What are three quotes from Romeo and Juliet that address different love relationships?

Romeo describes his unrequited love for Rosaline to his kinsman, Benvolio, in Act I, Scene 1.  He says,

She'll not be hit

With Cupid's arrow.  She hath Dian's wit,

And, in strong proof of chastity well armed,

From love's weak childish bow she lives uncharmed (I.1.216-219).

He means that Roasline refuses to fall in love (which would happen if she were hit with the arrow of Cupid, the god of love).  Continuing the mythological allusions, Romeo says Rosaline is as chaste and clever as Diana.  Rosaline's heart simply cannot be touched by the arrows of love.  In fact, she has sworn to be a virgin forever, like the goddess Diana.  That his love remains unrequited makes Romeo utterly miserable.

Juliet describes romantic love in her balcony scene in Act II, Scene 2.  She says,

O Romeo, Romeo, wherefore art thou Romeo?

Deny thy father and refuse they name,

Or, if thou wilt not, be but sworn my love,

And I'll no longer be a Capulet (2.2.36-39).

Juliet's love is so strong that she is prepared to ask Romeo to give up his identity to be with her, or, if he is unwilling to do so, she will swear her love to him and give up her identity as a Capulet.  This romantic love becomes the most important thing to both of them, more important than friends or family honor and loyalty.  The fact that Juliet is willing to give up all she knows to be with Romeo is quite powerful.

Friar Lawrence also has a general love for everyone, and he wishes for peace and for the end of all feuding and violence.  When Romeo approaches the Friar with his wishes to marry Juliet, the Friar eventually agrees, saying, "this alliance may so happy prove / To turn your households' rancor to pure love" (II.3.98-99).  Friar Lawrence hopes this act of love between Romeo and Juliet will compel their families to stop their fighting, and he marries the couple out of his love for all humankind and his love of peace.

I am writing an essay about whether beauty pageants are a way of objectifying women. Can you help me to get started?

In order to get started writing your paper, I recommend you take some notes. First, what do you already know about beauty pageants? What do you want to know? When looking into whether or not pageants are objectifying, try to find opinions from both sides. Many people who participate in pageants say that it makes them feel good about themselves. Let's not forget that the voices of people who actually participate in these contests are important. On the other hand, some people feel that beauty pageants encourage women to fit into a narrow or unrealistic ideal of beauty. Let's consider the intent of beauty pageants and some of the criticisms on this activity.

Beauty pageants are a type of contest where women enter and compete for an award. The award may be in the form of money, a trophy, or a garment or accessory. Sometimes, multiple forms of the award are given, but all consistently add up to a monetary reward. The basis for judging the contestants is traditionally based on physical beauty standards, but some competitions also consider a woman's "inner beauty." Inner beauty may be measured based on her personality, passions, hobbies, talents, and whether she performs any sort of advocacy or charity work. Some pageants offer a college scholarship as a reward, and in recent years some pageants have moved away from the bikini portion of the contest in favor of a demonstration of skill in public speaking.

One of the biggest criticisms of beauty pageants is that they reward some women for fitting into narrow criteria of what constitutes inner and outer beauty. Depending on the time period and location of the beauty pageant, ideals of beauty are not concrete. What is considered beautiful in one year may be totally different in the next. Invariably, women who do not fit the criteria are excluded for their failure to meet arbitrary standards of beauty.

Many people criticize pageants for upholding racist or ethnocentric ideals of beauty. Historically, women of color have been excluded from participating in pageants for their skin color and/or bone structure. Even in international competitions, such as the Miss Universe pageant, contestants are expected to conform to an ideal of light skin and Anglo-European bone structure. This reinforces the idea that beauty is a very narrow category, yet women should be rewarded for fitting into such a narrow box.

Another criticism is that the "narrow box" of beauty excludes women who have healthy to excess amounts of body fat. In the United States especially, women are expected to be very thin and athletic, with little body fat. This reinforces the idea that women who are fat, curvy, pregnant, chubby, or however else you choose to call it, cannot be beautiful.

When children grow up participating in beauty pageants, it can teach them that their physical beauty (as determined by others) is more important than their personal happiness or comfort. The television program Toddlers and Tiaras has been controversial not just because it shows children participating in beauty pageants, but because a lot of the children don't want to be  made to participate in the first place. Many parents do not consider their child's input on whether or not they want to have a spray tan, get their teeth whitened, or wear a wig. This is especially a case of obectification because parents essentially treat their child as a plaything to be decorated and paraded, rather than a person with feelings and other interests.

The biggest critique of beauty pageants is that despite any measure of inner beauty involved, the contests reduce a woman or girl's value down to her physical appearance. Beauty or value in a person is not limited to their physical appearance. 

I think it would be a great idea for you to find some testimonies from current and/or past pageant participants. This opens up the opportunity to create citations in your paper and connect the subject to real, lived experiences.

How does legislation address substance abuse?

Scope of the Issue

In 2015, according to the Federal Bureau of Prisons, nearly one-half of persons in prisons in the United States were imprisoned for drug-related crimes. According to the National Substance Abuse Index, the United States is the largest single market in the world for illegal drugs. States generally are left to legislate substance abuse issues.

Federal law, however, may require states to take certain actions, such as tracking specific instances or reporting some types of infractions. Laws also generally distinguish between legal substances, such as alcohol, and illegal substances, including the unlawful use of prescription medication.

Each state chooses what federal laws to enact. Though there are thirty-nine federal laws pertaining to alcohol, for example, states are not bound by them. States also are required to follow the parameters of federal sentencing guidelines.

History of Substance Abuse Legislation

The criminalization of drugs in the United States began in 1914 with the Harrison Tax Act. Under this law, a tax of $1,000 was imposed for the nonmedical exchange of certain drugs; the law, however, pertained to tax evasion, not drug use or transfer.

In the early and middle decades of the twentieth century several federal agencies had varying responsibilities and power in drug law enforcement. By the 1960s most of this enforcement was in the hands of the federal Bureau of Narcotics and the Bureau of Drug Abuse Control. Changing attitudes toward drug use during the 1960s and into the 1970s gradually led to increases in crime. Federal law enforcement agencies continued to evolve, as did legislation.

The US Congress passed the Controlled Substances Act
, part of the 1970 Comprehensive Drug Abuse Prevention and Control Act, launching national substance control campaigns. The law consolidated legislation that regulates the manufacture and distribution of illicit substances—anabolic steroids, depressants, hallucinogens, narcotics, and stimulants—and some chemicals used to produce controlled substances. As public health threats from other substances became known, the act was amended. In its infancy, the Controlled Substances Act was enforced by the Bureau of Narcotics and Dangerous Drugs under the Department of Justice (DOJ).

In 1973, US president Richard M. Nixon created the Drug Enforcement Administration (DEA) within the DOJ to centralize efforts to combat substance abuse. Interagency rivalry and the necessity of coordinating investigation and prosecution efforts were among the reasons cited for the creation of the DEA. In announcing the DEA, Nixon declared the United States’ global war on drugs.

As the war on drugs continued, investigators developed intelligence units and technology to aid agents. Laboratories were built and staffed to support the DEA’s efforts. The DEA has continued to monitor substance abuse developments and to respond to emerging trends. In 2011, for example, the DEA took action against three synthetic cathinones, widely called bath salts, following alarming and increasing reports of abuse of the substances.

Classification and Penalties

There are five classifications of controlled substances. Laws mandate the penalties for crimes of trafficking based in part on the classification, or schedule, of the drugs, and in some cases, as with trafficking marijuana, on the amount of drug confiscated. Penalties may include incarceration and fines. Each state sets its own penalties for sale and possession of these substances within the federal guidelines.

Schedule I drugs are classified as substances with high potential for abuse and no accepted medical use in the United States. The law requires that these drugs be tightly controlled, including mandating security for manufacturing and storing them, and establishing quotas and licensing guidelines. Schedule I drugs include heroin, LSD, marijuana, peyote, and ecstasy.

Schedule II substances may have accepted medical use and high potential for abuse; they also are likely to lead to severe physical or psychological dependence. Methadone, oxycodone, amphetamine, methamphetamine, and cocaine are examples of schedule II drugs.

Schedule III drugs include anabolic steroids, codeine with aspirin, and some barbiturates; these substances have less potential for abuse than schedule I and II drugs, have accepted medical uses, and have some potential for dependence.

Schedule IV and V substances have low potential for abuse or dependence and also have accepted medical uses. Valium and Xanax are among the schedule IV drugs. Over-the-counter medicines, such as cough medicines with less than 200 milligrams of codeine per 100 milliliters, are examples of schedule V drugs.

Much of the federal legislation regarding illegal substances pertains to alcohol, marijuana, cocaine, heroin, and methamphetamine. Persons who have been convicted of drug offenses may lose some federal benefits, such as grants and loans, and assistance including food stamps and Social Security benefits. A college or university student receiving federal financial aid, for example, could lose the aid if convicted of a drug offense; the penalty could be temporary for a first offense of possession, but permanent following multiple offenses.

