In A Tale of Two Cities, explain Charles Darnay's problem and then offer him advice to solve his problem.

Charles Darnay’s problem is that he comes from a horrible aristocratic family.

Throughout the course of the novel, Charles Darnay has more than one problem, but they can all be summed up as caused by his family.  Charles is now the Marquis St. Evremonde.  The family has a history of despicable abuse toward peasants, which also makes them a target for retribution during the French Revolution.  Although Darnay himself is innocent, he is guilty by association as far as they are concerned.

Problem:  Arrested for treason.  Advice:  Hire a good lawyer.

The first time his problem is presented to us is when he is on trial in England.  He is accused of being a spy, and his brilliant but dysfunctional lawyer Sydney Carton is able to get him acquitted on a technicality.  Carton realizes that he and Darnay look a lot alike.  He uses that resemblance to create reasonable doubt, and that is that. 

Problem: Secretly affiliated with the family that imprisoned your girlfriend’s father.  Advice:  Tell the truth.

When Darnay becomes involved with Lucie Manette, he has another problem.  His fiancé and her father do not know about his past.  Essentially he has been lying to them.  They think he was just in the wrong place at the wrong time and is an innocent French tutor.  This may not be so bad, hiding your name from your fiancé and future in-law, but there is an additional problem.  Charles’s family was responsible for imprisoning Lucie’s father, Dr. Manette, in France.

Darnay eventually tells Dr. Manette the truth, but he waits until he is leaving for his honeymoon.  By the doctor’s reaction, he knew all along.  He stops Charles before he can get into specifics.

"Your confidence in me ought to be returned with full confidence on my part. My present name, though but slightly changed from my mother's, is not, as you will remember, my own. I wish to tell you what that is, and why I am in England."

"Stop!" said the Doctor of Beauvais. (Book 2, Ch. 10)

Dr. Manette does not want to confront the reality of Darnay’s identity, because in doing so he has to confront his past.  In fact, the secret’s revelation sends him into a psychotic break of sorts, relapsing to his shoemaking days.  After the nine days, he is fine.  Lorry arranges for his shoemaking materials to be removed, and that is that.   It was good for Darnay to tell him right before leaving, so that his daughter did not see him like that.

Problem: A friend in France needs you, and you cannot go back to France.  Advice:  Don’t go!  It’s a trap. 

Alas, this is not advice that Darnay took.  Darnay got word that his friend and servant Gabelle had been imprisoned by the revolutionaries. He wanted to go back to France to rescue him.  This is extremely dangerous.  It is a bad idea all around!  Not only does he go, but he brings an entourage with him of basically everyone he knows, including his wife and daughter.  Thus he brought them all into danger too.  Fortunately, Sydney Carton had another idea.  The question then becomes: do you agree to change places with a man, even though it will result in his death?

No, Darnay is too good a man for that.  Oh, there is also the fact that he doesn't think that it will work.

"Carton! Dear Carton! It is madness. It cannot be accomplished, it never can be done, it has been attempted, and has always failed. I implore you not to add your death to the bitterness of mine." (Book 3, Ch. 13)

Carton drugs him, and goes to the guillotine in his place.  He loves Lucy, and that is all that matters to him.  He is willing to die so that she can be happy.  It’s romantic.  It’s also pretty depressing and creepy.  Carton feels that his life is not worth living, and this is the best way to use it.

What internal and external conflicts does Uncle Jack face in To Kill a Mockingbird?

Uncle Jack decides to play "parent" to Scout in chapter 9 of To Kill a Mockingbird. He hears that Scout has been swearing up a storm to get attention, recently; so, he tells her that while he is visiting them for the week of Christmas, he doesn't want to hear any of her bad words. When she and Francis get in a fight, apparently Scout calls her cousin "a whore-lady" and jumps on him. When Jack discovers this, he says, "You know I told you you'd get in trouble if you used words like that? I told you, didn't I? . . . Well, you're in trouble now. Stay there" (84).

As Uncle Jack is spanking Scout, she screams that she hates him, she'll hate him for the rest of her life, and she'll never speak to him again. Now the external conflict is how tough it is for him to hurt Scout physically. The internal conflict is dealing with Scout's resentment after being physically punished by her favorite uncle. These conflicts seem to go hand-in-hand because afterwards, Jack asks Scout, "Why, I didn't think you'd hold it against me. . . I'm disappointed in you--you had that coming and you now it" (85).

Therefore, externally, Uncle Jack is faced with having to deal with Scout's decision to use a bad word and him having to hold himself to his threat to spank her. Then, he is faced with the internal and emotional backlash of having disciplined Scout for her actions. Both conflicts damage the relationship between the two of them until the truth is revealed about why Scout called Francis a "whore-lady"--to defend Atticus. Later, Atticus tells his brother the following:

". . . you had the right answer this afternoon, but the wrong reasons. Bad language is a stage all children go through, and it dies with time when they learn they're not attracting attention with it. Hotheadedness isn't. Scout's got to learn to keep her head and learn soon" (87).

In the end, Uncle Jack decides to keep the reason Scout used bad words with Francis a secret by not telling Atticus. This helps to mend his relationship with Scout and solve both external and internal conflicts for the future.

Why was the Industrial Revolution called a revolution?

The Industrial Revolution was truly a revolution. It brought about many changes that impacted many people.

The Industrial Revolution changed the working environment significantly. Before the Industrial Revolution, many people worked at home or in small working environments. The workers often knew the owners and their families. The working environment was fairly informal. Products were often made by hand. When the Industrial Revolution arrived, things changed. Machines were used to make the products. More people worked in factories. The workers often didn't know the owners. Working conditions weren’t very good. Factories were often unsafe and unclean. Workers had long hours and had low pay. Working conditions deteriorated during the Industrial Revolution.

The Industrial Revolution also impacted the economy. Many new products were developed. Products could be made quicker because the machines made it easier and quicker to produce things. Transportation improved making it easier and quicker to transport products and people. This allowed the economy to grow because more products were being made and being sold. People could move to the western regions easier than in the past. Businesses expanded as they followed the people. Thus, the economy and the country grew.

The changes that occurred because of the Industrial Revolution were very significant. The name is very appropriate.

What is the difference between mainstream tourism and Islamic tourism?

Islamic tourism is different than mainstream tourism in many ways. Islamic tourism or halal tourism is geared toward respecting the religious principles of Muslim travelers.  For Muslims, their religion is an important part of how they live their lives on a daily basis.  Halal tourism keeps this in mind and offers a number of vacation destinations in which the adherent does not have to compromise his or her faith.  Halal tourism has a number of differences from mainstream tourism:

• Alcohol is not served in vacation destinations that are considered Islamic tourist venues.


• Prayer facilities are provided on site so the adherent may complete their daily prayer responsibility.


• Food menus reflect Islamic law and dietary practice.


• There are separate swimming and bathing facilities for males and females.

While some of these alterations would detract from the vacation experience for most Westerners, it removes many of the temptations that exist in traditional tourist destinations for the more than one billion people who practice Islam.  

What are 5 good questions for chapters 35 to 39?

It sounds to me like you are asking for some discussion questions based on chapters 35-39 in Maniac Magee.  I can help with that.  A good way to do this might be to come up with one discussion question for each of those chapters.  

Chapter 35 is all about Maniac's time in the McNab house.  Your question could focus on what Maniac thinks about the house.  Or you could have the question ask the reader what he/she thinks about the kind of environment the McNab brothers are growing up in.  

Chapter 36 has Maniac trying to figure out ways to keep Russell and Piper in school.  Ask a question that has the reader hypothesize about how effective Maniac's new plan will be.  

Chapter 37 is really short.  Maniac continues to do heroic deeds to keep the two boys in school.  The boys then dare Maniac to do something they believe is truly scary.  Your question could be "what do the boys dare Maniac to do?"  Or a better question might be to ask why Russell and Piper think that their particular dare is so scary.  

In chapter 38, Mars Bar challenges Maniac to a race.  At one point in the chapter, the following line occurs:

Even as the race began -- even after it began -- Maniac wasn't sure how to run it.

Ask your readers to explain why Maniac had his doubts.  

For chapter 39, ask about the McNab house.  It was in bad shape before, but it's worse now.  What has happened?  Or you can ask a reader to explain the last line in the chapter.  

Now there was no room that Maniac could stand in the middle of and feel clean. Now there was something else in that house, and it smelled worse than garbage and turds.

How does Gatsby's character change in chapter five?

Chapter Five is the chapter in which Gatsby finally meets Daisy again, five years after she broke his heart by marrying Tom. The meeting occurs at Nick's house.

While waiting to meet Daisy—and even for the first few minutes after meeting her—Gatsby is so nervous that he's in anguish. He even tells Nick at one point, "This is a terrible mistake, a terrible, terrible mistake." 

After Nick leaves the two of them alone together for about half an hour, Gatsby and Daisy are no longer nervous. They have apparently had an emotional reunion. Gatsby is very happy, because it seems to him that his dream of getting Daisy back is finally coming true. As the scene proceeds, with a tour of Gatsby's house, Daisy and Gatsby act increasingly in love; by the end of the chapter, when Nick takes his leave of them, "They had forgotten me. . . Gatsby didn't know me now at all."

Gatsby's character does not really change during the course of this chapter. His goal (winning Daisy back) is what it has always been. His assumptions and abilities are the same. What has changed is his emotional state, and also Nick's state of knowledge about Gatsby. Before the revelations of chapters 4 and 5, Gatsby was a mystery figure to Nick. Now, Nick understands what drives Gatsby. He begins to see Gatsby's nobility, but also his limitations.

What is a method to separate salt from salt water?

A solution of salt water is prepared by mixing salt (solute) and water (solvent). Salt can be separated from salt water by using the differences in the properties of water and salt, that is, the solvent and the solute. Water evaporates to the gaseous phase at 100 degrees Celsius, while the salt does not. We can use boiling as the method of separation.

When we boil a solution of salt water, the water will evaporate at around 100 degrees C, leaving behind all the salt in the container. If we also want to recover water, the water vapors can be collected and condensed back to collect all the water.

