What are some examples of safety and precautionary measures for different kinds of weather?

There are three basic rules during severe weather: get in, get down, and cover up! Having a safety plan before a disaster strikes will allow individuals to act promptly and lessen the likelihood of being adversely affected by the severe weather. Therefore, it is a good idea to have a safety kit created ahead of time that contains first-aid materials in case an injury is caused by adverse weather.  Below are several safety precautions to abide by during different weather conditions.

Lightning

• Lightning is an electrical discharge that is created when charged particles in clouds attract other charged particles within the cloud or the ground. Metals are great conductors of electricity. Therefore, it is advised that individuals do not touch metal objects when out in a lighting storm. This is because the electrical current from the lightning could be conducted through the metal and into the body. This would electrocute the individual who is touching the metal object.

Tornado

• When inside a building during a tornado, you should move into a location where there are no windows.  


• Protect your head from flying debris.


• If at home, move into the basement.


• If outside during a tornado, move into a trench.

Flash Floods

• Move to higher ground.

Hurricane

• Board windows to prevent the glass from breaking.

Snow Storms

• It is advised that individuals keep shovels, food, water, sand or salt, and blankets in their vehicles if they have to drive during a snow storm.

What is the structure of bacteria? How does bacteria grow?

Definition

Bacteria are single-celled organisms that reside in every
habitat, including the human body. Bacteria are a necessary part of the normal
flora of the human body; very few species actually cause illness, and many are beneficial. Bacteria are the smallest known organisms that can reproduce independently.

General Structure

Bacteria are the most common life-form on Earth. These single-celled organisms come in a variety of shapes and sizes. The millions of known species of bacteria live in a wide range of environments, from vents deep in the ocean floor to the recesses of the human digestive tract. The vast majority of bacteria are harmless to humans; some are actually helpful and necessary for human health, while a small fraction are pathogenic. Despite these diverse features, all types of bacteria have fundamental characteristics in common.

Bacteria have a simpler structure than plant and animal cells, which are higher
life-forms called eukaryotes. Eukaryotes have cells that are divided into smaller compartments by
membranes. Each compartment, or organelle, carries out specialized functions.
Bacteria are prokaryotes, which have no organelles. They consist of just one compartment that
is separated from the outside world by a cell membrane and a cell wall. The
interior of the cell, called cytoplasm, contains a solution of sugars, salts, vitamins, enzymes, and other
substances dissolved in water. Suspended in the cytoplasm are large numbers of
ribosomes and a nucleoid made of DNA (deoxyribonucleic acid).

The cell membrane is a semipermeable barrier that separates the inside of the cell from the outside. This thin structure is vital to the survival of the cell. The membrane is created by the assembly of phospholipids and proteins into a bilayer. The inner and outer surfaces of the bilayer are charged and, thus, are attracted to the water molecules inside and outside the cell. The center layer of this structure is composed of fatty acids, which repel water. These chemical properties of the cell membrane ensure that the watery contents of the cell cannot leak through.

The structure of cell membranes also allows for the selective passage of certain molecules. This important feature ensures that necessary nutrients are allowed to enter the cell and that waste products are allowed to exit. While some substances cross the membrane through passive diffusion, most are transported actively by processes that require energy. The active transport of molecules across the membrane is mediated by proteins that are embedded in the cell membrane.

The cell membrane also serves as a site for the attachment of proteins involved
in essential biochemical reactions. One example is the electron transport system,
which generates adenosine triphosphate (ATP), the cell’s energy currency. In
bacteria, ATP is generated by a chain of proteins bound to the inner side of the
cell membrane. In eukaryotes, this process occurs on the inner membranes of
mitochondria. The bacterial cell membrane thus provides some of the functions
carried out by organelles in eukaryotes.

The cell wall is a tough network of fibers that encloses and protects the
bacterial cell. The substance that makes up the cell wall is a unique polymer
called peptidoglycan, which is not found in eukaryotes. Peptidoglycan is made of long
sugar molecules that are connected to each other by short peptides. Bacteria can
be divided into two major groups based on the structure of their cell walls.
Gram-positive bacteria have a thicker peptidoglycan cell wall that will turn purple when
treated with a Gram’s stain. The cell walls of gram-negative bacteria are surrounded by an outer membrane, which prevents the adhesion of
a Gram’s stain. The extra protection provided by the more complex cell wall of
gram-negative bacteria makes them less sensitive to some antibiotics,
which can penetrate the cell walls of only the gram-positive bacteria.

Several classes of antibiotics target the cell walls of bacteria.
Penicillins, cephalosporins, and vancomycin
interfere with cell-wall construction, causing the bacteria to rupture and die.
The goal in treating bacterial infections with antibiotics
is to kill the intended organisms without damaging the cells of the host. Because
human and animal cells lack cell walls, they are not affected by such drugs.

The internal components of bacteria use nutrients in the environment to allow
the organisms to grow and reproduce. The bacterial cytoplasm is rich with
ribosomes. As in eukaryotic cells, bacterial ribosomes carry out protein synthesis
and are made of ribonucleic acid (RNA). Slight differences in the structure of
eukaryotic and prokaryotic ribosomes make the ribosome a target for antibiotic
action. Multiple classes of antibiotics, including streptomycin (and its
relatives), tetracycline, and erythromycin, disrupt protein synthesis in
bacteria but not in the cells of the host.

Bacterial DNA is organized into one large ring-shaped chromosome. In contrast to eukaryotes, the bacterial chromosome is not encased in a nucleus. The bacterial chromosome contains all the information needed to provide for the basic functions of the organism. Bacteria may also contain circular DNA structures called plasmids. The genes on plasmids are not usually necessary for survival, but they may become so in certain environments; plasmids can carry genes for antibiotic resistance, allowing the host bacteria to survive in the presence of a drug that is normally deadly to its species.

Specialized Features

The variety of specialized features found in bacteria reflects their adaptation to the broadest range of environments of any organism on Earth. Bacteria are diverse in their size and morphology. Although the average size of a bacterial cell is 1 to 5 micrometers (m) in diameter, they range in size from 0.1 to 750 m in diameter. One of the most distinguishing features of bacterial cells is their shapes, which can be used diagnostically. The most common shapes are spheres (cocci), rods (bacilli), comma shapes (vibrios), and spirals (spirochetes and spirillum).

Many bacteria have developed specialized structures that allow them to move in their environment. Some have flagella, which are long filaments that protrude from the cell wall and are used to produce a swimming motion. The arrangement of flagella on the bacterial cell depends on the species. A cell can have a single flagellum or multiple flagella, either clumped at one end of the cell or spread over the entire surface. Some bacteria exhibit a gliding motion, which is created by structures known as pili. These cell surface projections can extend and retract, causing the bacteria to move. Bacteria also use pili to attach to surfaces and to each other. Some aquatic bacteria use gas vesicles to adjust their position in their environment. Gas vesicles are hollow structures made of protein. When present, they increase the buoyancy of the organism, making it rise to the water surface. Gas vesicles disintegrate and reassemble according to the concentration of nutrients in the cell.

Capsules are specialized structures that add an extra layer of protection to the exterior of some bacterial cells. The capsule is made of a polysaccharide-containing material that forms rigid layers on the cell wall’s exterior. Species that have capsules are extremely resistant to the action of phagocytes, cells of the host immune system that engulf and kill bacteria. Capsule-bearing strains of Streptococcus pneumoniae, for example, cause a particularly invasive and dangerous form of pneumonia.

Some species of bacteria can survive harsh conditions by forming endospores,
which allow the bacteria to become dormant. Endospores, small cells that develop within bacterial cells, contain DNA and a
portion of the cytoplasm. A strong wall surrounds and protects the endospore. Once
the bacteria die, the endospores are released into the environment, where they can
survive indefinitely. These tough structures are resistant to heat, radiation,
chemicals, and desiccation. When environmental conditions improve, the endospore
rapidly germinates and develops into a bacterial cell. Endospore-forming bacteria
include Bacillus anthracis, which causes anthrax, and
Clostridium botulinum, responsible for a serious form of food
poisoning called botulism.

Bacterial Growth

Bacteria possess all the machinery necessary to grow and reproduce independently of other cells. They are the smallest creatures on Earth that have this capacity. While they may use a host organism as a habitat, nearly all bacteria can reproduce without invading host cells. This feature sets them apart from viruses, which carry their own genetic material but require host-cell components for reproduction. The small size and relatively simple structure of bacteria allow them to grow and reproduce much faster than eukaryotic cells.

Bacteria reproduce asexually by dividing in half, in a process called
binary
fission. Individual bacterial cells grow continuously, making copies of
their components and duplicating their DNA. The two copies of the chromosome move
toward opposite ends of the cell, ensuring that each “daughter” cell will receive
this essential DNA. When enough new material is present to sustain two cells, the
cell membrane begins to pinch inward at the center. A cell wall grows to form a
partition that divides the cell into two daughter cells. Because bacterial
reproduction is asexual, each daughter will be identical to the parent cell.

Populations of bacteria grow at a rate determined by the time it takes individual cells to grow and divide, creating the next generation. The population doubles in size with each generation. The time required for a population of cells to double is known as the doubling time. Bacterial doubling times vary with the species, ranging from a few minutes to several hours. The nearly explosive growth rate of bacteria is about one hundred times faster than that of eukaryotic cells. Rapid binary fission allows bacteria to become extremely numerous in a short amount of time. If one bacterium with a doubling time of twenty minutes were allowed to grow for forty-four hours, the resulting mass of bacteria produced would equal the mass of the earth.