The Controlled Substances Act also includes prohibitions and penalties for selling drugs to minors or near schools and other locations. Federal penalties are often more severe than those for crimes prosecuted at the state level. Local jurisdictions also may pass laws pertaining to drug possession and trafficking.

Current Legislative Issues

Substance abuse issues continue to arise as chemists develop new synthetic drugs and as others experiment with substances. Such issues often develop in other countries and eventually arrive in the United States. Drug enforcement authorities are continually monitoring and responding to developments.

Designer Drugs

One example of a developing issue is the collection of designer drugs
commonly called bath salts, which were first seen in Europe. Hospitals and health care workers reported sharp increases in the number of patients being seen for the effects of bath salts beginning in 2009 and escalating in 2011. These designer drugs were being used for their psychoactive properties.

Under the Comprehensive Crime Control Act of 1984 the US attorney general has the authority to temporarily place substances into schedule I for up to one year. The DEA took action on bath salts in 2011; an order in October temporarily scheduled the bath salt substances into schedule I because the drugs were deemed threats to public safety. The following year, President Barack Obama signed a bill into law that banned the active ingredients of many types of synthetic drugs, including bath salts. However, by 2015, concerns had risen over the increased use of flakka, a synthetic drug similar to bath salts but deemed even more dangerous.

Misuse of Prescription Medicine

Many people who
misuse prescription medicine believe that these substances are safe because they are prescribed by doctors. Some people take a larger dose than was recommended because they believe more is better, while others take the medication to induce euphoria. The latter is an example of drug abuse.

Misuse and abuse of prescription medication can cause harm or death. AAccording to the Substance Abuse and Mental Health Services Administration (SAMHSA), approximately 15 million people in the United States age twelve years and older used prescription drugs for nonmedical purposes in 2014. Among the most common prescription drugs abused are oxycodone, Valium, amphetamine, methamphetamine, and barbiturates.

Penalties for prescription drug abuse vary by state. North Carolina, for instance, mandates prison sentences of seventy to eighty-four months for anyone with more than 4 grams of opium, opium derivatives, or heroin. A person illegally in possession of six Vicodin pills, for example, would be in prison for up to seven years. Penalties increase with the amount of the drug a person has. In contrast, someone caught in North Carolina with more than 10 pounds of marijuana could be sentenced to twenty-five to thirty months in prison.

Prenatal Exposure

According to data from the SAMHSA, for the years 2012 and 2013, 5.4 percent of pregnant girls and women age fifteen to forty-four years, including 8.6 percent of women age eighteen to twenty-five years, admitted to some kind of current illicit drug use. A number of states require health care professionals to screen infants for prenatal drug exposure, and many states go further, requiring that women suspected of prenatal substance abuse be reported to child protective services. Federal laws such as the Child Abuse Prevention and Treatment Act, however, regard such actions as referrals for treatment and investigation of child safety issues, not grounds for criminal prosecution.

Eighteen US states classify substance abuse during pregnancy as child abuse as of 2015. Some states also require actions including reporting parents to authorities. Responses to substance abuse also vary widely from state to state; some make treatment for pregnant women a priority, others make furnishing drugs to pregnant women crimes. Women who have been charged criminally for prenatal actions often face charges of child endangerment or abuse, fetal murder or manslaughter, or illegal drug delivery to a minor (via umbilical cord), depending on the state.

Federal Alcohol Laws, State Discretion

All fifty states have adopted some federal alcohol laws, such as the law making it illegal to operate motor vehicles with a blood alcohol concentration (BAC) at or above 0.08. Most states have adopted the administrative license revocation law, which suspends licenses of those who fail the BAC test.

Several states have adopted the federal law making driving under the influence with a minor child in the vehicle a separate offense or increasing the penalty for doing so. Another federal law mandating jail for a second offense of driving under the influence has been adopted by forty-six states. By 1987, all fifty states had laws making age twenty-one years the legal drinking age; national statistics indicated that per capital consumption of alcohol dropped considerably.

Bibliography

Campo-Flores, Arian. "Potent New Stimulant Flakka Ravages Florida." Wall Street Journal. Dow Jones, 12 Aug. 2015. Web. 30 Oct .2015.

Gray, James. Why Our Drug Laws Have Failed and What We Can Do about It. Philadelphia: Temple UP, 2011. Print.

Haggin, Patience. "Obama Signs Federal Ban on 'Bath Salt' Drugs." Time. Time, 10 July 2012. Web. 30 Oct. 2015.

Lyon, Joshua. Pill Head: The Secret Life of a Painkiller Addict. New York: Hyperion, 2009. Print.

Valverde, Mariana. Diseases of the Will: Alcohol and the Dilemmas of Freedom. New York: Cambridge UP, 1998. Print.

What are obstetrics?

Science and Profession

Obstetrics is the branch of medical science dealing with pregnancy and
childbirth in women. Once conception has occurred and a
woman is pregnant, major physiological changes occur within her body as well as
within the body of the developing embryo or fetus. Obstetrics deals with these
changes leading up to and including childbirth. As such, obstetrics is a critical
branch of medicine, for it involves the complex physiological events by which
every person comes into existence.

The professional obstetrician is a licensed medical doctor whose area of expertise
is pregnancy and childbirth. Often, the obstetrician is also a specialist in the
closely related science of gynecology, the study of diseases and
conditions that specifically affect women, particularly nonpregnant women. The
obstetrician is especially knowledgeable in female anatomy and physiology,
including the major bodily changes that occur during and following pregnancies.
Obstetricians also have a detailed understanding of the necessary diagnostic
procedures for monitoring fetal and maternal health, and they are educated in the
latest technologies for facilitating a successful pregnancy and childbirth with
minimal complications. Obstetrical care is also provided by certified nurse
midwives (CNMs) and by nurse practitioners, particularly those with certification
in women’s health (women’s health care nurse practitioners).

Broadly, the diseases and conditions managed by the clinicians in this field
include preconception counseling, normal prenatal care, and the management of
pregnancy-specific problems such as preeclampsia, gestational
diabetes, premature labor, premature rupture of membranes,
multiple
gestations, fetal growth problems, and Rh incompatibility and
isoimmunization. In addition, obstetricians manage medical
problems that can occur in any woman but that take on special importance in
pregnancy, such as thyroid disorders or infections. Obstetricians make assessments
and decisions regarding when a baby is best delivered, particularly if there are
in utero conditions that make it safer for the baby to be born immediately, even
if prematurely. Obstetricians manage both normal and high-risk labors. They are
able to assess the progress and position of the infant as it makes its way down
the birth canal. They are knowledgeable about pain control options during labor
and make decisions regarding when a cesarean section is indicated.
Obstetricians assist with normal vaginal deliveries, either spontaneous or
induced, and sometimes use special instruments such as forceps or vacuum-suction
devices. They also perform cesarean sections. Obstetricians are trained in
appropriate postpartum care for the mother and infant.

In natural, spontaneous fertilization, pregnancy begins at conception,
with the fertilization of a woman’s egg by a man’s sperm following
sexual
intercourse, the chances of which are highest if intercourse
takes place during a two-day period following ovulation.
Ovulation is the release of an unfertilized egg from the woman’s ovarian follicle,
which occurs roughly halfway between successive periods during her
menstrual
cycle. Fertilization usually occurs in the upper one-third of
one of the woman’s fallopian tubes connecting the ovary to
the uterus. Upon entering the woman’s vagina, sperm must
travel through her cervix to the uterus and up the fallopian tubes, only one of
which contains a released egg following ovulation.

Once fertilization has occurred, the first cell of the new individual, called a
zygote, is slowly pushed by cilia down the fallopian tube
and into the uterus. Along the way, the zygote undergoes several mitotic cellular
divisions to begin the newly formed embryo, which at this point is a bundle of
undifferentiated cells. Upon reaching the uterus, the embryo implants in the
lining of the uterus. Hormonal changes occur in the woman’s body to maintain the
pregnancy. One of these hormones is human chorionic gonadotropin, which is the
chemical detected by most pregnancy tests. Failure of the embryo to be implanted
in the endometrium and subsequent lack of hormone production (specifically the
hormone progesterone) will cause release of the endometrium as a bloody discharge;
the woman will menstruate, and there will be no pregnancy. Therefore, menstrual
cycles do not occur during a pregnancy.

The embryo will grow and develop over the next forty weeks of gestation. The heart
forms and begins beating at roughly five and one-half weeks following conception.
Over the next several weeks and months, major organ systems begin to organize and
develop. By the end of the first three months of the pregnancy, the developing
human is considered to be a fetus. All the major organ systems have formed,
although not all systems can function yet. The fetus is surrounded by a watery
amniotic fluid within an amniotic sac. The fetus receives oxygen and nutrients
from the mother and excretes waste products into the maternal circulation through
the placenta. The fetus is connected to the placenta via the
umbilical
cord. During the second and third trimesters, full organ
system development; massive cell divisions of certain tissues such as nervous,
circulatory, and skeletal tissue; and preparation of the fetus for survival as an
independent organism occur.