If time is not a constraint, then we can just leave the salt water out in the open and water will evaporate on its own, leaving behind the salt. That is how salt was obtained from sea water, in older times. 

Whenever separation needs to be done for a solution or a mixture, the differences in the properties of individual constituents can be used to our advantage.

Hope this helps.

How do culture, language and gender portray French Canadian and English relations in The Tin Flute?

The relationship between French Canadians and English people is represented in the novel by the relationship between Daniel and his British nurse, Jenny. The dynamic between the two characters illustrates the level of connection possible between two people that are externally very different. The language barrier between the nurse, who speaks English, and Daniel, who speaks French, is a metaphor for the differences between French Canadians and English-speaking Canadians.

The novel portrays French Canadian culture as a very austere and difficult world to live in. Certainly, the level of poverty informs the cultural differences. For example, Daniel's mother is unable or unwilling to buy him a tin flute that he wants. However, the nurses get it for him as he lays in his sick bed. 

It's also important to note the symbolism of Daniel's situation. The women are responsible for controlling the situation, while gender roles amongst the French Canadians are the opposite. This is seen in the family dynamics of the French Canadians.

List five events that led up to the attack on Fort Sumter.

There were several events that led to the attack on Fort Sumter. In the 1850s and the 1860s, several events occurred that drove the country further apart. The passage of the Kansas-Nebraska Act in 1854 led to conflict in Kansas. Since the people would decide if slavery would exist in Kansas, both pro-slavery people and anti-slavery people clashed over the issue. While slavery could have existed in Nebraska, it wasn’t practical for that to happen. As a result of the fighting in Kansas, two governments were established. One was pro-slavery while the other was anti-slavery. Lives were lost and property was destroyed as a result of the fighting.

Another issue dividing the country was the Dred Scott decision. The Supreme Court ruled in 1857 the slaves were property and could be taken anywhere. The ruling also stated that the Missouri Compromise was illegal. It also said that popular sovereignty was illegal. Southerners were delighted with the ruling while northerners were upset with it.

The Lincoln-Douglas debates in 1858 also contributed to the attack on Fort Sumter. When Stephen Douglas talked about how states could be unfriendly to slavery, in what was known as the Freeport Doctrine, Southern Democrats knew they could never support him. This split the Democratic Party and contributed to the election of Abraham Lincoln as President in 1860. Southerners had no trust in Abraham Lincoln.

The events at Harpers Ferry, West Virginia in 1859 also showed the divide that existed in our country. When John Brown attacked a federal arsenal in hopes of starting a slave revolt, southerners were horrified. Northerners, however, praised him as a martyr. While this attack was unsuccessful in starting a slave revolt, it showed how differently the South and the North viewed certain events.

 The election of 1860 also led to the start of the Civil War. When Abraham Lincoln won the election, southerners were convinced he was going to end slavery. Even though President Lincoln never said he would end slavery, southerners were convinced he would do that. While President Lincoln was against slavery, he was prepared to allow it to remain where it already existed. President Lincoln’s goal was to keep the country together.

It was no surprise when southerners attacked the ships heading to Fort Sumter. President Lincoln was trying to bring supplies to this fort that was located in South Carolina. The southerners couldn’t let that happen, as it would be an acknowledgement that they were still under the control of the United States.

If a block moving up at `Theta` equal to 30 degree with a velocity 5m/s, stops after 0.5 sec, then `mu` is..??

A block is moving up a slope inclined at 30 degrees to the horizontal. The initial velocity of the block is 5 m/s and it stops after 0.5 seconds. We need to determine the coefficient of friction between the block and the surface on which it is moving.

As the block moves up the slope there is a deceleration of the block due to frictional force. Let the mass of the block be m. The normal force of the block on the surface is `(m*g)/sin 30` . If the coefficient of friction is `mu` , the frictional force is equal to `((m*g)/sin 30)*mu` . The acceleration of the block is `(g/sin 30)*mu` = `19.6*mu`

As the block stops moving after 0.5 seconds, using the equation v = u + a*t gives:

`0 = 5 - 19.6*mu*0.5`

`mu = 25/49`

The coefficient of friction between the block and slope is approximately 0.5102

How can you construct a commentary or literary essay that explains the poem "Mushrooms" by Sylvia Plath as a story about history, rebellion and...

To begin crafting a literary essay about the poem "Mushrooms" by Sylvia Plath, you should first create an outline. Structurally, outlines will help keep essays organized and the continuity of ideas clear. There should be three main sections in the body of your outline--one each for history, rebellion, and revolution. An introduction will go before the body addressing your controlling purpose of the essay. At the end will, of course, be a conclusion wrapping up your ideas. 

In terms of history, "Mushrooms" is often analyzed as a poem with a feminist message. Critics argue that Plath was referring to women's rights and women being respected as equal to men. Lines that can be used as evidence include: "Nobody sees us," and "Earless and eyeless, [...] Perfectly voiceless" (7, 15-16). 

The rebellion that echoes throughout the poem sustains the idea that women are coming to the fore of social evolution. Lines that would support such claims include: "Soft fists insist . . ." and "Our hammers, our rams [...] Widen the crannies, Shoulder through holes" (10, 14, 17-18). 

The poem remarks on revolution by stating the change is soon to come. The final three lines of the poem perhaps say this best: "We shall by morning Inherit the earth. Our foot's in the door" (31-33).

Do you agree that Romeo, from Shakespeare's Romeo and Juliet, is a romantic, self-centered boy who doesn't consider the consequences of his decisions?

Arguing whether or not Romeo is "a romantic, self-centered boy who doesn't consider the consequences of his decisions" is a little tricky since being a romantic does not necessarily preclude him being self-centered or inconsiderate of consequences. Is Romeo a romantic? Yes. Is Romeo self-centered and inconsiderate of consequences? No.

Romeo as Romantic: 

Before we even meet Romeo, we're told of his sad countenance as observed by his father Lord Montague: “Many a morning hath he there been seen, / With tears augmenting the fresh morning dew. / Adding to clouds more clouds with his deep sighs” (1.1.134-136). Apparently, Romeo has been seen crying in the garden, and has even resorted to shutting himself up in the dark in his room, as Montague continues telling Benvolio.

We later learn, when Romeo first enters the stage, that he is in love (1.1.173) but cannot be with his love because she has sworn herself to a life of chastity (1.1.225), which is the cause of his ill demeanor. These first few moments with Romeo are crucial in understanding that he is ruled by his heart, laying the foundational characteristics that the rest of the play will build on.

If we look at but a portion of Romeo’s most famous soliloquy, we’re treated to an even clearer example of Romeo’s romanticism:

But soft, what light through yonder window breaks? / It is the East, and Juliet is the sun. / Arise, fair sun, and kill the envious moon, / Who is already sick and pale with grief / That thou, her maid, art far more fair than she. (2.2.2-6)

Here Romeo is comparing Juliet to the rising sun as she steps onto her balcony, saying that her beauty is enough to fend off the night. Romeo goes on to say that the brilliance of her cheeks would put the stars to shame like sunlight would a lamp (2.2.19-21). To say that Romeo is a romantic is an understatement when looking to the rest of these lines.

Romeo not as Self-Centered:

One example of Romeo as a gentleman comes from Lord Capulet himself when he sees Tybalt preparing to accost Romeo at the Capulet party: “Content thee, gentle coz, let him alone. / He bears him like a portly gentleman, / and, to say truth, Verona brags of him / To be a virtuous and well-governed youth” (1.5.74-78). In the ensuing dialogue with Tybalt, Capulet makes it quite clear that he will not tolerate Romeo being hurt at the party despite Tybalt’s anger and frustration at having his family enemy present. If this doesn’t speak to Romeo’s reputation and character, what does?

Perhaps a clearer example of Romeo’s self-sacrifice, rather than self-centeredness, is when he refuses to fight Tybalt in Act 3, Scene 1, knowing that it would cause grief to their families and those involved. Even as Tybalt insults him, Romeo bares him kindness and love. In fact, Romeo pleads with Mercutio and Tybalt to stop fighting after Mercutio attempts to defend Romeo’s honor:

Draw, Benvolio, beat down their weapons.

Romeo draws.

Gentlemen, for shame forbear this outrage!

Tybalt! Mercutio! The Prince expressly hath

Forbid this bandying in Verona streets.

Hold, Tybalt! Good Mercutio!

Romeo attempts to beat down their rapiers.

Tybalt stabs Mercutio. (3.1.87-91)

It is clear here that Romeo intends to stop the fighting, showing full well that the repercussions would be disastrous. And, later on, when Romeo avenges Mercutio’s death by killing Tybalt, he tells Tybalt to take back his slandering of Romeo, making it clear that Tybalt’s insults were indeed hurtful and not easily dismissed; Romeo only dismissed them earlier because of his love for Juliet and his desire to keep the peace between the feuding families.

Conclusion:

To say that Romeo is a romantic is a fair assessment. But, to say that he is self-centered or inconsiderate of consequences is to simplify his character and actions. If anything, Romeo shows thoughtfulness and appreciation for his friends, enemies, and situations.

If George Orwell wrote 1984 as a warning, what is it that he warns us about?

In 1984, George Orwell warns his readers of mankind's potential to destroy what makes us human. This destruction of man's humanity is accomplished by different means:

• Totalitarianism

One a socialist, Orwell became disillusioned with this ideology after living the life of a wandering socialist. When he witnessed what occurred under the Stalin regime, Orwell felt he should alert people to the dangers of the oppression that communist regimes wield. 

The proles are examples of the poor people who are virtually thrown away. The others are watched by Big Brother. Big Brother also exemplifies Orwell's concern that technology could be used against people's individual freedoms through spying on and recording words and actions. 

• Control of Information and History

Having witnessed how Nazi and Communist regimes used propaganda to disseminate misinformation and control ideas, and how history was revised to suit the ruling ideologies, Orwell warns against the death of truth. In 1984, Doublespeak, propaganda, and brainwashing are used to accomplish the death of truth. For instance, when Winston finally agrees 2+2=5, his brainwashing is complete and he no longer recognizes truth.

