What are some examples of topic sentences about swine flu?

Swine flu is a very large topic, which is both good and bad when writing a research paper. It's good because it's broad, and you can take a lot of different angles with it. It's bad for the same reason: it can be difficult to narrow the topic down to a manageable amount. 

The purpose of a topic sentence is to introduce and summarize the focus of a paragraph in an essay. This is how a topic sentence differs from a thesis statement, though they, in essence, do the same job. A thesis statement gives an (often arguable) overview of your topic and sets up the essay for the reader, whereas a topic sentence is limited to the paragraph it begins. 

Since you specified a research paper, which is informational (rather than persuasive), I'll assume that you are planning to write about swine flu itself, rather than, for example, taking a social or political angle. To begin to think about what your topic sentences might be, start by writing down what you already know about the topic and see if that sparks some ideas about the main ideas of your paragraphs. For example, one thing you might know about swine flu is that it's transmittable through human contact or through indirect contact like touching a contaminated surface. You may decide that one of your topic sentences should be related to transmission. 

You can also write down questions you have about the topic. Just because you don't know the answer doesn't mean you can't use it; it's a research paper, after all, and it's likely you'll discover the answers as you go along. You may wonder how swine flu differs from the regular flu. A topic sentence could be to compare (or contrast) swine flu and the regular flu. 

Don't get overly concerned about the complexity of your topic sentences, especially since you're still in the beginning stages of your writing process. It's enough to write, for example, "Swine flu is very similar to the regular flu, with only minor differences." You may discover through your research that they are more different than you originally thought, and that's okay! Writing is an ongoing, back-and-forth process. 

For the six sentences you need for your assignment, think about elements like symptoms, diagnosis, history (where the illness originated), medications, etc. There are lots of aspects you can address. Remember, too, that you don't need to address everything there is to know about swine flu. It's better for you to limit your scope and talk about fewer things more in depth than to try to take on too much and give only surface information about lots of elements. 

What is psycho-oncology?

Subspecialties: Behavioral medicine, health psychology, medical-liaison psychiatry/psychology, pain management, psycho-immunology, psychoneuroimmunology, psychosomatic medicine, psychosocial medicine, psycho-spirituality

Cancers treated: All

Training and certification: Because psycho-oncology is a clinical and research application of professional training, there is not a universally accepted academic credential although training programs exist at most major cancer treatment centers. Professional organizations promoting the work of psycho-oncology include the American Psychosocial Oncology Society, the British Psychosocial Oncology Society, and the International Psycho-oncology Society. Their membership consists of oncologists, psychiatrists, and allied health professionals.

Those practicing or researching psycho-oncology come from several professional disciplines that apply their training to the psychological and psychosocial treatment of cancer patients and their families: residency-trained physician oncologists, residency-trained physician psychiatrists, clinical health psychologists, nurse practitioners, medical social workers, and pastoral counselors. (Pastoral counselors are not routinely required to possess a state license.) Professionals follow the individual requirements of their disciplines regarding obtaining licenses to practice their specialty independently, privileges to treat patients from the institutions where they practice, and specialty board certification (where applicable) and maintaining (renewing) board certification.

Specific training in psycho-oncology usually occurs as an elective track or certificate program at the major cancer treatment centers for professionals in training there. Psycho-oncology is not typically a requirement of curricula in oncology, psychiatry, health psychology, or social work. Therefore, people who engage in its practice are generally those who have actively sought out training, reflecting a high degree of interest and commitment.

The National Comprehensive Cancer Network (NCCN) is an organization representing nearly all the major comprehensive cancer care centers in North America. It has produced standards for psychosocial cancer care and clinical practice guidelines for those involved in providing psycho-oncology services, including nonlicensed professionals such as pastoral counselors. Institutional regulatory and oversight bodies such as the Joint Commission of Accreditation of Heathcare Organizations (JCAHO), the American Osteopathic Association (AOA), and governmental departments of health have not yet fully incorporated these guidelines or psycho-oncological care itself as standard criteria for providing treatment to cancer patients.

Reimbursement for and revenue generation by psycho-oncology interventions is meager relative to other cancer treatment modalities such as surgery, radiation oncology, and chemotherapy. When institutions reassess fiscal priorities, psycho-oncology services and programs are often among the first to be discontinued.

Services and procedures performed: Historically, receiving a cancer diagnosis was equivalent to receiving a terminal diagnosis. In a humanely motivated effort to protect patients from completely losing hope and entering a state of despair, a cancer diagnosis routinely was not revealed to patients, though families were generally told. In the mid-1970’s people began to believe that it was generally more harmful to patients to keep their diagnosis a secret, an idea that was supported by studies on patients’ psychological reactions to having and being treated for cancer conducted at Memorial Sloan-Kettering Cancer Center in New York and the Massachusetts General Hospital in Boston. Early services in psycho-oncology promoted telling the truth to patients, encouraging patients with similar diagnoses to meet for emotional support, disseminating treatment information, and educating professionals about quality-of-life considerations and the values in comfort care over curative intervention among grave prognostic cases. These growing changes in the environment of cancer treatment were concurrent with improvements in actual cancer treatments and growing survival rates. In the twenty-first century, psycho-oncology professionals provide multiple services under the umbrella of engaging the psychological and psychosocial aspects of having cancer.

Psycho-oncology researchers have developed many instruments that assess a wide range of patients’ reactions to cancer, including pain, anxiety, depression, and delirium. These instruments assist with evaluating the efficacy of interventions and provide quantitative parameters through which ongoing research in psycho-oncological methods can be tracked and understood. Preexisting psychological “tests” or instruments were not normed on populations that were this medically ill and routinely overreported patients’ experiences. Researchers have developed scales derived from patient responses to sets of questions that are cancer specific.

Psycho-oncology’s contribution to outcomes research (whether a new treatment, drug, or procedure is effective, worth the costs and risks, and so on) has moved it beyond whether the intervention increases survival to include consideration of whether the survival is worth having it asks the question whether sustaining this life allows the patient to enjoy a high enough quality of life. In the twenty-first century, oncological treatments must not only reduce tumor growth but also promote sufficient functional status for them to be considered efficacious and beneficial. “Quality-adjusted life years” is a widely cited statistic combining survivability (how much time the treatment adds to patients’ lives) with measures of patients’ quality of life. Mortality rate statistics are inadequate by themselves.

Psycho-oncology practitioners who perform consultation-liaison services commonly treat adjustment disorders that arise in cancer patients. In effect, they treat not the disease but the disturbed emotions that understandably arise in the face of coping with cancer. They treat not cancer, but patients’ reactions to having cancer.

Health psychologists’ study of how patients cope with illness and comply with treatment plans has become a standard component of what psycho-oncologists work to facilitate in their patients: adaptive patterns of feeling, thinking, and behaving in facing cancer and its treatments and informed compliance with treatment plan options. Psycho-oncology practitioners unite understanding patients’ subjective experiences without judgment or reprimand, respect for patients’ rights to react in the way they do, and compassionate positive regard for their emotional suffering with the focused treatment of the cancer itself.

Practitioners of psycho-oncology also focus on preventive and behavioral health measures, helping patients effect lifestyle changes to reduce the risk of developing or exacerbating cancer. Reducing sun exposure and high-fat, high-calorie food intake; eliminating tobacco use; and achieving and maintaining healthy levels of exercise can reduce cancer risk.

Psycho-oncology’s contribution to cancer treatment includes the provision of comfort and palliative care so that patients who are terminally ill do not suffer needlessly as a result of aggressive or invasive treatments that prolong life at the cost of reducing functional ability. Helping patients and their loved ones deal with life-threatening disease means that psycho-oncologically oriented treatments encourage inclusion of patients’ spiritual beliefs, religious practices, and search to find meaning when death is inevitable.

Finally the high emotional demands of dealing with life and death, the uncertainty of treatments, and cancer-caused physical and emotional pain profoundly affect not only patients but also health care professionals and caregivers. Psycho-oncology interventions include protocols and strategies to avoid provider burnout and depression.

Barraclough, Jennifer. Cancer and Emotion: A Practical Guide to Psycho-Oncology. New York: Wiley, 1999.

Bearison, David J., and Raymond K. Mulhern, eds. Pediatric Psychooncology: Psychological Perspectives on Children with Cancer. New York: Oxford University Press, 1999.

Holland, Jimmie C., et al., eds. Psycho-Oncology. New York: Oxford University Press, 1998.