Changes also occur in the mother. Increased levels of the female steroid hormone
estrogen create increased skin vascularization (that is,
more blood vessels near the skin) and the deposition of fat throughout her body,
especially in the breasts and the buttocks. The growing fetus and stretching
uterus press on surrounding abdominal muscles, often creating abdominal and back
discomfort and potentially leading to acid reflux. Reasonable exercise is
important for the mother to stay healthy and to deliver the baby with relative
ease. A balanced diet also is important for the nourishment of her body and that
of the fetus. A diet rich in folic acid is particularly important.

Late in the pregnancy, the protein hormones prolactin and
oxytocin will be produced by the woman’s pituitary gland.
Prolactin activates milk production in the breasts. Oxytocin causes muscular
contractions, particularly in the breasts and in the uterus during labor. Near the
time of birth, drastically elevated levels of the hormones estrogen and oxytocin
will cause progressively stronger contractions (labor pains) until the baby is
forced through the vagina and out of the woman’s body to begin its independent
physical existence. The placenta, or afterbirth, is discharged shortly
thereafter.

Diagnostic and Treatment Techniques

The role of the obstetrician is to monitor the health of the mother and unborn fetus during the course of the pregnancy and to deliver the baby successfully at the time of birth. Once the fact of the pregnancy is established, the obstetrician is trained to identify specific developmental changes in the fetus over time in order to ensure that the pregnancy is proceeding smoothly.

The mainstay of diagnosis is the physical examination during prenatal visits.
Early in the pregnancy, prenatal visits typically occur once monthly, but they
become more frequent as the pregnancy progresses. During these visits, the woman
may receive counseling regarding a balanced diet, folic acid and iron
supplementation, and substances, foods, or activities to avoid that may pose a
risk to the pregnancy. The woman’s growing uterus is measured to confirm proper
growth, and, if indicated, a vaginal or cervical examination may be performed.
After ten weeks of gestational age, fetal heart tones are also assessed at every
prenatal visit using a simplified ultrasonic technique, to ensure that they are
within the normal number of beats per minute. Fetal heart tones that are
abnormally slow may indicate a fetus in jeopardy.

The other main component of diagnosis is through laboratory tests. Early in the
pregnancy, the woman will receive a Pap test to screen for cervical
cancer. Blood tests will be ordered to determine whether the
mother is a carrier of the human immunodeficiency virus (HIV),
hepatitis B
virus (HBV), or hepatitis C virus, which can be
transmitted to the fetus. In addition, the mother is checked for anemia, and
the blood type of the mother is assessed. If the mother’s blood type indicates
that she is Rh negative, she will receive RhoGAM in the third trimester to prevent
the development of a disease called isoimmunization, a condition that could be
fatal to the fetus. An additional diagnostic test performed routinely during
pregnancy is a screening test for gestational diabetes, which many pregnant women
are at risk for developing.

Another important method of diagnosis in obstetrics is ultrasonography. Ultrasonography early in pregnancy can
determine the gestational age of a pregnancy in cases in which a woman’s last
menstrual period is unverified. The correct development of the fetus and the
presence of any birth defects can be assessed using this procedure. Ultrasound can
also determine whether the placenta is growing in a safe location and whether the
proper amount of amniotic fluid is found in the amniotic sac. Ultrasound is also
a useful tool in guiding diagnostic procedures. For instance, amniocentesis
can be safe when performed under ultrasound guidance. Finally, one of the main
methods of diagnosis in the third trimester is fetal heart monitoring. This
technique involves following the heartbeat of the infant while in utero. Any
concerning dips in the heart rate may be indicative of a poor fetal state and a
cause for increased monitoring or, in extreme cases, delivery of the infant.

Obstetricians have at their disposal a variety of treatment modalities. They are
trained to turn manually fetuses that are in a breech (feet-first) position, a
procedure called external cephalic version. In cases where the artificial
induction of labor is necessary, the obstetrician may employ mechanical or
hormonal means of cervical dilation, followed by infusions of a drug called
pitocin to stimulate contractions or the artificial rupture of the amniotic sac to
promote natural contractions. When immediate delivery of the infant is needed and
the chances of it emerging via the vaginal route are remote, then the obstetrician
may perform a cesarean section. Common indications for cesarean section include
fetal distress, breech position, multiple gestation, preeclampsia, and lack of
progress in labor.

Other treatments commonly used by obstetricians include the use of medications
such as magnesium to relax the uterus in cases of premature labor and maternal
steroid injections to induce fetal lung maturity when the fetus is premature but
delivery is anticipated. When a woman experiences difficulty in the final stages
of labor and the fetal head has descended almost to the vaginal opening, the
obstetrician may employ forceps or vacuum devices to facilitate the delivery,
particularly in cases of fetal distress. Obstetricians also treat the
complications associated with childbirth, including postsurgical care after a
cesarean section and repair of any lacerations of the vagina, cervix, or rectum
after vaginal delivery.

Perspective and Prospects

Obstetrics is central to medicine because it deals with the very process by which all humans come to exist. The health of the fetus and its mother in pregnancy is of primary concern to these doctors. The field of obstetrics has blossomed as a sophisticated specialty, more likely to be practiced by obstetricians, certified nurse midwives, and specially trained and certified nurse practitioners, rather than the general practitioners who used to provide this care.

Advances in medical technology have enabled more precise analysis and monitoring
of the fetus inside the mother’s uterus, and obstetrics has therefore become a
complex specialty in its own right. Technology such as ultrasonography and fetal
heart rate monitoring, among other techniques, allows the obstetrician to collect
a much larger supply of fetal data than was available to the general practitioner
prior to the 1960s. Increased data availability enables the obstetrician to
monitor the pregnancy closely and to identify any problems earlier.

New advances in product development continue to improve the diagnostic ability of
obstetricians. One example is the development of a test for fetal fibronectin,
which enables obstetricians to predict which patients are at low risk of premature
delivery. This test involves a simple swab of the upper vagina. When negative,
this test is highly reliable and allows the pregnant patient to leave the hospital
and avoid prolonged and unnecessary hospitalization.

Advances in prenatal diagnosis and basic science have made it possible for parents
to obtain information about their fetuses down to the molecular level. Through
techniques such as amniocentesis and chorionic villus sampling (in which a
small sample of placental cells is obtained early in pregnancy), genetic analysis
has enabled the detection of chromosomal defects responsible for defects
responsible for inherited diseases (such as cystic fibrosis). Amniocentesis has
also made it possible to detect biochemical changes that may be indicative of
major structural defects in the fetus, as well as to assess the developmental
maturity of organs such as the lungs.

Advances in medical practice have dramatically decreased the morbidity and
mortality of premature birth. For instance, with the introduction and
widespread use of maternal steroid injections, the severity of serious diseases of
prematurity, such as respiratory distress syndrome, has been
dramatically reduced. The development of drugs against HIV has prevented the
transmission of the virus from mother to infant in many cases.

The medical science of obstetrics continues to advance. There is ongoing research
into the physiology and basic science of preeclampsia and eclampsia, potentially
dangerous diseases peculiar to pregnancy. Fetal surgery programs at academic
centers open the possibility that serious birth defects
may be correctable while the fetus is in utero. Although many controversies
currently exist in the field of obstetrics, an increased push toward medical
practice grounded in scientific evidence promises many exciting advances in the
future. It is hoped that many of these advances will result in improved outcomes
and quality of life for patients.

Bibliography

Cohen, Barbara J.
Memmler’s The Human Body in Health and Disease. 12th ed.
Philadelphia: Lippincott, 2012. Print.

Cunningham, F., et al. Williams
Obstetrics. 24th ed. New York: McGraw Hill, 2014.
Print.

Gabbe, Steven G.,
Jennifer R. Niebyl, and Joe Leigh Simpson, eds. Obstetrics: Normal
and Problem Pregnancies. 6th ed. Philadelphia: Saunders, 2012.
Print.

Gaudin, Anthony J.,
and Kenneth C. Jones. Human Anatomy and Physiology. New
York: Harcourt Brace Jovanovich, 1997. Print.

Harkness, Gail, ed.
Medical-Surgical Nursing: Total Patient Care. 10th ed.
St. Louis: Mosby, 1999. Print.

Limmer, Daniel, et al.
Emergency Care. 12th ed. Boston: Brady, 2012.
Print.

Wallace, Robert A., Gerald P. Sanders, and Robert J. Ferl. Biology: The Science of Life. 4th ed. New York: HarperCollins, 1996.

In To Kill a Mockingbird, what does Dill see on the Radley porch?

