Were German militarism and diplomacy responsible for WWI?

World War I began on July 28, 1914, and would last until an armistice with Germany was signed on November 11, 1918. The causes of this war cannot be attributed to any single country or policy, but to a culmination of many factors that reached a tipping point in 1914.

As I'm sure you already know, the assassination of Archduke Franz Ferdinand of Austria was the spark that set the war in motion. Had this event been contained between Serbia, Bosnia, and Austria, it is doubtful that other nations would have gotten involved. To understand how this act of violence could prompt such a large scale war, one must first examine the system of alliances that were in place in Europe in the 1910s. During this time, many nations feared the growing military and technological power of their neighbors, prompting them to make strategic alliances to pool their power in case of a conflict. This eventually resulted in two divisive alliances being formed, with nearly every European country belonging to one side or the other. So, when a small conflict between two small nations on opposite sides of the alliance broke out, the larger nations felt obligated to support their allies, which effectively expanded the conflict on an exponential scale.

In short: The growth of German militarism in the 1910s contributed to the formation of strategic alliances across Europe, as well as the arms race, for many nations feared being less powerful than their neighbors. As for German diplomacy, their decisions to aid in Austria's retaliatory attacks on Serbia, and to declare war on Russia, succeeded in expanding the scale of World War I.

How can I understand the distinction between public goods (non rivalrous and non excludable) and primary goods (as defined by John Rawls)? I...

Pollution would be a "negative public good", sometimes called a "public bad"; but that's not really the fundamental distinction here.

Public goods, as you note correctly, are any goods that are nonrival (they can be used by many people at once) and nonexcludable (it's difficult to stop anyone from using it if they want to).

Public goods can be directly compared to private goods, which are typical goods that are rival and excludable (e.g. shoes), club goods, which are nonrival but excludable (e.g. nightclubs, toll roads), and common goods, which are rival but nonexcludable (e.g. water supply). Common goods are really the worst; they are what give us the Tragedy of the Commons.

These are all economic concepts with clearly defined descriptive meaning.

Primary goods are a more philosophical concept with a more normative sense behind them; John Rawls uses the term to describe anything that is intrinsically valuable to humans, anything that would be desirable from the "original position" behind the "veil of ignorance" in which we know nothing about what sort of person we'll be.

He gives some examples such as intelligence and health; presumably everyone wants to be intelligent and healthy, there aren't a lot of people who want to be stupid and sick.

He also considers rights to be primary goods; everyone wants to be free, everyone wants to have a say in their government.

Examples of things that would not be primary goods are anything that varies based on culture or taste. Not everyone wants to eat vanilla ice cream, some people don't like vanilla; not everyone wants to live in a big city, some people prefer the countryside.

The idea is that primary goods are what we should be trying to get if we're in the veil of ignorance, while goods that we'd only want once we knew something about ourselves or our position in society would not be primary goods. We decide how to make a just society under the veil of ignorance, so only primary goods are important in that judgment.

You're right that a lot of primary goods are public goods---fresh air, free speech. But some primary goods are private goods---Rawls includes wealth as a primary good. Still others are hard to place, like health: Is health rival? Is it excludable? Healthcare seems like mostly a private good (a doctor can only treat one person at a time, and can always choose not to), but then there are considerations of public health (such as vaccination and herd immunity) that make it more like a public good. But health is definitely an example of a primary good in the sense Rawls intends.

To be honest, I find this concept a bit tendentious. It's pretty hard to clearly define what everyone would want, especially in some deep sense of fundamental desirability to all rational persons. Maybe not everyone wants a say in their government, for example; perhaps some would prefer to be left alone and let people who know what they're doing make the decisions. That's not incoherent at least, even if we might disagree with it. Nor is it clear to me that a society could deny people taste goods at will---banning chocolate, say---without being unjust or imposing upon liberty.

Indeed, if that example seems silly, try this one: Banning homosexuality. This is something a great many countries around the world have done, and sex with people of the same gender can't be a primary good since not everyone wants it---but it certainly seems like a fundamental violation of liberty to ban it. Maybe we can justify this by some broader primary good like love or sexual freedom; but at least for me it raises some serious doubts about whether primary goods are doing any useful work for our judgments about justice and injustice.

What is stretching?

Stretching, as it relates to physical fitness, is the process of positioning the limbs of the body in ways that will lengthen the muscles and surrounding soft tissue. Stretching builds muscle elasticity and tone, as well as creates better flexibility. Stretching also increases a person's range of motion, improves circulation, relieves muscle soreness, and reduces overall fatigue. The two basic types of stretching are
static stretching
and dynamic stretching. Proper technique is an important component of stretching. Incorrect stretching can lead to injury.

Understanding Stretching

When the body is stretching, several things are taking place deep in the muscles and soft tissue. A muscle contains thousands of tiny stringlike cells called muscle fibers. Muscle fibers are situated close together within a muscle and are usually very long. Muscle fibers are composed of thousands of even smaller threads called myofibrils, which make muscles able to lengthen, relax, and contract. Within the myofibrils are millions of minuscule bands called sarcomeres, which are made up of overlapping strands of protein-laden myofilaments. Stretching a muscle lengthens and narrows the muscle fibers and their smaller components. When a muscle is lengthened during a stretch, the connective tissue and sheath of the muscle tendons elongate. As the body gets used to stretching, the surrounding ligaments, tendons, connective tissue, skin, and scar tissue begin to adapt to the movement. Continual stretching over long periods of time leads to many benefits.

The Benefits of Stretching

Stretching improves a person's overall athletic ability. Stretching the muscles leads to greater flexibility, and flexibility allows for greater range of motion. The activity improves range of motion by reducing muscle tension in the stretched part of the body. Improved range of movement allows the limbs to move farther apart without the muscles or tendons becoming damaged. Consistent stretching after athletic activity reduces an athlete's risk of injury.

Apart from reducing risk of injury, stretching also eases post-exertion muscle soreness. Soreness occurs after strenuous exercise and is the result of micro tears in the muscle fibers, blood pooling in the legs, and waste accumulation, such as lactic acid buildup. Lengthening the muscle fibers during a stretch increases blood circulation and helps eliminate waste products. Stretching after a workout also reduces bodily fatigue, which can diminish future physical and mental performance. Fatigue creates greater muscle tension and forces the body to work harder during physical activity. Greater flexibility relieves muscle pressure and the body requires less effort from the working muscles as a result.

Regular stretching also corrects posture and strengthens physical coordination. Better circulation also leads to increased energy. A person can learn many things about the body by performing frequent stretches, which can lead to greater relaxation and stress relief.

Types of Stretches

Stretching falls into two basic categories: static stretching and dynamic stretching. Static stretches are done without other types of movement. A static stretch involves a person getting into a stretch and remaining there for a given amount of time. The position of the stretch is meant to place gradual tension on the muscle as it is stretched. Static stretching is recommended for beginners and for people who are not very active. Other types of static stretches include passive stretching, active stretching, and isometric stretching. Passive stretching involves another person or apparatus moving a limb to create a stretch. Active stretching is the use of muscle strength to generate a stretch in a specific area. Raising the leg high in the air and keeping it there without external assistance is an example of an active stretch. Isometric stretches are passive stretches that lengthen muscles for long amounts of time with great intensity.

Dynamic stretches involve stretching and movement. While stretching a specific part of the body, a person also swings or bounces the body part to extend its range of motion. The force of the bouncing or swinging creates greater flexibility in the limb. Dynamic stretches can also work to strengthen muscles. Resistance stretching and loaded stretching contract and elongate a muscle simultaneously. The muscle is stretched through its full range of motion while being contracted, leading to increased strength. Due to the demands dynamic stretching places on the musculoskeletal system, this type of stretching is most beneficial to people who are regularly active.

Stretching Safely

Stretching can do serious damage to the body if performed incorrectly. Individuals should listen to their bodies when stretching. Any movement that causes pain or discomfort should be avoided. A person should never stretch an injured area of the body until the area has recovered or the individual has been cleared by a physician to perform the activity. Warming up is also very important prior to stretching. Stretching cold muscles can lead to muscle damage. Body heat loosens muscles, making them more pliable for stretching. Warm-ups also increase blood flow and release more oxygen into a person's system, nourishing the muscles. Comprehensive stretching of all major muscle groups in the body is an important part of physical activity. Expert opinion varies as to whether stretching before exercise is beneficial, but most agree that stretching after a workout is crucial to muscle recovery.

Bibliography

Reynolds, Gretchen. "Stretching: The Truth." Play Magazine. The New York Times Company. 31 Oct. 2008. Web. 24 Mar. 2015. http://www.nytimes.com/2008/11/02/sports/playmagazine/112pewarm.html

Roberts, Melanie, and Stephanie Kaiser. "The Different Types of Stretching." Idiot's Guides: Stretching. New York: Alpha Books, 2013. 8–10. Print.

"Stretching: Focus on Flexibility." Mayo Clinic. Mayo Foundation for Medical Education and Research. Web. 23 Mar. 2015. http://www.mayoclinic.org/healthy-living/fitness/in-depth/stretching/art-20047931

Walker, Brad. The Anatomy of Stretching. Berkeley: North Atlantic Books, 2007. 12–24. Print.

What is the gallbladder?