• Language as Thought Control

By eliminating words and changes in the structure of ideas, the government of Orwell's 1984 narrative controls thoughts that are not in accord with its ideology. This is much like today's political correctness that vilifies those who violate it, as well as efforts on university campuses to allow only one political side of thought in classrooms or with speakers. Moreover, in the world that Orwell constructs, there are no words for dissenting thoughts. Therefore, little dissension exists, so the government is able to control people.

By diminishing individual thoughts, disseminating propaganda, creating constant conflicts, and controlling information, the government of 1984 steals people's humanity from them. Orwell feels this scenario can, indeed, become a reality, and wrote 1984 to warn of this danger.

What is a summary of Chapter 1 of Margaret McMullan's novel When I Crossed No-Bob?

Chapter 1 establishes the main characters through descriptions of their positions in life, clothes and actions. It establishes setting of time and general location through describing the physical characteristics, attitudes and past actions of peripheral characters, for instance:

[The men] all came back with the guns they kept even though they were supposed to give them up and promise never ever to take up arms against the government of the United States again. After the war almost every family was armed.

The first characters introduced are the narrator, the bride (Irene) and the narrator's Momma. Addy and her Momma are uninvited guests, looking in from out-of-doors, at the wedding of elegant Irene, who must have grown up with slaves ("Back when they had slaves"), to tall "happy-scared" Mr. Frank Russell. Both "have all their teeth," which constitutes the possible introduction of a "teeth" motif of riches versus want. Irene's and Frank's families are historically positioned in this part of the narrative in relation to the Civil War. Irene's uncle is giving her away, and contrast is made between Frank's "pa" with one arm and Frank's "ma" with "both arms."

Addy wonders how Mr. Frank, a thin man, could possibly have summoned enough courage to ask Irene's very large uncle--standing in for her father because her "pa died in the war"--for her hand in marriage. Frank's courage--the small facing up to the large--introduces a critical theme developed throughout the book. Addy wonders if "Mr. Frank will ever go away to Texas like" her "pappy" did, leaving Momma with a terrible attack of "misery" that changed the color of her blond hair to brown to white in one short year. Addy would have helped her Momma's misery with herbs and teas if she had known how--and if her Momma had just asked her once.

Addy and her Momma pretend to be happy along with the other guests who have spilled outside the church with cloths spread for feasting. Addy discloses their poverty by saying that they smooth their "thin brown calico dresses" before digressing to character development: she says how "O'Donnells all attend Sunday services" barefoot, with their guns left at the door. Addy sees children playing games all around her and sees the war crippled men; her pappy had told her "stories about the war and the world" before going to Texas with a promise, many years ago, to send for Addy and Momma. After the war, the men kept the guns they were supposed to hand over to the United States government, so nearly all families were armed. The wedding scene is "ten years later in [that] time called peace, when people still walk around ... half clothed, half fed" with ears "still ringing from the four years of war noise. Pappy said after the war, the light was different." Ruins greet people every dawn.

Addy uses the waiting time--waiting for food to be served or offered-- to tell about how people back away when they see her and Momma, about the "O'Donnel way" of ploughing without a mule, and about "No-Bob" land, land into which a "freed black man named Bob" had the misfortune of wandering, going straight "into O'Donnell territory," never to be seen again despite the sheriff's search party. Addy's attention goes back to Momma who instructs her to listen for silver jingling in "people's purses and pockets" and point them out to her. Addy also notices Momma talking to a man with a mule, telling about her woes and about Texas. When Momma looks at Addy again, she looks at her "differently, like [Addy's] a sack of bricks she's tired of hauling."

Addy finds food and sneaks off with it. She says "Hey" to the flower girl, Little Brit, who wanders by. The girls get to talking and meander down to the creek to eat the cakes Little Brit brings to share with Addy. At the creek, they see two Choctaw women on the far side cutting reeds ("cane") for basket weaving. The Choctaw are "squatters" since their tribal lands were taken from them through the "Treaty of Dancing Rabbit Creek." Addy has an unusual experience, for one of the Choctaw women, usually never looking over the creek, looks up at her, "and for a minute, it feels like [they] recognize each other." This is foreshadowing of future events, perhaps an ominous warning of what is to come for Addy. In the creek water, Addy sees her reflection next to Little Brit's. She notes the contrasts and ends the chapter by saying: "I am dirty, it's true and Little Brit has shoes and I do not."

What is the relationship between albinism and genetics?

Risk Factors

Tyrosine, an amino acid, is normally converted by the body to a variety of pigments called "melanins," which give an organism its characteristic colors in areas such as the skin, hair, and eyes. Albinism results when the body is unable to produce melanin because of defects in the metabolism of tyrosine. Those with albinism can be divided into two subgroups: tyrosinase-negative (those who lack the enzyme tyrosinase) and tyrosinase-positive (those in whom tyrosinase is present but inactive). The most serious case is that of complete albinism or tyrosinase-negative oculocutaneous albinism, in which there is a total absence of pigment.

Etiology and Genetics

Albinism appears in various forms and may be passed to offspring through autosomal recessive, autosomal dominant, or X-linked modes of inheritance. In the autosomal recessive case, both parents of a child with autosomal recessive albinism are carriers—that is, they each have one copy of the recessive form of the gene and are therefore not albino themselves. When both parents are carriers, there is a one-in-four chance that the child will inherit the condition. On the other hand, X-linked albinism occurs almost exclusively in males, and mothers who carry the gene will pass it on 50 percent of the time.

Symptoms

People with this condition have white hair, colorless skin, red irises, and serious vision defects. The red irises are caused by the lack of pigmentation in the retina and subsequent light reflection from the blood present in the retina. These people also display rapid eye movements (nystagmus) and suffer from photophobia, decreased visual acuity, and in the long run, functional blindness. People with this disorder sunburn easily, since their skin does not tan. Partial albinos have a condition known as "piebaldism," characterized by the patchy absence of skin pigment in places such as the hair, the forehead, the elbows, and the knees.

Ocular albinism is inherited and involves the lack of melanin only in the eye, while the rest of the body shows normal or near-normal coloration. This condition reduces visual acuity from 20/60 to 20/400, with African Americans occasionally showing acuity as good as 20/25. Other problems include strabismus (crossed eyes or “lazy eye”), sensitivity to brightness, and nystagmus.

Several complex diseases are associated with albinism. Waardenburg syndrome
is identified by the presence of a white forelock (a lock of hair that grows on the forehead) or the absence of pigment in one or both irises, Chediak-Higashi syndrome
is characterized by a partial lack of pigmentation of the skin, and tuberous sclerosis
patients have only small, localized depigmented areas. A more serious case is the Hermansky-Pudlak syndrome, a disorder that includes bleeding.

Screening and Diagnosis

A physical examination will reveal the nature and extent of albinism. In ocular albinism, the color of the iris may be any of the normal colors, but an optician can easily detect the condition by shining a light from the side of the eye.

Treatment and Therapy

Albinism can affect an individual’s lifestyle. Treatment of the disease involves reduction of the discomfort the sun creates. Thus, photophobia may be relieved by sunglasses that filter ultraviolet light, while sunburn may be reduced by the use of sun protection factor (SPF) sunscreens and by covering the skin with clothing.

In ocular albinos, the light shines through the iris because of the absence of the light-absorbing pigment. Children with this condition have difficulty reading what is on a blackboard unless they are very close to it. Surgery and the application of optical aids appear to have had positive results in correcting such problems.

Prevention and Outcomes

Albinism has long been studied in humans and captive animals. Since albinism is basically an inherited condition, genetic counseling is of great value to individuals with a family history of albinism. Albinism has not been found to affect expected life span among humans. However, albino humans are susceptible to sunburns and skin cancer.

Albinism has also been detected in wild animals, but such animals often have little chance of survival because they cannot develop normal camouflage colors, important for protection from predators. Animals in which albinism has been recorded include deer, giraffes, squirrels, frogs, parrots, robins, turtles, trout, and lobsters. Partial albinism has also been reported in wildlife. In other cases, such as the black panther of Asia, too much melanin is formed and the disorder is called "melanism."

Albinism has also been observed in plants, but their life span rarely goes beyond seedline state, because without the green pigment chlorophyll, they cannot obtain energy using photosynthesis. A few species of plants, such as Indian pipes (Monotropa), are normally albino and obtain their energy and nutrition from decaying material in the soil.

Bibliography

Alan, Rick. "Albinism." Health Library. EBSCO Information Services, 14 Jan. 2014. Web. 14 July 2014.

"Albinism." Medline Plus. US National Library of Medicine, 29 Oct. 2013. Web. 14 July 2014.

Gahl, William A., et al. “Genetic Defects and Clinical Characteristics of Patients with a Form of Oculocutaneous Albinism (Hermansky-Pudlak Syndrome).” New England Journal of Medicine 338.18 (1998): 125. Print.

Gershoni-Baruch, R., et al. “Dopa Reaction Test in Hair Bulbs of Fetuses and Its Application to the Prenatal Diagnosis of Albinism.” Journal of the American Academy of Dermatology 24.2 (1991): 220–22. Print.

Lewis, Richard Alan. "Oculocutaneous Albinism Type 1." GeneReviews. U of Washington, Seattle, 16 May 2013. Web. 14 July 2014.

King, Richard A., et al. “Albinism.” The Metabolic and Molecular Bases of Inherited Disease. Ed. C. R. Scriver et al. 7th ed. New York: McGraw, 1995. Print.

King, Richard A., and C. Gail Summers. “Albinism: Ocular and Oculocutaneous and Hermansky-Pudlak Syndrome.” Management of Genetic Syndromes. Ed. Suzanne B. Cassidy and Judith E. Allanson. 3rd ed. Hoboken: Wiley, 2010. 53–68. Print.

Pollier, Pascale. Journal of Audiovisual Media in Medicine 24.3 (2001): 127. Print.

