Is there any use of personification?

Yes. In fact, Sonnet 65 is brimming with personification! Here are all the instances of this particular device that we see in the poem:

1. "sad mortality"

The speaker is attributing a human emotion, sadness, to the nonhuman concept of mortality.

2. "How with this rage shall beauty hold a plea"

Here, the idea is that beauty might be able to plea, or beg. That's a human activity, again attributed to an abstract concept: beauty.

3. "summer's honey breath hold out"

The speaker personifies the summer, saying it has "breath" (which is something that humans have, not periods of time).

4. "the wreckful siege of battering days"

Saying that days can siege someone is another instance of personification: it's giving the human power of fighting a war or launching an attack to the nonhuman concept of "days."

5. "Or what strong hand can hold his swift foot back?"

In the line above, "his" means "Time's." The line personifies "Time," saying it has a swift foot, like a human might have.

You might point to a few more examples of personification in this poem, such as in the line that implies that Time has the power to decay--but to me, these examples stray a bit too far from the definition of personification to be properly characterized as examples of it. "Decaying" is something that happens to us, rather than some activity that we ourselves put into effect. So whether or not you interpret that line as personification is a matter of personal perspective.

Overall, as you can see, Shakespeare's use of personification throughout this poem gives it a grand, dramatic tone, and it helps us imagine the forces of nature and human beauty as timeless, powerful entities.

How long does it take for Earth to orbit the sun?

Our Earth is in continuous motion. In fact, it has two different motions. It rotates on its own axis and also travels around the Sun. The motion of Earth on its own axis is known as its rotation and it takes about 24 hours. Earth's motion around the Sun is known as its revolution and it takes about 365.25 days. 

Our Earth travels around the Sun in a slightly elliptical orbit and takes 365.25 days to complete one revolution around the Sun. It is this motion around the Sun, in addition to Earth's rotation and its tilt, that is responsible for seasons on Earth. It is also the reason why the Northern and Southern hemispheres experience contrasting weathers at the same time (summer in the Northern hemisphere and winter in the Southern hemisphere at the same time). 

Hope this helps.

Where did the pigs get the money to buy whiskey in the end?

In Chapter Nine of Animal Farm, the pigs have a crate of whiskey delivered to the farm. The other animals are uncertain where the funds to buy the crate have come from:

The word went round that from somewhere or other the pigs had acquired the money to buy themselves another case of whisky.

Arguably, the pigs were able to buy this crate as a result of Boxer's death, another key event in Chapter Nine. When Boxer is taken away in a van, for example, Squealer says that he is going to see a vet in nearby Willingdon but the writing on the van suggests otherwise:

Alfred Simmonds, Horse Slaughterer and Glue Boiler, Willingdon. Dealer in Hides and Bone-Meal.

It appears, then, that the pigs have sold Boxer to a glue manufacturer and will profit from his death. When the animals express outrage over this, Squealer says that the writing on the van is a mistake; that the van was recently purchased by the vet who has not had time to change the writing. But Squealer and Napoleon have deliberately misled the others: the farm is doing so badly and food is so scarce that the money must have come from Boxer's death.

At the Statesville County Fair, the probability of winning a prize in the basketball toss game is 0.1. Show the probability distribution for the...

(a) We are given that the probability of winning p=0.1, and we are asked to give the probability distribution for n=8 trials.

This is an example of a binomial distribution: there are two outcomes (win/lose), the outcomes are independent, the probability does not change, and there are a finite number of trials. Thus we can use the binomial probability to compute the individual probabilities.

A probability distribution consists of a number of possible events and their associated probabilities.

P(0 wins)= `([8],[0])(.1)^0(.9)^8~~.4305 ` where the first factor is the number of combinations of 8 items choosing 0.

P(1 win)= `([8],[1](.1)^1(.9)^7~~.3826 `

etc... (These could also be computed with a statistical package in a graphing calculator or with something like Excel.)

The probability distribution:

X    P(X)
0    .4305
1    .3826
2    .1488
3    .0331
4    .0046
5    .0004
6    `2.3"x"10^(-5) `
7    `7.2"x"10^(-7) `
8    `1"x"10^(-8) `   or `(.1)^8 `

You can display this graphically using the probabilities along the vertical axis and the events along the horizontal axis.

(b) If the game is played 500 times, we can use the expected value to compute the number of prizes to keep on hand. The expected value is given by `mu=np ` , so here we have 500(.1)=50.

(In the real world, you would want to keep a few more than 50.)

The system has three components in series and have a system reliability of 83.79%. Component A has a reliability of 90% Component B has a...

We have three components in series; component A has reliability .9, component B has reliability of .98 and we are asked to find the reliability of component C if the total system reliability is .8379:

The reliability of the series of components is found by multiplying the reliabilities of each of the components. If x is the reliability of component C then we have:

(.9)(.98)x=.8379

.882x=.8379 Dividing both sides by .882 we get x=.95

The reliability of component C is .95 or 95%

In The Great Gatsby, why does Wolfsheim act the way he does?

Meyer Wolfsheim seems to act the way he does because he can.  He's a powerful man, a man who can tell another man to "'[shut] his mouth'" without being challenged.  He's a criminal, and he keeps company with other criminals.  If he is feared, and I can only imagine that the purpose of wearing human molars as cufflinks is to instill fear in others, then he can really get away with just about anything.  He eats with "ferocious delicacy," a phrase that makes me think of a wolf (like his name), because he is voracious at the same time that he savors his meal.  Further, his eyes "roved very slowly all around the room," and he even turns to look behind him, while he eats, perhaps because he is on the lookout for someone who might be keeping an eye on him.  He doesn't want to end up like Rosy Rosenthal.  Apparently his caution has worked for him, however, because, as Gatsby says, "'He's a smart man,'" and this is why the cops can't any of his crimes on him, even fixing the 1919 World's Series.  

How do authors like Anne Bradstreet, Emily Dickinson, and Jhumpa Lahiri participate in a literary tradition which has consistently disfranchised...

It is certainly true that even though the three American writers you have mentioned—Anne Bradstreet, Emily Dickinson, and Jhumpa Lahiri— all wrote during disparate eras, they each participated in a literary tradition that has disenfranchised or else undervalued female writers until fairly recently. However, even though they participated in this restrictive literary tradition, this does not necessarily mean that they were complicit in their marginalized status, or that they added to this misrepresentation of women. Indeed, I argue that they all actually broke ground for women writers in their own ways.

Anne Bradstreet was the first woman writer of note in the early history of American literature. Her poem “The Author to Her Book” may initially be read as a woman unhappy with her artistic ability. Indeed, Bradstreet laments a poem that she wishes she never published:

“In critic's hands beware thou dost not come,

And take thy way where yet thou art not known;

If for thy father asked, say thou hadst none;

And for thy mother, she alas is poor,

Which caused her thus to send thee out of door.” (107)

While this could be perceived by a patriarchal reader to at first be an admittance of her own shortcomings as a female author, it must be noted that she is more upset that the piece was not perfected before it was published. Additionally, the sheer fact that she was a woman publishing literature in 17th century America is remarkably subversive of phallocentric discourse.

Similarly, Emily Dickinson may initially appear to contribute to the marginalized status of women writers through her odd and reclusive behavior, but the fact that she has become such an important voice in early American poetry demonstrates that she too is subversive. In “The Soul selects her own Society,” Dickinson interestingly uses a female voice. This female voice is strong and assertive, the opposite of restrictive gender scripts at the time.

Finally, Jhumpa Lahiri, a modern author addressing the issues that face modern women, may, at first glance, appear to contribute to narrow gender scripts. Her short story “Sexy” from Interpreter of Maladies begins with an overly broad statement that oversimplifies the needs and fears of married women:

“It was a wife’s worst nightmare. After nine years of marriage, Laxmi told Miranda, her cousin’s husband had fallen in love with another woman” (83).

This initially appears to contribute to a narrow societal perspective of women and what women value. However, again, by addressing the needs of women from a distinctly female perspective, Lahiri is not contributing to the pejoration of women writers, but instead challenging patriarchal discourse through her story. Thus, these three disparate women writers do in fact participate in a phallocentric literary tradition, but, I contend that they do not contribute to the marginalized status of women writers, and actually empower women writers who draw on their inspiration.

As far as women writers engaging with different forms than male writers, I would suggest you examine Hélène Cixous and her seminal essay "The Laugh of the Medusa," as she attributes the difference between male and female writers to women writers (or else writers in touch with their feminine side) being able to write the female form, and this renders their writing inherently different from the restrictive purposes of patriarchal language.

I pulled my textual evidence from:

The Norton Anthology of American Literature, Volume 1, 7th ed.

Jhumpa Lahiri’s “Sexy” from Interpreter of Maladies

Should Macbeth be killed for what he did?

According to the laws of his time, Macbeth should indeed be killed for murdering the king. The crime of killing a king is called regicide, and was long thought to be one of the most traitorous and blasphemous crimes that one can commit.  For obvious reasons, it is an act of treason to kill one's king: if one is attempting to overthrow one's sovereign, one is materially damaging one's country, and this is traitorous.  However, regicide was also considered blasphemy (meaning: lacking respect for God or something holy) because they believed that kings were ordained by God, that kings were chosen by God to be rulers.  Thus, to kill a king was to sin against God as well as commit a crime against one's country.  According to these laws, then, Macbeth ought to die for his crime.  

How can I give a speech about how Cristiano Ronaldo achieved his dreams by overcoming adversity?

This sounds like the speech of appreciation that I make my public speaking students perform.  It sounds like you need to explain why you appreciate Ronaldo, which means you are going to mix informational facts about him and persuasive opinions of your own.  The persuasive opinions of your own will be easy to do by simply concentrating on the positive aspects of him.  