Structure and Functions

The gallbladder is part of the digestive system. Bile originates in the liver then flows into the gallbladder through a system of ducts. Some bile flows directly into the small intestine, but the gallbladder collects and concentrates much of the bile. It then contracts and releases more bile into the small intestine as food is eaten. Bile helps break down the fats and neutralize the acids in the food. The organs and ducts that transport bile are collectively called the biliary system and include the gallbladder, liver, pancreas, stomach, small intestine, and the ducts connecting these organs.

Disorders and Diseases

Gallstones are a very common gallbladder problem. Two types of stones may form. Cholesterol stones are the most common type of gallstone, and they form when there is too much cholesterol in the bile. Pigment stones are less common, occurring only about 20 percent of the time; they are formed when there is too much bilirubin in the bile. Gallstones may be any size, ranging from stones that are tiny, like grains of sand, up to the size of a golf ball. When stones are small, they may form a type of “sludge” that affects the functioning of the gallbladder. If they are large, then they may move about and cause blockage of the ducts that drain the bile from the gallbladder into the digestive system, causing pain or a “gallbladder attack.” Stones may exit the gallbladder and block other areas of the digestive system, causing pain, infection, or organ damage. However, it is possible to have gallstones that cause no pain or problem at all.

Some risk factors for gallstones include being female (especially females who have been pregnant or have taken hormones), being overweight, losing weight quickly (such as with “crash” dieting), or having high blood cholesterol levels.

Common symptoms of gallstones include pain in the upper right abdomen (especially within thirty minutes after a fatty meal), nausea, vomiting, fever, indigestion, gas, constipation, diarrhea, or bloating. Stones blocking the common bile duct are likely to cause symptoms such as jaundice, dark urine, and rapid drop in blood pressure. Some relief may be found by following a low-fat diet, and some patients find relief through nontraditional methods, such as acupuncture or herbal medicine. More conventional treatments may involve dissolving the gallstones by various methods; however, once gallstones begin to form, they are very likely to return, so this option may not be a long-lasting one. Another possibility is to perform a therapeutic endoscopic retrograde cholangiopancreatography (ERCP), which allows stones to be removed or ducts to be opened. In complicated or recurring cases, the treatment for gallstones involves removing the gallbladder (cholecystectomy). Without the gallbladder, all bile flows directly from the
liver into the small intestine. In most people, gallbladder removal has almost no side effects; in a very small percentage (approximately 1 percent), bile traveling directly into the small intestine can cause diarrhea.

Untreated gallstones can become life-threatening due to infection or organ damage because of blockages, and complications including gangrene and perforation of the gallbladder can occur. People with diabetes are, for unknown reasons, more likely to have serious complications from gallstones.

Gallbladder cancer
is quite rare, with new cases of less than ten thousand per year in the United States. It is seen most often in people aged seventy and older and is more common in women than in men. The cause of gallbladder cancer is unknown, but risk factors include a history of gallstones, porcelain gallbladder (a rare condition where calcium lines the walls of the gallbladder), smoking, family history of gallbladder cancer, and obesity. There are usually no symptoms of gallbladder cancer; most cancers are found incidentally during surgery to remove gallstones. Surgery to remove the gallbladder, radiation therapy, and/or chemotherapy are all possible treatments for gallbladder cancer.

Perspective and Prospects

The gallbladder has been recognized throughout history as an important organ in the digestive process. It is one of the organs in the “four humors” system of medicine, which may have originated in Mesopotamia or Egypt but reached its height in the Greek system of medicine. In that system, the gallbladder was linked to the season of summer and the element of fire, and an overabundance of bile was thought to cause one to be bad-tempered or “choleric.” In traditional Chinese medicine, the gallbladder is thought to affect the quality and length of sleep.

Bibliography

Andrén-Sandberg, Åke. "Diagnosis and Management of Gallbladder Cancer." North American Journal of Medical Sciences 4, no. 7 (July, 2012): 293–99.

Clavien, Pierre-Alain, ed. Diseases of the Gallbladder and Bile Ducts: Diagnosis and Treatment. 2d ed. Wiley-Blackwell, 2006.

"Gallbadder Removal—Laparoscopic." MedlinePlus, August 1, 2011.

Kraus, J. The Etiology, Symptoms, and Treatment of Gall-Stones. BiblioLife, 2009.

Lack, Ernest E. Pathology of the Pancreas, Gallbladder, Extrahepatic Biliary Tract, and Ampullary Region. New York: Oxford University Press, 2001.

Mitchell, George. Learn About Your Liver and Gallbladder. Dupage Digital, 2008.

PM Medical Health. Twenty-first Century Ultimate Medical Guide to Gallbladder and Bile Duct Disorders: Authoritative Clinical Information for Physicians and Patients. Progressive Management, 2009.

Savitsky, Diane. "Gallstones." Health Library, September 30, 2012.

Thomas, Charles, and Clifton Fuller, eds. Biliary Tract and Gallbladder Cancer: Diagnosis and Therapy. Demos, 2008.

Thudichum, John Louis William. A Treatise on Gall-stones: Their Chemistry, Pathology, and Treatment. BiblioLife, 2009.

What kinds of things had George done to Lennie?

In the third chapter of Steinbeck's Of Mice and Men, George and Slim come into the bunkhouse at the end of the first day's work and start to chat. Slim compliments Lennie for being a good, strong worker, but he is also curious as to why George and Lennie travel together. George explains that Lennie's Aunt Clara took him in when he was a baby, and when she died, Lennie simply followed George to work and it caught on. Thinking back makes George reminisce about his younger years with Lennie and all of the jokes he played on him just for the fun of it. George says he played the jokes on Lennie because he was "too dumb to take care of 'imself." George muses that teasing him made him feel like he was smart compared to Lennie. George gives some examples, as in the following passage:

"If I tol' him to walk over a cliff, over he'd go. That wasn't so damn much fun after a while. He never got mad about it, neither. I've beat the hell outa him, and he coulda bust every bone in my body jus' with his han's, but he never lifted a finger against me" (40).

What finally made George stop teasing Lennie was when he told him to jump into the Sacramento River. Lennie almost drowned because he can't swim, so George had to pull him out. All the while, Lennie was grateful that George had saved him, and that made George stop teasing Lennie. George doesn't clarify whether he stopped because out of guilt or out of a newfound maturity, but it was probably a little of both. As George started taking care of Lennie, he became his protector rather than his bully.

What do we learn of Hamlet's feelings for Ophelia in Act II, Scene 1?

In truth, we don't learn that much about Hamlet's feelings for Ophelia. It raises more questions than it answers. We know from her conversations with Polonius and Laertes that Hamlet has expressed his love for her (both men tell her to reject his advances). In Act II, Scene 1, Ophelia tells her father about an encounter she had with Hamlet where the prince entered the room in a state of distress, clothing unkempt, wild-eyed, and "with a look so piteous inpurport/As if he had been loosed out of hell..." Polonius thinks this erratic behavior is because Hamlet is distressed and "mad" because Ophelia has spurned his love, and resolves to tell the King about the incident. Hamlet's "mad" behavior is a choice, however; it is one of many examples of dramatic irony in the play. The audience knows Hamlet has already, as part of his plot to avenge his father's murder, planned to "put an antic [i.e., mad] disposition on." He said as much in the final scene of Act I, so we do not really know at this point if Hamlet is really mad for Ophelia's love or if he is feigning insanity in order to carry out his plot. 

Did Martin Luther King, Jr. or Malcom X have children, and were they friends?

Martin Luther King, Jr. and Malcolm X both had children.

King had four children with his wife, Coretta Scott King— Yolanda Denise, Martin Luther III, Dexter Scott, and Bernice Albertine. 

Malcolm X had six children with his wife, Betty Shabazz— Attallah, Qubilah, Ilyasah, Gamilah Lumumba, Malikah, and Malaak. 

Reverend King and Malcolm X only met on one occasion (March 26, 1964) and did not maintain a friendship. The two felt that while they had similar aspirations for racial equality, their methodologies almost entirely prevented them from working together. Leading up to the assassination of Malcolm X, the two were increasingly in contact and there may have been potential for King and Malcolm X to unite their religious and sociopolitical influences. Unfortunately, this potential was not realized in their lifetimes. 

As for whether the children of Reverend King and Malcolm X were friends, Yolanda King and Attallah Shabazz met for the first time in 1979 and went on to collaborate on a theatrical production. It is possible the other King and Shabazz children met or corresponded on some occasion, as their fathers both died fighting for civil rights, but there is nothing to suggest friendship between any of them.

What is prenatal physical development?

Introduction

Pregnancy encompasses the development of a single-celled fertilized egg into a trillion-celled baby. The many changes that transform the fertilized egg into a newborn infant over nine months of human pregnancy constitute prenatal development. Prenatal development comprises three stages (zygote, embryo, and fetus) and is also commonly categorized into three trimesters, each lasting three months. Although prenatal development typically follows a predictable course, development can be disrupted by both genetic and environmental factors. This disruption may result in a range of outcomes, from fetal death and severe abnormalities such as deformed or missing limbs, to minor abnormalities such as low birth weight and neurological dysfunction such as learning disabilities or attention-deficit hyperactivity disorder (ADHD).

