Obesity: History, BMI Classification, Determinants and Effects

Obesity: History, BMI Classification, Determinants and Effects OBESITY Obesity is fast becoming a serious epidemic in the United States due partly to eating habits and physical inactivity amongst Americans. According to the Centre for Disease Control, Seventy-three percent of adults and 43 percent of all children in the United States are overweight or obese. Among African-Americans 20 years and over, more than two-thirds are overweight or obese (Gaines, 2010). Generally, the rate of overweight and obesity are higher for African-American and Hispanic women than Caucasian women, higher in the south and Midwest and increases with age (Ogden et al., 2014; Gregg et al., 2009; Sherry et al., 2010). According to the World Health Organization, body mass index (BMI) of an obese person has a value greater than or equal to thirty. Type 2 diabetes and high blood pressure are two diseases that ultimately affect African Americans and this is predominantly caused by an increase in weight as those extra pounds predisposes a person to these diseases (Gaines, 2010). Obes ity is one of the primary risk factor for heart diseases, diabetes and a number of cancers and these are major causes of death in American today. The health implication of obesity and the complications associated with it is increasingly becoming more detrimental than cigarette smoking and has therefore become one of the major preventable causes of death worldwide. This investigation paper focuses on the brief history of obesity; this will take obesity from its discovery over 2000 years to this present day. An understanding of the BMI classification, aetiological determinants, pathophysiology and health effects is important if obesity prevalence will be curtailed. Furthermore, the socio economic impact of obesity management on the United States economy will be looked into. Finally, its treatment options, prevention and trends of the disease will be discussed. HISTORY OF OBESITY The Ancient Greeks were the first to acknowledge obesity as a health disorder and this was further recognized by the Ancient Egyptians in a similar way. According to Hippocrates, corpulence is not only a disease itself, but the harbinger of other diseases (Haslam & James, 2005). Hippocrates which was the Ancient Greek Father of Western medicine acknowledged obesity in his work and details of various diseases including diabetes was first given by him. Another Indian surgeon Sushruta, also discovered the association between obesity, diabetes and heart diseases and he was the first person to find out the significant signs, symptoms, causes and health implications. In the Ancient days, man always strived for food due to scarcity or famine and this resulted in obesity being regarded as a sign of wealth and good fortune in the middle age. However, all this changed when the scientific society of the 20th century revealed the medical implications of obesity (Caballero B., 2007) With the inception of the industrial revolution, body size and strength of soldiers and workers became pertinent as this was attributed to the military and economic power of Nations (Caballero, 2007). The increase in the average body mass index from underweight to the normal on the BMI charts played an important role in the development of industrialized societies (Caballero, 2007).   Therefore in the 19th century, there was an increase in weight and height generally. However, during the 20th century, the genetic potentials for height was reached and this resulted to weight increasing more than height in this century and thus resulted in the average increase in BMI (Caballero, 2007). In human evolution, for the first time, the number of adults with excess weight exceeded the number of those who were underweight which further led to obesity (Caballero, 2007). The perceptions of the public as regards healthy body weight varied from those regarded as normal in the western society, but this perception was changed in the beginning of the 20th century. There was a reduction in the weight seen as normal since 1920s and this was evident by the 2% increase in average height of the Miss America pageant winners and a 12% decrease in weight between year 1922 and 1999 (Rubinstein & Caballero, 2000). Also, the perception of most people as regards healthy weight has changed, for example in Britain the weight at which people regarded themselves to be overweight was considerably higher in 2007 than in 1999 (Johnson & Wardle, 2008). Obesity is still regarded as an indication of wealth and well-being in many parts of Africa and this has become more widespread since the HIV epidemic began (Haslam & James, 2005). BODY MASS INDEX (BMI) CLASSIFICATION According to the World Health Organization, Body Mass Index (BMI) is a simple index of weight-for-height that is commonly used to classify underweight, normal weight, overweight and obesity in adults. It is defined as the weight in kilograms divided by the square of the height in metres (kg/m2) (W.H.O. 2004). For example, an adult who weighs 60kg and whose height is 1.65m will have a BMI of 22.0. BMI = 60 kg / (1.65 m2) = 60 / 2.72 = 22.04 LEAN BODY MASS Lean Body Mass is a component of body composition, it is calculated by subtracting body fat weight from total body weight. Total body weight is lean plus fat. In equations: LBM = BW − BF Lean Body Mass equals Body Weight minus Body Fat LBM + BF = BW Lean Body Mass plus Body Fat equals Body Weight Lean Body Weight (men) = (1.10 x Weight(kg)) 128 ( Weight2/(100 x Height(m))2) Lean Body Weight (women) = (1.07 x Weight(kg)) 148 ( Weight2/(100 x Height(m))2) Ideal Body Weight (men) = 50 + 2.3 ( Height(in) 60 ) Ideal Body Weight (women) = 45.5 + 2.3 ( Height(in) 60 ) Body Mass Index = Weight(kg) / Height(m)2 The table below further explains the classification of BMI in relation to the weight and height of an individual. Table 1: The International Classification of adult underweight, overweight and obesity according to BMI Source: Adapted from WHO, 1995, WHO, 2000 and WHO 2004. BMI values are age dependent and are the same for both males and females (WHO, 2000). The health risks associated with increasing BMI are many and the interpretation of BMI values in relation to risk may vary for different populations in different geographical locations (WHO, 2004). AETIOLOGY DETERMINANTS OF OBESITY Obesity is a heterogeneous group of conditions with numerous causes, it is not merely a single disorder and it is predominantly expressed phenotypically (Susan A.J, 1997). Obesity is hereditary, but the genetic component does not follow simple Mendelian principles and the effect of the genotype on the aetiology of obesity may be decreased or increased by factors that are non-genetic (Susan A.J, 1997). Several factors determine the body weight, and these are interactions of genetic, environmental and psychosocial factors which are in relation to the amount of energy consumed and the amount of energy expended and the resulting acting through the physiological mediators Table 1: The International Classification of adult underweight, overweight and obesity according to BMI of energy intake and energy expenditure and the resulting equilibrium between both (Susan A.J, 1997). ENDOCRINE AND HYPOTHALAMIC DISORDERS Certain endocrinological disorders may lead to obesity, but this applies to a very small percentage of the total number of cases (Susan A.J, 1997). The endocrinological determinants of obesity have been reviewed recently (Bouchard C., Perusse L., Leblanc C., Tremblay A, & Theriault, 1988). The single disorder that causes obesity in this group is hypothyroidism in which increased weight occurs largely as a result of reduced energy expenditure (Susan A.J, 1997). Other endocrinological factors contributing to obesity include Cushing’s syndrome and disorders of corticosteroid metabolism, where weight gain is typically accompanied by a distinctive prototype of fat deposition in the trunk, sex hormone disorders including hypogonadism in men and ovariectomy in women, insulinoma and growth hormone deficiency (Susan A.J, 1997). The key causes of weight gain in these cases are the amount of energy intake. Certain hypothalamic tumors or damage to the hypothalamic part of the brain as a result of excessive exposure to radiation, infectious agents or head trauma can also lead to obesity with defect in appetite control and hyperphagia (Susan A.J, 1997). A hypothalamic disorder is also believed to be the foundation of a number of congenital abnormalities which could also result in obesity, e.g. Prader-Willi syndrome, which is an abnormality that could be a primary cause of obesity (Susan A.J, 1997). GENETIC INFLUENCE At a population level, the genetic influence of obesity is expressed in terms of heritability (Susan A.J, 1997). This refers to the percentage of the total difference in a character which is attributable to genetic factors (Susan A.J, 1997). The heritability of obesity may be considered either in terms of the total fatness of an individual or the distribution of body fat in an individual (Susan A.J, 1997). Several discoveries have been made over the years regarding the influence of genetics on chronic diseases like cardiovascular disease and obesity (R. C. Whitaker, J.A. Wright, M.S. Pepe, K.D. Seidel, &W.H. Dietz., 1997). Recent reports indicate that at least 32 genes contribute to common forms of obesity. Many of these genes are thought to be related to the development of obesity through the deregulation metabolic hormones in the body (Susan A J, 1997).   The obesity related variant in the fat mass and obesity-associated protein also known as alpha-ketoglutarate-dependent dioxygenase FTO, has aroused interest in pediatrics due to its relationship with increased weight and ponderal index at 2 weeks of age (A. Lopez-Bermejo, C.J. Petry, M. Diaz, et al., 2008). FTO is located on the long arm of the chromosome 16 and is expressed in the brain, specifically the hypothalamic nuclei (Khung E. Rhee et al. 2012). Those who are homogenous for the at-risk allele have been found to be 3kg heavier than those who do not have the allele (T.M. Frayling, N. J. Timpson, M. N. Weedon et al. 2007). This weight gain is likely due to the gene’s involvement in the regulation of energy intake (Khung E. Rhee et al. 2012). According to recent studies, individuals carrying the at-risk allele prefer dense energy foods (J.E Cecil, R. Tavendale, P. Watt, M. M. Hetherington, & C.N.A Palmer, 2008), have reduced feeling of satiety (J. Wardle, S. Carnell, C.M.A. Haworth, I.S. Farooqi, S. O’Rahilly, & R. Plomin, 2008), display loss of control over eating (M. Tanofsky-Kraff, J.C. Han, K. Anandalingam et al. 2009), consume more fat and calories (even after adjusting for BMI) (N. J. Timpson, P.M. Emmett, T.M. Frayling, et al. 2008) and display a greater tendency towards consuming palatable foods after eating a meal (J. Wardle, C.Llewellyn, S. Sanderson, & R. Plomin, 2009). Therefore, FTO isn’t associated with energy expenditure, but it increases the susceptibility of individuals to higher calorie consumption and decreased satisfaction. A meta- analysis of 45 studies found that adults who were physically active attenuate the odds of obesity associated with FTO by almost 30% (T.O. Kilpelainen, L. Qi, S. Brage, et al. 2011). Thus carrying a gene for obesity does not necessarily predestine one to be obese (D. Meyre, K. Proulx, H. Kawagoe-Takaki et al. 2010), but rather increases the risk in