Factors Affecting Bacterial Growth Rates

The actual occurrence of exponential bacterial growth is greatly limited by environmental factors, both in natural habitats and in laboratories. Long before a bacterial population could grow to match the earth’s mass, the supply of nutrients in the environment for the bacteria would be depleted. Bacterial growth rates are highly dependent on many factors, including temperature, the availability of nutrients, pH (acidity), and oxygen concentrations. Measures that reduce the rate of bacterial growth can be used to prevent illnesses caused by bacteria; most pathogenic bacteria must be present in large numbers to cause illness.

The optimal temperature for bacterial growth depends upon the species. Bacteria that live inside humans, including those of medical significance, thrive at an optimal temperature of about 98.6° Fahrenheit (37° Celsius). They can survive at temperatures generally ranging from 50° to 118.4° F (10° to 48° C), but their growth rates will be significantly reduced at lower temperatures. Their ability to survive below the optimal temperature may allow them to live outside a host for short periods until they enter a new host. This temperature tolerance facilitates the spread of bacteria from one host to another.

Bacterial growth rates can be reduced by controlling the temperature of the environment. Refrigeration of food slows the growth of bacteria, keeping their numbers low enough to prevent illness. Aqueous solutions heated to boiling 212° F (100° C) for thirty minutes will kill all bacteria in the solution. Medical instruments and solutions can be sterilized in an autoclave by heating above 248° F (120° C), which kills bacteria and heat-tolerant endospores.

Bacteria take in nutrients from their environment. Specific nutrients will vary depending on the habitat of a given species. General nutritional requirements of most bacteria include a carbon-source for energy, such as sugar; a nitrogen source, such as ammonia or nitrate; a variety of minerals and salts; vitamins; and other growth factors.

Bacteria are sensitive to the pH of their environment and can live only within
a relatively narrow pH range. Most species of bacteria grow optimally in neutral
environments, with a pH level between 6 and 8. Some species are specially adapted
to live in extremely acidic or basic environments. The optimal pH of a given
species will determine where it thrives, even within the human body. The stomach,
with a pH of 2, is home to low numbers of acid-tolerant species of
lactobacilli and streptococci. The large intestine, with
a neutral pH of 7, is a much more popular residence; enormous numbers of bacteria
from a minimum of ten different species live in the large intestine. The
sensitivity of most bacteria to low pH can be used to inhibit bacterial growth, as
occurs when foods are pickled in vinegar.

The presence of oxygen in the environment is another factor that affects bacterial growth. Most species, the aerobes, require oxygen for growth. For these species, low oxygen will cause a decrease in growth rate; if oxygen levels fall too low, they will not survive. For other species, the anaerobes, oxygen is not necessary for growth. Oxygen is toxic to some species; these obligate anaerobes cannot survive in environments where oxygen is present. Oxygen tolerance is an attribute used to identify bacterial species.

Impact

Bacteria are ubiquitous, and they will remain so. They have developed diverse traits that allow them to thrive in an amazing variety of habitats, including unimaginably harsh conditions. Their demonstrated adaptability should give pause and guide future scientific and medical strategies for preventing and treating bacterial illnesses.

Bibliography

Braude, Abraham I., Charles E. Davis, and Joshua Fierer. Infectious Diseases and Medical Microbiology. 2d ed. Philadelphia: W. B. Saunders, 1986. Microbiology from a medical perspective, designed for medical students. Provides a systematic approach, with highly detailed information about pathogens.

Brooker, Robert J., et al. Biology. New York: McGraw-Hill Higher Education, 2008. A standard biology textbook for undergraduate college students. Bacterial structure and reproduction covered in a concise manner, with excellent photographs.

Koch, Arthur L. The Bacteria: Their Origin, Structure, Function, and Antibiosis. Bloomington, Ind.: Springer, 2006. Evolutionary history of bacterial structures.Focuses on how the evolution of the cell-wall structure led to diversification of bacterial species. Covers the mechanism of action of cell-wall antibiotics and presents an evolutionary perspective on antibiotic resistance.

Madigan, Michael T., and John M. Martinko. Brock Biology of Microorganisms. 12th ed. Upper Saddle River, N.J.: Pearson/Prentice Hall, 2010. A standard microbiology textbook for undergraduate students, with detailed descriptions of cell structures and clear illustrations. Includes evolutionary perspectives and covers pathogenesis.

What is leishmaniasis?

Causes and Symptoms

Leishmaniasis, also known as kala-azar in its visceral form, is a parasitic disease that strikes nearly two million persons each year. At least 350 million persons, from more than ninety subtropical and tropical countries around the world, are at risk of contracting the disease. Leishmaniasis has received more attention among United States’ medical authorities because of the risk of contracting the disease faced by US military personnel in Southwest Asia, including Iraq, and Central Asia, including Afghanistan. Leishmaniasis may be a contributor to the complex of illnesses called Gulf War
syndrome reported from veterans of the first Persian Gulf War in 1991.

Leishmaniasis is caused by any of more than twenty species of the protozoan
parasite
Leishmania. They are transmitted by the bites of sandflies, small bloodsucking insects in the subfamily Phlebotominae. The parasite may also be transmitted by blood transfusion, sharing of needles by intravenous drug abusers, and other modes not requiring the bite of a sandfly. Humans are one of many mammalian hosts of these parasites. Infection can cause skin disease, called cutaneous leishmaniasis. Leishmania can also affect the mucous membranes, frequently resulting in ulcers, or cause systemic disease called visceral leishmaniasis, which is often fatal. Infection in children is usually sudden, with symptoms including vomiting, fever, abdominal discomfort, diarrhea, weight loss, and cough. Adults suffer from similar symptoms, but they may be accompanied by nonspecific symptoms such as fatigue, weakness, and loss of appetite. The skin may become darker, dry, and flaky, and
the hair may begin to thin. Other signs include an enlarged spleen, liver, and lymph nodes.

Diagnosis is based on demonstration of the organism in spleen pulp, lymph nodes, liver, or peripheral blood. Species of Leishmania cannot be differentiated morphologically. They are distinguished on the basis of the disease produced, the host and its immune response, and geographical distribution.

Treatment and Therapy

Compounds containing the mineral antimony are the principal medications used to treat leishmaniasis. These compounds include meglumine antimonite and sodium stibogluconate. When these drugs are ineffective, other antiprotozoan medications may be utilized, including amphotericin B, pentamidine, flagyl, and allopurinol. With mucocutaneous leishmaniasis, plastic surgery may be needed to correct the disfigurement caused by destructive facial lesions. Removal of the spleen may be required in drug-resistant cases of visceral leishmaniasis. Relapse may occur and infection may persist despite treatment.

Perspective and Prospects

Cases of infection by Leishmania have been reported on all the continents except Australia. In the Americas, Leishmania can be found from southern Mexico into the South American continent. The disease is widespread in the tropics. In the United States, cases have been reported in dogs, cats, and humans in Texas, Ohio, and Oklahoma.

The prognosis for leishmaniasis is quite variable and depends on the specific strain of infecting protozoan, as well as on the individual patient’s immune system response to infection. Cure rates are high with antimony compounds. There are no preventive vaccines. Preventing sandfly bites is the most immediate form of protection. Insect repellent, appropriate clothing, screening of windows, and fine mesh netting will reduce exposure.

Bibliography

Centers for Disease Control and Prevention. "Parasites—Leishmaniasis." Centers for Disease Control and Prevention, January 10, 2013.

Chang, K.-P., and R. S. Bray, eds. Leishmaniasis. New York: Elsevier, 1985.

Hide, G., et al. Trypanosomiasis and Leishmaniasis: Biology and Control. Wallingford, Oxon, England: CAB International, 1997.

Lane, R. P. “Sandflies (Phlebotominae).” In Medical Insects and Arachnids, edited by Richard P. Lane and Roger W. Crosskey. New York: Chapman & Hall, 1993.

MedlinePlus. "Leishmaniasis." MedlinePlus, April 5, 2013.

Raghunath, D., and R. Nayak, eds. Trends and Research in Leishmaniasis: With Particular Reference to Kala Azar. New York: Tata/McGraw-Hill, 2005.

Ryan, Kenneth J., and C. George Ray, eds. Sherris Medical Microbiology: An Introduction to Infectious Diseases. 4th ed. New York: McGraw-Hill, 2004.

What quotation show the difference between how adults and young people feel about marriage?

Until Tybalt's death changes his mind, Juliet's father's thoughts about marriage are very moderate (at least, for his time).  Although Paris is very anxious to marry her, Capulet considers her too young -- she's not quite fourteen -- to marry right now.  He encourages Paris to "Let two more summers wither in their pride / Ere we may think her ripe to be a bride" (1.2.10-11).  In other words, he wants Paris to wait at least two more years before he brings up marriage again.  It's pretty sound advice: he's concerned that Juliet could be "marred" if she is made a wife and mother too soon.  He wants to give her time to grow up a little bit and be more sure of what she wants (and he seems to want the same thing for Paris, too). 

Romeo and Juliet, on the other hand, are utterly immoderate and ready to rush into marriage, betrothing themselves to one another on the first night that they meet.  From her balcony, she says to him, "If that thy bent of love be honorable, / Thy purpose marriage, send me word tomorrow [...]" (2.2.150-151).  She says that if Romeo's feelings for her are sincere, he should figure out where and when they can marry and then let her know.  At this point, knowing that he's the son of her father's enemy, having only known him herself for a few hours at most, Juliet is prepared to lay "all [her] fortunes at [his] foot [...] / And follow [him] throughout the world" (2.2.154-155).  She will give up everything, relinquishing family and fortune, just to be with him. 

Why should we care about Frederick Douglass?

Douglass was one of the first great African-American public intellectuals, who not only shaped the discourse about slavery and black life in America, but also came to represent the indomitable spirt of those who fought slavery and stood up against oppression. Douglass escaped from slavery at the age of 20, fled to Massachusetts, where in 1845 he penned his seminal autobiography, Narrative of the Life of Frederick Douglass, an American Slave. 