The fourth century b.c.e. Greek philosopher Aristotle is regarded as the first in Western civilization to study prenatal development. In the years that followed, others superficially investigated the topic. However, it was not until the beginning of the twentieth century that researchers intensified their study of prenatal development. In the early 1900s, researchers were significantly influenced by the evolutionary theories of Charles Darwin and believed that all aspects of prenatal development were genetically determined.

Josef Warkany, a pioneering American scientist, engendered a shift in the thinking of the scientific community during the 1940s. Warkany documented that environmental factors, called teratogens, could adversely affect prenatal development and cause malformations at birth. About a decade later, the notion that environmental factors could harm prenatal development became mainstream after the 1950s thalidomide tragedy. Thalidomide was a drug given to pregnant women to combat symptoms of nausea. When taken in the first trimester of pregnancy, the drug produced severe physical deformities in infants, including missing arms and stunted limbs, and its use was subsequently banned. Following this tragedy and the resulting acceleration in understanding of the importance of intrauterine life, diagnostic tests have become routinely used to monitor the course of prenatal development.

Stages of Prenatal Development

Prenatal development begins when a sperm successfully fertilizes an egg (ovum) and usually lasts an average of thirty-eight weeks (nine months). The American College of Obstetrics and Gynecology has standardized the terminology used to describe the three stages of prenatal development. The first stage, the zygote (or germinal) stage, begins at fertilization and ends two weeks later, shortly after implantation of the zygote in the uterine wall. The second stage, the embryo stage (weeks three to eight), is the most vulnerable to teratogenic (environmental) insult. The fetal stage (weeks nine to thirty-eight) represents the final and longest stage of prenatal development.

The Zygote Stage

Fertilization of an egg by a sperm creates a zygote. The two-week period of the zygote after conception ends with its implantation into the uterine wall. During these two weeks, the zygote grows rapidly and is carried by currents in one of the Fallopian tubes toward the uterus. The movement through the Fallopian tube usually takes five days. The zygote divides from a single cell into a mass of approximately one hundred cells. Approximately one week after fertilization, the zygote is ready to attach itself to the uterine wall. Many potential pregnancies terminate at this point as a result of implantation failure. Implantation takes approximately one week to complete, connects the zygote with the woman’s blood supply, and triggers hormonal changes that prevent menstruation. At this stage, the implanted zygote is less than a millimeter in diameter but is beginning to differentiate into two structures: the germinal disc and the placenta. The germinal disc eventually develops into the baby, while the remaining cells transform into the placenta. The placenta is the structure through which nutrients and waste are exchanged between the mother and the developing child. Successful implantation and differentiation into the placenta and germinal disc mark the end of the period of the zygote.

The Embryo Stage

On successful implantation in the uterine wall, the zygote is called an embryo and pregnancy enters its second stage. The embryo stage typically begins three weeks after conception (fertilization) and lasts through the eighth week of pregnancy. At the beginning of the embryo stage, the embryo is only two millimeters long and less than an ounce in weight. The embryo is enclosed in a protective sac called the amnion, which is filled with amniotic fluid that cushions and maintains a constant temperature for the embryo. The embryo’s cells form into three layers: The outer layer (ectoderm) becomes the hair, the outer layer of skin, and the nervous system; the middle layer (mesoderm) forms muscles, bones, and the circulatory system; and the inner layer (endoderm) forms the digestive system and lungs. At the beginning of this stage, the embryo looks more like a lizard than a human being, as a result of the shape of its body and head. By the end of the eighth week of pregnancy, the embryo manifests distinguishable human characteristics (eyes, arms, legs) and contains in rudimentary form all of its organs and body structures. Despite these significant changes, the embryo remains too small to be detected by the mother.

The Fetal Period

The longest and final phase of prenatal development is known as the fetal period. The fetal period represents a time when the finishing touches are put on the structures of the fetus. This period begins at nine weeks and ends with the birth of the baby. During this stage of pregnancy, the growth and development of the fetus is astounding. The fetus will increase in mass from less than one ounce at week nine, to eight ounces at four months, and to nearly eight pounds at birth. Around the start of the fetal period, the fetus begins to differentiate sex characteristics. At twelve weeks, the circulatory system becomes functional. At sixteen weeks, the mother can detect fetal movements known as quickening. By twenty weeks, a fine layer of hair (called lanugo) begins to grow over most of the fetus’s body. Sucking and swallowing reflexes are present by twenty-four weeks of gestation. Brain specialization becomes particularly acute by about twenty-eight weeks. At thirty-two weeks of gestation (seven months), the fetus is viable outside the mother’s womb. By this time, most systems function well enough that a fetus born at this age has a chance to survive. Despite the potential to survive, premature birth predisposes a baby to myriad additional developmental problems (health problems, learning disabilities, and cognitive deficits). By thirty-two weeks of prenatal development, the fetus has regular periods of physical activity, and the eyes and ears begin to function. By thirty-six weeks of gestation, the fetus experiences rapid weight gain, and development consists largely of an increase in weight and length. At approximately thirty-eight weeks of gestation, birth will occur. The average newborn baby weighs between seven and eight pounds.

Disruptions in Prenatal Development

Although most of prenatal development progresses in a healthy and predictable fashion, numerous factors can disrupt the course of prenatal development. It is customary to divide the possible cause of these malformations into genetic factors (chromosomal abnormalities) and environmental factors (such as drugs or viral infections). There is often an interaction between environmental conditions and genetic factors such that the environment can either exacerbate or mitigate any potential adverse outcomes. The impact of both genetic and environmental factors may result in abnormalities that range from fetal death and severe structural defects to subtle neurological malformations that may not manifest themselves until several years after birth (as with learning disabilities or ADHD).

General Risk Factors

Parental age can have an impact on prenatal development. Women over the age of thirty-five are at greater risk of giving birth to children with birth defects such as Down syndrome and other chromosomal abnormalities. Recent research suggests that older men also have an increased risk of fathering children with birth defects as a result of the presence of damaged sperm that may fertilize the egg. Teenage girls are also at greater risk for giving birth to children with birth defects as a result of poor maternal health and inadequate prenatal care. When prenatal nourishment and care are lacking, the baby is more likely to be born prematurely, have a lower birth weight, and be at greater risk for learning difficulties and a host of behavioral and emotional problems. Recent research has also implicated other factors during pregnancy as a general risk factor for psychological, behavioral, and educational outcomes.

Genetic and Chromosomal Risk Factors

Thousands of genetic and chromosomal anomalies can potentially disturb normal prenatal development. Although many of the causes of genetic and chromosomal abnormalities are unknown, some may be attributable to exposure to teratogens that damage the chromosomes during prenatal development. Research emerging out of the Human Genome Project is continuously documenting additional chromosomal abnormalities that may have an impact on prenatal development. A chromosome is a microscopic component of a cell that carries its genetic makeup. One of the most common chromosomal disorders is Down syndrome. Individuals with Down syndrome have slanted eyes; thick, fissured tongues; and a flat, broad face. They are often mentally disabled and have significant language impairments. Other chromosomal and genetic disorders include Turner syndrome, Klinefelter syndrome, fragile X syndrome, muscular dystrophy, and neural tube defects that result in spina bifida. Many of these conditions produce intellectual disability and physical anomalies such as brain damage, unusual appearance, and malformed limbs.

Prenatal Diagnostic Tests

Prenatal diagnosis of potential problems is possible using tests, such as amniocentesis, that can detect the presence of many chromosomal and genetic abnormalities. Amniocentesis involves the insertion of a hollow needle through the mother’s abdomen into the amniotic sac and the withdrawal of fluid containing fetal cells. Amniocentesis can detect chromosomal abnormalities such as Down syndrome, but it is not usually performed until the fifteenth week of pregnancy. Chorionic villus sampling (CVS) provides the same information as amniocentesis, but at a much earlier gestational period (seven weeks). In CVS, fetal cells are obtained from the placenta by means of a tube inserted through the vagina. There is greater risk of infection and miscarriage with CVS. Fetoscopy is a surgical procedure involving the insertion of an instrument that permits actual viewing of the fetus and the obtaining of fetal tissue. This procedure is more precise than CVS and amniocentesis but carries a highter risk of miscarriage.

Ultrasound involves the use of sound waves that provide a computer-enhanced image of the fetus. It is a noninvasive, painless, and low-risk procedure that provides an actual image of fetal shape and movement. It is useful for detecting normal and abnormal fetal development and for determining fetal position and age. Preimplantation diagnosis is an experimental, highly technical genetic examination of cells before their implantation in the uterine wall. It typically follows in vitro fertilization and permits the detection of specific genetic disorders. In the future, it may be useful for correcting genetic disorders as well.

Through prenatal diagnostic tests, researchers are able to detect genetic weaknesses (and strengths) from the earliest moments of life. Researchers have also begun to experiment with ways of altering genetic messages, the results of which may lead to corrections of genetic abnormalities in the future.

Environmental Risk Factors

A teratogen is an environmental agent such as alcohol, cocaine, or infectious organism that has an adverse impact on prenatal development following maternal exposure. The word has Greek origins and literally means “monster-forming.” Certain stages of prenatal development are more vulnerable to teratogens than others. Exposure during the period of the zygote usually results in spontaneous abortion of the fertilized egg, while exposure during the embryo stage can lead to major defects in bodily structure and quite possibly death. Exposure during the fetal period usually produces minor structural defects, such as wide-set eyes, and neurological impairment, such as intellectual disability or learning problems. Some of the more commonly implicated teratogens include infectious agents such as cytomegalovirus, varicella virus, and human parvovirus B19, and drugs such as alcohol, cocaine, and nicotine.