Dill, Scout, and Jem decide to spy on Boo Radley. They wait until it is dark outside and they quietly sneak onto the Radley property. They open the creaking gate and step inside the fenced area, which every other kid in Maycomb is terrified to do. Dill, Scout, and Jem walk around to the rear of the house and see the Radleys' back porch. The porch makes the house look abandoned:

The back of the Radley house was less inviting than the front: a ramshackle porch ran the width of the house; there were two doors and two dark windows between the doors.  Instead of a column, a rough two-by-four supported one end of the roof.  An old Franklin stove sat in a corner of the porch; above it a hat-rack mirror caught the moon and shone eerily (To Kill a Mockingbird, Chapter 6).

The children run into some chickens as they prowl around the back yard. Dill peers into a window on the side of the house, but he cannot see anything except for curtains. Dill suggests looking through the back window, but Scout protests. He goes around to the back anyway with Scout and Jem following. Jem quietly climbs onto the run-down porch and looks through the window. Then Scout notices something:

Then I saw the shadow. It was the shadow of a man with a hat on. 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.

After this, Dill sees the shadow,too. Afraid, he covers his face with his hands. Jem is the last one to see the shadow. Terrified, the children run as fast as they can to escape.

List three similarities and differences between plant and animal cells.

Structures Found in Both Plant and Animal Cells (Similarities)

• 
  Golgi Apparatus: membrane-bound sacs involved in protein secretion from the cell


• 
  Pinocytotic Vesicle: vacuoles formed by endocytosis of the membrane


• 
  Lysosome: vesicles containing digestive enzymes


• 
  Mitochondria: site of aerobic respiration and ATP production


• 
  Endoplasmic Reticulum: membrane-bound channels that run throughout the cell; smooth endoplasmic reticulum does not have attached ribosomes; rough endoplasmic reticulum does have attached ribosomes


• 
  Ribosomes: location of protein synthesis


• 
  Nucleolus: small organelle containing chromatin


• 
  Nucleus: location of most of the cell's DNA

Structures Found Only in Plant Cells (Differences)

• 
  Cell Wall: a layer of cellulose that surrounds the plasma membrane of plant cells


• 
  Large Central Vacuole: a large fluid filled sac that occupies a large part of the plant cells; stores water and other water soluble substances


• 
  Chloroplast: site of photosynthesis and ATP production


• 
  Amyloplast: a membrane-bound organelle composed of starch

How can the interests of the individual states be protected?

The only good way to protect the interests of the individual states is by political action.  Those who want to protect the states’ interests have to create interest groups and/or social movements to fight for those interests. They have to vote for politicians who will protect those interests.  There is no other way to make this happen.

In the United States, we have a federal system in which the states are supposed to have extensive rights.  Over time, however, the federal government has taken more and more power for itself.  This has happened even though there have been no constitutional amendments to change the balance of power between the federal government and the state governments.  Instead, the balance has changed simply because political leaders and regular citizens have allowed it to.

If the balance of power in our federal system has changed without any changes to the Constitution, that means that the balance is not determined by the Constitution.  Therefore, we cannot change the balance by changing the Constitution.  If the balance has changed because people wanted it to, we have to create a situation where people want the balance to change back.  That is, we have to get people to want the states to have more power again.  In order to do this, we would need political action.

We have seen that political action can get people to change their minds on various issues.  Perhaps the clearest example of this in recent times is the issue of gay rights.  Without changing the Constitution, we have gone from a time when gay sexual activity could be a crime to a time where gay marriage is protected by the Supreme Court.  This has happened in the space of less than 15 years.  What this tells us is that political action can be relevant.

To protect the interests of individual states, we would have to have a movement similar to the gay rights movement.  We would have to have interest groups pushing for states’ rights.  We would have to have them educating and persuading people that states’ rights are important.  We would have to have them working to elect leaders who would protect states’ rights.  This sort of political action is the only way in which the interests of individual states can be protected.

What are some examples of how magical realism is used in the book Shoeless Joe?

Magical realism (also called magic realism) is a literary movement often associated with Latin-American authors. Magical realism attempts to establish a realistic setting in which fantastic or paranormal events are accepted as part of the natural world order. Characters who encounter "magic" in their world accept it as a real, concrete event, which serves to draw the reader into the author's creation. 

W.P. Kinsella develops magical realism in Shoeless Joe by allowing his characters to discover that their dreams can be realized as long as they are willing to suspend their skepticism and embrace their imagination. 

I would argue there are three seminal moments of magical realism in Shoeless Joe.

1. After Ray and Salinger talk with the elderly Archibald "Moonlight" Graham, Ray encounters a reincarnation of the younger Graham and decides to help him achieve his dream to play baseball with Shoeless Joe Jackson.


2. As fans flock to Ray's field to watch the other reincarnated players, Salinger accepts the ballplayers' offer to join them as they disappear into the cornfield.


3. Ray has a game of catch with his father's younger self, which allows Ray to bury the resentments of his past.

Characters within Kinsella's world accept these events as real, which seems to strengthen the emotional impact of the magical realism in the novel.  

What is the advantage of leaving some slack when installing electrical cables?

The main purpose of providing slack in electrical cables is to prevent the effects of thermal stress in them.

Most materials expand when heated and contract when cooled. This can be easily observed by heating a metal object (preferably made of iron) and cooling it after it has melted. The iron will contract when cooled. The same happens with electrical cables. These cables expand when heated (due to warm weather) and contract when cooled (due to colder weather). If the cables were completely taut without any slack in them, expansion would not be as serious an issue as contraction. That is, during colder weather, the taut cable would contract and would pull the poles closer, an unfavorable scenario.

Thus, we ensure to leave some slack while installing electrical cables. The slack also ensures the availability of wire when any remodeling or reconnections are needed. The wires can also be moved around a little bit during times of remodeling. 

Hope this helps. 

What is meant by ergonomics, and what changes can be made to decrease the risk of developing injuries related to computer use?

Ergonomics simply means fitting a job to a person, or in other words, adjusting the working conditions to improve a person's ability to do their job. As it relates to workplace injuries from computer use, ergonomics usually refers to ways in which a workstation can be outfitted to help lessen the strain of repetitive activities and thereby reduce the possibility of repetitive stress injuries.

Workers in office environments who use computers are vulnerable to a number of different repetitive stress injuries, including carpal tunnel syndrome, trigger finger (also known as tendosing synovitis), tendinitis, and other conditions. Other physical problems resulting from frequent computer use include eye strain and eye fatigue, back pain, and shoulder pain, as well as headaches (usually resulting from muscle tension in the neck). 

Basic changes that can help reduce these potential injuries can apply to work habits as well as work stations. Changes to work habits could include taking frequent breaks, looking out the window or at something in the near distance occasionally to reduce eye strain, stretching the hands and fingers occasionally, and standing and walking around to keep the circulation flowing and the muscles moving.

Work station changes might include making sure proper lighting is used, having a workplace that is sufficiently warm (as cold can make muscles vulnerable to injury), having chairs adjusted to be at the proper height, using a cushion the provides lumbar support, and using specially-designed ergonomic keyboards that cause lessened strain while typing, utilizing a "mouse" that is larger or rounder (such as a tracking ball mouse), and voice dictation software that lessens the need for physical typing of text.

Compare and contrast Venice and Belmont. What is the significance of these distinct settings in the play?

During Shakespeare's time, Jewish people were not allowed in England by law. Venice was more tolerant, at least by comparison. Because Venice was a center of trade, the city had laws to protect foreign traders and keep the economy strong. Still, strife was common enough in Venice despite the diversity, and though Jews were allowed to live there, they were forced to live in ghettos during Shakespeare's time.

In the play, Venice is the epitome of big city living, with most of the action of the play taking place out on the street, where traders and merchants and money-lenders are hustling and doing business. It is very public, with everyone's business discussed on the street; consider Shylock running around and yelling about his daughter and ducats. Venice's interest focuses on money and wealth and it is a place where one's fortunes seem to rise and fall easily.

In contrast, Belmont seems to embody the quiet, calm countryside, where one can retreat when the hustle and bustle of Venice is too much. Its beauty and peacefulness are reflected in Portia herself, a beautiful, wealthy woman who seems in control of every situation. When Portia is at home, she spends her time gossiping with her servant and entertaining suitors. The pace of life in Belmont is slower and more relaxed than it is in Venice.

What were effects of the Cuban Missile Crisis, and how did it change the United States?

The Cuban Missile Crisis describes the attempt of the Soviet Union to put offensive missiles in Cuba and our response to this threat. When we discovered that the Soviet Union was building missiles and had placed missiles with offensive capabilities in Cuba, we demanded that the missile sites be dismantled and that the missiles be removed. We placed a naval blockade around Cuba to prevent any ships from the Soviet Union with materials that could aid in the building of these sites from entering Cuba. We would search all ships before letting them pass through the blockade.