Lewis, Clare E., Jennifer Barraclough, and Rosalind O’Brien. The Psychoimmunology of Cancer. New York: Oxford University Press, 2002.

American Psychosocial Oncology Society
.


http://www.apos-society.org, 2365 Hunters Way, Charlottesville, VA 22911.

American Society of Clinical Oncology
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http://www.asco.org, 1900 Duke Street, Suite 200, Alexandria, VA 22314.

National Comprehensive Cancer Network
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http://www.nccn.org, 500 Old York Road, Suite 250, Jenkintown, PA 19046.

How does Marlow change throughout the novella Heart of Darkness?

In Joseph Conrad's Heart of Darkness, Marlow is rarely directly involved in the action of the story, and serves mainly as a narrator who relates the story of Kurtz's degradation. Be that as it may, Marlow does not escape the narrative unscathed, and he changes from an idealistic and excited young boy into a man hardened by the evils dwelling within the human heart.

Marlow tells us that he was passionate about maps as a young boy and dreamed of traveling to distinct locales, especially Africa. From this description, we can surmise that Marlow, like many young children, was idealistic and a touch naive. Moreover, we can assume that he considered traveling to be adventurous and full of excitement. By the time Marlow finds Kurtz and witnesses the man's death, however, things have changed. At that point in the story, Marlow has come to recognize the evil corruption governing the European presence in Africa, and he regards it with revulsion. That is not to say, however, that Marlow is entirely embittered by the end of the story. It would be more accurate to say that he regards exploration more realistically and no longer entertains naive boyhood fantasies. As such, we can see that, through the course of the narrative, Marlow matures considerably and is better equipped to view colonization from a critical point of view.

How can a student create a thesis statement relating the theme of guilt and Pip in Great Expectations?

The theme of guilt can be explored through two main relationships in Great Expectations. As an innocent child who grows up to be an equally innocent young adult, Pip’s relationships are varied and complex. Dickens presents Pip’s guilt in his relationship with his brother-in-law, Joe Gargery. A simple man, Joe has unbounded love for Pip. He has been responsible for rearing him and has instilled in him a kindness that he would not have known if he were left to his sister alone. When Pip begins his journey to becoming a gentleman, however, he turns his back on Joe because of Joe’s simple and countrified ways. Estella poked fun at Pip for things that Pip learned from Joe. In his rejection of Joe, Pip acknowledges his guilty feelings, but pushes past them and continues to work at being the gentleman that he envisions himself to becoming. When Abel Magwitch reveals himself to be Pip’s benefactor, Pip feels guilt toward the source of his money, as well as ashamed for his self-delusion in believing that he was being groomed by Miss Havisham as Estella’s future husband. In both cases (Joe and Magwitch), Pip reverts to the kindness that Joe had taught him. He walks away from London and the life of a gentleman to become a simple clerk. He stays by Magwitch’s side until the ex-convict dies. He ceases to ignore his guilt, faces it, and uses it to remake himself into a man who has the true nature of a real gentleman.

Do you think that the theories from Keynes to the present time still support the ideology of liberalism? Why or why not?

Classical economic liberalism is based entirely on the theory of free markets, of allowing the economy to adjust itself with no or minimal government intervention. It grounds itself in the work of Adam Smith, a Scottish Presbyterian minister, who thought an "invisible hand" (perhaps providence) regulated markets and was more effective than any mere human interventions which might interfere with its operations. Classic economic liberals believe that governments should not intervene to support wages and should let markets correct themselves.

Keynes was opposed to liberal economics, believing that wage supports and public works programs were needed to lift countries out of recessions. Both Britain and the United States implemented Keynesian policies to end the Great Depression. Economists still debate whether the end to this depression was caused by the public works programs or by World War II. Governments also responded to the recent world financial crisis with economic stimulus.

While public works programs focused on improving infrastructure seem to have a net positive effect on GDP, economic theorists still debate whether Keynesian or classic liberal economic policies are superior. 

"The buzz saw snarled and rattled in the yard." How does the poet's word choice in this line effectively convey the different sounds made by the saw?

Interestingly, "snarl" and "rattle" are both etymological equivalents. "Snarl" comes from the German word for "rattle." Both words are onomatopoeic, meaning that the words imitate the sound they stand for. However, despite their similar meanings, the connotations are slightly different. "Snarl" implies an animal baring its teeth and growling. This is an appropriate word for the saw for a couple of reasons. First, Frost personifies the saw later in the poem; it "knew what supper meant." Second, the saw had teeth. It was not a chain saw as we might envision modern log-cutting projects using. The poem calls it a buzz saw, which is a saw with a large round wheel full of teeth that turns by a pulley. See the link below for pictures and an excellent discussion of what the saw Frost wrote about in 1916 may have been. Therefore, the "snarl" of the saw would be the sound the saw made when in contact with the wood, when the teeth were in use.

The word "rattle" is the sound of something shaking or vibrating. When the saw was running but not engaged with wood, it would make a shaking, vibrating sound. "Rattle" also has an ominous connotation associated with a rattlesnake, which makes a fearsome, death-predicting sound. In that way, the word "rattle" foreshadows the tragedy that occurs later in the poem. Thus the sounds filling the yard would be alternating snarls and rattles; snarls when the wood was being cut and rattles when the saw was awaiting its next log. 

What is coccidioidomycosis?

Causes and Symptoms

Coccidioidomycosis is an infection caused by the soil-based fungi Coccidioides immitis (C. immitis) and Coccidioides posadasii (C. posadasii). These fungi are found only in the Western hemisphere, and they prefer dry, alkaline soils. C. immitis and C. posadasii are endemic to the southwestern United States (south-central California, Nevada, Arizona, New Mexico, and western Texas), those regions of Mexico that border the western United States, parts of Central America (Guatemala, Honduras, and Nicaragua), and the desert regions of South America (Argentina, Paraguay, and Venezuela).

While in the soil, Coccidioides, like most fungi, grows as thin, branching filaments called hyphae. A collection of hyphae is called a mycelium. When it rains, the mycelium grows quite rapidly, but once the soil dries out, it forms resting cells called arthrospores. If disturbed by wind, earthquakes, or soil excavation, these arthrospores become airborne and, if inhaled, can cause coccidioidomycosis.

Once inhaled, the arthrospore transforms into a thick-walled, spherical structure called a spherule that divides itself into hundreds of small endospores. When the spherule ruptures, it releases the endospores, which grow into spherules that form more endospores.

About 60 percent of patients show no symptoms, and the disease resolves spontaneously. Those patients who show symptoms suffer from fever, sore throat, headache, cough, fatigue, painful bumps on the skin (erythema nodosum), and chest pain approximately one to three weeks after inhaling arthrospores. About 95 percent of symptomatic patients recover without further problems after several weeks. If symptoms persist beyond three months, however, then the patient has chronic progressive coccidioidal pneumonia. Between 5 and 7 percent of patients with coccidioidal pneumonia form pulmonary nodules, which are areas of the lung where the immune system has walled-off the organism from the rest of the lung. On an X-ray, these nodules can look exactly like cancerous masses in the lung. A biopsy is often necessary to distinguish between lung cancer and coccidioidal pulmonary nodules. In 5 percent of patients with coccidioidal pulmonary
nodules, the nodules enlarge to form pulmonary cavities that can become infected, rupture, and bleed, causing the release of pus between the lungs and the ribs (empyema). Small cavities (less than 2.5 centimeters) can heal after one to two years, but larger cavities can persist and cause the patient to spit up blood (hemoptysis) and allow the growth of fungi throughout the cavity (mycetoma).

A minority of patients develop disseminated coccidioidomycosis, in which the organism penetrates blood vessels, invades the bloodstream, and infects any organ in the body. Disseminated coccidioidomycosis occurs weeks or months after the primary pneumonia and can even develop in cases where there is no previous evidence of respiratory disease. Particular ethnic groups such as Filipinos and African Americans show increased risk of developing disseminated disease, as do pregnant women in the third trimester of their pregnancy, infants younger than one year old, diabetics, patients with Acquired immunodeficiency syndrome (AIDS), or those taking drugs or suffering from diseases that suppress the immune system.