That book, which vividly described the circumstances and psychological toll of his enslavement, became not just a best-selling memoir, but also a rallying cry against the institution of slavery. Having written the book, Douglass became a staple of the abolition movement's national speaking tour, following William Lloyd Garrison and other prominent abolitionist intellectuals around the country to convince ordinary Americans that slavery was not only unjust, but a bad policy for the country.

During and directly after the Civil War, Douglass became a close adviser and confidante to Abraham Lincoln, becoming the first African-American to be invited to stay at the White House. Douglass's passion for justice also led him to take up the fight for Women's Suffrage, along with Elizabeth Cady Stanton, whom he accompanied to the famous Seneca Falls Convention on Women's Rights in 1848. 

Once the Civil War was over, Douglass became the first black American to be appointed to a federal post, when during Reconstruction, he served as President of the Freedman's Savings Bank. Subsequently, Douglass served as head of the diplomatic mission for United States Embassy in the Dominican Republic, and later served as a minister in Haiti's government. 

In 1872, Douglass became the first African American vice presidential nominee when he ran with Victoria Woodhull for the party of Equal Rights. Along with W.E.B. Dubois and George Washington Carver, Douglass was one of the first universally celebrated African American intellectuals, who helped to demonstrate to the country and the world that Black Americans had every bit as much intelligence, courage and integrity as the whites who had held a monopoly on power.

What is the style of the narration in The Turn of the Screw?

Henry James' The Turn of the Screw is what's often referred to as a nested narrative, which is basically a fancy term for a story within a story. In James' novella, we are originally introduced to a nameless narrator, who then tells us about another narrator reading aloud the governess' written account of the main story. Thus, we're getting several layers of storytelling all at once. Many authors have used framing devices for several reasons, and James might have used this narrative style in order to increase the credibility of the story, as the realistic frame for the supernatural events make said events somewhat more credible. 

It's also worth noting that the narrative exhibits James' classically ornate style. The governess tells her story with elegant diction and long, often convoluted sentences that take considerable time for the modern reader to decipher. Additionally, the governess is constantly qualifying statements and, in some ways, questioning herself. This stylistic choice adds to the novella's ambiguous atmosphere, leaving the reader unsure of what exactly happened. 

Helen Keller called the examination time the "dreaded hour." Do you agree with her views?

Helen Keller found school examinations to be tiresome and overwhelming. Helen could not simply sit down, read an examination paper, and write the answers like most students. She instead had to have someone finger spell each question into her hand. She had to use a special typewriter to compose her answers. Then she had these answers read back to her using finger spelling. It was an exhausting and tedious affair. She considered school examinations to be the "chief bugbears of [her] college life."

Even though Helen studied diligently, she sometimes struggled to summon the information needed when the time came to answer the test questions. Despite her cramming, Helen sometimes found that the information she had learned would "take to themselves wings and fly away" when she needed it. This caused Helen to have trouble answering questions on the exam. Soon she realized that her test-taking time was up.

Each element is given a specific ______________that usually consists of one or two letters?

Elements are the purest form of substances. Elements consist of atoms of similar kind that have the same properties (there may be some isotopes). In comparison, compounds and mixtures are composed of atoms of different kinds. Elements are named and provided a certain symbol, consisting of one or two letters, for easy reference and reporting. For example, the element oxygen (not to be confused with oxygen gas, which is O2) has the chemical symbol O. The element sodium has a chemical symbol of Na. Similarly, precious elements such as gold and silver have chemical symbols of Au and Ag, respectively. 

These chemical symbols are used in the periodic table of elements to denote a particular element. The same chemical symbol is used for a given element throughout the world, which helps maintain a uniform standard for reporting.

Hope this helps.

In Chaucer's Canterbury Tales, how does the squire appear to embody the code of chivalry?

In terms of chivalry, Chaucer definitely stacks the deck in the squire's favor in the prologue to Canterbury Tales. The first character introduced in the prologue is the knight, who is obviously a favorite of the narrator's. The knight is all about medieval chivalry. Then, in the first line about the squire, Chaucer says “With him [the knight] was his son.” Just the simple linkage to the knight lends a chivalric air to the squire. Chaucer reinforces the idea in the second line about the squire with “on his way to knighthood.” At this point, it would be a shock if the squire turned out to be anything other than chivalric.

The squire's behavior also exemplifies the characteristics of chivalry. After telling the reader that the squire had been on cavalry expeditions, Chaucer writes:

. . . he had borne himself well,

in the hope of winning his lady's favor.

One of the characteristics of chivalry is the attitude the male takes toward the woman he loves. It is nothing like a modern courtship. Instead, a knight (or in this case, a squire, who is often an aspiring knight) puts the object of his affection on a pedestal and then goes off on military adventures with the intention of proving himself worthy of her love. To do so he must comport himself with courage and honor. He must also be what we would call a “nice guy”--which Chaucer shows the squire to be in the second to last line:

He was courteous, humble, and serviceable.

Today, to be chivalric means to be polite and helpful to a woman—opening doors, lending overcoats, walking to the car in the rain and then driving back to the restaurant door to pick up your date (where she stands sheltered and dry). In Chaucer's time chivalry was something different—the male actually put his life on the line to prove himself worthy of a woman that he had probably not yet even courted.

Chivalry also governed other aspects of knightly behavior, stipulating, among other things, that knights must be fair in battle and devoted to God.

What was Alice used for on the Waller Plantation?

Alice, in the novel, Nightjohn, represents all the horrors female slaves often endured during slavery. Alice is a little mentally disabled, and her master, Mr. Waller, decides that she would make a good breeder of children to increase his population of slaves. Alice fights against the master, and he ties her down and forces several male slaves to rape her. Alice is devastated by this experience and becomes even more despondent than ever. She wanders the plantation in a daze and enters the big house where she and other slaves are forbidden to go. Master Waller has her whipped so hard that her skin is torn from her body. He also rubs salt into her bleeding wounds. Unable to withstand the abuse, Alice runs away, and when the master’s dogs are set upon her, she stands there and lets them rip her apart. However, Alice doesn’t die, and Mammy nurses her back to health.

The novel is a testament to the horrific mental and physical abuse many slaves suffered throughout their lives. Alice’s story is especially troubling because of the ghastly, inhumane things she went through as a woman.

Do the Zoroastrians dispose of their dead in the towers of silence because of a shortage of burial space?

Formally, Zoroastrians dispose of their dead in the Towers of Silence for religious reasons. They believe that the dead body is unclean and to bury it would pollute the earth. Similarly, cremation might pollute the fire or air. Placing the bodies up  high where they are exposed to the sun and carrion birds allows for the remains to be disposed of or "recycled" in a way that prevents the spiritual pollution of the environment. 

This means of disposing of the dead has been practiced for at least three thousand years. However, it is predated by the practices of cremation and embalming before burial. Because of this, one might assume that the practice arose as a response to a lack of space for interment. That would make sense from a structural-functionalist point of view, and it is a possibility. It is also possible that there were negative consequences, such as spread of disease, which resulted from burial in the ground or in tombs. This desire to prevent the spread of disease or avoid the smell of decomposition is at the root of most burial traditions. Open-air burial is just the way that Zoroastrian people prefer to do it, believing it is the best possible means of disposal of the dead.

What is fatigue? How does it affect cancer patients?

Risk factors: In the setting of cancer, fatigue may be caused by the type of cancer and its stage, chemotherapy or radiation therapy, stress, anemia, depression, chronic pain, lack of sleep, lack of proper nutrition, nausea and vomiting, infections, dehydration and electrolyte imbalance, and weight loss.

Etiology and the disease process: The causes of fatigue in patients with cancer are not clearly understood and appear to be multiple. Fatigue can be one of the first symptoms of the presence of cancer and can also be an indication of disease progression. The disease of cancer itself can cause fatigue, primarily through the release of cytokines, which are thought to induce fatigue, the increased need of cancer cells to maintain their high rate of metabolism, and the alteration of hormone levels. The stress of having cancer also can be the cause of fatigue. Treatments can lead to fatigue as the body tries to deal with the insult of cytotoxins or radiation and tries to rebuild cells after treatment. Many biological therapies (those that attempt to strengthen the patient’s immune system to fight cancer) have flu–like symptoms, including fatigue, as side effects. Medication used as supportive care (for example, to treat depression or vomiting) can cause fatigue. Another cause of fatigue is lack of sleep, which may be caused by pain, emotional issues, depression, and anxiety. Poor nutrition, caused by lack of interest in food or an inability to eat because of mucositis, diarrhea, nausea, or vomiting, has been implicated in fatigue. Surgery for cancer may be the cause of fatigue, which often lessens as the patient recuperates and heals. One way that cancer can cause fatigue is by spreading to bone marrow, where it destroys red blood cell production and leads to anemia, the most commonly reported cause of fatigue. Both chemotherapy and radiation therapy can destroy bone marrow and cause anemia.

Incidence: Depending on the type of cancer and its treatment, approximately 14 to 96 percent of patients with cancer report feeling mentally and physically fatigued during the course of treatment while 19 to 82 percent of patients report cancer-related fatigue following treatment, according to the National Cancer Institute's 2014 estimates.

Symptoms: Fatigue is manifested by extreme tiredness and inability to perform normal daily functions. Fatigue can then lead to other symptoms, such as depression or poor nutrition (if the patient is unable to shop for groceries or cook). Because of the nature of cancer-related fatigue and its interactions with risk factors and other conditions, it is difficult to pinpoint a single symptom. Common symptoms, however, can include dizziness, confusion, inability to think clearly, loss of balance, being bedridden for more than one day, and worsening conditions (for example, increased vomiting, pain, or depression).