Many people feared the United States and the Soviet Union were heading for a nuclear confrontation. It seemed that neither side was willing to budge and that a military option would be needed to resolve this dispute. Many people believed this would include the use of nuclear weapons. Fortunately, both sides realized that compromise was a better option.

The Cuban Missile Crisis helped both the Soviet Union and the United States realize that there needed to be a reduction in tensions so that neither side would get so close to possible nuclear warfare. Tensions did decrease between the countries to some degree. This can be seen in the agreement we made with the Soviets banning the above ground testing of nuclear weapons in 1963. Many Americans also realized how fragile peace could be in the world. Any event could threaten to put us in a state of conflict. Americans realized we needed calm and rational thinking when handling international disputes. Americans realized the threat of nuclear war was a real threat.

The Cuban Missile Crisis impacted us greatly.

During the evening's festivities in Silas Marner, how much progress does Godfrey make in winning Nancy's approval?

The festivities in chapter XI bring Nancy and Godfrey closer than ever with a unique chance to sit and talk alone.

This chance came as a result of a wardrobe malfunction that prevented Nancy from enjoying the dance fully, and it gave Godfrey a chance to move her somewhere else. He was very happy at the chance, and made some bold moves throughout their conversation.

[Godfrey] got rather bold on the strength of her confusion, and was capable of leading her straight away, without leave asked, into the adjoining small parlour, where the card-tables were set.

Nancy, on her part, was equally excited. Her personality is so complex—and her behavior so strange—that it is hard to extrapolate her exact feelings. After all, Nancy is described as someone so obsessed with appearing and acting righteous and proper that she sometimes loses herself in the process. Nevertheless, she does show some glimpses of her interest in Godfrey that he definitely picks up on.

Therefore, while their entire conversation is awkward, and Nancy does not want to let go of her self-control, Godfrey makes clear gains in the journey toward Nancy's heart. He has not entirely won her "approval" as far as being a formal love interest, but it is clear their feelings are mutual despite the obstacles blocking their potential coming-together.

What is the meaning of the lines "Or let autumn fall on me / Where afield I linger, / Silencing the bird on tree, / Biting the blue finger"?

These lines are from “The Vagabond,” a poem written by Robert Louis Stevenson and included in a collection of other poems he wrote entitled Songs of Travel. “The Vagabond” is about a life of wandering and travel. The poet asks only for “the jolly heaven above / And the byway nigh me.” He desires neither hearth nor home, but only the sky above him and the road beneath his feet.

In these particular lines, the poet is emphatic in his desire to wander, come what may, even in the harsher seasons. He says to go ahead and “let autumn fall on me / Where afield I linger.” He will wander, even when autumn begins to fall, signaling the harshness of the winter to come; even so, he will be lingering in the fields, in the open, with no habitation but the sky and road and fields. Not only does the onset of autumn signal the coming of winter, it also succeeds in “silencing the bird on tree.” In the autumn, even the birds succumb to the weather and seek warmer climes. Even when the birds take flight and their very songs are taken away from him, the poet will still linger in the meadows and “the frosty field.” Even as the poet remembers the “warm . . . fireside haven,” he still insists, “not to autumn will I yield, / Not to winter even!”

As far as the line “Biting the blue finger,” Stevenson could be referring to the cold fingers of frostbite in the winter turning blue. The term may possibly be a lost Scottish idiom, but as far as I have researched, I cannot find any evidence of that.

Robert Louis Stevenson, a nineteenth century novelist, poet, and essayist, was a prolific writer and a consummate wanderer. Due to ill health from childhood lung and respiratory issues thought to be tuberculosis, Stevenson traveled the world, a vagabond of sorts, attempting to find a climate that might soothe his health. He ultimately settled in Samoa, where he died, and was buried, in 1894.

How can I begin an essay if I don't know what to write?

Writing is often a challenging task; this is even more so when time is of the essence.

When you don't know where to begin, it helps to determine what you want to write about. Decide what the subject of your essay will be. If this is a free-style essay, the sky's the limit where subjects are concerned. Let's say your subject is second-hand cigarette smoke. Take a stance on your subject; this will be the basis of your thesis statement.

A thesis statement basically explains in one or two sentences what you believe about second-hand smoke. Such a statement is extremely important, not only because it tells your readers where you are headed with your arguments, it also keeps you from going off in tangents as you proceed through your paragraphs. Think of your thesis statement as a guide, an invaluable one.

To return to the subject of second-hand smoke, your feelings about such a topic can range from negative/positive to ambivalent. Let's say that your feelings about second-hand smoke are negative. This alone will decide how you craft your thesis statement.  Let's take a look at two:

1)All students should learn about the dangers of second-hand smoke so that they do not become susceptible to lung cancer.

2)Second-hand smoke is injurious to health, and cigarettes should be banned on college/school campuses.

Now, the thesis statement is just one or two sentences in your first paragraph. What will you write for the rest of your paragraph? Your teacher may have taught you to use 'hooks' at the very beginning of your essay; this can be an interesting quote, a personal anecdote/story, or some reference to a news story about second-hand smoke. Your thesis statement can be inserted towards the end of your first paragraph.

If your teacher has given you a prompt, begin to study what the prompt asks for. Is it asking you to compare and contrast between two different ideas, characters, or novels? Does the prompt ask for an analysis of a particular work? Either way, the first thing to do is to decide how you feel about the prompt and what your eventual stance about the prompt will be (this is where you form your thesis statement). The subject of your prompt may be Shakespeare's Macbeth and the prompt may ask you to analyze whether Lady Macbeth or her husband is more culpable for King Duncan's death.

If you think that Lady Macbeth is more responsible for Duncan's death, say this in your thesis statement. But, write your thesis statement in such a way that there will be room for argument. For example,

'Lady Macbeth is more responsible for King Duncan's death because she is more treacherous, corrupt, and ruthless than Macbeth.'

You can begin your first paragraph by briefly highlighting three or more instances where you think Lady Macbeth proved more treacherous, corrupt, and ruthless than her husband. Your thesis statement can be inserted towards the end your first paragraph, if you like. The body of your essay will concentrate on discussing in greater detail your main points in the first paragraph. End your essay by introducing some counter-arguments and refuting those. That's one way to write!

1. In this chapter Fitzgerald writes about the Valley of Ashes. He also mentions dust and smoke (at the party). All three of these reappear...

The Valley of Ashes is a major symbol in The Great Gatsby.  Although most of the action in the novel takes place elsewhere, some very pivotal things happen at George Wilson's garage, located on the edge of the valley of ashes.  This is the home of Myrtle Wilson, Tom's mistress.  It is here that Myrtle is hit by Gatsby's car, wildly driven by Daisy, it is here that she dies, and it is here that George Wilson cracks up and emerges to find and kill whoever killed Myrtle.

George and Myrtle live in the valley of ashes, trapped in relative poverty.  The wealthier characters, who live in East and West Egg, may not live in the valley, but they have to pass through it every time they go to the city.  So one thing it symbolizes is the difference between the lives of the privileged classes and the working classes.  Myrtle seeks to escape the valley of ashes through her affair with Tom, who takes her to an apartment in the city.

In the link below is an article that argues that The Great Gatsby is loosely based on Dante's Inferno, which is a tour downward through the successive circles of hell.  Nick's description of the valley of ashes is meant to sound hellish ... but interestingly, according to the article, hell includes New York City itself: "The Plaza Hotel on 59th Street and Fifth Avenue is apparently the ninth circle of hell." 

Though the wealthy characters have no desire to dwell in the valley of ashes, its influence keeps reaching out to get them.  Tom, for some reason, chooses to take a mistress from there, thus setting in motion a tragic chain of events that ends in the deaths of Myrtle, Gatsby, and George Wilson.  The valley of ashes is surprisingly difficult to escape from, as Nick describes:

The valley of ashes is bounded on one side by a small foul river, and when the drawbridge is up to let barges through, the passengers on waiting trains can stare at the dismal scene for as long as half an hour.  There is always a halt there of at least a minute ...

Now, what in the world is a dim, dirty, hellish place to live ... in which some are sentenced to spend their whole lives ... which others try to avoid but must pass through from time to time ... which fascinates some people even as it repels them ... which tends to trap those who pass through it ... which tends to cling to, or follow, those who have passed through it, bringing destruction with it?

Call it Poverty, or Murphy's Law, or Human Frailty, Sin, or even just The Real World.  The valley of ashes could be all these things.  Dust and smoke encroaching on Gatsby's party show that even there, he cannot escape these things. 

What are natural treatments for colds and flus?

Principal Proposed Natural Treatments

Various natural treatments have shown promise for treating or preventing colds and flu.

Zinc. One well-known alternative treatment for colds and flu is the use of zinc in nasal gel or lozenges. When zinc is taken this way, it is not being used as a nutrient. Rather, certain forms of zinc release ions that are thought to directly inhibit viruses in the nose and throat.