Salway, Jack G. “Amino Acid Disorders: Maple Syrup Urine Disease, Homocystinuria, Alkaptonuria, and Albinism.” Medical Biochemistry at a Glance. 3rd ed. Malden: Blackwell, 2012. 102–4. Print.

Scriver, Charles, et al., eds. The Metabolic and Molecular Bases of Inherited Disease. 8th ed. 4 vols. New York: McGraw, 2001. Print.

Tomita, Yasuchi. “Molecular Bases of Congenital Hypopigmentary Disorders in Humans and Oculocutaneous Albinism 1 in Japan.” Pigment Cell Research 13.5 (2000): 130. Print.

What is a summary of "A Child's Thought" by Robert Louis Stevenson?

In his poem “A Child’s Thought,” Robert Louis Stevenson captures the musings of a seven-year child as he drifts off to his sleepy dreams. In the second stanza, he describes the child’s room as it sits the next morning.  The poem is written in couplets which provide a quick, child-like rhyming pattern.

The first stanza describes the young child’s dreams. The child sees castles, gardens, heroic horsemen, and ladies who need rescuing. There are “magic fruits” in the lush, imaginary land a seven-year conjures in his sleepy head.  

In the second stanza, Stephenson, describes how the child seeks that enchanted dreamland when he awakes. The child’s room is just as it should be with chairs, carpet, bath, and boots all in place. There are no gallant horsemen or damsels in distress.  It is the room of seven-year-old, not of his dreams.

How is agency theory relevant today?

Agency theory developed in the 1960s and 1970s. The idea asserted that a principal (organization, leader) delegated authority to an agent (manager). The agent was then expected to act in the best interest of the principal, but there was no assurance that an agent would always act in the best interests of the principal or that the agent's behavior would be appropriate.

Today, the principal and agent relationship continues to exist. Managers are often considered agents of organizations, which are the principals. Principals often delegate work to the agent, expecting the agent to carry out that work in the best interest of the organization and the organization's stakeholders.  Unfortunately, the agent does not always act in the best interest of the principal. The agent may act in his or her own best interest or the best interest of that agent's particular division. This creates a dichotomy in the agent and principal relationship. Furthermore, when an agent does not act in the best interest of the principal, the agent places the principal at financial risk and possibly legal risk as well.

What is the most essential internal conflict within Gabriel Garcia Marquez's "A Very Old Man with Enormous Wings"? What are the external conflicts?

The story of "A Very Old Man with Enormous Wings" by Gabriel García Márquez is an example of magical realism, in which the appearance of the mysterious winged man reveals the moral failure of the villagers he encounters, and especially their failure when measured against standards of Christian charity that form a moral backdrop for the story. The essential conflict in the story is that of how to respond to the appearance of the mysterious old man. 

In a sense, there is no real external conflict, for all though the old man is mistreated by the villagers, he does not harm them or struggle against them, but is passive, serving as a sort of mirror of their own understandings of their world.

The village priest Father Gonzaga, speaks to the man in Latin, and when the man does not understand the language, claims that the ignorance of Latin and the man's shabby condition prove he is not an angel. Of course, more sophisticated Christian theologians would consider Hebrew or an mysterious angelic form of communication, not Latin, to be the language of angels, and Jesus himself and his disciples were people of modest backgrounds rather than the rich and powerful. The conflict here is between the priest's confusion of holiness with wealth and outward display and a less worldly understanding of religion.

The villagers, in seeing the old man primarily in utilitarian terms, are also in conflict with a moral vision that judges people on their innate worth. In a sense, another central conflict is between that of the villagers who wish to shape and understand the old man according to their own needs and preconceptions and the irreducibly mysterious nature of the man himself. 

The internal conflicts of the old man are really not known as we do not as readers have access to his thoughts. His external struggles are to regain his health and escape. Pelayo and Elisenda have as internal conflicts their struggles to decide what to do with the old man. 

How many bones does a sixteen-year-old have?

This question is a tricky one for a couple of reasons. First, the number of bones in the body changes during our lifetime. Newborn babies have around three hundred bones, but throughout childhood, adolescence, and even into adulthood, many of these bones will fuse together. Have you ever looked at an adult skull and noticed the lines running across the top and back of the skull? These are the seams where five cranial plates have grown together. In a newborn, these five plates of bone were not connected, but during growth they have fused into one piece of cranial bone. 

Everyone experiences growth at a slightly different rate; as such, two people of the same age may have slightly different skeletal structures. Biological sex plays a part in when bones are fusing, with female adolescents completing their bone growth and fusion a few years earlier than males. For example, the growth plates of the elbow fuse at about age twelve to fourteen in females, but not until fifteen or sixteen in males.

That being said, almost all people complete their skeletal growth and fusion by the age of twenty-one, and the majority of people are finished by age eighteen. Much of the fusion which reduces the bone count (as with the cranial plates) takes place in childhood or early adolescence. With this in mind, I would estimate a typical sixteen-year-old has slightly more than or about the same number of bones as an adult: two hundred and six.

In Catcher in the Rye, who did Holden try to sexually advance on, but did not carry it out? And who were examples of people that Holden tried to...

Holden tries to alienate himself from just about everybody.  The list would be shorter if you asked who does Holden not alienate himself from.  I can only think of one character for sure that Holden genuinely enjoys being around, wants to spend time with, and isn't willing to run away from.  That would be his sister, Phoebe.  You might include Jane in that list, but she never actually appears in the novel, so I don't think that she is a good choice.  Holden alienates just about everybody else.  He alienates his roommate, Stradlater as well as his hall neighbor Ackley.  Holden also intentionally distances himself from adults as well.  Throughout the novel he avoids his own family and distances himself from Mr. Spencer, who was the only teacher that Holden liked in the first place.  

Holden tried to make sexual advances with Sunny, a prostitute.  He could not carry through with it though, because he began seeing her as a person instead of a sexual object. 

"I'll pay you and all, but do you mind very much if we don't do it? Do you mind very much?" The trouble was, I just didn't want to do it. I felt more depressed than sexy, if you want to know the truth. She was depressing. Her green dress hanging in the closet and all.

Why is imagination closely linked with Romanticism?

As opposed to Enlightenment philosophers who privileged logic and learning, the Romantics felt that emotion and imagination were more vital, important and reliable than logic.  The reason they believed this is that emotion and imagination do not need to be learned; we know how to feel and to imagine without being taught, and so, to them, it seemed more integral to the human experience.  Intense emotion, especially, was thought to be desirable because it is so visceral, and imagination could inspire writers to produce works that would compel this kind of very intense feeling -- like horror -- in the reader.  It is in this way that Mary Shelley's Frankenstein qualifies as a work of Romantic fiction.  The horror produced in the reader from her imaginative descriptions of the creature and his monstrous doings is just the kind of intense emotion prized by Romantics. 

What is Social Darwinism?

Social Darwinism is not really something that many people believe in today.  It is more common to talk about Social Darwinism in the past tense because many people believed in it roughly a century ago.  Social Darwinism was the idea that human beings (both as individuals and groups) have to compete for survival in the same way that plants and non-human animals do.  Because humans also have to compete to survive, they are subject to natural selection.  This means that those people who prosper do so because they are the “fittest.”

Social Darwinism got its name from Charles Darwin.  Darwin proposed the theory of evolution, which holds that plants and animals have to compete to survive.  The process of natural selection picks the individuals and species that survive.  Therefore, the survivors are simply naturally better for the environment in which they live (they are the fittest).

Social Darwinism held that people were the same way.  An individual who succeeded in life (who, for example became rich or powerful) must have done so because they were better than those who did not.  A society that became rich and powerful did so because it was superior to the poorer and weaker societies.  The same was true of a race that came to have more power. 

This was a very important idea because it implied that inequality was completely justified.  If some people were poor and others were rich, that was natural.  It happened because people got what they deserved.  If whites, for example, were better-off than blacks, it was because they were racially superior.  All of this meant that there was no need for the government to try to do anything about inequality.  This is one reason why Social Darwinism was a major theory that underpinned the society and politics of the late 1800s and early 1900s.

What is tolerance?

Background and Basic Principles

For millennia, humans have sought to counteract the effects of harmful substances by taking small amounts of the substance and then gradually increasing its levels. This practice is called mithridatism, named for Mithridates VI, the former ruler of Pontus who, after his defeat by the Romans in 63 bce, tried to commit suicide by taking poison. However, because he had built up immunity to diverse poisons by years of incremental exposure to them, the poisons did not end his life and he had to resort to demanding he be killed with a sword. Mithridatism can be effective if the substance does not pass through the body too quickly or accumulate to dangerous levels; it works because tolerance to the drug has been established.

Tolerance is influenced by diverse variables, including type of drug, dosage level, frequency of administration, environmental circumstances, psychological factors, and the drug user’s physiology. Tolerance may develop to some effects of a drug; however, little or no tolerance may occur to other effects. Although tolerance normally develops slowly, it sometimes occurs after only one or a few administrations, a phenomenon called tachyphylaxis. The effects of tolerance may accrue to other, usually closely related, drugs, through cross-tolerance.

Drug tolerance typically dissipates when exposure to a drug is limited or stopped. Conversely, with reverse-tolerance, or sensitization, in which a drug’s effectiveness progressively increases with repeated administration, the effect often persists long after a drug is discontinued.

Tolerance Mechanisms

The complexity and diversity of tolerance phenomena indicate that multiple factors underlie its occurrence. Three main mechanisms of tolerance have been identified, two are physiological and one is more psychological. Metabolic tolerance (also known as dispositional tolerance) involves increased levels of enzymes in the body to metabolize a drug; subsequently, the level of the drug in the body decreases. Metabolic tolerance will diminish all effects of a drug because the amount of the drug throughout the body is lowered.

Cellular-adaptive tolerance (also known as pharmacodynamic or physiological tolerance) is the second main physiological mechanism of tolerance. Cellular-adaptive tolerance involves diverse adjustments by the body to restore its predrug functioning; this results in decreased drug effects. Essentially, cellular-adaptive tolerance is marked by the body’s compensatory actions to reestablish the homeostasis (the normal physiological stability) disrupted by the introduction of a drug.