The fetus is most vulnerable to the effects of teratogens during the first trimester. These effects are severe and may result in structural deformities and death.

Sarnoff Mednick and others at the University of Southern California reported on a more subtle form of prenatal disturbance following second trimester exposure. Mednick reported preliminary data that linked second trimester viral infections to later psychological outcomes such as depression and schizophrenia. Jose Cordero, former U.S. assistant surgeon general and director of the CDC’s Center for Birth Defects and Disabilities, indicated greater need for awareness of a broader range of teratogens such as fever and infectious agents in relation to outcomes such as learning disabilities, mood disorders, and attention deficits. Stefan Dombrowski, a professor at Rider University in New Jersey, and Roy Martin, a professor at the University of Georgia, compiled the first book on the topic of prenatal exposures in relation to psychological, behavioral, and educational outcomes in children. These two researchers indicate that certain prenatal exposures including fever, influenza, stress, and air pollution may be associated with adverse psychological, behavioral, and educational outcomes. The hypothesis guiding this research is that a prenatal exposure disrupts the neurological development of the fetus and produces abnormal behavioral and psychological outcomes in offspring.

There are additional environmental agents that can potentially disrupt the normal course of prenatal development. Studies have investigated the impact of caffeine. Although the results are equivocal, exposure to moderate amounts of caffeine may result in lower birth weight and decreased fetal muscle tone. Excessive caffeine use during pregnancy should, therefore, be avoided. The impact of alcohol during pregnancy is well documented. Chronic alcohol use produces fetal alcohol syndrome and associated cognitive deficits and physical deficits such as heart problems, retarded growth, and misshapen faces. Maternal alcohol use during prenatal development is the most common cause of intellectual disability. Because even moderate daily alcohol use (two ounces of alcohol) has been associated with some of these outcomes, it is recommended that alcohol use during pregnancy be avoided. Nicotine exposure from cigarette smoking is another well-established teratogen. Research indicates that prenatal cigarette exposure increases the risk for low birth weight, cognitive deficits, learning problems, behavior problems, and even fetal death as a result of nicotine-induced placental and neurological defects.

Overall, the critical prenatal period for exposure to teratogens is during the first trimester of pregnancy. Within the first trimester, certain periods are even more sensitive to teratogens than others. For example, the first six weeks of pregnancy is a particularly sensitive period in the development of the central nervous system, while the eyes are vulnerable during weeks five through eight. It is commonly accepted that exposure to teratogens during the first eight weeks of pregnancy may induce major structural abnormalities. Exposure during the remainder of prenatal development, depending on the type of teratogen and intensity and duration of exposure, may lead to minor structural abnormalities (wide eyes, webbed hands) as well as cognitive, behavioral, and psychological difficulties. Although central nervous system development and brain growth are most vulnerable to disruptions during the first trimester of pregnancy, these structures continue to develop throughout the prenatal period. Thus, exposure to any environmental risk factor should be minimized if at all possible.

Bibliography

Berk, Laura E. Infants and Children: Prenatal through Middle Childhood. 7th ed. Boston: Pearson, 2011. Print.

Cordero, J. F. “A New Look at Teratogens and Behavioral Outcomes: A Commentary.” Birth Defects Research Part A: Clinical and Molecular Teratology 67 (2003): 900–902. Print.

Dombrowski, S. C., R. P. Martin, and M. O. Huttunen. “Association between Maternal Fever and Psychological/Behavioral Outcomes: A Hypothesis.” Birth Defects Research Part A: Clinical and Molecular Teratology 67 (2003): 905–10. Print.

Marin-Padilla, Miguel. The Human Brain: Prenatal Development and Structure. New York: Springer, 2011. Print.

Martin, R. P., and S. C. Dombrowski. Prenatal Exposures: Psychological and Educational Consequences for Children. New York:. Springer, 2008. Print.

Moore, Keith L., T. V. N. Persaud, and Mark G. Torchia. Before We Are Born: Essentials of Embryology and Birth Defects. 8th ed. Philadelphia: Saunders/Elsevier, 2013. Print.

Paul, Annie Murphy. Origins: How the Nine Months before Birth Shape the Rest of Our Lives. New York: Free, 2011. Print.

Shepard, Thomas H., et al. “Update on New Developments in the Study of Human Teratogens.” Teratology 65.4 (2002): 153–61. Print.

Warkany, Josef. Congenital Malformations. Chicago: Year Book, 1971. Print.

Watson, Jennifer B., Sarnoff A. Mednick, Matti O. Huttunen, and Xueyi Wang. “Prenatal Teratogens and the Development of Adult Mental Illness.” Development and Psychopathology 11.3 (1999): 457–66. Print.

Discuss how communication is an ethical act.

In order to develop a solid ethics program within an organization, communication must exist within and between departments, managers, employee, and internal and external stakeholders. Ethics programs cannot exist in a vacuum.  However, transparency should be used to demonstrate a solid commitment to creating sound ethical principles in an organization. 

Organizational leadership must create a safe harbor for employees to feel respected and willing to participate in open communication. Punishment for providing communication and honest feedback does not assist in the creation of a solid ethics program. Employees should also feel able to utilize communication tools such as the internet, email, phones, messaging, and face to face communications without concern over retribution, excessive control or punishment. According to the National Communications Association (NCA), Credo for Ethical Communication, Communication should foster a positive working environment and not make others feel intimidated, coerced, or used as an expression of violence or hatred. 

What is amphetamine abuse?

Causes

Amphetamines are rapidly absorbed once ingested. When they reach the brain, they cause a buildup of the neurotransmitter dopamine. This leads to a heightened sense of energy, alertness, and well-being that abusers find to be pleasurable and productive for repetitive tasks. Tolerance develops rapidly, leading to the need for higher doses.

Amphetamines are easy to obtain, often through diversion from legal use, and they are relatively inexpensive. Using them does not carry the social stigma or legal consequences associated with the use of other stimulants, such as methamphetamine and cocaine.

Risk Factors

Amphetamine abuse is widespread and has been present almost since their introduction for medical use in the 1930s. Amphetamines were widely abused by soldiers during World War II to maintain alertness during long hours on duty. They are still used by some military personnel in combat settings.

After the war, amphetamines became popular among civilians, especially students who used them to keep awake for studying and as appetite suppressants and recreational drugs. By the 1960s, about one-half of all legally manufactured amphetamines were diverted for illegal use. With greater control over distribution of commercially manufactured amphetamines, manufacture by clandestine laboratories increased dramatically. In addition, the Internet has become a popular source for nonprescription amphetamines.

Abuse now occurs primarily among young adults (age eighteen to thirty years). A common venue for their abuse is the rave, an all-night music and dance concert or party. Use among males and females is evenly divided, except for intravenous use; in this case, males are three to four times more likely to use the drug intravenously. Abusers can rapidly become both physically and psychologically dependent on amphetamines, with a compulsive need for the drug.

Symptoms

Physical symptoms of amphetamine abuse include euphoria, increased blood pressure, decreased or irregular heart rate, narrowing of blood vessels, dilation of bronchioles (the breathing tubes of the lungs), heavy sweating or chills, nausea and vomiting, and increases in blood sugar. High doses can cause fever, seizures, and cardiac arrest.

Frequent, high-dose abuse can lead to aggressive or violent behavior, ending in a psychotic state indistinguishable from paranoid schizophrenia. Features of this state include hallucinations, delusions, hyperactivity, hypersexuality, confusion, and incoherence. One such delusion is formication, the sensation of insects, such as ants, crawling on the skin. Long-term use can result in permanent memory loss.

Screening and Diagnosis

Routine blood and urine testing do not detect amphetamines in the body. Abusers who use pills or who snort amphetamine leave no outward signs of the abuse. Smokers may use paraphernalia to use the drug. Abusers who inject the drug will have needle marks on their skin.

A change in behavior is the primary clue to amphetamine abuse. The abuser develops mood swings and withdraws from usual activities and family and friends. Basic responsibilities and commitments are ignored or carried out erratically. The abuser becomes hostile and argumentative. Any change in a person’s appearance, such as sudden weight loss, or in behavior, such as agitation or change in sleep patterns, should be addressed. Such changes may indicate amphetamine abuse. Experts recommend that parents focus their concern with the youth’s well-being, and not on the act of abuse.

Treatment and Therapy

Symptoms of amphetamine withdrawal can develop within a few hours after stopping use. Withdrawal symptoms include nightmares, insomnia or hypersomnia (too much sleep), severe fatigue or agitation, depression, anxiety, and increased appetite. Severe depression can produce suicidal thoughts. Withdrawal symptoms usually peak within two to four days and resolve within one week.

No specific medications are available for directly treating amphetamine abuse. However, antidepressants can be helpful in the immediate and post-withdrawal phases.

The National Institute on Drug Abuse recommends psychotherapeutic intervention utilizing a cognitive behavioral approach. Such an approach helps the abuser learn to identify counterproductive thought patterns and beliefs and to change them so that his or her emotions and actions become more manageable. The abuser is also taught how to improve coping skills to address life’s challenges and stresses. Narcotics Anonymous and amphetamine-specific recovery groups are also helpful.

