Saturday, July 31, 2010

What are the physical traits of the characters in Jeanne DuPrau's The City of Ember, including Doon Harrow, Lina Mayfleet, and Poppy Mayfleet?

We learn quite a bit about the physical descriptions of many of the characters throughout Jeanne DuPrau's The City of Ember. We learn many character descriptions in the opening chapter and others throughout other chapters.

In the opening chapter, we learn Lina Mayfleet, the first protagonist, is thin, has long dark hair and is dressed a bit raggedly because the storerooms are so low in stock on clothing. Lina is dressed in a "ragged cape" and socks that are "loose and tended to slide down around her ankles." Later, in chapter 2, when she begins working as a messenger, her ragged cape is replaced by the red jacket that is part of the messenger uniform. We also learn she has long legs she loves to run with, and she thinks she is plain except when she's very happy.

In the first chapter, we learn that Doon Harrow, the second protagonist, has rumpled hair and "dark, thick eyebrows" that made one straight line depending on his emotions. He is also dressed in an old and tattered corduroy jacket.

In multiple chapters, Lizzie Bisco, Lina's best friend, is described as freckle-faced with bright orange hair.

In the second chapter, we learn Poppy, Lina's two-year-old sister, has big brown eyes and brown hair, just like Lina.

How was Panama affected by the "big stick" policy?

In the case of Panama, the "big stick" was the arrival of American troops to maintain order.


In the early 19th century, Americans were competing with the British for trade and influence among the emerging new nations of Latin America.  There was an indication that the nations of continental Europe were showing a renewed interest in the area.  President Monroe, in response, issued the Monroe Doctrine that essentially stated that the Americas were no longer open for colonization and an attack on any one of them would amount to an attack on the United States.  We, for our part, would not meddle in the affairs of Europe.


By the time Theodore Roosevelt became president, the United States was no longer an underdeveloped nation, gratefully receiving investments from abroad.  United States Steel, for example, produced more steel than all the mills of Great Britain.  The United States Navy was second only to that of Britain.  As a people we had come to believe that the time was right for us to be seen and heard on the world's stage.


About 1902, Venezuela defaulted on its debts, and was soon blockaded by elements of the British, Italian, and German fleets.  Shockingly, German ships began shelling a Venezuelan port.  What is more, rumors were afoot that Germany intended to build a naval base in the area.  Roosevelt reminded them of our "big stick" (the U.S. Navy) and the Germans backed off.  The Roosevelt Corollary to the Monroe Doctrine stated that the United States had the right to oppose European intervention in Latin American affairs, and we had also the right to intervene in the internal affairs of American republics if they could not maintain order and their national sovereignty.


If, however, the United States wanted to be taken seriously as a major power, it would have to be able to effectively defend the west coast, and this was impossible if the nation's navy had to make the time-consuming, dangerous transit around the South American continent.  We needed a canal.  The most practical route was across the Isthmus of Panama, then a Colombian province.


Secretary of State John Hay negotiated a treaty with the Colombian Charge d'Affaires, Tomas Herren.  The United States would pay Colombia $10,000,000 and an annual rent of $250,000.  The Colombian senate, however, refused to ratify the treaty.  They wanted $20,000,000 and a share of the $40,000,000 the United States would pay the French interest that had already started the canal.  Representatives of Roosevelt got in touch with Philippe Bunau-Varilla, who managed to have a Panamanian rebellion (there had been lots of them in the past) declare independence.  Roosevelt recognized the new republic in three days and our troops arrived to maintain order.

What are some examples of injustice and justice in To Kill a Mockingbird?

Examples of justice and injustice can be seen through the experiences of three major characters: Scout, Boo Radley, and Tom Robinson. First, Scout faces injustice from her Aunt Alexandra. It seems as if everything Scout does is not good enough for her Aunt. She explains as follows:



"Aunt Alexandra was fanatical on the subject of my attire. I could not possibly hope to be a lady if I wore breeches; when I said I could do nothing in a dress, she said I wasn't supposed to be doing things that required pants. . . Aunty said that one had to behave like a sunbeam, that I was born good but had grown progressively worse every year. She hurt my feelings and set my teeth permanently on edge" (81).



Aunt Alexandra deals unjustly with her because she wants Scout to represent the Finch family as a gentlewoman, not a tomboy. As a result, Aunt Alexandra talks behind Scout's back with Atticus, tells her that her friends are trash, and is continually on her case. The worst part is Scout is a child and cannot fight back or really defend herself.


Next, Boo Radley is the big mysterious phantom of Maycomb. As the children get to know him more, they realize that people simply pass along gossip and neighborhood legends for attention and entertainment value without considering the value of the human being they are discussing. For example, Miss Stephanie Crawford spreads tales that Boo Radley roams around at night looking into people's windows. That scares women and children and paints him for a freak. Scout describes how badly Boo's name was tossed around as follows:



"Once the town was terrorized by a series of morbid nocturnal events: people's chickens and household pets were found mutilated; although the culprit was Crazy Addie. . . people still looked at the Radley Place, unwilling to discard their initial suspicions" (9).



Unbeknownst to the town are Boo's real problems, but they sling his name around anyway. Boo is probably mostly shy, if not a little bit slow as well, and Miss Maudie tells Scout that he prefers to stay indoors--end of story. Scout discovers that he's actually a good friend and neighbor, too. Similar to Scout, Boo can't fight back against the injustice that faces him, either.


Finally, there's Tom Robinson, a black man who is caught at the wrong place at the wrong time and sentenced to death for it. Even though Tom had one of the best lawyers in the world to fight against the injustice he faced, the odds were so highly stacked against him that he tried to go at it alone by escaping prison rather than waiting on the appeals process to set him free. Maybe Tom understood more about the injustice that faced him than Atticus had hope in the judicial system. He knew he could never fight the racism in the South, and gave up. 


So where are the examples of justice? It's in Maycomb's future--Jem and Scout. It's in the fact that justice and fair play can be taught, and the good people like Atticus, who value and fight for justice, keep waking up in the morning and going to work. Justice is also found in the help and hope that others give in the wake of injustice. For example, Link Deas takes care of Tom's family after his death by providing his wife Helen with a job. There's justice for Scout and Jem when they are attacked by Bob Ewell and their lives are saved by the most unlikely character in the whole book--Boo Radley. And sometimes justice is kept secret as Heck Tate protects Boo Radley from the spotlight over saving the kids. Rather than take Boo's private lifestyle away from him by advertising what a hero he was that night, he protects it by saying Ewell fell on his knife. The justice, again, is in the future and in the way people help each other weather the injustices found in the storms of life. 

Mr. Raymond says, “I don't reckon it's---Miss Jean Louise, you don't know your pa's not a run-of-the-mill man, it'll take a few years for that to...

In Chapter 20, Dolphus Raymond comments on Scout's childhood innocence and mentions that her father doesn't act like a typical Maycomb citizen. Atticus is a morally upright man who abides by his own conscience. Several times throughout the novel Atticus mentions to his children that he considers a person to be "trash" for treating black people wrong. The majority of Maycomb's citizens are prejudiced towards black people and believe that Atticus should not defend Tom Robinson. In Chapter 15, Link Deas comments to Atticus that he has everything to lose from defending Tom. Even Atticus' own family members encourage him to leave the case alone. Atticus believes that he could not face his children if he chose not to do the right thing by defending Tom Robinson.


When Dolphus Raymond comments that Scout hasn't seen enough of the world yet, he is referring to her innocent childhood disposition. Scout is too young to fully understand the wickedness and hatred that prejudiced white people have towards black community members. When Dolphus says that all Scout has to do is step back into the courtroom to see how the world operates, he is speaking about the racial injustice Tom Robinson is about to suffer. Mr. Raymond is all too familiar with how black people are treated in Maycomb. Dolphus is correct in his assumption that Maycomb's prejudice will be revealed via a guilty verdict. Scout ends up losing her childhood innocence after witnessing Tom's conviction.

Is there an example of sacrifice for friendship in Twelfth Night?

One of the most interesting relationships in Twelfth Night is that of Antonio and Sebastian. While minor in the play, the language Shakespeare uses and the depth of feeling between the two (mainly on Antonio's side) suggests a deep friendship and even hints at a romantic love. Antonio saves Sebastian's life after the shipwreck and immediately becomes completely devoted to him, offering up his time and money, and even risking his own safety to help Sebastian when he travels to Illyria, a place where Antonio is wanted for the crime of theft. When begging Sebastian to allow him to act as his servant on the trip, Antonio says, 



"If you will not murder me for my love, let me be your servant" (2.1.30).



In this quote, Antonio suggest that denying his request and killing him would be the same thing, since he loves Sebastian so much. Clearly, Antonio's devotion to Sebastian causes him to give up everything to help him, even when Sebastian doesn't seem to reciprocate the feeling. 

What are some quotes about family from The Outsiders?

Pony comments that his gang members are like family.  This is because they are all very close since they have to depend on each other for everything.  Pony goes to the movie by himself, and feels nervous because the Socs often jump greasers who walk alone.



Or I could have gotten one of the gang to come along, one of the four boys Darry and Soda and I have grown up with and consider family. We're almost as close as brothers; when you grow up in a tight-knit neighborhood like ours you get to know each other real well. (Ch. 1)



The gang is not just a loose group, and not just a bunch of trouble makers.  They are exceptionally supportive of one another, and will come to the aid of any gang member.  Pony and the other greasers often do not go anywhere alone.


Pony also explains that his own family is different because his parents died in a car accident, leaving his brother Darry to take care of his two younger brothers.



Sodapop... a dropout so he could get a job and keep me in school, and Darry, getting old before his time trying to run a family and hold on to two jobs and never having any fun... (Ch. 3)



Darry had to become a father to his brothers, and Soda dropped out of school.  Pony felt the weight of Darry’s expectations.  It often seemed like Darry was too strict and overbearing.  He wanted so badly to keep Soda and Pony out of trouble that he went overboard with Pony.  The death of Pony's parents also means that he and his brothers rely more on the gang.


The significance of the greaser gang being family is obvious when Johnny is in the hospital dying.  Johnny’s doctor wants to limit his visitors.



The nurses wouldn't tell us anything about Johnny and Dally, so Darry got hold of the doctor. The doctor told us that he would talk only to the family, but Darry finally got it through the guy's head that we were about as much family as Dally and Johnny had. (Ch. 7)



The doctor realized that the greasers were Pony’s family and allowed them to visit with him anyway.  After all, he was dying.  He didn’t even want to see his own mother.  The gang meant more to him than his real family, which was abusive and distant.


