Evidence for the Safety and Efficacy of Metal

Evidence for the Safety and Efficacy of Metal Introduction The development of joint replacement surgery was a major milestone in orthopedic surgery. Hip replacement is often the only viable solution for patients with advanced joint deterioration. Total hip arthroplasty is usually the last recourse for patients whose condition cannot be resolved clinically.Advertising We will write a custom critical writing sample on Evidence for the Safety and Efficacy of Metal-on-Metal Hip Prosthesis: Sufficient or Insufficient? specifically for you for only $16.05 $11/page Learn More Successful hip replacement usually leads to a better quality of life for the patient, due to the elimination of pain, and restoration of mobility. In addition, hip replacement improves the overall functioning of the body. The most common medical condition that can lead to the need for hip replacement is osteoarthritis. Other conditions include inflammatory arthritis, fracture, dysplasia, and malignancy. The use of Metal-on-Metal hip repla cement implants arose from the need to have durable implants. Metals also offered biomedical engineers a wide range of possibilities when designing Metal-on-Metal hip implants. Apart from durability, biomedical engineers could treat metals to make them inert, and to make them withstand corrosion better that most materials. Materials and Design There are two types of Metal-on-Metal hip replacement systems. The first type is the total hip replacement system. Total hip replacement involves the substitution of the hipbone and the hip joint with a metallic system as shown in Figure 1 below. The second type of hip implant is used in cases where the hipbone is not very damaged, by where the hip joint has deteriorated. In this case, a replacement hip joint substitutes the lining of the hip joint in the place of worn out cartilage as shown in Figure 1 below. Four main types of hip replacements are available to patients. The first type is the Metal-on-Plastic implant. Usually, this type of i mplant is made using a polyethylene socket, while the bearing is made from cobalt-chrome alloy. The second type of hip implant is the Metal-on-Metal implant made from cobalt-chromium alloy, titanium alloy, or sometimes stainless steel.Figure 1: Metal-on-Metal Hip Implant SystemsAdvertising Looking for critical writing on health medicine? Let's see if we can help you! Get your first paper with 15% OFF Learn More The third type of implant is the Ceramic-on-Ceramic implant. This type of implant has the best durability because of the resistant nature of ceramics. The debris produced as the joint wears is also not toxic to the human body. The fourth type of implant is the Ceramic-on-Polyethylene implant. This type combines the qualities of the two materials to produce a very durable implant. Table 1 below compares devices from different manufacturers Name of Device Manufacturer Market Status Reasons ASR XL Acetabular system DePuy Recalled 2010 High 5-year fa ilure rate of 13% R3 Acetabular system Smith and Nephew Orthopaedics Recalled 2012 Studies showed problems with metal liners in systems Rejuvenate ABG II metal hip stems Stryker Recalled 2012 Multiple failures including dislocation and pain Acetabular Component (Durom Cup) Zimmer Durom Recalled 2008 Voluntary recall by company citing low skill levels among surgeons Table 1: Device Comparison Clinical Safety and Efficacy A team of researchers at the Joint Replacement Institute of the Orthopedic Hospital in Los Angeles conducted a study to investigate the performance of Metal-on-Metal hip replacement implants. The study was titled â€Å"Metal-on-Metal Hybrid Surface Arthroplasty: Two to Six-Year Follow-up Study†. It was published by Amstutz et al. in 2004 in the Journal of Bone and Joint Surgery. The researchers studied the performance of 400 Metal-on-Metal hip replacements in 355 patients who had undergone arthroplasty after an average of three and a half years. The r eviews were done three months after the arthroplasty, and then annually for a period of three years. The findings from the study were as follows. First, the researchers found that most of the patients were able to resume active lifestyles after the arthroplasty, including participating in sporting activities. The level of activity of each patient dictated the rate of wear of the replacement joints. Out of the 400 hip arthroplasty procedures, twelve (3%) required total replacement after four years due to loosening of the femoral component, or due to neck fractures on the femoral component. The main risk factors associated with the degradation of the femoral component were large femoral heads, female gender, patient height, and small component size in male patients.Advertising We will write a custom critical writing sample on Evidence for the Safety and Efficacy of Metal-on-Metal Hip Prosthesis: Sufficient or Insufficient? specifically for you for only $16.05 $11/page Learn More The researchers concluded that in the overall sense, their review of the performance of Metal-on-Metal arthroplasty gave an encouraging picture. Secondly, the researchers concluded that optimal femoral preparation was a key success factor in hybrid Metal-on-Metal arthroplasty. In addition, optimal sizing of the replacement joint was also necessary for successful operation of a replacement hip. The researchers also concluded that replacing a Metal-on-Metal joint by a standard femoral component is easy to carry out. This research project supported the continued use of Metal-on-Metal hybrid joints based on their durability. The researchers failed to take into account the impact of the metallic debris on