Screening and diagnosis: Because of the complex nature of cancer-related fatigue and its many presumptive causes, it is necessary to carefully rule out causes before effective treatment can occur. It is imperative to understand the pattern of fatigue, including when it started, how long it lasted, and how it changed the patient’s daily activity pattern. If fatigue was reported only after radiation therapy, for example, depression and other medications could be ruled out as the cause. The kind of cancer and its stage is important to know, as are known treatment-related symptoms. The side effects of chemotherapeutic agents or other medications may be instructive in determining the cause of fatigue. The health care provider should understand the patient’s sleep patterns before starting treatment for cancer as well as during treatment for cancer. It is important to know if the patient’s eating habits have changed. Patients should be screened for depression, as this is a common cause of fatigue. Patients may be depressed because of their cancer or because they fear losing their jobs, are having financial difficulties, or are upset about their inability to perform their normal daily activities.

Anemia, which is a common cause of fatigue, can be determined through blood tests. Depression scores can be determined through the use of various screens. No staging is available, however, for grading cancer-related fatigue.

Treatment and therapy: To be treated properly, the source of fatigue whether is it physical, emotional, or psychological must be determined. Because anemia is the most common cause of fatigue, blood tests generally are done to check for low red blood cell counts, low hemoglobin concentration, or both. Anemia can be corrected by blood transfusions. After a focused review, in 2010 the US Food and Drug Administration approved a new risk management program and demanded updated warnings and revised dosing instructions for the use of erythropoiesis-stimulating agents (ESAs) in the treatment of anemia as these agents were found to decrease survival and/or augment the chance of tumor development or reappearance in patients with several types of cancer.

Fatigue due to lack of sleep, depression, or poor nutrition generally can be helped by administration of supportive care, such as drugs, or correction of an underlying cause, such as the inability to shop for and prepare food.

Patients may be able to help themselves by being aware of what causes their fatigue. It may be important to schedule regular naps or limit the number of visitors. It is important to save energy for important tasks and to ask for help with other tasks. Energy levels may be maintained by scheduling regular eating times, including healthy snacks, limiting caffeine and alcohol, and drinking increased amounts of fluids. Some patients report that mild to moderate exercise also helps fight cancer-related fatigue, allows for a better frame of mind, and increases the ability to sleep at night. Exercise can include aerobic or resistance training. Relief of cancer-related fatigue may also come from practicing yoga or meditation. Research suggests that psychosocial interventions, such as group or individual therapy, education, stress management, or support groups, also have a positive effect on cancer-related fatigue.

Prognosis, prevention, and outcomes: Because cancer-related fatigue is often caused by many overlapping factors, it is difficult to predict which patients will be most affected. Fatigue may subside once treatments are completed and the patient’s bone marrow has recovered. Fatigue may increase as the cancer stage progresses and the cancer spreads in the body.

Bower, Julienne E., and Donald M. Lamkin. "Inflammation and Cancer-Related Fatigue: Mechanisms, Contributing Factors, and Treatment Implications." Brain, Behavior, and Immunity 30 (2013): S48–S57. Print.

"Fatigue." National Cancer Institute. Natl. Cancer Inst., 28 Aug. 2014. Web. 10 Sept. 2014.

Hofman, Maarten, et al. “Cancer-Related Fatigue: The Scale of the Problem.” Oncologist 12 (2007): 4–10. Print.

Minton, Ollie, et al. "Cancer-Related Fatigue and Its Impact on Functioning." Cancer 119.S11 (2013): 2124–30. Print.

Morrow, Gary R. “Cancer-Related Fatigue: Causes, Consequences, and Management.” Oncologist 12 (2007): 1–3. Print.

Ryan, Julie L., et al. “Mechanisms of Cancer-Related Fatigue.” Oncologist 12 (2007): 22–34. Print.

Weis, Joachim, and Markus Horneber. Cancer-Related Fatigue. New York: Springer Healthcare, 2014. Print.

What is atrial fibrillation?

Causes and Symptoms

Atrial fibrillation, also called A-Fib or AF, may occur with or without heart abnormalities, but commonly there is an underlying heart condition. Patients with atrial fibrillation often have a stiffening of the arteries, aortic stenosis, or enlargement of the left ventricle. Also, hypertension (high blood pressure) is a predisposing factor of this conduction irregularity. Other risk factors include aging, obesity, sleep
apnea, diabetes, and myocardial infarction (heart attack). An accurate model to describe the cause of atrial fibrillation is one recognizing the interdependence between genetics, the heart’s response to risk factors, and aging.

Atrial fibrillation is usually characterized by electrical conduction abnormalities seen on an electrocardiogram (ECG or EKG), which analyzes the heart’s rhythm. Three common conduction abnormalities are intermittent, persistent, and permanent.

The disease is characterized by a variety of symptoms, and some patients are without symptoms. A patient might describe feeling either a slow heartbeat (for example, heart “pauses”) or a fast heartbeat. Other symptoms that may occur during an atrial fibrillation episode are shortness of breath, lightheadedness or dizziness, fatigue, and chest discomfort.

Treatment and Therapy

There are generally three treatment categories for atrial fibrillation: acute, subacute, and chronic. The primary goal of therapy, when possible, is restoring the heart to a sinus rhythm. Additionally, treatments focus on preventing thromboembolic complications of atrial fibrillation and rate control.

If the patient is experiencing acute atrial fibrillation, then the causative factors should be addressed. Often, electrical cardioversion is still the treatment of choice. Heart rates often are controlled effectively with medications such as beta-blockers, calcium channel blockers, or digoxin. Rare complications including embolic stroke may result because of the lack of proper blood flow in the atria coincident with the abnormal contractions (fibrillation). Anticoagulants (blood thinners) such as aspirin or warfarin are used to prevent stroke. In some instances, ablation therapy, antiarrhythmic medications, or the Maze procedure (which creates new electrical pathways through the heart using scar issue) may be used.

Lifestyle changes such as trigger avoidance and regular exercise may help patients avoid recurrences of acute atrial fibrillation.

Perspective and Prospects

It is projected that atrial fibrillation will continue to increase in incidence worldwide over the next few decades. Therefore, improvements in both the classification and the characterization of the disease are imperative. Refining the understanding of genetics, such as chromosome 4 variants, offer prospects for intervention. Stroke prevention, comprehensive treatment including both rate and rhythm control, and management of underlying conditions may also help mitigate atrial fibrillation.

Bibliography

A.D.A.M. Medical Encyclopedia. "Atrial Fibrillation or Flutter." MedlinePlus, June 22, 2012.

Camm, A. John, Thomas F. Lüscher, and Patrick W. Serruys, eds. The ESC Textbook of Cardiovascular Medicine. 2d ed. New York: Oxford University Press, 2009.

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

Fox, C. S., et al. “Parental Atrial Fibrillation as a Risk Factor for Atrial Fibrillation in Offspring.” JAMA: Journal of the American Medical Association 291, no. 23 (2004): 2851–2855.

Mosby’s Medical Dictionary. 8th ed. St Louis: Mosby, 2009.

Wood, Debra, and Michael J. Fucci. "Atrial Fibrillation." Health Library, November 9, 2012.

What is the relationship of the theme and conflicts in Fahrenheit 451 by Ray Bradbury with our current society? Do you believe that the warnings...

Censorship, the main theme of Fahrenheit 451 by Ray Bradbury, has been around almost since people first started reading. That may be a slight exaggeration, but history tells us that certain books were banned at least as far back as 221 B.C.E. when Ying Zheng took over as emperor of the Qin during the Imperial Dynasty in China.  He had many Confucians killed and had their books burned because he disagreed with them. 

One might think our society is above all that, and while it is true that in the United States people are not executed for reading books, censorship is alive and well. Every year, parents ask that certain books be banned from school libraries and in classrooms. The Adventures of Huckleberry Finn by Mark Twain was first banned in the United States in 1885, and it is still one of the books most often challenged today. The biggest criticism comes because of the language, especially that used to describe African Americans, but when Mark Twain wrote it, he was using the language of his day.

Cartoonists have had their lives threatened for publishing their depictions of the prophet Mohammed. Newspapers and publishers have been threatened as well, and violence has occurred against them, such as the Charlie Hebdo killings in France.

Another "banned" book is Fahrenheit 451 itself, which is pretty ironic, don't you think? People, again, object to the language and often cite religious reasons for not wanting their children to read it. Bradbury's book is important because it is a warning of what might come to pass if we get rid of books. The Fahrenheit world is one where everyone is told what to think, what to do, how to act. Nobody is allowed to think for him/herself. Books help us to do that. From books we can learn about other cultures, other cities, states, countries, continents, etc. They open up an entire world for us. Some people are frightened by that. 

Others rebel against the idea of censorship, and a week called "Banned Books' Week" is celebrated every year around the end of September. I've included a link to an article about it at the bottom. 

So, yes, Bradbury's book is still very relevant today. He wrote it in 1953, highly influenced by the events in WWII Germany. In an interview on January 5, 2005, he answered a question about his motivation for writing Fahrenheit 451.

"Well, Hitler of course. When I was fifteen, he burnt the books in the streets of Berlin. Then along the way I learned about the libraries in Alexandria burning five thousand years ago. That grieved my soul. Since I'm self-educated, that means my educators--the libraries--are in danger. And if it could happen in Alexandria, if it could happen in Berlin, maybe it could happen somewhere up ahead, and my heroes would be killed" (Interview with Dana Giola).

How does Lyddie find the value of reading in Lyddie?

Diana and Betsy teach Lyddie how to read with Oliver Twist.