Before you begin outlining your speech, pick three events in Ronaldo's life that you believe helped shape him into the person/player that you admire so much.  Your speech will contain those three items, and it covers the teacher's requirement to talk about specific events.  Because you chose major events that helped make Ronaldo great, you have built in the ability to conclude with your own opinion about achieving your goals by following his example.  

To start your speech, you need an "attention getter."  Some teachers call it the hook.  Regardless, the first words out of your mouth need to get your audience interested.  If they are not, they will not listen. I teach five attention-getting tools.  

1. Make a bold statement.  Lean toward opinion here.  Facts are seen as boring. 


2. Use a quote.  For you, I recommend using something Ronaldo said or a famous quote about achieving your goals.  


3. Give a definition.  I don't see how this would work well for your speech.  Stay away. 


4. Ask a question.  It's simple and effective, because it forces your audience to immediately engage mentally with your speech. 


5. Use an anecdote.  Tell a brief story that ties into your speech topics.  

After your opening attention getter, then you will move into the body that contains the three main things about Ronaldo that you want to talk about.  Pre-plan your transitions that move you from main point to main point.  Those must be smooth.  In your conclusion, emphasize why Ronaldo matters to you and why his example can inspire your audience as well.  Good luck and have fun! 

In "Counterparts" by Joyce, what do Mr. Alleyne’s complaints about Farrington tell us about Farrington? What is his private reaction to these...

In James Joyce's "Counterparts," Mr. Alleyne complains that Farrington always has "some excuse or another for shirking work" and that he must "[u]nderstand once and for all that you get half an hour for your lunch and not an hour and a half." Mr. Alleyne's comments about Farrington are perfectly accurate. Farrington is lazy, immature and suffers from an inferiority complex. In addition, he's not particularly bright.

These traits can be seen in Farrington's reaction to these comments. He returns to his desk for a few minutes and begins his work, but he decides he needs to escape the office and heads down to the pub for a "glass of plain porter." After returning to the office, Farrington insults Mr. Alleyne. His first reaction isn't to apologize out of concern for his job and, by extension, his family, but to head to a pawn shop to sell his watch so he could enjoy a night out. This lack of responsibility, coupled with Farrington's immaturity, prompts him to spend his money at the pub bragging about his insult to his boss. Despite being a married man, he attempts to woo a woman and then, in order to prove his masculinity, he attempts to arm wrestle a friend, but loses.

After this defeat at arm wrestling, Farrington goes home feeling "humiliated and discontented ... He cursed everything." Because of his inferiority complex and his "shirking" of responsibility, Farrington takes out his anger on his son, whom he forgot was going to be home alone that night. He beats his son for not keeping his food warm, but really because he feels the need to show his superiority over someone.

What is socialism?

While there are many different variations of socialist thought, they all share a few common factors.  We can say that those factors are the basic ideas of socialism.

The first idea of socialism is that there should be no large-scale private ownership.  What that means is that individual people should be able to own little things like their clothes and their houses, but they should not be able to own big things like companies.  Companies should be owned by society as a whole.  This would probably mean that the government would need to own them.  That way, there would be no owners of companies who get rich off the work of other people.

The second main idea of socialism is that everything should be controlled democratically.  The people should be able to have control of their society.  The needs of the people would be able to override the needs or desires of individuals.  In a socialist society, there would be less emphasis on individual rights and more emphasis on the needs of the collective.

The third and final main idea of socialism is that all people should be more or less equal to one another.  Socialists abhor inequality of wealth such as we have in our society where there are some very rich people and very many people who are much poorer.  Socialism holds that all people should have the right to have all material goods that they need and that no one has the right to have much more than everyone else.

The basic idea of socialism, then, is equality.  Everyone should be about equal and no one’s rights or desires can be placed above the needs of the society.

How did slavery in America develop?

Slavery developed in America over time. As more colonies were created, especially in the South, the need for slaves grew. Some slaves came with the original settlers. Slaves were used in the Jamestown settlement to help with the growing of tobacco. As farming became more important, so did the need for the slaves.

The South was an excellent region for farming. The soil was very fertile, and the climate was warm and mild. Some southerners had very large farms. The farm owners wanted inexpensive labor to work on these farms, which were called plantations. Having slaves work on these farms could fill this need.

When Eli Whitney developed the cotton gin in 1793, the need for slaves also grew. The cotton gin made it easier to separate the seeds from short-staple cotton. Since short-staple cotton could be grown anywhere in the South, the whole South was now open for growing cotton, which was a very profitable crop to grow. The ability to grow more cotton increased the need for slaves. The cotton gin was a critical factor in increasing the number of slaves needed in the South.

To some degree, the continuation of slavery also resulted from a belief that the European race and ways of life were superior to the African race and ways of life. Eventually, slavery became so ingrained in the culture of the South, it was hard for southerners to see a life where there was no slavery.

Slavery was a part of our history from the time the earliest settlers came until the Civil War ended.

When Bob Ewell accuses Atticus of being too proud to fight, what does Atticus say in reply?

In Chapter 23, Scout retells Miss Stephanie Crawford's account of how Bob Ewell approached Atticus outside the post office. Miss Stephanie said Bob cursed at Atticus, spat on him, and then threatened to kill him. According to Miss Stephanie, Atticus didn't bat an eye and simply wiped the spit off of his face with his handkerchief. Bob Ewell continued to curse at Atticus and said, "Too proud to fight, you nigger-lovin' bastard?" (Lee 134). Atticus responded by saying, "No, too old" (Lee 134). Atticus's calm response shows his tolerant demeanor. Following Atticus's run-in with Bob Ewell, Scout and Jem begin to worry about their father's safety. Atticus then explains to them that Bob Ewell had to have some kind of comeback, which was why Bob spit in his face. Atticus tells Jem and Scout that Bob had to take his anger out on someone and that Atticus would rather it be him than Mayella or her siblings.

What are the purposes of enclosed seeds inside plants?

The main purpose of a seed is reproduction, so seeds are sometimes enclosed for protection. The seed is a structure formed from the maturation of the ovule of the angiosperm. Angiosperms are flowering plants that have seeds enclosed within fruits. The term angiosperm means “enclosed seed” or “covered seed.” Seeds within a fruit are protected by the fruit to allow for dispersal. A fruit signals maturity by its color, texture, fragrance, and taste. This lets an animal know it is ready to eat. These seeds have a protective coating to be able to withstand the digestive system in animals. Since animals are not stationary, the seed will be released in a different spot than where it was consumed. This allows a wider dispersal of the seed so more plants will be able to grow and then reproduce. Seed dispersal is important because there are limited resources such as food, water, and space in a given area. This limits the number of that plant that can survive and reproduce. So, some seeds are encapsulated to be able to be safely transported to a new area.

What are liver disorders?

Causes and Symptoms

The
liver is the largest internal organ, lying in the upper-right abdominal cavity. Intricately attached to it by a system of ducts on its lower surface is the pear-shaped gallbladder. Unique to the liver is a blood supply that derives from two separate sources: the hepatic artery, carrying freshly oxygenated blood from the heart, and the portal vein, carrying blood rich in the products of digestion from the digestive organs. The liver cells, or hepatocytes, are arranged in thin sheets that are separated by large pores, blood vessels, and ducts. The result is a very soft, spongy organ filled with a large volume of blood.

The liver performs a wide variety of complex and diverse functions, more so than any other organ. Most commonly known is the production of
bile, which is formed from the breakdown of red blood cells, cholesterol, and salts, stored in the gallbladder, and used in the small intestine to digest fats. The liver also serves the all-important purpose of detoxification by chemically altering harmful substances such as alcohol, drugs, and ammonia from protein
digestion. Additionally, the liver is involved in the formation of such essential materials as blood proteins, blood-clotting factors, and sugar and fat storage compounds.

Because of the liver’s many responsibilities and unique position as an intermediary between the digestive process and the blood (via the portal vein), it easily falls prey to many disease-causing agents. Chemicals, illegal drugs, alcohol, viruses, parasites, hormones, and even medical drugs can damage the liver and have widespread effects on the rest of the body. The liver is also the most frequent target of cancer cells that have spread beyond their primary site. In the United States and other industrialized countries, liver disease is usually related to alcoholism and cancer, while in the developing world, it is often the result of infectious contamination by viruses and parasites.

There are two simplified methods of classifying liver disorders. The first is based on cause: infections (viruses and parasites), injury (alcohol and other toxins), inheritance (inability to perform certain functions), infiltration (iron and copper deposits), and tumors (both benign and malignant). The second method of classification is based on the result, such as hepatitis (inflammation), cirrhosis (permanent injury from alcohol or other toxins), or cancer.

Each of these liver diseases produces a particular set of signs and symptoms depending on the length of time and the specific disruption of structure and function. Pain and swelling rarely occur alone and are usually associated with one or more of the following: nausea and vomiting, jaundice, ascites, blood-clotting defects, and encephalopathy. Indeed, in some cases liver failure ensues, leading to coma and death.

Jaundice, a yellow discoloration of the skin and whites (sclera) of the eyes, is caused by the secretion of bile precursors (bilirubin) from the damaged liver cells directly into the blood rather than into the ducts leading to the gallbladder. Consequently,
bilirubin accumulates in the body’s tissues, including the skin and eyes. Ascites, the collection of fluid beneath the liver in the abdomen, is an important sign of liver disease. This fluid comes primarily from the portal vein system, which lies between the liver and the digestive organs. As the liver becomes congested and enlarged in response to injury or infection, blood flow becomes difficult and pressure begins to build, causing liquid to leak from the blood vessels into the abdominal cavity. Easy bruising, excessive bleeding, and other problems with blood clotting are important signs that reflect the failure of the liver to produce essential blood proteins. Neuropsychiatric symptoms such as asterixis (flapping hand tremor)
and
encephalopathy (a state of mental confusion and disorientation that can quickly progress to coma) are not well understood, but it is likely that they result from an accumulation of toxic substances that would normally be cleared from the blood by the liver. Several other problems, such as the enlargement of male breasts, atrophy of the testicles, and other sexual changes, derive from the inability of the liver to clear the blood of hormones.