Prevention

As there are medical indications for amphetamines, experts recommend that prescription formulations be kept from potential abusers. Pill counts should be taken regularly. Young people should be taught the differences between medical use and illegal abuse. Parents should ensure that their children are not attracted to social settings or activities where amphetamine abuse is or might be encouraged or tolerated.

Bibliography

Abadinsky, Howard. Drug Use and Abuse: A Comprehensive Introduction. 7th ed. Belmont: Wadsworth, 2011. Print.

Julien, Robert M. A Primer of Drug Actions. 11th ed. New York: Worth, 2008. Print.

Kuhn, Cynthia, Scott Swartwelder, and Wilkie Wilson. Buzzed: The Straight Facts about the Most Used and Abused Drugs from Alcohol to Ecstasy. 3rd ed. New York: Norton, 2008. Print.

Lowinson, Joyce W., et al., eds. Substance Abuse: A Comprehensive Textbook. 4th ed. Philadelphia: Lippincott, 2005. Print.

Rogge, Timothy. “Substance Abuse—Amphetamines.” MedlinePlus. US Natl. Lib. of Medicine, 21 May 2014. Web. 28 Oct. 2015.

What is being satirized in Chekhov's story "The Lottery Ticket"?

In his short story "The Lottery Ticket," Anton Chekhov satirizes people's inability to maintain their contentment or to generate their own happiness.

With irony, Chekhov begins his story by describing Ivan Dmitritch as being "very well satisfied with his lot." When his wife asks him to check the newspaper for the winning number in the lottery, and he sees that the number matches hers, they hesitate to look for the last two numbers. Instead, they choose to fantasize about what they would do if the money were to become theirs.

To torment and tantalize oneself with hopes of possible fortune is so sweet, so thrilling!

As Dmitritch imagines leisurely long walks, warm baths, visits with neighbors, glasses of vodka, and buying property, he becomes less satisfied and more discontented and even distrustful of what his wife will want to do with their fortune if they do win the lottery. However, she, too, has her own daydreams as she understands what her husband's dreams are. "She knew who would be the first to try to grab her winnings." 

As Dmitritch senses his wife's motives and reflections, he spitefully looks at the last two numbers, and discovers that they do not match. He calls them out, ending their dreams. "Hatred and hope both disappeared at once." Now, instead of hope, they each experience despair, for their fantasies of winning the lottery have caused them to yearn for more and create their own discontentment. Chekhov satirizes the human weakness of being inclined to unhappiness.

Why is cutting off his hair such a major step for Ponyboy?

Ponyboy's hair is a big part of his identity as a Greaser.  Ponyboy also has a lot of personal pride in his hair.  He thinks that he looks better with long hair, and it happens to be one of the first details about himself that he gives to readers. 

My hair is longer than a lot of boys wear theirs, squared off in back and long at the front and sides, but I am a greaser and most of my neighborhood rarely bothers to get a haircut. Besides, I look better with long hair.

Ponyboy's hair marks him as a Greaser, which Ponyboy is proud of.  All of the Greasers are proud of their long, greased hair.  That is why when the Socs threaten to cut hair, the threat is so worrisome.  To a Greaser, having his hair cut would be the equivalent of having a body part cut off.  

It was my pride. It was long and silky, just like Soda's, only a little redder. Our hair was tuff--- we didn't have to use much grease on it. Our hair labeled us greasers, too- -- it was our trademark. The one thing we were proud of. Maybe we couldn't have Corvairs or madras shirts, but we could have hair.

In chapter five, Ponyboy and Johnny are forced to cut their hair.  The reality of the situation is that they are fugitives on the run, and they must cut and color their hair in order to change their appearance.  But symbolically, the event marks the place in the story that Ponyboy begins to throw off aspects of being a Greaser.  That is why the haircut is such a major step for Ponyboy.  He is willingly casting off a part of himself.  That transformation is carried through to the end of the story and culminates with Ponyboy being able to have a regular conversation with a Soc.  

What is pneumonia? How does it affect cancer patients?

Related conditions:

Aspiration pneumonia, atypical pneumonia, viral pneumonia, walking pneumonia, Legionella pneumonia, pneumocystis carinii pneumonia (PCP), other pneumonia, primary lung cancer, metastatic lung disease

Definition:
Pneumonia is a disease of the lungs and respiratory system in which the alveoli (air sacs) become inflamed, infected, or blocked and cannot exchange air (oxygen).

Risk factors: People with respiratory problems tend to be more prone to pneumonia. The elderly, children, and people with complicating health problems are more affected by pneumonia. Pneumonia usually follows a cold or case of the flu. Persons with compromised immune systems such as acquired immunodeficiency syndrome (AIDS) patients, organ transplant patients, and cancer patients are at risk.

Another risk factor is smoking, as this can damage the cilia (microscopic hairs) that naturally sweep impurities out of the lungs. Smoke can paralyze the cilia, allowing secretions to accumulate in the lungs. If these secretions contain bacteria, pneumonia can result.

Exposure to chemicals or other pollutants on the job or in the environment can cause inflammation in the lungs, making it harder to clear the lungs of secretions. People in hospital intensive care units may be exposed to bacteria in the breathing tube of a mechanical ventilator.

Sometimes a tumor will restrict or block a cancer patient’s airways, which results in the inability to clear secretions from the lungs. This can predispose the patient to pneumonia. Other risk factors for the cancer patient include radiation therapy, chemotherapy, steroids, malnutrition, surgery, neutropenia (depressed white cell count), limited mobility, antibiotics, and spleenectomy, which results in immune-system problems.

Etiology and the disease process: Pneumonia can be caused by bacteria, fungi, viruses, or chemical and physical damage such as inhalation of toxins and cancer. When a person breathes, the air passes through the trachea (windpipe) to the lungs, which branch into tubes called bronchi. The bronchi divide into smaller narrow tubes called brochioles that lead to small saclike alveoli (air sacs). The function of the alveoli is to exchange gases (oxygen and carbon dioxide) with the blood capillaries. In pneumonia, these alveoli become inflamed or blocked so that the exchange of oxygen and carbon dioxide is diminished. How severely this exchange is restricted depends on the underlying cause of the pneumonia and the overall health of the patient.

Incidence: An estimated 4 million Americans develop pneumonia each year. Pneumonia and influenza (together) are the eighth leading cause of death in the United States. In 2011, pneumonia claimed 52,294 lives. About 50 percent of all pneumonia is caused by respiratory viruses. Streptococcus pneumoniae (pneumococcus) is the most common pneumonia-causing bacterium.

Symptoms: When people have bacterial pneumonia, they experience difficulty breathing, have shallow rapid breathing, and may have a productive cough. Their cough may produce greenish or yellow sputum (phlegm) or sometimes blood-tinged sputum. Patients with bacterial infections usually experience shaking, chills with fever, and sharp pain in the chest that gets worse when coughing or breathing deeply. Patients with viral pneumonia exhibit more flulike symptoms such as a dry cough, headache, muscle pain, fever, and fatigue. The cough may produce a small amount of clear or white sputum. Viral pneumonia can become bacterial pneumonia (a secondary infection) under the right conditions. Other symptoms include headache, loss of appetite, severe fatigue, sweating and clammy skin, and sometimes mental confusion in older adults.

Screening and diagnosis: Diagnosis is made by physical examination and by listening to the sound of the breath (such as crackles) through a stethoscope. The health care provider usually orders a chest x-ray and reviews the scan for consolidations (white or opaque areas) that represent infected or blocked areas. Sometimes the pneumonia is not easy to visualize with an x-ray, so computed tomography (CT) may be used. Other procedures that may be used to diagnose pneumonia include pulse oximetry and a Pleural fluid culture.

The health care provider may request a culture of the sputum (Gram-staining procedure) to isolate the causal bacteria and confirm that the bacteria are sensitive to the prescribed antibiotic. A complete blood count test will allow the provider to monitor elevated white cell counts that can indicate bacterial disease. Blood tests for specific organisms may be needed to further define the cause of the pneumonia. In severe cases, arterial blood gases may be used to assess oxygenation of the blood.

The diagnostic health care provider may also use a bronchoscope (flexible tube) to examine the lungs for swelling, inflammation, obstruction, or a tumor if the pneumonia is severe and not responding to treatment.

Treatment and therapy: Pneumonia is treated based on the cause of the disease. Antibiotics are used to treat bacterial pneumonia but are useless for viral pneumonia. Strains of bacteria that are resistant to antibiotics are making the treatment of pneumonia a challenge. Most people can be treated at home unless they have underlying chronic diseases such as cancer or are elderly or very young. In these cases, hospitalization is necessary to stabilize the person with intravenous antibiotics and fluids, and possibly oxygen therapy. Occasionally steroid drugs must be used to decrease inflammation or wheezing.

If a patient is allowed to recuperate at home, the health care provider will encourage increased fluid intake to loosen the lung secretions and allow the patient to expectorate (spit out) phlegm. Key to recovery is rest and symptom control, such as managing fever with acetaminophen or aspirin (no aspirin in children).

Sometimes postural drainage will be ordered for patients who need help removing phlegm. With assistance, the patient will lean over the side of the bed with head down and allow gravity to drain the lungs. Those assisting can gently but firmly pound the patient’s upper back to mechanically dislodge mucus. This can be done for about five to fifteen minutes, three times a day, or as tolerated by patients.

