Idiopathic Inflammatory Myopathies (IIMs)

Idiopathic Inflammatory Myopathies (IIMs) 1.1 Introduction to IIMs Idiopathic inflammatory myopathies (IIMs) are a group of rheumatic disorders affecting skeletal muscle, they are thought to be auto immune in origin (Rothwell et al., 2013), but as their name implies the actual cause remains something of an enigma. The phenotype of IMMs is generally characterised by progressive symmetrical proximal muscle weakness and rapid fatigue, MHC class 1 expression in muscle fibres (van der Pas et al., 2004), increased circulating muscle enzymes (Creatine kinase, lactate dehydrogenase)(Cox et al., 2010), and the invasion of inflammatory infiltrates such as immune cells and cytokines (Lundberg et al., 1997; Grundtman et al., 2007). They are heterogeneous in their clinical presentation with patients displaying differing histopathological features, and exhibiting varying disease durations and treatment responses; this is probably associated with the numerous genetic and environmentally implicated factors that have been recently discovered (Rothwell et al., 2013). Interestingly, overt muscle atrophy is not a typical feature of IMM as it is in most diseases associated with muscle fatigue. Inflammatory infiltrate presence in muscle fibres is indicative of cytotoxicity (Lundberg et al., 1997). However, it is often observed that the extent of infiltrate presence in the muscle fibre does not often correlate with the degree of muscle dysfunction (Grundtman et al., 2010), implying that impaired muscle performance is the result of something other than muscle cell damage induced by inflammatory cells and their products; and the continued progression of pathology in the absence of infiltrates suggests that the muscle itself could be contributing. Furthermore, it has been found that weakness can in-fact precede infiltrate presence, and in immune-suppressed individuals weakness can persist (Lundberg Chung, 2000). Muscle weakness is usually initiated in the large muscles around the hips and shoulders, but often spreads to more distal areas resulting in quadriparesis (weakness in all four limbs) that can be severely debilitating. The impact of this can cause the patient difficult y in carrying out even simple everyday tasks such as climbing stairs and can be particularly dangerous in older patients who often have related morbidities. As the disease progresses, eventually the patient’s fine motor skills can be impeded: distal muscle action is required for these movements and weakness in these regions can have affect fine motor skills (Dalakas, 1991). Dysphagia (difficulty swallowing) is also common in severe cases and can cause fatal choking. IMMs clearly have an adverse impact on the patient’s quality of life, and a deeper understanding into the disease is essential for this to be improved. However, some patients are only mildly affected; this heterogeneity makes it difficult to establish the definitive cause of myositis, and treatment is therefore limited. IMMs can be subdivided into three main discrete histological categories: Polymyositis, Dermatomyositis, and Inclusion Body Myositis. 1.2 Dermatomyositis (DM) DM is a microangiopathy that affects both the skin and muscle tissue, and is caused by the lysis of endomysial capillaries and muscle ischemia (Dalakas Hohlfeld, 2003). It was Hohlfeld that described the criteria for diagnosing IMMs; a diagnosis can be made subsequent to three laboratory experiments: serum muscle enzyme concentrations, electromyography, and muscle biopsy (Dalakas Hohlfeld, 2003), and in some cases a skin biopsy may be useful in diagnosing DM. Creatine Kinase (CK) elevation is the main indicator of DM, and is usually correlative to disease severity. It is common for skeletal muscle CK concentration to increase fifty-fold in patients with active DM, but in some patients levels remain basal (Dalakas Hohlfeld, 2003). The muscle biopsy is critical for an accurate diagnosis and would generally show perifascicular atrophy caused by phagocytosis and necrosis of the muscle fasciculus; this is diagnostic of DM even in the absence of inflammation. CD4 positive T-cells are us ually detected in the dermis at sites of perivascular inflammation, and capillary density is dramatically reduced with vessel perforation. DM was unsurprisingly