Using quotes from the play, explain Stella and Blanche's personalities.

Blanche and Stella are sisters, but their personalities are very different. Blanche is a romantic, and speaks in lyrical language that often uses figurative language or references poets or writers. She's extremely self-conscious about her appearance, especially about how she has aged. Both of these qualities--her romanticism and her fixation on being young and beautiful--relate to one of Blanche's most intense qualities: she is very nostalgic. These qualities are captured in the passage below: 

"Not far from Belle Reve, before we had lost Belle Reve, was a camp where they trained young soldiers. On Saturday nights they would go in town to get drunk... and on their way back they would stagger onto my lawn and call-- 'Blanche! Blanche!'-- The deaf old lady remaining suspected nothing. But sometimes I slipped outside to answer their calls... Later the paddy-wagon would gather them up like daisies... the long way home." 

Stella, by contrast, is less nostalgic or romantic, and more modern and sensual. She has made her home in the wild and modern city of New Orleans, and is in a passionate and sometimes violent relationship with her husband, Stanley. She explains to her sister: 

"But there are things that happen between a man and a woman in the dark-- that sort of make everything else seem-- unimportant." 

Her sister is repulsed by this idea of love. She says: 

"What you are talking about it brutal desire-- just-- Desire! -- the name of that rattle-tap street-car that bangs through the Quarter, up one old narrow street and down another." 

What do you think the first readers learned from reading Black Beauty?

First readers of Anna Sewell's Black Beauty probably attained new perceptions of horses and, at least, some compassion for animals as well as learning of the dangers of intemperance.

Ms. Sewell wrote her one novel with the main purpose of informing readers of the mistreatment of horses specifically, and other animals in general. In the nineteenth century when this novel was written, horses were treated like machines to be used to do work that men were unable to do, and to transport people. For the upper class, having fashionable horses was de rigeur, so matched pairs were purchased and horses who had high stepping trots were popular. A very cruel device, the bearing rein, was used to force horses to keep their heads up at all times as it held the horse's head and neck in a sort of elevated hyperflexion. This bearing rein, then, could cause dangerous strain on a horse's back if it needed to go up hill as it pulled a carriage because of the unnatural position in which it was placed. For, a horse must be able to move its head and neck in order to pull heavy weights or absorb the strain of going uphill.

In addition to pointing out the cruelty of the bearing rein, Anna Sewell writes of many other cases of mistreatment such as in an episode Chapter 29 in which she tells of townspeople who rarely use a horse and buggy:

They always seemed to think that a horse was something like a steam engine, only smaller....they think that if only they pay for it, a horse is bound to go just as far and just as fast and with just as heavy a load as they please.

One driver is described as racing along and until it side-swipes a carriage. This collision causes the poor horse to have his flesh torn open with the blood streaming down. 

In addition to the promotion of animal rights, Anna Sewell, who was raised  as a Quaker in the Victorian Age, describes some of the dangers and repercussions of drunkenness. For instance, the groom who is responsible for Beauty’s knees being damaged is inebriated when he causes the accident. Frequently also, those who are described mistreating horses are in a state of drunkenness.

Certainly, animal rights and moral, upright behavior are help up to the readers as standards in Anna Sewell's didactic novel, Black Beauty.

What happens to the speed of light when it enters glass from water?

When light rays enter one medium from another, refraction takes place. Refraction refers to bending of light rays due to change in the speed of light rays as they move from one medium to another. 

The refractive index of a medium is defined as:

n = c/v

where, n is the refractive index of a medium, c is the speed of light in vacuum and v is the velocity of light in that medium. 

The refractive index of water is about 1.33, while that of glass is around 1.5 - 1.6 (depending on the type of glass). To have a higher refractive index, there are two possibilities:

a) higher value of c, which is not possible, as the speed of light in vacuum is a constant.

b) lower value of v, which is possible.

Thus, the speed of light rays decreases as they enter glass from water. 

In general, when light enters a denser medium from a rarer medium, its speed decreases.

Hope this helps. 

What are the jobs of the Executive Branch of the United States?

The executive branch is responsible for enforcing the laws of Congress.  The President of the United States is the head of the executive branch and chooses the heads of all of the executive departments.  When Congress passes a law, the President supervises fifteen executive departments that can enforce that law. Examples of executive departments are the Department of State, Department of Defense, Department of Commerce, and Department of Education.  Depending on the type of law that is passed, one of those departments will execute or enforce the law.  Within the larger departments are hundreds of smaller agencies like the Federal Bureau of Investigation and the Securities and Exchange Commission.  All of these agencies have been created to enforce federal laws.  