Families come in all shapes and sizes.  It takes more than a mother, father, and kids to be a family.  Family is people who care about you and look out for you.  Pony's gang of greasers served that purpose.

In Freak the Mighty by Rodman Philbrick, how does Kevin change Max's summer routine?

In Chapter 8, Max says that he usually just reads comic books or watches TV each day of summer vacation. Sometimes he will emerge to go to the store with Gram, but that's not very exciting. After Max meets Kevin, though, his summer changes. Each morning Kevin drags and crawls his way to Max's basement room from his house next door and wakes him up. Once Kevin is done banging on Max's headboard, he tells him, "Get outta bed, you lazy beast! There are fair maidens to rescue! Dragons to slay!" (44).


Then, Kevin rushes Max through his breakfast by telling him to hurry up the whole time. This happens every morning and Max actually doesn't mind it because it gets him out of bed earlier than he ever would have been; and then, the two boys are off on adventures going somewhere and doing something outdoors rather than staying inside. Each day Kevin creates some sort of quest for them to go on, too. As a result, Max gains muscle carrying Kevin around, he understands what a quest is, and he starts living life rather than simply wasting it.

Friday, July 30, 2010

What conclusions can be made about the contradicting opinions in "Marriage is a Private Affair" by Chinua Achebe?

The opinions of Nnaemeka's father, the village men, and the women of Lagos are simply a product of prejudice and fear of the other. It is the same fear that gripped America (and still does in many households) over interracial marriage. Nnaemeka is an Ibo man and Nene an Ibibio woman. In past times the tribes did not mix and may have been, at one point in history, enemies. In modern times, however, these ethnic groups live amenably in areas of Nigeria, especially the large city of Lagos. Yet even in Lagos there is prejudice against these interethnic relationships.


Achebe's story is an attempt to break down these barriers. Twice in the story he suggests that the marriage will be ultimately accepted. In Lagos, the initial prejudice toward Nene by the Ibo women begins to evaporate and they are impressed by the orderliness of her home as she gains friends and acceptance. Nnaemeka's father too begins to relent after receiving a letter from Nene informing him that he has two grandsons who would very much like to see him. In the closing lines, Achebe suggests that the father will give in and accept Nene and the children of the mixed relationship. Children are often a good reason for families to put aside old disagreements and grudges.

What is viral gastroenteritis?


Definition

Viral gastroenteritis is an infection of the intestines
caused by a virus.


















Causes

Viral gastroenteritis is caused by one of several viruses that assault the intestines. The viruses are usually spread through contact with someone who is infected or with something the infected person touched. Viral gastroenteritis also can spread through food or water that is contaminated.




Risk Factors

Risk factors for viral gastroenteritis include one’s age (children and the elderly) and location, especially child-care centers and nursing homes, and in other group settings (such as on cruise ships, in college dormitories, and at campgrounds).




Symptoms

The symptoms of viral gastroenteritis usually begin one to two days after
exposure to the virus. The illness usually lasts one to two days, but it can last
up to ten days. Symptoms may include watery diarrhea, nausea, vomiting, abdominal
cramps, fever, muscle aches, and headache. Vomiting and diarrhea can lead to
dehydration, especially in children.




Screening and Diagnosis

A doctor will ask about symptoms and medical history and will perform a
physical exam. Blood tests and a stool culture may be ordered by the
doctor. The stool culture will check for bacteria in a
stool sample, which would indicate a different type of illness and one that is not
caused by a virus.




Treatment and Therapy

There is no specific medical treatment for viral gastroenteritis.
(Antibiotics are not helpful for infections caused by any
virus.) However, there are a number of things one can do to be more comfortable
and avoid dehydration.


One should ingest fluids to replace those lost during the illness by having small sips of water, by sucking on ice chips, or by drinking clear soda or decaffeinated sports drinks (such as Gatorade). Children should be given an oral rehydration solution (such as Pedialyte) instead of water.


One should gradually begin to eat bland foods, such as toast, crackers, bananas, rice, chicken, and potatoes, and should avoid dairy products, caffeine, fatty foods, and spicy foods until feeling better. Breast-feeding infants who are sick should continue with breast-feeding; if the sick infant is bottle-fed, he or she should receive oral rehydration solution or formula.


One should rest while sick and should contact a doctor if unable to keep fluids down for twenty-four hours or if having symptoms such as vomiting blood, bloody diarrhea, or a fever higher than 101° Fahrenheit. Other symptoms requiring medical attention are vomiting for more than two days and having signs of dehydration (such as dizziness or light-headedness, excessive thirst or dry mouth, or dark urine or little or no urine).


For children, one should contact a doctor if the child is under six months of age, has a fever of 102° F or higher, seems tired or irritable, has bloody diarrhea, has stomach pain, or has signs of dehydration (such as unusual drowsiness or dry lips and mouth, no tears when crying, dark urine or not urinating much for example, no wet diaper in three hours or feeling thirsty but vomiting after drinking fluids).




Prevention and Outcomes

There are several steps one can take to prevent viral gastroenteritis. If
possible, one should avoid contact with people who have the condition; wash hands
thoroughly with warm water and soap (and help children wash their hands
thoroughly); use bleach to disinfect contaminated surfaces in the home, including
toilets and sink faucets; and avoid sharing personal items such as toothbrushes,
towels, and drinking glasses.


Also, one should take special care when traveling to countries that are more likely to have contaminated food and water. Experts recommend that travelers drink only bottled water, avoid ice cubes, and avoid eating raw foods, including vegetables.




Bibliography


Blaser, Martin, eds. Infections of the Gastrointestinal Tract. 2d ed. Philadelphia: Lippincott Williams & Wilkins, 2002.



Blum, Richard H., and W. LeRoy Heinrichs. Nausea and Vomiting: Overview, Challenges, Practical Treatments, and New Perspectives. Philadelphia: Whurr, 2000.



Centers for Disease Control and Prevention. “Viral Gastroenteritis.” Available at http://www.cdc.gov/ncidod/dvrd/revb/gastro/faq.htm.



“Infectious Diarrheal Diseases and Bacterial Food Poisoning.” In Harrison’s Principles of Internal Medicine, edited by Joan Butterton. 17th ed. New York: McGraw-Hill, 2008.



Kapadia, Cyrus R., James M. Crawford, and Caroline Taylor. An Atlas of Gastroenterology: A Guide to Diagnosis and Differential Diagnosis. Boca Raton, Fla.: Parthenon, 2003.



Kirschner, Barbara S., and Dennis D. Black. “The Gastrointestinal Tract.” In Nelson Essentials of Pediatrics, edited by Karen J. Marcdante et al. 6th ed. Philadelphia: Saunders/Elsevier, 2011.

What details stand out as particularly true to life in Updike's A & P? What does this close attention to detail contribute to the story?

Updike really is a master of sensual description, allowing readers to see, hear, feel, taste and smell the surroundings created in his writing. He studied to be a visual artist which may partly explain his deft style in describing how things look. In this story, one of his most famous, the physical descriptions of the girls and the store are very naturalistic and authentic. The first-person narration is also reliable because it is not hard to imagine this teenage grocery store employee who has memorized the inventory and layout of the store, but who is also bored with his job and becomes excited when something out of the ordinary happens, especially if it involves teenage girls.


One line that describes an aisle the girls walk down says: "they all three of them went up the cat-and-dog-food-breakfast-cereal-macaroni-rice-raisins-seasonings-spreads-spaghetti-soft drinks-crackers-and-cookies aisle." The ease with which he names the items found in this aisle says he is intelligent, observant and has also made an effort to learn his job. But the description also hints at the dull sameness and regimented atmosphere of his job, in which he is expected to memorize the location of items. Anyone who has worked a retail job of this kind can relate to this idea. The store is an oppressive environment and so when he quits impulsively we know he has perhaps been waiting to find the courage to do so.


The narrator also describes what he calls the usual thoughts and behavior of shoppers in a very evocative way: 



I bet you could set off dynamite in an A & P and the people would by and large keep reaching and checking oatmeal off their lists and muttering "Let me see, there was a third thing, began with A, asparagus, no, ah, yes, applesauce!" or whatever it is they do mutter.



His perception of shoppers' thoughts, as well as the way he notices the girls and the way they shake up "business as usual" at the A & P, shows a narrator who is profoundly sensitive and observant. These descriptions ultimately are a very revealing look at the narrator who may well be based upon Updike himself.

Thursday, July 29, 2010

According to Peter Brown's Augustine of Hippo and The World of Late Antiquity, what were some important religious and philosophical movements and...

The main religious developments of the fourth century stemmed from Constantine's conversion to Christianity. Starting with the Edict of Milan in 313 which legalized Christianity, there was a gradual shift from the traditional gods being linked with imperial power to Christianity becoming the official religion of the Roman Empire. 


When Christianity had been an underground religion promulgated by a persecuted minority, having a clear and authoritative hierarchy and uniform doctrine had been less important than simple survival, although even as early as the late first century we find many internal doctrinal differences within Christianity. As an official imperial religion, Christianity needed to be strongly centralized and uniform. The Council of Nicaea marks the beginning  of collaboration between the episcopate and the Emperor to make Christianity an imperial religion, functioning as part of the Roman state. Stamping out of heresy and suppressing dissent became a priority.


The fourth century was also a period of the blossoming of monasticism, especially in the Greek east. Also, it was a period in which Augustine and subsequent thinkers argued that classical learning could be assimilated into Christian thought in the manner of the Egyptian gold the Jews had appropriated during the Exodus. 


In pagan philosophy, the fourth century was a period of syncretism, with Platonist philosophy, mystery religions, and Hellenic culture blending to create a more monolithic opposition of traditional paideia to the new Christian religion. Platonism became more heavily Pythagoreanized during this period, moving from the skepticism of the middle Platonists to a more mystical form of neoplatonism, characterized by the work of Plotinus, Iamblichus, and Proclus. This was also a major period for commentaries, both on the Platonic dialogues and Aristotle, whose work was assimilated to Platonism by Porphyry and subsequent Platonists. 

Would Squeaky make a good friend in "Raymond's Run"?

Squeaky would be a good friend because she is loyal, sincere and has interesting hobbies.