Treatment for cancer patients with pneumonia must be aggressive and prompt. Bed rest and taking medications to expel phlegm to clear the airways may be prescribed. The health care provider must choose treatment approaches that complement the therapy that patients are receiving for their cancer so as not to decrease the immune response.

Alternative or complementary treatments offer no cure for pneumonia but may provide some symptom relief. Acupuncture can be used to relieve congestion and may improve generalized fatigue. Some people benefit from a warm bath or room vaporizer using either plain, distilled water or distilled water with essential oils like eucalyptus added. People with asthma should avoid heat inhalations as these can irritate sensitive lung tissue.

Other complementary treatments include massaging the upper back, taking homemade cough syrup of honey and other natural ingredients, and drinking echinacea herbal tea. Supplements such as zinc or vitamins A, C, and E may support the immune sytem.

Prognosis, prevention, and outcomes: Pneumonia can range in severity from mild to severe to fatal, depending on the cause and the age and health of patients. With adequate treatment of the cause, most pneumonia patients will show improvement within about two weeks. If patients have other compromising diseases, such as cancer, recovery may be slower. If patients fail to respond to treatment, they may die of respiratory failure.

Prevention is especially important for patients with cancer or infected with the human immunodeficiency virus (HIV). Measures to prevent infection include frequent washing of hands after blowing the nose or coughing, going to the bathroom, diapering a baby, and before and after food preparation. Immune-compromised people should avoid contact with anyone who has a cold or flu or has been exposed to these illnesses. They should also use a protective mask when cleaning to decrease exposure to dust and molds. The influenza and pneumonia vaccines may also be options and should be checked out with a health care provider.

Baez-Escudero, José L., et al. “Pneumocystis Carinii Pneumonia in Cancer Patients.” Abstracts in Hematology and Oncology 7.1 (2005). Print.

Cunha, Burke A., ed. Pneumonia Essentials. Royal Oak: Physicians’, 2007. Print.

Fein, Alan, et al. Diagnosis and Management of Pneumonia and Other Respiratory Infections. Caddo: Professional Communications, 1999. Print.

File, Thomas. Community-Acquired Pneumonia: Controversies and Questions. Philadelphia: Elsevier, 2013. Print.

Hasleton, Philip S. Spencer’s Pathology of the Lung. Cambridge: Cambridge UP, 2013. Print.

Lechner, Andrew J., George M. Matuschak, and David S. Brink. Respiratory: An Integrated Approach to Disease. New York: McGraw-Hill, 2012. Print.

Terry, Peter B. Lung Disorders: Your Annual Guide to Prevention, Diagnosis and Treatment. Baltimore: Johns Hopkins, 2013. Print.

At what age do children get freedom in Lois Lowry's The Giver?

Each December in Jonas's community marks a transitional period for children up to age twelve. Two days in December are celebrated as holidays and the whole community turns out to witness each year's coming-of-age ceremony. There are defining clothing, hairstyles and opportunities that signify each growing year. For example, at age Eight kids receive volunteer hours, lose their comfort objects and get pockets in their jackets to signify that they are responsible enough to keep track of small personal items. Lily, Jonas's sister is turning eight, and he encourages her as follows:

"'There are good things each year. . . This year you get to start your volunteer hours. And remember last year, when you became a Seven, you were happy to get your front-buttoned jacket?'

The front-buttoned jacket was the first sign of independence, the first very visible symbol of growing up. The bicycle, at Nine, would be the powerful emblem of moving gradually out into the community, away from the protective family unit" (40-41).

Therefore, as stated above, Sevens get a jacket they can unbutton themselves, rather than needing someone else to unbutton them from the back during ages four through six; so, it is at age seven that kids receive their first stage of independence, or freedom. Each year thereafter receives a level of responsibility along with more freedom. Eights get the freedom to choose where they will volunteer their service time as well. The freedom to choose is very valuable under such a strict society.Then by age nine, the bicycles give the children even more freedom to travel where they want to go and more quickly; but with the bicycles also comes the responsibility to take care of them properly. 

How does Calpurnia teach Scout respect in To Kill a Mockingbird?

At the beginning of Chapter 3, Jem stops Scout from beating up Walter Cunningham Jr. and then invites him over for dinner. In the middle of dinner, Walter asks for molasses and proceeds to pour the syrup all over his meat and vegetables. Scout is utterly disgusted and asks Walter what the "sam hill" he is doing. Walter immediately puts the saucer down because he feels embarrassed, and Atticus shakes his head at Scout. Scout continues to protest about Walter's eating habits until Calpurnia summons her to the kitchen.

Once Scout is in the kitchen with Calpurnia, Calpurnia reprimands Scout for her behavior. Calpurnia tells Scout that there are some people who don't eat like them, but that doesn't give Scout the right to contradict them. Calpurnia then explains to Scout that anybody who steps foot in their home is considered "company." Cal says,

"...don't you let me catch you remarkin' on their ways like you was so high and mighty! Yo' folks might be better'n the Cunninghams but it don't count for nothin' the way you're disgracing' 'em" (Lee 17).

Calpurnia's conversation with Scout about how she should act towards her company is one example of how Cal teaches Scout respect in the novel.

What is the standard measurement system used by scientists around the world?

Measurements in science are made in Système International (SI) units. The use of SI units was agreed upon by an international association of scientists in 1960.

The SI system is a base 10 system. This means that units in the SI system vary by multiples of ten. Base units are established and prefixes are used to indicate smaller and larger units. 

Base Units:

length: meter (m)

volume: cubic meter (`~m^3` )

mass: kilogram (kg)

temperature: Kelvin (K)

energy: Joule (J)

Prefixes:

mega (M) - multiply base unit by `~10^6`

kilo (k) - multiply base unit by `~10^3`

deci (d) - multiply base unit by `~10^-^1`

centi (c) - multiply base unit by `~10^-^2`

milli (m) - multiply base unit by `~10^-^3`

micro (`mu` ) - multiply base unit by `~10^-^6` ` `

nano (n) - multiply base unit by `~10^-^9`

pico (p) - multiply base unit by `~10^-^12`

What is the Articles of Confederation? Explain the weaknesses found inside of this document and what happened to fix this.

The Articles of Confederation was our first plan of government. It was created after the Revolutionary War so we could govern ourselves. There were many weaknesses in this plan.

Because the colonists were so worried about having a strong government or a strong leader, they created a weak federal government. The government created by the Articles of Confederation was not able to levy taxes. This made it difficult for the government to pay its debts. The government couldn’t force people to join the military. This made it hard to deal with countries like Spain and Great Britain that were pushing us around. There was no place for states to resolve their disputes because there was no court system. The government even had trouble keeping order at home. This was clearly seen when Shays’ Rebellion occurred.

Eventually, people realized that we needed a new plan of government. A meeting was held in Philadelphia in 1787 to work on developing this new plan. As a result of this meeting, the Constitution was created. The federal government had more power. For example, the federal government could levy taxes. A court system was also created. However, there were controls put in place to limit this power. Each branch could control the others, and no branch could do everything by itself.

The Constitution tried to resolve some of the issues that existed because the government created by the Articles of Confederation was too weak.

`1 + 4 + 7 + 10 + ... (3n - 2) = n/2 (3n - 1)` Use mathematical induction to prove the formula for every positive integer n.

You need to use mathematical induction to prove the formula for every positive integer n, hence, you need to perform the two steps of the method, such that:

Step 1: Basis: Show that the statement P(n) hold for n = 1, such that:

`1 = 1/2*(3*1-1) => 1 =2/2 => 1=1`

Step 2: Inductive step: Show that if P(k) holds, then also P(k + 1) holds:

`P(k): 1 + 4 + 7 + .. + (3k-2) = (k(3k-1))/2 ` holds

`P(k+1):  1 + 4 + 7 + .. + (3k-2) + (3k+1) =  ((k+1)(3k+2))/2`

You need to use induction hypothesis that P(k) holds, hence, you need to re-write the left side, such that:

`(k(3k-1))/2 + (3k+1) = ((k+1)(3k+2))/2`

`3k^2 - k + 6k + 2 = 3k^2 + 2k + 3k + 2`

You need to add the like terms, such that:

`3k^2 + 5k + 2 = 3k^2 + 5k + 2`

Notice that P(k+1) holds.

Hence, since both the basis and the inductive step have been verified, by mathematical induction, the statement `P(n): 1 + 4 + 7 + .. + (3n-2) = (n(3n-1))/2`  holds for all positive integers n.

In what ways has Charlie’s relationship with Miss Kinnian changed? What are her fears about Charlie’s feelings for her? Do you think she has...

In Flowers for Algernon by Daniel Keyes, the relationship between Miss Kinnian and Charlie begins to change. Miss Kinnian had been Charlie's teacher at a school for the mentally disabled, but as he becomes more and more intelligent, he begins to see her as a woman and a peer. He falls in love with her. Miss Kinnian, though, is concerned that he will soon leave her behind intellectually, and there is little hope for a long term commitment. She explains to Charlie the many levels of intelligence and how he is moving up those levels at such a fast pace, nobody will be able to keep up, including her. 