The Constitution of the United States also states that the President is commander-in-chief of the armed forces.  Because of this, the Executive Branch is responsible for the organization of the branches of the military.  The president, as head of the Executive Branch, also has limited legislative power in that he/she can veto laws or establish Executive Orders.  

How are the ballerinas handicapped?

The ballerinas in this story are handicapped with weights, masks, and noise-making devices to cancel out their strength, beauty, and intelligence, respectively.

First, we find out that the ballerinas are handicapped to hide their strength and beauty. Their bodies are weighed down with heavy objects, and their faces are obscured by masks. Here's how George first perceives these handicapped dancers on television:

They were burdened with sashweights and bags of birdshot, and their faces were masked, so that no one, seeing a free and graceful gesture or a pretty face, would feel like something the cat drug in.

We also know that mental handicaps have been imposed on at least some of the ballerinas. When George's thoughts are interrupted by a loud noise in his head that causes him to flinch, he sees some of the dancers on the screen also flinching in the same manner. This observation leads us to infer that they, too, have noise-making devices implanted in their bodies to prevent them from thinking too deeply or for too long. In fact, when George hears a subsequent, particularly painful sound in his head--of a "twenty-one-gun salute"--he sees a few of the ballerinas on screen actually collapse, presumably from the shock of the same sudden sound.

As the story reaches its climax, we see what happens when a ballerina's handicaps are removed to reveal her true intelligence, strength, and beauty, in that order:

Harrison plucked the mental handicap from her ear, snapped off her physical handicaps with marvelous delicacy. Last of all he removed her mask. She was blindingly beautiful.

What does Scout say a jury never does in To Kill a Mockingbird?

Scout, Jem, and everyone else in the courtroom wait eagerly for the jury to emerge with their verdict. Jem is certain the jury will not convict Tom Robinson based on the evidence presented to them, but Scout is not so sure. When the jury finally emerges, Scout knows what the outcome will be. Scout knows "a jury never looks at a defendant it has convicted" (Chapter 21). Not a single member of the jury looks at Tom Robinson. This is how Scout knows the jury is about to convict Tom Robinson.

The judge reads the decision of each member of the jury. Scout closes her eyes as the judge reads the word "guilty" over and over again. Jem is enraged. He cannot believe the jury would convict Tom Robinson. Jem cries when he thinks of the injustice Tom Robinson has faced.

How does Nick feel about Tom in Chapter 1 of The Great Gatsby by F. Scott Fitzgerald?

When we are reading a story through the eyes of a narrator, the narrator gets to choose which details to share, and the details that Nick shares about Tom make it clear in what low regard he holds Tom.  He presents Tom as an aggressive, not particularly intelligent, bully.  Let's look at some details from the text that Nick gives us.

We are introduced to Tom as a man with "...a rather hard cruel mouth and a supercilious manner" (11), whose "arrogant eyes .. established dominance over his face" (11), giving the impression he was "leaning aggressively forward" (11). Nick says his body was "capable of enormous leverage - a cruel body" (11).

This impression of cruel brutality is reinforced when Nick shows Daisy calling Tom "a brute of a man" (16), after Tom has injured her finger. And we also learn that Tom has a mistress in New York, which is clearly causing Daisy pain as well. 

Nick also shares with us that Tom has been reading a book about how white people are intended to be the dominant race, which sounds like a particularly silly book, one that no intelligent person would take seriously.  Tom seems to lose his train of thought as he tries to provide some examples from the book to make his point, and Nick finds "something pathetic in his concentration" (18). 

This early portrait we get of Tom, in Chapter One, seen through the eyes of Nick, shows us an unpleasant man.  Nick sees him as not particularly intelligent, a strong and aggressive man who bullies his wife and no doubt bullies others as well. 

What do you think the scene with Curley's wife might foreshadow in Of Mice and Men?

Curley's wife appears in three scenes during the course of John Steinbeck's novella Of Mice and Men. The first two appearances tend to provide foreshadowing for the events which take place in chapter five when Lennie accidentally breaks the girl's neck after she allows him to stroke her hair. In chapter two, she comes to the doorway of the bunkhouse and makes a strong impression on Lennie who can't take his eyes off her and is described as being "fascinated" by her presence. When she leaves he draws a quick rebuke from George who grabs his ear and says,

“Listen to me, you crazy bastard,” he said fiercely. “Don’t you even take a look at that bitch. I don’t care what she says and what she does. I seen ‘em poison before, but I never seen no piece of jail bait worse than her. You leave her be.” 