Treatment and Therapy

Asymptomatic or symptomatic infections are usually self-limited and require little more than supportive care. Patients with coccidioidal pneumonia require fluconazole or itraconazole treatment for at least twelve months and intravenous amphotericin B for stubborn cases. Pulmonary nodules are typically not treated, but they may require surgery. Pulmonary cavities are only treated with antifungal drugs if the patient shows symptoms. Surgical removal might also be warranted if the infection resists treatment. Disseminated coccidioidomycosis requires higher doses of fluconazole, and very sick patients may require amphotericin B or a combination of fluconazole and amphotericin B. Amphotericin B is preferred for pregnant women, since other drugs harm the developing fetus.

Perspective and Prospects

Coccidioidomycosis was first described in 1892 by Roberto Johann Wernicke and Alejandro Posadas in South America. The first case in the United States was reported in California in 1894. Two years later, Emmet Rixford and Thomas Caspar Gilchrist reported several clinical infections that were caused by an organism that, they thought, resembled the protozoan Coccidia. Therefore they named it Coccidioides, which means “Coccidia-like.” In 1905, William Ophüls described the fungal life cycle and pathology of C. immitis. Charles E. Smith studied the epidemiology of coccidioidomycosis in the San Joaquin Valley of California and went on to develop the coccidioidin skin test and serological testing for the disease.

The Centers for Disease Control and Prevention released a study in 2013 that showed an increase in cases of coccidioidomycosis in the southwestern United States between 1998 and 2011. Cases in the states of Arizona, California, Nevada, New Mexico, and Utah increased from 2,265 reported in 1998 to 22,000 reported in 2011.

New treatments under investigation for coccidioidomycosis include posaconazole, voriconazole, caspofungin, and a new lipid-dispersal formulation of amphotericin B that reduces its kidney toxicity. Nikkomycin Z is another experimental agent that is very active against Coccidioides in culture and infected animals.

Bibliography:

Anstead, Gregory M., and John R. Graybill. “Coccidioidomycosis.” Infectious Disease Clinics of North America 20, no. 3 (September, 2006): 621–43.

Centers for Disease Control and Prevention. "Valley Fever Increasing in Some Southwestern States." CDC, Mar. 28, 2013.

Galgiani, John N. “Changing Perceptions and Creating Opportunities for Its Control.” Annals of the New York Academy of Sciences 1111 (September, 2007): 1–18.

Kohnle, Diana. "Coccidioidomycosis." Health Library, Nov. 26, 2012.

Kwon-Chung, K. J., and John E. Bennett. Medical Mycology. Philadelphia: Lea and Febiger, 1992.

Parish, James, M., and James E. Blair. “Coccidioidomycosis.” Mayo Clinic Proceedings 83, no. 3 (March, 2008): 343-348.

In "By the Waters of Babylon," how can details from the story be used to identify both the time and place of the events of this story?

I can be quite specific with the place, but the time that this story takes place is going to be much more vague.

By the time that the story ends, readers know for sure that the story takes place in the future. A Great Burning is mentioned a few times in the story, and that likely refers to some cataclysmic nuclear event. A nuclear event would explain why people have been forbidden to touch metal or to go east. The metal would have been full of harmful radiation, and a radioactive cloud can remain over an area and make it inhospitable for many years. The story takes place many, many, many years after the nuclear event took place because John is able to safely travel east and touch metal. Unfortunately, the story doesn't tell us what kind of nuclear event happened. Was it a nuclear meltdown or a nuclear bombing? That would make a big difference in determining how far after the Great Burning the story takes place. For example, Hiroshima is habitable today, and it has been less than 100 years since the United States dropped the first atomic weapon there. On the other hand, Chernobyl isn't supposed to be safe for human life for another 20,000 years. Narrowing down the time setting to anything more specific than a lot of years after a nuclear holocaust is not possible.

I can be more specific with the setting location, though. John eventually travels to New York City. Readers are told that he crosses the Hudson on a raft because the bridges to the island are too broken. One specific location that John goes to is Grand Central Terminal.

I found it at last in the ruins of a great temple in the mid-city. A mighty temple it must have been, for the roof was painted like the sky at night with its stars—that much I could see, though the colors were faint and dim. It went down into great caves and tunnels—perhaps they kept their slaves there.

John thinks that it is a great temple that leads to slave tunnels, but those tunnels are actually train and subway tunnels. The ceiling in that building is indeed painted with stars. John takes eight days to walk from his village to Manhattan. If a person covers 20 to 30 miles per day, then John's village is 160 to 240 miles west of Manhattan.

What is the setting of the story "Dusk" by Saki?

The bulk of the action in this story takes place on a park bench just to the left of Hyde Park Corner in London.   When the characters migrate from this bench, it is only to walk slightly further into the Park.  “It was some thirty past six on an early March evening, and dusk had fallen heavy over the scene,” Saki writes – an apt time of day, considering the title of the story.  The first paragraph is quite descriptive, and sets a scene buried in the half-light of a waning spring day, when the lines between all things blur:

There was a wide emptiness over road and sidewalk, and yet there were many unconsidered figures moving silently through the half-light, or dotted unobtrusively on bench and chair, scarcely to be distinguished from the shadowed gloom in which they sat.

It is within this setting that Norman Gortsby is sitting idly on his park bench, observing the individuals mentioned above with the very same scrutiny they keep their heads down to avoid.  According to Gortsby, “Dusk…was the hour of the defeated.”  And Gortsby considers himself among their ranks, though exactly why eludes the reader.  So, he seeks solace in this half-empty, half-dark, half-dying time of day, among those strangers he presumes to be of a similar mind to himself.

Why did Bill and Sam decide to kidnap a prominent citizen’s child?

In "The Ransom of Red Chief," Sam and his partner, Bill Driscoll, have an idea for obtaining the money they need to pull off a "fraudulent town-lot scheme in Western Illinois" without having to do any work: kidnap a child and demand a ransom. They choose the town of Summit because they believe it is the type of community where parents are especially fond of their offspring and because the police force doesn't seem too intimidating. Because they need a large sum of money, they must steal the child of a prominent citizen. An ordinary citizen wouldn't have access to $2000 to buy his child back, especially considering that $2000 in 1900 would be worth over $58,000 today.

It turns out, though, that Sam and Bill's selection of a victim was not ideal. The description of Ebenezer Dorset Sam provides indicates that he might not have been the best target, even though he was wealthy. For one thing, he was "tight," or frugal, and for another thing, he was a "stern ... forecloser." Thus he was a no-nonsense man who was willing to turn the screws as necessary to retain his profit in his business dealings. The men find out that both Johnny Dorset and his father end up being more than they bargained for, and they actually lose money on their plot that was conceived "during a moment of temporary mental apparition."

Describe the federal government of the United States of America.

The federal government of the United States is the government that is in charge of the country as a whole, as opposed to the state governments, which govern the individual states.  The form of the federal government is set out in the Constitution of the United States.

The federal government of the United States consists of three branches.  Each branch of government has its own powers.  This is known as separation of powers.  However, each branch also has some control over the other branches’ powers, a system called checks and balances.

The first branch to be mentioned in the Constitution is the legislative branch.  This branch, which is made up of the House of Representative and the Senate, is mainly responsible for making the laws that govern the country.  However, Congress can also check the other branches.  For example, the Senate must accept anyone that the president nominates as an ambassador before that person can take office. 

The second branch to be mentioned in the Constitution is the executive branch.  This branch is headed by the president.  The main power of the executive branch is to carry out the laws.  The president also has strong military powers as the commander-in-chief.  The executive can also check the other branches.  For example, it is the president who gets to nominate people to the Supreme Court.  As another example, the president has the power to veto bills passed by Congress.

Finally, there is the judicial branch.  This branch is headed by the Supreme Court of the United States.  This branch has the power to interpret the laws made by the Congress and signed by the president.  It also has the power to interpret the Constitution.  In doing these things, the judicial branch can check the other branches because it can invalidate actions of the other branches if it believes that they conflict with the Constitution.

This is the basic structure of the federal government of the United States.

What is Pompe disease?

Risk Factors

This is an autosomal recessive disorder; therefore, each parent must carry a defective GAA gene, both of which are inherited by the affected child. The National Institute of Neurological Disorders and Stroke (NINDS) reports (2013) that the incidence is estimated at 1 in 40,000 people worldwide. About one-third of patients have the infantile-onset form. Both sexes are equally affected, although the incidence does vary by geography and ethnic group.

Etiology and Genetics

The GAA gene, located on the long arm of chromosome 17, is the only gene associated with Pompe disease. More than three hundred mutations have been identified throughout the gene. Some defects are more common than others. For example, more than half of Caucasians with late-onset Pompe disease share a common splice-site mutation. According to the Emory University School of Medicine in 2010, some infantile-onset mutations are observed more frequently in certain geographic regions (such as southern China and Taiwan) or ethnic populations (such as African Americans).