The compensatory processes can work at multiple levels. For example, an appetite-suppressing drug may lose its effectiveness at the cellular level because its blocking action at neuronal receptors is diminished. This diminishment occurs because, postsynaptically, more receptors are being produced and, presynaptically, more neurotransmitter is being produced. Conversely, for an appetite-suppressing drug that works by increasing neurotransmitter levels at neuronal receptors, the number of receptors and the amount of neurotransmitter produced may be decreased (a process called down-regulation). The body may also compensate for the drug in other ways, such as by producing more ghrelin, a hormone that stimulates appetite, or by increasing activity in regions of the hypothalamus that stimulates appetite.

Environmental and psychological factors almost always alter the effectiveness of a drug through a third tolerance mechanism known as behavioral tolerance. Behavioral tolerance works through a variety of conditioning (learning) and psychological processes. Respondent (also called classical) conditioning, in which two stimuli are paired repeatedly and in which the response to one stimulus is eventually elicited by the other stimulus, was demonstrated by Ivan Pavlov (in the early twentieth century). The environment in which the drug is administered is a stimulus that is usually conditioned to the effects of the drug. What typically is conditioned is the body’s attempt to resist the drug. Thus, the environment elicits compensatory actions that cause a drug to be less effective; tolerance, controlled by environment, develops. This can have dangerous consequences for a drug addict who has developed tolerance to lethal doses of a drug consistently taken in a particular setting. If the person takes the drug in a novel setting, the conditioned tolerance is absent; the loss of this tolerance may result in a fatal overdose.

Operant conditioning, in which the frequency of a behavior is determined by its consequences, also plays a role in tolerance development. Research by Muriel Vogel-Sprott and colleagues in the 1990s demonstrated that when people are rewarded for resisting the effects of a drug, they develop tolerance more rapidly than those who are not rewarded. Conversely, withholding a reward may prevent tolerance from developing. For example, amphetamine causes loss of appetite in diverse species; however, if the drug is administered to a hungry animal that is not given the opportunity to eat after being given the drug, tolerance to the appetite-suppressive effects of the drug will not evolve. Thus, whether or not tolerance develops depends on the conditions in which a drug is administered.

Bibliography

Hart, Carl L., Charles Ksir, and Ray Oakley. Drugs, Society, and Human Behavior. 14th ed. New York: McGraw-Hill, 2011. Print.

Julien, Robert M., Claire D. Advokat, and Joseph E. Comaty. A Primer of Drug Action: A Comprehensive Guide to the Actions, Uses, and Side Effects of Psychoactive Drugs. 12th ed. New York: Worth, 2011. Print.

McKim, William A. Drugs and Behavior: An Introduction to Behavioral Pharmacology. 6th ed. Upper Saddle River, NJ: Pearson, 2007. Print.

"The Neurobiology of Drug Addiction 6: Definition of Tolerance." National Institute on Drug Abuse. NIH, Jan. 2007. Web. 4 Nov. 2015.

Siegel, Shepard. “Drug Tolerance, Drug Addiction, and Drug Anticipation.” Current Directions in Psychological Science 14.6 (2005): 296–300. Print.

What are hydroceles?

Causes and Symptoms

Hydroceles occur in 1 percent of adult males. In patients between the ages of eighteen and thirty-five, the presence of an underlying testicular tumor must be ruled out. Accurate diagnosis can be carried out through physical examination. A hydrocele is a smooth, cystlike mass completely surrounding the testicle such that only the mass can be palpated; the testis, inside, cannot be felt. Hydroceles do not involve the spermatic cord. When a light is shined through the cyst, the light is readily transmitted. If the hydrocele is large or tense and the testis cannot be examined, ultrasound examination can eliminate the diagnosis of a testicular abnormality.

Treatment and Therapy

Removal, called hydrocelectomy, is primarily indicated for adult hydroceles
that produce discomfort, objectionable scrotal enlargement, or an uncertainty regarding underlying testicular abnormalities upon scrotal ultrasound or physical examination. The presence of a hydrocele does not necessarily require surgical intervention, drainage, or other intervention; it must be accompanied by some significant abnormality to require surgery.

Surgical excision is the most effective method for treatment and can be done on an outpatient basis. A 5.0- to 7.6-centimeter (2.0- to 3.0-inch) incision is made in the scrotum, and the wall of the hydrocele is identified and dissected free. The hydrocele sac is removed and its edges sewn or cauterized to eliminate bleeding. The testis is then returned to the scrotum, and the incision is closed. For large hydroceles, a small drainage tube is introduced into the scrotum to limit swelling.

The most frequent complication of hydrocele surgery is scrotal swelling, which may continue for eight weeks. Most patients return to full activity within seven to ten days of surgery, however, and recurrences are rare.

In addition to surgical removal, other treatment options include needle aspiration and aspiration with the injection of sclerosing agents. Needle aspiration is rarely effective and increases infection risk. Fluid usually reaccumulates within three months of aspiration. Aspiration with the injection of sclerosing agents such as tetracycline is successful in fewer than 50 percent of patients and usually requires multiple treatments.

Bibliography

Francis, John J., and Laurence A. Levine. "Aspiration and Sclerotherapy: A Nonsurgical Treatment Option for Hydroceles." Journal of Urology 189, 5 (May 2013): 1725–1729.

Graham, Sam D., Jr., et al., eds. Glenn’s Urologic Surgery. 7th ed. Philadelphia: Lippincott Williams & Wilkins, 2010.

"Hydrocele." Mayo Clinic, November 3, 2011.

Kay, K. W., R. V. Clayman, and P. H. Lange. “Outpatient Hydrocele and Spermatocele Repair Under Local Anesthesia.” Journal of Urology 130, no. 2 (August, 1983): 269-271.

Lyons, Sonja. "Hydrocele/Varicocele." HealthLibrary, September 26, 2011.

Sherwood, Lauralee. Human Physiology: From Cells to Systems. 7th ed. Pacific Grove, Calif.: Brooks/Cole/Cengage Learning, 2010.

Wampler, Stephen M., and Mikel Lianes. "Primary Care Urology: Common Scrotal and Testicular Problems." Primary Care: Clinics in Office Practice 37, 3 (September 2010): 613–626.

Why did George Washington say Americans should be worried about political parties?

The answer to this question can be found in Washington's Farewell Address, issued in 1796 as he prepared to leave office. Washington was clearly concerned by the development of emerging political factions--so-called Republicans and Federalists--that coalesced in response to many of the serious political issues of the day. Washington feared what he called the "baneful effects of the spirit of party." He warned that some Americans had come to view the interests of their section (i.e. the South and Northeast) as preeminent over loyalty to nation, and sought to organize political factions around these interests. He worried as well that loyalty to one European nation (i.e. France or Great Britain) in the conflict raging in Europe could cause political division and strife. He summed up these effects in one of the most memorable passages from the Address:

It [the spirit of party] serves always to distract the public councils and enfeeble the public administration. It agitates the community with ill-founded jealousies and false alarms, kindles the animosity of one part against another, foments occasionally riot and insurrection. It opens the door to foreign influence and corruption...

Washington's real fear was that political parties and factions always resulted in disorder and chaos. He feared that, in response to the chaos created by parties, Americans would look to strong leaders, "cunning, ambitious, and unprincipled men," who would exploit people's fear of social disorder to emerge as despots. In this way, Washington thought, political parties represented a real threat to the republican government he had devoted his life to establishing.

How does a star like the sun become a red giant?

The sun, like other stars, is dependent on nuclear reactions for its energy. The particular type of nuclear reaction that powers the stars is nuclear fusion, in which smaller nuclei combine to form larger nuclei. Specifically, for a star in the main sequence (just like our sun), hydrogen is being converted to helium during the nuclear fusion process. Over time, the hydrogen at the core will be used up. When this happens, the core contracts as the fusion of hydrogen to helium stops and the fusion of helium to carbon starts. However, the outer portions of the star still contain hydrogen and the fusion of hydrogen to helium goes on in there. This causes an expansion of the outer portions of the star and the star grows in size. This also causes a cooling of the star and it turns red (and that is why it is called a red giant). 

All stars become a red giant at some point in their lifecycle.

Hope this helps. 

Who is the the protagonist in "Killings," and what are the two opposing forces that are pulling at him?

The protagonist in Dubus's "Killings" is Matt Fowler. He is the father of Frank who is killed by Richard Strout; and, Richard kills him because he was dating his estranged wife Mary Ann. The two opposing forces facing Matt Fowler are his and his wife's grief for the loss of their son and his sense of justice. First, Matt and his wife's grief for their murdered son is antagonized by the fact that the murderer is out on bail and walking around town as if he were free and clear of any responsibility. He even gets a job at a bar in the next town over; but Ruth, Matt's wife, doesn't feel comfortable even going to the store because she's afraid to run into the man who killed her son. The author describes Matt's grief as follows:

". . . and then he lost Frank in a way no father expected to lose his son, and he felt that all the fears he had borne while they were growing up, and all the grief he had been afraid of, had backed up like a huge wave and struck him on the beach and swept him out to sea."

Matt and Ruth's daily lives are filled with grief and pain for the loss of their son; and, Matt wants to relieve that grief no matter what it takes.

Then, when Matt articulates his concerns about his grieving wife to his friend, Willis helps to tug at Matt's sense of justice by reminding him of a woman who shot her husband and got away with it. Willis bets that Richard will only get five years in prison for Frank's murder. Not only is that an unsatisfactory number of years to serve for murder, if Ruth can't handle seeing Richard in town now, what would it be like in five years after he's served his sentence and allowed to roam free? In addition to the injustice discussed by the men about the justice system, Willis says that he will help Matt plan a way to take care of Richard.  

Other thoughts that trigger Matt's sense of justice center around the fact that Richard shot Frank in front of his two young son's, Mary Ann seemed painfully troubled while dating Frank, and so many people's lives have been hurt because of Richard. And to Matt, no one will receive justice for all of the pain that he has inflicted on them.

What were four causes of the Scientific Revolution?