periprosthetic tissue. This shows that the researchers were biased towards the performance of the Metal-on-Metal hybrid joints at component level. Clarke et al. (2003) conducted research into the toxicological exposure to Chromium and Cobalt in patients who had unde rgone Metal-on-Metal hip arthroplasty. The researchers presented their findings in the Journal of Bone and Joint Surgery in an article titled, â€Å"Levels of Metal Ions after Small and Large Diameter Metal-on-Metal Hip Arthroplasty†. The hypothesis of the project was that the production of arthroplasty debris would be less after resurfacing arthroplasty that after total hip arthroplasty. The patients chosen to participate in the research project were those who had undergone arthroplasty at least six months prior to the research. The inclusion criteria included having undergone either total hip arthroplasty or resurfacing arthroplasty. The exclusion criteria include the presence of other metallic prosthesis in the body with the exception of titanium. In addition, the researchers excluded patients with secondary exposure to cobalt or chromium. The researchers compared the levels of chromium and cobalt in two sets of 22 patients who had undergone resurfacing arthroplasty and th ose who has undergone total hip arthroplasty. The first finding was that patients who had undergone resurfacing arthroplasty had medium serum levels of cobalt and chromium of 38 nmol/l and 53 nmol/l.Advertising Looking for critical writing on health medicine? Let's see if we can help you! Get your first paper with 15% OFF Learn More These levels were much greater than the levels found in those who had undergone total hip arthroplasty, which were 22 nmol/l and 19 nmol/l respectively. This notwithstanding, the researchers noted that these levels were significantly greater than the levels in patients without implants, which is typically 5 nmol/l. The researchers concluded that larger diameter implants result in greater exposure to cobalt and chromium. In addition, they concluded that patients have a higher level of metal ion concentrations after resurfacing arthroplasty compared to total hip arthroplasty. The main criticism about this research project was that it focused too much on the impacts of the metal debris arising from hip arthroplasty. A balanced view of the subject should have included a cost-benefit analysis aimed at finding out whether this condition was better than the prognosis arising from hip problems. This way, it would have been easier to decide whether the risks are worth taking. A study by rese archers in South Korea sought to establish whether metal hypersensitivity had a role in the onset of osteolysis after total hip arthroplasty. Park et al. (2005) conducted their research in the Departments of Orthopedic Surgery, Dermatology, and Pathology in the Sungkyunkwan University School of Medicine, located at the Samsung Medical Center in Seoul, South Korea. They presented their findings in the Journal of Bone and Joint Surgery through an article titled, â€Å"Early Osteolysis Following Second-Generation Metal-on-Metal Hip Replacement†. The researchers wanted to investigate the possible role of metal hypersensitivity in the etiology of osteolysis. Their research was motivated by the increasing use of Metal-on-Metal components for hip arthroplasty as a replacement for metal-on-polyethylene components, especially on second-generation patients. The researchers studied 165 patients (169 hips) who had undergone total hip arthroplasty between 2000 and 2002. The researchers fo llowed the patients for a period of twenty-four months. After this period, the researchers found that nine patients had developed osteolytic lesions. The researchers then conducted skin patch tests for hypersensitivity on the nine patients, and in a control group of nine patients who did not have the lesions. The researchers also conducted further tests on two hips during replacement surgery. These tests included microbiological cultures, histopathologic examinations, and immunohistochemical analysis on the two hips. The results obtained by the researchers showed that the patients who had developed osteolytic lesions had a higher hypersensitivity reaction to cobalt compared to their cohort. The two hips that underwent further tests showed no signs of metallic staining. There was however a high concentration of lymphocytes in the periprosthetic region. The researchers failed to find a way of telling apart natural sensitivity to Cobalt from acquired hypersentivity. This leaves the res earch findings open to interpretation because there is no proof adduced to the heightened levels of cobalt in the bodies of patients. In the same way, the researchers failed to find out whether Metal-on-Metal prosthesis has anything to do with osteolysis. This reduces the overall efficacy of the report. A research project conducted in the Departments of Orthopedics and Pathology, at the Klinikum der Universitt Gà ¶ttingen in Gà ¶ttingen, Germany sought to find out whether there is evidence to support the presence of an immunological reaction in patients who undergo a successive arthroplasty using Metal-on-Metal implants. The findings of the research project by Willart et al. (2005) were presented in the article titled â€Å"Metal-on-Metal Bearings and Hypersensitivity in Patients with Artificial Hip Joints†. The initial observation by the researchers that triggered the research process was that the some patients experienced a recurrence of preoperative symptoms after underg oing a second-generation total hip arthroplasty. Ideally, the surgery should have alleviated the entire range of symptoms related to aging prosthesis. In this