In general, the type and combination of mutations inherited determine the residual level of GAA activity and thus the severity of the disease. If both chromosomes are fully compromised, GAA activity is nonexistent. Combinations of one severely mutated allele and one mildly affected allele usually preserve some GAA activity, meaning a slower disease progression, although the age of onset can vary. Researchers are cautious about correlating genotype with clinical features, however, because both infantile and late-onset forms have been observed in the same family.

Several factors explain how glycogen buildup in the lysosomes likely disrupts muscle function. As the lysosomes become bloated, they can displace myofibrils in neighboring cells, disrupting the muscle’s ability to contract and transmit force. In late-onset Pompe disease, swollen lysosomes can rupture or release other enzymes into surrounding tissues, damaging muscles. Disuse and oxidative stress may also play a role in muscle wasting.

Symptoms

Manifestations of Pompe disease vary depending on age of onset and level of residual GAA activity. In the classic infantile-onset form, symptoms are observed shortly after birth and include an enlarged heart, poor muscle tone (inability to hold the head up, roll over), feeding problems (difficulty swallowing, enlarged tongue), and respiratory distress (frequent lung infections). In the nonclassic infantile form, cardiac involvement is moderate and muscle weakness is delayed. In late-onset Pompe disease, symptoms can appear from two to seventy years. Muscle weakness and pain, primarily in the legs and trunk (difficulty climbing stairs or playing sports, frequent falls) and respiratory distress (shortness of breath, sleep apnea) are typical. In all cases, early diagnosis is critical for disease management.

Screening and Diagnosis

Pompe disease shares many symptoms with other muscle disorders, complicating diagnosis. Initial clinical studies include chest radiography and electrocardiograms, as well as muscle tests, electromyography, and nerve conduction tests in adults. The diagnosis is confirmed through tests of GAA activity (blood tests, skin fibroblasts cultures, and/or muscle biopsy in adults) or through DNA analysis. DNA analysis is also useful for identifying familial mutations and carriers and for newborn screening.

Treatment and Therapy

Historically, patients with Pompe disease were given supportive care only. However, enzyme replacement therapy (ERT) using recombinant human GAA has become a promising treatment, especially in infants younger than six months who do not yet require ventilatory assistance. As reported by the National Center for Biotechnology Information (2012), clinical trials of ERT in late-onset Pompe disease are ongoing and also show promise. Other treatment is multidisciplinary and aimed at preventing secondary complications such as infections, treating symptoms, and maintaining function as long as possible. These treatments include frequent cardiac evaluations, use of bronchodilators, steroids, and mechanical ventilation, and special diets and tube feeding. Physical, occupational, and speech therapies and immunizations are also advised.

Prevention and Outcomes

Before ERT, patients with infantile-onset Pompe disease typically died of cardiac and/or respiratory complications by one year of age. ERT has enhanced ventilator-free survival for many young patients; reduced heart size and improvements in cardiac and skeletal muscle function have also been seen. In late-onset Pompe disease, juvenile patients are usually more severely affected than adults and rarely survive past the second or third decade of life due to respiratory failure. They often require mechanical ventilation and wheelchairs. Older patients may also experience steadily progressive debilitation and premature mortality. However, improved screening techniques that enhance early diagnosis have become available. NINDS (2013) reports that not only ERT, but new drugs show promise for treatment.

Bibliography

Acton, Q. Ashton, ed. Pompe's Disease: New Insights for the Healthcare Professional. Atlanta: ScholarlyEditions, 2012. Print.

Anand, Geeta. The Cure: How a Father Raised $100 Million—And Bucked the Medical Establishment in a Quest to Save His Children. New York: Harper, 2006. Print.

Hirschhorn, R., and A. J. Reuser. “Glycogen Storage Disease Type II: Acid Alpha-glucosidase (Acid Maltase) Deficiency.” The Metabolic and Molecular Bases of Inherited Disease. Ed. Charles Scriver, et al. 8th ed. New York: McGraw, 2001. Print.

Hoffman, Georg F., et al. Inherited Metabolic Diseases. New York: Springer, 2010. Print.

Kishnani, Priya S., et al. “Pompe Disease Diagnosis and Management Guidelines.” Genetics in Medicine 8.5 (2006): 267–88. Print.

"Pompe Disease." Genetics Home Reference. Natl. Lib. of Medicine, 4 Aug. 2014. Web. 6 Aug. 2014.

Websites of Interest

Acid Maltase Deficiency Association (AMDA)

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http://www.amda-pompe.org/

Association for Glycogen Storage Disease

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http://www.agsdus.org/

Pompe Disease

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http://ghr.nlm.nih.gov/condition=pompedisease

Pompe Registry

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http://www.lsdregistry.net/pomperegistry/

What is leprosy?

Causes and Symptoms

Leprosy, also known as Hansen’s disease, is caused by the bacterium Mycobacterium leprae (M. leprae). Humans are the only natural host for this bacterium; it can be found only in leprosy victims. Most people who are exposed to this bacterium are unaffected by it; in the remainder, the bacterium grows inside skin and nerve cells, causing a wide range of symptoms that depend upon the person’s immune response to the growth of the bacteria.

M. leprae is an obligate intracellular parasite, which means that it can grow only inside other cells. M. leprae has a unique waxy coating that helps to protect it while it is growing inside human skin and nerve cells. The bacterium grows very slowly, dividing once every twelve days, whereas the average bacterium will divide every twenty to sixty minutes. M. leprae grows best at temperatures slightly below body temperature (37 degrees Celsius). The leprosy bacterium is the only bacterium known to destroy peripheral nerve tissue (nerves that are not a part of the central nervous system) and will also destroy skin and mucous membranes. This bacterium is closely related to the bacterium that causes tuberculosis: Mycobacterium tuberculosis.

Leprosy is not very contagious. Several attempts to infect human volunteers with the bacteria have been unsuccessful. It is believed that acquiring leprosy from an infected person requires prolonged intimate contact with that person, such as living in the same house for a long time. Although the precise mode of transmission of M. leprae bacteria is unclear, it is highly probable that the bacteria are transferred from the nasal or respiratory secretions of the victim to the nasal passages or a skin wound of the recipient.

Once inside a person, M. leprae will grow and reproduce inside skin and nerve cells and destroy tissue. The exact mechanism of tissue destruction is not understood, but it probably results from a combination of nerve damage, massive accumulation of bacteria, and immunological reactions. Because the bacteria grow so slowly, the length of time from infection to appearance of the symptoms (the incubation period) is quite long. The average incubation period is two to seven years, but incubation can range from three months to forty years. Since the bacteria prefer temperatures slightly lower than normal body temperature, symptoms appear first in the cooler parts of the body, such as the hands, fingers, feet, face, nose, and earlobes. In severe cases, symptoms also appear in the eyes and the respiratory tract.

The symptoms associated with leprosy can range from very mild to quite severe, and the symptoms that a person gets depend heavily on that person’s ability to mount a cellular immune response against the bacteria. In a normal infection, the human body is capable of defending itself through two processes of the immune system; the humoral immune response and the cellular immune response. The humoral response produces chemicals called antibodies that can attack and destroy infectious agents that are present in body fluids such as the blood. The cellular response produces white blood cells that can destroy infectious agents that are associated with cells. Since M. leprae hides and grows inside human cells, a cellular response is the only type of immune response that can be of any help in fighting the infection. The ability to generate a cellular immune response against M. leprae is dependent upon the genetic makeup and overall health of the victim, as well as the number of infecting bacteria and their ability to invade the body and cause disease. A quick and strong cellular response by a person infected with M. leprae will result in no symptoms or in the mild form of the disease: tuberculoid leprosy. A
slow or weak cellular response by a person exposed to leprosy may result in the more severe form of the disease: lepromatous leprosy.

Only one in two hundred people exposed to leprosy will get some form of the disease. The earliest symptom is a slightly bleached, flat lesion several centimeters in diameter that is usually found on the upper body or on the arms or legs. About three-fourths of all patients with an early solitary lesion heal spontaneously; the rest progress to tuberculoid or lepromatous leprosy or to one of the many forms that fall between these two extremes.