the face of an obesogenic environment (Khung E. Rhee et al. 2012). Numerous studies in different ethnic groups suggest that the familial correlation in the total body fatness, expressed as body mass index, (BMI; kg/m2) from parent to offspring is about 0.2 and for sibling-sibling relationships about 0.25 (Bouchard C, Perusse L, Leblanc C, Tremblay A, Theriault G. 1988). As would be expected, studies of twins show a much higher concentration, particularly in monozygotic pairs (Susan A.J, 1997). However, these findings do not segregate the independent effects of genetic transmission and a shared environment (Susan A.J, 1997). Further studies of twins reared apart attribute 50-70% of the difference in BMI in later life to genetic factors (Stunkard A, Harris J, Pedersen N, McClearn G. 1990). Adoption studies, where an individual is compared both to their biological parent and their adopted parents, have also demonstrated the importance of genetic influences (Susan A.J, 1997). There is a strong relationship between the BMI of the adoptee and their biological parents across the entire range of fatness, but no relationship between the adoptee and their adoptive parents (Stunkard A, Sorensen T, Hanis C. et al. 1986). Studies of fat distribution have considered both the ratio of subcutaneous to total fat mass and the distribution of subcutaneous fat in the trunk relative to the limbs (Susan A.J, 1997). Data from the Quebec Family Study, suggest that the size of the internal fat stores are more strongly influenced by genetic factors than subcutaneous depots (Bouchard C., Perusse L., Leblanc C., Tremblay A, Theriault, 1988). Familial clustering suggests that genetic factors may account for 37% of the variance in the trunk to extremity skin fold thickness ratio (Rice T, Bouchard C, Perusse L, Rao D. 1995). These combined evidence from these genetic analysis suggests that obesity is a polygenic disorder and that a considerable proportion of the variance is non-additive (Susan A.J, 1997). This would explain the higher correlations between siblings than those between parent and offspring, and the 2-fold greater correlation between monozygotic than dizygotic twins (Susan A.J, 1997). These genetic influences seem to operate through susceptible genes; the occurrence of the gene increases the risk of developing a characteristic but not essential for its expression nor is it, in itself, sufficient to explain the development of the disease (Susan A.J, 1997). Unlike animal models, where a number of single genes can lead to obesity, no human obesity gene has yet been characterized, but the heterogeneous nature of human obesity does not preclude the identification of small number of individuals with a single defect which leads to obesity (Susan A.J, 1997). In man, a number of genetically determined conditions result in excess body weight or fatness (e.g Prader-Willi syndrome or Bardet-Biedl syndrome), but these account for only a very small proportion of the obese population (Susan A.J, 1997). PHYSIOLOGICAL MEDIATORS Energy expenditure Studies in animals have postulated that at the time of overfeeding, a remarkable increase in metabolic rate may deplete the excess energy thus reducing the rate of weight gain below theoretical values (Rothwell N., Stock M., 1983). Genetically obese animals tend to gain more weight than their lean controls even when they are pair-fed, thus implying a greater metabolic rate (Thurby P., Trayhurn P., 1979). One possible explanation for this effect is the decrease in diet-induced thermogenesis which is lessened in animal models of obesity due to a decrease in the sympathetic activation of brown adipose tissue (Rothwell N., Stock M., 1983). These unequivocal effects on energy expenditure in obese animals contrast with the paucity of evidence in humans (Susan A Jebb, 1997). Susan A.J (1997) stated that in obese humans, there have been constant reports of abnormally low energy intake which indirectly imply that there must be a defect in energy expenditure. There are three basic elements to energy expenditure which have each been the focus of extensive research. Basal Metabolic Rate In 1997, Susan A Jebb defined basal or resting metabolic rate as the energy expended by an individual at rest, following an overnight fast and at a comfortable environmental temperature in the thermo neutral range. Several studies of basal metabolic rate have concluded that obese subjects have a higher BMR compared to their lean counterparts. Researchers like Swinburn B. & Ravussin E, reported that approximately 80% of the inter- individual variance in BMR can be accounted for by age, fat-free mass, fat mass and gender. Nevertheless, this still gives room for some likelihood that inter-individual difference in BMR which may influence individuals with a relatively low BMR to become obese (Susan A. Jebb, 1997). Diet induced thermogenesis A number of studies have suggested that the post-prandial increase in energy expenditure is attenuated in obese subjects, perhaps due to decreased Sympathetic Nervous System activity (Astrup A. 1996). Similar effects have also been demonstrated in the post-obese. However this is not a consistent finding, even among studies from the same laboratory. A recent review by Ravussin E. & Swinburn B. (1993) identified 28 studies in favour of a defect in thermogenesis in humans and 17 against. However, since thermogenesis accounts for only a fraction of total energy expenditure (approximately 10%), the potential for a significant effect on total energy expenditure is insufficient (Susan A. Jebb 1997). Physical activity The most significant component of energy expenditure is physical activity which may represent 20-50% of total energy expenditure. Studies of fidgeting movements in Pima Indians within a whole-body calorimeter have shown significant inter-individual variations in the daily energy cost of these actions from 400-3000 kJ/day, with low levels predictive of subsequent weight gain at least in males but not females (Zurlo F., Ferraro R., Fontvielle A. et. al. 1988). However, in free-living conditions, the freedom to undertake conscious physical activity or exercise increases the inter-individual variability even further (Susan A Jebb). Research in this area has been hampered by imprecision in the methods to measure physical activities which have included various actometers, heart rate monitoring, activity diaries and direct observation (Susan A. Jebb, 1997). The energy requirements of an individual encompass the summation of basal expenditure, thermogenesis and physical activity. A whole-body calorimeter can be used to measure the total energy expenditure of an individual. The analysis of total energy expenditure in 319 obese subjects clearly demonstrates a significant increase in energy expenditure with increasing body weight such that individuals with a BMI in excess of 35 kg/m2 have energy expenditure approximately 30% higher than those with BMI less than 25 kg/m2 (Susan A Jebb, 1997). The outstanding difficulty with these studies , as stated by Susan A. Jebb in 1997 is that the increase in energy expenditure seen in obese subjects as a result of their increased body size may mask pre-existing metabolic defects in the pre-obese state which exposes the individual to excessive weight gain. However, in experimental overfeeding researches, there is no remarkable difference in the degree of weight gain between lean and obese subjects when matched for their excess energy intake (Diaz E. Prentice A. M et. al. 1992).   Studies of total energy expenditure in post-obese subjects have not arrived at a definite conclusion; some studies show no difference in energy expenditure in the post-obese relative to never-obese controls (Goldberg G.R., et. al. 1991), whilst others show a modest suppression of energy expenditure (Geissler C. Miller D., Shah M. 1987). In general, there is little evidence to support the hypothesis that human obesity may be due to a specific defect in energy expenditure in predisposed individuals (Susan A Jebb, 1997). Susan A Jebb further stated that advocates of a metabolic basis to obesity, argue that only very small differences in energy expenditure are neccessary to produce significant weight gain over many years, and this difference may be lower than the limits of precision of even the most advanced methodology. Energy Intake The failure to identify a defect in the metabolic control of energy expenditure and the contrary observation of high levels of energy expenditure, and the contrary observation of high levels of energy expenditure in obese subjects has led to a focus on food intake to explain the aetiology of obesity (Susan A Jebb, 1997). The increase in energy expenditure associated with the development of obesity should automatically help to prevent continued weight gain; hence the failure of this auto-regulatory system suggests that there must be a considerable error in the regulation of food intake (Susan A Jebb, 1997). Furthermore, habitually lean individuals are able to regulate intake to match energy requirements over a wide range of energy requirements yet those who become obese seem unable to achieve this balance (Susan A Jebb, 1997).   Breakthrough in discerning the role of energy intake in the aetiology of obesity has been critically disconcerted by under-reporting which is now largely recognized as a feature of obesity (Susan A Jebb, 1997). Comparisons of energy intake and energy expenditure indicate consistent shortfalls in self-reported intake, averaging approximately 30% of energy requirements in obese subjects (Prentice A.M., Black A.E., Coward W.A., 1986; Lichtman S., Pisarska K., Berman E., et al., 1993). This phenomenon also extends to post-obese subjects and to others who may be very weight conscious (Susan A Jebb, 1997). Under-reporting may be cause by several factors and it is natural for individuals to change their eating pattern when they are to record their food intake.   This is usually associated with a reduction in intake as subjects consciously or sub-consciously adopt a self-imposed ‘diet’. (Susan A Jebb, 1997). Therefore they might give accurate results about their intake for that duration, but it may not be a true representation of their habitual pattern. Forgetfulness, underestimation of meal size and lack of basic knowledge of food consumption can also lead to under-reporting. Although, it is possible to have falsification and fabrication of dietary records, there are also instances of self-deception or deliberate manipulation of dietary records. Recent research into the appetite control system by Blundell J.; Bouchard C., Bray G. (1996), has identified a network of synchronous interactions which govern eating behavior. These effects are mediated through the central nervous system particularly the hypothalamus, where a number of neuropeptides appear to regulate feeding behavior via effects on hunger and satiety (Susan A Jebb, 1997). Laboratory studies of feeding behavior by Spiegel T., et al., in 1989, proposed that, following a convert energy preload, obese subject may be less able to accurately compensate for the energy content of the preload at a subsequent meal than lean subjects. However, these studies are usually of short duration in laboratory settings and may not accurately reflect eating behavior in a naturalistic setting, where knowledge of foods consumed and conditioned learning may invoke other regulatory processes (Susan A Jebb, 1997). There is also significant evidence that the individual macronutrients (protein, fat, carbohydrate and alcohol) have different influences on eating behavior, majorly due to their effects on satiety (Stubbs R., 1995). Experimental studies of manipulated foods and retrospective analyses of dietary records suggest that protein is the most satiating (DeCastro J., 1987; Hill A., Blundell J., 1990). Carbohydrate is also an efficient inhibitor of later food consumption, at least in the short terms, meal-to-meal context (Rolls B., et al. 1994). Fat seems to have a satiating capacity (Lawton C., Burley V., 1993). Fat hyperphagia occurs during a single meal due to subjects overeating high fat foods and is also known as passive over consumption. In 1994, Poppitt S., stated that fat has two times the energy per gram of carbohydrate or protein which may be due to the level of energy density and not necessarily a characteristic of dietary fat. Appetite is said to be stimulated by alcohol and according to DeCastro J & Orozco (1990), in free living circumstances, alcohol consumption with meals is associated with higher energy intakes, but this may also reflect that alcohol is more likely to be consumed on special occasions which in themselves are associated with increased food intake. Basically, taste preference can have an effect on the amount of food consumed and the kind of food.   