Lyddie has very little education, but that doesn’t mean she doesn’t want one.  She had to stop going to school when her father left because her mother was not capable of taking care of her younger sisters.  Later, when Lyddie started working at the factory, she was embarrassed because she could not properly read and write.

"Not so much time to read these days," Diana said. "We used to have more time. Do you like to read, Lyddie?"

Lyddie thought of the regulations that she was still trying laboriously to decipher when no one was looking. "I've not much schooling." (Ch. 9)

Lyddie learns to read and write because the other factory girls teach her.  She particularly likes Oliver Twist, a story by Charles Dickens about a young orphan living in terrible conditions.

She fought sleep, ravenous for every word. She had not had any appetite for the bountiful meal downstairs, but now she was feeling a hunger she knew nothing about. She had to know what would happen to little Oliver.  (Ch. 10)

With Betsy and Diana teaching Lyddie how to read and the joy of Oliver, Lyddie learns to value reading as much as anything else.  She looks forward to every chapter, and uses the book to learn how to read and write.  With this skill she writes letters home.

Later, Lyddie also teaches a new factory girl, an Irish girl named Brigid, how to read.  She even gives the girl a copy of Oliver Twist when she gets fired.  The book has become so important to her that she can’t bear to part with it, but she also wants to make sure that Brigid can continue her education without her.  Lyddie buys herself a dictionary, so she can learn the meaning of words.

What is Chagas disease?

Causes and Symptoms

Chagas disease, also known as American trypanosomiasis or South American trypanosomiasis, is a parasitic disease that affects millions of persons in both North and South America. More than 15 million persons are infected—most from Mexico south throughout South America—and about 50,000 die from the disease each year. More than 100 million are at risk of contracting the disease.

The protozoan Trypanosoma cruzi that causes Chagas disease is transmitted by the conenose bug (order Hemiptera, family Reduviidae, subfamily Triatominae), also known as the reduviid, assassin, or kissing bug. The feces of the bugs contain the parasites, which enter a human host through broken skin or mucous membranes. Entry of the parasites into cells in the subcutaneous tissue triggers an acute local inflammatory reaction. Within one to two weeks of infection, the trypanosomes spread to the regional lymph nodes and begin to multiply in the cells that phagocytose (digest) them. Chagas disease also can be transmitted by blood transfusion; by organ transplantation, especially heart; and by triatomine bugs.

Chagas disease is manifested in acute and chronic phases. Symptoms of the acute phase (most common in children) include anemia, loss of strength, nervous disorders, chills, muscle and bone pain, and varying degrees of heart failure. Death may ensue three to four weeks after infection. Symptoms of the chronic phase (most common in adults) include those of the acute phase, plus central and peripheral nervous dysfunction, which may last for many years and eventually lead to heart failure.

Treatment and Therapy

Unlike many other trypanosomes of humans, T. cruzi does not respond well to chemotherapy. The most effective drugs kill only the extracellular protozoa, but the intracellular forms defy the best efforts at eradication. The reproductive stages, which occur inside living host cells, seem to be shielded from the drugs. Nifurtimox and benznidazole have been shown to be somewhat effective in curing acute infections, but they require long treatment durations and have significant side effects.

Perspective and Prospects

In 1910, Carlos Chagas dissected a number of assassin bugs and found their hindguts swarming with trypanosomes some twenty years before they were known to cause disease. A century later, progress in controlling this harmful disease has been slow.

The 2005 report of the Scientific Working Group on Chagas Disease calls for, among other things, pediatric formulations of the two main drugs used to treat the disease, better diagnostic tools, better ways to screen donated blood to prevent transmission by transfusion, and improvements in control of the insects involved in transmission of the disease.

Bibliography:

Dorn, Patricia L., et. al. “Autochthonous Transmission of Trypanosoma cruzi, Louisiana.” Emerging Infectious Diseases 13, no. 2 (April, 2007).

Mascola, L., et. al. “Chagas Disease After Organ Transplantation—Los Angeles, California, 2006.” Morbidity and Mortality Weekly Report (MMWR) 55, no. 29 (July 28, 2006): 798–800.

MedlinePlus. "Chagas Disease." MedlinePlus, Jan. 14, 2013.

Perleth, Matthias. Historical Aspects of American Trypanosomiasis (Chagas’ Disease). Frankfurt, Germany: Lang, 1997.

Tarleton, Rick L. “Pathology of American Trypanosomiasis.” In Immunology and Molecular Biology of Parasitic Infections, edited by Kenneth S. Warren. 3d ed. Boston: Blackwell, 1993.

World Health Organization. Control of Chagas Disease: Second Report of the WHO Expert Committee on Chagas Disease. Geneva, Switzerland: Author, 2002.

What happened when the narrator of "A Poison Tree" did not express his anger?

In "A Poison Tree," the narrator says that his anger grew.  And he uses the growth of the tree as an extended metaphor for his anger, his wrath, viewing the anger like a tree that must be  given sunshine and water, so it will grow.  He waters it with "tears" (line 6) and suns it "with smiles" (line 7).  And the tree, or his anger, rather, grows and thrives, "Till it bore an apple bright (line 10). This apple, the fruit of his anger, attracts the narrator's foe, who eats it, only to be killed by the toxicity of the narrator's anger.  When we hold onto our anger, it is toxic, to our foes, certainly, but also to ourselves.  While there is no doubt some righteous anger to be felt for various reasons, it is keeping it to ourselves and holding onto it that causes the most harm.  

In which country did William Shakespeare die?

William Shakespeare is a famous playwright and poet who lived during the Elizabethan Period of England. He was born sometime in 1564, though our best guess comes from his baptismal record rather than any birth certificate. (Parents would sometimes wait days or weeks to be sure that mother and child were both well before performing a baptism.) Shakespeare spent his whole life in England—part in London and the rest in Stratford-Upon-Avon, where he was born. On April 23, 1616, William Shakespeare passed away in his hometown and was buried in the Holy Trinity Church two days later.

One can still visit Stratford-Upon-Avon today in Warwickshire County, England. Today, many fans and students of Shakespeare, as well as tourists, are drawn to England to see the sites of Shakespeare's life like the Globe Theatre in Southwark or his grave in Stratford-Upon-Avon.

What is systematic desensitization?

Introduction

Systematic desensitization, also called graduated exposure therapy, is a behavior therapy used in the treatment of fears, phobias, and anxiety disorders. The therapist asks the client to imagine successively more fear- or anxiety-arousing situations while engaging in a behavior, generally relaxation, which competes with being afraid or anxious. With treatment, the client’s fear or anxiety reactions gradually subside. Therapeutic intervention is warranted when the intensity of the fear or anxiety is disproportionate to the actual situation, interferes with normal functioning, and affects the quality of life.

Systematic desensitization involves three steps. First, the therapist teaches the client the technique of deep muscle relaxation or some other response that is incompatible with fear or anxiety. Deep muscle relaxation training involves first learning to distinguish between relaxed and tense states of different skeletal muscle groups and then learning to achieve deep muscle relaxation on command without tightening the muscles. Second, the therapist helps the client construct an anxiety hierarchy in which situations are ordered from least to most anxiety-evoking. Multiple hierarchies may be needed if a client has several problems, and the hierarchies may be modified if new concerns arise during treatment. Third, the therapist instructs the client to maintain a state of relaxation while imagining a scene from the anxiety hierarchy as it is described by the therapist (imaginal exposure). Therapy begins with the item on the hierarchy that elicits the least discomfort and advances to the next item only after the client can reliably relax to the presentation of the preceding item. Each scene is imagined for a few seconds at a time. If the client experiences an increase in fear while imagining a scene, the therapist instructs the client to discontinue imagining the fear-eliciting item and to concentrate on relaxing. The third step may be done under hypnosis.

The goal of systematic desensitization is to replace the anxiety associated with an item on the anxiety hierarchy with a new and competing response such as relaxation. The premise underlying this treatment is that a person cannot be simultaneously afraid and relaxed. For example, physiological correlates of fear such as rapid heart beat and increased respiration rate are the opposite of those associated with deep muscle relaxation in which the heart beat and breathing rate are slowed. During therapy, a client will also be encouraged to confront in real life (in vivo exposure) the imagined situations that no longer elicit fear in the treatment sessions.

Clinical psychologists Peter Lang and David Lazovik, along with others, conducted a number of laboratory studies of systematic desensitization in the 1960s using snake-phobic college students. One study of twenty-four snake-phobic students reported that students benefited significantly from their treatment both in the short term and at a six-month follow-up, as measured by avoidance of an actual snake and self-ratings. Moreover, there was no evidence of symptom substitution, a concern Freudian psychoanalysts had expressed about treatment of the overt manifestation of anxiety (fear and avoidance of snakes) rather than the underlying unconscious and unresolved conflict (anxiety about sex).

Subsequent research has shown that the essential component in systematic desensitization is repeated exposure to situations or stimuli that elicit fear or anxiety but with no actual negative consequences for the client. Exposure is generally considered one of the most powerful and dependable methods for reducing or eliminating human fears and anxiety, and is the key element in the behavioral component of cognitive behavior therapy.

History

Systematic desensitization was developed by the South African psychiatrist Joseph Wolpe during the 1950s on the basis of counterconditioning experiments he did with cats from June 1947 to July 1948 at the University of Witwatersrand. After using classical conditioning to make cats afraid of their cages, Wolpe demonstrated that their conditioned fear response could be eliminated by feeding the cats at locations progressively closer to their cages. This finding confirmed a 1924 report of counterconditioning by Mary Cover Jones, a student of the behaviorist John B. Watson, who successfully extinguished a young boy’s fear of rabbits by very gradually moving a rabbit toward the boy as he ate.

