote some of their airtime to discussing controversial matters of public interest, and to air contrasting views regarding those matters. Stations were given wide latitude as to how to provide contrasting views: It could be done through news segments, public affairs shows or editorials. (Rendall, 2005). In enacting such a doctrine you limit the diversity available on the airwaves. In trying to follow regulations stations will be more guarded in what they present to avoid being fined or shut down by the FCC.   It actually stifles the opportunity for rigorous debate and challenges to opinion; by either not offering up the discussion of more controversial issues or by censoring them.   In 1974 the Supreme Court, while still upholding the doctrine in the Miami Herald Publishing Co. v. Tornillo case concluded that it, inescapably dampens the vigor and limits the variety of public debate (Thierer, 1993). It also runs into the issue of who decides what fair coverage is.   .   .   a bunch of bureaucratic stuffed shirts at the FCC a board ultimately designed to enact ‘rules for censorship’.   How do we ensure that their own views wont taint their ‘fairness’ decisions. With the amount of available stations, forms of media, just access to get information in general, the concept of a Fairness Doctrine is outdated when people can just change the channel or disconnect all together.   Broadcasting whether for public or private availability is still just a form of entertainment and should be treated as such.   Its regulation should be deemed by its market segments because viewers are (or at least should be) more than capable of influencing what is available to them. Viewers should also be allowed to filter their own information, seek out differing opinions; after all just because an opposing view might be offered doesn’t mean that listener is obliged to stick around.   Just tuning out is the loudest and clearest form of speech and is all the regulation that is really needed. References Rendall, Steve. (2005). The Fairness Doctrine How We Lost it, and Why We Need it Back. FAIR, February 12, 2005. Retrieved March 15, 2009, from http://www.commondreams.org/views05/0212-03.htm Thierer, Adam. (1993). Why the Fairness Doctrine is Anything But Fair. The Heritage Foundation, Executive Memorandum #368, October 29, 1993. Retrieved March 15, 2009, http://www.heritage.org/Research/Regulation/EM368.cfm The Constitution of the United States. Amendment 1.

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

Feedback Stress: Does Auditory Feedback Negatively Affect Performance o

The Stroop Effect In his historic study, Stroop found that reading names of colors interfered with individuals’ ability to name the ink color the word was printed in when the two differed (i.e., the word â€Å"BLUE† written in red ink) (1935). However, the basis of this phenomenon can be traced back to Cattell who found that naming colors and pictures took twice as long to accomplish than reading the word these colors or pictures represented (1886). He concluded that this was due to reading being an automatic process while identifying colors or pictures requires a conscious effort (Cattell, 1886). MacLeod (1991) reflects that it was Cattell’s work which strongly influenced future psychologist including Stroop. In his experiment, Stroop investigated how the reaction time to name colors increased when it conflicted with the automatic process of reading. He broke down his experiment into three parts. In the first, he tested how reading the name of a color printed in a different ink color (i.e., BLUE) differed from reading the name of a color printed in black ink (i.e., BLUE). The difference between the name of the color and the ink color it was printed in caused a slight interference resulting in an increased reaction time of 2.3 seconds (Stroop, 1935). In the second part of his experiment, Stroop (1935) looked at reaction time differences between naming the color of solid blocks (i.e., ââ€"   ââ€"   ââ€"   ââ€"   ââ€"  ) versus naming the color of the ink not the name of the color (i.e., responding â€Å"RED† for BLUE). He found that participants required 74% more time to name the color of the ink when it did not agree with the name of the color (Stroop, 1935). Stroop concluded that it was the interference between the automatic process of reading the na... ...oop: An interference task specialized for functional neuroimaging – validation study with functional MRI. Human Brain Mapping, 6(4), 270-282. doi: 10.1002/(SICI)1097-0193(1998)6:4 Cattell, J. M. (1886). The time it takes to see and name objects. Mind, 11(41), 63-65. MacLeod, C. M. (1991). Half a century of research on the Stroop Effect: An integrative review. Psychological Bulletin, 109(2), 163-203. doi: 10.1037/0033-2909.109.2.163 Richards, A., French, C. C., Johnson, W. Naparstek, J., & Williams, J. (1992). Effects of mood manipulation and anxiety on performance of an emotional Stroop task. British Journal of Psychology, 83, 479-491. Shor, R. E. (1975). An auditory analog of the Stroop test. Journal of General Psychology, 93, 281-288. Stroop, J. R. (1935). Studies of interference in serial verbal reactions. Journal of Experimental Psychology, 18(6), 643-662.