regard, the researchers developed the project to find out why there was little or no change in patients who underwent arthroplasty involving second-generation Metal-on-Metal prosthesis. The researchers collected clinical data and examined periprosthetic tissue from nineteen patients who underwent arthroplasty in participating clinics. The sample was chosen on a consecutive basis as an application of random sampling. Out of the nineteen patients, fourteen patients received alumina-ceramic or metal-on-polyethylene implant. Five patients received second-generation Metal-on-Metal total joint replacement. The researchers used immunihistochemical methods to test the periprosthetic samples. They also used histological methods to test the samples. The main findings that the researchers reported were that the patients who underwent Met al-on-Metal total hip replacement had a recurrence of the preoperative symptoms characterized by an immunological reaction. The evidence adduced to support an immunological reaction was the presence of T and B lymphocyte cells in the periprosthetic region. In addition, immunohistochemical tests showed that the immunological reactions were ongoing as at the time of the test. This project made very important findings in regards to the impact of metallic debris arising from Metal-on-Metal prosthesis. The researchers did not provide a conclusive proposal on how to deal with the issues. This leaves the readers with task of deciding what to do about the prosthesis. Good research reports need to take into account the likely range of actions. Fisher et al. (2004) conducted a simulated experiment on the performance of surface engineered prosthesis to find out whether it is possible to reduce the rate to wear on metal-to-metal prosthesis. The researchers used a simulator to mimic the operatin g conditions of a Metal-on-Metal prosthesis. Lower rates of wear and tear associated with Metal-on-Metal prosthesis compared to other types of implants inspired the researchers. Metal-on-Metal prostheses have much lower wear rates compared to polyethylene prostheses. However, the researchers were aware that the levels of toxicity of the residue associated with Metal-on-Metal prostheses were higher that the levels associated with residue from other materials. Therefore, they identified the need for Metal-on-Metal prostheses with lower wear rates to eliminate or reduce the toxicity associated with metallic residue. The stated goals of the project were to investigate the wear, wear debris, and ion release of fully coated surface engineered Metal-on-Metal bearings for hip prostheses. The researchers used the Leeds Mark II physiological hip joint simulator operating at 1 Hz to conduct the wear experiments. This enabled them to collect the debris from the exercise. The test units were fiv e types of surface engineered prosthesis. The researchers also subjected conventional Metal-on-Metal prostheses to the simulator tests to develop a comparison. They found that the surface engineered bearings had a wear rate that was at least 18 times lower than traditional prosthesis after one million cycles and 36 times lower after five million cycles. The differences were calculated by measuring the debris levels and ion concentration in the lubricants. The debris levels and ion concentration in the lubricants were much lower when the experiments were done using surface engineered prostheses. The experiment by Fisher shows that it is possible to reduce the wear rate of metallic prostheses. Theoretically, this should reduce the problems associated with high serum concentration of metallic ions in patients with Metal-on-Metal prosthesis. However, the researchers failed to find out whether better surface engineering can reduce the problems associated with immunological responses espe cially in periprosthetic tissue. Conclusion This review shows that in the period prior to 2005, there was increasing concern regarding the use of Metal-on-Metal implants because of the immunological reactions caused by hypersensitivity to high ion concentration. In addition, the long-term impact of high ion concentration is unknown. Surface engineering can help resolve these fears. Reference List Amstutz, HC, Beaule, PE, Dorey, FJ, LeDuff, MJ, Campbell, PA Gruen, TA 2004, Metal-on-Metal Hybrid Surface Arthroplasty: Two to Six-Year Follow-up Study, The Journal of Bone and Joint Surgery, vol 86, no. 1, pp. 28-39. Bohle, P Quinlan, M 2000, Managing Occupational Health and Safety: A Multidisciplinary Approach, Macmillan Educational AU, South Yarra. Clarke, MT, Lee, PT, Arora, A Villar, RN 2003, Levels of Metal Ions after Small- and Large Diameter Metal-on-Metal Hip Arthroplasty, The Journal of Joint and Bone Surgery, vol 85, no. 6, pp. 913-917. FDA 2013, Medical Devices: Metal-on-Met al Hip Implants. Web. Fisher, J, Hu, XQ, Stewart, TD, Williams, S, Tipper, JL, Ingham, E, Stone, MH, Davies, C, Hatto, P, Bolton, J, Riley, M, Hardaker, C, Issac, G Berry, G 2004, Wear of Surface Engineered Metal-on-Metal Hip Prostheses, Journal of Material Science: Materials in Medicine, vol 15, no. 1, pp. 225-235. Park, Y-S, Moon, Y-W, Lim, S-J, Yang, J-M, Ahn, G Choi, Y-L 2005, Early Osteolysis Following Second-Generation Metal-on-Metal Hip Replacement, Journal of Joint and Bone Surgery, vol 87, no. 7, pp. 1515-1521. Singh, JA 2011, Epidemiology of Knee and Hip Arthroplasty: A Systematic Review, Open Orthopaedics Journal, vol 5, no. 1, pp. 80-85. Willart, H-G, Buchhorn, GH, Fayyazi, A, Flury, R, Windler, M, Koster, G Lohmann, CH 2005, Metal-on-Metal Bearings and Hypersensitivity in Patients with Artificial Hip Joints, Journal of Joint and Hip Surgery, vol 87, no. 1, pp. 28-36.