Squeaky can certainly be judgmental and she has a little trouble making friends, but she is extremely loyal.  She looks after her brother and protects him no matter what, even though people make fun of him for being a little different.  Although he is her big brother, he acts like her little brother. 



And a lot of smart mouths got lots to say about that too, especially when George was minding him. But now, if anybody has anything to say to Raymond, anything to say about his big head, they have to come by me.



This same loyalty and protectiveness makes her an excellent friend.  If Squeaky was your friend, she would be there for you no matter what.  If someone picked on you, she would stand up for you.  That is a great trait to have in a friend.


Another trait that makes Squeaky an excellent friend is her sincerity.  Squeaky can’t stand it when people pretend to be something they are not.  She doesn’t like false modesty, and she doesn’t like it when people pretend to like you when they don’t.



Gretchen smiles, but it’s not a smile, and I’m thinking that girls never really smile at each other because they don’t know how and don’t want to know how and there’s probably no one to teach us how, cause grown-up girls don’t know either.



For these reasons, with Squeaky you will always know where you stand.  She will always tell you what she thinks.  She means what she says, and doesn’t believe in pretending.  She can’t stand people who do.


Finally, Squeaky has a really cool hobby.  She is a great runner.  The fact that she is so committed to being a good runner means that she sees things through and is dedicated, but it would also give her great things to do with friends.  As Squeaky’s friend, you can become a better runner and you will always have something to do.

What is the significance of the key songs and key scenes in Good Morning Vietnam? Why were they chosen?

There is a historical and thematic significance to the songs selected in Good Morning, Vietnam.


Given how Cronauer is depicted, the use of Rock and Roll music is historically significant.  Set in 1965, Cronauer wanted to feature timely music that would appeal to the tastes of the soldiers who tuned into his radio show.  For this reason, the music selected is from the mid 1960s and represents the preferences that mirror the youth of the soldiers.  For example, songs like Them's "Baby, Please Don't Go," "I Get Around" by the Beach Boys, and The Rivieras's "California Sun" all come from the mid- 1960s.  This selection of music is historically accurate because it captures the feel of the music in the time period. Cronauer appealed to a "Rock and Roll" vibe with his listeners, and so he would feature music appropriate to it.  It is for this reason that he would not play music from artists like Ray Conniff and Lawrence Welk, selections that mirror the musical taste of Lieutenant Hauk.  


The selection of music in Good Morning, Vietnam is thematically significant.  For example, when Cronauer plays Armstrong's "Wonderful World," he selects a song that aspires to what the world should be.  The condition of Vietnam presents an emotional and political contrast to the song's lyrics.  The selection of Martha and the Vandellas's "Nowhere to Hide" is another example of a song that features thematic meaning.  The song's idea of "nowhere to run" and "nowhere to hide" reflects the escalation of the Vietnam conflict that serves as a backdrop to the film.  The thematic significance of the music enhances its meaning.

Wednesday, July 28, 2010

In To Kill a Mockingbird, of what crime is Tom Robinson found guilty?

In chapter 14, Scout asks her father what rape is: "He sighed, and said rape was the carnal knowledge of a female by force and without consent" (135). She asks this because in chapter 12, when she goes to Calpurnia's church, she had asked Cal what Tom Robinson was in jail for. When Calpurnia told her it was for rape, she told Scout to get the definition from her father. The court case is detailed in chapters 17-20. Bob and Mayella Ewell claim that while Tom Robinson was helping Mayella with some chores one day, he violently raped her. There are no other eye witnesses to vouch for what they say, though. There is also no solid evidence to support their claims--not even a doctor's examination to draw evidence from because Ewell didn't think it was necessary. He didn't think it was necessary because the rape charge is clearly fiction. Unfortunately, in Maycomb, Alabama in the 1930s, a criminal charge by a white man against a black one winds up in court, gets tried without evidence or witnesses, and Tom is convicted of rape as charged. 

Tuesday, July 27, 2010

What is the story of World War I?

Nationalism is probably the major story of World War I. Nationalism was a relatively new concept in Europe in the early Twentieth Century. People started to believe that they should be governed by people of similar ethnicity and heritage. A wave of strong patriotic feeling followed. Nationalism also caused nation-states to look out for their own national interests first. In this way, they expanded their empires in Africa and formed alliances with other countries to protect themselves. They also turned to militarism to demonstrate their power. All of these actions are considered underlying causes of World War I and were rooted in nationalism.


Nationalism was also the immediate cause of World War I in the Balkans. Many ethnic groups grew tired of the royal family of the Austria-Hungarian Empire. They sought their own nations for their own ethnic groups. From one such group, the Serbians, an individual assassinated the archduke of the royal family. This sparked a chain of events that led to World War I.

In The Help, how will Skeeter's book be different from Gone with the Wind?

Skeeter's book, The Help, is not intended to have very much in common with Gone with the Wind. On the surface, of course, both books describe the racial conflict, one during the Civil War, another a hundred years later.


Skeeter's goal in writing The Help is actually to contrast Gone with the Wind by focusing on black--instead of white--people of the South. As she tells her New York publisher, Margaret Mitchell (the author of Gone with the Wind) has already created this "glorified image of Mammy." But, she wonders, has anybody ever considered how Mammy feels about it? Skeeter is on a mission to tell the story of the hardship of Aibileen, Minnie, her own caregiver Constantine, and all other Mammies of Jackson, as opposed to the story of the challenges that a contemporary Scarlett might be facing.

How has Tom Robinson taught Scout life lessons in To Kill a Mockingbird?

Tom has taught Scout that the citizens of Maycomb may not really be the "best folks in the world" after all.


What has happened to poor Tom Robinson in the Maycomb county courtroom causes Scout to realize that good does not always conquer evil; further, Tom's cruel treatment by Mr. Gilmer and the jury has also taught Scout about the racial bias that exists in her environment. Indeed, Tom has taught Scout that one may be in the right, but still may be found guilty by those in power in order to satisfy their own desires.


From her witnessing of the proceedings of the trial of Tom Robinson, Scout begins to know the adult world of Maycomb as she becomes aware that there are things about her environment which differ greatly from her earlier perceptions. For instance, from listening to some of her father's cases, she is shocked that Mayella and even her dissolute father would lie under oath, yet they are somehow afforded some credibility by the jury. In addition, the gratuitous cruelty of the Ewells toward the man who was so kind to Mayella shocks her. Yet, somehow, the Ewells are also afforded more credibility than Tom is when he testifies honestly.
Thus, the most defining lesson for Scout is the mounting proof of racial bias toward the one-armed Tom who could not possibly have beaten Mayella as charged, while a reprobate like Ewell is allowed his lie. Further, when Tom is put on the stand, he ingenuously states that he felt sorry for Mayella, who has no one to aid her at her house, and helped her by breaking up a chiffarobe. Hearing this, Mr. Gilmer counters with vitriolic innuendos about Tom's expression of pity:



"You felt sorry for her, you felt sorry for her?" Mr. Gilmer seemed ready to rise to the ceiling.



For Tom, a "colored man," to feel sorry for a white woman is an egregious social mistake because this action implies that he feels himself superior to her. 



...nobody liked Tom Robinson's answer. Mr. Gilmer paused a long time to let it sink in.



Finally, Scout learns the deeper meaning of her father's words about it being a sin to kill a mockingbird. That is, the innocent Tom is shot trying to escape from prison after his conviction that comes as a result of a trial that has been nothing less than a travesty of justice. For, while in the courtroom, Tom has learned that he has been convicted before the start of the proceedings in the "secret courts of men's hearts." Therefore, after his conviction, he despairs of any hope for winning an appeal, and out of desperation, he tries to escape and is killed, having been shot an excessive seventeen times. 

Monday, July 26, 2010

How did the Emancipation Proclamation proclaim freedom and instill hope in the slaves?

The Emancipation Proclamation did not actually free any enslaved people at the time it was issued. It proclaimed that all slaves in states "in rebellion against the United States" were free. People in rebellion against the United States would not free slaves because Lincoln declared them emancipated--in fact, defending the institution of slavery was the most important reason they had rebelled in the first place. Moreover, Lincoln did not free the slaves in the border states or even in some areas where Union troops had already taken over. He thought he lacked the constitutional authority to do this. 


Despite this, the Proclamation was very important, in part because, as the question suggests, it gave hope to enslaved people. It redefined the war by ensuring that a Union victory would result in the destruction of slavery. This confirmed what many slaves had already recognized--if some people in the North saw the war as a war to preserve the Union, they had always seen it as a struggle for their freedom. Hundreds of thousands, in fact, had already flocked to Union lines for this reason. Another way the Proclamation gave hope to slaves in the South was to offer the opportunity to enlist in the United States armed forces. By the end of the war, more than 200,000 African-American men had taken advantage of this opportunity. Lincoln, in fact, credited black troops with helping turn the tide of the war. So the Emancipation Proclamation was of enormous importance, especially in redefining the meaning of the worst conflict in American history.

What is the relationship between stress and drug abuse?


Background

Stress has long been associated with drug abuse. The connection has been especially strong with drug relapse, and it also has been linked with the initiation of drug use. Correlations have been found between stressful life events and the use of substances. The higher rates of substance use by vulnerable populations have been attributed to the higher rates of stress from discrimination and socioeconomic disadvantage that group members often experience. Additional stressors that group members are disproportionately exposed to are violent and criminal environments.



Research has found that most people are affected by stressful events of great intensity. What is not well understood is why people react to stress differently. Also unclear are the determining factors for these differences. An additional area in need of investigation is why some persons react to stress by using drugs specifically.


Ethnographic researchers found that after life-threatening, stressful, catastrophic events, such as Hurricane Katrina in 2005 and the acts of terrorism of September 11, 2001, street addicts show a greater demand for drugs. Similarly, stress under conditions of war combat has led to elevated levels of substance use and subsequent addiction among soldiers and other military personnel. The implication is that some persons cope with stressful events by self-medicating with drugs.


Stress has been associated with the use of several different types of drugs. Studies have demonstrated, for example, that under laboratory-induced stress, animals were prone to relapse and to self-administer amphetamines, heroin, cocaine, alcohol, and nicotine. Also, cocaine abusers reported more cravings for cocaine and alcohol when cued with imagery that was considered stressful versus imagery that was considered neutral.




Brain Science Research

While many studies have demonstrated a correlation between stress and drug use, the science has not been able to explain the mechanism by which the two are intertwined. Research on humans and nonhuman animals has shed new light on how this mechanism might work. New discoveries in brain science have been especially exciting.