Learning to Lead Change

Learning to Lead Change†¦ â€Å"The simplest definition of leadership† says Peter Senge, of learning organisation fame, â€Å"is the ability to produce change. † Does your organisation need to build change leadership capability? There’s a big emphasis now on leadership, not just conventional management skills. One reason is a growing recognition that in times of change, when systems are unstable and futures are uncertain, it’s leaders we need – not managers.When you boil it down, leadership itself is largely about leading people through change. Leaders are the key drivers of change. They play a critical role in preparing people for it, and then leading them through it. No matter what your specific job, managers everywhere now need to be more change-adept. Organisations nowadays expect people to step out of their functional role and handle a formidable array of changes as part of their daily work – often with little preparation for it.In a word, we all need to become change leaders. Whether you introduce the change – a better procedure, a service-delivery improvement, redesigning work, merging work units, designing a new product line or introducing a new piece of technology – or whether it’s imposed on you, the ability to manage change and make it happen rapidly and smoothly is one of the keys to organisational vitality, renewal and success. And learning how to lead change is one of the critical skills that underscores successful implementation.To have the ability to: Identify when change is needed and constantly build their own and other’s capacity to learn, adapt and transform Translate change initiatives into working visions and strategies staff find comprehensible and want to sign onto Design down-to-earth workplace change and improvement strategies people can work with Communicate clearly about change in ways people can understand Reduce uncertainty and convert anxiety, denial and re sistance into constructive change energy Build momentum, create commitment, get people into action mode then facilitate them through change Many managers overlook the need to develop change capabilities in themselves or in others. Their assumption often sounds like this: ‘I’ve been managing this organisation for years – so I certainly know how to change it! ‘ What organisations frequently fail to see is that the skills to build change leadership capability are very different to those needed to manage a business in normal operational mode. Everyday management skills, sound as they may be, just don’t convert that easily into effective change leadership capabilities. New skills are needed but not many see this. Back to topKey practice areas for enabling change†¦ Here’s a list of key practice areas for enabling change†¦ They inter-connect. Changes in one flow through to all the others†¦ Learning to Lead Change: Put simply leadership is frequently about leading people through change. Leaders are key drivers of change and leadership learning should focus firmly on the critical role leaders play in preparing, and leading people through change in order to create change leaders – those with the capability to communicate clearly about change in ways people can understand, shape a vision they can sign onto, build momentum, create commitment, get people into action and then facilitate them through it.Facilitating Change: is a role for both change leaders and teams. It involves being capable of leading team activities, adopting a facilitation role to lead change teams and shifting from mental models of ‘managing’, ‘organising’ or ‘controlling’ to being facilitators & direction-setters. Leveraging Culture: Very little changes unless the culture it’s happening in gets addressed – the habits, assumptions and shared mental models carried by yourself and others. Th is involves sensing the current culture, assessing how supportive or not this is for change outcomes you envisage and learning to leverage and work with the culture to get these change results.Promoting Change Participation: Promote involvement in and responsibility for managing change processes. Our bias for participation is based on observation and experience that if you involve others in jointly determining what and how to change, it is more likely to be successful than imposed change. This involves working out ways to involve people – both participation inside your change team or target group and with stakeholders outside it. Building Change Capacity: What capacities do we need to build in order to change successfully? This includes individual skills, tools and disciplines you and your change team needs to develop change enabling capacity and the resources needed to support change – tangible and ‘in’.It also involves building longer term change capabil ity by embedding good practices in the work/learning habits of people impacted by changes. Systems Redesign: When things change, old work systems, processes and procedures need to change too. One reason change fails is a lack of know-how or refusal to change old work patterns, systems, structures and mental models that get in the way. At whatever level, change leaders constantly look for more innovative, efficient and flexible ways of re-organising work processes and procedures to meet ever-changing improvement challenges. All change leaders need to learn how to be systems redesigners. Change Leaders need Tools: Without tools, guiding ideas remain un-actioned.Leaders need new tools and processes to make a positive contribution to these more flexible and fluid forms of learning if they are to use learning to change and respond more quickly to successive change challenges. Our leadership-learning emphasises being transparent about the tools we use and injecting specific learning tools into the change coaching/action learning process for people to try out and experiment with. Monitoring Change: This involves developing ways to tell whether real change and improvement has taken place; identifying indicators and processes to evaluate whether our change actions and processes have made a real difference and get back on-track if changes aren’t working.