The Bermuda Triangle Essay Example | Topics and Well Written Essays - 1000 words - 1

The Bermuda Triangle - Essay Example The essay "The Bermuda Triangle" talks about the Bermuda Triangle, an area of the Atlantic Ocean, which has a mythical value as it is associated with the inexplicable disappearance of numerous vessels such as ships and airplanes passing through or over the area. The name emanates from the fact that the area is marked by a triangularly shaped border which connects Bermuda to Miami and then to San Juan back to Bermuda. It is believed that this section of the ocean is always busy with traffic, with commercial ships sailing through to places such as Europe, Caribbean and other ports in America while tourists fly over from Florida to Bermuda and other Islands in the vicinity and back using light airplanes. This section of the ocean is said to have numerous cases of strong currents, storms, and hurricanes during certain times of the year and this has been termed as the real reason as to why notable disappearances of vessels have occurred especially before the advancement in communication t echnologies, which are important in acquiring real-time information on the whereabouts of vessels cruising through the ocean or flying through the air. However, this has not helped much in changing the mythical identity of Bermuda triangle. The earliest allegation in this area was in 1950 by one Edward Winkle, who reported that there were mysterious disappearances, which could not be explained inhumanly possible terms. The disappearance of a Navy aircraft, Flight 19, in 1945 is cited as one of the most important historical events.

Oil price in GCC Essay Example | Topics and Well Written Essays - 750 words

Oil price in GCC - Essay Example Since the 1970s’ tremendous oil price shocks till the latest times, the oil prices have exhibited major changes which have immensely contributed to the volatility and uncertainty of the energy sector. The oil prices in the timeframe between 2007 and 2008 rose by 40 dollars to reach the threshold of 100 dollars down from 60 dollars, which had already increased to 147 dollars by July. By August, the prices fell to 145 dollars and in four months marked at the end of December 2008, they were trading at 45 dollars. The cycle of rise and fall of oil prices was repeated in 2009 and the trend has progressed till 2014. This trend has been a serious concern as it affects both producers and consumers. In the last decade, there has been much literature devoted to the exploration of the relationship between stock markets and oil prices in the GCC countries. Research from empirical documents indicate that the fluctuations in the oil prices has an impact on the corporate performance of companies, earnings and output as well as stock returns. Most of the studies conducted recently have indicated a link between stock prices and oil prices although such studies were based on market performances of developed economies. The assessment of the movement of GCC stock markets in response of the movements in oil prices can be examined both industry-level stock return data and country-level data (Bjornland, 2009). The findings show that there is a direct relationship between stock prices and oil prices in the short term which is not present in the long term. The casualty relationship exists, in most cases, running from oil prices to stock markets at the country level. At the industry level, the responses of the return on oil are relatively positive, as marked by only twelve out of twenty industries. The response of the oil price in relation to movements of the stock returns can be described as asymmetrical (Awartani & Maghyereh, 2013). This