Taking zinc orally as a nutrient might also be useful in some cases. The immune system does not function properly if one does not have enough zinc in his or her body. Because zinc is commonly deficient in the diet, especially among children and the elderly, nutritional zinc supplementation may certainly be useful for those who get sick easily.

A one-year double-blind study of fifty nursing home residents found that zinc supplements compared with placebo reduced rates of infection. In addition, more than ten other studies performed in developing countries have found that zinc supplements at nutritional doses can increase resistance to respiratory and other infection in children, and that they might reduce symptom severity. With zinc, more is not better; once one has enough zinc, getting extra will not help and might even be harmful.

Scientific evidence for zinc nasal gel and lozenges. The use of lozenges containing zinc gluconate or zinc acetate has shown somewhat inconsistent but generally positive results for reducing the severity and duration of the common cold. For example, in a double-blind trial, one hundred people who were experiencing the early symptoms of a cold were given a lozenge that contained either 13.3 milligrams (mg) of zinc from zinc gluconate or a placebo. Participants took the lozenges several times daily until their cold symptoms subsided. The results were impressive. Coughing disappeared within two days in the treated group versus four days in the placebo group. Sore throat disappeared after one day versus three days in the placebo group, nasal drainage in four days (versus seven days), and headache in two days (versus three days). Positive results have also been seen in double-blind studies of zinc acetate. Not all studies have shown such positive results. However, the overall results appear to be favorable.

It has been suggested that the exact formulation of the zinc lozenge plays a significant role in its effectiveness. According to this view, certain flavoring agents, such as citric acid and tartaric acid, might prevent zinc from inhibiting viruses. In addition, chemical forms of zinc other than zinc gluconate or zinc acetate might be ineffective. Zinc sulfate in particular might not work. Along the same lines, sweeteners such as sorbitol, sucrose, dextrose, and mannitol are said to be fine, while glycine has been discussed in an equivocal manner.

The use of zinc in the nose is somewhat more controversial. In addition to showing inconsistent results in studies, the use of zinc nasal gel can cause pain and possibly loss of sense of smell. In one double-blind, placebo-controlled trial, 213 people with a newly starting cold used one squirt of zinc gluconate gel or placebo gel in each nostril every four hours while awake. The results were significant: Treated participants stayed sick an average of 2.3 days, while those receiving placebo were sick for an average of 9 days, a 75 percent reduction in the duration of symptoms. Somewhat more modest but still significant relative benefits were seen with zinc nasal gel in a double-blind, placebo-controlled study of eighty people with colds. However, a slightly larger study of a similar zinc gluconate nasal gel found no benefit. Another study, this one involving seventy-seven people, failed to find benefit, even with nearly constant saturation of the nasal passages with zinc gluconate nasal spray.

Echinacea. Until the 1930s, echinacea was the number-one cold and flu remedy in the United States. It lost its popularity with the arrival of sulfa antibiotics. Ironically, sulfa antibiotics are as ineffective against colds as any other antibiotic, while echinacea does seem to be at least somewhat helpful. In Germany, echinacea remains the main remedy for minor respiratory infections.

Echinacea is generally thought to work by temporarily stimulating the immune system, although most later evidence has tended to cast doubt on this belief. Contrary to popular belief, however, there is little reason to believe that echinacea strengthens or “nourishes” the immune system when taken over the long term.

There are three main species of echinacea: E. purpurea, E. angustifolia, and E. pallida. A mixture containing all the parts of E. purpurea found above ground (flowers, leaves, stems) has the best supporting evidence for effectiveness in treating colds and flu; the root of E. purpurea is probably not effective, while the root of E. pallida may be the active part of that species.

Echinacea has shown promise for reducing the symptoms and duration of colds and aborting a cold once it has started. However, echinacea does not appear to be helpful for preventing colds. It may also not be effective in children.

Reducing the symptoms and duration of colds. Double-blind, placebo-controlled studies enrolling more than one thousand people have found that various forms and species of echinacea can reduce the symptoms and duration of a common cold. This is true for adults. In one double-blind, placebo-controlled trial, eighty persons with early cold symptoms were given either E. purpurea extract or placebo. The results showed that those who were given echinacea recovered significantly more quickly: in just six days among the echinacea group versus nine days among the placebo group.

Another double-blind, placebo-controlled trial looked at the reduction of the severity of cold symptoms. The results in 246 participants showed that treatment with E. purpurea significantly improved cold symptoms such as runny nose, sore throat, sneezing, and fatigue. Symptom reduction with E. purpurea was also seen in a double-blind, placebo-controlled study of 282 people.

In addition, three double-blind, placebo-controlled studies enrolling about six hundred persons found similar benefits with a combination product containing E. purpurea and E. pallida root, along with wild indigo and white pine.

While the evidence tends to suggest that the above-ground portion of E. purpurea is active against the common cold, two studies have failed to find benefit. One of these was a double-blind, placebo-controlled study enrolling 120 adults, the other an even larger trial (407 participants) involving children. The reason for these negative outcomes is not clear. E. angustifolia root has also failed to prove effective in a large study.

Aborting a cold. A double-blind study suggests that echinacea, in addition to making colds shorter and less severe, might also be able to stop a cold that is just starting. In this study, 120 people were given E. purpurea or a placebo as soon as they started showing signs of getting a cold.

Participants took either echinacea or placebo at a dosage of twenty drops every two hours for one day, then twenty drops three times a day for a total of up to ten days of treatment. The results were promising. Fewer people in the echinacea group felt that their initial symptoms actually developed into “real” colds (40 percent of those taking echinacea versus 60 percent taking the placebo actually became ill). Also, among those who did come down with “real” colds, improvement in the symptoms started sooner in the echinacea group (four days instead of eight days). Both of these results were statistically significant.

Preventing colds. Several studies have attempted to discover whether the daily use of echinacea can prevent colds from even starting, but the results have not been promising. In one double-blind, placebo-controlled trial, 302 healthy volunteers were given an alcohol tincture containing E. purpurea root, E. angustifolia root, or placebo for twelve weeks. The results showed that E. purpurea was associated with perhaps a 20 percent decrease in the number of people who got sick, and E. angustifolia with a 10 percent decrease. However, the difference was not statistically significant. This means that the benefit, if any, was so small that it could have come from chance alone.

Another double-blind, placebo-controlled study enrolled 109 persons with a history of four or more colds during the previous year and gave them either E. purpurea juice or placebo for a period of eight weeks. No benefits were seen in the frequency, duration, or severity of colds. Four other studies also failed to find statistically significant preventive effects.

A study often cited as evidence that echinacea can prevent colds actually found no benefit in the 609 participants taken together. Only by looking at subgroups of participants (a statistically questionable procedure) could researchers find any evidence of benefit, and it was still slight.

However, a more recent study using a combination product containing echinacea, propolis, and vitamin C did find preventive benefits. In this double-blind, placebo-controlled study, 430 children ages one to five years were given either the combination or the placebo for the months during the winter. The results showed a statistically significant reduction in frequency of respiratory infections. It is not clear which of the components of this mixture was responsible for the apparent benefits seen.

Andrographis. Andrographis is a shrub found throughout India and other Asian countries, sometimes called Indian echinacea because it is believed to provide much the same benefits. It has been used historically in epidemics, including the Indian flu epidemic in 1919, during which andrographis was credited with stopping the spread of the disease. It is now popular in Scandinavia as a treatment for colds.

Although it is not known how andrographis might work for colds, some evidence suggests that it might stimulate immunity. The ingredient of andrographis used for standardization purposes, andrographolide, does not appear to affect the immune system as much as the whole plant extract.

According to a few well-designed studies (almost all of which used the proprietary extract produced by a single company), andrographis can reduce the symptoms of colds. It may offer the additional useful benefit of helping to prevent colds.

Reducing cold symptoms. Seven double-blind, placebo-controlled studies enrolling almost one thousand people have found that andrographis (or a combination containing it as the presumed primary ingredient) significantly reduces the duration and severity of cold symptoms.

For example, a four-day, double-blind, placebo-controlled trial of 158 adults with colds found that treatment with a proprietary andrographis extract significantly reduced cold symptoms. Participants were given either placebo or 1,200 mg daily of an andrographis extract standardized to contain 5 percent andrographolide. The results showed that by day two of treatment, and even more by day four, participants given the actual treatment experienced significant improvements in symptoms compared to participants in the placebo group. The greatest response was seen in earache, sleeplessness, nasal drainage, and sore throat, but other cold symptoms improved too.

Three other double-blind, placebo-controlled studies, enrolling about four hundred people, evaluated a proprietary herbal combination treatment containing both andrographis and Eleutherococcus senticosus (Russian ginseng) and found benefit. Another study suggests that this combination may be more effective than echinacea. (Somewhat confusingly, this proprietary combination is sold under the same name, Kan Jang, as the pure andrographis product already noted; the manufacturer regards this combination as more effective than andrographis alone, and the combination version of the product has now superseded the previous single-herb version.) The same combination has also shown promise in two double-blind studies for reducing the duration, severity, and rate of complications of influenza.