Money Can Not Buy Happiness Essay

Do you believe that your income is the main factor in determining your happiness? It is a classic debate that has reached its tentacles into the minds of our nation’s individuals and wrapped itself firmly around their minds having them strive for happiness. Money does not buy happiness. Too many Americans are so blinded by their own ignorance that they constantly pursue happiness as if it was a matter of circumstance rather than their own perspective. Such a way of life is crippling to those individuals because they miss the plethora of opportunities for happiness that surrounds them in every way of life. Today, more and more people argue that money can buy happiness. Proponents of such a viewpoint often argue that money â€Å"makes the world go ‘round†. They may argue that it allows us to have carefree lives because we don’t have financial strain with money. They may argue that it gives people the ability to buy whatever they may want and that causes us to be pleased with our purchase. They may even argue that money allows one to be charitable to others. Those who make these arguments have the wrong perspective of the world. Those who argue that many buys happiness and those who live their lives in such a manner can never really attain true happiness. Clearly, these people who are striving to make money are really just striving to be happy. They dedicate their lives to being happy and thus place very significant value on being happy. One study attempted to determine the paradoxical effects of valuing happiness. It concluded, â€Å"valuing happiness could be self-defeating, because the more people value happiness, the more likely they will feel disappointedâ€Å" (Savino et al. 807). Furthermore, those that argue that happiness allows us to live carefree lives by removing the burden of financial strain need to change their  perspective in order to truly be carefree. People living life in such a manner are never truly carefree because they constantly have the stress on them to be making more money in order to live a carefree lifestyle. Such a conditional â€Å"happiness† is not truly carefree. Rather than living life in such a manner, people should remove the excessive stress of making money and appreciate their own respective situations. That certainly beats caging the circumstances under which they can thrive and be happy to only being included in a specific income bracket. Basically, put less value on how you regard happiness. â€Å"Valuing happiness may lead people to be less happy just when happiness is within reach† (Savino et al. 807). Individuals who believe that money can buy them happiness may believe that money allows them to buy certain objects or allows them to have certain experiences that allow them to be happy. However, one study showed, â€Å"†¦ that happiness seekers voluntarily choose to practice up to eight happiness strategies at a time suggests that by experience or instinct they have discovered a successful approach to the pursuit of happiness† (Lyubomirsky et al). However, there was little correlation between the application of these happiness seeking strategies and an actual real-world application’s effect on a boost in well being (Lyubomirsky et al). There is close to no correlation between activities or objects that â€Å"happiness-seekers† seek to buy and their own happiness. Rather than believing you can buy happiness with your money, one should perhaps try helping an old lady cross the street. The good feeling in your belly after such a kind and gracious act is true happiness. Raymond Angelo Belliotti argues that, â€Å"†¦leading a robustly meaningful, valuable life merits worthwhile happiness. But worthwhile happiness does not automatically follow from such a life. If we must choose, a robustly meaningful, valuable life is preferable to a merely happy life†¦Ã¢â‚¬  (Belliotti). I completely agree with Mr. Belliotti. However, I believe that placing value and finding meaning in all that we do will correlate to a happy life. Finding meaning in what we choose to do can be the true pursuit of happiness that attains happiness. Thus, it is the pursuit of meaning and value rather than a pursuit of money that gives one happiness. Throughout history, the adage that money does buy happiness has been disproven. If