Hepatitis, an inflammation of the liver generally caused by viruses, is one of the most common diseases in the world. Hepatitis A, B, and C; Epstein-Barr virus (the causative agent of mononucleosis); and herpes are a few of the organisms that can infect the liver. Hepatitis A, transmitted through contaminated food, water, and shellfish, is usually a self-limited disease that resolves itself. Hepatitis B, transmitted through contact with infected blood and body secretions, is much more serious, with a carrier state, progressive organ damage, cancer, and death as possible sequelae. Hepatitis C is transmitted by intravenous drug use or blood transfusion. Infection most often causes no symptoms initially but leads to chronic infection in about 80 percent of individuals. Chronic infection progresses to cirrhosis in 20 to 30 percent of cases and may lead to liver cancer. Noninfectious causes of hepatitis in susceptible people include such frequently used substances as acetaminophen (Tylenol), halothane (general anesthesia), and oral
contraceptives. Nonalcoholic steatohepatitis (NASH)
is a disease that causes chronic inflammation and, upon biopsy, resembles alcoholic hepatitis. It is diagnosed in patients with persistent abnormal liver function tests, no evidence of hepatitis B or C, and consumption of less than 40 grams of ethanol per week. NASH is most often found in patients with obesity, type 2 diabetes, and hyperlipidemia.

Cirrhosis is the result of continuous toxic exposure that injures the liver beyond repair. Fibrous scar tissue replaces the normally soft, spongy organ, making it small and firm, with few hepatocytes capable of functioning normally. Chronic alcohol abuse is by far the most frequent factor in the development of cirrhosis. Severe ascites, bleeding disorders, encephalopathy, and sex organ changes often herald imminent liver failure and death from this disease.

In the Western world, liver cancer
is most often secondary to malignancies that have spread from other sites. In Asia and Africa, primary tumors of the liver itself are much more common due to high incidences of hepatitis B infection, food toxins, and parasite infestation, among other factors. Chronic injury appears to play the critical role in liver cancer, with the main risk factors established thus far being cirrhosis, hepatitis B and C, and long-term exposure to a variety of chemicals, hormones, and drugs. Benign tumors may occur in young women who use oral contraceptives, but they are relatively infrequent.

Several other hepatic diseases warrant mention. Liver
abscesses, or encapsulated areas filled with infectious material, can be caused by bacteria, fungi, or parasites. These organisms enter the bloodstream through ingestion, skin puncture, or even intestinal rupture (as in cases of appendicitis and diverticulitis) and travel to the liver. Two unusual but notable disorders of iron and copper metabolism—hemochromatosis and Wilson’s disease, respectively—have prominent liver involvement. While the disease mechanisms are not well understood, these essential metals are retained in excess and deposited in body tissues in toxic levels, causing damage. Finally, several genetic disorders of bile production run the gamut from mere nuisances to potentially fatal in infancy. Bilirubin metabolism, in which red blood cell waste products are incorporated into bile, is affected or disrupted to varying degrees. Severe
jaundice reflects the accumulation of toxic levels of bilirubin in all body tissues, including the brain.

Treatment and Therapy

The diagnosis of a patient with suspected liver disease is an orderly process that begins with a thorough history and physical examination, supported by a number of valuable blood tests and imaging techniques. Liver biopsy, in which a tissue sample is obtained for microscopic analysis, is often a final and definitive procedure if the disorder remains ambiguous. Both the cause and the chronology or state of the disease—that is, whether it is of recent onset or advanced—determine treatment and outcome. While many signs and symptoms are nonspecific, including nausea, vomiting, pain, hepatic enlargement, and jaundice, others such as ascites, encephalopathy, blood-clotting defects, and sex organ changes reflect significant organ damage and an advanced stage of disease.

Careful questioning regarding the recent and past history of a patient can elicit facts that may point to a diagnosis, including exposure to known liver toxins such as alcohol, anesthetics, certain medications, and occupational chemicals; travel to countries with known contaminated water supplies (hepatitis A); blood transfusions, kidney dialysis, sexual promiscuity, or intravenous drug use (hepatitis B and C); unexplained weight loss (cancer); or even a history of gallstones (blocked bile ducts between the liver and gallbladder). Armed with suspicions from the history, the physician performs a physical examination to look for signs that confirm or reject the possibilities. A small and firm liver with ascites, tremor, enlarged male breasts, and small, shrunken testicles all point to an advanced stage of cirrhosis, for example. An enlarged and painful liver, vomiting, jaundice, and fever following recent ingestion of raw shellfish would likely suggest hepatitis A.

Blood tests play a critical role in evaluating liver disease. An elevated bilirubin level would correlate with the severity of jaundice. Blood protein levels (albumin) and blood-clotting factors (prothrombin) may be dangerously low, revealing a near inability of the hepatocytes to synthesize these vital substances. Special chemicals that exist primarily in liver cells (hepatic enzymes and the aminotransferases) may be quite high, indicating that these cells are dying and releasing their contents into the blood. Finally, elevated white blood cell counts and special tests for individual infections (viruses, bacteria, fungi, and parasites) can positively establish the diagnosis.

Depending on the suspected disease, confirmation may be needed from various imaging techniques, chosen specifically for a particular diagnosis. Plain x-rays do little to visualize the liver, although they can reveal air in the abdomen, a consequence of a perforated intestine, appendix, or ulcer. A much more advanced method, the
computed tomography (CT) scan, combines computer-generated views of multiple cross-sectional x-rays, providing a highly detailed examination of the liver and thereby establishing a diagnosis in the majority of cases. Two other techniques that have more specific uses are ultrasound, which uses sound-wave transmission, and
magnetic resonance imaging (MRI), which uses magnetic fields to create an image. Ultrasound can readily distinguish solid masses from those that are fluid filled (tumors versus abscesses) and can view the bile ducts. MRI is quite helpful in determining blood-flow problems such as portal hypertension.

Finally, if a precise diagnosis remains elusive, a
biopsy is performed. A sample of liver tissue is obtained using a large needle inserted through the skin, under the guidance of an ultrasound image. The sample is then viewed microscopically, which should make both the cause and the extent of liver damage readily apparent.

Treatment options for the majority of liver diseases are improving. If drug toxicity is suspected, especially from alcohol, immediate withdrawal of the agent can prevent further damage, as has been shown in cases of cirrhosis. Obstructing gallstones can be surgically removed to relieve pressure in the bile ducts. Combinations of surgery, radiation, and chemotherapy are used in cases of
liver cancer, but the prognosis is poor. Little can be done for the inherited diseases of bilirubin metabolism, while some success has been achieved in treating the iron- and copper-storage diseases.

Infections of viral origin have specific treatment regimens. Prevention of hepatitis A and B is possible if pooled serum
immunoglobulin is given immediately after exposure. This substance is a concentrated form of antibodies obtained from infected individuals whose diseases have completely resolved; essentially, it is a method of giving passive immunity. Chronic hepatitis B may be effectively treated with several antiviral medications or interferon. Chronic hepatitis C
is treated with a combination of an antiviral medication (ribavirin) and interferon. Response rates to therapy range between 50 and 80 percent, depending on the viral load, the genotype of the virus, and compliance with treatment. There are no specific therapies proven effective for treatment of NASH. Treatment is recommended for associated medical conditions, including weight loss, reduction of lipids (cholesterol and triglycerides), and control of diabetes. One area in which effective treatment does exist is in bacterial, fungal, and parasitic infections and abscesses. Appropriate antibiotics and surgical drainage yield dramatic improvement in most cases.

In many cases of liver disease, symptom relief and nutritional support, often carried out in the hospital, are the only options. Pain relief and the administration of intravenous fluid and nutrients to counteract vomiting and dehydration are the first steps. Ascites is relieved through bed rest, salt restriction, diuretics, and paracentesis, a procedure that uses ultrasound to guide a needle into the abdomen and withdraw fluid. Attempts to correct encephalopathy by removing toxins such as ammonia from the blood are generally ineffective, and mental changes, along with other intractable symptoms, often herald complete liver failure and imminent death.

Clearly, preventive measures are the most important factor in liver disease. One effective measure that is widely available is the hepatitis B vaccine, which is recommended during childhood in a three-injection series. Hepatitis A vaccine is available and recommended in children older than one year. Hepatitis A and B vaccines are recommended to any non-immune adult with chronic liver disease.

Perspective and Prospects

Liver transplantation offers approximately four thousand patients per year replacement of the diseased organ with a normal, donated one. The procedure was begun experimentally in the early 1960s, and after decades of low success rates (less than 20 percent), it has finally been accepted as a lifesaving operation, with five-year survival rates approaching 75 percent as of 2012. Technical improvements, especially intraoperative blood circulation and cadaver organ preservation, have been combined with refined patient selection and timing and advances in immunosuppressive therapy that counteract rejection. The result is that

liver transplantation has become the method of choice for patients whose liver disease is life-threatening, progressive, and unresponsive to other treatments.

Specific guidelines exist for both children and adults to be considered candidates for the procedure. It is imperative that the person is otherwise healthy and that the heart, lungs, kidneys, and brain are functioning well. Malignancy, human immunodeficiency virus (HIV) infection, incorrectable congenital defects, and continuing drug or alcohol abuse are obvious contraindications. Infants with inherited, inevitably fatal liver disorders are good candidates for transplantation, as are adults with end-stage liver failure, such as from chronic hepatitis. Controversial indications, requiring case-by-case evaluation, include advanced viral hepatitis (as recurrent infection in the donated organ often occurs) and alcohol-induced cirrhosis (because of the likelihood of damage to other organs and the high relapse rate after surgery). Relapse is also very common if the transplantation is done for a primary liver cancer.