In developing a method for extinguishing human fears, Wolpe modified and shortened the progressive muscle relaxation (PMR) method perfected by the physician Edmund Jacobsen in the 1930s, which could take more than two hundred hours to master. Wolpe also pioneered the idea that treatment of anxiety elicited by an imagined situation would transfer to its real-life counterpart. In Psychotherapy by Reciprocal Inhibition (1958), Wolpe reported that 90 percent of his clients showed significant improvement with systematic desensitization.

Underlying Theory

Wolpe’s observations of his fearful cats learning to eat in the presence of gradually incremented anxiety-evoking cues convinced him that eating inhibited their fear reactions. He formulated the principle of reciprocal inhibition: When an animal eats in the presence of a fear stimulus, an inhibitory connection is strengthened between the fear stimulus and the fear reaction. Thus, if a response (fear) is inhibited by an incompatible response (eating) and followed by reinforcement (for example, a reduction in drive), a significant amount of conditioned inhibition of the fear response will develop to the fear-eliciting stimulus. The theoretical influences of the Russian physiologist Ivan Petrovich Pavlov and of the psychologist Clark L. Hull are evident in Wolpe’s concept of reciprocal inhibition.

Reciprocal inhibition is a defining feature of the widely accepted dual process theory of motivation. According to this theory, there are two motivational systems underlying behavior, one that is appetitive, or positive, and the other that is aversive, or negative. Activation of the positive motivational system inhibits the negative motivational system, and activation of the negative motivational system inhibits the positive motivational system. Such reciprocal inhibitory links explain why an anxious person or fearful animal generally has no appetite.

Clinical psychologists Michael D. Spiegler and David C. Guevremont summarize additional explanations for why systematic desensitization works, including simple extinction; changes in the client’s thinking, such as being more realistic, having altered expectations, or increased self-confidence; and attention from the therapist.

Variations

Relaxation is the most frequently used competing response in systematic desensitization but it is not always optimal for some clients. Children, for example, may find it easier to use pleasant thoughts or humor and laughter as responses incompatible with anxiety. Other competing responses that may, under some conditions, be more appropriate than relaxation are sexual arousal, assertive behavior, and eating.

Fear or anxiety is the most common response to be treated with systematic desensitization, but treatment of other negative reactions including anger, jealousy, motion sickness, speech disorders, and racial prejudice has been successful. In Psychotherapy by Reciprocal Inhibition, Wolpe describes the case of a twenty-seven-year-old male client, Mr. E., whose unreasonable jealousy was threatening his engagement to Celia, his girlfriend. Whenever Celia said something nice about another man, Mr. E. experienced intense feelings of jealousy that would persist for days, making him irritable and excessively critical of anything Celia did. Following several interviews and training in relaxation, an anxiety hierarchy was constructed. Treatment was conducted under hypnosis and began with the lowest disturbing item: Celia commenting that his friend John (who was not viewed as much of a competitor by Mr. E.) has a nice way about him. After several months of imaginal exposure and various modifications to the anxiety hierarchy, Mr. E., who by then was married to Celia, could tolerate her speaking excitedly to another young man at a party.

Advances in technology have allowed therapists to use virtual reality or computer simulated exposure to replace in vivo exposure, which is not always practical, affordable, or safe. In a review of the research on virtual reality applications to mental health, clinical psychologists Lynsey Gregg and Nicholas Tarrier conclude that the relative effectiveness of exposure technology, in vivo and imaginal exposure, has yet to be fully determined.

Comparisons

A study by clinical psychologist Gordon L. Paul compared systematic desensitization and insight-oriented psychotherapy (which focuses on the source of a phobia) for the treatment of students with severe anxieties about public speaking. In a two-year follow-up, 85 percent of those in the systematic desensitization group showed significant improvement relative to pretreatment compared with 50 percent in the psychotherapy group and 22 percent in an untreated control group. Once again, there was no evidence of symptom substitution: no one in the systematic desensitization group reported new fears.

In their 2004 paper, clinical psychologist F. Dudley McGlynn and colleagues discuss reasons for the abrupt decline in academic-research interest in systematic desensitization based on relaxation in the 1970s and its reduced use in clinical practice since the 1980s. The decrease in peer-reviewed papers on systematic desensitization is attributed to a change in editorial policy toward studies using a pretreatment and posttreatment comparison to assess the effectiveness of systematic desensitization. The methodology used in such analogue desensitization studies was sharply criticized by clinical psychologists Douglas A. Bernstein and Gordon L. Paul. Their influential critique raised concerns about uncontrolled experimental demand effects and whether subjects were sufficiently phobic for meaningful conclusions to be drawn about treatment efficacy. Clinicians lost interest in systematic desensitization first because of the emergence of competing therapies, most notably flooding, implosive therapy, and participant modeling, and later because of the emergence of exposure technology and the shift toward cognitive behavior therapy.

Application to Animals

Applied animal behavior science is a field that covers research on and the treatment of behavior problems in companion animals or other domestic animals. Counterconditioning has been used to treat a variety of fear-related behavioral problems in dogs, including fear of other dogs, humans, and loud noises (such as thunderstorm, fireworks, and gunshots). A common protocol for treating a noise phobia usually involves exposing the fearful dog to increasingly louder prerecorded presentations of the sound that elicits fear while simultaneously playing with the dog and rewarding with treats for maintaining a calm and relaxed demeanor. As in systematic desensitization, the dog starts exposure training with a low intensity sound that elicits negligible anxiety and is exposed to an increment in the intensity of the fear-eliciting stimulus only when the dog remains completely relaxed at the preceding volume.

Bibliography

Bernstein, Douglas A., and Gordon L. Paul. “Some Comments on Therapy Analogue Research with Small Animal ‘Phobias.’” Journal of Behavior Therapy and Experimental Psychiatry 2.4 (1973): 225–237. Print.

Butler, Rynae, Rebecca J. Sargisson, and Douglas Elliffe. “The Efficacy of Systematic Desensitization for the Treating of Separation-Related Problem Behaviour of Domestic Dogs.” Applied Animal Behaviour Science 129.2–4 (2011): 136–145. Print.

Dubord, Greg. “Part 12. Systematic Desensitization.” Canadian Family Physician Médecin de Famille Canadien 57.11 (2011): 1299. Print.

Gregg, Lynsey, and Nicholas Tarrier. “Virtual Reality in Mental Health.” Social Psychiatry & Psychiatric Epidemiology 42.5 (2007): 343–354. Print.

Hoffman, Seymour, and Frumi Gottlieb. “Flooding and Desensitization in Treating OCD: A Case Study.” International Journal of Psychotherapy 18.1 (2014): 27–34. Print.

Iglesias, A, and A. Iglesias. “I-95 Phobia Treated with Hypnotic Systematic Desensitization: A Case Report.” American Journal of Clinical Hypnosis. 56.2 (2014): 143–151. Print.

Lang, Peter J., and A. David Lazovik. “Experimental Desensitization of a Phobia.” Journal of Abnormal and Social Psychology 66.6 (1963): 519–525. Print.

McGlynn, F. D., Todd A. Smitherman, and Kelly G. Gothard. “Comment on the Status of Systematic Desensitization.” Behavior Modification 28.2 (2004): 194–205. Print.

Paul, Gordon L. “Insight Versus Desensitization in Psychotherapy Two Years After Termination.” Journal of Consulting Psychology 31.4 (1967): 333–348. Print.

Spiegler, Michael D., and David C. Guevremont. Contemporary Behavior Therapy. 5th ed. Pacific Grove: Brooks, 2009. Print.

Wolpe, Joseph. Psychotherapy by Reciprocal Inhibition. Stanford: Stanford UP, 1980. Print.

`2, 9, 16, 23, 30, 37...` Decide whether the sequence can be represented perfectly by a linear or a quadratic model. If so, then find the model.

Firstly we need to determine whether the series is linear or quadratic. A linear sequence is a sequence of numbers in which there is a first difference between any consecutive terms is constant. However, a quadratic sequence is a sequence of numbers in which there is a second difference between any consecutive terms is constant. 

Now let's determine if the above sequence is linear or quadratic. 

Lets begin by finding the first difference: 

`T_2 - T_1 = 9 - 2 = 7`

`T_3 - T_2 = 16 - 9 = 7`

`T_4 - T_3 = 23 - 16 = 7`

From above we can see we have a constant number for the first difference, hence our sequence is linear.

Now let's determine the model of this sequence. The equation of a linear sequence is as follows: 

`T_n = a + d(n-1)`

Where 

T_n = Value of the term in sequence

a = first number of sequence

d = common difference (first difference)

n = term number 

Now let's substitute values into the above equation: 

`T_n = 2 + 7(n-1)`

`T_n = 2 + 7n - 7`

The model is simplified to: 

`T_n = 7n -5`

Now let's double check our model using terms 1, 3 and 6: 

`T_1 = 7(1) - 5 =2`

`T_3 = 7(3) - 5 = 16`

`T_7 = 7(6) - 5 = 37`

Summary: 

The sequence is linear. 

Model: 

`T_n = 7n - 5`

Who is Dorian Gray?

Dorian Gray is an exceptionally attractive young man who has been befriended by the painter Basil Hallward. At the beginning of the story, Basil is discussing Dorian, the subject of his most recent painting, with his friend Lord Henry Wotton. Lord Henry tells Basil that the portrait is his best work, and he wants to know more about the man it represents. Basil says that, when he first saw Dorian at a party, “’[He] knew that [he] had come face to face with some one whose mere personality was so fascinating that, if [he] allowed it to do so, it would absorb [his] whole nature, [his] whole soul, [his] very art itself.’” Inspired by Dorian’s innocence and goodness and beauty, Basil has made a point to see him every day, even if only for a few minutes, because, as he says, “’[…] a few minutes with somebody one worships mean a great deal.’” Dorian has become Basil’s muse, his inspiration, his idol, and Basil believes that the work he’s done since he met Dorian is the best work he’s ever done.