The Scientific Revolution occurred in the sixteenth and seventeenth centuries, leading to the Enlightenment. 

In the sixteenth century, Copernicus stated that the earth revolved around the sun. This was the beginning of the “heliocentric” view of the universe. This was a shocker for just about everybody. It shook the religious world to its roots. Previously, it had been assumed that everything revolved around the Earth, and that it did so because God wanted it to. To say that the Earth instead revolved around the sun was considered heresy by some. Once this barrier was broken, scientific progress continued to be made. Galileo confirmed Copernicus' theories in 1610 and added more new information about the planets.

The Protestant Reformation broke the hold of the Catholic church in some places. It began in 1517 with Martin Luther's 95 Theses. Some credit this religious change with making some degree of scientific progress more likely than would have been possible under Catholicism, although this viewpoint is debated. Martin Luther himself was not particularly supportive of any scientific ideas that were not supported by the Bible. 

The Renaissance brought back ancient scientific texts that had been more or less “lost.” These texts generated more interest in science and also gave scientists a better starting point than would have been possible without the revived texts.

The invention of the printing press in 1448 greatly facilitated the flow of information. Now scientists could learn of each other's experiments and observations much more quickly than they could have previously, when everything had to be handwritten, a slow and expensive process.

Later, of course, the Scientific Revolution was crowned by Newton's Laws, which provided a new way of looking at the universe, as a place that followed strict scientific laws that could be discovered and described.

What is the relationship between gods and mortals in Homer's Iliad?

The Iliad came out of a pagan warrior culture in which the gods were conceived of as very similar to mortals, only bigger and better.  They may have special powers and live in a different realm, but their behavior, emotions, loyalties, and so on are very similar to those of the people of the day.  That is why we often find the gods doing things that we would find objectionable, such as rape.  This is very different from the Judeo/Christian conception of God as holy, sinless and completely "other" than people.

The Iliad was written in an aristocratic culture.  There were kings (landowners/warlords), warriors, commoners, and slaves.  So, you find the gods behaving like a bunch of aristocrats relative to the mortals.  For example, they take people under their patronage, and then will protect and help that person and seek to harm his or her enemies.  You will even find a god becoming the patron of an entire city and fighting for it.  In return for their patronage, the gods expect respect, honor, and various gifts and sacrifices.

You also find the gods fighting among themselves (like petty kings), and also pouting and taking petty revenge, as when Apollo cursed Cassandra because she wouldn't sleep with him. 

The gods are very directly involved in the Trojan War in the Iliad.  You can find examples of them deflecting spear points and so on during battles.  However, because there are many gods and they are actually fighting against each other, the gods' involvement does not improve the lives of people as a whole but, if anything, contributes to the chaos, danger, and uncertainty of the world of the Iliad. 

In fact, you could argue that it's a major theme of the Iliad that the involvement of the gods and of fate tends to make people's lives tragic. 

What does Mr. Nathan Radley know about the intruders in the garden?

In chapter six of Harper Lee's To Kill a Mockingbird, Jem, Dill, and Scout venture into the backyard of the Radley home to get a peek at Arthur through a broken shutter. Dill and Scout wait near the fence as Jem sneaks up onto the back porch, but when he steps on the bottom step, it squeaks. This must have alerted Nathan Radley, because the kids see shadows moving from within the house. Suddenly, Scout sees someone on the porch with Jem.

"At first I thought it was a tree, but there was no wind blowing, and tree-trunks never walked. The back porch was bathed in moonlight, and the shadow, crisp as toast, moved across the porch toward Jem" (53).

Nathan Radley is on the back porch with Jem, but he doesn't seem him. In an effort to get away as soon as possible, Jem jumps off the porch and makes a run for it. Nathan Radley sees Jem, but because of the darkness, doesn't really know who the intruder is. He shoots his gun, which alerts all the neighbors, and Nathan Radley tells Stephanie Crawford that he "shot at a Negro in his collard patch" (54). This proves that Nathan Radley didn't know exactly who was in his yard because he blames it on a black man. It's obvious, too, that Nathan Radley did not see Scout and Dill because he probably would have told the  neighbors that a whole crew of black men had been in his yard.

What are natural treatments for alcoholic hepatitis?

Introduction

The liver is a sophisticated chemical laboratory, capable of
carrying out thousands of chemical transformations on which the body depends. The
liver produces some important chemicals from scratch and modifies others to allow
the body to use them better. In addition, the liver neutralizes an enormous range
of toxins.

A number of influences can severely damage the liver, of which alcohol is
the most common. This powerful liver toxin harms the liver in three stages:
alcoholic fatty liver, alcoholic hepatitis, and cirrhosis. Although the first two
stages of injury are usually reversible, cirrhosis is not. Generally, liver
cirrhosis is a result of more than ten years of heavy
alcohol
abuse.

Usually, alcoholic hepatitis is discovered through blood tests that detect levels of enzymes released from the liver. The blood levels of these enzymes, which are known by acronyms such as SGOT, SGPT, ALT, AST, and GGT, rise as damage to the liver (by any cause) progresses.

If blood tests show that a person has alcoholic hepatitis (or any other form of liver disease), it is essential that the person stop drinking. There is little in the way of specific treatment beyond this.

Principal Proposed Natural Treatments

Several herbs and supplements have shown promise for protecting the liver from alcohol-induced damage. However, none of these has been conclusively proven effective, and cutting down (or eliminating) alcohol consumption is undoubtedly more effective than any other treatment. Following is a discussion of the treatments used specifically to treat early liver damage caused by alcohol.

Milk thistle. Numerous double-blind, placebo-controlled studies
enrolling several hundred people have evaluated whether the herb milk thistle
can successfully counter alcohol-induced liver damage. However, these studies have
yielded inconsistent results. For example, a double-blind, placebo-controlled
study performed in 1981 followed 106 Finnish soldiers with alcoholic liver disease
over a period of four weeks. The treated group showed a significant decrease in
elevated liver enzymes and improvement in liver structure, as evaluated by biopsy
in twenty-nine subjects.

Two similar studies enrolling approximately sixty people also found benefits. However, a three-month, double-blind, placebo-controlled study of 116 people showed little to no additional benefit, perhaps because most participants reduced their alcohol consumption and almost one-half of them stopped drinking entirely. Another study found no benefit in seventy-two persons who were followed for fifteen months.

A 2007 review of published and unpublished studies on milk thistle as a treatment for liver disease concluded that benefits were seen only in low-quality trials, and even in those, milk thistle did not show more than a slight benefit. A subsequent 2008 review of nineteen randomized trials drew a similar conclusion for alcoholic liver disease generally, although it did find a modest reduction in mortality for persons with severe liver cirrhosis.

Other proposed natural treatments. The supplement
S-adenosylmethionine (SAMe) has also shown some promise for
preventing or treating alcoholic hepatitis, but there is no reliable evidence to
support its use for this purpose. The supplement trimethylglycine helps the body create its own SAMe and has
also shown promise in preliminary studies.

Herbs and Supplements to Avoid

High doses of the supplements beta-carotene and vitamin A
might cause alcoholic liver disease to develop more rapidly in people who abuse
alcohol. Nutritional supplementation at the standard daily requirement level
should not cause a problem.

Although one animal study suggests that the herb kava might
aid in alcohol withdrawal, the herb can cause liver damage; therefore, it should
not be used by people with alcoholic liver disease (and probably not by anyone).
Numerous other herbs possess known or suspected liver-toxic properties, including
coltsfoot, comfrey, germander, greater celandine, kombucha, pennyroyal, and
various prepackaged Chinese herbal remedies. For this reason, people with
alcoholic liver disease should use caution before taking any medicinal herbs.

Bibliography

Abittan, C. S., and C. S. Lieber. “Alcoholic Liver Disease.” Current Treatment Options in Gastroenterology 2 (1999): 72-80.

Leo, M. A., and C. S. Lieber. “Alcohol, Vitamin A, and Beta-carotene: Adverse Interactions, Including Hepatotoxicity and Carcinogenicity.” American Journal of Clinical Nutrition 69 (1999): 1071-1085.

McClain, C. J., et al. “S-adenosylmethionine, Cytokines, and Alcoholic Liver Disease.” Alcohol 27 (2002): 185-192.

Ni, R., et al. “Toxicity of Beta-carotene and Its Exacerbation by Acetaldehyde in HepG2 Cells.” Alcohol and Alcoholism 36 (2001): 281-285.

Rambaldi, A., and C. Gluud. “S-adenosyl-l-methionine for Alcoholic Liver Diseases.” Cochrane Database of Systematic Reviews (2001): CD002235. Available through EBSCO DynaMed Systematic Literature Surveillance at http://www.ebscohost.com/dynamed.

Rambaldi, A., B. Jacobs, and C. Gluud. “Milk Thistle for Alcoholic and/or Hepatitis B or C Virus Liver Diseases.” Cochrane Database of Systematic Reviews (2007): CD003620. Available through EBSCO DynaMed Systematic Literature Surveillance at http://www.ebscohost.com/dynamed.

How does air get from the nostrils to the lungs?

In order for respiration to occur, gases must be exchanged between the human and the environment. Oxygen must be inhaled while carbon dioxide must be exhaled as a waste.

When we inhale, air enters the nose where it is moistened and filtered due to hairs that can trap dust and other particles. Next, air passes into the pharynx, the tube inside the throat.  Next, air passes into the trachea, a tube which has cartilaginous rings to strengthen it and to help it remain open. At the top of the trachea are the vocal cords as well.

Next, the trachea branches into two large tubes called the bronchi and air continues on its journey. Each of these bronchi lead to one of the two lungs. Inside our lungs, the bronchi divide into smaller tubes called bronchioles. These continue to get smaller and smaller, with their ends culminating in tiny alveoli or air sacs. These are the organs of gas exchange. They are surrounded by tiny capillaries from the circulatory system which allow the exchange of gases between the alveoli and the blood stream. Oxygen in the air sacs enters the capillaries by diffusion, and can be transported in the circulating blood to the cells, while carbon dioxide in the bloodstream enters the air sacs by diffusion and can be exhaled.