the first to be reported in 1875 by Potain (Potain, 1875) (Oddis Medsger Jr, 1995), probably due to its extramuscular manifestation of heliotrope (upper eyelids), and erythematous (face, neck, back, shoulders) rashes that commonly precede muscular weakness (Dalakas Hohlfeld, 2003). The extensor joint surfaces of DM sufferers are commonly covered in Gottrons papules, along with dilated capillary loops at the base of the finger nail with thickened cuticles (Dalakas Hohlfeld, 2003). The outward appearance of DM often leads to a false diagnosis of systemic lupus erythematosus as muscle weakness is not always evident in DM patients; however, the two diseases differ in that only the latter involves a phalangeal rash. DM has been shown to be the most common form of juvenile myositis, though there have been reported rare incidences of polymyositis (Sato et al., 2000). If treated early on, DM has been shown to respond to immunotherapeutic agents; however, the first line of treatment is usually corticosteroids such as high-dose oral Prednisone. Patients usually show some degree of response to steroid treatment alone, but they are usually administered in conjunction with other immune targeted treatments (Aggarwal Oddis, 2012). 1.2 Polymyositis (PM) In 1887 Unverricht reported the first case of PM (Unverricht, 1887), which presents without the classical rash associated with DM. It is the least common form of myositis and onset is almost universally after 18 years of age, though as previously mentioned it has been reported in the juvenile form (Sato et al., 2000). Epidemiology of PM is difficult to quantify due to it being a rare form of a rare disease that was for many years indistinguishable from Inclusion Body Myositis. PM develops slowly over months or years, and identifying the exact, or even approximate, time of onset is difficult due to the progressive nature and lack of the characteristic rash associated with DM. Muscle weakness progresses in much the same way as DM and is equally as debilitating (Dalakas Hohlfeld, 2003). Diagnosing PM generally involves the exclusion of other similar myopathies using the three diagnostic laboratory experiments described earlier. In PM, unlike DM, CK concentration is always elevated significantly above the basal level. CD8-positive T-cells are found to be invading healthy muscle fibres expressing MHC class I antigens forming a CD8/MHC-1 complex (Dalakas Hohlfeld, 2003). There has long been evidence to suggest that PM could be induced by viral infiltration, possibly via retro-viral infection (Dalakas et al., 1986). The treatment approaches for PM are the same as DM, and in about 70% of patients intravenous immunoglobulin appears to be a promising treatment. 1.3 Inclusion Body Myositis (IBM) IBM was not universally accepted as a separate classification to DM and PM until 1978 (CARPENTER et al., 1978), but it has since been found to be the most common acquired IMM in the elderly, and in men over the age of fifty (Dalakas Hohlfeld, 2003). There are two types, sporadic- and hereditary-IBM, the two are histologically and ultrastructurally similar, but hIBM lacks inflammation. IBM was pathologically characterised by Yunis and Samaha, who coined the term in 1971 (Yunis Samaha, 1971); they noted in patients the presence of vacuoles containing cytoplasmic degradation products with fibrillary nuclear and cytoplasmic inclusions that distinguished IBM from PM, something it is often misdiagnosed as. Insoluble amyloid protein deposits are also found in the muscle tissue of IBM patients, along with the invasion of CD8/MHC-1 complexes that are also associated with PM, and perivascular and endomisial inflammatory infiltrates (Grau Selva-O’Callaghan, 2008). CK levels are usuall y, but not always, elevated slightly. The vacuoles associated with IBM are indicative of muscle atrophy, something that is not generally seen in DM or PM. The process is gradual, occurring slowly over years similarly to many muscular dystrophies. In PM patients that do not respond to therapy, a diagnosis of IBM is now generally considered. Most IBM patients do not show a marked response to anti-inflammatory or immunosuppressant therapy; a few, probably those with an early diagnosis, show a limited response to corticosteroids, and cytotoxic drugs, but this is not always sustained. Exercise therapy is often suggested to stabilize muscle strength and function, and is frequently advised (Grau Selva-O’Callaghan, 2008). 