"'I can see only a little bit of that, Charlie, and I won't go much higher than I am now, but you'll keep climbing up and up, and see more and more, and each step will open new worlds that you never even knew existed.' She frowned. 'I hope. . . I just hope to God--'" (Keyes 22).

Miss Kinnian is also worried about the possibility that Charlie's intelligence will reverse itself, and of course, that is exactly what does happen. Charlie, at this point, does not see it coming because Algernon has not yet begun to regress. Miss Kinnian's fears, of course, are legitimate. It is very difficult to have a relationship with someone who functions at a much higher level than you. It is almost as if their roles are reversed. Miss Kinnian, in a way, becomes like the student that Charlie was in her classroom. 

What is quinsy?

Causes and Symptoms

Quinsy, also called peritonsillar abscess, is a rare disorder. Medical professionals most often diagnose the condition in young adults. Primarily after extreme tonsillitis,
bacterial infections (usually streptococci) spread from one or both tonsils to adjacent tissues, which become pus-filled. In addition to the throat, the infection may cover the palate and extend to the lungs, potentially blocking the airway.

Patients develop a fever and tender throat glands. Some people experience chills. Because swollen tonsils shift and push the uvula aside, patients often are unable to open their mouths normally, a condition known as trismus, and swallowing is painful. Patients sometimes lean their heads in the direction of the abscess. Other symptoms include swelling of facial tissues, drooling, fatigue, earache, and headache. Some patients become hoarse and have foul breath.

Quinsy is often prevented because patients with tonsillitis are administered antibiotics and are monitored to stop infections from spreading. A person who has had tonsillitis and who develops symptoms of quinsy should consult health care professionals. Sore throats that do not heal with antibiotics or that become worse alert physicians to the possibility of quinsy.

Medical professionals evaluate patients for quinsy by examining the tonsils for swelling and abnormal reddening of the mouth, throat, and chest tissues. In some cases of quinsy, the tonsils may appear normal. Samples of aspirated abscess
fluid are examined for bacteria. Ultrasound or computer imaging is used if patients cannot open their mouths.

Treatment and Therapy

Physicians are divided on the preferred treatment for quinsy. Surgical procedures involve draining pus from abscesses
through incisions or needle aspiration. Studies have shown that incision drainage is effective at stopping quinsy and that needle aspiration is more likely to result in additional abscessing. Tonsillectomy specifically for quinsy is usually advised only if no other treatments are effective. Approximately 10 to 15 percent of patients undergoing treatment experience recurring quinsy.

Emergency surgery is necessary if quinsy affects breathing. Other possible complications include pneumonia, meningitis, heart
inflammation (pericarditis), and fluid surrounding the lungs (pleural effusion). Rarely, quinsy patients develop endocarditis, a bacterial infection of the heart. Quinsy patients should seek medical care if they have chest pains, coughing, or breathing complications.

Perspective and Prospects

The word “quinsy” is based on references made by the ancient Greeks to abscessed throats. As early as the fourteenth century, medical literature included details about the peritonsillar space. The term “quinsy” was appropriated after that time to describe sore throats and tonsils. Modern physicians disproved claims that President George Washington died from quinsy, as contemporary sources had claimed. Since the 1980s, researchers have been evaluating the most effective treatments for quinsy. The Haemophilus influenzae type b vaccine, first administered in 1987, has minimized quinsy occurrence.

Bibliography

Ben-Joseph, Elana Pearl. "What Is a Peritonsillar Abscess?" TeensHealth. Nemours Foundation, May 2012.

Bluestone, Charles D., et al., eds. Pediatric Otolaryngology. 4th ed. 2 vols. Philadelphia: W. B. Saunders, 2003.

Gleeson, Michael, et al, ed. Scott-Brown’s Otolaryngology: Head and Neck Surgery. 7th ed. Boston: Butterworth-Heinemann, 2008.

Litin, Scott C., ed. Mayo Clinic Family Health Book. 4th ed. New York: HarperResource, 2009.

Neff, Deanna M., and Michael Woods. "Peritonsillar Abscess." Health Library, Mar. 15, 2013.

Schwartz, Seth, et al. "Periotonsillar Abscess." MedlinePlus, Nov. 9, 2012.

Woodson, Gayle E. Ear, Nose, and Throat Disorders in Primary Care. Philadelphia: W. B. Saunders, 2001.

What are some quotes from Hamlet that prove Hamlet and Ophelia's love for one another?

When Hamlet learns that Ophelia has died and that it is her grave that the gravedigger he's been bantering with is digging, he clearly feels great grief.  When Laertes, her brother, jumps into her grave to hug her one more time, Hamlet steps forward, reveals himself, and insists that he loves Ophelia more than Laertes does.  He says, "I loved Ophelia. Forty thousand brothers / Could not with all their quantity of love / Make up my sum" (5.1.247-249).  In other words, Hamlet says that his love is so much greater than Laertes's that even if there were 40,000 brothers to love Ophelia, Hamlet's love would still be bigger. 

Further, Hamlet wants to prove how much more he loves Ophelia than Laertes does, and he says that he's willing to do anything to prove the strength of his love.  He asks Laertes, "Dost thou come here to whine, / To outface me with leaping in her grave? / Be buried quick with her?—and so will I" (5.1.256-258).  He asks if Laertes just came to her grave to whine and moan or to show Hamlet up by leaping into Ophelia's grave with her, and so he says that he will jump into her grave too, that he will even be buried alive with her in order to prove his love is greater than her brother's. 

What is the indirect characterization that the author uses for Vera?

Indirect characterization is when a character is not explained explicitly. Another way to say it is that the reader must use inference to figure out the personality or description of a character based on implied clues. A question about Vera in Saki's "The Open Window" might be posed in order to obtain the correct inference needed to nail down who she is: What type of person would tell a stranger such a tragic lie about her uncles dying out in a bog, knowing full well that they would be returning soon after?

Not only does Vera set up Mr. Nuttel with the tragic tale, but when the men come back from hunting, she plays the scared little girl role perfectly. She acts out her own horror to close the deal on the story and really frightens Mr. Nuttel! The reader is left to infer whether or not Vera is malicious or simply a practical joker--and that is indirect characterization. One might argue that she's young and was simply playing a really good joke on Mr. Nuttel. On the other hand, the tale doesn't show her running after him to apologize or explain the joke.

What is muscular dystrophy?

Causes and Symptoms

Muscles,
attached to bones through tendons, are responsible for movement in the human body. In muscular dystrophy, muscles become progressively weaker. As individual muscle fibers become so weak that they die, they are replaced by connective tissue, which is fibrous and fatty rather than muscular. These replacement fibers are commonly found in skin and scar tissue and are not capable of movement, and the muscles become progressively weaker. There are several different recognized types of muscular dystrophy. These have in common degeneration of muscle fibers and their replacement with connective tissue. They are distinguished from one another on the basis of the muscle group or groups involved and the age at which individuals are affected.

The most common type is Duchenne muscular dystrophy. In this disease, the muscles involved are in the upper thigh and pelvis. The disease strikes in early childhood, usually between the ages of four and seven. It is known to be genetic and occurs only in boys. Two-thirds of affected individuals are born to mothers who are known to carry a defective gene; one-third are simply new cases whose mothers are genetically normal. Individuals afflicted with Duchenne muscular dystrophy suffer from weakness in their hips and upper thighs. Initially, they may experience difficulty in sitting up or standing. The disease progresses to involve muscle groups in the shoulder and trunk. Patients lose the ability to walk during their early teens. As the disease progresses, portions of the brain become affected, and intelligence is reduced. Muscle fibers in the heart are also affected, and most individuals die by the age of twenty.

The dystrophin gene normally produces a very large protein called dystrophin that is an integral part of the muscle cell membrane. In Duchenne muscular dystrophy, a defect in the dystrophin gene causes no dystrophin or defective dystrophin to be produced, and the protein will be absent from the cell membrane. As a result, the muscle fiber
membrane breaks down and leaks, allowing fluid from outside the cell to enter the muscle cell. In turn, the contents of affected cells are broken down by other chemicals called proteases that are normally stored in the muscle cell. The dead pieces of muscle fiber are removed by scavenging cells called macrophages. The result of this process is a virtually empty and greatly weakened muscle cell.

A second type is Becker’s muscular dystrophy, which is similar to the Duchenne form of the disease. Approximately three in two hundred thousand people are affected, and it too is found only among males. The major clinical difference is the age of onset. Becker’s muscular dystrophy typically first appears in the early teenage years. The muscles involved are similar to those of Duchenne muscular dystrophy, but the course of the disease is slower. Most individuals require the use of a wheelchair in their early thirties and eventually die in their forties.

Myotonic dystrophy is a form of muscular dystrophy that strikes approximately five out of one hundred thousand people in a population. Myotonia is the inability of a muscle group to relax after contracting. Individuals with myotonic dystrophy experience this difficulty in their hands and feet. On average, the disease first appears at the age of nineteen. The condition is benign, in that it does not shorten an affected person’s life span. Rather, it causes inconveniences to the victim. Affected persons also experience a variety of other problems, including baldness at the front of the head and malfunction of the ovaries and testes. The muscles of the stomach and intestines can become involved, leading to a slowing down of intestinal functions and diarrhea.