Persons under chronic stress have been found to have problems with the regulation of stress-induced corticotropin releasing factor (CRF), which stimulates hormonal responses that are a part of the fight-or-flight (stress) response. In such a case, the hormones and thus the person’s biophysiological responses are not returning to normal (to homeostasis) once the stress is over. This process is thought to enhance a person’s susceptibility to stress-related illnesses and drug use. An impaired hormonal regulatory system that renders a person chronically hypersensitive may lead that person to cope with that impairment by self-medicating with drugs. The body’s naturally occurring opioid peptides function to inhibit the release of the CRF and, thus, to suppress the fight-or-flight response under normal circumstances when no threat is present or when the cause for alarm has ended.


Opioids, such as heroin, morphine, and methadone, act similarly to the opioid peptides and may thus explain their self-medicating properties, which dull stressful emotions for some persons. However, during periods of absence from the drugs (withdrawal), hypersensitivity to stress returns at even greater levels, as does the need to self-medicate with the opiates. Cocaine is thought to operate similarly. Methadone maintenance is theorized to be effective for heroin addiction by helping to stabilize the self-regulatory system.


Persons with post-traumatic stress disorder also appear to have a propensity for drug abuse, possibly because of a problem with their own hormonal system not properly self-regulating. Challenges for researchers and clinicians working in psychology and addiction include developing better treatment and prevention programs that teach healthier stress-management strategies to those persons vulnerable to stress-induced drug use.




Bibliography


Al’Absi, Mustafa. Stress and Addiction: Biological and Psychological Mechanisms. San Diego: Academic, 2007. Print.



Bride, Brian E., and Samuel A. MacMaster. Stress, Trauma, and Substance Use. New York: Routledge, 2009. Print.



“Post Traumatic Stress Disorder and Addiction.” DualDiagnosis.org. DualDiagnosis.org, 2015. Web. 9 Nov. 2015.



Sinha, Rajita. “Chronic Stress, Drug Use, and Vulnerability to Addiction.” Annals of the New York Academy of Sciences 1141 (2008): 105–30. PDF file.



Stewart, Sherry H., and Patricia Conrod. Anxiety and Substance Use Disorders. New York: Springer, 2008. Print.

Sunday, July 25, 2010

When the narrator brings Doodle to Old Woman Swamp, what is the significance of nature as described in the passage, and how is nature connected to...

[The original 6 questions had to be reduced to one main one as this is standard procedure. Please re-post the others separately.]


Whenever the brother feels a connection to Doodle, a bond begins to form, and when Doodle shares his love of the beauty of Old Woman Swamp, there is a new, closer relationship formed between them.


Earlier, the brother pays attention to his baby brother only when the boy learns to crawl and is brought out to the front room as one of the family. "For the first time he became one of us." Still, Doodle is a "burden" to the brother as he must pull the frail boy around in a go-cart. Then, one day when he takes Doodle to a favorite spot of his, Old Woman Swamp, Doodle becomes so emotional about the beauty of nature in this pristine area that he cries and remarks, "It's so pretty. So pretty, pretty, pretty." 


It is at this point that Doodle connects again with his brother because they share a deep love of nature together. Returning to this favorite location in the fair weather, the brother gathers all sorts of wildflowers and they weave them into necklaces and crowns, wearing them in sheer delight of the beauty of nature.
But, in the midst of this halcyon experience, the brother narrates that 



...pride is a wonderful, terrible thing, a seed that bears two vines, life and death.



Now, when they go to Old Woman Swamp the brother, in his "death vine" of pride insists that Doodle learn to walk. When Doodle finally accomplishes this skill, the brother shows Doodle off to his family.


These passages that describe Old Woman Swamp hint at Doodle's strong connection to nature. For, much as in the natural world there is a similar impermanence and transitory quality to frail, small boy; however, this frailness is a quality that in his selfish pride the brother ignores, a psychological state in him that presages the tragic actions of the future as he pushes Doodle to accomplish more physical skills.

What is Cushing's syndrome?


Causes and Symptoms

Cushing’s syndrome is a group of abnormalities that result from either excessive levels of hormones produced by the outer layer of the adrenal glands
or the taking of steroid hormones. The primary source of the disorder is the hormone cortisol. This condition is typically triggered by an excess production of adrenocorticotropic hormone (ACTH)
from the pituitary gland. ACTH in turn stimulates the adrenal glands to produce hormones, particularly cortisol. Excessive production of ACTH may result from a pituitary gland tumor or a tumor associated with other organs or as a side effect from taking steroid hormones used to treat asthma, rheumatoid arthritis, and other serious diseases. Adrenal gland
tumors
also produce excess amounts of cortisol. Though extremely rare, an inherited tendency to develop endocrine gland tumors is another cause of Cushing’s syndrome.



Since the hormones produced by the adrenal glands regulate processes throughout the body, excess production can cause widespread disorders. Some of the more common symptoms of Cushing’s syndrome are a rounded face, an obese trunk with thin arms and legs, fat pads over the neck and shoulders, purple stretch marks on the skin, easy bruising, muscle weakness, poor wound healing, fractures in weakened bones, high blood pressure, diabetes mellitus, emotional instability, and severe fatigue. Men can experience diminished desire for sex, while women may experience increased hairiness, acne, and decreased or absent menstrual periods. Children are usually obese, and their growth rate is slow.




Treatment and Therapy

Cushing’s syndrome is treated by restoring the hormonal balance within the body, which may take several months. If Cushing’s syndrome is left untreated, it can lead to death. The disease is diagnosed through blood and urine tests to determine excess amounts of cortisol. Pituitary tumors and tumors at other locations in the body that have been diagnosed as producing ACTH are surgically removed, when possible, or are treated with radiation or chemotherapy. Cortisol replacement therapy is provided after surgery until cortisol production resumes. Lifelong cortisol replacement therapy may be necessary. If steroids are not being used to control a life-threatening illness, then their use should be discontinued.


Adrenal and pituitary tumors are always surgically removed. The remaining adrenal gland, which has usually diminished in size as a result of inactivity, will return to its normal size and function. As it is doing so, steroid hormones are administered to supply the needed cortisol and then tapered off over time. Some tumors may recur after surgical excision.




Perspective and Prospects

The first diagnosis of Cushing’s syndrome was made by Harvey Cushing in 1912. In 1932, he linked the syndrome to an abnormality in the pituitary gland that stimulated an overproduction of cortisol from the adrenal glands; this condition is known as Cushing's disease. Pituitary tumors cause approximately 70 percent of cases of Cushing's syndrome. The syndrome is more common in women than in men, with most cases occurring between the ages of twenty-five and forty-five. The disease can be very serious, possibly even fatal, unless diagnosed and treated early.




Bibliography


A.D.A.M. Medical Encyclopedia. "Cushing Syndrome." MedlinePlus, December 11, 2011.



Badash, Michelle. "Cushing's Syndrome." HealthLibrary, May 1, 2013.



Fox, Stuart Ira. Human Physiology. 11th ed. Boston: McGraw-Hill, 2010.



Kronenberg, Henry M., et al., eds. Williams Textbook of Endocrinology. 11th ed. Philadelphia: Saunders/Elsevier, 2008.



National Endocrine and Metabolic Diseases Information Service. "Cushing's Syndrome." National Institutes of Health, April 6, 2012.

In To Kill a Mockingbird, how does their father's involvement in the Tom Robinson case impact Jem and Scout?

When Atticus takes the Tom Robinson case, both Jem and Scout have to deal with people from the community saying rude and prejudiced comments to them about their father. The rude comments start flying a little more than six months before the trial begins, which is a long time for kids to have to endure such things. Scout starts off easily provoked into fighting when she first hears Cecil Jacobs say her dad "defended ni***s" (74). Atticus tells her he doesn't want her fighting; but it doesn't last long because her cousin Francis says her father is a "ni***r lover" at Christmas time--and she can't let him get away with that (83). As a result, Scout gets bloody knuckles from the fight and a spanking from her Uncle. From then on, she really does her best not to get into fights. However, she also has to watch Jem deal with the same comments and how it impacts him.


The worst that Jem gets while enduring the tedious time before the trial is when Mrs. Dubose pushes him too far. In chapter 11, Mrs. Dubose not only calls Atticus "trash," but she brings up their deceased mother as well (102). Such harsh and condescending words from this woman only echoes those from the community; and when Jem had had enough, he chops off the tops of all her camellia bushes! Scout says "that for a few minutes he simply went mad" (102). Atticus soon found out what Jem did and had him go discuss it with the old woman without Scout. In the end, he had to read with her for a month as penance.


Overall the Finches suffered great verbal persecution as a result of Atticus taking the Tom Robinson case. For the most part, their lives resumed as before; but it was an unforgettable and defining time for both Jem and Scout. They both learned about the hypocrisy behind people who preached "love one another" on Sundays but treated African Americans like second-class citizens every day. They also learned to fight the right fight at the right time and in the right way, as shown in the following passage:



"'Atticus, are we goning to win it?'


'No, honey.'


'Then why--'


'Simply because we were licked a hundred years before we started is no reason for us not to try to win,' Atticus said" (76).


Saturday, July 24, 2010

What are important dates to remember leading up to the 2016 election?

The primary schedule in the United States is really important to remember, especially this election cycle where any given candidate's chance to get nominated may very well come down to the last few states. 


Here are the dates of the remaining primaries: 


Republican Primaries


Tuesday, March 22: American Samoa, Arizona, and Utah


Tuesday, April 5: Wisconsin 


Tuesday, April 26: New York, Connecticut, Delaware, Maryland, Pennsylvania, and Rhode Island


Tuesday, May 3: Indiana


Tuesday, May 10: Nebraska and West Virginia


Tuesday, May 17: Oregon


Tuesday, June 7: California, Montana, New Jersey, New Mexico, and South Dakota


Democratic Primaries


Tuesday, March 22: Arizona, Idaho, and Utah


Saturday, March 26: Alaska, Hawaii, and Washington


Tuesday, April 5: Wisconsin


Saturday, April 9: Wyoming


Tuesday, April 19: New York, Connecticut, Delaware, Maryland, Pennsylvania, and Rhode Island


Tuesday, May 3: Indiana 


Saturday, May 7: Guam


Tuesday, May 10: West Virginia


Tuesday, May 17: Kentucky and Oregon


Saturday, June 4: Virgin Islands


Sunday, June 5: Puerto Rico


Tuesday, June 7: California, Montana, New Jersey, New Mexico, North Dakota, South Dakota


Tuesday, June 14: District of Columbia 



Both parties' convention dates will be important to note too as both of the nominations may come down to these meetings. 