George understands that Lennie could be tempted to do something foolish, just as he had done in Weed with the girl in the red dress. It is only a matter of time before Lennie is caught alone with Curley's wife.

Curley's wife's interest in Lennie is shown in chapter four when she comes into Crooks's room and questions Lennie about the bruises on his face and about what happened to Curley's hand. Again, Lennie is described as being "fascinated." She is obviously impressed by the fact that Lennie was able to get the best of Curley in a fight. His only response is that Curley "got his han’ caught in a machine” and his usual line that someday he will get to "tend rabbits." Curley's wife then playfully responds, “Well, if that’s all you want, I might get a couple rabbits myself.” This open flirtation will continue in the very next chapter as the girl finds Lennie alone in the barn mourning his dead puppy.

What are narcotics' effects on the body?

Addiction to Narcotics

Substance use is a choice, but over time the use of substances can develop into dependency. The overuse, or abuse, of substances brings lasting physiological changes to the brain that lead to psychological and behavioral changes. With the abuse of narcotics, the damage to the brain is profound.

Addiction is a brain disorder. Narcotics disrupt the biochemical processes of the brain, eventually leading to addiction. To understand the damage of narcotics abuse requires an understanding of why narcotics are used and how they alter the brain.

Because narcotics (opioids) produce a euphoric state of relaxation, even sleep, they serve a medical purpose for controlling pain. Narcotics affect the mu (µ) opioid receptors in the brain, also known as the painkilling parts of the brain, or the reward pathway. When abused, narcotics block endorphins, the brain’s natural pain-control chemical. A person with narcotics addiction experiences profound disruptions to normal brain activity and therefore feels a powerful need for the drug in order to maintain normal functioning and avoid withdrawal symptoms. Increasingly, the addict needs higher doses to feel the same effects.

In his book Helping the Addict You Love, Laurence W. Westreich warns the friends and relatives of addicts about the damage to the brain that substance abuse causes and how it leads to the impairment of judgment and common sense. Love and logic are not enough to convince an addict to stop using the substance. Much more occurs in the body physiologically with addiction that can hamper the addict’s decision-making abilities and impulse control.

According to Westreich, several models explain why a person becomes addicted to a substance. Based in neuroscience, the learning theory model suggests that addiction evolves from the reward mechanism in the brain. The high is the reward, and the brain adjusts to receive more of the reward. The self-medication hypothesis suggests that people abuse substances as a way of coping with traumatic events and stress in life.

The biopsychosocial model assumes that addiction is driven by a combination of psychological and social factors and, therefore, must be treated at the same time other underlying factors are treated. The moral model assumes a fault in the addict’s moral character as the fundamental cause for the development of the addiction. Conversely, the disease model considers addiction a disease or a medical condition that must be treated medically, and not as a defect in the addict’s moral character.

In their book Freedom from Addiction, David Simon and Deepak Chopra summarize the impact of narcotic drugs on the body this way: “Opiate-derived chemicals directly activate the pleasure receptors of the brain, bypassing all usual methods to achieve comfort.” They continue, “When the opiates are metabolized, the body is left without intrinsic or extrinsic pain relievers.” Therefore, the short-term impact on the body is intense pleasure and pain relief, while the long-term impact is the inability of the brain to regulate pleasure and pain in the body normally.

Narcotics Abuse Versus Dependency

In Addiction: Why Can’t They Just Stop?, researchers John Hoffman and Susan Froemke define
substance abuse
and substance dependence. Accordingly, abuse is “a pattern of substance use that causes someone to experience harmful consequences,” which includes failing to meet key responsibilities; engaging in reckless activity; and refusing to resist the substance despite recurrent interpersonal, occupational, and financial problems brought on by drug use. Dependence is a physical addiction to a substance resulting in physiological and behavioral changes to the user. Physiologically the dependent person needs increasingly higher doses of the substance to achieve a high. He or she then experiences intense withdrawal symptoms when deprived of the substance. Behaviorally the person is obsessed with acquiring the next dose, prioritizing the substance over all relationships and obligations, including care for his or her own health.