Careful donor selection is equally important. The principal source of cadaver organs is victims of head trauma who are declared brain-dead. Organs are accepted from those sixty years of age or younger who have no viral, bacterial, or fungal infections and who were otherwise healthy up to the time of death. In the United States, recipient-donor matches are made through a nationwide organ transplantation registry, with highest priority going to those most critically ill. Only twelve to eighteen hours can elapse between organ retrieval and implantation; beyond that, liver tissue begins to degenerate.

The use of immunosuppressive therapy, drugs that keep the recipient’s immune system in check, has contributed significantly to success and survival. Rejection of the transplanted organ remains one of the most feared postoperative complications, along with hemorrhaging. Because the body recognizes the organ as foreign tissue, the immune system’s white blood cells attack and damage the implanted donor liver. The use of drugs to counteract this process allows the new liver to heal and the body to adapt to the presence of foreign tissue. Despite the use of these potent drugs, which themselves have serious side effects, rejection continues to be a problem. Nevertheless, one-year survival rates are 87 percent, and at five years, 73 percent of transplant patients are alive.

Bibliography:

American Liver Foundation. http://www.liverfoundation.org.

Blumberg, Baruch S. Hepatitis B: The Hunt for a Killer Virus. Princeton, N.J.: Princeton University Press, 2003.

Chopra, Sanjiv. Dr. Sanjiv Chopra's Liver Book: A Comprehensive Guide to Diagnosis, Treatment, and Recovery. New York: Simon & Schuster, 2002.

Feldman, Mark, Lawrence S. Friedman, and Lawrence J. Brandt, eds. Sleisenger and Fordtran’s Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 9th ed. 2 vols. Philadelphia: Saunders/Elsevier, 2010.

Fishman, Mark, et al. Medicine. 5th ed. Philadelphia: Lippincott Williams & Wilkins, 2004.

Goldman, Lee, and Dennis Ausiello, eds. Cecil Textbook of Medicine. 23d ed. Philadelphia: Saunders/Elsevier, 2007.

“Liver Diseases.” MedlinePlus, October 2, 2012.

Longstreth, George F., and David Zieve. “Hepatic Encephalopathy.” MedlinePlus, October 16, 2011.

Yamada, Tadataka, et al., eds. Textbook of Gastroenterology. 5th ed. Hoboken, N.J.: Blackwell, 2009.

Who is Gretel and why does Bruno refer to her as the "Hopeless Case"?

Gretel is the name of Bruno's 12-year-old sister, who he refers to as the "Hopeless Case." She earns this nickname because of her mean spirited nature and disagreeable attitude. Bruno has essentially "lost all hope" in getting along with her and changing Gretel for the better. Bruno is continually complaining about Gretel's behavior and mentions that she takes too much time in the bathroom, accuses him of messing with her doll collection, and allows her friends to pick on Bruno. Gretel and Bruno both share feelings of contempt for each other, and Bruno is appalled by Gretel's infatuation with Lieutenant Kotler. Bruno also comments on Gretel's lack of manners. Gretel is portrayed as a bully throughout the novel, and even disrespects Maria, which upsets Bruno. Bruno and the "Hopeless Case" are at odds throughout the entire novel.

What is the main message for the story "All Summer in a Day" by Ray Bradbury?

The story "All Summer in a Day" is a futuristic story set on the planet Venus. Although "rocket men and women" from Earth have settled on Venus, they must live primarily underground because the climate is not suitable to be out of doors. Thunderstorms and rain are constant, except for about an hour once every seven years when the sun comes out and the rain stops. Margot, one of the schoolchildren, is the only one who remembers having seen the sun because she came to Venus from Earth when she was four. For this and other reasons, her classmates view her as "other" from them and tease and bully her. On the day of the predicted sun appearance, they force her into a closet so she misses the chance to run outside and play in the sunshine.

The primary message of the story is a study in bullying. Several factors work together in the story to create the bullying that steals something from Margot that can never be replaced. First, the children's teacher is negligent; she not only left them unsupervised, allowing the children to lock Margot up, but she also let her own excitement keep her from properly accounting for all the children under her charge. Second, one boy starts the teasing Margot and pushing her simply because she is different. Third, none of the children stand up to him; instead, they assent to his teasing. Fourth, all the children work as a mob, giving in to peer pressure, to push Margot into the closet. No one breaks ranks to take Margot's side. Fifth, the children get distracted by the excitement so that they forget about Margot when they all run outside. This shows the trajectory of bullying--how it escalates from simple teasing to causing a person real emotional harm. Bradbury uses an interesting setting--Venus--to showcase a problem that is ubiquitous in children on Earth, namely, bullying.

How does the "African" scene show a new side to the relationship between Walter and Beneatha?

The scene, which takes place at the beginning of Act Two, Scene One, does not exactly "show a new side" to their relationship, but instead is a moment at which both are able to connect to each other through a desire to tap into the glory of their ancestors. Beneatha wishes to do this so that she can forge a new sense of identity and kinship based on a black aesthetic. Walter "channels the ancestors" out of a desire to feel greater pride in himself as a man.

Beneatha, through her education and contact with African exchange students, is learning more about Africa, including its rituals, customs, and art. Though her intentions are good, she is not as attuned to the continent as she thinks, a fact that is revealed in the exposition of the play:

She parades for RUTH, her hair completely hidden by the headdress; she is coquettishly fanning herself with an ornate oriental fan, mistakenly more like Butterfly [McQueen, "Prissy" in Gone with the Wind] than any Nigerian ever was...She promenades to the radio and, with an arrogant flourish, turns off the good loud blues that is playing...

"Enough of this assimilationist junk!" she asserts, without realizing that blues is as uniquely and distinctly a product of black expression as the costume her boyfriend, Asagai, bought her. Her behavior comes off as less regal than intended and should remind the audience more of Butterfly McQueen's performance as the servile "Prissy" in Gone with the Wind. Lorraine Hansberry does not draw this parallel to insult Beneatha or the memory of Ms. McQueen, but instead uses it to show that Beneatha is trying to usurp something that is, in fact, foreign to her. She is no more a product of Nigeria than Asagai would be a product of Kenya. She has African ancestry, yes; but she is not culturally African.

While Beneatha parades around, Walter stumbles in drunk. It is important that this scene begins after he has left the apartment in shame due to being unfavorable toward Ruth's pregnancy. He does not want the pregnancy because they can barely afford the child they have. Another, in his estimation, would make it even more difficult for them to improve their lives.

By channeling African imagery (e.g., "the lion is waking," "waters rushing against the shores of the coastlands," "the birds flying low over the mountains and the low places of our land"), he can feel the majesty, power, and strength of the man he wants to be. He does not feel this as a lowly Chicago chauffeur living in a housing project on the Southside.

What both Walter and Beneatha are trying to do is to forge identities as black people that are separate from—and more positive than—what America has taught them they are. They are trying to learn to have pride in themselves. In this regard, the two share a common goal.

In To Kill a Mockingbird, why does Scout think the trial is a "gala"?

Scout notices that many people treat the trial of Tom Robinson like a party, or gala, especially those who may not be close with Tom Robinson and thus see it as more of a form of entertainment. On page 160, Scout observes:

It was a gala occasion. There was no room at the public hitching rail for another animal, mules and wagons were parked under every available tree. The courthouse square was covered with picnic parties sitting on newspapers, washing down biscuits and syrup with warm milk from fruit jars. Some people were gnawing on cold chicken and cold fried pork chops. The more affluent chased their food with drugstore Coca-cola in bulb-shaped soda glasses. Greasy-faced children popped-the-whip through the crowd, and babies lunched at their mothers’ breasts.

Instead of the somber attitude that one might expect from people during a trial, the atmosphere that she describes outside of the courthouse is quite party-like. People are gathered eating food that they have brought, much like they would do at a social gathering. This seems a bit out of place, as a man is on trial for his life. It seems that people fail to acknowledge this, at least at the moment. Children, especially, seem completely oblivious to the fact that a trial is taking place and behave as if they are at a picnic of some kind and are almost having fun as they “pop-the-whip through the crowd.” Harper Lee is criticizing the people of Maycomb and their indifference toward Tom Robinson and his fate.

What does Harper Lee, the author of To Kill a Mockingbird, think of the character Jem?

Although the story in To Kill a Mockingbird is told from the point of view of Jem's little sister Scout, Jem is one of the main characters in the book. The book is a coming-of-age story, not only about Scout, but about Jem as he learns to put himself in others' shoes, as he wrestles with the reality of injustice in his town, and as he learns to become a man of integrity like his father.

The book covers about three years of the children's lives. Jem is nine when the book opens, and almost thirteen when it closes. At the beginning of the book, Jem is fully a child. He eagerly believes ghost stories with Scout and Dill, he fears to approach Boo Radley's house, and he sees nothing wrong with playing a game that makes fun of Boo. Partway through the book, Jem starts to hit puberty. He gets taller, he becomes moody, and he no longer plays with Scout like he once did. He mulls over things a great deal more than Scout, and figures things out before she does.

One early example of this figuring out is in Chapter 8. Prior to Chapter 8, Jem has thought long and hard about the fact that Boo Radley fixed a pair of pants that Jem left in his yard, and that Boo had apparently been leaving little treasures in the old tree for Jem and Scout to find. But Jem has said nothing about any of this to his father.