Republican National Convention: July 18-21, 2016


Democratic National Convention: July 25-28, 2016


And, of course, actual election day is an important date to remember. The day to cast your vote in the 2016 Presidential Election is November 8th. 

What major question is never answered in "The Cask of Amontillado"? (Look back to the beginning the story)

One major question that is never answered is whether or not Montrestor considers himself to have successfully exacted revenge on his nemesis, Fortunato.  He claims that revenge is incomplete unless it can be accomplished in a way that does not result in punishment for the avenger.  "A wrong is unredressed," he says, "when retribution overtakes its redresser."  He feels that it is not true revenge if the avenger is caught or otherwise punished because then it's like he has been wronged twice by the one who he seeks to punish.  


By the end of the story, Montresor's success is somewhat ambiguous.  If he feels guilty for the murder of Fortunato and has been allowing it to weigh on his conscience for the past fifty years (he says it has been "half a century" since the events in the story took place), then he has not achieved real revenge because he has been punished by his own guilty conscience.  If, however, he has not really been feeling guilty for the murder, then he has achieved revenge because no punishment has been inflicted upon him.  Whether or not Montresor feels guilty about his action is uncertain, and so whether or not he's truly been successful in achieving his revenge is likewise unclear.

Friday, July 23, 2010

How do water and the sewage field help readers' understanding of "The Things They Carried"?

The next mention of rainwater and the sewage field is located in the chapter "In The Field." As the chapter begins, the Song Tra Bong river has overflowed (due to the rains) and the muck is now thigh-deep in the sewage field.


Again, there is the mention of Kiowa's corpse submerged in the sewage field. This imagery highlights the fact that war is no respecter of persons. In all respects, Kiowa is a fine soldier and human being; yet, he dies in a sewage field. In war, he is just another soldier caught up in the realities of battle. O'Brien asserts that the rains are also part of the 'war.' When it rains, the sewage fields are tedious and difficult to patrol. The soldiers must labor against gravity to make their way through the muck.


During patrols, the soldiers all look alike, their faces caked in the muck from the sewage fields. This imagery again reinforces the fact that, in war, every soldier is nondescript and dispensable. In the chapter, we learn that, although Lieutenant Cross prefers to treat his men like human beings, he must instead treat them as "interchangeable units of command" in order to maintain his sanity as a leader.


The sewage field is also a treacherous place during mortar attacks; during such times, there is no place to hide. The field simply erupts in explosions of "rain and slop and shrapnel." The falling shells cause great craters to form in the sewage field; when the craters fill back up with mud, all manner of things are pulled down with it into the depths of the field. This is how Kiowa's body becomes submerged in the field. In fact, his fellow soldiers have to dig laboriously to free his entrenched body from the stubborn muck. Again, the sewage field represents all the ugliness of war, how it buries our humanity and how it destroys our will to survive.


The next mention of the sewage field is in the chapter "Field Trip." Here, after twenty years, the author is supposedly visiting the sewage field with his daughter, Kathleen. In this chapter, the sewage field is no longer as imposing as it once was. It is "flat and dreary and unremarkable." Yet, all the author can remember as he stands before the field is how it has robbed him of all his sensibilities. To him, the field will always represent all the "vulgarity and horror" of the Vietnam War. Essentially, the book itself is a cathartic exercise that facilitates redemption and renewal. By once more confronting his past at the sewage field, the author begins to heal.

What was the Quota Act of 1921, and why was it so important?

The Emergency Quota Act of 1921 was passed in the midst of an anti-radical hysteria that swept the United States in the aftermath of World War I. It essentially established quotas that limited all immigration, but, due to the terms of the quota, especially immigration from Southern and Eastern Europe. This was a response to the view among many Americans that Eastern Europeans were not only racially inferior, but brought radical political beliefs like anarchism and communism to the country. Additionally, anti-Semitism and anti-Catholicism were especially strong among some Americans at the time, and this law reflected these trends. It would be followed by a more comprehensive immigration restriction law that actually reduced the numbers of immigrants that could enter the country in 1924. Immigration from some countries was almost totally curtailed by the law. Its historic significance lies in the fact that it represents a longstanding trend of anti-immigrant sentiment, often in response to global events or economic pressures. Often called nativism, discrimination against immigrants has always existed in tension with the idea that the United States is a "nation of immigrants," and the Emergency Quota Act represents a low point in attitudes toward immigrants.

Alliteration occurs with what words in "Fire and Ice" by Robert Frost?

Robert Frost's "Fire and Ice" weaves together ongoing alliteration of /s/ and /f/ sounds ("Some say," "ice," "tasted," "twice," "say," "destruction," "also," and "suffice"; "fire," "From," "favor," "enough of," "for," "suffice"). These are smooth, slippery consonant sounds. In linguistics, they are classified as fricatives. This means a speaker allows air to flow through the mouth to produce them, instead of stopping the air in some way; the speaker must also constrict the opening of the mouth somewhat to control the quality of the sound produced. Creating this kind of sound is a literal embodiment of the flowing, elemental forces that Frost's poem invokes.


Likewise, Frost intersperses more staccato consonants to develop the poem's message, alliterating with /t/ and /d/ ("what," "tasted," "twice," "hate," "to ... that ... destruction," "great"; "world," "desire," "hold," "destruction") creating some sonic punctuation at critical points in the rhythm and content of the poem. These are sounds that linguists call stops, because the mouth has to stop the flow of air to make them. The placement of the word "great" serves as a humorous punchline after the turning point of the poem; the /g/ sound is an even stronger form of linguistic "stop," called a glottal stop, and deviates from the more literary and lyrical tone of the rest of the poem.


This alternation between sounds and degrees of formalness signals to the reader to interpret the poem on multiple levels of meaning. There are allegorical undertones in the first half of the poem, invoking a vaguely philosophical question of how "the world will end," and perhaps provoking the reader to think about human nature or the natural order of things. But there is also a deeply personal, psychological level that Frost brings into play in the second half of the poem; you can imagine him recalling specific episodes in his own life of feeling or witnessing the bite of coldness coming from another person's hatred. These different kinds of "ends," the burning of fire and freezing over by ice, come across in alliteration through a flow of fricatives, punctuated by a handful of sharp stops. 

Wednesday, July 21, 2010

What is the chest?


Structure and Functions

The chest, or thorax, consists of those parts of the body lying between the diaphragm and the neck. Included here are the rib cage, diaphragm, heart, lungs, chest muscles, and breasts.



The skeletal support of the chest consists of the thoracic vertebrae and rib cage. In humans, there are usually twelve pairs of ribs and twelve thoracic vertebrae. Each thoracic vertebra consists of a cylindrical portion, the centrum or body, and a neural arch attached to the dorsal side of the centrum. The neural arch surrounds and protects the spinal column. A spinous process extends dorsally from the neural arch of each thoracic vertebra and serves as a site for muscle attachment. Near the base of each neural arch are two pairs of articular processes (zygapophyses). The superior pair of one vertebra face toward each other and articulate with the inferior articular processes of the adjacent vertebrae.


Attached to each thoracic vertebra is a rib. There are usually twelve pairs of ribs, but this number occasionally varies. Each rib consists of a bony portion and a cartilaginous extension, the costal cartilage. At its vertebral end, each rib has two articulating processes, the head (capitulum) and the tubercle (tuberculum). The costal cartilages of the first seven ribs (the number occasionally varies) extend all the way to the sternum. The next two or three ribs have costal cartilages that attach to the costal cartilage above them. The remaining ribs have costal cartilages that are “floating” and have no attachments. Together, the ribs make up a cagelike structure called the rib cage, which shapes the chest and protects the heart and lungs from injury.


The sternum, or breastbone, runs along the front of the chest in the midline of the body. It consists of a flattened top portion called the manubrium; a long, extended body (corpus); and an extension called the xiphoid process, which is made mostly of cartilage. The manubrium has notches for the attachment of the clavicle and the first rib on either side. The attachment for the second rib lies between the manubrium and corpus and is shared by both bones. The corpus of the sternum is formed by the fusion of five individual parts called sternebrae. The costal cartilages of the second through seventh ribs articulate with the corpus of the sternum and mark the boundaries between the individual sternebrae. Beyond the notch for the attachment of the seventh costal cartilage, the xiphoid process extends downward along the midline.


A muscular diaphragm marks the boundary between the chest cavity and the abdominal cavity. Although it is located at the lower end of the chest cavity, it originates in the neck region and derives its nerve supply, the phrenic nerve, from within the neck. The diaphragm is the principal muscle used in breathing. Normally dome-shaped and bowed upward, the diaphragm flattens when its muscles contract, expanding the chest cavity and resulting in the inhalation of air. Relaxation of the diaphragm returns the curvature of the dome upward, compressing the chest cavity and resulting in the exhalation of air. The diaphragm has openings for the passage of the esophagus and the major blood vessels, especially the descending aorta and inferior vena cava.


The heart and major blood vessels lie within the chest cavity and are protected by the rib cage. The heart
is a muscular pump that has four chambers (two atria and two ventricles). The right atrium receives oxygen-poor blood from the body’s organs via the superior vena cava (from the head and upper extremities) and the inferior vena cava (from the abdominal region, pelvic region, and lower extremities). Blood from the right atrium passes through the tricuspid valve to the right ventricle, from which it is pumped into the pulmonary artery. The pulmonary artery then divides in two branches that run separately to each lung. Oxygen-rich blood from the lungs returns to the heart by means of the pulmonary veins, which empty into the left atrium. Blood from the left atrium passes through the bicuspid valve and empties into the left ventricle, which has an extremely thick, muscular wall. Contraction of the left ventricle propels the blood out of the aorta and through the body via the arteries.


Contractions of the heart originate in a location known as the sinoatrial node, located on the surface of the right atrium. From this point, contractions spread to the atrioventricular node, located at the point where all four chambers meet. The wave of contraction then spreads rapidly down the septum between the two ventricles and up the side walls of each ventricle. A specialized bundle of cardiac muscle called the bundle of His, composed of modified muscle fibers (Purkinje fibers), is responsible for this rapid conduction.