Tuberculoid leprosy is characterized by flat skin lesions five to twenty centimeters in diameter. The lesions are lighter in color than the surrounding skin and are sometimes surrounded by nodules (lumps). The lesions contain only a few bacteria, and they, along with the surrounding tissue, are numb. These lesions are caused by a hypersensitive cellular immune response to the bacteria in the nerves and skin. In an attempt to destroy the bacteria, the immune system overreacts, and some of the surrounding nerve and skin tissue is damaged while the bacteria are being killed. This causes the areas of the skin to lose pigment as well as sensation. Often, tuberculoid leprosy patients can experience more extensive physical damage if the numbness around the lesions leads to accidental loss of digits, skin, and so forth. Leprosy victims may burn and cut themselves unknowingly, since they have no feeling in certain areas of their bodies.

In lepromatous leprosy, the bacteria grow unchecked because of the weak cellular immune response. Often, there are more than 100 million bacterial cells present per square centimeter of tissue. These bacteria cause the formation of tumorlike growths called lepromas as well as tissue destruction of the skin and mucous membranes. Also, the presence of so many bacteria causes large numbers of antibacterial antibodies to be produced, but these antibodies are of no benefit in fighting off the infection. Instead, they can contribute to the formation of lesions and tissue damage both internally and on the skin through a process called immune complex hypersensitivity. This is a process whereby the large number of antibodies bind to the large number of bacteria in the body and form immune complexes. These complexes can be deposited in various parts of the body and trigger a chemical reaction that destroys the surrounding tissue. The large number of bacteria puts pressure on the nerves and destroys nerve tissue, which causes loss of sensation and tissue death.

The initial symptoms of lepromatous leprosy are skin lesions that can be spread out or nodular and are found on the cooler parts of the body, such as the inside of the nose, the front part of the eye, the face, the earlobes, the hands, and the feet. Often, the victim loses all facial features because the nodules enlarge the face, and the eyebrows and nose deteriorate, giving the victim a characteristic lionlike appearance. Severe lepromatous leprosy erodes bones; thus, fingers and toes become needlelike, pits form in the skull, nasal bones are destroyed, and teeth fall out. Also, the limbs become twisted and the hands become clawed. The destruction of the nerves leads to the inability to move the hands or feet, deformity of the feet, and chronic ulceration of the limbs. In addition, as is the case with tuberculoid leprosy, destruction of the small peripheral nerves leads to self-inflicted trauma and secondary infection (infection by another bacterium or virus). As the disease progresses, the growth of bacteria in the respiratory tract
causes larynx problems and difficult breathing. Deterioration of the optic nerve leads to blindness. Bacteria can invade the bloodstream and spread infection throughout the whole body except the central nervous system. Death associated with leprosy usually results from respiratory obstruction, kidney failure, or secondary infection.

Treatment and Therapy

A physician can tell whether a person has leprosy by looking for characteristic symptoms (light-colored and numb lesions, nodules, and so forth) and by determining whether the patient may have been exposed to someone with leprosy. In addition, samples of scrapings from skin lesions, nasal secretions, fluid from nodules, or other tissue secretions can be examined for the presence of M. leprae. Samples are treated with a procedure called the acid-fast technique. Because of M. leprae’s waxy coating, these bacteria retain a pink stain after being washed in an acid-alcohol mixture, whereas all other bacteria lose the pink stain. Therefore, pink, rod-shaped bacteria observed in samples treated with the acid-fast technique indicate the presence of M. leprae. It is easy to find the acid-fast M. leprae in lepromatous leprosy patients because they have so many bacteria in their lesions, but the bacteria are more difficult to find in the lesions of tuberculoid leprosy patients.

The lepromin test was originally developed to be used as a diagnostic tool for leprosy, in the same way that the tuberculin test is used as a diagnostic tool for tuberculosis. Lepromin, which is heat-killed M. leprae taken from nodules, is injected under the skin in the lepromin test. Two reactions are possible: an early reaction that appears twenty-four to forty-eight hours later and a late reaction that appears three to four weeks later. In both reactions, a hard red lump at the injection site indicates a positive lepromin test. This test is not specific for leprosy, however, because a person who has been exposed to M. leprae, M. tuberculosis, or the tuberculosis vaccine,
Bacillus Calmette-Guérin (BCG), will show a positive early reaction. Even though this test is not useful as a diagnostic tool, it is useful in determining whether a patient has a strong or a weak cellular immune response to M. leprae. Tuberculoid leprosy patients show both the early and late reactions, while lepromatous leprosy patients show no reaction at all.

Leprosy can be treated with antibiotics. The antibiotic dapsone began to be used on a wide scale in the treatment of leprosy in 1950. Since that time, however, many dapsone-resistant strains of M. leprae have appeared. This means that, for some victims, this drug is no longer helpful in fighting the disease. In 1981, in response to the problem of dapsone-resistant strains, the World Health Organization (WHO) recommended a multidrug regimen for leprosy victims. For lepromatous leprosy patients, dapsone, rifampin, and clofazimine are recommended, whereas tuberculoid leprosy patients need take only dapsone and rifampin. For patients who are intolerant of one or more of the standard antibiotics or who suffer from infections unresponsive to these medications, doxycycline and moxifloxacin are additional antibiotics that have been found to be effective. Treatment is expected to continue until skin smears are free from acid-fast bacteria, which can last from two years up to the lifetime of the patient. Since 1989, the US recommendations for tuberculoid leprosy are six months of rifampin and dapsone daily, then dapsone alone for three years. For lepromatous leprosy, the recommendation is to use rifampin and dapsone daily for three years, then dapsone only for the rest of the person’s life.

Often, antibiotics are given to family members of leprosy patients to prevent them from contracting the disease. Antibiotic therapy can make a leprosy victim noncontagious, stop the progress of the disease, and in some cases cause a reversal of some of the symptoms. Until treatment is complete, however, it is recommended that patients sleep in separate bedrooms, use their own linens and utensils, and not live in a house with children. Thus, leprosy victims can lead nearly normal lives without fear of infecting others in the community.

The best ways to keep from getting leprosy are to avoid exposure to leprosy bacteria and to receive antibiotic therapy following exposure. It should be possible to control and, eventually, eliminate leprosy. If every case of leprosy were treated, the disease could not spread and the bacteria would die out with the last leprosy victim. Progress in this direction is slow, however, because of ignorance, superstition, poverty, and overpopulation in areas with many leprosy cases. The first strategy in controlling leprosy is to treat all leprosy cases with antibiotics. As of 1991, about 50 percent of all leprosy victims were not receiving drug therapy. Second, the early detection and rigid isolation of lepromatous leprosy patients are important, as is preventive antibiotic therapy for individuals in close contact with those patients. Finally, even in the early twenty-first century, too many countries lack adequate basic health resources, and too many patients disabled by leprosy are not receiving adequate care. The development of a vaccine for leprosy would aid control efforts.

A global effort for the production of a vaccine for leprosy is being made under the auspices of WHO. The first problem with vaccine development is that, until recently, it was not possible to grow M. leprae bacteria outside a leprosy victim; therefore, not much is known about the nature of the bacteria. Even though this bacterium was the first to be associated with a disease, it cannot be grown on an artificial laboratory medium, whereas nearly all other bacteria known can be grown artificially. It was not until 1960 that scientists at the Centers for Disease Control (CDC) discovered that the bacterium could be grown in the footpads of mice. Finally, in 1969, scientists at the National Hansen’s Disease Center in Carville, Louisiana, found that the bacteria would grow in the tissues of the nine-banded armadillo. Several potential vaccines for leprosy have been tested since that time. One vaccine being tested is BCG, a live bacterial vaccine of the bacteria Mycobacterium bovis, which is a close relative of M. leprae. In four major trials with BCG, a range of 20 to 80 percent protection from leprosy was obtained. It is not known why there was such a wide variation in results. Recent strategies for vaccine development include making a modified BCG that contains M. leprae cell wall antigens. It is more advantageous to use BCG than M. leprae in a vaccine because BCG is much easier to grow. In addition, scientists are trying to find a way to grow M. leprae artificially so that larger quantities will be available to be used for a vaccine. In 1999, WHO set up a strategic plan titled “The Final Push Toward Leprosy Elimination: 2000–2005” and the Global Alliance for the Elimination of Leprosy was launched.