1.4 Epidemiology Onset of myositis is most common in adults and is generally sporadic, though it has been postulated that there could be some underlying genetic predisposition that could attribute to myositic presentation in some individuals (Cox et al., 2010; Rothwell et al., 2013). Juvenile myositis is less common than the adult form, with dermatomyositis being most prevalent (Dalakas Hohlfeld, 2003); it’s incidence creates discrete age brackets in which IIMs occur. IIMs are regarded as rare, and though there have been numerous attempted epidemiological studies they generally have a low sample size, and it is therefore difficult to determine accurate statistics; also, most statistics are no longer accurate as the old classification of IMMs (Bohan and Peter) could not distinguish between Polymyositis and Inclusion Body Myositis. IMMs have been shown to be most prevalent in women, with DM being the most common diagnosis (Dalakas Hohlfeld, 2003). 1.4 High Mobility Group-box 1 Protein (HMGB1) HMGB1 is a non-histone chromatin associated protein; under typical physiological conditions it is confined within the nucleus where it regulates an array of important transcriptional pathways by binding to and distorting sections of DNA, allowing for the assembly of multi-protein complexes (Bianchi Manfredi, 2004). In response to tissue damage, the normally nuclear protein translocates to the extracellular space and acts as an inflammatory cytokine. Excessive cytokine signalling by HMGB1 has been shown to be fatal in mice (Wang et al., 1999). However, it has been observed that in models of tissue regeneration HMGB1 acts as a chemotactic agent to recruit stem cells such as mesangioblasts in vitro, which indicates it has an in vivo role of favouring muscle regeneration by promoting vessel formation (Vezzoli et al., 2011) (Sachdev et al., 2013). It is therefore interesting that it’s implicated role in IMMs is pathological. 1.5 HMGB1 in IIMs When activated by inflammatory stimulants, HMGB1 is actively secreted from monocytes and macrophages via specialised organelles such as secretory lysosomes (Bianchi Manfredi, 2004); HMGB1 is found to be significantly elevated in patients with IIMs (Grundtman et al., 2010). This translocation is permitted by the hyperacetylation of lysines on HMGB1 (Bonaldi et al., 2003) allowing it to be permanently dissociated from the chromatin, and become packaged in secretory lysosomes. In necrotic cells the cellular membranes lose their integrity and soluble proteins such as HMGB1 are allowed to leak out; this differs from apoptosis where the cell death is not signalled by this leak as HMGB1 remains tightly bound to the chromatin (Bianchi Manfredi, 2004). Necrosis is thought to be the predominant route for cell death in IIMs (Schneider et al., 1996); this allows for HMGB1 to be passively released from the cell. HMGB1 exists in mutually exclusive redox forms that mediate specific inflammatory roles (Venereau et al., 2012). Full reduction of Cysteines 23, 45, and 106 occurs initially, forming all-thiol-HMGB1; in this state it has a cytokine stimulating activity. It is thought that this is the form secreted by activated monocytes to help contribute to the inflammatory response. Later, a disulphide bond forms between C23 and 45 in the HMG-BoxA domain of HMGB1 whilst the Box B C106 remains unpaired and in the thiol state (Venereau et al., 2012). The disulfide form possesses chemoattractant capabilities, causing the migration of leukocytes to the region of inflammation (Venereau et al., 2012). Only the fully reduced form can recruit motile cells, making the cytokine stimulating and chemoattractant activities of HMGB1 also mutually exclusive. Terminal oxidation of HMGB1 fully abrogates its bioactivity, but slight oxidation is required to convert all-thiol HMGB1 to disulphide-HMGB1; it is thought that infiltrating inflammatory cells cause the conversion by maintaining the extracellular oxidative environment as they are a well characterised source of reactive oxygen species (ROS). HMGB1 is a ligand for the Toll-like Receptor 4 (TLR4), a mediator of the innate immune response; though it is found in both