Some people can become addicted to narcotics without necessarily abusing narcotics. Rather, they may become dependent on narcotics from using them to manage chronic physical pain over an extended period of time. Even when narcotics are prescribed by a doctor, patients must be aware of the drugs’ potential for dependency and addiction. Although many of these drugs are obtained through prescriptions, dependence or abuse of narcotics often falls into the category of nonmedical use. According to the Substance Abuse and Mental Health Services Administration, in 2013 53 percent of users had access to the drugs through a friend of family member and 21.2 percent of users obtained them through a prescription.

A continuum exists among opioid abuse, opioid dependence, and addiction. Signs of abuse include the user’s inability to fulfill normal responsibilities and the prevalence of interpersonal problems. Dependence is characterized by the consumption of larger and more frequent doses of the narcotic over a span of time, an increased tolerance of the effects (the high) of the narcotic, and a clear demonstration that the user is obsessed with acquiring the narcotic regardless of cost to his or her own health and personal relationships. Addiction is the state in which the craving for the narcotic becomes so compulsive and overpowering that the addicted person’s behavior becomes grossly self-destructive.

Short-Term Effects

Opiate narcotics like heroin, morphine, and prescription painkillers (such as oxycodone and Vicodin) will produce a surge of euphoria and drowsiness. The short-term effects of narcotics include relaxation, sleepiness, pain relief, an inability to concentrate, apathy, flushing of the face and neck, constipation, and nausea and vomiting.

Opiates also can slow systems in the body, such as the nervous, respiratory, and digestive systems. Physical dependence can become severe and can gravely affect the body’s normal nervous, respiratory, and digestive functions. Heroin tricks the brain’s neurotransmitters by activating abnormal messaging. In effect, the reward circuit of the brain is overstimulated.

Long-Term Effects

Long-term abuse causes the brain to adapt to the drug-induced surges of dopamine, thereby producing less of its own dopamine naturally. The most significant long-term effect of narcotics abuse is this reduction of dopamine and dopamine receptors in the brain. The brain then cannot stimulate the reward circuit on its own. The neurotransmitter glutamate is permanently altered, and the brain develops a drive to achieve messaging to the reward center through narcotics. This desire trumps all other decisions and judgments.

Addiction is the underlying long-term effect on the body. The body craves the substance biologically just like it does food. “The addict’s need for his or her substance of choice is like a starving person’s primal need for food,” Westreich explains. “Drugs and alcohol literally ‘hijack’ the brain, physically and emotionally driving the addict to find, use, and keep using whatever drug he or she has chosen.” Once addicted, withdrawal is a necessary challenge to overcome when first embarking on the journey of recovery. In withdrawal from opiates, whether street heroin or prescription pain pills, the addict will experience extreme restlessness, severe pain in the muscles and bones, diarrhea, vomiting, and cold sweats. Heroin and morphine use can also cause permanent damage to the body through bacterial infections of the blood, heart valves, liver, or kidneys. Heroin, morphine, and prescription painkillers also can cause serious damage to the lungs if inhaled or snorted.

Bibliography

Hoffman, John, and Susan Froemke, eds. Addiction: Why Can’t They Just Stop? New York: HBO, 2007.

Lawford, Christopher Kennedy. Moments of Clarity. New York: Morrow, 2009.

"Results from the 2013 National Survey on Drug Use and Health: Summary of National Findings." SAMHSA. SAMHSA, Sept. 2014. Web. 30 Oct. 2015.

Simon, David, and Deepak Chopra. Freedom from Addiction. Deerfield Beach, FL: Health Communications, 2007.

Westreich, Laurence M. Helping the Addict You Love. New York: Simon & Schuster, 2007.

When did the Articles of Confederation reign, and when did the Constitution become the law of the land?

Technically speaking, the Articles of Confederation “reigned” beginning on March 1, 1781.  They were replaced by the Constitution of the United States, which became “the law of the land” almost exactly 8 years later, on March 4, 1789.

The Articles of Confederation were the first constitution for the United States.  They were written before the country had won the Revolutionary War and become independent in the eyes of the world.  They were actually written and finalized in October of 1777 and sent to the states to be ratified in the next month.  However, the Articles would not become binding until all of the states formally ratified them.  Therefore, they did not officially go into effect until Maryland became the last state to ratify them in March of 1781.  From 1777 to 1781, then, the US government was without a formal constitution.  During that time, the structure of government was set by the Articles of Confederation even though the Articles had not actually been ratified.  So, we might argue that the Articles “reigned” from 1777 on, but they were not technically in effect until March of 1781.