Another type is limb girdle muscular dystrophy. The muscles of both upper and lower limbs—the shoulders and the pelvis—are involved. The onset of this dystrophy form is variable, from childhood to middle age. While the disorder is not usually fatal, it does progress, and victims experience severe disability about twenty years after the disease first appears. While this variant is also genetically transmitted, men and women are about equally affected.

One type of muscular dystrophy found almost exclusively among individuals of Scandinavian descent is called distal dystrophy. It first appears relatively early in adult life, between the thirties and fifties. The muscles of the forearm and hand become progressively weaker and decrease in size. Eventually, the muscles of the lower leg and foot also become involved. This form of muscular dystrophy is not usually fatal.

Oculopharyngeal muscular dystrophy is a particularly serious form that involves the muscles of the eyes and throat. In this disease, victims are affected in their forties and fifties. There is progressive loss of control of the muscles that move the eyes and loss of the ability to swallow. Death usually results from starvation or from pneumonia acquired when the affected individual accidentally inhales food or drink.

A type of muscular dystrophy for which the location of the genetic abnormality is known is facioscapulohumeral muscular dystrophy; the defect is confined to the tip of the fourth chromosome. This disease initially involves the muscles of the face and later spreads to the muscles of the posterior or back of the shoulder. Eventually, muscles in the upper thigh are involved. The affected person loses the ability to make facial expressions and assumes a permanent pout as a result of loss of muscle function. As the condition advances, the shoulder blades protrude when the arms are raised. Weakness and difficulty walking are eventually experienced. As with other forms of muscular dystrophy, there is some variability in the degree to which individuals are affected. Occasionally, a variety of deafness occurs involving the nerves that connect the inner ear and the brain. Less commonly, victims become blind.

There are other variants of muscular dystrophy that have been recognized and described. These forms of the disease, however, are rare. The main problem facing physicians is differentiating accurately the variety of muscular dystrophy seen in a particular patient so as to arrive at a correct diagnosis.

Treatment and Therapy

The diagnosis of muscular dystrophy is initially made through observation. Typically, parents notice changes in their affected children and bring these concerns to the attention of a physician. The physician takes a careful family history and then examines a suspected victim to make a tentative or working diagnosis. Frequently, knowledge of other family members with the condition and observations are sufficient to establish a firm diagnosis. Occasionally, a physician may elect to order physiological or genetic tests to confirm the tentative diagnosis. As
Duchenne muscular dystrophy is the most common form of muscular dystrophy, it provides a convenient example of this process.

A diagnosis of Duchenne or any other form of muscular dystrophy is rarely made before the age of three. This form of the disease almost always occurs in boys. (Variants, rather than true Duchenne muscular dystrophy, are seen in girls, but this situation is extremely rare.) The reason for this finding is that the genetic defect occurs on the X chromosome, of which males only possess one. Approximately two-thirds of all victims inherit the defective chromosome from their mothers, who are asymptomatic carriers; thus, the condition is recessive and said to be X-linked. The disease occurs in the remaining one-third of victims as a result of a fresh mutation, in which there is no family history of the disease and the parents are not carriers.

Victims usually begin to sit, walk, and run at an older age than normally would be expected. Parents describe walking as waddling rather than the usual upright posture. Victims have difficulty climbing stairs. They also have apparently enlarged calf muscles, a finding called muscular
hypertrophy. While the muscles are initially strong, they lose their strength when connective and fatty tissues replace muscle fibers. The weakness of muscles in the pelvis is responsible for difficulties in sitting and the unusual way of walking. Normal children are able to go directly from a sitting position to standing erect. Victims of Duchenne muscular dystrophy first roll onto their stomachs, then kneel and raise themselves up by pushing their hands against their shins, knees, and thighs; they literally climb up themselves in order to stand. These children also have a pronounced curvature of their lower backs, an attempt by the body to compensate for the weakness in the muscles of the hips and pelvis.

There is frequently some weakness in the muscles of the shoulder. This finding can be demonstrated by a physician, but it is not usually seen by parents and is not an early problem for the victim. A physician tests for this weakness by lifting the child under the armpits. Normal children will be able to support themselves using the muscles of the shoulder. Individuals with Duchenne muscular dystrophy are unable to hold themselves up and will slip through the physician’s hands. Eventually, these children will be unable to lift their arms over their heads. Most victims of Duchenne muscular dystrophy are unable to walk by their teen years. The majority die before the age of twenty, although about one-quarter live for a few more years. Most victims also have an abnormality in the muscles of the heart that leads to decreased efficiency of the heart and decreased ability to be physically active; in some cases, it also causes sudden death. Most victims of Duchenne muscular dystrophy suffer mental impairment. As their muscles deteriorate, their measured intelligence quotient (IQ) drops approximately twenty points below the level that it was at the onset of the disease. Serious mental handicaps are experienced by about one-quarter of victims.

Other forms of muscular dystrophy are similar to Duchenne muscular dystrophy. Their clinical courses are also similar, as are the methods of diagnosis. The critical differences are the muscles involved and the age of onset.

Laboratory procedures used to confirm the diagnosis of muscular dystrophy include microscopic analysis of muscle tissue, measurement of enzymes found in the blood, and measurement of the speed and efficiency of nerve conduction, a process called electromyography. Some cases have been diagnosed at birth by measuring a particular enzyme called creatinine kinase. It is possible to diagnose some types of muscular dystrophy before birth with chorionic villus sampling or amniocentesis.

There is no specific treatment for any of the muscular dystrophies.
Physical therapy is frequently ordered and used to prevent the remaining unaffected muscles from losing their tone and mass. In some stages of the disease, braces, appliances, and orthopedic surgery may be used. These measures do not reverse the underlying pathology, but they may improve the quality of life for a victim. The cardiac difficulties associated with myotonic dystrophy may require treatment with a pacemaker. For victims of myotonic dystrophy, some relief is obtained by using drugs; the most commonly used pharmaceuticals are phenytoin and quinine. The inability to relax muscles once they are contracted does not usually present a major problem for sufferers of myotonic dystrophy.

More useful and successful is prevention, which involves screening individuals in families or kinship groups who are potential carriers. Carriers are persons who have some genetic material for a disease or condition but lack sufficient genes to cause an apparent case of a disease or condition; in short, they appear normal. When an individual who is a carrier conceives a child, however, there is an increased risk of the offspring having the disease.

Genetic counseling should be provided after screening, so that individuals who have the gene for a disease can make more informed decisions about having children.

Chemical tests are available for use in diagnosing some forms of muscular dystrophy. Carriers of the gene for Duchenne muscular dystrophy can be detected by staining a muscle sample for dystrophin; a cell that is positive for Duchenne muscular dystrophy will have no stained dystrophin molecules. The dystrophin stain test is also used to diagnose Becker’s muscular dystrophy, but the results are not quite as consistent or reliable. Approximately two-thirds of carriers and fetuses at risk for both forms of muscular dystrophy can be identified by analyzing DNA. Among individuals at risk for myotonic dystrophy, nine out of ten who carry the gene can be identified with DNA analysis before they experience actual symptoms of the disease.

Perspective and Prospects

Muscular dystrophy has been recognized as a medical entity for several centuries. Initially, it was considered to be a degenerative disease only of adults, and it was not until the nineteenth century that the disease was addressed in children with Guillaume-Benjamin-Amand Duchenne’s description of progressive weakness of the hips and upper thighs. An accurate classification of the various forms of muscular dystrophy depended on accurate observation and on the collection of sets of cases. Correct diagnosis had to wait for the development of accurate laboratory methods for staining muscle fibers. The interpretation of laboratory findings depended on the development of biochemical knowledge. Thus, much of the integration of knowledge concerning muscular dystrophy is relatively recent.

Genes play an important role in the understanding of muscular dystrophy. All forms of muscular dystrophy are hereditary, although different chromosomes are involved in different forms of the disease. The development of techniques for routine testing and diagnosis has also occurred relatively recently. Specific chromosomes for all forms of muscular dystrophy have not yet been discovered. Considering initial successes of the
Human Genome Project, an effort to identify all human genes, it seems likely that more precise genetic information related to muscular dystrophy will emerge.

There still are no cures for muscular dystrophies, and many forms are relentlessly fatal. Cures for many communicable diseases caused by bacteria or viruses have been discovered, and advances have been made in the treatment of cancer and other degenerative diseases by identifying chemicals that cause the conditions or by persuading people to change their lifestyles. Muscular dystrophy, however, is a group of purely genetic conditions. Many of the particular chromosomes involved are known, but no techniques are yet available to cure the disease once it is identified.

The availability of both a mouse model and a dog model of Duchenne muscular dystrophy, however, has facilitated the testing of gene therapy for this disease. Dystrophic mouse early embryos have been cured by injection of a functional copy of the dystrophin gene; however, this technique must be performed in embryos and is not useful for human therapy. Two avenues of research under way in these animal models are the introduction of normal muscle-precursor cells into dystrophic muscle cells and the direct delivery of a functional dystrophin gene into dystrophic muscle cells. It is hoped that these studies will lead to a cure for the disease.

In the meantime, muscular dystrophy continues to cause human suffering and to cost victims, their families, and society large sums of money. The disease is publicized on an annual basis via efforts to raise money for research and treatment, but there is little publicity on an ongoing basis. For these reasons, muscular dystrophy remains an important medical problem in contemporary society.

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