The individual preference for certain meals would make them more likely to consume more of that meal. Therefore, sensory preferences plays a role on energy balance since is it associated with energy intake. According to Witherley S, Pangborn R & Stern J (1980), several reports of sensory preferences for particular food groups in association with obesity, but inter-subject variability is so great as to obscure any underlying obese-lean differences. The relationship between sensory preference for fat versus sugar and BMI was pinpointed by Drewnowski in 1992. Obese women had preference for foods with high fat to sugar ratio while women with low BMI had preference for high sugar to fat ratio, therefore increase in weight is closely related to increase for fatty foods. Eating frequency has effect on weight gain, because people who eat several small meals at intervals have less weight than those that eat fewer meals in larger quantity and therefore large quantity of food consumed at a time may be a risk factor for obesity, however, studies as regards this, showed no remarkable relationship (Bellisle F, McDevitt R, Prentice A.M. 1997). Research in this area is contradicted by under-reporting of food consumption in obese subjects and by post-hoc variations in eating patterns as a result of obesity and efforts to control weight (Susan A Jebb, 1997). Eating frequency in obese subjects is however an unreliable blueprint to the eating patterns involved in the aetiology of obesity (Susan A Jebb, 1997). ENVIRONMENTAL INFLUENCE Obesogenic environment which was first coined in the 1990s, in a bid to explain the present obesity epidermic. According to King D (2007), obesogenic environment is the sum of the influences that the surroundings, opportunities or conditions of life have on promoting obesity in individuals and populations. This encompasses the cultural, social and infrastructural conditions that affect the ability of a person to embrace a healthy lifestyle. Individuals in a population respond to unhealthy environment and the more urbanized the environment, the more individuals are pressurized to adopt unhealthy habits. The pressure from the surrounding makes it difficult for individuals to change their lifestyle and practice healthy habits when the environment itself is unhealthy. Environmental factors may have a critical effect in the development of obesity by unmasking genetic or metabolic susceptibilities (Susan A.J, 1997). Environmental influences on diet involve a wide range of factors including accessibility to food and high calorie drinks. Eating habits are commonly influenced by the availability and accessibility of unhealthy food, which is an important consideration in the effect on obesity. Studies in the United States recommend that the availability of high quality, affordable ‘healthy’ food is limited for people who reside in low-income communities and such scarcity is associated with unhealthy diet and obesity (White 2007) .However despite several epidemiological studies that shows environmental influences play an important role in the aetiology of obesity, it is a fact that some people within the same ‘unhealthy environment’ still managed to maintain a healthy weight (Susan A.J, 1997). PSYCHO-SOCIAL INFLUENCES Food is sometimes used as a coping mechanism by individuals with weight issues, especially when they are unhappy, nervous, stressed, bored and depressed. In many obese individuals there seems to be a perpetual cycle of mood disturbance, overeating, and weight gain (Jennifer C. Collins & Jon E. Bentz 2009). When they feel frustrated, they rely on food for comfort, even though this coping mechanism may pacify their mood, the resultant weight gain that results may cause a dysphoric mood due to their inability to control their stress (Jennifer C. Collins & Jon E. Bentz, 2009). Eventually a guilty feeling may restart the cycle and might steer a habitual pattern of eating food to get comfort. This habitual pattern is specifically significant if there is a genetic risk factor for obesity or an ‘obesogenic’ environment where foods high in calorie & density are readily accessible and sedentary lifestyle is present. Regrettably, these situations are popular in America. In addition to depression and anxiety, other risk factors include problematic eating behaviors such as â€Å"mindless eating,† frequent snacking on high calories foods, overeating, and night eating (Glinski J., Wetzler S., Goodman E.2001). American Psychiatric Association has currently included Binge eating disorder (BED) in an appendix of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) and is characterized by: recurrent episodes of eating during a discrete period of time (at least 2 days a week over a 6 month period); eating large quantity of food than majority of the people would eat at the same time; a feeling of loss of control during the episodes; and guilt or distress following the episodes (Jennifer C. Collins & Jon E. Bentz, 2009). According to Wadden T.A., Sarwer D. B., Fabricatore A. N., Jones L., Stack R., & Williams N.S (2007), BED is estimated to occur in approximately 2% of the general population and between 10% and 25% of the bariatric population. An important differentiation pointed out by the American Psychiatric Association, between BED and bulimia/anorexia is that BED is not associated with any regular compensatory behaviors, such as purging, fasting, or excessive exercise. It can therefore be implied that the majority of individuals with BED are overweight. Night eating, which was first identified in 1955 as another disorder that can lead to remarkable weight gain, though night eating syndrome (NES) is not currently recognized by the American Psychiatric Association as a distinct diagnosis in the DSM-IV-TR. Night eating syndrome is characterized by excessive late night consumption (> 35% of daily calories after the evening meal), unhealthy eating patterns, â€Å"morning anorexia,† insomnia, and distress (Stunkard A. J., Grace W. J. & Wolff H. G. 1955). NES occurs in approximately 1% of the general population and an estimated 5-20% of the bariatric population (Wadden T.A., Sarwer D. B., Fabricatore A. N., Jones L., Stack R., & Williams N.S. 2007). More recently, NES has been seen as a disorder of circadian rhythm that includes a delay of appetite in the mornings and the continuation of appetite and over consumption of food during the night (Jennifer C. Collins & Jon E. Bentz, 2009). PATHOPHYSIOLOGY OF OBESITY There are several possible pathophysiological mechanisms involved in the advancement and prolongation of obesity. This field of research had been almost unapproached until the leptin gene was discovered in 1994 by J. M. Friedman’s laboratory (Zhang, Y., Proenca, R., Maffei, M., Barone, M., Leopold, L., Friedman, J.M., 1994). These researchers proposed that leptin was a satiety element. However, soon after J. F. Caro’s laboratory could not ascertain any mutations in the leptin gene in humans with obesity. In 1995, Considine, RV; Considine, EL; Williams, CJ; Nyce, MR; Magosin, SA; Bauer, TL; Rosato, EL; Colberg, J., & Caro, J.F. proposed a contrary view that Leptin expression was increased, postulating the possibility of Leptin-resistance in human obesity. Since the discovery of leptin, insulin, ghrelin, orexin, cholecystokinin, adipokines, peptide tyrosine tyrosine, as well as many other mediators have been researched. The adipokines are intermediators produced by adipose tissue; their action is thought to revise many obesity-related diseases. Leptin and ghrelin are considered to be interrelated in their effect on appetite, with ghrelin produced by the stomach regulating short-term appetitive control (i.e. hunger pangs when the stomach is empty and satiety when the stomach is stretched). Leptin is created by adipose tissue to signal fat storage reservoirs in the body, and mediates long-term appetitive controls (i.e. to eat more when fat storages are low and less when fat storages are high). Although administration of leptin may be effective in a small subset of obese humans who have deficiency in leptin, most obese humans are considered to be leptin resistant and have been found to have high levels of leptin (Hamann A., & Matthaei S. 1996). This resistance is thought to explain in part why administration of leptin has not been shown to be effective in suppressing appetite in most obese people (Flier J.S. 2004). Leptin and ghrelin act on the hypothalamus and are produced peripherally. They control appetite through their actions on the central nervous system. They act on the hypothalamus, a region of the brain central to the coordination of food consumption and energy expenditure. There are several circuits within the hypothalamus that contribute to its performance in integrating appetite, the melanocortin pathway being the most well understood (Flier J.S. 2004). The circuit starts with an region of the hypothalamus, the arcuate nucleus, that has outputs to the lateral hypothalamus (LH) and ventromedial hypothalamus (VMH), the brains feeding and satiety centers, respectively (Boulpaep, Emile L., Boron, & Walter F. 2003). According to Flier J.S. (2004), the arcuate nucleus contains two distinct groups of neurons; the first group co expresses neuropeptide Y (NPY) and agouti-related peptide (AgRP) and has stimulatory inputs to the LH and inhibitory inputs to the VMH and the second group coexpresses pro-opiomelanocortin (POMC) and cocaine- and amphetamine-regulated transcript (CART) and has stimulatory inputs to the VMH and inhibitory inputs to the LH (Flier J.S. 2004). Consequently, NPY/AgRP neurons stimulate feeding and inhibit satiety, while POMC/CART neurons stimulate satiety and inhibit feeding (Flier J.S. 2004). Both groups of arcuate nucleus neurons are regulated in part by leptin. Leptin inhibits the NPY/AgRP group while stimulating the POMC/CART group (Flier J.S. 2004).   