Perspective and Prospects

Leprosy is one of the oldest known diseases. References to leprosy are contained in Indian writings that are more than three thousand years old. The Bible refers to leprosy and the isolation of lepers, although the term refers to other skin diseases as well. The examination of ancient skeletons has provided insights into how leprosy spread in past centuries. Early evidence suggests that the disease was highly contagious and that leprosy was widespread in Europe during the Middle Ages. Leprosy was so prevalent, in fact, that both governments and churches moved to deal with the problem. At that time, the cause of leprosy was unknown, and the disease was generally believed to be a punishment for some personal sin. Lepers were treated as outcasts and required to shout “unclean.” They were required to wear gloves and distinctive clothes and carry a bell or clapper to warn people of their approach. They were forbidden to drink from public fountains, speak loudly, eat with healthy people, or attend church. Some lepers were even pronounced legally dead, burned at the stake, or buried alive. Later, they were isolated in asylums called leprosaria, and at one time about nineteen thousand leprosaria existed—mostly in France.

There was a sharp decrease in the number of leprosy cases in the sixteenth century. Several factors may have contributed to this decline, including the isolation of lepers, a better diet, warmer clothes, the plague epidemic, and the increase in tuberculosis, which may have provided resistance to leprosy. Leprosy is no longer as deadly or contagious as it once was, yet the stigma attached to this disease has remained. In an effort to alleviate the social stigma, the Fifth International Congress on Leprosy in 1948 banned the use of the word leper and encouraged the use of the term Hansen’s disease instead of leprosy. M. leprae, the causative agent of leprosy, was first identified in the tissues of leprosy patients by the Norwegian physician Gerhard Armauer Hansen in 1873—hence the alternate name, Hansen’s disease. Today, victims of leprosy are referred to as Hansenites or Hansenotic.

From the 1960s to the 1980s, estimates of the number of cases of leprosy worldwide ranged from 10 to 12 million. In 2001, at the Fifty-fourth World Health Assembly, it was announced that the global prevalence of leprosy had fallen to below one case per ten thousand by the end of 2000 and health experts believed that eliminating leprosy in all countries was an attainable goal by the year 2005. More than 600,000 new cases of leprosy were reported globally in 2002. A new combination of drugs known as multidrug therapy has been used to treat and completely cure patients. The drugs are donated free through foundations, and since these donations began in 2000, millions of the “blister packs,” each of which provides one month’s treatment to one patient, have been shipped. By 2008, some countries had achieved elimination, but leprosy remained endemic in others. And, although the disease has not been completely eliminated, its incidence has decreased dramatically. The World Health Organization reports that, worldwide, about 219,000 new cases of leprosy were reported in 2011 and that about 182,000 people had the disease in early 2012.

Leprosy is prevalent in tropical areas such as Africa, Southeast Asia, and South America. In the United States, most cases occur in Hawaii and small parts of Texas, California, Louisiana, and Florida. The number of new cases in the United States annually—mostly from foreign-born immigrants from leprosy-prone areas—has been very low in the last several decades.

Bibliography

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World Health Organization. "Leprosy." World Health Organization Media Centre, September 2012.

Explain Golding's ideas about the beast and how the beast is presented in the novel Lord of the Flies.

At the beginning of the novel, the beast is presented as a figment of the boys' imaginations. The littlun with the mulberry-colored birthmark describes it as a "snake-thing." Golding uses the "snake-thing" to allude to the serpent in the Garden of Eden found in the Old Testament. The beast is symbolic of the inherent evil found in human nature. Each character has their own interpretation of the beast's true identity. While Ralph, Jack, and Piggy dismiss the idea of an actual beast on the island, only Simon has the insight to understand the true nature of the beast. Simon suggests that the beast is the inherent wickedness present in each individual.

In Chapter 6, a dead paratrooper is shot out of the sky. The paratrooper's descent towards the island alludes to Lucifer's fall from heaven. Golding also uses the dead paratrooper to represent the physical manifestation of evil on the island. Samneric are the first to spot the grotesque looking corpse and mistake the dead man for the beast. After explaining to the boys what they witnessed, Jack leads his band of hunters on an expedition to find the beast. Jack ends up killing a pig and leaving its head on a stake as a sacrifice to the beast.

In Chapter 8, Simon hallucinates and speaks with the Lord of the Flies, whose name translates to Beezlebud in Hebrew. The Lord of the Flies tells Simon,

"There isn't anyone to help you. Only me. And I'm the Beast...Fancy thinking the Beast was something you could hunt and kill!...You knew, didn't you? I'm part of you? Close, close, close! I'm the reason why it's no go? Why things are what they are?" (Golding 143).

Simon was correct in his assumption that the beast was inside of each boy on the island. After Simon spots the dead paratrooper, he attempts to share the news with the boys but is tragically mistaken for the beast and brutally murdered.

Throughout the novel, Golding suggests that humans are inherently wicked and evil. He uses the concept of a beast on the island as a symbol to represent evil. The only reason individuals do not murder and pillage on an everyday basis is because there are societal restrictions and laws in place that prevent people from acting out their violent predisposed behaviors.

Why does Dee think that mama and Maggie don't understand their heritage in "Everyday Use"?

Dee thinks that Mama and Maggie do not understand or appreciate their heritage because they routinely use the family items that Dee thinks should be preserved.  First, she marvels over the rump prints in the benches that her father made when they were too poor to buy chairs.  Then, she insists that she wants Grandma Dee's butter dish (even though she doesn't want to keep her name, same as her grandmother's), then the churn top and the dasher: all of which Mama and Maggie still use in daily life.

The final straw, however, is when Dee insists that she wants the old family quilts, refusing newer ones because they have been stitched by machines instead of by hand.  Mama says that the machine-stitching will help them to hold up longer, but Dee doesn't want to use them; she wants to hang them.  When Mama tells her that those hand-stitched quilts are promised to Maggie, Dee cries, "'Maggie can't appreciate these quilts! [...] She'd probably be backward enough to put them to everyday use.'"  Thus, for Dee, heritage is something to preserve, to show off; for Mama and Maggie, heritage is remembering and using those items made by loved ones because that's how one keeps one's family and heritage alive.  Heritage, for them, is meant for everyday use, and this is why Dee believes that they cannot appreciate it.

Identify and discuss the first person narrative point of view of Nick Caraway and its importance to The Great Gatsby by F.Scott Fitzgerald.

Nick Caraway, Gatsby's next-door neighbor, tells the story of the summer he encountered Gatsby, Jordan, Tom, and Daisy from his own point of view. This enhances the story because Nick is a lyrical writer who pulls us in with his beautiful words. 

On the other hand, because the story is told in an "I" voice from Nick's point of view, it's subjective, and we learn that Nick is an unreliable narrator. We're not getting an objective story told by a disinterested party, say a newspaper reporter. Nick, as he tells us, is drawn in by Gatsby in spite of himself, and the story conveys his admiration for Gatsby's charm and his single-minded pursuit of his dream:

If personality is an unbroken series of successful gestures, then there was something gorgeous about him, some heightened sensitivity to the promises of life.… [Gatsby had] an extraordinary gift for hope, a romantic readiness such as I have never found in any other person and which it is not likely I shall ever find again.

Nick also hates Tom and seldom misses a chance to take a shot at him for being a rich, racist, and violent man whose glory days were on the college football team. So perhaps we're getting an unfair picture of the characters: is Gatsby worse and Tom better than Nick makes them out to be? Nick also states quite openly that the story he narrates wasn't the central part of his summer: primarily he was at work in Manhattan, not on Long Island. He may have missed important parts of the action. What story might Gatsby, Daisy, Tom, or even Jordan be able to tell that Nick can't?

Finally, Nick is blind to himself in many ways. He says he is honest, that honesty is one of his "cardinal" virtues, but we know he is dishonest about his girlfriend back home. Many people, including Daisy and Tom, have heard the rumor that Nick is engaged to this woman, and Nick himself alludes to stringing her along without being seriously interested in her. He says he doesn't like her so much, remembering the way sweat would form a mustache on her upper lip after a game of tennis. Fitzgerald didn't create this backstory for no reason: he did it to suggest Nick's unreliability as a narrative voice.

In sum, we love the way Nick seduces us with his beautiful words, but we don't always trust what those words say. 

What is the poetic device used in the line "My name is Ozymandias, King of Kings"?

Interestingly, this single line uses at least four poetic devices. The two sound devices that are most prominent in the line are alliteration and consonance. In the phrase "King of Kings," the initial consonant /k/ sound is repeated, which is alliteration. The words "Ozymandias" and "name" both contain the /n/ and /m/ consonant sounds, but not at the beginning of both words. Repeating internal or end consonant sounds between words is called consonance.