Then in Chapter 8, Jem and Scout have been standing in front of the Radleys' house to watch a neighborhood fire. Later they find that someone has placed a blanket around Scout's shoulders. This is too much for Jem, and he begins telling his father all his worries about Boo:

Jem seemed to have lost his mind. He began pouring out our secrets right and left ... omitting nothing, knot-hole, pants and all.

"—he's crazy, I reckon, like they say, but Atticus, I swear to God he ain't ever harmed us, he ain't ever hurt us, he coulda cut my throat from ear to ear that night but he tried to mend my pants instead..."

At this point, Scout still feels a spooky fear of Boo Radley, but Jem has begun to realize that Boo is a human being who means them no harm. This is very cleverly done, since it is Jem's insight but is told from Scout's semi-comprehending point of view.

Another example of when Jem understands more than Scout, and feels more deeply, is during the trial. Scout faithfully reports all that was said during the trial, and she understands some of it, but Jem is hanging on every word, fully invested, making comments like "We've got him" when Atticus shows that Mr. Ewell is left-handed (Chapter 17). In Chapter 21, waiting for the jury's verdict, Jem is confident: "Don't fret, we've won it. Don't see how any jury could convict on what we heard." After the jury bring back their guilty verdict for Tom Robinson, Jem is shocked and crushed: "It ain't right.  How could they do it, how could they do it?"

This is a turning point for Jem. The morning after the trial, Miss Maudie serves the children cake as she often does, but she serves Jem a piece from the big cake instead of baking a tiny cake for him, as if he is an adult now.

Later that day (Chapter 23), Jem and his father have a long conversation (which Scout overhears) about in what ways the system is broken and how it could possibly be fixed. Jem proposes we "do away with juries. He wasn't guilty in the first place and they said he was."

"If you had been on that jury, son, and eleven other boys like you, Tom would be a free man," said Atticus. "So far nothing in your life has interfered with your reasoning process."

So now we have Atticus's opinion (which is also Harper Lee's) that Jem is a boy of integrity, one who is learning to think clearly about the law and about life.

How do you state a claim utilizing the middle ground method?

Unlike a traditional debate, wherein each side argues opposing positions on an issue, the middle ground method of argumentation is essentially an attempt to find a compromise. For example, if you were engaged in a debate about allowing prayer in public schools, one side would argue for and the other against. However, the third option would be the middle ground argument in which you would attempt to find a solution that satisfies both sides. The most important aspect of middle ground method is that both sides of the argument are given equal consideration, including the need for a solution and potential outcomes.

Using the example from above, your middle ground argument could be that prayer in school is clearly an emotionally charged issue for which there is no easy solution. On one hand, prayer is a very important aspect of many people's lives and they feel strongly that having prayer in school would benefit their children. On the other hand, many people feel that religion has no place in public schools and imposing prayer on children would violate their rights.

Having established the main argument and opposing viewpoints, you would then consider all the implications (legal, social, etc.) of including and excluding prayer in public schools. Your main objective is to find a compromise; therefore, after reviewing the evidence your position (claim) could be that the best possible outcome would be to allow a specific time and private space for students to pray. This should satisfy those that want prayer in school without imposing it on others or violating their rights.

It's worth noting that the middle ground argument probably won't completely satisfy either side, particularly when the issue is divisive. Nevertheless, the goal of the middle ground argument is to find a mutually agreeable solution that both sides can live with.

Describe the factors that shaped family life for enslaved African-Americans in the antebellum South.

Family life was extremely difficult for the African-Americans during slavery. Slave marriages were not legal in the eyes of the legal system of the states or the nation. For this reason, slaves could be sold to other plantations, leaving their wives and children behind. Sometimes slave children were sold to other plantations, causing, even more, pain and emotional distress. It was not uncommon for slave owners or plantation overseers to force slave women into romantic relationships even if they were married.

Economically, the slave could not own property and was not paid for their efforts on the plantation. The man of the house could not provide for his family, he was at the mercy of his owner to provide housing and food. These accommodations were not nearly enough for African-Americans to feel comfortable or happy. As a result of all of this turmoil, African-Americans grew a sense of kinship and community with one another. They took care of one another even if they were not related by blood.

What angle of the SALT (Strategic Arms Limitations Talks) I and II can argue about?

At the end of the 1960s, the United States began to negotiate with the Soviet Union to reduce the buildup of ICBMs (Intercontinental Ballistic Missiles). The United States was concerned that the Soviet Union might be constructing defenses that would prevent a missile from reaching Moscow. The SALT I (Strategic Arms Limitation Talk) agreement, signed in 1972 between Nixon and Brezhnev, was the first time the Soviets and the United States had agreed to reduce their nuclear arsenals. Talks regarding SALT II, intended to reduce Multiple Independently Targeted Re-Entry Vehicles (MIRVs), began in 1972, but this treaty was never ratified (though both sides abided by its terms).

A research paper on this topic might focus on why SALT II was never ratified, as it ran into internal American opposition related to Soviet treatment of dissidents in their country. In addition, the Soviet invasion of Afghanistan in late 1979 derailed the SALT II talks. A paper could also discuss other sticking points related to the ratification of SALT II, including the inability of the U.S. and the Soviet Union to agree on the number of warheads and strategic bombers and disagreement about the way in which the two nations would verify that the other side was abiding by the terms of the treaty.

What urban and social reforms did the Progressives favor in the late 1800s to the early 1900s?

The Progressives saw many problems in our society. They tried to expose these problems so changes could occur. They were successful in doing this in many areas.

There were many social and urban reforms that occurred as a result of the Progressive Movement. It was a common practice for kids to be working in factories instead of going to school. Child labor laws were passed, and a government agency to monitor child labor was established. Child labor was forbidden in some industries, and kids were required to attend school. Laws were also established to make factories a safer place to work. There were few health and safety laws before the Progressive Movement began. Worker compensation laws also were passed. Also, zoning laws were passed to keep industrial areas away from residential areas.

The Progressives were concerned about the meat industry and the food and the drug industries. They saw very dirty conditions in the meat plants, and they saw that foods and medicines were being falsely labeled in order to increase profits. The Meat Inspection Act required the federal government to inspect the meat supply before it could be sold to the public. The Pure Food and Drug Act prevented the false labeling of foods and medicines.

New forms of local government were created along with other political reforms. The commission plan of government was one example of a new form of local government that gave voters more of a say about whom their leaders would be. The people also got the power to directly elect their U.S. Senators with the passage of the 17th amendment. The initiative, referendum, and recall were new methods that gave people a greater opportunity to influence the political process and to have more control over their elected leaders.

The Progressive Movement brought about changes in many areas. The Progressives wanted to speak up and make many changes, including social and urban ones, to help the middle class and the working class.

How is aggression controlled and reduced?

Introduction

Aggression has been humankind’s steady companion throughout history—in life, literature, and art. Many hypotheses have been suggested by psychologists and other scientists concerning the nature of aggression; some have suggested that it is learned behavior, others that it is an innate, genetically inherited drive. The fields of ethology and sociology have mustered evidence to support the evolutionary (genetic) basis of aggression. Theories based on these viewpoints hold that at some point in humankind’s past, aggressiveness was an adaptive trait—that is, aggression helped ensure the survival of the individual who possessed that quality, thereby enabling the aggressive trait to be passed on to future generations. Social psychologists, on the other hand, have studied the effects of modeling aggressive behavior. When children, for example, have been exposed to aggressive behavior modeled (acted out or demonstrated in some way) by others, they have shown an increase in aggressive behavior. In other words, the children observe and learn the behavior. Albert Bandura’s social learning theory describes this concept of aggression.

The frustration-aggression hypothesis, as described by John Dollard, holds that both violence and aggression are the result of being frustrated in an attempt to reach a goal. When basic needs have been thwarted, aggression appears. As Leonard Berkowitz states in Roots of Aggression (1969), “If a person is aggressive, he has been frustrated. If a person is frustrated, he has become aggressive.” Negative environmental factors are also believed by many to have a major impact on aggression. Studies have found links, for example, between the number of violent crimes and air temperature. Overcrowding and economic hard times are also associated with higher crime rates. These studies tend to support negative affect theory, which holds that exposure to stimuli that create discomfort leads to aggression.

The amount of hope a person holds for the possibility of reducing or controlling aggression depends, to some extent, on the theory of aggression that the individual believes to be most accurate. If aggressive behavior is an integral part of the genetic makeup of the human species, the outlook is not nearly as promising as it is if aggression is primarily a behavior learned from others and reinforced by certain rewards. In the former case, aggressive actions can perhaps be controlled by societal strictures, but the aggressive instinct will always remain within. In the latter case, decreasing the modeling of aggression or increasing the modeling of and rewards for nonaggressive behavior could conceivably produce effective results. Different studies have produced different results concerning the effectiveness of various attempts to reduce aggressive behavior.

Another complication in understanding and controlling aggression is that different people will react very differently when in similar circumstances. When frustrated, some people will react aggressively, while others will become withdrawn and depressed. Depression itself can lead to aggression, however, and this type of delayed aggression can produce seemingly unpredictable acts of violence. Psychologists simply do not have all the answers to why some people react aggressively and others do not when faced with identical predicaments.

Treatment Techniques

Psychologists Matthew McKay, Martha Davis, and Patrick Fanning adapted Donald Meichenbaum’s concept of stress inoculation training to produce one technique that allows aggressive people to control their own aggressive behavior. McKay and his colleagues present simple, concise, step-by-step directions to deal with aggression. Because aggression is often fueled by emotional distress, they offer a technique of “covert assertion” through the development of two separate skills: thought interruption and thought substitution. When becoming angry or frustrated, the potential aggressor thinks of the word “stop” or some other interrupting device. The void suddenly created is then filled with a reserve of previously prepared positive, nonaggressive thoughts. This technique can be mastered, these psychologist maintain, if it is practiced conscientiously throughout the day for three days to a week.