Researches done by Flier J.S., 2004, thus concluded that a deficiency in leptin signaling, either via leptin deficiency or leptin resistance, leads to overfeeding and may account for some genetic and acquired forms of obesity. EFFECT ON HEALTH Obesity is a severe medical condition and a chronic health issue worldwide. The association between body weight and mortality is a subject of concern, especially in regards to the optimal weight for longevity (JoAnn E. Manson, M.D., Walter C. Willett, M.D., et al, 1995). The significance of understanding the true relationship between weight and mortality is underlined by the increasing prevalence of obesity in the United States (Kuczmarski RJ, et al, 1994) especially women (Harlen WR, et al, 1988). Obesity is a major risk factor for cardiovascular diseases (e.g., heart disease, stroke and high blood pressure), diabetes (e.g. type 2 diabetes), musculoskeletal disorders (e.g., osteoarthritis), some cancers (e.g., endometrial, breast, and colon cancer), high total cholesterol or high levels of triglycerides, liver and gallbladder diseases, sleep apnea and respiratory problems, reproductive health complications such as infertility and mental health conditions (WHO, 2012). Obesity and Cancer Obese people are more vulnerable to cancer and their prognosis is extremely worse when diagnosed. Men that are obese are 33% more likely to die from cancer and obese women also have a 50% higher likelihood of dying from breast cancer (Weight Management Centre, 2010). Additional to obesity, cancer has recently been linked to diet and physical activity status (Bray 2004, Barnard 2004, Wiseman 2008). The cancers most significantly associated with obesity in women are cervical, uterine, kidney, breast and endometrial cancer and in men are colon, pancreatic and liver cancer (Calle, Rodriguez, Walker-Thurmond & Thun 2003). One study, using National Cancer Institute Surveillance, Epidemiology, and End Results data, estimated that in 2007 in the United States, about 34,000 new cases of cancer in men (4 percent) and 50,500 in women (7 percent) were due to obesity. The percentage of cases attributed to obesity varied widely for different cancer types but was as high as 40 percent for some cancers, particularly endometrial cancer and esophageal adenocarcinoma (National Cancer Institute, 2012). Obesity and cardiovascular disorders Cardiovascular disease (CVD) is one of the major cause of death in U.S. Obese people are more liable to die from CVD largely due to accelerated atherosclerosis, hyperlipidaemia, loss of glyceamic control and hypertension. Until recently the relationship between obesity and coronary heart disease was viewed as indirect, i.e., through covariates related to both obesity and coronary heart disease risk (Lew E.A., Garfinkel L., 1979) including hypertension; dyslipidemia, particularly reductions in HDL cholesterol; and impaired glucose tolerance or non–insulin-dependent diabetes mellitus. Insulin resistance and accompanying hyperinsulinemia are typically associated with these comorbidities (Reaven G.M., 1988). Although most of the comorbidities linking obesity to coronary artery disease increase as BMI increases, they also relate to the total distribution of body fat. Long-term longitudinal studies, however, indicate that obesity as such not only relates to but independently predicts coronary atherosclerosis (Manson J.E., et al., 1995; Garrison R. J., et al. 1985; Rabkin S.W., 1977). Messerli F. H. (1982) stated that left ventricular hypertrophy is mostly seen in patients with obesity and is related to systemic hypertension and may be related to the severity of obesity. Hypertension is approximately three times more commonly found in obese individuals than normal-weight persons (Van Itallie T.B., 1985). This relationship may be directly related such that when weight increases, there is an increase in blood pressure (Kannel W.B., Brand N., et al., 1967) and when weight decreases, blood pressure also decreases (Reisin E., Frohlich E.D., et al., 1983). Obesity and mental health Individuals diagnosed with obesity tend to be less favorable on all levels of the psychological assessment and may exhibit several symptoms ranging from mere sadness to chronic depression. Evident are more episodes of mood swings, anxiety, personality and eating disorders, basically related to or associated with obesity experienced by individuals with obesity (Pickering, Grant, Chou, Compton 2007). Obesity may be an inception of psychiatric manifestations and vice versa and is related to psychosocial deterioration and bias based on weight. This comprises of loss of self-worth, and reduced self-esteem associated with stigmatization. Stigmatization can further lead to desolation and withdrawal and thus many obese individuals seek solace in binge eating, thereby gaining more weight. Based on reports from Roberts, Deleger, Strawbridge & Kaplan 2003; Herva, Laitinen, Miettunen, Veijola, Karvonen & Lasky 2006; Kasen, Cohen, Chen &Must 2008, concern, shame and guilt associated with low self-worth, which is finally related to excessive food consumption completes the obesity-mental disorder circle. There is bias and discrimination associated with obesity. They generally report reduced quality of life and functional wellbeing, collectively called Health-related quality of life (HRQOL) (Puhl & Brownell 2001; Wadden & Phelan 2002). This relationships is majorly expressed by women (Fontaine 2001) and for people with severe obesity (Hudson, Hiripi, Pope & Kessler 2007; Scott, Bruffaerts, Siomn, Alonso, Angermeyer, de Girolamo et al. 2008). Obesity and diabetes Diabetes is usually a terminal illness. i.e. it is a lifelong chronic disease characterized by high levels of sugar in the blood. One of the major risk factors for diabetes is obesity. Obesity is directly associated with Diabetes 2. The association between obesity and type 2 diabetes are firmly established and without the intervention of a healthy diet and proper exercise, obesity can lead to type 2 diabetes over a very short period of time.   In fact, obesity is believed to account for 80-85% of the risk of developing type 2 diabetes, while recent research suggests that obese people are up to 80 times more likely to develop type 2 diabetes than those with a BMI of less than 22 (National Health Service, 2014). It is a known fact that obesity carries a greater risk of developing type 2 diabetes, especially if you have excess weight around your abdomen. Studies postulates that abdominal fat causes fat cells to releases ‘pro-inflammatory’ chemicals, which can reduce the body’s sensitivity to the insulin, this can also disrupt the function of insulin responsive cells and their ability to react to insulin. This is known as insulin resistance   which is a primary activator for type 2 diabetes. Excess abdominal fat is a major high-risk form of obesity. SOCIO-ECOMOMIC/ FINANCIAL COST OF OBESITY In 1999-2000, nearly 65 percent of U.S. adults were either obese or overweight. Obesity accounts for $117 billion a year in direct and indirect economic costs. Obesity is associated with 300,000 deaths per year, and is fast becoming the leading cause of preventable deaths† (Mancino, Lin, and Ballenger, 2004). Certainly, obesity has become a large problem in America. Recent increase in meal portions and reduction in availability of natural food production may propose why people find it challenging to maintain a healthy diet. Although, certain People have been successful at maintaining a healthy nutritional status and avoiding this unhealthy situation. Gary Becker’s human capital theory is a groundwork that helps to clarify the effect of weight status on the economy in terms of the labor market outcomes for the individual. Human capital is the educational qualification, job experience/training, and the health condition that workers devote their time in to boost their capacity and skills to be â€Å"rented out† to employers (Ehrenberg and Smith, 2005). Healthy weight status in relation to labour is a type of human capital investment. According to Robert Pindyck and Daniel Rubinfeld (2004), â€Å"When an investment decision is made, the investor commits to a current outlay of expenses in return for a   stream of expected future benefits.† These stated costs for a healthy weight may include buying of food with high nutritional values and creating time for physical activities. As an investment, the individual sacrifices money, time and other resources to attain a healthy weight to become more productive in the future and, hence, earn higher income. Obese workers miss more days of work and inflict more cost on employers especially in medical and disability claims and also workers compensation claims. As a result, firms end up with extra costs associated with obesity, this is one of the economic effects of obesity. Obesity places significant burden on the society through health care expenditures and disability payments combined through group health insurance and public programs. The estimated annual medical cost of obesity in the U.S. was $147 billion in 2008 U.S. dollars; the medical costs for people who are obese were $1,429 higher than those of normal weight (CDC, 2011). Obesity there has direct and indirect effect on the Nation’s resources, as more money is spent on the obese due to the high risk of comorbidity with other life threatening diseases like type 2 diabetes, osteoarthritis and cardiovascular diseases. TREATMENT There are several weight-loss schemes available but many are ineffectual and short-term, especially for those who are morbidly obese. The strategies for weight loss with non-surgical programs usually involve a combination of diet modification, behavior modification therapy and appropriate exercise. Dietary Modification Dietary modifications for obesity are designed to create a negative energy intake-energy expenditure balance (i.e., calories consumed < calories expended) by reducing daily energy intake below the required level. The required energy varies by weight, sex and level of physical exercise such individuals with higher weights, more activity have greater energy needs, including men (Melanson K. & Dwyer J. 2002). Uniformly, higher energy deficits results in higher weight losses. Low calorie diet is recommended for obese individuals and they are advised to check calorie content of meals before consumption. Very low calorie diet is recommended for morbidly obese individuals with little or no success in low diet consumption. Behaviour Therapy The oldest report of the use of behavioral therapy in the management of obesity occurred in 1967. Since then, it has been widely used in the management of obesity (Gupta R. & Misra A. 2007). Behavior therapy involves setting out goals and principles to patients to aid their adherence to the diet modification and activity goals for weight loss. Conventional tactics include self-monitoring of food intake and exercise, reduced portion of meals and number of times of food intake, intellective restructuring, problem solving, and prevention of regression. The primary aim of behavior modification therapy is to change eating pattern and exercise practices to promote weight loss (CDC, 2011). Components of behavioral therapy Self-monitoring: This is one of the main elements of behavior therapy in obesity. Self-monitoring includes maintaining food dairies and activity logs (Guare J.C., et. Al., 1989).Stimulus Control: This is the second key element in behavior therapy. In this element, focus is placed on altering the environment that initiates eating and modifying it to help prevent overeating. Stimulus control includes proper purchase of food items, excluding energy-dense processed food and introducing more fruits and vegetables (Wing R.R., 2004) Slower