The other two poetic devices relate to "King of Kings." First, this term is an epithet. An epithet is a descriptive term used in place of or alongside of a person's name to characterize the person, often in a positive or negative way. Here the great king chose this epithet as a way to describe his prominence among rulers of his day.

"King of Kings," besides being an epithet, is also hyperbole. Hyperbole is an exaggeration for effect. Although the king claims to be the the king of [all] kings, that was certainly not literally true, or he would have been ruler of the entire world. He chooses to exaggerate his role among other nations as a way to establish his greatness.

Lastly, one could consider whether personification is used here because the statue is speaking. However, because the king had his own words inscribed on the pedestal, this does not really count as giving human qualities to an inanimate object. 

What is criminality?

Biochemical Abnormalities

Scientists have long sought an answer to the heritability of criminality. Early attempts to identify the roots of human criminal behavior were based on the concept of biological determinism,
which explains and justifies human behavior as strictly a reflection of inborn human traits, with little or no attention paid to psychological or environmental influences. For example, Italian physician Cesare Lombroso
reported in L’uomo delinquente (1876; The criminal man) that certain “inferior” groups, by virtue of their “apish” appearance, were in actuality evolutionary throwbacks with criminal tendencies. Since that time, however, more sophisticated scientific theories and methods have been developed to identify the multiple etiologies of human behavior, including criminality.

Among the best-known theories of human behavior to find support in the scientific community are those suggesting certain biochemical imbalances, particularly involving neurochemicals, potentially play a role in generating a wide range of abnormality. Neurotransmitters are responsible for activating behavioral tendencies and patterns in explicit areas of the brain, so it makes sense that imbalances in these chemicals might also negatively affect behavior.

In some research studies, decreased levels of the neurotransmitter serotonin have been discovered in people who are depressed or aggressive, have attempted suicide, or have poor impulse control, such as impulsive arsonists and children who torture animals. In other studies, though, normal levels of serotonin have been found in these same groups, as well as abnormal levels in normal groups. As well, abnormalities in the brain’s levels of dopamine (another primary neurotransmitter) have also been implicated in aggressive and antisocial behaviors, although studies have yielded mixed results. Put simply, the role of neurotransmitters, including serotonin and dopamine, in abnormal behavior remains controversial and likely does not adequately explain criminality without taking into account social and psychological influences.

Perhaps the most widely researched theories of criminality have addressed potential genetic influences. The majority of early investigations in this area examined the role of an abnormality of the sex chromosomes—47,XYY—involving the presence of an additional Y chromosome in an otherwise normal male karyotype. Beginning in the 1960s, Dr. Patricia Jacobs proposed that those males who possess this extra Y chromosome were overrepresented in prisons and mental institutions. She studied nine males (out of more than three hundred males in a maximum security prison) who had an XYY karyotype. These XYY males had above-average height (generally over six feet tall) and below-average intelligence, exhibited personality disorders, and were more prone to have engaged in antisocial acts leading to their incarceration. A number of studies also supported these early findings, which understandably generated considerable interest—and debate—into the abnormal behaviors potentially associated with a XYY condition. By the 1970s, multiple investigations into XYY males in various settings, not just prisons, yielded inconsistent findings with respect to behavior. In fact, the only dependable feature of XYY males, whether incarcerated or not, appears to be that of increased height. No definitive associations between XYY males and criminal behaviors have ever been absolutely demonstrated.

Another proposed genetic explanation for criminal behavior involves an abnormality in the enzyme monoamine oxidase A (MAOA). This important enzyme is responsible for degrading certain neurotransmitters, including dopamine and epinephrine. Theoretically, criminal behavior is more liable when the normal levels of neurotransmitters in the brain are disrupted, which in turn leads to behavioral alterations. To date, no definitive causal link to criminal behavior has ever been established in individuals with a MAOA abnormality.

The biology of criminality is comparable to the biology of aggression, with testosterone (or similar androgens) typically being referenced in order to explain belligerent male behavior. Yet defining male criminal behavior in terms of excessive testosterone, or another biochemical entity, has almost become a cliché, and one without solid scientific merit. A multimodal approach is instead preferable. Therefore, the roles of psychology and environment in criminal behavior must also be considered. When physiological dysfunction exists secondary to genetic dysfunction, cognitive deficits and impulsiveness may also coexist, which sets the stage for criminal tendencies to be acted out. First, a neural defect in almost any form is frequently associated with impatience, irritability, and impulsiveness. Next, misperceptions and ideation, symptoms associated with many different kinds of antisocial behavior, increase anxiety and the tendency to “act out” or “retaliate” for both real and imagined reasons. Finally, intellectual deficits not only diminish judgment but also lessen the person’s ability to acknowledge feelings and describe them verbally rather than through inappropriate actions.

Overall, genetic abnormalities clearly play a role in affecting numerous human characteristics, including mental capabilities and behavior, but to ignore psychology and environment in human characteristics is to be simplistic. After all, criminality refers to a violation of the law, and since there are numerous types of crimes and motivations for them (anger, revenge, financial gain), it is difficult to make claims of definitive, nonenvironmental links between biochemical disorders and criminal behavior without exploring all potential variables. In other words, the nature of human criminal behavior defies simple and straightforward explanations. The exact causes of aberrant behavior are complex and involve multiple influences, of which is genetics is one critical component.

Impact and Applications

Research into the biological and genetic causes of criminality entered the public spotlight starting in the early 1990s as part of the US government’s Violence Initiative, championed by then secretary of health and human Services Louis Sullivan. The uproar began when Frederick Goodwin, then director of the Alcohol, Drug Abuse, and Mental Health Administration, made comments comparing urban youth to aggressive jungle primates. The public feared that research on genetic links to criminality would be used to justify the disproportionate numbers of African Americans and Hispanics in the penal system. Psychiatrist Peter Breggin also warned that unproved genetic links would be used as an excuse to screen minority children and give them sedating drugs to intervene in their impending aggression and criminality. After all, forced sterilization laws had been enacted in thirty US states in the 1920s to prevent reproduction by the “feebleminded” and “moral degenerate.” In the early twenty-first century, the general public remains highly suspicious of any medical or genetic research that might be used to target and marginalize minority or disadvantaged groups as predisposed to “criminal” behavior. This is all the more the case as the Human Genome Project continues to discover genetic links to diseases and pathological behaviors.

In an era in which genes have been implicated in everything from bipolar disorders to the propensity to change jobs, the belief that genes are responsible for criminal behavior is very enticing. However, this belief may have severe ramifications. To the extent that society accepts the view that crime is the result of pathological and biologically deviant behavior, it is possible to ignore the necessity to change social conditions such as poverty and oppression that are also linked to criminal behavior. Moreover, this view may promote the claim by criminals themselves that their “genes” made them do it. While biochemical diagnosis and treatment with medications may be simpler and therefore more appealing than social interventions, this is perhaps reminiscent of the days when frontal lobotomy was the preferred method of biological intervention for aggressive mental patients. In the future, pharmacological solutions to social problems may be viewed as similarly questionable.

Criminality as a specific form of human behavior has been studied by scientists, psychiatrists, psychologists, sociologists, and others who ultimately seek to understand its causes, primarily in the hopes of lessening the occurrence and impact of its more deleterious manifestations. Those researchers who look for solutions in genetics sometimes lose sight of the roles that psychology and environment play in the various expressions of criminal behavior. The same can be said of social scientists who sometimes ignore the roles that genetics and neurochemistry play. It makes better sense to conclude that a combination of genetic, psychological, and environmental influences work in different ways for different individuals leading to the development of criminal behavior in some but not all.

Key terms



metabolic pathway

:

a biochemical process that converts specific chemicals in the body to other, often more useful, chemicals with the help of proteins called enzymes.





neurotransmitter


:

a neurochemical that transmits messages between neurons.





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Winters, Robert C., Julie L. Globokar, and Cliff Roberson. An Introduction to Crime and Crime Causation. Boca Raton: CRC, 2014. Print.

In A Tale of Two Cities, when Madame Defarge ties the knots of her scarf, what does she really mimic doing and have in her mind? What does this...

Madame Defarge is constantly knitting, watching events and people go by her. Each knot represents another person who will face the wrath of the revolution when it comes. Symbolic of the knots on the ropes used to hang from the lampposts those who oppose the principles of the revolution (later followed by the guillotine), Madame Defarge keeps a running record in her own special code. She watches and she knits.