healthy individuals and myositis patients, it is proposed to be the receptor for which muscle dysfunction in IIMs is mediated (Zong et al., 2013). The TLR4 plays an important role macrophages and monocytes where it is involved in pathogen recognition. Patient data from a recent study suggests that HMGB1 may induce MHC class 1 expression in patients with IIMs via activation of the TLR4: MHC class 1 and TLR4 have been found to be coexpressed in the muscle fibres of patients with myositis but not healthy individuals (Zong et al., 2013). Another receptor through which HMGB1 signals is the Receptor for Advanced Glycation Endproducts (RAGE); an in-vitro knock out study using intact single fibres demonstrated that HMGB1 acts via the TLR4 and not RAGE to induce muscle MHC class 1 expression and fatigue by decreasing the Sarcoplasmic Reticulum (SR) Ca2+ released by actio n potentials (Zong et al., 2013). However, this may not necessarily be true in-vivo. Nevertheless, the HMGB1-TLR4-MHC 1 pathway seems to be an integral part of the pathogenesis of IMMs and could therefore be a potential therapeutic target. It has been shown that aerobic exercise (a common and beneficial intervention for IIM patients) reduces TLR4 mRNA in skeletal muscle of rats (Zanchi et al., 2010), thus further suggesting that TLR4 plays a key role in IMMs. References Aggarwal R Oddis CV. (2012). Therapeutic advances in myositis. Current opinion in rheumatology 24, 635-641. Bianchi ME Manfredi A. (2004). Chromatin and cell death. Biochimica et Biophysica Acta (BBA) Gene Structure and Expression 1677, 181-186. Bonaldi T, Talamo F, Scaffidi P, Ferrera D, Porto A, Bachi A, Rubartelli A, Agresti A Bianchi ME. (2003). Monocytic cells hyperacetylate chromatin protein HMGB1 to redirect it towards secretion. The EMBO Journal 22, 5551-5560. CARPENTER S, KARPATI G, HELLER I EISEN A. (1978). Inclusion body myositis A distinct variety of idiopathic inflammatory myopathy. Neurology 28, 8-8. Cox S, Limaye V, Hill C, Blumbergs P ROBERTSà ¢Ã¢â€š ¬Ã‚ THOMSON P. (2010). Idiopathic inflammatory myopathies: diagnostic criteria, classification and epidemiological features. International journal of rheumatic diseases 13, 117-124. Dalakas M, London W, Gravell M Sever J. (1986). Polymyositis in an immunodeficiency disease in monkeys induced by a type D retrovirus. Neurology 36, 569-572. Dalakas MC. (1991). Polymyositis, Dermatomyositis, and Inclusion-Body Myositis. New England Journal of Medicine 325, 1487-1498. Dalakas MC Hohlfeld R. (2003). Polymyositis and dermatomyositis. The Lancet 362, 971-982. Grau JM Selva-O’Callaghan A. (2008). Sporadic inclusion body myositis. In Diagnostic Criteria in Autoimmune Diseases, pp. 165-168. Springer. Grundtman C, Bruton J, Yamada T, Ãâ€"stberg T, Pisetsky DS, Harris HE, Andersson U, Lundberg IE Westerblad H. (2010). Effects of HMGB1 on in vitro responses of isolated muscle fibers and functional aspects in skeletal muscles of idiopathic inflammatory myopathies. The FASEB Journal 24, 570-578. Grundtman C, Malmstrà ¶m V Lundberg IE. (2007). Immune mechanisms in the pathogenesis of idiopathic inflammatory myopathies. Arthritis research therapy 9, 208. Lundberg I Chung Y-L. (2000). Treatment and investigation of idiopathic inflammatory myopathies. Rheumatology 39, 7-17. Lundberg I, Ulfgren AK, Nyberg P, Andersson U Klareskog L. (1997). Cytokine production in muscle tissue of patients with idiopathic inflammatory myopathies. Arthritis Rheumatism 40, 865-874. Oddis CV Medsger Jr TA. (1995). Inflammatory myopathies. Baillià ¨res clinical rheumatology 9, 497-514. Potain P. (1875). Morve chronique de anormal. Bull et Mem Hop Paris 12, 314-318. Rothwell S, Cooper RG, Lamb JA Chinoy H. (2013). Entering a new phase of immunogenetics in the idiopathic inflammatory myopathies. Current opinion in rheumatology 25, 735-741. Sachdev U, Cui X Tzeng E. (2013). HMGB1 and TLR4 mediate skeletal muscle recovery in a murine model of hindlimb ischemia. Journal of vascular surgery 58, 460-469. Sato M, Bando T, Hasegawa S, Kitaichi M Wada H. (2000). Recurrent spontaneous pneumothoraces associated with juvenile polymyositis. CHEST Journal 118, 1509-1511. Schneider C, Gold R, Dalakas MC, Schmied M, Lassmann H, Toyka KV Hartung H-P. (1996). MHC Class l-Mediated Cytotoxicity Does Not Induce Apoptosis in Muscle