Breathing is regulated by carbon dioxide levels in the blood. Higher levels mean that the brain sends impulses to the diaphragm (a muscular organ between the chest and abdomen) to cause it to contract. When this occurs, the air pressure inside the chest cavity is lower than the surrounding air. This change in pressure pushes air into the nose and it begins its journey to the lungs.

When we exhale, the diaphragm relaxes. This  causes the air pressure inside the chest cavity to become higher than in the surrounding air. This pushes air out of the lungs and, eventually, we exhale.

I have included a link to a labeled diagram of the human respiratory system.

What are developmental disorders?

Causes and Symptoms

According to the revised fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (known as the DSM-IV-TR), published in 2000 by the American Psychiatric Association, the developmental disorders may be categorized into five distinct disorders that all share the central feature of childhood development that is outside the norm in some manner. These disorders are included under the heading of pervasive developmental disorders in the DSM-IV-TR. The term pervasive is used to indicate the extensive developmental deficits found among these disorders. The five pervasive developmental disorders in the DSM-IV-TR are autistic disorder, Rett syndrome, childhood disintegrative disorder, Asperger syndrome, and pervasive developmental disorder not otherwise specified (PDD-NOS).

Autistic disorder is probably the best known of the disorders in the developmental disorders group. The disorder has an onset before age three but may not be formally diagnosed until some years later. Children with autistic disorder do not commonly show any unusual physical characteristics, but they demonstrate a number of behavioral, social, and affective symptoms. There are usually major deficiencies in the capacity to show social relatedness to others, including parents. The social smile is absent during infancy, and autistic children continue to show deficits in play activities and social attachments throughout their lives. There is an inability to understand or infer the feelings and mental state of other people around them. Language development is usually limited, with difficulties in communicating ideas even when the vocabulary is present. Delayed mental development occurs in a high percentage of children with autism, with greatest deficits in abstract reasoning and social understanding. Children from an early age do not show interactive play activity but rather engage in repetitious actions such as rocking and other unusual mannerisms. Children with autism usually form attachments to inanimate objects rather than to people. Their mood is usually marked with sudden changes and potentially aggressive outbursts. Although the exact cause in unknown, autistic disorder is considered to have a biological cause with a high genetic vulnerability. Research has indicated that two regions on chromosomes 2 and 7 contain genes involved with autistic disorder. Studies suggest that abnormal levels of serotonin and other neurotransmitters in the brain are found because there is a disruption of normal brain development early in fetal development caused by defects in the genes. The temporal lobe area of the brain has been implicated in the development of autism since this area is strongly associated with social development.

Rett syndrome features a period of normal development for approximately six months after birth that is followed by deterioration of functioning. Symptoms such as encephalopathy, seizures, breathing difficulties, loss of purposeful hand movements, loss of social engagement with others, poor coordination, and severely impaired language development then develop. The growth of the head circumference slows and produces microcephaly. The child begins to show repetitious movements such as hand-wringing and problems walking. The condition is progressive, and the skill level remains at the level of the first year of life. Children may live for ten years or more but must use a wheelchair as a result of muscle wasting. The cause of Rett syndrome has been identified as related to a genetic mutation. The gene is located at the Xq28 site on the X chromosome. Only one of the two X chromosomes need have the mutation in order for it to cause the disorder. This means that it is an X-linked dominant disorder. Rett syndrome is a rare condition usually found in females.

Childhood disintegrative disorder is diagnosed when there is marked regression or deterioration in a number of areas of functioning after age two. Children with this disorder begin to lose language and social skills previously developed in the first two years of life. Both bowel and bladder control as well as manual skills can be lost. It is common for these children to exhibit high levels of anxiety as the deterioration progresses. Children with this disorder also typically develop seizures. The cause of childhood disintegrative disorder is unknown, but it is considered to be related to some central nervous system pathology.

Asperger syndrome is marked with symptoms of severe and sustained impairments in social interactions. Repetitive patterns of behavior are commonly seen. In contrast to autism, children with Asperger syndrome do not exhibit significant delays in language or cognitive development. Common characteristics of Asperger syndrome include a lack of empathy toward the feelings of others, minimal social interactions, limited ability to form friendships, pedantic and monotonic speech, and intense fascination with trivial topics learned in rote fashion. The cause of Asperger syndrome is unknown but is believed to have a genetic base. Current research suggests that a tendency toward the condition may run in families. Children with Asperger syndrome are also at risk for other psychiatric problems, including depression, attention-deficit disorder, schizophrenia, and obsessive-compulsive disorder. Persons with Asperger syndrome have a variable
prognosis depending upon their cognitive abilities and language skills, but all continue into adulthood showing an awkward manner toward other adults and lack of comfort in social settings. Asperger syndrome is usually first diagnosed in children between the ages of two and six.

PDD-NOS is the fifth developmental disorder described in the DSM-IV-TR. It is viewed as a severe impairment in communication skills with deficiencies in social behavior. It differs from autistic disorder in terms of the severity of symptoms, and persons diagnosed with this disorder experience better functioning into adulthood than those with autistic disorder.

Treatment and Therapy

The goal for treatment of autistic disorder is to increase socially acceptable behaviors and decrease or extinguish unusual actions such as rocking and self-injurious behaviors. Therapy attempts to improve verbal and nonverbal communication skills to enhance interactions with other people. Therapy usually involves both educational and behavioral interventions with structured classroom training using behavioral techniques that employ rewards or positive reinforcements. Treatments for children with autistic disorder require a great deal of structure and repetition. Family members often participate in counseling sessions to help with the stressors of raising a child with autistic disorder. Medications are used as an adjunct to educational and behavioral treatments to diminish temper tantrums, self-injurious behaviors such as head banging, and hyperactivity. Antipsychotic medications such as risperidone and haloperidol are the most commonly used adjunctive treatments.

Rett syndrome has limited treatment options. The focus is on providing symptomatic relief whenever possible and structured behavioral techniques of positive rewards to concentrate on positive behaviors. Anticonvulsive medications are used to control seizures that can develop in this disorder and also diminish self-injurious behaviors. Physical therapy can assist with the distress associated with muscle deterioration.

Childhood disintegrative disorder is treated with similar methods as used in autistic disorder. Highly structured educational and behavioral programs are used to maintain the limited language and cognitive skills that had developed prior to the onset of the disorder.

Asperger syndrome treatments depend upon the level of functioning present among those with this disorder. Emphasis is usually placed upon improving social skills and adaptive functioning in social situations.

Treatment for PDD-NOS is largely the same as used with autistic disorder. Children with this disorder have a higher functioning of language skills than found with autistic disorder; consequently, the educational and behavioral treatments are supplemented with individual psychotherapy.

Perspective and Prospects

Autistic disorder was initially identified in 1867 by psychiatrist Henry Maudsley, but it was not until 1943 that Leo Kanner coined the term infantile autism and carefully described the associated signs and symptoms of the condition. Even with this description, many children with autism received the diagnosis of childhood schizophrenia. This tendency toward misdiagnosis continued into the 1980s. When considering the causes for the development of infantile autism, Kanner initially hypothesized that infantile autism was caused by emotionally unresponsive or “refrigerator” mothers who were unable to provide nurturance and emotional warmth to their newborn infants. Some children reacted to this emotional coldness by turning inward as a defense mechanism. Because of this defense, the child with autism focused on his or her inner world and did not develop communication skills. The child with autism usually focuses on inanimate objects rather than people and exhibits repetitious or self-stimulating behaviors such as rocking to gain personal satisfaction. Additions to this theoretical idea focused on the unresponsiveness of both parents toward the child and feelings of rage directed toward the child. Theories focusing on parental factors have since been discarded in favor of the current emphasis on identifying biological and genetic factors in the development of autism.

Rett syndrome was first identified by pediatrician Andreas Rett in 1966. Practicing in Austria, Rett based his descriptions on a pool of twenty-two girls who had developed normally until they were around six months of age. Rett published his findings in several German medical journals, but the information was largely ignored in the rest of the world. Awareness about the disorder increased when Rett published a description of the disease in English in 1977, but it was a 1983 article that appeared in the mainstream English-language journal Annals of Neurology that finally raised the recognition of this disorder.

Childhood disintegrative disorder was first described in 1908 by Viennese remedial teacher Theodor Heller. He described six children who had unexpectedly developed a severe mental deterioration between their third and fourth years of life, after previously normal development. Heller termed the condition dementia infantilis, and it was subsequently called Heller’s syndrome. The disorder is more often diagnosed in males than in females. Although the DSM-IV-TR uses two years of age as the standard for its diagnosis, most cases emerge when a child is between three and four years of age.

Asperger syndrome was first described in 1944 by Austrian pediatrician Hans Asperger, who called the condition autistic psychopathy. Asperger described a number of children, and his descriptions were close to Kanner’s idea of infantile autism. Asperger’s portrayals differed from Kanner’s, however, in that speech was less commonly delayed and the onset appeared to be somewhat later. The children that Asperger described were seen to have social behavior that was labeled as odd or unusual. Asperger called the children with this condition “little professors” because of their formal manner when talking about their favorite topics using great detail. Asperger also suggested that similar problems could be observed in the children's family members, particularly their fathers. Most of the scientific literature concerning Asperger’s discovery initially appeared in European professional journals until Asperger syndrome was made official in 1994, when the diagnosis was added to the DSM-IV.

In 2013, the American Psychiatric Association published the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, known as DSM-5. This edition made significant changes to a number of classification systems, perhaps most notably the classification of pervasive developmental disorders. Autistic disorder, Asperger syndrome, childhood disintegrative disorder, Rett syndrome, and PDD-NOS were subsumed under the category autism spectrum disorder. This change was met with criticism from some members of the medical community; however, others argued that the new system would aid medical professionals in making diagnoses.

Bibliography:

Aman, M., et al. “Medication and Parent Training in Children with Pervasive Developmental Disorders and Serious Behavior Problems: Results from a Randomized Clinical Trial.” Journal of the American Academy of Child and Adolescent Psychiatry 23 (October, 2009): 1025–38.