this argument was true, then the argument would be made that serfs, peasants, and all poor or financially unprivileged individuals throughout history were unhappy. However, when put it such a broad context, that argument seems ridiculous. Throughout all of history, individuals found happiness in love, their families, their religions, their surroundings, their countries, etc. Uncivilized human beings who had no concept of money probably found much more happiness in all that they did because they lived without the shackles of the concept of money. One fascinating study was conducted that may silence those who believe money can buy happiness forever. â€Å"This study provides the first evidence that money impairs people’s ability to savor everyday positive emotions and experiences. In a sample of working adults, wealthier individuals reported lower savoring ability (the ability to enhance and prolong positive emotional experience). Moreover, the negative impact of wealth on individuals’ ability to savor undermined the positive effects of money on their happiness† (Mikolajczak, et al). This study clearly demonstrates the inability to have a prolonged positive emotional experience in wealthier individuals. This study literally states that money cannot buy happiness in other words. Furthermore, it goes on to say that those who have money actually tend to be less wealthy. This study gives evidence that could give so many people so much happiness if they applied it to themselves and stopped believing that money could buy happiness. The individuals who argue for the idea of money buying happiness may argue that money allows individuals to be more charitable and therefore allows individuals more happiness through their charitable work. Certain wealthy individuals like Bill Gates even has his own charity, which truly does magnificent work and helps the world. However, people are not all as privileged as Bill Gates. Individuals who have less money can still be incredibly charitable and save many lives. For example, thinking outside the box, volunteering at homeless shelters, helping the elderly, helping individuals around you in need on a daily basis, planting trees, etc. all  have great benefits and can help the lives of many people! All you really need to do to be charitable is ask yourself what it is that interests you and put your efforts into pursuing that charitable task! In conclusion, money simply does not buy anyone happiness. Happiness is a result of our perspective and how we see the world around us. People have found happiness is the worst circumstances imaginable. Many stories are told of those who survived the holocaust who put all their efforts into finding some piece of beauty around them in order to be happy. Something as simple as appreciating the sunrise can make someone happy. Happiness is not limited to high net worth individuals. Happiness is not reserved for the people who have money. Happiness is a human emotion and experience that is engrained into who we are as living creatures. Living things all around us experience happiness. My dog literally does not have a penny to his name (unless he has been stashing hundred dollar bills that I am unaware of), and literally is one of the most joyful things when he is taken to the park to run around with his owner and the other dogs. Happiness surrounds us in everything we do, it permeates every situation, money does not buy it; it is only attainable when you realize it was always there in the first place. Just reach out and grab it. Works Cited Belliotti, Raymond Angelo. â€Å"The Seductions Of Happiness.† The Oxford handbook of happiness. 291-302. New York, NY US: Oxford University Press, 2013.PsycINFO. Web. 1 July 2013. Moà ¯ra Mikolajczak, et al. â€Å"Money Giveth, Money Taketh Away: The Dual Effect Of Wealth On Happiness.† Psychological Science (Sage Publications Inc.) 21.6 (2010): 759-763. Academic Search Complete. Web. 16 July 2013. Nicole S. Savino, et al. â€Å"Can Seeking Happiness Make People Unhappy? Paradoxical Effects Of Valuing Happiness.† Emotion 11.4 (2011): 807-815.PsycARTICLES. Web. 1 July 2013. Sonja Lyubomirsky, et al. â€Å"Pursuing Happiness In Everyday Life: The Characteristics And Behaviors Of Online Happiness Seekers.† Emotion 12.6 (2012): 1222-1234. PsycARTICLES. Web. 1 July 2013.