Innovation and change Essay Example | Topics and Well Written Essays - 3500 words

Innovation and change - Essay Example The potential of firms to be innovative is critically examined in this paper; particular emphasis is given on the fact that each firm can learn to be innovative, a claim that is discussed by referring to the literature published in the particular field. In order to show whether a firm can learn to be innovative, reference is made primarily to the requirements and the characteristics of innovation; then the effects (benefits and drawbacks) of innovation and change are presented aiming to evaluate whether it is feasible for a firm to learn to be innovative and the terms under which such process could be successfully completed. It is proved that, indeed, a firm can learn to be innovative but the level at which innovation will actually become part of the specific organization cannot be standardized. In fact, each firm is likely to respond differently to the requirements of innovation, as part of the strategic planning process. Moreover, leaders and managers in modern organization are lik ely to develop different views on the needs and the scope of innovation, an issue which should be also taken into consideration when examining the influence of innovation on organizational life and, especially, the level at which each organization can learn to be innovative. 2. ... ion to exist it is necessary that the changes in the existing organizational practices are such that the product/ process involved is unique or at least quite difficult to be identified by customers in the particular market (Tidd et al. 2005, 8); also, time is quite important when referring to innovation. The introduction of the innovative products/ services in the market need to be developed quite fast, ensuring that no similar products/ services are available in the market at the particular time point (Tidd et al. 2005, 8). Innovation could also refer to the following issues: a) the introduction of a process/ platform, which would be used for the development of other products/ services in the future; these processes could pre-exist but they have not been used in the specific role up to now or b) the introduction of totally new platform/ processes (Tidd et al. 2005, 9), an initiative which may be risky, especially because there are no prior indicators of the performance of the speci fic processes. Innovation requires the change of existing organizational practices – referring also to those practices, which are introduced for first time, since such initiative indicates the change in the organization’s strategy. Different approaches have been used in the literature in order to define change – as part of innovation. In accordance with Andriopoulos et al (2009) change has been characterized as both ‘an ongoing dynamic process and as an episode in the life of an organization’ (Andriopoulos et al. 2009, 16). It is noted that both the above views perceive change as a factor contributing to the organizational development (Andriopoulos et al. 2009, 16). In this context, the interpretation of change, as part of the organizational life, cannot affect its role in

Stopping By Woods On A Snowy Evening :: essays research papers

The circumstances surrounding the composition of Robert Frost's poem "Stopping by Woods on a Snowy Evening" explain his use of "The darkest evening of the year" (L.8) which is closely related it to the greater theme of perseverance in the face of hardship. Frost wrote this poem, in November(Frost Chronology) 1923; on the same late night he finished his book New Hampshire (Jackson sec. 1). Being "a little excited from getting over-tired"(qtd. in Jackson sec. 3), he decided to venture out into the wilderness, probably to calm down. Frost hitched his horse to a sleigh and left on his journey to eventually find the "Woods" in this poem. Being in an "autointoxicated"(qtd. in Jackson sec. 3) state, Frost was mesmerized by the scene of the woods beside the frozen lake. He eventually broke out of his trance, possibly with the aid of his horse, by thoughts of prior commitments. The former statement is shown in the text by: "He gives his harness bells a shake To ask if there is some mistake"(L.L. 9-10) and the latter by: "But I have promises to keep And miles to go before I sleep"(L.L. 13-14). According to Frost, upon his return home, "Stopping by Woods on a Snowy Evening" "was wri tten in a few minutes without any strain"(qtd. in Jackson sec. 1). Therefore, Frost wrote this poem about himself and his journey. Literally, "The darkest evening of the year"(L.8), refers to the winter equinox on December 21st. But, if thought of symbolically, this line could be the culmination of difficult work, by the author, to finish his book New Hampshire. Furthermore the equinox aspect of "The darkest evening of the year"(L.13) symbolizes the transition, from the writing of a new book to its realization. Therefore, the meaning "The darkest evening of the year"(L.8) is dual even if the poem was not written in December 21st. In and of itself, the poem is an extended metaphor for perseverance. The reader only realizes this after having finished reading the poem because the information about the narrator's prior commitments and fatigue is provided at the end. In retrospect, the first stanza can be analyzed as the narrator's difficult journey. The middle and last parts of the text, like the woods, can be seen as the temptation, as is evident in the lines "The woods are lovely dark and deep"(L. 13). But the narrator overcomes his temptation shown by: "But I have promises to keep, And miles to go before I sleep†¦"(L.