Fibers nor in Inflammatory T Cells: Studies in Patients with Polymyositis, Dermatomyositis, and Inclusion Body Myositis. Journal of Neuropathology Experimental Neurology 55, 1205-1209. Unverricht H. (1887). Polymyositis acuta progressive. Zeitschrift fur Klinische Medizin 12, 533. van der Pas J, Hengstman GJD, ter Laak HJ, Borm GF van Engelen BGM. (2004). Diagnostic value of MHC class I staining in idiopathic inflammatory myopathies. Journal of Neurology, Neurosurgery Psychiatry 75, 136-139. Venereau E, Casalgrandi M, Schiraldi M, Antoine DJ, Cattaneo A, De Marchis F, Liu J, Antonelli A, Preti A Raeli L. (2012). Mutually exclusive redox forms of HMGB1 promote cell recruitment or proinflammatory cytokine release. The Journal of experimental medicine 209, 1519-1528. Vezzoli M, Castellani P, Corna G, Castiglioni A, Bosurgi L, Monno A, Brunelli S, Manfredi AA, Rubartelli A Rovere-Querini P. (2011). High-mobility group box 1 release and redox regulation accompany regeneration and remodeling of skeletal muscle. Antioxidants redox signaling 15, 2161-2174. Wang H, Bloom O, Zhang M, Vishnubhakat JM, Ombrellino M, Che J, Frazier A, Yang H, Ivanova S Borovikova L. (1999). HMG-1 as a late mediator of endotoxin lethality in mice. Science 285, 248-251. Yunis E Samaha F. (1971). Inclusion body myositis. Laboratory investigation; a journal of technical methods and pathology 25, 240. Zanchi NE, Lira FS, de Siqueira Filho MA, Rosa JC, de Oliveira Carvalho CR, Seelaender M, Santos RVT Lancha Jr AH. (2010). Chronic low frequency/low volume resistance training reduces pro-inflammatory cytokine protein levels and TLR4 mRNA in rat skeletal muscle. European journal of applied physiology 109, 1095-1102. Zong M, Bruton JD, Grundtman C, Yang H, Li JH, Alexanderson H, Palmblad K, Andersson U, Harris HE Lundberg IE. (2013). TLR4 as receptor for HMGB1 induced muscle dysfunction in myositis. Annals of the rheumatic diseases 72, 1390-1399.

A Civil Engineering Success :: essays research papers

Civil Engineering History and Heritage U.S. 20 Iowa River Bridge   Ã‚  Ã‚  Ã‚  Ã‚  The Iowa River Bridge on Highway U.S.20 was built in such a way that it not only was able to expand the once two lane blacktop roads into a four lane highway, but also to keep environmental impacts of construction and existence of the bridge to a minimum. The $21 million dollar bridge consists of two 12.0 m wide deck structures that each contain five spans of 92 m. These deck structures are made from erecting a weathering steel I-Girder superstructure. â€Å"Each deck structure will consist of a 230 mm concrete slab with a 38 mm low-slump concrete wearing course supported by a system of four 3450 mm deep I-girders spaced at 3600 mm centers†(1). The support for these structures will be cast-in-place reinforced concrete substructure units. These units consist of two column bents ranging in heights of 20 m to 38 m, and are founded on drilled shafts or driven H-Piles. Engineering Success   Ã‚  Ã‚  Ã‚  Ã‚  The construction method used on this bridge is the first of its kind in the United States on a steel I-girder highway. The bridge was constructed by a launch erection method in order to avoid damaging its surroundings. This method allowed for large steel portions of the structure to be assembled on large rollers behind one of the bridge abutments and then pushed from pier to pier with the use of hydraulic thrusts (or pulling with motors and cables). This area is one of few woodlands left in Iowa, and by doing intensive research Engineers were able to obtain their goal while leaving as much of the natural surroundings unaffected as possible. Lessons Learned   Ã‚  Ã‚  Ã‚  Ã‚  As stated earlier, this was the first use of this construction method and therefore a lot of lessons came from this erection of this bridge. Among these were mostly environmental concerns. The reason this method was necessary is due to all of the environmental concerns through the Iowa Greenbelt, which is home to a number of endangered animals, plants and aquatic life. Another aspect of the bridge that the environmental issues affected was the timeline. This included a â€Å"winter shut-down† for a little over 5 months due to the eagle’s roost, as well as the need to shut down any time noise or activities seemed to disrupt the eagles roosting habits.