eating: Reducing the speed of eating so as to allow signals for fullness come into play.Goal setting: Setting realistic goals for one’s self or setting goals for patients as appropriate (Bandura A. & Simon K.M., 1977). Behavioral contracting: Reinforcing of successful outcomes or rewarding good behaviors plays a key role (Volpp K. G., et. al., 2008).Education: Nutritional education is a necessary component of a successful behavior therapy for obesi ty. A structured meal plan in conjunction with consultation with a dietician will be helpful (Pedersen S. D., et. al., 2007).Social support: Behavioral modification is more sustainable in the long term when there is social support. Enhancing social support is essential for behavioral therapy (Avenell A. et. al., 2004). Physical activity Physical activity is the third component of non-surgical weight loss interventions and lifestyle modification. The advantages of physical activities include promoting negative energy balance by maximizing calorie expenditure, preserving fat-free part during weight loss, and improving cardiovascular fitness. Physical activity, however, is ineffective in weight loss in the absence of diet modification. The greatest benefit of physical activity is in facilitating the maintenance of weight loss (Pronk N.P & Wing R.R. 1992). Case studies have shown that people who exercise regularly are more successful in maintaining weight losses than are those who do not exercise. Kayman S., Bruvold W., Stern J.S. 1990; Klem M.L., Wing R.R., McGuire M.T., Seagle H.M., Hill J.O.1997). Additional evidence comes from randomized trials. Participants who receive diet plus exercise maintain greater weight losses 1 year after treatment than do those who receive diet alone, although the differences are not always statistically significant (Wing, R.R. 1999). PREVENTION Obesity is a long-lasting medical condition, which is linked with several debilitating and life-threatening conditions. The increasing rate of obesity globally is a public health concern (Srinivas N., et. al., 2004). Hence an effective way to control obesity requires strategies that would tackle the major issues relating to prevention (Srinivas N., et. al., 2004). The treatment and prevention of obesity are interrelated. The prevention of obesity involves several levels i) Primary ii) Secondary iii) Tertiary (Timothy P.G., 1997). Primary prevention: The goal of primary prevention is to reduce the number of new cases. Diet modification/ healthy diet habits is a primary way of preventing obesity. Sedentary life style which is one of the causes of obesity can be prevented by appropriate exercises and activities that help burn out excess calories in the body and also prevent accumulation of fat. Simple habits ranging from 30 minutes walk in a day to weekly work out at the gymnasium can go a long way in maintaining a healthy weight. Health education is also very important in this aspect because some individuals in the community are unaware of the health implications of their habits. Appropriate health education programs should be organized to increase awareness. Accessibility to healthy food is also an important factor in the prevention of obesity. Formulations of policies that would facilitate healthy eating habit should be adopted by the Government; this would go a long way in reducing the economic effects of ob esity and the burden on the Nation’s resources. Policy and environmental approaches that make healthy choices available, affordable and easy can be used to extend the propagation of strategies designed to raise awareness and support people who would like to make healthy lifestyle changes (CDC, 2011).Secondary prevention: Secondary prevention is to lower the rate of established cases in the community (Srinivas N., et. al., 2004). Secondary prevention includes strategies to diagnose and treat an existing medical condition in its early stage to avoid complications. (Jeffery G.K., 2014). Tertiary prevention: Tertiary prevention is to stabilize or reduce the amount of disability related to obesity ((Srinivas N., et. al., 2004). For those who are already obese and showing signs and symptoms of complications, there are clinical preventive maintenance and treatment regimes (Srinivas N., et. al., 2004). These treatment includes medications and increase in fruit and vegetable consumpti on. Some extreme cases may include surgery and this is used usually when BMI exceeds 30kg/m2 or 40 kg/m2 and when other treatment options have failed. Examples of surgical procedures to treat obesity and its complications includes gastric partitioning and gastric by-pass (Srinivas N., et. al., 2004). REFERENCES Allison, B. D., Fontaine, R. K., Manson, E. J., & VanItallie, B. T. (1999). Annual deaths attributable to obesity in the United States. Journal of American Medical Association , 282 (16), 1530-8. Barness, A. L., Opitz, M. J., & Gilbert, E. (2007). Obesity: Genetic, molecular and environmental aspects. American Journal of Medical Genetics , 143 A (24), 3016-3034. Calle, E. E., Thun, J. M., Petrelli, M. J., Rodriguez, C., & Heath, W. C. (1999). Body mass index and mortality in a prospective cohort of U. S. adults. New England Journal of Medicine , 341 (15), 1097-105. Cawley, J., & Meyerhoefer, C. (2012). The medical care costs of obesity: An instrumental variables approach. Journal of Health Economics , 31 (1), 219-230. CDC.gov. (2011). National Diabetes Fact Sheet. Retrieved November 29, 2014, from Center for Disease Control and prevention http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2011.pdf Flegal, M. K., Ogden, L. C., Wei, R., Kuczmarski, L. R., & Johnson, L. C. (2001). Prevalence of overweight in US children: Comparison of growth charts from the centre for disease control and prevention with other reference values for body mass index. American Journal of Clinical Nutrition , 73 (6), 1086-93. Glenny, A., & et, a. (1997). A systematic review of the interventions for the treatment of obesity and the maintenance of weight loss. International Journal of Obesity and Related Disorders . Gray, S. D., & Fujioka, K. (1991). Use of relative weight and body mass index for the determination of adiposity. Journal of Clinical Epidermiology , 44 (6), 545-550. Haslam, W. D., & James, P. W. (2005). Obesity. Lancet , 366 (9492), 1197-1209. Healthy weight: Assessing your weight; BMI: About BMI for children and teens. (2009, April). Retrieved April 2009, from Centre for Disease Control and Prevention. Miech, A. R., Kumanyika, K. S., & Stettler, N. (2004). Trends in the association of poverty with overweight among US adolescents. Journal of American Medical Association , 2385-2393. Mokdad, H. A., Marks, S. J., Stroup, F. D., & Gerberding, L. J. (2004). Actual causes of death in the United States, 2000. Journal of American Medical Association , 291 (10), 1238-45. Ogden, L. C., Flegal, M. K., Carroll, D. M., & Johnson, L. C. (2002). Prevalence and trends in overweight among US children and adolescents, 1999-2000. Journal of the American Medical Association , 288 (14), 1728-1732. Popkin, M. B., Adair, S. L., & Ng, W. S. (2012). Global nutrition transition and the pandemic of obesity in developing countries. Nutrition Reviews , 70 (1), 3-21. Sturm, R. (2007). Increases in morbid obesity in the USA: 2000-2005. Journal of Public Health , 121 (7), 492-6. Sweeting, N. H. (2007). Measurement and definitions of obesity in childhood and adolescence: Afield guide for the uninitiated. Nutritional Journal , 6 (1), 32.

Computer Assisted Language Learning

Introduction Computers can be tremendously useful tools for English language instruction. They process data quickly and integrate voice, music, videos, pictures and text into lessons. They can be programmed to tailor instruction and test for each individual learner. They can even used to make students feel more comfortable and willing to take risks, because of their â€Å"untiring, unjudgmental nature† (Butler-Pascoe 1997:20). While there are many potential benefits to be derived from these â€Å"machines†, the issue now is not whether but how computers should be used for language instruction. Regardless of the speculated disadvantages of using computers for language instruction, advance by some individual or groups, computers and CALL materials are already being used for English language instruction and will continue to be used. It can be used as a modern approach towards language teaching and learning in which the computer is utilized as an aid to the presentation, and as reinforcement and assessment of material to be learned by usually including substantial interactive materials. Over the years with the emergence of the World Wide Web or the Internet, CALL widened its scope. It has become communicative, interactive and explorative such that audio and video exercises or activities can easily be integrated. The role of language teaching has grown as years have gone by. As observed, interactivity in learning becomes â€Å"a necessary and fundamental mechanism for knowledge acquisition and the development of both cognitive and physical skills† (Barker, 1994:1). Today, computer technology can help advocate the communicative approach to learning because it, too, is concerned with the interaction between the teacher and the learner, and the students’ learning needs and learning styles. Due to the significant changes in second language teaching and learning (e. g. the role of the teacher, the role of the learner, the role of multimedia, and the way the learning process is conducted in the classroom settings), interaction has become an increasingly important and relevant area of study in the field of second language acquisition since it reflects what goes on in learning and teaching processes. Communication is intrinsic to success, effective instructional practice as well as individual discovery. The implementation of interactivity can be perceived as an art (Sims 1997) because it requires a comprehensive range of skills, including an understanding of the learner, an appreciation of software application capabilities, the importance of rigorous instructional design and the application of appropriate learning materials. The value of the multimedia and the Internet in the enhancement of interaction for language learning can not be disregarded. Warschauer, M. , & Healy, D. 1998) stated that the type of software and the task teachers set for the students have a large effect on the type and quality of students interaction with each other when working in pairs or small groups. With the continuing development of technological advances in the areas of communication and multimedia, the challenge for English (foreign language) classrooms goes far beyond current knowledge about the effective use of technology. The CALL is a milestone as far as language teaching is concerned. And with that realization in mind, this study, â€Å"Computer Assisted Language Learning (CALL): Interactive Teaching in English Using Different Websites in San Pablo Elementary School is presented. Statement of the Problem The general objective of this study is to help improve the English capability and competency of the students in Grade I of San Pablo Elementary School making it interactive and communicative using the Computer Assisted Language Learning (CALL) materials imparted through the use of Different English Websites. Specifically, it tried to answer the following questions: 1. How will the CALL technology provide interactive English comprehension, vocabulary, and writing exercises? 