Basil is devoted to Dorian, and this is why he asks Lord Henry to stay away from him. Perhaps he sees a kernel of cruelty in Dorian that, if cultivated by someone like Lord Henry, will grow. He says that he occasionally feels as though he has “given away [his] whole soul to some one who treats it as if it were a flower to put in his coat” because Dorian can be “horribly thoughtless” at times “and seems to take a real delight in giving [him] pain.” Thus, Dorian’s nature does include a capacity for mercilessness, even in the beginning.

Despite Basil’s request, however, Lord Henry befriends and corrupts Dorian, influencing him to see the world in terms of the pleasure it can offer him instead of in terms of what is right and good. In the meantime, Basil has given Dorian the portrait, but the friends grow further and further apart as a result of Lord Henry’s effect on Dorian. Therefore, Dorian Gray is a good man who is too easily corrupted by pleasure, and he becomes a hedonist who cares little to nothing for others and seeks only to gratify himself. He ultimately kills Basil, providing further evidence of his moral declension.

In the first paragraph of John Steinbeck's Of Mice and Men, the author creates a mood when he describes the Salinas River. What is the mood and...

The mood created by Steinbeck in the first paragraph of Of Mice and Men can be described as "flourishing." Steinbeck is describing the Salinas River as a peaceful place where nature is growing and working abundantly. This is a place where everything is as it should be. 

Of course, the novel describes a world where things are not as they should be. It describes people who are, for one reason or another, cut off from flourishing. This kind of masterful juxtaposition is characteristic of Steinbeck. 

This first paragraph is lush with language that helps to create the tone. Words like "green," "golden," and "fresh" are expertly placed to create, in the reader's mind, an Eden-like, flourishing area of the country. 

Later, Steinbeck will call the leaves on the ground "so crisp that a lizard makes a great skittering if he runs among them" (the important adjective being, of course, 'crisp'). He has begun to weave in images of animals, not just plants, flourishing in this area as well. 

Near the end of the paragraph he calls the flats around the river "damp." The river is so strong and lively that its water even seeps into the land around it. This is land and water that has abundance. 

And it makes it all the more heartbreaking to read of people who do not have abundance; who are forced or choose to make violent decisions to survive. 

What exactly is the meaning of the title "The Wisdom of the New?"

The title, The Wisdom of the New, refers to the Western ideals that Wou Sankwei adopts as an Americanized immigrant. To Sankwei's wife, Pau Lin, this 'wisdom of the new' is antithetical to the ancient wisdom inherent in traditional Chinese culture; therefore, it represents a threat to her personal security and happiness.

In the story, Pau Lin is visibly upset when their six year old son, Yen, copies his father's American English. It is obvious that Pau Lin views language as a necessary and intrinsic part of ethnic heritage; to her, language is the sacred repository of history and culture. In adopting Wou Sankwei's 'new' language, little Yen endears himself to his father. However, his mother is deeply unhappy about this state of affairs, as she fears that her son will also adopt foreign ideals.

In Chinese culture, sons are very important to mothers; it is to sons that mothers turn to for financial and emotional support in their twilight years. As a mother assumes her favored position above the hierarchy of daughters-in-law, it is her sons who ensure that her place is never subverted. Hence, the Chinese mother enjoys a measure of control and autonomy in her old age that she greatly treasures and will fiercely protect at all costs.

Pau Lin cannot see any value in the 'new' wisdom because her reason has been clouded by jealousy; she thinks that her husband has been seduced by the beauty and intelligence of the western women he consorts with, and she especially blames Mrs. Dean and her niece, Adah Charlton, for Sankwei's seemingly disrespectful behavior towards her. In short, Pau Lin's feels insulted that Sankwei, a typical Chinese husband who exhibits a characteristic, patronizing indulgence towards her, should be so inclined to take on the advice of strange women. Ironically, she is not privy to Adah's private words to Wou Sankwei on her behalf.

Pau Lin is further distressed when her young son removes his queue. She tells him that she is deeply ashamed of his deed; Pau Lin longs for the old 'Chinese days whose impression and influence ever remain with the exiled sons and daughters of China.' To Pau Lin, the 'Chinese days' represent the ancient wisdom of the motherland (Zhong Guo or China) that must never be corrupted by the wisdom of the 'new' from a younger, foreign culture. In other words, Pau Lin feels that the wisdom of centuries is superior to that of 'new' (American/western) wisdom.

In the story, Pau Lin poisons her eldest son in order to 'save' him from further 'corruption.' Ominously, her second child dies prior to his older brother's premature death. The author is silent as to the cause of the second child's death, but Pau Lin's possible culpability in both her son's deaths lends an unsettling mood to the resolution of the story. Pau Lin appropriates the concept of the newly emerging butterfly from its cocoon to explain her son's necessary release from life. As the story concludes, she basks in the macabre satisfaction that she has saved her son from irreversible damage to his psyche and identity.

Sooner would I, O heart of my heart, that the light of thine eyes were also quenched, than that thou shouldest be contaminated with the wisdom of the new.

"He is saved," smiled she," from the Wisdom of the New."

What is self-care?

Overview

A person undertakes self-care decisions and actions to address a health problem or to improve his or her health. Popular self-care therapies include relaxation, meditation, imagery, hypnosis, biofeedback, education, special diets, natural products, and nutrition supplements. In 2009, the National Center for Complementary and Alternative Medicine (NCCAM) (later renamed the National Center for Complementary and Integrative Health (NCCIH)) announced that Americans had spent an estimated $22 billion on self-care classes and materials over twelve months.

Mechanism of Action

It is difficult to evaluate the action of self-care therapy because in most situations, it is not feasible to use placebo controls. For example, in one of the better-documented modalities, the Arthritis Self-Management Program, retrospective analysis shows that pain reduction was maintained four years after therapy began and that physician visits decreased by 40 percent. The program used education, cognitive restructuring, relaxation, and physical activity, but it is impossible to show what treatment was responsible for what result; also, no control group was included for comparison.

Uses and Applications

Several health care trends favor the use of self-care therapies. Some persons see conventional health care becoming more effective but also unaffordable for many. Studies show that those who have delayed or skipped medical care for financial reasons are highly likely to try self-care, particularly self-medication.

At the other end of the spectrum are those who distrust mainstream health care and want instead a type of care that promotes empowerment and personal control. Another factor leading people to try self-care is having learned about and becoming comfortable with complementary and alternative medicine (CAM) therapies over time. In addition, CAM therapies that previously could be found only through nontraditional outlets are now widely available. Likely CAM users include the elderly, those who are well educated, and those with conditions such as severe depression and panic attacks. Studies also show that people between the ages of thirty-five and fifty years are part of a fast-growing group of CAM users.

Another study showed that twice as many people read self-help literature as see a CAM practitioner to learn relaxation techniques. This follows a general trend showing that the use of self-care therapies has increased at the same time that consultation with CAM providers has decreased. An analysis of persons on Medicare showed that the most frequently sought forms of CAM were those for back problems, chronic pain, general health improvement, and arthritis. Research has demonstrated the efficacy of relaxation, biofeedback therapy, cognitive strategies, and education in treating chronic pain conditions such as osteoarthritis, rheumatoid arthritis, and fibromyalgia. Persons using self-care engaged in health-affirming practices such as exercise, smoking reduction, and limiting alcohol consumption.

Scientific Evidence

Some of the studies used to measure self-care are flawed because the research questions depend on a person’s ability to report CAM use accurately or to remember his or her use of CAM. Typically, information is collected once, so there is no opportunity to study CAM use over time.

Flawed methodology can occur if researchers do not spell out distinctions between complementary and alternative therapies versus more radical alternatives. Peer-reviewed studies of self-care have shown improvements in cancer-related pain, headache pain, and cardiovascular disease as a result of relaxation techniques, behavior modification, imagery, hypnosis, stress management, and health education. Clinical trials showed, for example, a 43 percent reduction in headache activity, improvement of chemotherapy-related symptoms such as nausea and vomiting, and a 41 percent reduction in cardiac deaths.

One study looked at changes in health status longitudinally and found no difference in health status when researchers compared therapies such as chiropractic, massage, acupuncture, and herbs with conventional medicine. However, the results of CAM therapies in general, and of self-care specifically, may take longer to manifest. Researchers have called for controlled clinical trials, including large-scale surveys, and in-depth studies of specific populations.

Safety Issues

A lack of relevant scientific studies makes it difficult to determine the safety and efficacy of self-care. Herbal remedies may interact with prescription medicines in harmful ways, with both the person seeking care and the prescribing physician unaware of the risks. Scientific literature on interactions is scarce. Existing information may be skewed, because many people do not tell their physicians that they are using a self-care modality of CAM.

Bibliography

"Americans Spent $33.9 Billion Out-of-Pocket on Complementary and Alternative Medicine." National Center for Complementary and Integrative Health. Natl. Inst. of Health, 30 July 2009. Web. 27 Jan. 2016.

Astin, J. A., et al. “Complementary and Alternative Medicine Use Among Elderly Persons.” Journal of Gerontology: Medical Sciences 55A (2000): M4–M9. Print.

Astin, J. A., et al. “Mind-Body Medicine: State of the Science, Implications for Practice.” Journal of the American Board of Family Medicine 16 (2003): 131–47. Print.

Nahin, R. L., et al. “Costs of Complementary and Alternative Medicine (CAM) and Frequency of Visits to CAM Practitioners: United States, 2007.” National Health Statistics Reports 18 (2009): 1–15. Print.