Madame Defarge sees herself as a victim of the nobility, and in a very real way she is, as was the rest of her family. The only justice that she sees is death to the upper class, both literally and figuratively. It is the peasants who must control France. She is sure that they will be just and true to the ideas of “Liberty, Equality, Fraternity.” So, as the Fates of ancient Greece measure out, weave, and cut short the destinies of humanity, Madame Defarge knits away the destinies of those who cross her.

What is the moral or the lesson of "Ozymandias"?

A moral of a story or work of literature is a lesson that the reader can take away regarding what is right, prudent, or good. In Percy Bysshe Shelley's sonnet "Ozymandias," we can take several morals from the life of the ancient Egyptian ruler and his fallen statue.

First, every person leaves a legacy and will be remembered. We don't all have inscriptions that will remain for thousands of years, yet we all affect this world in one way or another. The moral we could take from this poem is that we should live in such a way that we will be remembered fondly as one who benefited others. This king wanted to be remembered as one who brought fear and dread to others. He is a negative example, and we should want to be remembered in the opposite way.

Second, the poem shows that life is fleeting and power is transitory. Ozymandias, at the height of his power, had a statue made of himself with an inscription that commanded respect and fear. But by the time the "traveller from an antique land" saw the statue, the king had been dead for centuries. His life and his power were dismantled long ago, as represented by the way the statue now lies a "colossal Wreck." No matter how great or powerful one thinks himself or herself to be, that power will fade, and life will end, so one should not be overcome with pride.

Third, the person who is being oppressed can take comfort in knowing that his oppressor will not thrive forever. Keeping in mind that a proud slave-driver will eventually be brought low may give his victims a big-picture view that can help them bear their injustice.

Fourth, tyrants will fall. This was a concept dear to the author's heart because he was someone who yearned for a more equitable society. From the point of view of a citizen of 19th-century England, the fallen statue and terminated kingdom of Ozymandias could show that times were improving and that those current leaders who had a "hand that mocked them and [a] heart that fed" would also be overthrown. This moral states that the oppressor should beware his coming doom.

These are some possible morals from Shelley's 14-line poem about Ozymandias.

What is experimental psychology?

Introduction

Wilhelm Wundt
founded the field of psychology, which he termed “experimental psychology,” on establishing his lab at the University of Leipzig in Germany in 1879. Wundt was the first to identify psychology as a separate science, on par with the natural sciences such as biology, physics, and chemistry. Wundt himself was trained as a physiologist and philosopher, and the methods he used in both of those disciplines combined to give structure to the new field. The role of experimental psychology at its founding was to answer philosophical questions using scientific methods. Wundt defined consciousness as the appropriate subject matter for experimentation and devised methods such as introspection (reporting on inner experiences by the subjective observer) to study the activity and structures of the mind (the basis for the school of thought later termed structuralism). Wundt was responsible for removing psychology from the metaphysical realm, providing conclusive evidence that the mind could be studied scientifically. This profoundly affected the development of psychology in the years following, establishing an emphasis on the importance of scientific research methods.

Over the first century of its existence and beyond, psychology came to be defined as the scientific study of consciousness, emotions, and behavior, and experimental psychology is no longer the only type. There now are many other subfields in psychology, such as clinical psychology, social psychology, and developmental psychology, but experimental methods still underlie most of them because that is how knowledge is accumulated in each area. Experimental psychology itself has expanded to include both basic and applied research.

Basic and Applied Research

Basic research, the kind that Wundt himself conducted, is undertaken for the purpose of advancing scientific knowledge, even if the knowledge gained is not directly relevant to improving the lives of individuals. This type of research is more likely to take place in laboratory settings, often on university campuses, using undergraduate students or specially bred lab animals as experimental subjects. These settings do not approximate the natural environment, permitting factors that could interfere with interpretation of the results to be controlled or eliminated, making conclusions more accurate. Examples of basic research include studying animal behavior, examining the perceptual abilities of humans, or determining the factors contributing to aggressive behavior.

Basic research was the only type of research conducted in experimental psychology until the first decade of the twentieth century, when applied psychology was introduced through the American school of thought termed Functionalism. It was at this time that psychologists began being interested not only in how the mind works but also in how the mind works to help individuals interact with their environment. Most of the newer research involved conducting research with humans in their natural environment. For example, school psychologists were trying to find effective tests so that students could be taught at the appropriate levels (the first intelligence tests) and to identify how behavioral problems in the school or home could be controlled. Researchers also were trying to determine the factors that would increase efficiency and satisfaction in the workplace. In addition to these scenarios, researchers now attempt to solve such problems as finding effective ways to teach children with developmental disabilities, identifying new therapy techniques for those with psychological disorders, and developing strategies to increase healthy behaviors such as exercise and decrease unhealthy behaviors such as drug abuse. Applied research results tend to be more generalizable to others, but the relative lack of control sometimes limits the conclusions that can be drawn based on the results, so caution must be taken when recommending procedures from experiments.

The Scientific Method

The methods used for conducting either basic or applied research in experimental psychology are essentially the same as for conducting research in any other science. The first step in the process is identifying a research problem, a question that can be answered by appealing to evidence. Next will be a search for a theory, a general statement that integrates many observations from various research studies and is testable. From the theory is formed a hypothesis, a more precise version of the theory that is a specific prediction about the relationship between the variables in the research being conducted. At this point, the research is designed, which involves decisions about how many and what type of participants will be used, where the research will be conducted, the measurement procedures to be developed, and so on. After the relevant data are collected, they must be analyzed visually or statistically. This allows the drawing of conclusions about the findings, which are communicated to others in the form of presentation or publication. The research process is circular, in that the more questions that are answered the more new questions arise, and that is how science advances.

There are key characteristics that must be present for good scientific research. Objectivity means that research must be free from bias. Data are to be collected, analyzed, interpreted, and reported objectively so that others are free to draw their own conclusions, even if they are different from those of the researchers. Control of factors that may affect the results of the research is necessary if those factors are not the specific ones being studied. For example, control for the effects of gender can be accomplished by ensuring that research samples include approximately the same number of males and females, unless the researcher is interested in looking for potential gender differences in behavior. In that case, the researcher would still want to control for factors such as age, education, or other characteristics that might be relevant. Control allows researchers to be more confident about the accuracy of their conclusions.

Operationism involves defining the variables to be studied in terms of the way they are measured. Many different operational definitions are possible for a particular concept such as aggression or love, and the results of research studies that use different operational definitions when combined provide more complete knowledge than if only one operational definition were used. Finally, replication is a key part of the research process because the aim of science is to accept only knowledge that has been verified by others. This requirement that results be replicable helps prevent bias and furthers objectivity.

Descriptive Versus Experimental Research

Descriptive research is conducted to describe and predict behavior. Often these results are useful on their own, or such studies provide information to be used in future, more controlled, experiments. It can include archival research, an analysis of existing records of behavior, case studies, in-depth analysis of one or a few individuals, naturalistic observation, monitoring the behavior of subjects in their natural environment, or survey research in which individuals report on their own behavior. Descriptive research also includes correlational research, which examines relationships between variables that cannot be manipulated (such as gender, family background, or other personal characteristics that are not changeable). Correlational studies make it possible to predict changes in one variable based on observing changes in another, but as in all descriptive research, it is impossible to know whether or not changes in one variable caused the observed changes in another, so the conclusions to be drawn are limited.

The only type of research that can explain the causes of behavior is true experimental research, because that is the only type of research in which variables can be manipulated to see the observed effects on behavior. The variable that is manipulated is called the independent variable, and the variable that is measured to see the effects of the manipulation is called the dependent variable. Independent variables can be manipulated by measuring the effects of their presence versus absence (for instance, how reaction times differ when alcohol is consumed), their degree (how reaction times change as more alcohol is consumed), or their type (reaction times when alcohol is consumed as compared to when caffeine is consumed). Dependent variables are measured in terms of their latency (how long it takes for a response to occur) or duration (how long a response lasts), force (how strong the response is), rate or frequency (how often a response occurs within a period of time), or accuracy (the correctness of the response). There can be one or more each of the independent and dependent variables in any experiment, although having more variables increases the complexity of the analysis of the results. Every other variable that is present that could have an effect on the dependent variable in addition to the independent variable is considered an extraneous variable. These must be controlled (kept constant) or eliminated so that the researcher can be sure that changes in the dependent variable are due only to changes in the independent variable.

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