2. How will the CALL create interaction among the student and teacher? 3. How will the lessons be made interactive and communicative? 4. Will this approach be found satisfactory through test result? And 5. Will this approach be found satisfactory by its users? Significance of the Study English learning has become the most important task for students. At very young age parents send their children to private training or classes to enhance their English learning and to provide their children a strong foundation in English. However, there are still some problems and dilemmas for students in language learning. Most students still could not have effective communication after years of English language learning. Some students have difficulty in their expression in an English presentation, although they have higher scores in English tests. Computer has been considered as an important learning tool in the modern second language learning. Computer Assisted Language Learning (CALL) has provided amazing opportunities for improving second language learning such as it can motivate students’ interesting or improve learners’ varied linguistic skills (AbuSeileek 2007). Nowadays, San Pablo Elementary has 6 computers (2 are originally school property, 4 are personal property of the teachers) placed in a laboratory room equipped with new hardware and software but it’s not fully explored and utilized in English language teaching. The study is important due to the following reasons: 1. To help improve the English capability and competency of the students in Grade I of San Pablo Elementary School. 2. To help students learn to interpret new information and experiences on their own terms. 3. With the use of CALL more shy students can feel free in their own students'-centered environment. This will raise their self-esteem and their knowledge will be improving. 4. Through the use of different English Educational Websites students will perform collaborative project where in they will do their best to perform it within set time limits. 5. To make the class more interesting and to increase students’ interest and motivation. 6. To provide information’s regarding Computer Assisted Language Learning (CALL). METHODOLOGY There are various concerns considered in this action research. There is no simple finite number of these concerns, nor is there a simple dichotomy between qualitative and quantitative approaches. Indeed, there is an off-cited division in the second language acquisition (SLA) field between those researchers who favor qualitative methodologies and those who prefer quantitative ones. Research Design: This study is an action research. This study was conducted for the purpose of solving a problem or obtaining information in order to solve some kind of day to day immediate concern such as how to figure out ways to use technology to improve the teaching of grammar in the classroom. To dealt with are the needs and concerns of the students. Data concerning the problem (both qualitative and quantitative) were collected and interpreted. Qualitative- the data collected include a pre-survey and a post-survey. Quantitative- a test (post-test) administered. Research Procedure: The Profile of the students’ background, experience and future needs are obtained. The purpose of the needs analysis was to find out whether they agree or disagree on the use of the CALL technology in language learning and to find out their familiarity with the CALL materials and the Internet in teaching the English language. The following are stages conducted in this study: Stage 1: Survey by Interview To help determine the age, gender, needs and experience of the students using a computer, a structured interview were prepared and administered. Stage 2: Utilization of the Different English Websites in the Classroom The primary audience for the websites are the Grade I students of San Pablo Elementary school with a particular teacher, the audience used worldwide ESL sites exist which are designed for a certain English language level. It is important to consider a site’s purpose, since meaningful comparisons of evaluations can be made among sites with the same or at least similar intended goals, uses and audiences. In this study English websites can be directly used by the Grade I students of San Pablo Elementary School. Stage 3: The Post Test To help determine the progress of the students in San Pablo Elementary School after taking the lesson using CALL materials. Stage 4: The Post Survey Administered and answered by the students after the â€Å"test-run†. Research Setting and Participants This action research was conducted at San Pablo Elementary located at Block. 14 San Pablo, Tarlac City. The school is categorized as a complete, non-central school, mono-grade having 2 sections each grade level. Computer laboratory provided by the teachers in the school was used. This study used 35 students in Grade I section Daisy. The section is heterogeneous. The data collected for this study will come from the observations and tests taken by the students. An in depth analysis of the collected data was carried out. PRESENTATION AND ANALYSIS OF DATA A survey interview has been developed in participants’ home language for the purpose of collecting background information. Based on the pre-survey interview, the researcher collected this data. Table 1: Students Profile No. NameAgeGenderComputer at HomeWith / without Experience in computer 1Banag, Jonie D. 7MNoneWithout 2Bermudo, Mark Anthony D. C. 6M1With 3Boehn, Adrian M. 6M1With 4Butchayo, John Carlo G. 7MNoneWithout 5Fallorina, Jerry M. 8MNoneWithout 6Gaupo, Gerald7MNoneWithout 7Lacanlale, Christian G. 7MNoneWithout 8Luna, Alexander N. 6MNoneWithout 9Manalili, John Lloyd C. 6M1With 10Maninang, Emer6MNoneWithout 11Manlapas,Randy A. 6MNoneWithout 12Martinez, Clive Xavier M. 5MNoneWithout 13Morales, Aiveen Nash M. 6MNoneWithout 14Pilariza, Hans Russell L. 7M1With 15Puno, Jerome M. 6MNoneWithout 16Roldan, Rainier T. 6MNoneWithout 7Tolentino, John Michael E. 7M1With 18Uring, Justine H. 6MNoneWithout 19Bautista, Marichell D. C. 6FNoneWith 20Botio, Renalyn M. 7F1With 21Casem, Allyana N. 6F6With 22Castaneda, Rey-ann 7FNoneWithout 23Dizon, Clarisse Joy R. 6F1With 24Lacanlale, Clarissa G. 6FNoneWith 25Manlapas, Adrian Mae 6FNoneWithout 25Nucup, Lyka M. 6FNoneWithout 27Obenario, Angelina D. C. 6FNoneWithout 28 Padua, Maricar 7FNoneWithout 29Panag, Maiel T. 6F1With 30Pangan, Cristina C. 7FNoneWithout 31Pangilinan, Gloria8FNoneWithout 32Quintos, Jennalyn Y. 6FNoneWithout 33Sabat, Maadrian E. 6FNoneWithout 34Sagadraca, Angelika Joy M. 6 FNoneWithout 35Salas, Jomae V. FNoneWithout There were 35 participants that took part in study. The table shows that the students consist of 19 male and 16 female. One of them is 5 years old, 21 are 6 years old, 11 are 7 years old, and 2 are 8 years old. Out of 35 students, only 6 have their own computer at home and 10 have experience in operating a computer. The second quarter test result serves as point of reference in this study. The test is composed of 30 items consisting questions about listening skills, vocabulary, grammar, reading and comprehension. The table below shows the scores of the students and the calculated mean. Table 2: Second Quarter Test Result No. NameScore 1Banag, Jonie D. 15 2Bermudo, Mark Anthony D. C. 12 3Boehn, Adrian M. 16 4Butchayo, John Carlo G. 20 5Fallorina, Jerry M. 17 6Gaupo, Gerald15 7Lacanlale, Christian G. 16 8Luna, Alexander N. 12 9Manalili, John Lloyd C. 17 10Maninang, Emer13 11Manlapas,Randy A. 18 12Martinez, Clive Xavier M. 18 13Morales, Aiveen Nash M. 19 14Pilariza, Hans Russell L. 19 15Puno, Jerome M. 22 16Roldan, Rainier T. 14 17Tolentino, John Michael E. 22 18Uring, Justine H. 18 19Bautista, Marichell D. C. 14 20Botio, Renalyn M. 21 21Casem, Allyana N. 20 22Castaneda, Rey-ann 12 23Dizon, Clarisse Joy R. 14 24Lacanlale, Clarissa G. 21 5Manlapas, Adrian Mae 24 25Nucup, Lyka M. 16 27Obenario, Angelina D. C. 23 28Padua, Maricar 16 29Panag, Maiel T. 21 30Pangan, Cristina C. 15 31Pangilinan, Gloria12 32Quintos, Jennalyn Y. 22 33Sabat, Maadrian E. 16 34Sagadraca, Angelika Joy M. 18 35Salas, Jomae V. 14 Formula of Mean: The mean may often be confused with the median, mode or range. The mean is the arithmetic average of a set of values, or distribution; however, for skewed distributions, the mean is not necessarily the same as the middle value (median), or the most likely (mode). The arithmetic mean is the â€Å"standard† average, often simply called the â€Å"mean†. Total scores602 . Mean= Number of cases M= 35 Mean= 17. 2 November 3, 2010 marks the first day for Third Quarter period and ended January 20, 2011. In this period of time the Grade I students of San Pablo Elementary School had undergone the said study. The children were exposed to different English websites that cater different reading, speaking, listening, grammar, and vocabulary exercises. The teacher serves as the moderator that helps and guides the students on operating the computers and explaining further instructions and directions. The researcher focuses on three English websites and these are the following: 1. Agenda Web – Hundreds of Free English Exercises (http://www. agendaweb. org/) 2. English Interactive – (http://www. englishinteractive. net) 3. Calluni. net – (http://www. calluni. net) The said websites have different activities that are suitable for primary grade level taking up English lessons. CALL Programs designed for teaching grammar include drill and practice on a single topic (Irregular Verbs, Definite and Indefinite Articles), drills on a variety of topics (Advanced Grammar Series, English Grammar Computerized I and II), games (Code Breaker, Jr. High Grade Builder), and different programs which are specifically designed to promote second-language listening (Listen! ), multimedia programs for second language learners (Accelerated English, Rosetta Stone), and multimedia programs for children or the general public (Aesop's Fables, The Animals). Pronunciation programs (Sounds American, Conversations) generally allow students to record and playback their own voice and compare it to a model. Several comprehensive multimedia programs (Firsthand Access, The Lost Secret) include similar features. Reading programs designed for ESL (English Second Language learners and tutorials designed for children or the general public (MacReader, Reading Critically, Steps to Comprehension). and games (HangWord). Also included are more general educational programs which can assist reading (Navajo Vacation, The Night Before Christmas) Text reconstruction programs allow students to manipulate letters, words, sentences, or paragraphs in order to put texts together. They are usually inexpensive and can be used to support reading, writing, or discussion activities. Popular examples include Eclipse, Gapmaster, Super Cloze, Text Tanglers, and Double Up. Vocabulary activities includes drill and practice programs (Synonyms), multimedia tutorials (English Vocabulary), and games (Hangman, Scrabble). Teacher and learner roles The distinct roles in the laboratory are compared and differentiated from the roles assumed in the traditional classroom. The researcher noticed a big difference between a traditional classroom setting and a laboratory setting using the CALL technology. Various factors influenced the way students and the teacher interacts. The teacher and the computers interact and interpret their roles in the laboratory. Warschauer, 1998 says that when multimedia