The creation of an aggression stimulants structure gives those who are compelled to be negatively aggressive the opportunity to take a personal inventory of who (or what) the targets of their aggression are, what the feelings associated with those people are, and what would occur if a plan of “attack” against them were to be put into action. This type of analysis lends itself well to self-accountability; it allows people to “own” the problem and to believe that it can be controlled if they choose to control it. It also allows, through its identification of specific targets and imaging of the act of aggression, a global perspective on what can otherwise seem a very fragmented problem.

Aggression in the work environment can be damaging and disruptive both for individuals and for organizations. In a 1987 article in the Journal of Occupational Psychology, Philip L. Storms and Paul E. Spector claim that high frustration levels of organizational employees were positively related to interpersonal aggression, sabotage, and withdrawal. Suggestions for dealing with aggression in the workplace have included such strategies as training courses and the use of humor to defuse tensions. Diane Lamplugh notes that aggression in this arena can range from whispered innuendo to harassment to violence. She maintains that a training course that focuses on tension control, relaxation techniques, customer-relations orientation, assertiveness practice, aggression-centered discussions, and self-defense training can be helpful. She also states that support from management in identifying problem areas and formulating guidelines for staff support is crucial. William A. Kahn promotes humor as a means for organizational members to make statements about themselves, their groups, or their organization. Humor, he notes, is a nonthreatening vehicle that allows people to say things that might otherwise insult or offend coworkers, thereby making them defensive and threatening working relationships.

Written or unwritten laws, rules, and codes of conduct are established in an attempt to curb unacceptably aggressive behavior. A company may terminate an employee who does not adhere to certain standards of behavior; athletes are benched for aggression or violence. Society as a whole formulates laws to control its members’ aggressive behavior. When individuals act in ways that are damagingly aggressive to other people or to the property of others, law-enforcement agencies step in to safeguard the population. Perpetrators are fined or sentenced to prison terms.

Studies disagree as to the most effective means of rehabilitating offenders, but many studies do suggest that rehabilitation is possible. One avenue that is frequently explored is the use of various techniques founded in behaviorism. In Psychological Approaches to Crime and Its Correction (1984), edited by Irving Jacks and Steven G. Cox, Stanley V. Kruschwitz investigates the effectiveness of using a voluntary token reinforcement procedure to change the behavior of inmates who are difficult to manage. In the same volume, Albert F. Scheckenbach makes an argument for behavior modification as it relates to adult offenders. Modeling positive behaviors and holding group discussions have been found at least somewhat effective in rehabilitating juvenile delinquents, as has the development of behavioral contracts. John Lochman and his colleagues, using what they called an anger coping mechanism, explored cognitive behavioral techniques for reducing aggression in eleven-year-old boys. The boys treated with this procedure showed vast improvements—a reduction of disruptive classroom behavior and an increase in perceived social competence. Such techniques, used with young people, might reduce their high-risk status for later difficulties.

Theoretical Explanations

Acts of aggression have been central in human history, myth, literature, and even religion. In the biblical account, for example, humankind has barely come into existence when Cain kills his brother Abel. Almost as old are questions concerning the causes of aggression and the debate over how to control it.

Sigmund Freud
saw aggression as the result of struggles within the psyche of the individual. He believed that the tension produced in the struggle between the life instinct and the death instinct creates outward aggression. Alfred Adler
another psychodynamic theorist, stated that aggression represents the most general human striving and is a necessity of life; its underlying principle is self-assertion. Humanistic theorist Rollo May
notes that attention to aggression has nearly universally focused on its negative aspects. In Power and Innocence (1972), May writes that “we have been terrified of aggression, and we assume— delusion though it is—that we can better control it if we center all our attention on its destructive aspects as though that’s all there is.”

It was first the behaviorist school, then the proponents of social learning theory
(such as Albert Bandura), who explored ways to reduce and control aggression. The frustration-aggression hypothesis, for example, was developed in the 1930s. Behaviorists tended to approach aggressive behavior in terms of stimuli, responses, and reinforcement. In a general sense, any approaches that seek to punish unacceptably aggressive behavior or to reward positive behavior are related to the behavioral view. Bandura and other social learning theorists found that in some situations, children would respond to viewing aggressive acts by performing aggressive acts themselves. The implications of this have been widely argued and debated; one aspect concerns the effects of viewing violence in the media
. Viewing violence on television and in films has been linked to increased aggressive behavior in some studies, although because of the nature of the types of studies most often performed, it can be difficult to draw incontestable cause-and-effect relationships.

Controlling Aggression

The debate over whether aggression is learned, innate, or both (and, if both, over the relative importance of the two aspects) is not likely to end soon. Debates over how to control aggression will also continue. As in many areas of psychology, bridging the gap between the theoretical and the practical is difficult.

Researchers in the behavioral and social learning schools have developed numerous methods of controlling aggression. Interventions to control aggression can be made at the individual and group levels. Individuals can learn to control their aggression through relaxation training, self-control training, communication skills training, contingency management, and psychotherapy. These techniques vary in the extent that they involve and rely on others. Relaxation training involves breathing techniques or meditation. Self-control training involves rational restructuring, cognitive self-instruction, and stress inoculation. It basically teaches people to make verbal statements to themselves reminding them to think first and respond in a less aggressive manner. It has been proven to work. Communication skills training focuses on methods of negotiation and conflict resolution. Contingency management involves the use of rewards for desired behavior and nonphysical punishment for undesired behaviors. Psychotherapy tries to find the root of the person’s problem with aggression.

Group interventions, done in small groups, involve skill training as well as values, character, and moral education. Skills training educates people on how to use procedures such as modeling, behavioral rehearsal, and feedback on performance to manage their aggression. It has been shown to be effective. The other interventions typically take place in a school setting. All three seek to teach prosocial behavior to children and differ in the extent to which they teach students or let them discover on their own. Moral education teaches morality, and character education uses a series of lessons to foster prosocial character traits. Values clarification involves students in activities that help them identify and choose values.

In addition to these behavioral methods of controlling aggression, there are control methods based on biological or societal causes of aggression. These methods examine biological factors such as serotonin, hormones, and genetics and can involve pharmaceuticals as well as behavior therapy. Studies have found correlations, for example, between aggressiveness and high levels of norepinephrine and low levels of serotonin, two important neurotransmitters, although the significance of such chemical findings remains to be ascertained. The biological approach to fighting aggression involves the fields of neuroanatomy, neurochemistry, neuroendocrinology, genetics, and psychopathology. Another approach looks for an underlying mental condition such as a personality disorder. If the aggression is a symptom of such a disorder, then control of it becomes a matter of treating the mental condition. If the aggression occurs in a particular environment—bullying in a school, aggression or domestic violence in a family, fights in bars, or even war in the political arena—the efforts to control aggression take on a much wider approach, looking at societal and economic factors as well.

Bibliography

Berkowitz, Leonard, ed. Roots of Aggression. New York: Atherton, 1969. Print.

Cavell, Timothy A., and Kenya T. Malcolm, eds. Anger, Aggression, and Interventions for Interpersonal Violence. Mahwah: Erlbaum, 2007. Print.

Forgas, Joseph P., Arie W. Kruglanski, and Kipling D. Williams, eds. The Psychology of Social Conflict and Aggression. New York: Psychology, 2011. Print.

Hewstone, Miles, Wolfgang Stroebe, and Klaus Jonas. An Introduction to Social Psychology. 5th ed. Chichester: Wiley, 2012. Print.

Hudley, Cynthia. You Did That on Purpose: Understanding and Changing Children’s Aggression. New Haven: Yale UP, 2008. Print.

Krahé, Barbara. The Social Psychology of Aggression. 2nd ed. New York: Psychology, 2013. Print.

Martinez, Manuela, ed. Prevention and Control of Aggression and the Impact on Its Victims. New York: Kluwer Academic, 2001. Print.

May, Rollo. Power and Innocence. New York: Norton, 1998. Print.

Nelson, Randy J. Biology of Aggression. New York: Oxford UP, 2006. Print.

Simmons, Rachel. Odd Girl Out: The Hidden Culture of Aggression in Girls. San Diego: Harcourt, 2002. Print.

Who is more of a hero? Amir in The Kite Runner by Khaled Hosseini or Father Ralph in The Thorn Birds by Colleen McCullough?

It is difficult to look at a character in a book and say that he is all good or all bad. A good author will create characters with emotional complexities that make them human. This is very much true of Amir in The Kite Runner and Father Ralph in The Thorn Birds. 

There are elements to each character that make it difficult to qualify either of them as heroes, yet there are moments in which both display heroic tendencies.

One might say that Father Ralph starts more heroic, and finishes the book less so. Conversely, Amir is anything but a hero at the beginning of the book, but can be viewed in some ways as a hero by the time the book concludes.

In the case of Father Ralph, his initial attention to Meggie at the beginning of the book is unselfish and good-hearted. Though he is struck by the beauty of the 9-year-old Meggie he meets, he is very much her friend and protector during her childhood years. 

However, as Meggie gets older, Father Ralph's feelings for her become more intense. Despite the fact that the couple has a secret romantic relationship that begins when Meggie is 17 years old, Father Ralph's ambition to rise in the Catholic priesthood is stronger than his love for Meggie.

Though Father Ralph helps ensure that Meggie is financially taken care of, his inability to put his love for her (and her love for him) above his career ultimately defines him as a selfish participant in their relationship, rather than an equal partner.

With Amir in The Kite Runner, his jealousy is painfully obvious early in the story. While jealousy alone doesn't define a person, Amir allows the jealousy to consume him in a way that causes him to behave in ways that certainly aren't becoming of a hero. 