Except for the pulmonary arteries, the arteries of the chest region are all branches of the aorta, the major artery that flows out from the left ventricle of the heart in an upward direction. The aorta can be subdivided into an initial portion (the ascending aorta), an aortic arch, and a longer descending aorta which extends from the thoracic region into the pelvis. The coronary arteries are small but important branches that arise from the ascending aorta as it leaves the heart. These arteries supply blood to the muscular wall of the heart itself. From the arch of the aorta, the most common pattern of branching is that of a brachiocephalic trunk, which then splits into a right common carotid and right subclavian artery, followed by a left common carotid artery and then a left subclavian artery. There is considerable variation, however, in this pattern of branchings. The carotid arteries run up the sides of the neck to supply blood to the head and neck.


The subclavian arteries of either side run first upward and then laterally through the chest cavity, continuing toward the upper extremity as the axillary artery. Along its course, each subclavian artery gives off the following branches: vertebral artery, thyrocervical trunk, internal thoracic artery, costocervical artery, and descending scapular artery. The vertebral artery, the largest branch, supplies blood to the vertebrae of the neck region and ultimately to the base of the brain. The short thyrocervical trunk divides almost immediately into three branches: an inferior thyroid artery to the larynx, trachea, esophagus, and surrounding muscles; a suprascapular artery to the subclavius and sternocleidomastoid muscles and to the overlying skin; and a transverse cervical artery to the muscles of the shoulder region.


The right and left internal thoracic arteries (also called internal mammary arteries) run along the ventral side of the chest, just beneath the costal cartilages and just to either side of the sternum. Each internal thoracic artery gives off branches to the diaphragm, the pleura, the pericardium, the thymus, the transverse thoracic muscle, the ribs and intercostal muscles, the pectoral muscles, and the mammary glands. Beyond the sixth rib, each internal thoracic artery divides into a musculophrenic branch to the last six ribs and the diaphragm and a superior epigastric artery, which descends along the abdominal surface, supplying the muscles of this region before meeting the inferior epigastric artery that ascends from the pelvic region.


The veins of the chest region include the external and internal jugular veins, draining the head and neck, and the subclavian veins, draining the upper extremities. These veins come together to form the right and left brachiocephalic veins, which then drain into the superior vena cava. The superior vena cava also receives several smaller tributaries, including the azygos vein, the paired internal thoracic and inferior thyroid veins, the highest intercostal vein, and several smaller veins of the vertebral column. The azygos vein (on the right) and the hemizygous vein (on the left) run parallel to each other on either side of the vertebral column along the dorsal or rear wall of the chest cavity, draining blood from the muscles of the back, the bronchi, the ribs, and the mediastinum. The right and left internal thoracic veins receive tributaries from the ribs and intercostal muscles as well as the diaphragm, pericardium, and mediastinum. The highest intercostal veins drain the first two or three intercostal spaces on either side, also receiving smaller tributaries from the bronchi and the upper portion of the diaphragm. The inferior thyroid veins drain the thyroid gland, esophagus, trachea, and larynx. In addition to the veins listed above, the veins of the heart muscle all drain into a coronary sinus, which runs between the left atrium and ventricle, then drains directly into the right atrium near the inferior vena cava.


The lungs, the principal organs of respiration, consist of several lobes. The right lung has superior, medial, and inferior lobes; the left lung has superior and inferior lobes only. Inhalation of air, or inspiration, is brought about by the lowering (contraction) of the diaphragm and by the raising and outward expansion of the rib cage. Exhalation of air, or expiration, is brought about by the raising (relaxation) of the diaphragm and by the relaxation of the intercostal muscles, lowering and contracting the rib cage. Under most conditions, inspiration is an active process requiring muscular contraction, while expiration takes place passively as the muscles relax.


Together, the heart, the lungs, and the thoracic portion of the esophagus occupy the thoracic cavity, or chest cavity. Each of these organs is surrounded by a thin membrane, the visceral pleura. This membrane is continuous with the parietal pleura, another thin membrane that lines the outer walls of the chest cavity. The right and left visceral pleura come together to form a septum called the mediastinum, which separates the bulk of the thoracic cavity into right and left pleural cavities, each containing one of the lungs. The pericardial cavity, containing the heart, is inserted between the layers of the mediastinum. Also occupying part of the thoracic cavity is a large mass of lymphoid tissue, the thymus body. The thymus is irregular in shape and occupies the highest portion of the thoracic cavity above the heart.


Muscles of the chest region may be divided into those associated developmentally with the upper extremity and those that are associated with the trunk of the body. One muscle, the trapezius, is a modified gill muscle that belongs developmentally to neither group. Fibers of the trapezius muscle originate from the cervical and thoracic vertebrae, including the adjoining ligaments and the adjacent part of the skull. These fibers converge onto the spine and acromion of the scapula and onto the clavicle. The muscles associated with the trunk of the body are called axial muscles. Of those in the chest or thoracic region, four are responsible primarily for movements of the shoulder blade (scapula), twelve for movements of the rib cage, and another eleven for movements of the vertebral column.


The levator scapula runs from the transverse processes of the first four cervical vertebrae to the vertebral border of the scapula; by contracting, it raises and rotates the scapula. The two rhomboid muscles run from the vertebral column to the vertebral border of the scapula. The rhomboideus minor originates from the spinous processes of the seventh cervical and the first thoracic vertebra and from the nuchal ligament that runs from these spinous processes to the skull. The rhomboideus major originates from the spinous processes of the second through fifth thoracic vertebrae. Both rhomboideus muscles run diagonally from the vertebral column to the vertebral border of the scapula, including the base of the scapular spine. The serratus anterior, also called serratus ventralis, is a sheetlike muscle that lies between the scapula and the rib cage. Its fibers originate from the ribs as a series of strips that converge slightly; they all insert onto the vertebral border of the scapula. The attachments of this muscle to the ribs resemble a series of angular sawteeth (serrations) that give the muscle its name. The four preceding muscles all share a common embryological origin, and all have a common nerve supply from the dorsal scapular nerve.


The axial muscles associated with movements of the rib cage include the scalenus anterior, scalenus medius, scalenus posterior, intercostals, subcostals, levatores costarum, transversus thoracis, serratus posterior superior, serratus posterior inferior, rectus abdominis, and diaphragm. The three scalene muscles, as their name implies, are all shaped like elongated scalene triangles (with three sides of different lengths). The scalenus anterior arises from the transverse processes of the third through sixth cervical vertebrae and inserts (attaches) onto the first rib. The largest of the scalene muscles is the scalenus medius, which runs from the transverse processes of the last six cervical vertebrae to an insertion on the first rib. The scalenus posterior arises from the transverse processes of the last two or three cervical vertebrae and inserts onto the second rib.


The intercostal muscles run between the ribs in two sets of fibers. The external intercostals run from each rib to the next in a diagonal direction; the upper end of each fiber is situated closer to the vertebral column than is the lower end. The internal intercostals also run diagonally from each rib to the next, but deep to the fibers of the external intercostals and perpendicular to them, so that the lower end of each fiber is closer to the vertebral end of each rib than is the upper end. Both sets of intercostals are broad, extending nearly along the entire extent of each rib, but the fibers are in each case short, extending only from one rib to the next. The subcostals are similar in position and orientation to the internal intercostals, except they are usually confined to the last few ribs and they span two or three intercostal spaces at a time. The levatores costarum are a continuation of the external intercostals onto the transverse processes of the vertebrae, from the last cervical vertebra to the eleventh thoracic vertebra. Each levator costarum is a triangular slip located in the angle between one of the ribs and the vertebra in front of it, running from the transverse process of the vertebra onto the rib.


The transversus thoracis is a flat muscle that covers part of the inside of the rib cage. Its fibers originate from the corpus and xiphoid process of the sternum; these fibers radiate both horizontally and diagonally upward to insert on the deep surfaces of the second through sixth ribs. The serratus posterior superior arises from the spinous processes of the first few thoracic vertebrae and the seventh cervical vertebra, as well as from the ligaments connecting these spinous processes with one another and with the skull. The fibers converge only slightly and are inserted in four separate slips onto the superior margins of the second through fifth ribs. The serratus posterior inferior is a similar but broader muscle located farther down the spine. It arises from the spinous processes of the last two thoracic and first few lumbar vertebrae, runs diagonally upward, and divides into four separate slips that insert onto the inferior margins of the last four ribs. The rectus abdominis, obliquus externus, obliquus internus, and transversus abdominis are abdominal muscles that pull down on the chest and particularly on the rib cage. The rectus abdominis consists of a strip of muscle fibers running vertically along the ventral midline. The other abdominal muscles are sheetlike and cover the majority of the abdominal surface. Contractions of these muscles generally pull downward on the ribs and oppose the expansion of the rib cage.


The diaphragm is also an axial muscle of the chest cavity. Its muscle fibers originate from the inside of the xiphoid process of the sternum (the sternal portion), from the inner surfaces of the last six ribs and their costal cartilages (the costal portion), and from two muscular arches and two tendinous crura that make up the lumbar portion. The medial lumbocostal arch forms a passage for the greater psoas muscle, while the lateral lumbocostal arch forms a passage for the lumbar quadrate muscle. The right and left crura arise from the ventral surfaces of the first few lumbar vertebrae. Together, the sternal, costal, and lumbar portions of the diaphragm converge upon a sheetlike central tendon, which is divided into large left and right leaflets and a small middle leaflet.


The axial muscles concerned with movements of the thoracic vertebrae include the longus and splenius muscles and the muscles of the erector spinae complex. The longus colli arises from the centra of the last few cervical and first few thoracic vertebrae along their ventral surfaces; it runs upward to insert onto the bodies of the first four cervical vertebrae and the transverse processes of the fifth and sixth cervical vertebrae. The splenius capitis originates from the spinous processes of the last cervical and the first three or four thoracic vertebrae and from the ligaments connecting these processes to one another and to the back of the skull. The muscle inserts onto the occipital and temporal bones on the back of the skull, including the mastoid process. The splenius cervicis arises from the spinous processes of the third through sixth thoracic vertebrae and runs to an insertion on the transverse processes of the first few cervical vertebrae. The muscles of the erector spinae complex include the iliocostalis, longissimus, spinalis, semispinalis, multifidius, rotatores, and intertransversarii. Collectively, these muscles are responsible for dorsal movements (extension) of the vertebral column throughout the lumbar, thoracic, and cervical regions.