is used the role of the teacher as authority source and expert changes. Hence, the teacher does not dominate the floor and does not do most of the talking. Besides, he or she does not direct and redirect the development of the topic, pose display questions, nominate students as next speakers, or evaluate individual student's contributions, all of which is the norm in traditional teacher-fronted EFL (English Foreign Language) classrooms. There are several aspects that determine the role of the students in the laboratory setting. The researcher noted that the setting, the tools (the computers), the personality of the students, and the way in which the teacher establishes the teaching learning activities as well as the way that he or she interacts with them plays an important role in the laboratory classroom setting. These aspects are interrelated each other and in the next section they are expanded. In the traditional classroom students are more willing to pay attention to the teacher lecture. In contrast, at the laboratory, according with Huang 2000 the student-teacher communication seemed to be blocked to some extent by the layout of the computer lab. Physically, the computer laboratory is larger than the traditional classroom. The physical distance enlarged the psychological distance. It has the tendency that the two-way communication between the teacher and the students turned to be the one-way teacher to student communication. During the development if this research and from time to time the researcher ncouraged her students to interact with each other. She constantly asks herself the way to combine more interaction into the laboratory learning activities more often than she does. To enrich the interaction, she tried and determined what strategies will work and how to do it. Therefore, using the instructional guides that she has designed, she made suggestions and she frequently encouraged her students to employ new strategies to promote multiple-level interaction in t he lab. She has moved toward interaction taking place between the learner and the content, the learner and the instructor, and between learners. Traditional classroom roles are considerably changed. There are two main types of roles that appear at the lab. On the one hand, by the nature of the setting there are a number of roles which emerge and come into sight. On the other hand there are also a number of roles that learners begin to have. In the computerized classroom there are some roles that emerge which are very different from the traditional classroom. For instance, high interactive computer programs have the power to catch student attentions; sometimes, this power that multimedia technology induces over learners is so high till the point that at times students got so concentrated in the computer proposed activities that they ignore the teacher’s instructions. The role of the teacher changes from source of knowledge to instigator, promoter, coach, helper, model, and guide of knowledge construction. It is not easy to change the teacher traditional role of simply showing students how to do things and providing then with the answers they seek. It would be much better to require students to engage in activities that make them be critical thinkers using computers as a learner partner. After three months of the intervention using the Computer Assisted Language Learning Technology the children took up their Third Quarter Test that serves as the Post Test for this study and employed post survey interview which was intended to collect data on participants’ attitudes toward learning English with CALL technology, and their perception of CALL technology. The table below shows the result of the Third Quarter Test taken up by the students in Grade I students together with the previous scores taken on the First Quarter Test. Table 3: Test result From First to Second Quarter No. NameScores Second QuarterThird Quarter 1Banag, Jonie D. 1520 2Bermudo, Mark Anthony D. C. 1221 3Boehn, Adrian M. 1628 4Butchayo, John Carlo G. 2023 5Fallorina, Jerry M. 1722 6Gaupo, Gerald1525 7Lacanlale, Christian G. 1627 8Luna, Alexander N. 1225 9Manalili, John Lloyd C. 1726 10Maninang, Emer1326 11Manlapas,Randy A. 1827 12Martinez, Clive Xavier M. 825 13Morales, Aiveen Nash M. 1924 14Pilariza, Hans Russell L. 1923 15Puno, Jerome M. 2220 16Roldan, Rainier T. 1419 17Tolentino, John Michael E. 2226 18Uring, Justine H. 1825 19Bautista, Marichell D. C. 1422 20Botio, Renalyn M. 2129 21Casem, Allyana N. 2030 22Castaneda, Rey-ann 1221 23Dizon, Clarisse Joy R. 1419 24Lacanlale, Clarissa G. 2118 25Manlapas, Adrian Mae 2430 25Nucup, Lyka M. 1627 27Obenario, Angelina D. C. 2329 28Padua, Maricar 1620 29Panag, Maiel T. 2126 30Pangan, Cristina C. 1521 31Pangilinan, Gloria1218 32Quintos, Jennalyn Y. 2221 33Sabat, Maadrian E. 1618 4Sagadraca, Angelika Joy M. 1819 35Salas, Jomae V. 1424 The above table shows the satisfying result of the Third Quarter Test. Table 4: Test Result (Second – Third Quarter) Quarter TestNumber of Cases Number of ItemsHighest ScoreLowest ScoreTotal Number of scoresMean Second3530221260217. 2 Third3530301882423. 54 The table number four shows the big difference between the scores of First to Second Quarter Test. After conducting the test run students were asked if they find the program satisfying. 33 of the students answered â€Å"yes† and still hoping for some more lessons using CALL technology. of the students answered â€Å"no† because for them CALL is a much complicated way in studying the English subject. Summary of Findings Based on the data gathered in this research CALL technology in the classroom provi ded a context in which opportunities for English development are enhanced, since students are motivated to extend their efforts and resources in order to meet the demands of real communication in a social context. It also entails meaningful use of the target language and demands teachers and students to treat language as a medium of communication. The second quarter result shows a great improvement compared to the result taken last quarter. The program works best with individual users, but pair work would also be possible. Use in the classroom situation would be dependent upon the availability of computers. CALL technology proved an effective tool for language learning and teaching. Although Internet is more affordable and available today than ever before, unfortunately and despite the incredible advances and advantages, not very many English as a foreign language students and teachers benefit from its potential. Computers have a eaningful application in the area of foreign language teaching and learning. The incorporation of CALL into the curriculum and language programs is important but there is a need to integrate it into the course goals, based on research practices. In addition, this may provide opportunities for authentic language practice. Almost all the student who undergone the program find the program very satisfying and keep on asking for more lessons with the same strategy of teaching. Conclusion: Computer Assisted Language Learning (CALL) for Teaching English to Young Learners (TEYL). The computer is a child's wonderland. The use of CALL software such as Windows Messenger, E-mail, the Internet, and other specific and non specific software can be integrated using effective pedagogy to create a powerful language learning program. Computer Technology offers a certain degree of independent and structured learning. It easily assists and even stimulates young second language learners in all four skills of listening, speaking, writing, reading and also critical thinking (Cobb & Stevens, 1996). Technology has the potential to play a major role in English or foreign language learning and instruction. The history of CALL suggests that the computer can serve a variety of uses for language teaching. It can be a tutor which offers language drills or skill practice; a stimulus for discussion and interaction; or a tool for writing and research. With the advent of the Internet, it can also be a medium of global communication and a source of limitless authentic materials. But as pointed out by Garrett (1991), â€Å"the use of the computer does not constitute a method†. Rather, it is a â€Å"medium in which a variety of methods, approaches, and pedagogical philosophies may be implemented† (p. 5). The effectiveness of CALL cannot reside in the medium itself but only in how it is put to use. Recommendation: In the contemporary educational environments, it is a pity, that there are some schools that despite the fact of having a computer room which is privilege, there is not a full possible exploitation of that source of knowledge. Many people and some teachers feel uncomfortabl e with technology even there are times when they get scare of it; in that case, the best way to overcome this fear is facing it by solving as many computer exercises as possible. An important implication of this study is to foster the use of computer assisted learning without neglecting the mystery that covers up the uses of new technologies. Teachers especially from government owned schools should have opportunities such as trainings and seminars about the use of computer and how it would be used in teaching Teacher’s computer literacy is important. A feeling of satisfaction is received and accomplished when teachers and students discover that computer provides another way to acquire knowledge. It enhances motivation and promotes interaction. In traditional classrooms, interaction has been limited because of minimal physical possibilities or because of teachers’ lack of training in using technology.. Working with computers is a joint of motivational elements that makes the students’ participation more free and spontaneous. It is frequent that students bring English music compact discs to the laboratory. Those elements also promote interaction and new roles for both students and teachers. Therefore, students have more responsibility, risk taking, interaction and self-evaluation criteria towards the autonomous learning. The teacher should take individual differences in preferences, and ability into account. For example, interactivity is limited when there is only one way of navigating the internet, and the materials are presented in a rigid manner. There are more ways of navigating the internet and many different possible topics to explore. Students can select different activities to read and study. Different aspects of every day life and people work are listed to account for individual differences in ability, and preferences. The Department of Education should help in improving the computer laboratories of each government school and for those who has no computer at all. They should also consider applying an Internet connection for each school that can not only be used in teaching but also in easy communication of the school to the main office or division. It can also serve as an easy way of submitting reports and help decrease the paper works for the teachers and principals. Teachers should also take a rigid guidance on the students on how they will use the computer and the internet in searching for knowledge. Students should always be properly guided while surfing the internet for them to be protected about the negative influences of the internet. Bibliography: †¢ ^ a b Levy M. (1997) CALL: context and conceptualisation, Oxford: Oxford University Press. †¢ ^ a b Schmid Euline Cutrim (2009) Interactive whiteboard technology in the language classroom: exploring new pedagogical opportunities, Saarbrucken, Germany: VDM Verlag Dr. Muller. †¢ ^ a b Lamy M. -N. & Hampel R. (2007) Online communication in language learning and teaching, Houndmills: Palgrave Macmillan. †¢ ^ Shield L. & Kukulska-Hulme A. (eds. (2008) Special edition of ReCALL (20, 3) on Mobile Assisted Language Learning. †¢ ^ Davies G. & Higgins J. (1982) Computers, language and language learning, London: CILT. †¢ ^ Bush M. & Terry R. (1997) (eds. ) Technology-enhanced language learning, Lincolnwood, Illinois: National Textbook Company. †¢ ^ a b c Davies G. , Walker R. , Rendall H. & Hewer S. (2011 ) Introduction to Computer Assisted Language Learning (CALL). Module 1. 