Mercutio vs Romeo Essay

Love is a hard thing to define but lust is a burning desire for another person, and it usually doesn’t last a very long time. Love can transform over years and still remain consistent. Lust is superficial when only the appearance is considered but nothing else, which can be called ‘love at first sight’. Lust is only a short-term relationship, whereas love leads to a deeper understanding of the other person and one develops affection and caring for them. Mercutio’s idea of love doesn’t involve commitment, is more realistic than Romeo’s view and Mercutio doesn’t allow love to inflict any pain. Romeo’s idea of love includes commitment, and has a deeper, more passionate love and he allows himself to be vulnerable to his emotions and lets them take over. Mercutio and Romeo’s view on love are both similar in the sense that they involve desire for a girl and they are driven by their emotions. Both are fuelled by madness and this leads to them making rash decisions that result in a big loss and in Mercutio’s case, his life. Mercutio’s anger and feud with Tybalt leads him to go mad and be stabbed to death. Romeo’s anger gets the better of him which results in him stabbing Tybalt, after just having married Juliet. In the end, Romeo’s grief over Juliet’s ‘death’ overcomes his will to listen to reason and this poor decision ends up terminating his life too soon. Another similarity is that both characters are captivated by looks. They both speak of a woman’s outer appearance and have rarely talked about their personalities. When Romeo first sees Juliet, he marvels at her beauty without trying to figure out who see really was. O, she doth teach the torches to burn bright! It seems she hangs upon the cheek of night, Like a rich jewel in an Ethiop’s ear; Beauty too rich for use, for earth too dear† (1. 5. L. 44-47) In Act II, Scene 2, we see Mercutio trying to lure Romeo out by describing Rosaline’s appearance, â€Å"I conjure thee by Rosaline’s bright eyes, By her high forehead and her scarlet lip, By her fine foot, straight leg, and quivering thigh. †(2. 1. L. 17-19) In the start of the play, Romeo and Mercutio think that all ther e is to ‘love’ is having sex. Even the servants, Sampson and Gregory mentioned wanting to sexually harassing the maids of the Montagues. â€Å"That shows thee a weak slave; for the weakest goes to the wall. † â€Å"’Tis true; and therefore women, being the weaker vessels, are ever thrust to the wall: therefore I will push Montague’s men from the wall and thrust his maids to the wall. † (1. 1. L. 12-17) This proves that most men in this time thought of themselves as superiors compared to women. As the play progresses, Romeo’s view on love changes after he meets Juliet. After meeting Juliet, he falls in love with her as a whole instead of just her appearance. While there are minor similarities between Mercutio and Romeo’s view on love, the differences are pronounced and deserve thorough examination because the line between lust and love is very confusing and many people in society mix the two up. On one hand, Mercutio’s view can be described as ‘a chase for something sexual’. He never mentions settling down with a girl and having a committed relationship. Mercutio, unlike Romeo, does not believe in fate deciding his path, instead he lives in the moment. Mercutio doesn’t let love overthrow his conscience and guide his actions. Romeo says â€Å"Is love a tender thing? It is too rough, too rude, too boisterous, and it pricks like a thorn. † (1. 4. L. 25-26), to which Mercutio replies with â€Å"If love be rough with you, be rough with love; Prick love for pricking, and you beat love down. † (1. 4. L. 27-28) In those lines, he talks about how in order to defeat love and to not have it afflict with your actions is to have sex instead of loving someone and go through the pain of them not reciprocating your feelings. On the other hand, Romeo has a romanticized view which is shown by his strong reliance on fate, and the stars. In these lines, Romeo says â€Å"I am too enpierced with his shaft, To soar with his light feathers, and so bound, I cannot bound a pitch above dull woe. Under love’s heavy burden do I sink† (1. 4. L. 19-22) Romeo is being pulled down by the amount of pain from not being able to see Rosaline. At first he’s a victim of being caught up in Rosaline’s looks and mistook it as love. It wasn’t until he met Juliet that he truly discovered the true meaning. Romeo wallows in self-pity and loves by night. â€Å"I have night’s cloak to hide me from their sight; And but thou love me, let them find me here: My life were better ended by their hate, then death prorogued, wanting of thy love† (2. 2. L. 75-78) In contrast, Mercutio appears in the play mostly in the day and shows that he believes he can control his life and is more realistic than Romeo. He serves as the contrasting character to show a ifferent perspective on love from Romeo’s passionate, and emotional view on love. In culmination, Romeo’s idea of love is stimulated, loyal, and susceptible to pain. Romeo shows his vulnerability and readers and viewers of the movie have an easier time relating to his feeling for heartbreak. His loyal and never changing love for Juliet even as she was ‘dead’ made readers fall in love with his character. Although Romeo and Mercutio have different perspectives on love, they also have similarities which make them able to be such good friends.