The muscles associated developmentally with the extremities are called appendicular muscles. Appendicular muscles of the chest region include the pectoralis, latissimus dorsi, and subclavius. The pectoralis major is triangular in shape; it originates from the sternum, costal cartilages, and a portion of the clavicle, from which its fibers converge toward an insertion onto the greater tuberosity of the humerus. The pectoralis minor originates from the third through fifth ribs and inserts onto the coracoid process of the scapula. The latissimus dorsi is a broad, flat muscle that originates from the lower half of the vertebral column (and part of the ilium) by way of a tough tendinous sheet (the lumbar aponeurosis); it inserts high on the humerus. The subclavius muscle runs from the bottom surface of the clavicle diagonally onto the first rib. Upon contraction, this muscle helps pull the shoulder inward and the rib cage upward.


Each of the paired breasts consists of a mammary gland, nipple (papilla), areola, and surrounding fat tissue. The breasts are small in children and remain small in most adult men, but they become larger during puberty in women and enlarge even more during late pregnancy and throughout lactation. Toward the end of pregnancy, the gland begins to secrete milk, a white, nutritive fluid containing lactose (milk sugar), proteins, and some fats (more sugar and less fat than in cow’s milk). The secretion of milk is known as lactation. During lactation, the mammary gland continues to secrete milk as long as the baby continues nursing. When the child is weaned, the mammary gland undergoes a process of involution (shrinkage). The smaller ducts of the mammary gland collect into larger ducts, each draining a wedge-shaped section of the breast. These larger ducts converge toward a raised nipple (papilla) from which the milk exudes. The nipple is surrounded by a circular area, the areola, characterized by thin skin which is a bit more heavily pigmented (usually redder) than the remainder of the breast.



Agur, Anne M. R., and Arthur F. Dalley. Grant’s Atlas of Anatomy. 13th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2012.


"Chest Pain: First Aid." Mayo Clinic, February 3, 2012.


Crouch, James E. Functional Human Anatomy. 4th ed. Philadelphia: Lea & Febiger, 1985.


Marieb, Elaine N. Essentials of Human Anatomy and Physiology. 10th ed. San Francisco: Pearson/Benjamin Cummings, 2011.


Rosse, Cornelius, and Penelope Gaddum-Rosse. Hollinshead’s Textbook of Anatomy. 5th ed. Philadelphia: Lippincott-Raven, 1997.


Standring, Susan, et al., eds. Gray’s Anatomy. 40th ed. New York: Churchill Livingstone/Elsevier, 2008.

Monday, July 19, 2010

In Doris Gates' novel Blue Willow, where did Janey want to stay the most at the fair?

In Doris Gates’ novel Blue Willow, the children in Janey’s school are economically and socially deprived, seemingly destined to lives of ignorance and want. The Great Depression has taken its toll, and even once relatively prosperous families have been rendered destitute. Janey, however, has seen a little more of the country, and been exposed to more than most of her classmates. As the young protagonist of Gates’ novel, she is perceptive and intelligent, and her trip to the county fair in Fresno with her friend Lupe proves more transformative than even this intellectually curious child had imagined. It is the abundance Janey observes at the fair, however, that she finds particularly striking. Approaching the obligatory agricultural exhibit, she marvels at the “great mounds” of fresh fruit. For this child from a Texas farm, the wealth in fresh fruits she witnesses amazes even her. As the story’s narrator describes Janey’s reaction, “Nowhere except in the pages of the Old Testament had she ever come upon such a bounty . . . Surely, this San Joaquin Valley was a land flowing with milk and honey.”


While Jayne is mesmerized by the abundance of fresh produce at the fair, however, it is a strangely-adorned booth there that most entrances her. Gates describes the setting as follows:



“In its center was a round table literally heaped with books. Big books and little books, all of them shiny and new had been arranged on some kind of rack so that from the table’s edge they rose in a circle to make a small mountain of books . . . The gay covers caught Janey’s eye and held her spellbound. She felt drawn to that table as by some force beyond her power to withstand.”



This booth, of course, is the library booth, and Janey’s entry into this booth symbolizes her entry into an entirely new world. Like all the children in her school, Janey had access to books, but they were all old and worn. These books, however, were new, and they cast a spell on this young girl that would not be broken, and that would draw her back. As this chapter on Jayne and Lupe’s trip to the fair progresses, Janey’s fascination with the books only grows, and it is clear that, henceforth, books will play an increasingly important role in her life.

Sunday, July 18, 2010

Shakespeare made Mercutio so sparkling and diverting that he had to kill him in order to allow the tragic focus of the play to emerge. Do you agree?

Clearly, this is debatable, meaning you could argue either side, but I will argue that Shakespeare does NOT kill off Mercutio because he is so sparkling and diverting that he detracts from the tragic focus of the play. In other words, I am disagreeing with the statement.


First, I will agree that Mercutio is witty and diverting (and sometimes obnoxious, as when he offends Juliet's maid by suggesting she is a prostitute.) But I believe Shakespeare made Mercutio such a full-bodied character so that we as an audience would understand why Romeo was close friends with him. Mercutio is not just a cardboard, place-holder "best friend" but a real person that you or I might like. Therefore, although Romeo at first tries to avoid a duel with Tybalt for good reason, as he has just married Juliet, when Tybalt kills Mercutio, we as an audience feel Romeo's pain. We know what a great guy Mercutio was and this makes it easier for us to understand why Romeo, stricken with grief and anger, kills Tybalt. After all, killing Tybalt, rationally speaking, was a very foolish thing for our young hero to do if he wanted to reconcile with his wife's family. But by making Mercutio real, Shakespeare makes us understand all the more the torn loyalties Romeo (and Juliet too when she gets upset over Tybalt's death) feel.


Of course, too, for the play to proceed down its tragic path, Romeo has to kill Tybalt and be banished. Shakespeare, unlike a lesser playwright, gives him a strong, relatable motive for doing so, ie the death of the sparkling Mercutio. This, I would argue, is part of what makes Shakespeare a great playwright: he introduces psychological realism into his plays. Further, just as an aside, it livens up the first half of the play to have Mercutio around--and Shakespeare wanted his audiences entertained. 

Saturday, July 17, 2010

What is medical marijuana? How does it help cancer patients?




Access to medical marijuana: Federal law in the United States supports the use of Marinol and Cesamet but does not support the use of other forms of marijuana for medicinal purposes. There are some conflicts, however, between state and federal law in the United States. By 2008, twelve states had passed legislation legalizing medical marijuana in one way or another. In some cases, there were state-level rules governing possession of dried forms of the drug and/or plants in varying quantities for patients and care providers; in others, circumstances varied county by county. Many required users of medical marijuana to obtain the drug in certain ways and/or maintain registration for medical purposes. Rules varied from country to country as well. Holland, for instance, permitted use of marijuana by the public for any purpose in establishments called coffee shops. Even in Holland, however, there were strict guidelines on where it could be used, the amount permitted to be given to each user or to be present in each shop, and other matters, such as the impact of the coffee shop on the surrounding community.





Medicinal effects and uses: Marinol and Cesamet address appetite problems, as well as nausea and its associated vomiting. In terms of nausea, they are used typically in individuals undergoing chemotherapy for cancer, and particularly in individuals who have not responded to other forms of treatment for those conditions. In terms of appetite, they are used typically in clients with acquired immunodeficiency syndrome (AIDS) to combat a loss of appetite and its associated weight loss. Other, diverse conditions have been reported as potentially benefiting from medical marijuana, including Alzheimer’s disease, anorexia, cancer, chronic or debilitating pain, cramping, Crohn disease, glaucoma, human immunodeficiency virus (HIV), multiple sclerosis, seizures, muscle spasms, and wasting syndrome (cachexia). This list does not include all conditions that varying state laws recognize as eligible for marijuana use. Many of the states that have legalized medical marijuana have, as part of the law, clauses that either allow the list of treatment-eligible conditions to be amended or are open-ended and subject to physician approval. Scientific reports continue to generate speculation about conditions that may receive benefit from treatment, such as depression. Use of marijuana for all of these conditions, however, remains the subject of great debate and is illegal in most states.




Controversies of medical marijuana: Despite the fact that synthetic THC and THC derivatives serve medical purposes, and despite the fact that twelve states allowed the use of marijuana for medicinal purposes as of 2008, medical marijuana is a controversial topic. Opponents of medical marijuana are quick to point out that Marinol and Cesamet exist as pharmaceuticals regulated by the Food and Drug Administration (FDA) and are adequate to cover the conditions most often treated with marijuana. Proponents of medical marijuana counter that those drugs do not work well for everyone and that they are only to be used for certain conditions. In the light of pain and suffering caused by other conditions, they argue, why not allow medical marijuana use? Again, opponents answer that other viable treatments exist that are better to try as treatment options, that the evidence for marijuana’s efficacy in treating these other conditions is weak, and that there are strong social, physical, mental, and behavioral cons to the use of marijuana and its alternative forms.


Typical cons cited are posed in terms of short-term and long-term risks. In the short term, these may include memory and learning difficulties, panic, anxiety, coordination problems, and impaired problem solving. In the long term, these may include problems related to addiction, such as abuse or dependence, motivational problems, daily cough, phlegm problems, respiratory problems, impact on the immune system, and possibly cancer. Proponents argue that the pros outweigh the cons and that, despite evidence that some may consider weak, this method of treatment for such debilitating conditions deserves further study.


The debate continues, however, from state to state and country to country. Future studies focusing on the risk impacts of marijuana use are to be expected. Expanding the use of Marinol to other conditions may be on the horizon. The fight to allow studies examining the utility of marijuana for treating health conditions faces continued struggles in the United States and elsewhere.




Bibliography


Earleywine, Mitch. Understanding Marijuana: A New Look at the Scientific Evidence. New York: Oxford University Press, 2002.



Gerber, Rudolph Joseph. Legalizing Marijuana: Drug Policy Reform and Prohibition Politics. Westport, Conn.: Praeger, 2004.



Rosenthal, Ed, and Steve Kubby. Why Marijuana Should Be Legal. New York: Thunder’s Mouth Press, 2003.



Russo, Ethan B., and Franjo Frotenhermen, eds. Handbook of Cannabis Therapeutics: From Bench to Bedside. Binghamton, N.Y.: Haworth Press, 2006.