Andrographis has also been compared to acetaminophen
(Tylenol). In a double-blind study of 152 adults with sore throat and fever,
participants received andrographis (in doses of 3 or 6 g per day for seven days)
or acetaminophen. The higher dose of andrographis (6 g) decreased symptoms of
fever and throat pain to about the same extent as acetaminophen, but the lower
dose of andrographis (3 g) was not as effective. There were no significant side
effects in either group. This study used a different form of andrographis than the
proprietary product already noted.

Preventing colds. According to one double-blind, placebo-controlled study, andrographis may increase resistance to colds. A total of 107 students, all eighteen years of age, participated in this three-month trial that used the same proprietary extract of andrographis noted earlier. Fifty-four of the participants took two 100 mg tablets standardized to 5.6 percent andrographolide daily, considerably less than the 1,200 to 6,000 mg per day that has been used in studies on treatment of colds. The other fifty-three students were given placebo tablets with a coating identical to the treatment. Then, once a week throughout the study, a clinician evaluated all the participants for cold symptoms.

By the end of the trial, only sixteen people in the group using andrographis had experienced colds, compared to thirty-three of the placebo-group participants. This difference was statistically significant, indicating that andrographis reduces the risk of catching a cold by a factor of two compared with placebo.

Vitamin C. Vitamin C may mildly reduce symptoms of
colds when they occur, but it probably does not help prevent colds.

Treating colds. Numerous studies have found that vitamin C supplements taken at a dose of 1,000 mg or more daily can reduce the severity of cold symptoms and shorten their duration. However, the effect is modest at best. In addition, at least one study suggests that vitamin C can enhance the effect of standard cold treatments, such as acetaminophen. According to most of these studies, using vitamin C throughout the cold season, rather than intermittently, appears to be beneficial. For example, a review of twenty-nine placebo-controlled trials involving almost one thousand episodes of illness concluded that taking a minimum of 2,000 mg per day seems to result in shorter and less severe colds when they occur. However, high doses of vitamin C do not appear to decrease the number of colds experienced during a season.

Many people use vitamin C for colds in a different way: They begin taking it only after cold symptoms first appear. In a review of seven randomized and nonrandomized trials, researchers found that this approach–taking high doses of vitamin C (for example, 2,000 to 4,000 mg) at the first sign of illness–does not seem to affect the cold’s severity or duration.

Preventing colds. Although some studies suggest that regular use of vitamin C throughout the cold season can help prevent colds, most other studies have found little to no benefit along these lines. Vitamin C has shown a bit more promise for prevention of one type of cold, the so-called postmarathon sniffle. These are colds that develop after endurance exercise; the use of vitamin C before and during competition may help keep a person cold-free afterward. In addition, vitamin C seems to help prevent respiratory infections among persons who are actually deficient in the vitamin.

Essential oils. Eucalyptus is a standard ingredient in cough
drops and in oils meant to be added to humidifiers. A standardized combination of
three essential
oils has been tested for its usefulness in respiratory
conditions. The studied combination, called essential oil monoterpenes, includes
cineole from eucalyptus, d-limonene from citrus fruit, and alpha-pinene from pine.
Numerous double-blind trials have found them effective when taken orally for acute
bronchitis, chronic bronchitis, sinus infections, and other respiratory
conditions, in both adults and children. Cineole alone at a dose of 200 mg three
times daily showed benefit in a double-blind, placebo-controlled study of 152
people with cold symptoms. A second study involving 150 persons also demonstrated
favorable results of cineole compared to a combination of five other herbal
products.

Ginseng. Although most people in the West think of
ginseng as a stimulant, in Eastern Europe ginseng is widely
believed to improve overall immunity to illness. As noted, echinacea does not seem
to prevent respiratory infections, but it appears that the regular use of ginseng
might be able to provide this important benefit.

There are three different herbs commonly called ginseng: Asian or Korean ginseng (Panax ginseng), American ginseng (Panax quinquefolius), and Siberian ginseng (Eleutherococcus senticosus). The latter herb, which is not discussed here, is actually not ginseng.

A double-blind, placebo-controlled study of 323 people found meaningful evidence that an extract of American ginseng taken at 400 mg daily may help prevent the common cold. Participants who used the extract for four months experienced a reduced number of colds compared to those taking placebo. Comparative benefits were also seen regarding the percentage of participants who developed two or more colds and the severity and duration of cold symptoms that did develop. Similar benefits were also seen in a study of forty-three people. Two double-blind, placebo-controlled studies enrolling about one hundred people indicate that American ginseng may also help prevent flulike illness in the elderly.

Garlic. The herb garlic has a long history of use for treating or preventing colds. However, until 2001, there was no scientific evidence that it actually works for this purpose. In one twelve-week, double-blind, placebo-controlled trial, 146 persons received either placebo or a garlic extract between November and February. The results showed that participants receiving garlic were almost two-thirds less likely to catch cold than those receiving placebo. Furthermore, participants who did catch cold recovered about one day faster in the garlic group compared with the placebo group. Note that these studies do not indicate that taking garlic will help once a person already has a cold.

Probiotics. Probiotics are healthful organisms that
colonize the digestive tract. Not only can they help prevent intestinal
infections, they also appear to help prevent colds.

A seven-month, double-blind, placebo-controlled study of 571 children in day care centers in Finland found that the use of milk fortified with the probiotic bacterium Lactobacillus GG modestly reduced the number and severity of respiratory infections. In another controlled trial, probiotics (L. rhamnosus GG and Bifidobacterium lactis Bb-12) given daily to infants in their formula significantly reduced the risk of acute otitis media and recurrent respiratory infections during the first year of life compared with placebo. Benefits were also seen in three other large studies, in which probiotics, alone or combined with multivitamins-multiminerals, helped prevent colds or reduce their duration and severity in adults.

Another controlled trial involving twenty healthy elite distance runners found
that L. fermentum given for four months during winter training
was significantly more effective at reducing the number and severity of
respiratory symptoms than a placebo. In addition, a small double-blind study found
evidence that the use of the probiotic bacterium L. fermentum
improved the effectiveness of the influenza vaccine. The probiotic
supplement was taken in two doses: the first two weeks before the vaccine, and the
other two weeks after.

Other Proposed Natural Treatments

Various other natural treatments have shown some promise for preventing or treating colds and flu.

Preventing respiratory infections. The use of multivitamin-multimineral supplements, or supplements containing zinc and selenium alone, may help prevent respiratory infections in the elderly, according to some studies. One small double-blind study suggests that the supplement arginine might be helpful for preventing colds in children.

A gargle made from green tea extract has shown promise for preventing influenza. In a double-blind, placebo-controlled study, 124 residents of a Japanese nursing home gargled with green tea catechins or placebo for three months. All participants received standard influenza vaccine. The results showed that those who gargled with the tea extract were less likely to develop influenza than those using placebo. In addition, another double-blind study found preliminary evidence that oral consumption of a green tea extract might help prevent both colds and flu.

There is some evidence that the supplement glutamine
may, like vitamin C, help prevent postexercise infections. For example, a
double-blind, placebo-controlled study evaluated the benefits of supplemental
glutamine (5 g) taken at the end of exercise in 151 endurance athletes. The result
showed a significant decrease in infections among those treated. Only 19 percent
of the athletes taking glutamine got sick, compared to 51 percent of those on
placebo. Echinacea has also shown some promise for this purpose.

In contrast, some evidence suggests that a combination of vitamin E and
beta-carotene treatment might increase the risk of exercise-associated colds. The
evidence regarding whether vitamin E taken alone can prevent respiratory
infections is conflicting.

The thymus gland plays a role in immunity. A one-year, double-blind, placebo-controlled trial of sixteen children with frequent respiratory infections found that treatment with thymus extract could reduce the rate of infection. However, a double-blind, placebo-controlled trial of sixty athletes failed to find any significant evidence of benefit with thymus extract for preventing postexercise infections.

An extract of rice bran has shown some promise for preventing or treating colds in the elderly. Also, a throat spray made from sage has shown considerable promise for reducing sore throat pain. A study widely reported as showing that the supplement colostrum can help prevent colds was actually far too preliminary to prove anything. There is some evidence that elements in kelp might help to prevent infection with several kinds of viruses, including influenza. However, the evidence thus far is more theoretical than practical.

Various herbs, including ashwagandha, astragalus, garlic, maitake, reishi, and suma, are said to enhance immunity over the long term. However, there is no meaningful evidence that they really work. In addition, several herbs, including ginger, kudzu, osha, and yarrow, are said to help avert colds when taken at the first sign of infection; but again, there is no scientific evidence that they are effective.

Products containing colloidal silver are sometimes used in the belief that they will prevent colds and otherwise strengthen the immune system; however, because colloidal silver can cause permanent color changes in the skin, its use is not recommended.