Perhaps the most dramatic example of this is when Amir sees the attack and subsequent rape of his friend and rival, Hassan, but does nothing about it. Later, in an effort to get Hassan removed from his beloved Baba's home, Amir hides money and a watch under Hassan's mattress, thus framing Hassan for a theft he didn't commit.

As Amir grows and matures, he feels guilt for the things he did in his younger years and wants to make restitution for the things he did earlier in life. He is able to do this in some ways after he rescues Hassan's son from an orphanage in Kabul. In doing so, he actually squares off against Assef—the young man who raped Hassan many years earlier. However, instead of being passive and cowardly, Amir shows his growth as a human in boldly and bravely standing up for Hassan's son.

Though neither Amir or Father Ralph are perfect characters, one could argue that Amir showed a greater desire to make restitution later in his life than Father Ralph, thus, perhaps, making Amir more of a hero.

What is the overall mentality and "national character" of poetry in modern American literature?

I always hesitate to generalize art. Most movements are categorized more by time period than style, since even within close literary movements there are massive differences. Please be mindful that generalizations are dangerous and often inaccurate. That said, academics sometimes use generalizations to talk about periods of literature in broad strokes. Another thing to keep in mind is that the word "modern" means something different in literature than in daily life. It does not mean current. It refers to a very specific period of the 20th Century. Today we are no longer in the Modern Period.

Modernism was characterized as a loss of the values represented in the prewar period. Contrary to the previous answer, I would actually say it was a rejection of early poets such as Whitman, who wrote about unity and American Exceptionalism. Modernism borrowed from thinkers such a Freud and Darwin to paint a word devoid of objective reality. The most important poet of this period would probably be T.S. Elliot. He  alluded to the great Western traditional while also abandoning the starry-eyed romanticism of the time before.

The Modern Period of American poetry was deeply intellectual, subjective, allusive, and difficult. Poets like Gertrude Stein abandoned earlier use of language as patriarchal. Poets like Pound turned to the past, and even looked to extremist politics as a solution to a world they say as crumbling. Despite large differences, most of the major writers seemed to question the very notion of American culture after the First World War. Artists rejected the early ways of seeing things, and painted a cynical America, where there was no clear difference between right and wrong. Many of these writers even left the country to work abroad. Once again, broad strokes are dangerous and inaccurate. Pound and Stein are in many ways as different as two writer can be. These are the sorts of traits that scholars typically use to discuss the time, however.

What is a lumbar puncture?

Indications and Procedures

A lumbar puncture, often referred to as a spinal tap, is indicated for the diagnosis of meningitis
because it is the best method for detecting meningeal irritation. A laboratory examination of the cerebrospinal fluid
(CSF) harvested through a lumbar puncture can detect problems relating to the brain and spinal cord. Meningitis cannot be diagnosed through imaging methods such as computed tomography (CT) scanning.

Similarly, some subarachnoid (brain) hemorrhages

involve the loss of so little blood that they are not detectable radiologically. When this is the case, the CSF may contain small amounts of blood that continues to be present in successive testing. If diagnosis is delayed, then the blood from a subarachnoid hemorrhage may have dissipated, making the CSF yellowish. This signifies that the blood in it is being metabolized. When this is the case, an immediate angiogram is indicated.

CSF withdrawn through a lumbar puncture should be examined immediately by a pathologist or hematologist to determine if blood is present or, if it is xanthochromic or yellowish, to ascertain if the protein level is abnormally high or a subarachnoid hemorrhage exists and blood is spreading over the surface of the brain. Such leakage may indicate an aneurysm and generally requires prompt surgery.

Although lumbar puncture is essentially a diagnostic tool, it is sometimes indicated when CSF has built up to dangerous levels in the spinal canal and the patient is hydrocephalic. In such instances, excess CSF can be withdrawn from the spinal canal, but it is imperative that the cause of the buildup be immediately determined and treated.

Patients undergoing lumbar punctures lie on their side, with their chin down and their knees drawn up to separate the vertebrae. Local anesthetic is used to numb the area surrounding the lower vertebrae. A hollow needle is inserted between two lower vertebrae and pushed into the spinal canal. The entire procedure takes about twenty minutes and involves minimal discomfort. The puncture wound left by the needle is covered with a sterile bandage. Patients may experience a headache following the procedure, but it usually disappears quickly. If it does not disappear within a few days, a small amount of the patient’s blood can be injected into the site, creating a patch that should eliminate the headache.

Uses and Complications

Lumbar puncture is used to inject dyes into the spinal canal to serve as a contrast medium in diagnostic procedures involving x-rays, particularly myelography. It is also used to introduce medications into the CSF for the treatment of certain types of cancer. This use, often appropriate in cases of leukemia and carcinomas of the nervous system, is frequently employed in pediatric care.

Some surgical procedures require that patients be awake during surgery. In such cases, local anesthetics are introduced into the spinal canal through lumbar puncture, allowing patients to remain conscious while rendering them insensate.

As with any invasive procedure, there is risk of infection, but it is minimal. The procedure is performed under sterile conditions. One danger, in the case of a subarachnoid hemorrhage, is blood loss. Bleeding, in rare cases, may become uncontrollable and result in death. One cautionary note is that a lumbar puncture should never be performed in cases where a brain abscess is suspected unless reliable CT scans or other tests have failed to reveal a mass or reveal only a small mass.

Lumbar puncture in and of itself is not a high-risk procedure, although the conditions that require its use often involve high risks for the patient. It is advisable in most cases that the procedure be performed in a location where immediate surgery can be carried out if the patient’s condition deteriorates suddenly.

Perspective and Prospects

The earliest use of CSF in diagnosis was in the nineteenth century, when such primitive tools as sharpened bird quills were used to penetrate the lumbar region. The technique came into its own in the mid-twentieth century, when most problems of the central nervous system were diagnosed through an examination of the CSF.

Because of the importance of CSF in diagnosing meningitis, cerebral hemorrhages, and other dangerous conditions, the lumbar puncture procedure has seen considerable progress and become increasingly sophisticated. However, the imaging tools currently available to surgeons, neurologists, hematologists, and pathologists are so advanced and accurate that lumbar puncture is used as a diagnostic tool less often than in the past.

Bibliography

Bowden, Vicky R., and Cindy Smith Greenberg. Pediatric Nursing Procedures. 3d ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2012.

Colyar, Margaret R. Well-Child Assessment for Primary Care Providers. Philadelphia: F. A. Davis, 2003.

Doherty, Gerard M., ed. Current Diagnosis and Treatment: Surgery. 13th ed. New York: Lange Medical Books/McGraw-Hill, 2010.

Dougherty, Lisa, and Sara E. Lister, eds. The Royal Marsden Hospital Manual of Clinical Nursing Procedures. 8th ed. Ames, Iowa: Wiley-Blackwell, 2011.

Dugdale, David C., Kevin Sheth, and David Zieve. “Cerebral Spinal Fluid (CSF) Collection.” MedlinePlus, June 18, 2011.

Lukas, Rimas, and Michael Woods. “Lumbar Puncture.” Health Library, May 20, 2013.

McAllister, Leslie D., et al. Practical Neuro-oncology: A Guide to Patient Care. Boston: Butterworth-Heinemann, 2002.

How does Romeo act around Benvolio and Mercutio?

When Romeo is around Benvolio and Mercutio, he seems able to be very much himself. In Act 1, Scene 1, Benvolio is able to get Romeo to reveal what has been bothering him — Rosaline, the woman he loves, doesn't return his feelings.  Neither Romeo's parents nor his other friends, according to his father, were able to gain his confidence in this way.

In Act I, Scene 4, when Mercutio is trying to convince Romeo to go to the Capulets' party with them, the two engage in some clever wordplay and witty repartee. Romeo is smart, and his language conveys this to his friends. Romeo is honest, again, about his unwillingness to go to any party right now, and he and Mercutio debate love and what to do about the sadness Romeo feels due to his unrequited love for Rosaline. 

Romeo and his friends are particularly lewd in Act II, Scene 4, just before the nurse arrives, and they make a lot of sexual jokes. Honestly, I think this shows Romeo and his friends act a lot like typical teenage boys. They are fiercely loyal to and honest with one another, but they also joke around.

What is a quotation from Macbeth which describes the witches' relationship to each other?

At the beginning of Act 1, scene 3, the scene in which the Weird Sisters confront Macbeth and Banquo with their respective prophecies as the two nobles return from the battlefield, the witches first meet up with one another and discuss what they've been doing since they last met (in Act 1, scene 1). The first witch asks, "Where has thou been, sister?" to which the second witch replies, "Killing swine" (1.1.1, 1.1.2). The third witch then asks the first witch, "Sister, where thou?" (1.3.3) These lines would indicate that the three witches are, in fact, sisters. Further, they seem to have a rather supportive relationship; when the first witch says that she's going to sail to Aleppo and seek revenge on the husband of a woman who wouldn't share her food, the second witch says, "I'll give thee a wind," to which the first witch replies, "Th' art kind" (1.3.12, 1.3.13). So, the three witches are sisters who have much in common and help one another with their vindictive pursuits.

How was Antony's speech more effective than Brutus' in Julius Caesar

Brutus and Antony are two different types. Brutus is philosophical and rational. He wants peace and order. Antony is a notorious hedonist and fun-lover. It is natural that each man should have a different objective. Brutus wants everybody to listen to reason. Antony wants chaos. Antony actually tells the crowd that it is only reasonable to express their emotions--and he probably really believes this, since he is so emotional himself.

I speak not to disprove what Brutus spoke,
But here I am to speak what I do know.
You all did love him once, not without cause;
What cause withholds you then to mourn for him?
O judgement, thou art fled to brutish beasts,
And men have lost their reason. Bear with me;
My heart is in the coffin there with Caesar,
And I must pause till it come back to me.