Russo, Ethan B., Melanie Dreher, and Mary Lynn Mathre, eds. Women and Cannabis: Medicine, Science, and Sociology. Binghamton, N.Y.: Haworth Press, 2002.



Selvanathan, Saroja, and Eliyathamby A. Selvanathan. The Demand for Alcohol, Tobacco, and Marijuana: International Evidence. Burlington, Vt.: Ashgate, 2005.

How is marketing affected by social responsibility?

When engaging in marketing techniques and practices, both for-profit and non-profit organizations must consider social responsibility.  Social responsibility is a company's dedication to and interest in the community, or society, around them. When a firm acts socially responsible, it focuses not only on maximizing profit, but also on its impact on the community.


Chipotle provides a good example of social responsibility in marketing. Although the intent of Chipotle, like many organizations, is to market to increase profit and customer base, it also highlights social responsible activities. The socially responsible activities that Chipotle has recently been noted for are natural meat products without hormones, increasing cleanliness and training in their restaurants, and educating the public about healthier food choices.


On the other hand, some organizations may wish to separate their social responsibility marketing side from their traditional marketing methods. For example, a health care company may advertise their products, and then create or sponsor separate commercials or events that benefit the public. 

Friday, July 16, 2010

How does fascism connect with a formative element in The Prime of Miss Jean Brodie?

Miss Brodie herself is a fascist. She admires Mussolini, and when she visits Nazi Germany in 1938, she approves of what Hitler has done. She calls her chosen students, known as the "Brodie set," the "creme de la creme," as if they were a sort of master race (though they are not), and she feels can mold them in her own image, much as the fascists wanted to mold young people in their own image. Her fascism is significant because it is her undoing. Miss Brodie has been clashing with the head of the school, Miss McKay, for some time, but when one of Miss Brodie's 'set' betrays her as a fascist, that then becomes a pretext for getting rid of her. The novel captures the spirit of a time period, the 1930s, and the dangers (and sometimes the seductiveness) of fascism.

The ideals that Europeans espoused at the outbreak of the First World War were very different from those which influenced Europeans during the...

This is a very complex question. The nineteenth century witnessed some of the most significant social, intellectual, and political changes in human history. For the most part, the most relevant changes to this question can be understood as part of what historian Eric Hobsbawm called the "dual revolution" of the early nineteenth century. The two events that initiated the "dual revolution" were the French Revolution and the Industrial Revolution, and they were important because they ushered in many of the changes that characterized the period. Let us look at a few of these changes.


First, the nineteenth century witnessed the rise of nationalism, which was itself kindled by the French Revolution and the Napoleonic Wars. Nationalist movements formed in virtually every region of Europe, most notably in Italy, where Giuseppe Mazzini's "Young Italy" movement advocated Italian nationhood as early as the 1820s. Several new European nations, including Belgium and Greece were formed in the two decades or so after the Napoleonic Wars, and Italy and Germany became unified through wars in 1861 and 1871, respectively. The emerging spirit of nationalism destabilized both the Austrian and the Ottoman Empires, a situation that continued well into the twentieth century, when it played a major role in sparking World War I. 


Another massive change was industrialization. Beginning in England, the Industrial Revolution spread to France and Germany in particular by the mid-nineteenth century. This created a large and disaffected working class in many European nations. It also contributed to national identity through the proliferation of "print capitalism," which tended to give one language priority over other dialects. Industry also helped power the mighty war machines that emerged in European nations, outfitting massive armies with modern weapons.


A side effect of the Industrial Revolution was the emergence of radical ideologies among the workers mentioned in the previous paragraph. These included socialism (both revolutionary and democratic) and anarchism. Many among the traditional aristocracy as well as wealthy industrialists and the comfortable middle classes feared the rise of these movements. Some governments tried to institute moderate reforms to lessen their appeal, while others opted for brutal crackdowns on radicals. 


These changes, I would argue, were the most significant in Europe during the nineteenth century. 

What is scleroderma?


Causes and Symptoms


Scleroderma is a connective tissue

disease characterized by fibrosis and hardening of the skin and internal organs. The word “scleroderma” is derived from the Greek sclero, meaning “hard,” and derma, meaning “skin.” Women are four times more affected than men. The disease generally affects persons between the ages of thirty and fifty.



It is believed that scleroderma is autoimmune in origin. The exact cause of the disease is yet to be discovered, but an overproduction of collagen
has been observed in skin biopsies of patients with scleroderma. Two types of the disease have been recognized: localized scleroderma and systemic sclerosis. The localized form of the disease is more common in children and can affect small areas of the skin or muscle or can be widespread, manifesting as morphea and/or linear scleroderma. Morphea affects the skin, with gradually enlarging inflammatory plaques or patches; they may regress spontaneously over time and typically last for months to years. The skin over the lesions appears firm to hard, and the lesions themselves are ivory or yellow in color. Linear scleroderma usually affects a limb or the forehead and, if present early in childhood, can result in permanent limb shortening. This type may also affect the muscles and joints, causing limited joint mobility.


Systemic sclerosis, on the other hand, is a more widespread disease that affects multiple organs, such as the skin, esophagus, gastrointestinal tract, muscles, joints, blood vessels, heart, kidneys, lungs, and other internal organs. This disease usually manifests in adults, with symptoms of at least one or more of the following: Raynaud’s phenomenon (extreme sensitivity of the extremities to cold temperatures, with a tingling sensation and the limb turning blue, red, or white upon exposure to cold); thickening of the skin with a leathery, shiny appearance (sclerodactyly);
fibrosis and thickening of the joints with decreased mobility; swelling of the hands and feet, with pain and stiffness of the joints; and orofacial abnormalities from thickening of the skin. Some patients may experience symptoms of esophageal, heart, lung, or kidney disease. Systemic sclerosis should always be suspected in every case of difficulty swallowing and
heartburn, especially if seen in a middle-aged woman. Patients may complain of nonspecific problems, such as bloating of the abdomen, weight loss, fatigue, generalized weakness, diarrhea, constipation, shortness of breath, and vague aching of joints and muscles. They may also exhibit dryness and redness of the conjunctiva and mucous membranes (Sjögren’s syndrome
or keratoconjunctivitis sicca).


Some patients experience the CREST syndrome, which is an acronym for calcinosis, Raynaud’s phenomenon, esophageal dysmotility, sclerodactyly, and vascular
telangiectasia. Another form of the disease is localized cutaneous systemic sclerosis, which affects mainly the skin of the hands, face, feet, and forearms, with Raynaud’s phenomenon being the primary symptom.


Diagnosis of the disease is difficult, especially in the initial stages, as the symptoms are common to a variety of immunologically mediated diseases such as rheumatoid arthritis, Sjögren’s syndrome, and systemic lupus erythematosus (SLE). The diagnosis is mainly based on clinical findings, an elevated erythrocyte
sedimentation rate (ESR), and a skin biopsy showing elevated collagen levels. Sometimes, a positive antinuclear antibody test and a positive rheumatoid factor test may be seen. About 30 percent of patients are positive for the Scl-70 antibody, which is highly specific for the disease. X-rays and lung function tests are used to determine the extent of the disease.


Those with the systemic form are prone to various complications, including heart failure, kidney failure, respiratory problems, and intestinal malabsorption.




Treatment and Therapy

As of the beginning of the twenty-first century, no cure for scleroderma had been found. Each symptom, however, can be treated effectively, and the quality of life can be greatly improved if the disease is detected early in its course. The disease is primarily managed by rheumatologists and dermatologists, owing to the severity of its course and the difficulty of diagnosis. Calcium-channel blockers are used to decrease the symptoms caused by Raynaud’s phenomenon, joint pain and stiffness can be treated with nonsteroidal anti-inflammatory drugs (NSAIDs), esophageal dysmotility and subsequent heartburn is treated with antacids and antireflux measures, lung inflammation and fibrosis can be treated with cyclophosphamide, and heart failure and renal failure are treated appropriately with drugs. Penicillamine and corticosteroids are used to treat the fibrosis seen in the disease. In addition, physical and occupational therapy is instituted to improve joint mobility.


Morphea or localized scleroderma can be managed by the application of cortisone ointment to the lesions. This will not reverse or treat the disease completely, but it appears to slow the progression and provide symptomatic relief. Patients are also advised to use sunscreen lotions and moisturizers to soften the skin and prevent sunburn. Plastic surgery may be employed to correct serious deformities.




Perspective and Prospects

Scleroderma is an individual disease, with each patient exhibiting different aspects. This makes diagnosis even more difficult and complicated. Scleroderma is not contagious, and it is not believed to be heritable. It is thought that certain people are inherently more susceptible to the disease, and they develop it only if environmental or physical trigger factors, such as stress, are activated. Prognosis of the localized form of scleroderma is good, with the lesions resolving spontaneously, and the five-year survival rate for those with systemic disease is 80 to 85 percent. Many clinical trials are being conducted for such treatments as the use of stem cells as a “rebooting” mechanism, alpha interferon, ultraviolet therapy, and even psychotherapy. These approaches appear promising and aim to at least improve the quality of life of patients with scleroderma, if not cure the disease.




Bibliography


Alan, Rick, and Rosalyn Carson-DeWitt. "Scleroderma." Health Library, Sept. 1, 2011.



Brown, Michael. Scleroderma: A New Role for Patients and Families. Los Angeles: Scleroderma Press, 2002.



Fauci, Anthony S., et al, eds. Harrison’s Principles of Internal Medicine. 18th ed. New York: McGraw-Hill, 2012.



Frazier, Margeret Schell, and Jeanette Wist Drzymkowski. Essentials of Human Diseases and Conditions. 5th ed. St. Louis, Mo.: Saunders/Elsevier, 2013.



Mayes, Maureen D. The Scleroderma Book: A Guide for Patients and Families. Rev. ed. New York: Oxford University Press, 2005.



Rakel, Robert E., ed. Textbook of Family Practice. 8th ed. Philadelphia: W. B. Saunders, 2011.



"Scleroderma." MedlinePlus, May 13, 2013.



Tapley, Donald F., et al, eds. The Columbia University College of Physicians and Surgeons Complete Home Medical Guide. Rev. 3d ed. New York: Crown, 1995.



"What Is Scleroderma?" National Institute of Arthritis and Musculoskeletal and Skin Diseases, Aug. 2010.

How does the choice of details set the tone of the sermon?

Edwards is remembered for his choice of details, particularly in this classic sermon. His goal was not to tell people about his beliefs; he ...