Some older persons do not respond fully to the influenza vaccine. There is some evidence that vitamin E supplements may strengthen the immune response to vaccinations. Similarly, evidence from two double-blind trials, but not a third, suggests that combined multivitamin-multimineral supplements may improve their response. However, in another trial, a multivitamin tablet without minerals actually worsened participants’ response to the vaccine.

Two studies suggest that combined multivitamin-multimineral supplements can also improve immune response to the vaccine. However, two others failed to find benefit, and in one study a multivitamin tablet without minerals actually worsened participants’ responses to the vaccine. The reason for these discrepancies is unclear. In a double-blind, placebo-controlled study of 124 people, the supplement chlorella at a dose of 200 or 400 mg daily failed to enhance response to influenza vaccine. Another study failed to find benefit with a remedy from the traditional Chinese herbal medicine Hochu-ekki-to.

Treatment of respiratory infections. A standardized product containing elderberry combined with small amounts of echinacea and bee propolis has been widely marketed as a cold and flu remedy. Weak evidence suggests that this mixture may stimulate the immune system and also inhibit viral growth. In a preliminary double-blind study, the combination significantly reduced the recovery time from epidemic influenza B (a relatively mild form of influenza). Another small double-blind study found similar benefits in both influenza A and B.

One small study found that the popular Throat Coat brand of medicinal beverage teas actually does reduce sore throat discomfort, compared with placebo tea. Also, inhaled essential oils have shown some slight promise for the treatment of colds.

The herb Pelargonium sidoides is used in Europe for the treatment of colds and other respiratory infections. A double-blind study of 133 adults who had just come down with the common cold found that taking a standardized Pelargonium extract at a dose of 30 milliliters three times daily significantly reduced the severity and duration of symptoms compared with placebo.

In double-blind, placebo-controlled studies enrolling more than three hundred
people, a combination of four herbs (primrose, gentian root, elderberry, common
sorrel, and vervain) has shown promise for treatment of sinusitis.
Another study provides weak evidence that a standardized combination of
horseradish and nasturtium might be helpful for the treatment of the common cold
in children. Other herbs sometimes recommended to reduce cold symptoms, but that
lack meaningful supporting scientific evidence, include hyssop, ivy leaf, linden,
marshmallow, mistletoe, mullein, oregano, and peppermint.

In a double-blind, placebo-controlled trial, colostrum was not helpful for people with sore throat. (The researchers were sure to exclude people with strep throat, but some participants may have had sore throat caused by bacteria rather than cold viruses.) A substantial (254-participant) double-blind, placebo-controlled study failed to find that the use of the berry of Hippophae rhamnoides (sea buckthorn) reduced the number or duration of colds. Finally, a 2009 review of seventeen trials found that there is limited evidence to support the use of traditional Chinese herbal preparations for the common cold.

Cox, A. J., et al. “Oral Administration of the Probiotic Lactobacillus fermentum VRI-003 and Mucosal Immunity in Endurance Athletes.” British Journal of Sports Medicine 44 (2010): 222-226.

Eby, G. A., and W. W. Halcomb. “Ineffectiveness of Zinc Gluconate Nasal Spray and Zinc Orotate Lozenges in Common-Cold Treatment.” Alternative Therapies in Health and Medicine 12 (2006): 34-38.

Goel, V., et al. “A Proprietary Extract from the Echinacea Plant (Echinacea purpurea) Enhances Systemic Immune Response During a Common Cold.” Phytotherapy Research 19 (2005): 689-694.

Halperin, S. A., et al. “Safety and Immunoenhancing Effect of a Chlorella-Derived Dietary Supplement in Healthy Adults Undergoing Influenza Vaccination.” CMAJ: Canadian Medical Association Journal 169 (2003): 111-117.

Hemila, H., E. Chalker, and B. Douglas. “Vitamin C for Preventing and Treating the Common Cold.” Cochrane Database of Systematic Reviews (2010): CD000980. Available through EBSCO DynaMed Systematic Literature Surveillance at http://www.ebscohost.com/dynamed.

Hubbert, M., et al. “Efficacy and Tolerability of a Spray with Salvia officinalis in the Treatment of Acute Pharyngitis.” European Journal of Medical Research 11 (2006): 20-26.

Kurugol, Z., N. Bayram, and T. Atik. “Effect of Zinc Sulfate on Common Cold in Children.” Pediatrics International 49 (2007): 842-847.

Larmo, P., et al. “Effects of Sea Buckthorn Berries on Infections and Inflammation.” European Journal of Clinical Nutrition 62 (2008): 1123-1130.

Linde, K., et al. “Echinacea for Preventing and Treating the Common Cold.” Cochrane Database of Systematic Reviews (2006): CD000530. Available through EBSCO DynaMed Systematic Literature Surveillance at http://www.ebscohost.com/dynamed.

O’Neil, J., et al. “Effects of Echinacea on the Frequency of Upper Respiratory Tract Symptoms.” Annals of Allergy, Asthma, and Immunology 100 (2008): 384-388.

Olivares, M., et al. “Oral Intake of Lactobacillus fermentum CECT5716 Enhances the Effects of Influenza Vaccination.” Nutrition 23 (2007): 254-260.

Rautava, S., S. Salminen, and E. Isolauri. “Specific Probiotics in Reducing the Risk of Acute Infections in Infancy.” British Journal of Nutrition 101 (2009): 1722-1726.

Rowe, C. A., et al. “Specific Formulation of Camellia sinensis Prevents Cold and Flu Symptoms and Enhances T Cell Function.” Journal of the American College of Nutrition 26 (2007): 445-452.

Tesche, S., et al. “The Value of Herbal Medicines in the Treatment of Acute Non-purulent Rhinosinusitis.” European Archives of Oto-Rhino-Laryngology 265 (2008): 1355-1359.

Zhang, X., et al. “Chinese Medicinal Herbs for the Common Cold.” Cochrane Database of Systematic Reviews (2007): CD004782. Available through EBSCO DynaMed Systematic Literature Surveillance at http://www.ebscohost.com/dynamed.

In Shakespeare's play Macbeth, why is Macbeth so upset to see the vision of Banquo and the eight kings?

When Macbeth goes to the witches to hear more prophecies later in the play, the witches conjure up three apparitions -- one says no man born of a woman can harm Macbeth, another says to beware Macduff, and a third says Macbeth's power will not be lost until the forest marches up the hill -- along with the vision of Banquo and the mirrored line of kings. Macbeth is satisfied with the apparitions, as he reads them in the most generous way for himself. He thinks they secure his power, and he admits he already knows to be wary of Macduff. The vision of Banquo and the line of kings, however, causes Macbeth to lash out at the witches. The reason this upsets Macbeth is that it recalls the prophecy given in Act I: That Macbeth would be King and Banquo would not, but Banquo would "get kings," as in "beget," or be the father to kings. The vision here confirms that Banquo will, indeed, be the father to a long line of at least eight kings; his legacy will continue for generations. Macbeth has tried to circumvent this prediction by having Banquo and his son Fleance killed, but Fleance escaped, so this is already a sore subject for Macbeth. Further, Macbeth has no sons of his own to carry his legacy into the future. Macbeth is beginning to see the meaning of the original statement made by the witches that Banquo would be "lesser than Macbeth but greater." Macbeth is furious to think that all of the crimes he has committed will do nothing more than ensure Banquo's and his family's legacy. 

How does Morrie rationalize his thought that aging is growth and not decay?

In the book, Morrie tells Mitch that aging isn't just about decay but about growth as well. He rationalizes his position from a philosophical standpoint: accepting this dual view of aging enables one to live a richer and more satisfying life.

Morrie believes that how he chooses to live determines how he will eventually die. He tells Mitch that young people are not without their own share of challenges in life. It's all a matter of perspective:

All these kids who came to me with their struggles, their strife, their feelings of inadequacy, their sense that life was miserable, so bad they wanted to kill themselves ... And, in addition to all the miseries, the young are not wise. They have very little understanding about life.

Both the old and the young have to overcome their challenges in order to fully appreciate all that life has to offer them. When Mitch argues that no one ever wishes they could be old, Morrie maintains that people who lament old age never learned to discover the true meaning of life. Because of their preoccupation with outward appearances, they lead unsatisfying lives. They envy the vitality of the young and neglect to detach themselves from that envy.

Morrie asserts that there are advantages for those who learn to accept the dawning of old age. They become open to new experiences and so, are able to attain more knowledge and lead more satisfying lives than those who envelop themselves in doubt and anger. Also, Morrie tells Mitch that age is a matter of perspective and that accepting the inevitability of aging is part of acknowledging the decay process of life. Morrie maintains that this mature outlook is the growth that most people never attain because they are too busy lamenting the loss of their youth.

“You have to find what’s good and true and beautiful in your life as it is now. Looking back makes you competitive. And, age is not a competitive issue.”