Antony is suggesting that they are not showing the good judgement which Brutus was appealing to because they are not venting their emotions. He then pauses because he is supposedly overcome with his own emotions, and he is thereby setting an example.

Antony's speech is more effective because he is trying his best to stir up the crowd, whereas Brutus's speech ia less effective because he ia trying to calm them down. Antony also has an ace-in-the-hole. He has Caesar's will which he brings out and waves at the mob, and then, when he gets them to force him to read it, he first shows them Caesar's mutilated body. This is actual history recorded by Plutarch. Brutus has told the people that he loved Caesar, and earlier he had told the other conspirators:

Let us be sacrificers, but not butchers
.   .   .   .   .   .   .   .   .   .   .   .   .   .
Let's kill him boldly, but not wrathfully;
Let's carve him as a dish fit for the gods,
Not hew him as a carcass fit for hounds;      II.1

But the condition of the corpse tells a different story. Caesar looks as if he had been crudely butchered by dozens of savage, impassioned men motivated by envy, hatred, and fear. Only Brutus stabbed Caesar in the spirit of making a sacrifice.

Antony succeeds in creating total chaos. He has to do this because he is all alone against an organized group of conspirators headed by a highly respected man. Antony proves to be more eloquent than anyone, including anyone in Shakespeare's audience, might have expected. Although he calls himself a plain, blunt man, Antony comes up with dazzling oratory in Shakespeare's best iambic pentameter. It is noteworthy that Antony speaks in poetry while Brutus speaks entirely in prose. Antony is telling the mob he has no power of speech and at the same time exhibiting power that Brutus himself, a trained orator, was incapable of matching.

I am no orator, as Brutus is;
But, as you know me all, a plain blunt man,
That love my friend, and that they know full well
That gave me public leave to speak of him.
For I have neither wit, nor words, nor worth,
Action, nor utterance, nor the power of speech,
To stir men's blood. I only speak right on;
I tell you that which you yourselves do know;
Show you sweet Caesar's wounds, poor poor dumb mouths,
And bid them speak for me. But were I Brutus,
And Brutus Antony, there were an Antony
Would ruffle up your spirits and put a tongue
In every wound of Caesar that should move
The stones of Rome to rise and mutiny.

Caesar's wounds appear to be calling for the citizens to mutiny. Brutus himself seems to be calling for them to mutiny because Brutus has figuratively traded places with Antony. And finally the very stones of Rome seem to have acquired arms and legs and are all arising, figuratively speaking, to take part in a universal mutiny. There is no comparison between the speeches of Antony and Brutus. Later when the generals are holding a parley before the battle of Philippi, Cassius will say to Antony, partly in praise and partly to embarrass Brutus:

The posture of your blows are yet unknown;
But for your words, they rob the Hybla bees,
And leave them honeyless.           V.1           

Shakespeare must have coveted the opportunity to render Antony's historic funeral speech in English iambic pentameter, and Shakespeare's version was probably the best thing he ever wrote.

What are the principles of Liberalism?

Liberalism can sometimes be a misunderstood concept in contemporary politics, party because modern liberalism can have different meanings, depending on where you are. In the U.S., we are so often accustomed to hearing about the conflict between conservative and liberal political ideas that we assume that the term “liberalism” means something other than what it really means.

Liberalism as a political concept has its roots in seventeenth century England, with the theoretical work of Enlightenment philosopher John Locke.

Locke espoused a form of the “social contract” theory that says that government earns the right to govern by the consent of the people. This was a sharp break from the traditional British way of looking at government—to them the monarchy ruled by divine right, and the people they ruled didn't have much to say about it. This might be the most important principle of Liberalism—the government has to meet with the approval of the people or it will be removed.

Other important principles of Liberalism sound like the Bill of Rights in the United States Constitution.

People should be free; free to speak, gather, worship, vote, etc. Liberalism, in its classic sense, is about putting political power in the hands of the people, who possess natural rights that the government may not infringe upon.

What we (in the United States) call “liberals” partly refers to a political philosophy that promotes the idea of using government to solve social problems. Ironically, today's liberals call for a bigger, stronger government than conservatives. That is because they want to use the government to deal with difficult issues, rather than relying on private persons and organizations.

What is avoidant personality disorder (AVPD)?

Introduction

Avoidant personality disorder is one of the psychiatric disorders described in the American Psychiatric Association’s

Diagnostic and Statistical Manual of Mental Disorders: DSM-V (5th ed., 2013) and is included in the category of personality disorders. Personality disorders are problems in personality development that begin in childhood and continue to cause problems for a person throughout adulthood. Personality is a combination of a person’s behavioral tendencies and inner feelings. Development of personality begins in childhood, and once formed, personality remains essentially stable throughout adulthood. Persons with personality disorders develop certain feelings about themselves and behaviors toward other people that can cause problems in their everyday functioning.

The individual with avoidant personality disorder fears rejection from other people and avoids social situations. Although uneasy in social situations, the person with avoidant personality disorder desires or wishes for companionship and social interaction. Avoidant personality disorder is often described as an inferiority complex, which means that the person feels a lack of competence in social skills and is highly self-critical. The inferiority complex produces a wide variety of negative feelings about the self that inhibit confidence in social situations. Avoidant personality was first formally included among psychiatric disorders in 1981.

Who and Why

Avoidant personality disorder is considered to be a fairly common condition. The National Institute of Mental Health (NIMH) cited a 2007 report stating that the condition affects 5.2 percent of the US adult population . According to the same report, sex and race were not shown to be associated with personality disorders, including avoidant personality disorder.

In attempts to identify the possible causes of avoidant personality, researchers have focused on innate or inborn characteristics exhibited by an infant and early childhood experiences. Infants have been found to display different types of temperaments, including one that is inhibited. Considered to be innate or inherited, the inhibited temperament is characterized by a timid orientation to the external world. Whenever an inhibited infant encounters new situations, the infant’s response is subdued and fearful. This early inhibited temperament has been found to be consistent throughout infancy and early childhood before developing into a pattern of shyness whenever around people.

In addition to the innate temperament, persons with avoidant personality often have experienced some negative events in their infancy and early childhood. As they go through childhood, these children are often punished or shamed in a manner that promotes their fears of being humiliated. Apparently persons who develop avoidant personality disorder did not receive parental affection and were subjected to rejecting behavior from their parents.

The combination of an inhibited temperament in infancy and rejecting behavior on the part of parents appears to produce an individual with low self-esteem and fears of being publicly humiliated. These feelings solidify into an avoidant personality or inferiority complex that then prevents a person from engaging in satisfying social interactions despite the desire to do so.

Diagnosis

The person with an avoidant personality disorder exhibits high levels of anxiety in any social situation. The person appears tense and vulnerable to criticism whenever being asked to engage in social exchange. The formal diagnosis of avoidant personality disorder requires that the person demonstrate a continuing social inhibition, feel inadequate, show hypersensitivity to being evaluated, avoid situations that involve interpersonal contact, be very restrained in expressing feelings, have a preoccupation with being criticized, be fearful of being embarrassed, and view the self as socially inept. Hypersensitivity toward any signs of being rejected by other people is a prominent characteristic of the disorder.

Avoidant personality disorder is often confused with three other psychiatric diagnoses: schizoid personality, social phobia, and agoraphobia. The schizoid personality also shows a pattern of avoiding social situations, but the key difference is the presence of indifference toward and disinterest in social situations. This is unlike the person with avoidant personality, who has a desire for social interactions. Social phobia is diagnosed among persons who are fearful of performance situations such as speaking in public. However, outside the performance situation, the person has comfortable social interactions, unlike the person with avoidant personality. Agoraphobia is the condition in which a person may avoid crowds or social situations because of fears of having a panic attack, which is not true of persons with avoidant personality.

Treatment Options

The typical treatment for persons with avoidant personality is a combination of psychotherapy and medications. Psychotherapy is used to help the patient overcome fears of rejection and humiliation in social situations. The therapy focuses on methods to cope with these fears and helps to guide the patient toward engaging in an increasing number of social activities. Assertiveness training or group therapy is often a part of the psychotherapy process. Both provide the patient with opportunities to learn effective ways to interact with other people without the fear of rejection. Psychoactive medications that alleviate anxiety are usually prescribed for the patient. With anxiety controlled, the patient is able to enter into social situations. Patients with avoidant personality disorder often experience depression because of their isolation from other people. In cases in which depression is present, an antidepressant medication is added to the treatment regimen.

Bibliography

DePanfillis, C., et al. “Parental Bonding and Personality Disorders: The Mediating Role of Alexithymia.” Journal of Personality Disorders 22 (2008): 496–508.

Dobbert, Duane L. Understanding Personality Disorders: An Introduction. Westport: Praeger, 2007. Print.

Kantor, Martin. Distancing: Avoidant Personality Disorder. Rev. ed. Westport: Praeger, 2003. Print.

Kienast, T., et al. “Psychotherapy of Personality Disorders and Concomitant Substance Abuse.” Current Opinions in Psychiatry 21 (2008): 619–624. Print.

Miller, J., et al. “Scoring the DSM-IV Personality Disorders Using the Five-Factor Model: Development and Validation of Normative Scores for North American, French, and Dutch-Flemish Samples.” Journal of Personality Disorders 22 (2008): 433–450. Print.

National Institute of Mental Health. "The Numbers Count: Mental Disorders in America." National Institute of Mental Health. National Institutes of Health, n.d. Web. 19 Feb. 2014.

Rogge, Timothy. "Avoidant Personality Disorder." MedlinePlus. MedlinePlus, 3 Feb. 2014. Web. 19 Feb. 2014.

Sellborn, Martin. "Personality Disorders in the DSM-5 and Beyond." Gavel. APA Division 18: Psychologists in Public Service, July 2013. Web. 19 Feb. 2014.