Pagán, J. A., and M. V. Pauly. “Access to Conventional Medical Care and the Use of Complementary and Alternative Medicine.” Health Affairs 24 (2004): 255–62. Print.

Palinkas, L. A., and M. L. Kabongo. “The Use of Complementary and Alternative Medicine by Primary Care Patients.” Journal of Family Practice 49 (2000): 1121–30. Print.

Sparber, A., and J. C. Wootton. “Use of Alternative and Complementary Therapies for Psychiatric and Neurologic Diseases.” Journal of Alternative and Complementary Medicine 8 (2002): 93–96. Print.

In Speak, what are Melinda's parent's reactions in meeting with the principal?

Melinda's parents' meeting with the principal and guidance counselor of Merryweather High demonstrates the failings of the school system to help kids in intense situations like Melinda's. Everyone in the room wants Melinda to "get better," to some degree. However, none of them has any sense of how deep her pain and depression goes, and so they cannot properly address the situation. Instead of getting to the bottom of what's affecting Melinda, the school officials and her parents fall into blaming one another:

"Dad: Well something is wrong. What have you done to her? I had a sweet, loving little girl last year, but as soon as she comes up here, she clams up, skips school, and flushes her grades down the toilet. I golf with the school board president, you know.

Mom: We don't care who you know, Jack." (pg 114-115)

From there, the guidance counselor asks Melinda's parents about their marriage and an argument ensues. Melinda tunes out of the conversation, imagining it as a ridiculous musical number in which the adults lament their situation. When her fantasy version makes her giggle, her mother chastises her for not taking the situation seriously. Overall, the adults in Melinda's life seem too caught up in their own lives and problems to offer her the help she needs.

What are pseudopods?

A psuedopod, meaning "false foot" or "sort-of foot," is a temporary protrusion used by protozoans to move around or "grab" nearby stuff. Pseudopodia are composed of filament structure and filled with cytoplasm, and if you watch protozoans utilize them under a microscope, it may look like the eukaryote is stretching itself in a particular direction. Pseudopods may appear as long, finger-like protrusions or appear to incorporate the bulk of a protozoan's structure. Multiple psuedopods may also work together to form a net-like structure, known as reticulose pseudopodia, which better enables ingestion of food particulate. Pseudopodia work similarly to how we imagine an inchworm moves: a series of extensions and contractions.

Pseudopod is also the name of a podcast website which specializes in short horror stories.

How has addiction affected the people in Angela's Ashes?

Addiction is a major theme throughout Angela's Ashes, and is more ambiguous than it may first appear. The most obvious example of addiction in the novel is Malachy's alcoholism, which condemns him, and his family, to grinding poverty. Malachy's addiction renders him unable to work, and so his family is perpetually "on the dole." They live on the brink of starvation in a hut-like home which is always flooding, and which is next to an outdoor lavatory. Malachy's addiction even leads to the death of some of his children via poverty. This is devastatingly symbolized by his placing of a glass of beer on an infant-sized coffin.

It is Malachy's inability to work (and his spending of the family's "dole" money on beer) that dooms his family to such a pitiful existence. Due to his family's poverty, Frank stops going to school at age 13 and takes up a series of tough, often dangerous jobs (for example, his stint as a coal deliverer). Thus, Frank's own life and potential are damaged by the poverty and turbulence caused, in large part, by alcoholism. Last, Malachy's addiction all but destroys Angela's life. Angela is subjected to poverty, and is regularly mistreated and humiliated by neighbors, "dole" workers, and the institutional Catholic Church.

However, it can also be argued that Angela's smoking is also an addiction, and that said addiction helps her cope with the atrocities of her life. While we must take into account that, at the time, smoking was not understood to be addictive, and that Angela's "addiction" is nowhere near as consuming as Malachy's, it is interesting to note how tobacco plays an ambiguous, if not vaguely positive, role in Angela's Ashes. Angela, who is unable to either control her husband or find work for herself (there were few jobs for women in Ireland at the time), finds solace in her ritualistic smoking.

At what age does the left ventricle become bigger than the right ventricle?

The heart is one of the first organs to develop in the embryonic stage. The tissue that later becomes the heart forms as the mesoderm around 18 to 19 days of age. The mesoderm then separates to form the cardiogenic cords. The cardiogenic cords quickly develop and form the endocardial tubes. The endocardial tubes then merge to create the primitive heart tube. The primitive heart tube then quickly separates to five very distinct heart regions. One of the tubes, the bulbus cordis, develops into the right ventricle. The primitive ventricle then becomes the left ventricle. This occurs at approximately 23 to 28 days gestation. 

Although the ventricles may be the same in size, they are not the same in structure. The left ventricle tends to have a thick muscle wall and creates high pressure into the blood stream. The right ventricle has a less thick muscle wall and creates less pressure into the blood stream. 

Hypoplastic left heart syndrome (HLHS) is a congenital heart disease that occurs when the left ventricle is underdeveloped. 

What is shiatsu?

Overview

Shiatsu, a Japanese word meaning “finger pressure,” is a traditional, noninvasive healing technique in which the fingertips and especially the thumbs are used to apply pressure along the body’s meridian system to unblock energy dams and reinstate optimal energy flow. This energy, called qi in Chinese and ki in Japanese, is considered the essence of life. The underlying belief is that unbalanced energy invites illness and injury.

The Chinese introduced shiatsu into Japan more than fifteen hundred years ago. In 1940, the Japan Shiatsu College was founded by Tokujiro Namikoshi to systematically train shiatsu practitioners in anatomy, physiology, and therapeutic technique. The localized deep-muscle stimulation, sometimes referred to as “acupuncture without needles,” is believed to induce a healing response.

Mechanism of Action

Shiatsu is performed on a large quilted floor mat with the client lying down. No massage oil is used, and the client may remain dressed in comfortable clothing. The practitioner finds the energy points on each of the fourteen meridians along the body and works them to trigger the release of endorphins, which in turn reduce blood pressure, increase circulation, and stimulate lymphatic drainage.

Shiatsu also involves the rotating and stretching of the joints to straighten the pathways. In areas of low energy, long stretches will allow energy to flow in, as will pressure held for ten to fifteen seconds. Conversely, quick stretches and brief periods of pressure will dispel excess energy that has built up.

Shiatsu is considered a method of touch communication, as the practitioner reads the energy flow of the client and assesses overall health. By the end of a session, the client may express an emotional release, such as by crying or laughing. The caring touch of the shiatsu practitioner is thought to arouse the self-healing response within the client.

Uses and Applications

Shiatsu is used to improve body function, to release tension, and to improve circulation for relief from stress. It quiets an overstimulated sympathetic nervous system. It also stimulates the release of endorphins, natural painkillers produced by the body, and excites the immune system. These effects make shiatsu beneficial for targeting muscular, internal, and emotional pain. In addition to bringing relief from discomfort, shiatsu also imparts a calmer mind, clearer thinking, and a general sense of well-being. Self-shiatsu may be performed, often in combination with yoga breathing, meditation, and sound therapy.

In Japan, shiatsu has been recognized and regulated as a distinct health profession since the mid-twentieth century. It is indicated for nervous system disorders such as neuralgia; for stroke recovery, polio, and insomnia; for digestive system disorders such as chronic enteritis and constipation; and for metabolic disorders such as gout. It is contraindicated in cases of trauma, internal bleeding, malignancies, ulcers, active infections, acute inflammation, and blood vessel disease.

Scientific Evidence

In double-blind studies, shiatsu has been shown to improve the quality of sleep for elderly nursing home residents with sleep disturbances and to reduce agitation in elderly nursing home residents with dementia. It increased arm movement and decreased depression in persons recovering from hemiplegia stroke. The use of shiatsu was significantly correlated with increasing body weight in premature babies. It reduced chronic low back pain more effectively than physical therapy, and improvement was still evident at the six-month follow-up. However, studies have failed to show that shiatsu is any more effective than placebo at preventing nausea and vomiting in surgical patients, in emergency room patients with fractures, and in women in labor.

Choosing a Practitioner

Reputable practitioners of shiatsu in the United States should have graduated from an accredited massage therapy school and must practice in accordance with each state’s respective licensing requirements. The term “Shiatsupractor” (a registered trademark of the International Shiatsu Association) is a title recognized around the world and is given to those who have completed formal education and training as a professional shiatsu practitioner.

Safety Issues

Shiatsu should not be performed on persons who are prone to blood clots because there is a risk that the localized pressure could dislodge clots. This massage technique should not be applied directly over open wounds, inflamed skin or rashes, bruises, tumors, hernias, mending bone fractures, or surgical sites. It is not recommended for pregnant women, for people with osteoporosis, or for people who have recently undergone chemotherapy or radiation therapy.

Bibliography

American Organization for Bodywork Therapies of Asia. http://www.aobta.orga.

Beresford-Cooke, Carola. Shiatsu Theory and Practice. 3d ed. New York: Churchill Livingstone/Elsevier, 2010. This illustrated textbook includes a DVD of shiatsu techniques and routines.

Liechti, Elaine. Shiatsu: Complete Illustrated Guide. Rockport, Mass.: Element Books, 2002. In addition to the history of shiatsu and diagrams of techniques and pressure points, this book contains information on self-shiatsu.

Lundberg, Paul. The Book of Shiatsu: A Complete Guide to Using Hand Pressure and Gentle Manipulation to Improve Your Health, Vitality, and Stamina. New York: Fireside Books, 2003. Written by a master shiatsu practitioner and instructor. An authoritative guide that also presents many color drawings and photographs.

Shiatsu Diffusion Society. http://shiatsupractors.org.

Somma, Corinna. Shiatsu. Upper Saddle River, N.J.: Prentice Hall, 2006. This textbook includes protocols for the various client positions and study questions and chapter tests.