A Literary Critic of “The Secret Life of Walter Mitty” Essay

The story â€Å"The Secret Life of Walter Mitty† is a form of a short story genre variety. This story was written by James Thurber, and published in The New Yorker in 1939 (Clugston, 2010). This is an intriguing story of a daydreaming husband, Walter Mitty, and his domineering wife as they run a few errands to town. I will make use of literary criticism by explaining my connection to the story, analyzing the meaning of the story, and taking the formalistic approach in discussing James Thurber’s story. My connection to this story is strongly held by the fact that I am also a daydreamer. I will admit this is a frustrating characteristic for others, but for one’s self as well; eventhough, the situations discussed in the story seem quite humorous to the reader. Mr. Thurber presents the tone, or mood, of frustration throughout this story. As Walter is daydreaming and driving faster than Mrs. Mitty likes, she abruptly interrupts him. Although the daydream breaks for an instance, he quickly returns to his daydream. Mrs. Mitty is quick to interrupt again, â€Å"It’s one of your days. I wish you’d let Dr. Renshaw look you over.† Her frustration is evident because she thinks that something must be wrong with him. Later when Walter is not wearing his gloves, Mrs. Mitty is certain he has lost them. James Thurber has reinforced her frustration. Walter’s frustration is expressed in the story several times as well. An instance when a parking attendant awakens Walter from another daydream, the story reads â€Å"Mitty becomes a little testy.† When Walter makes several mistakes trying to park the car, the frustrated attendant tells him to â€Å"leave her sit there, I’ll put her away.† When the attendant parks the car with some expertise, Walter replies â€Å"they’re so damn cocky, they think they know everything.† Probably the sharpest image portrayed in the story is  when Mrs. Mitty is hassling Walter for not having the sense to put on his overshoes. Walter’s reaction is one of self-defense stating â€Å"Does it ever occur to you that I am sometimes thinking.† This set the tone that Walter is letting his wife know that just because he may seem lost, does not make him senseless, or that she needs to keep after him the way she does. As a daydreamer myself, I have experienc ed some of the same frustrations depicted in this story, so I connected with the story immediately. Now moving on to the analysis of this story, there are several meanings illustrated. According to Koger, there are four themes or meanings conveyed through this story which are â€Å"the contrast between a human being’s hopes for life and its actuality, the power of the mind or imagination, the conflict between the individual and authority, and the ascendancy of technology and materialism in the twentieth century† (Koger, 2004). I agree that all of these themes are displayed throughout the story; however, I believe one has been overlooked. I feel that Walter Mitty may have self-esteem issues that he is able to overcome in his daydreams or, even better, they do not exist. Many examples are apparent contrasting one’s hopes and reality. Walter’s â€Å"heroic ability† in his daydreams versus his inadequacies in the reality of the story is one example (Koger, 2004). Another fine example is Mitty’s ability to master technology in his daydreams versus his inability to maneuver his car, or appropriately unwind tire chains (Koger, 2004). Another example, of my own accord, is the confidence that is portrayed in the fantasies that do not exist in the reality. For example, in the first daydream he is a commander taking charge of a ship and traveling through a storm versus being told to wait in front of the drug store, in the rain, for his wife as though he were a child. The power of the mind and imagination another theme to the story is exemplified through Mitty’s daydreams. Mitty is able to overcome every dilemma he faces in reality through his daydreams. He becomes an expert of machinery, and he no longer fears authority figures, but instead becomes an authority figure. He even boosts his self-esteem by allowing the phrase â€Å"the old man ain’t afraid of hell.† Self-esteem is an important characteristic of the story. The persona or narrator may or may not reflect the author’s perspective (Clugston, 2010). However; Thurber lost an eye as a child (Clugston, 2010). I find it very symbolic that in Walter Mitty’s first daydream; the narrator describes the commander â€Å"with the heavily braided white cap pulled down rakishly over one cold gray eye.† I am inclined to think that James Thurber may be the Walter Mitty in the story. That being said, I also understand where the lack of confidence has played into the story. Mr. Thurber is able to cover his bad eye through the words that he writes. Thompson describes Mitty as a â€Å"docile nobody muffled in layers of winter clothing with a loquacious and overprotective wife beside him† (Thompson, 2008). This is yet more evidence of the poor self-esteem portrayed characteristically through Walter Mitty. The formalistic approach is â€Å"the most widely used in literary criticism; it focuses on the form and development of the literary work itself† (Clugston, 2010). The setting of the story is memorable because it is cold, and the characters must drive into town to run errands giving clues that the Mitty’s live in the country or a very small town. James Thurber also creatively interrupts the daydreams at their climax, adding to the jolt back to reality. This gives the readers a chance to get lost in the daydreams, and be jolted back to reality as well. Walter is described as a middle aged man unhappy with his life. The evidence of his unhappiness is portrayed through his daydreams where his life is almost perfect. Mrs. Mitty is described as a nagging old woman who is constantly frustrated with her husband’s absentmindedness. She is constantly telling him what to do and how to act. When he does not, she assumes he has fallen ill. Thurber also uses the same simple phrases such as â€Å"pocketa-pocketa-pocketa† for every machine giving the reader the sense that in reality, all machines have the same amount of value in Walter’s mind. Using the simple fountain pen to fix an expensive piece of machinery also gives clues to Walters’s lack of intelligence when it comes to technology. The author also uses very explicit daydreams allowing the reader to understand how far Walter Mitty had escaped from reality. In conclusion, I have discussed my connection, analyzed the meaning, and taken a formalistic approach to critic this wonderful piece of literature. The connection to the story is easy to come by as every person daydreams occasionally. The story consists of five different meanings or themes as I have discussed. I have also discussed the several different literary actions and the artistic ability used to create an amazingly humorous piece of art. References Clugston, R. W. (2010). Journey into literature. San Diego, CA: Bridgepoint Education, Inc. Retrieved from https://content.ashford.edu/books/AUENG125.10.2/sections/ Koger, G. (2004). Masterplots ii: Short story series, revised edition. (2nd ed. ed., Vol. 1). United Kingdom; England: Salem Press. Retrieved from http://search.ebscohost.com/login.aspx? Thompson, T. (2008). â€Å"he sprang to the machine† : â€Å"the secret [technological] life of walter mitty. (1 ed., Vol. 41, pp. 110-115). Retrieved from http://web.ebscohost.com/lrc/detail?vid=5&hid=19&sid=280101a3-6742-45d0-88ee-24b153429c1a@sessionmgr12&bdata=JnNpdGU9bHJjLXBsdXM=