TESOL English Teaching - Free Essay Example

Sample details Pages: 6 Words: 1820 Downloads: 10 Date added: 2017/06/26 Category Teaching Essay Did you like this example? TESOL ellipsis stands for Teaching English to speakers of other languages. Of late, the English teaching industry has developed this acronym which is associated to learning, teaching and examination and also certification of the English language. Presently, the world studies two major branches of English; British English and American English. Don’t waste time! Our writers will create an original "TESOL English Teaching" essay for you Create order Since the English language is the world language there has been creation of different acronyms all over the globe by trainers and educators in this field. North Americas # I rated TESOL institutions and Global TESOL collages leads to the way in professional academic based TESOL in the whole world. All the in-class and distance education syllabuses are designed professionally, monitored, administered and quality controlled so as to ensure that the graduates are of very high quality of teachers available today. The in-class TESOL guaranteed courses are offered across America and Canada. Globally, the North America and other colleges have become a household name in TESOL distance learning, offering quality professional quality TESOL diploma and certification courses online and also through correspondence (Ohta 2001, pg 53). About 35 percent of graduates complete successfully their TESOL courses by distance learning. Global TESOL institution was the first institution to provid e a TESOL teacher qualification program in Canada. It has currently expanded its programs to include professional and advanced level diplomas to achieve the demands of students worldwide and English teachers. All basic and secondary institution students presently in the United States will be contributing to and living in an increasingly varied society and inter reliant community a countries in the 21 century. To understand their social, personal and long term career goals, individuals will be in a position to communicate with others proficiently, effectively and appropriately. The challenge of modern education is to prepare all the students for life in the new world, together with the learners who join schools with another language other than English. There has been increased purpose aim of identifying the ESL standards and their roles in associated with the system. In the United States, communities and schools are experiencing increased cultural and linguistic diversity. Annually, more and more learners with different languages other than English and who come from communities, homes with varied traditions, histories educational experiences and world views, fill classrooms in urban, rural, and suburban settings. There has been an increment in the number of youths and school-age children who speak other languages other than English by 68.6 percent in the last 10 years. In 1993, the English language learners in United States public schools totalled to more than 2.5 million. Currently, projections estimate that, by the year 2000 most of the school age individuals in over 50 major United States will be from language minority surroundings (Klahr 1976, pg 86). There is a great variation in proficiency level and academic needs to the ESL students. Some of the ESOL students are current refugees and immigrants, taken to the United States by their families searching for refuge from persecution, political repression or by families looking for econo mic opportunities like business activities. Other students have acquired limited formal schooling. Some students are members of ethno linguistic clusters that have stayed on the continent for generations, some more extensively than the United States has existed as a nation. Some of the students have had former education, including accuracy in their nature languages. The primarily concern is with the students in basic and secondary schools who are non-native speakers of English and who are referred to as ESOL learners and students. There have been standards set to describe and specify the language competencies ESOL students in secondary and preliminary schools so as to become fully proficient in English, to have unrestricted admission to grade-appropriate directions in challenging educational subjects, and decisively to lead rich and prolific lives. The establishment of the standards has been by the effort of other national standard set of groups especially by the foreign language standards and English language arts. The total three language standards schemes share an emphasis on the essence of: assessment that respects cultural and language diversity, the role of ESOL learners native language in their general learning development and English language, cognitive, cultural and social processes in academic development and language, language as communication, the societal and individual value of both bi-and multilingualism and also language learning through significance and meaningful use (Braine 1990, pg 121). For TESOL research to be effective for second learning, its standards have seemed not to work alone. In turn, other professional organizations and firms have devised world-class standards which are developmentally appropriate and useful. These standards provide high levels of success in content education for all scholars, including the ESOL students. But the substance standards do not provide the educators with the strategies and directi ons they need to help ESOL learners to get these standards because they have an assumptions that, students ability and understanding English to engage with the content. Most of the substance standards do not recognize the central role of language in the content achievement. Nor do they emphasize the styles of learning and particular assessment and instructional requirements of students who are still developing ability in ability in English. In summary, the substance standards do not add English to the personal home languages, SOESL standards are high required in TESOL learning. The ESL standards have recognized that besides school entry, the students should