4 in Davies G. (ed. ) Information and Communications Technology for Language Teachers (ICT4LT), Slough, Thames Valley University [Online]: http://www. ict4lt. org/en/en_mod1-4. htm †¢ ^ Levy M. & Hubbard P. 2005) Why call CALL â€Å"CALL†? Computer Assisted Language Learning 18, 3: 143-149. †¢ ^ Marty F. (1981) â€Å"Reflections on the use of computers in second language acquisition†, System 9, 2: 85-98. †¢ ^ Sanders R. (ed. ) (1995) Thirty years of computer-assisted language instruction, Festschrift for John R. Russell, CALICO Journal Special Issue, 12, 4. †¢ ^ Delcloque P. (2000) History of CALL [Online]: http://www. ict4lt. org/en/History_of_CALL. pdf †¢ ^ Davies G. (2005) Computer Assisted Language Learning: Where are we now and where are we going? [ Online]: http://www. camsoftpartners. co. uk/docs/UCALL_Keynote. htm †¢ ^ Hubbard P. 2009) (ed. ) Computer-assisted language learning, Volumes I-IV, Routledge: London and New York: http://www. stanford. edu/~efs/callcc/ †¢ ^ Language Learning & Technology (2010) 14, 3, pp. 14-18 [Online]: http://llt. msu. edu/issues/october2010/index. html †¢ ^ Butler-Pascoe M. E. (2011) â€Å"The history of CALL: the intertwining paths of technology and second/foreign language teaching†, International Journal of Computer-Assisted Language Learning and Teaching (IJCALLT) 1, 1: 16-32: http://www. igi-global. com/ijcallt †¢ ^ Davies G. & Higgins J. (1985) Using computers in language learning: a teacher's guide, London: CILT. ^ Jones C. & Fortescue S. (1987) Using computers in the language classroom, Harlow: Longman. †¢ ^ Hardisty D. & Windeatt S. (1989) CALL, Oxford: Oxford University Press. †¢ ^ a b Warschauer M. (1996) â€Å"Computer-assisted language learning: an introduction†. In Fotos S. (ed. ) Multimedia language teaching, Tokyo: Logos International [Online]: http://www. ict4lt. org/en/warschauer. htm †¢ ^ Warschauer M. & Healey D. (1998) â€Å"Computers and language learning: an overview†, Language Teaching 31: 57-71. †¢ ^ Underwood J. (1984) Linguistics, computers and the language teacher: a communicative approach, Rowley, Massachusetts: Newbury House. ^ Schneider E. W. & Bennion J. L. (1984) â€Å"Veni, vidi, vici, via videodisc: a simulator for instructional courseware†. In Wyatt D. H. (ed. ) Computer-assisted language instruction, Oxford: Pergamon. †¢ ^ Fuerstenberg G. (1993) A la rencontre de Philippe: Videodisc, Software, Teacher's Manual and Student Activities Workbook: Yale University Press [Online]: http://web. mit. edu/fll/www/projects/Philippe. html †¢ ^ Warschauer M. (2000) ‘†CALL for the 21st Century†, IATEFL and ESADE Conference, 2 July 2000, Barcelona, Spain. †¢ ^ Bax S. (2003) â€Å"CALL – past, present and future†, System 31, 1: 13-28. †¢ ^ Bax S. Chambers A. (2006) â€Å"Making CALL work: towards normalisation†, System 34, 4: 465-479. †¢ ^ Bax S. (2011) â€Å"Normalisation revisited: the effective use of technology in language education†, International Journal of Computer-Assisted Language Learning and Teaching (IJCALLT) 1, 2: 1-15: http://www. igi-global. com/ijcallt †¢ ^ Mounteney M. Spaced repetition learning systems (SRS): http://www. omniglot. com/language/srs. php. Accessed 14 July 2011. †¢ ^ Decoo W. (2001) On the mortality of language learning methods. Paper given as the James L. Barker lecture on 8 November 2001 at Brigham Young University [Online]:

Mariano Azuela’s novel “Los de Abajo” Essay

Mariano Azuela’s novel â€Å"Los de Abajo†, titled â€Å"The Underdogs† by Enrique Munguà ­a Jr., in his English translation, has been hailed as the novel of the Mexican revolution. In this novel Azuela creates characters representative of the two factions that are at variance, the revolutionaries and the federalists. The novel is divided into three parts and each part subdivided into chapters, the first part being the longest and the third being the shortest. Enrique Munguà ­a’s translation is about 140 pages in length and many have noted that this novel is one of Azuela’s shortest. The novel is, however, quite entertaining and it maintains the readers’ attention throughout. For anyone interested in a serious study of Mexican history, this is an essential novel to read as it gives a perspective into the social aspects of the revolution that few textbooks can capture. The book has historical significance because it gives a description of the Mexican revolution from the perspective of people who were directly affected by and involved in the revolutionary process. Literally the title of the novel in Spanish â€Å"Los de Abajo† translates to mean those from or at the bottom. This I believe is a very appropriate title and in itself captures Azuela’s primary argument that he maintains throughout the novel. The revolutionaries and the federalists are constantly juxtaposed against each other in the novel but Azuela, through the eyes of Luis Cervantes, allows the reader to see that the two groups are not that dissimilar. Both factions display distrust, treachery, moral decadence and kill so mercilessly that it is no wonder that the words of the title â€Å"Los de Abajo† is used in the novel to refer to both the rebels and the federalists. Early in Part I chapter three when Demetrio led his men into the first ambush of the government troops he instructs his men to â€Å"Get those coming up from under! Los de Abajo! Get the underdogs!† be screamed. Later on in chapter 6 the narrator reflects of Luis Cervantes, on the first night of his joining the revolutionaries, that â€Å"Did not the sufferings of the underdogs, of the disinherited masses, move him to the core?†¦ the subjugated, the beaten and baffled.† The events in the novel mirror the Mexican revolution of 1910. The main plot of the story is that of a peasant farmer, Demetrio Macias who, after having suffered at the hands of the federalists, decides to join Pancho Villa’s revolutionary army. A defector of the government army, Luis Cervantes – elite and educated, joins Demetrio’s troop because of his support of the ideals he believed the revolutionaries espoused. Azuela, however, uses this character as his mouthpiece and, in his disillusionment that the revolutionaries were not fighting based on ideologies; the reader gets an understanding of Azuela’s perspective. He, like Cervantes, abandoned the struggle and migrated to the United States after having worked along with Pancho Villa as a military doctor believing his ideals to have been betrayed. One of the main lessons that Azuela delivers here is relevant in so many areas of life. His major argument in presenting his novel is that without purpose, focus, planning and proper management, even the most worthwhile efforts will prove to be futile. The most positive aspect of Azuela’s novel is that it was written while the struggles in the revolution were still going on. Beginning in 1914 the novel began to be published as a series in a Texas newspaper in installments though it was not until 1925 that it began to gain worldwide attention. This novel details the battles in the Mexican revolution from the perspective of the author who himself was a witness of these very events. Prior to moving to Texas, Azuela supported the revolutionary movement by offering his medical services to Pancho Villa’s army. In such a position he was exposed to the ills of the revolutionary battle, more so from the perspective of the revolutionaries. Azuela was therefore in a fitting position to discuss the Mexican revolution because he too had been very intimately involved in the process. However, while this novel bears relevance to the themes that were facing the Mexicans at the time when they were most involved in the revolution, it fails to give a complete picture of the revolutionary process. The problem with the novel is precisely because it was written so close to the actual events. This prevents the reader from having a total picture of the ‘before’, the ‘during’ and the ‘after’ of the revolution. In the same way that Demetrio’s eyes remain ‘leveled in an eternal glance’ at the end of the novel, so does the battle between the revolutionaries and the federalists give the impression that it will last eternally without resolution or victory for either side. The tone of Azuela’s novel therefore comes off as being very pessimistic. Failure and doom is the only outcome of the revolutionary struggle and no one seems to be winning. Azuela’s conclusion here seems to be rather generalized. Authors who have written about the revolution subsequent to Azuela have had the benefit of seeing the long-term results of the struggle which revealed much more positive effects than what were immediately obvious while the struggles were still going on. REFERENCES Azuela, Mariano (1963). The Underdogs (Enrique Munguà ­a Jr. Trans.). The U.S.A.: Penguin Group. (Original work published 1916).

One Of The Most Valued Amendments Written In The U.S....

One of the most valued amendments written in the U.S. Constitution is the First Amendment, which guarantees Americans freedom of speech. Individuals view the restriction of this right to be â€Å"unamerican†. Unfortunately, over the years colleges and universities have experienced an increase of hate speech. Victims of this type of crime may suffer from emotional and psychological distress. Due to this, restrictions have been placed on the ability to speak freely (Garrett). An ongoing debate has been placed in the hands of many people regarding whether Americans should be entitled to speak in an expressive way or if schools should focus on the safety of their students (Darden). Colleges should restrict hateful speech on campus regardless of†¦show more content†¦Similarly, imposing threats and/or hate speech upon others is a violation of others’ rights and freedoms. What is the point of having freedom of speech and a democracy in the US if it allows others to be degraded? The rights of all Americans should be respected and despite what the Constitution states, people have to take a step back and analyze the fact that their words can affect others. Students should be restricted as to what they’re saying to others for this exact reason. With little being done with the hate speech present in today’s campuses, more ignorant people are allowed to walk the streets unpunished. Hate speech must be controlled. Although people should be given the right to express how they feel, it must be done in a manner that would not cause others any harm (â€Å"Hate Speech People Students First†). Philosophers state in unison that the freedom of expression is inevitably one the most powerful possessions a person can have. But, those who are open with their opinions are often times ridiculed. Their voices, ideas, and experiences are brushed off and silenced. When people are shut down in this manner, there may be devastating effects. 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