Siddhartha Gautama, Siddhartha And The Country Of Nepal

Buddha was born in a mountain kingdom, north of India, the country of Nepal. His Birth name is Siddhartha Gautama; Siddhartha is a compound of Sanskrit words, sidd and artha. Sidd meaning Perfection and Artha meaning to have a goal, so the overall meaning of Siddhartha is the one whose goal is perfection. He was born in a second highest caste in a Hindu family. In Buddhism, Siddhartha is not considered to be a god; he is just a person and only is considered to have certain abilities, as an extraordinary human. He was kept inside the kingdom until the age of 29, and at that time Siddhartha became very unsatisfied with his life despite having family and wealth. Finally he figured out the problems that are happening in the world, and questions himself why these things like illness, death, poverty are happening. He decided to leave the palace in the middle of the night. When everyone was sleeping he went to his wife, gave her a goodbye kiss and left the palace seeking the liberation fro m the cycle of rebirth. Him leaving wealth, family and home is known as going for the Great Renunciation. For the next 6 years he wandered around India studying with the greatest Hindu gurus, and mastered the Hindu practices that normally leads to Renunciation. He is still dissatisfied with his life; he didn t find what he was primarily looking for. He thought he is not putting enough efforts and stopped eating. That didn’t help him get what he wanted. He then sat on the bank of the river,Show MoreRelatedCompare and Contrast Judaism and Buddhism Essay647 Words   |  3 PagesBuddhism have lots of differences beliefs and practices and only few similarities. Judaism was started in 2000 B.C.E, led by Abraham. Buddhism was started in 560 B.C.E, by Siddhartha Gautama. Both religions have different point of view. Buddhism don’t believe in deity and Judaism believe in deity. 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