acquire extra culture and language and learn the competencies in English that are characteristics of English native speakers at the same age and that are basic to the full English language skills attainment and other content standards. The ESL principals articulate developmental English language requirements of ESOL st udents and highest special assessments and instructional considerations that must be provided to ESOL students if they are to gain from and get the high principles proposed for other matters. Therefore, the ESL principles are vital because they; emphasize the main role of language in attaining of other principles, emphasize on the English language development requirements of ESOL students, and also ensure provision of directions to tutors on how to meet the requirements of ESOL learners (Harkla 1999, pg 93). Several myths have been associated with the second language learning which prevail both among several educational professionals, several lay persons and policy makers. It is perceived that ESOL students learn English quickly and easily due to being exposed to and enclosed by native English speakers. The fact of this matter is that it takes more time for an individual to learn the second language. It also involves a quite significant effort on the part of the studen t. It is hard work to learn the second language because even the youngest students do not just simply pick up the language. It is also perceived that when ESOL students can be able to communicate comfortably in English, they have proficiently developed in English language. The fact of this is that it can take a student for ESOL around 6-9 years to attain the same level of proficiency in learning English as a native speaker. More so the ESOL student taking part in thoughtfully designed programs of sheltered or bilingual content direction remain in school longer and achieve significantly higher academic rates as compared to learners without such advantages. Majority of the people also perceive that, in earlier periods, refuge children learned English rapidly and assimilated quicker in to American life. Contrary to that, most of the refuge students in the early part of this century did not easily learn English quickly or well. Most of them dropped out of education to work in s ectors that did need the type of academic attainment and communication skills that substantive career opportunities need today. Consequently, TESOL came up with a vision of effective learning for all students. The purpose of ESL principal can only be fully recognized in the wider context of learning for ESOL students. Therefore, before presentation of the ESL principles, it is of great importance to outline and explain the over arching vision of effective learning. Some of the TESOLs vision include: the knowledge of over one culture and language which is of advantageous for all learners, the effective learning also needs comprehensive provision of the first rate services and full acquisition to the services by all learners (Braine 2005, pg 88). All educational personnel should have an assumption of responsibility for the learning of ESOL learners. At the same time, effective education for ESOL learning comprises of native like levels of ability in English. Last but not t he least the effective learning for ESOL students should include the promotion and maintenance of ESOL learners native language in community and school context. Effective learning for ESOL students includes native like stages of proficiency in English. For ESOL learners to be successful in a learning institution and ultimately outside school, they must be in a position to utilize English to accomplish their personal, educational and social goals with the similar proficiency as English native speakers. In school, the ESOL students require to be able to both write and read English so as to demonstrate their learning and achieve academic content. ESOL students also require to be in a position to follow routine classroom directives provided in English and recognize and utilize appropriate communication models so as to become successful learners in the academic environment. Lastly, ESOL students require using English to have effective function in social settings when outside the school and also in academic performance and assessment principals that differentiate between academic and language achievement are also needed if ESOL learners are to be granted full credit for learning academic content as they acquire English (Braine 2005, pg 114). For effective learning of ESOL, there should be promotion and maintenance of ESOL students native languages in both community and school contexts. Through definition, the ESOL students already know and utilize other languages. Both the school completion and academic achievement for ESOL learners is enhanced significantly especially when they are able to use their native language facilitates development of the second language. The development and use of ESOL learners native language also serves United States national interests since it increases the cultural and linguistic cultural available as the US competes globally in economy. The achievement of challenging world class educational principles by learn ers is only possible if all the schools prepare their educational missions with ESOL students as well as others in mind. For comprehensive learning, there should be sharing of responsibilities by and collaboration among all educational professionals working with the ESOL learners (Helbert 1976, pg 155). Professionals should extend their knowledge to encompass aspects of relevance to the learning of ESOL students. References Braine G, (1990). Non-Native Educators in English Language Teaching. Mahwah. Braine G, (2005). Teaching English to the World: History, Curriculum, and Practice. Mahwah. Harkla L, (1999). Generation 1.5 Meets College Composition: Issues in the Teaching of Writing to U.S.-Educated Learners of ESL. Mahwah. Hiebert E, (2005). Teaching and Learning Vocabulary: Bringing Research to Practice. Mahwah. Klahr D, (1976). Cognition, Learning, Psychology of Collections. Hills lade. Ohta A, (2001). Second language acquisition processes in the classroom. Mahwah.