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Washington, D.C.: American Psychiatric Publishing, 2013.

Bopp, K., et al. “Behavior Predictors of Language Development over Two Years in Children with Autism Spectrum Disorders.” Journal of Speech, Language, and Hearing Research 52 (October, 2009): 1106–20.

Elder, J., et al. “Supporting Families of Children with Autism Spectrum Disorders: Questions Parents Ask and What Nurses Need to Know.” Pediatric Nursing 35 (July/August, 2009): 240–45.

National Institute of Mental Health. "Autism Spectrum Disorders (Pervasive Developmental Disorders." National Institutes of Health, May 23, 2013.

National Institute of Neurological Disorders and Strokes. "NINDS Pervasive Developmental Disorders." National Institutes of Health, May 7, 2013.

Noterdaeme, M., et al. “Asperger’s Syndrome and High-Functioning Autism: Language, Motor, and Cognitive Profiles.” European Child and Adolescent Psychiatry 8 (October, 2009): 875–925.

What adjectives appear in the poem "I Stood Tip-Toe Upon a Little Hill" by John Keats?

Adjectives are words that modify (describe) nouns. This means that adjectives are extremely common in most kinds of writing, including poetry. "I Stood Tip-Toe Upon a Little Hill" is full of adjectives. Consider the first two lines of the poem: 

"I stood tip-toe upon a little hill, / The air was cooling, and so very still..." 

The bolded words are adjectives. Why? Because "little" describes the hill, and "still" describes the air. 

Think about the next few lines, which get a little more complicated: 

"That the sweet buds which with a modest pride / Pull droopingly, in slanting curve aside..." 

Again, the adjectives are bolded: "sweet" describes the buds, "modest" describes the pride, and "slanting" describes the kind of curve that the buds follow. "Droopingly" is an adverb, meaning that it describes a verb ("pull") in the same way that adjectives describe nouns.

What is bedwetting?

Causes and Symptoms

Primary enuresis is defined medically as the inability to hold one’s urine during sleep. The condition is quite common and occurs most often in children; between 15 and 20 percent of children under the age of six suffer from the condition. These percentages decrease to about 5 percent at age ten, 2 percent at age fifteen, and only about 1 percent of adults. Secondary enuresis is bed-wetting in a child who had previously achieved bladder control. (These terms do not apply, however, to urination problems caused by physical illness, disease, or anatomical defect.) The condition is more common in boys than in girls. Bed-wetting usually occurs during the first third of sleep, although it can occur during all sleep stages and without relation to awakening periods.

It is important to realize that enuresis is considered to be a developmental concern rather than an emotional, behavioral, or physical one. Donald S. Kornfeld and Philip R. Muskin report in The Columbia University College of Physicians and Surgeons Complete Home Medical Guide (rev. ed., 1989) that “enuresis is due to a lag in development of the nervous system’s controls on elimination.” Many parents fail to understand this neuropsychological element and thus punish the child for a wet bed. Punishing, ridiculing, or shaming the child does not correct the situation; in fact, in many cases, it may prolong the problem as well as cause other unnecessary and undesirable psychological problems. Emotional problems have resulted from enuresis, as the child may be too embarrassed to partake in normal childhood activities such as camping or sleepovers.

Treatment and Therapy

Techniques for helping the enuretic child achieve dryness range from withholding liquids near bedtime to alarm systems to medical intervention. Generally, restriction of liquid intake after dinner is the first course of action. This treatment method, however, does not have a very high success rate. Should this treatment fail after a trial period of a few weeks, other methods may be employed.

Alarm therapy can help a child achieve control within four months, sometimes in only a few weeks. A beeper- or buzzer-type alarm sounds when moisture touches the bedding or underwear; the desired result is that the child, while sleeping, will eventually recognize the need to urinate and awaken in time to get to the bathroom. Electronic alarms are generally of two types. The first is a wired pad, consisting of two screens, which is placed under the sheets to detect wetness; when the child wets, the moisture activates the battery-operated alarm. The second is a device worn on the body, either in the underpants and connected by a wire to an alarm or a wristwatch-type alarm; the underwear serves as a separating cloth for the contact points. In either case, as wetness occurs, the alarm sounds, thus wakening the child; the child can then be directed to the bathroom to complete urination.

Barry G. Powell and Lynda Muransky cite several case histories in which alarm therapy proved to be effective in stopping enuresis. For example, a six-year-old who never had a dry bed achieved dryness within a week through the use of an alarm. In another case, a fifteen-year-old had been trying to overcome his bed-wetting problem for ten years. Several trips to the doctor showed that he had no physical cause for enuresis. His parents labeled him “lazy, inconsiderate, and difficult.” His desire to join his hockey team in overnight travel gave him the impetus to seek help. Powell and Muransky found his problem to be primary enuresis aggravated by family ridiculing. Through the use of his alarm, he achieved dryness within two weeks.

A case involving secondary enuresis is described as well. A child who had suffered through primary enuresis, then achieved dryness, was found to be wetting again. This second bout of bed-wetting seems to have been the result of his parents’ marital separation. After a medical examination revealed no physical problems, it appeared the problem was psychological, caused by emotional upset. He resumed dryness in three weeks (although an alarm system on his bed for six months gave him more confidence). It is important to note, however, that alarms can take up to several months’ time before a child feels comfortable in stopping its use. Also, parental supervision is imperative for this type of therapy to work properly.

Chiropractic spinal manipulation has been found to be effective in the treatment of some cases of enuresis. Some believe that a spinal reflex is involved in bed-wetting. As nighttime breathing slows down (a normal reaction), carbon dioxide builds up in the body. When the carbon dioxide buildup reaches a certain level, a breathing mechanism called the
phrenic reflex is triggered. This mechanism normally causes the diaphragm to return breathing to its normal pattern. If the mechanism does not work properly, however, the carbon dioxide continues to increase, resulting in an involuntary relaxation of the sphincter muscle at the opening to the bladder. Fluid (urine) is released and leaks out of the bladder. A child in a deep state of sleep does not recognize that the bed has been wet. Generally, chiropractors believe that the bed-wetting child sleeps in a state of high carbon dioxide intoxication.

While immature development of the phrenic reflex is the most common cause of bed-wetting, in some children a misalignment of the bones in the neck and spine (referred to as “subluxation” by chiropractors) is thought to cause pressure on the nerves that are related to the phrenic reflex. Through chiropractic adjustments, it is argued, the subluxation can be corrected, thus relieving pressure on the nerves. With the spine realigned and bodily functions working normally, enuresis can be eliminated. One child had never had a dry bed in his first ten years of life; after only two spinal adjustments by a licensed chiropractor, the child stopped wetting immediately. Chiropractors usually recommend a series of adjustments in order to realign the spine and nerves and keep them in the proper position.

Drug therapy solely for the treatment of enuresis is controversial. However, when an illness such as diabetes mellitus is the underlying cause of the bed-wetting, the use of drugs may be indicated. The drug imipramine hydrochloride (an antidepressant agent) has been studied to assist in contraction of the sphincter; however, because of the high toxicity and limited effectiveness of such antidepressants, its use is not widespread. Relapse rates are high, and cure rates are relatively low. More success has been achieved with desmopressin acetate, an antidiuretic drug. There is an immediate improvement in 70 percent of treated children. Relapse rates are lower than those associated with imipramine but higher than with the use of bed-wetting alarms, probably because the sphincter muscle is not fully developed in the enuretic child. In general, drug therapy yields a final success rate of about 25 percent.

Perspective and Prospects

The history of bed-wetting is probably a lengthy one. The term “enuresis” was coined around 1800, and the condition has plagued children from every ethnic background and socioeconomic level around the world. It continues to be a problem for many children today and probably will be so in the future as well.

Most enuretics are deep sleepers who are usually quite active during their waking hours. This sleeping pattern, combined with urinary systems that are not yet fully developed, is generally the main cause of bed-wetting. There are some indications that enuresis is hereditary; many children who suffer from the condition have a parent who was enuretic as a child. It is reassuring to know that almost all affected children outgrow the problem by adulthood. While no immediate cure is available, continued experiments with alarm systems and drugs will certainly alleviate the discomfort and embarrassment until the body’s lag in development corrects itself.

Bibliography

A.D.A.M. Medical Encyclopedia [Internet]. Atlanta (GA): A.D.A.M., Inc.; ©2005. Bedwetting; [updated 2011 Aug. 2; cited 2013 Aug. 29]; about 3 p.

“Alarm Bells for Enuresis.” The Lancet 337 (March 2, 1991): 523.

American Medical Association. American Medical Association Family Medical Guide. 4th rev. ed. Hoboken, N.J.: John Wiley & Sons, 2004.

“Defining Enuresis.” FDA Consumer 23 (May, 1989): 10.

Hurl, C. "Urine Trouble: A Social History of Bedwetting and Its Regulation." History of the Human Sciences 24.2 (2011): 48–64.

Kemper, Kathi J. The Holistic Pediatrician: A Pediatrician’s Comprehensive Guide to Safe and Effective Therapies for the Twenty-five Most Common Ailments of Infants, Children, and Adolescents. 2d ed. New York: Quill, 2007.

Kornfeld, Donald S., and Philip R. Muskin. “Enuresis, or Bed-Wetting.” In The Columbia University College of Physicians and Surgeons Complete Home Medical Guide, edited by Donald Tapley et al. Rev. 3d ed. New York: Crown, 1995.

Morison, Moya J. “Living with a Young Person Who Wets the Bed: The Families’ Experience.” British Journal of Nursing 9, no. 9 (May 11–24, 2000): 572.

Rogers, June. “Child Centered Approach to Bed-Wetting.” Community Practitioner 76, no. 5 (May, 2003): 163–65.

Ronen, T., L. Hamama, and M. Rosenbaum. "Enuresis: Children’s Predictions of Their Treatment’s Progress and Outcomes." Journal of Clinical Nursing 22 no. 1–2 (January, 2013): 222–32.