After the Revolution, Americans soon came to think that the Articles were flawed.  They wanted a stronger central government than the one the Articles had created.  Therefore, they convened a convention that ended up writing a new constitution, the Constitution of the United States.  That document was written in 1787 and finally ratified on June 21, 1788.  However, it did not formally take effect until March 4, 1789.

What is a summary of the poem "Be a Friend" by Edgar A. Guest?

This poem is a short, simple, lighthearted one: the kind you'd write in a greeting card, or the kind you'd put on a poster.

Here's a quick summary: In Edgar A. Guest's poem "Be a Friend," the speaker encourages us to show compassion to others and to be both helpful and kind; in return for this effort, we'll experience the "wealth" that comes with having many friends.

Here's a more detailed summary:

In the first stanza, the speaker explains that it doesn't cost any money to be a good friend. We just have to have a cheerful, helpful, generous attitude and be willing to reach out to others.

The second stanza lists some of the "duties" of friendship: we should forgive our friends' little mistakes, encourage them in whatever they're trying to do, and share in their sadness.

Lastly, the third stanza points out that although smart people who only work for their own benefit do earn a lot of money, we can earn a more valuable kind of wealth by being friendly. That is, all of our neighbors will be our friends; that makes us richer than royalty.

In Antigone, how does the mood of the chorus change during the play?

The Chorus in Antigone reflects the attitude of the citizens of Thebes. At first, the Chorus supports Creon’s position, as he is the King of Thebes and is trying to return Thebes to stability after the attempt by Polynices to take Thebes from his brother, Eteocles. Like Creon, the Chorus is in no mood to be lenient on anyone who would honor those who fought, in its eyes, against Thebes.

After Antigone is identified as the one who defied the decree not to bury Polynices, the Chorus seems to waiver in its support for Creon, and thus it urges him to reconsider the punishment announced in the decree. From this, the viewer can see that Creon is losing some of the support of the citizens of Thebes. This loss of support likely contributes to Creon deciding to entomb Antigone alive instead of directly executing her publicly.

The Chorus completes its reversal after Teiresias visits Creon and warns him that the gods see his actions as an affront and thus have abandoned Thebes. This loss of the Chorus’s support coincides with Haemon’s decision to defy his father, showing the audience that Creon has lost not only the support of the citizens, but the support of those closest to him as well.  

Name one major internal and one major external conflict in Gathing Blue.

An internal conflict is a struggle that takes place within a character's mind, while an external conflict is a struggle that takes place between the character and another character, the society, nature, or even technology. In Gathering Blue, an internal conflict for Kira starts to build as she finds Jo, the little singer, locked in her room and miserable. As she pieces together her own history, Thomas's, and Jo's, she begins to realize that "although her door was unlocked, she was not really free." She starts wishing that she could use her talent with embroidery to create her own designs, not the designs she is required to make on the Singer's robe. As she lies in bed, she wants to "leave this place, despite its comforts, and return to the life she had known." Yet she knows she can't; that life is gone, and she has no way that she can see to build a different future for herself.

One strong external conflict for Kira comes near the beginning of the book. As she comes back from the Field of Leaving, she intends to rebuild her burnt cottage, but Matt warns her that Vandara and the other women have planned to claim her lot and use it for a pen for their tykes and chickens. Vandara confronts her with a rock in her hand and tells her, "Your space is gone. It's mine now. Those saplings are mine." Kira must fend off an imminent stoning by the women, yet because of her disability she has few options for fight or flight. She uses her analytical skills, reminding the women of the laws against killing someone in a dispute that has not been brought before the guardians. 

One of Kira's internal conflicts is her desire to pursue her artistic abilities freely rather than being controlled by the guardians. An external conflict is her confrontation with Vandara.

What are natural treatments for sexual dysfunction in women?

Introduction

Although male sexual disorders have long been the subject of intensive medical research, sexual disorders in women have received relatively little attention until recently. The tremendous commercial success of the erectile dysfunction drug Viagra has prompted pharmaceutical companies to focus on finding a comparable treatment for women.

Many women experience loss of libido, painful intercourse, or difficulty achieving orgasm. In most cases, the causes are unknown. Possible identifiable causes include side effects from drugs such as antidepressants or sedatives, hormonal insufficiency, or adrenal insufficiency. Conventional treatments for sexual dysfunction in women are limited, except when a simple treatable cause is present (such as the use of an antidepressant in the selective serotonin reuptake inhibitor, or SSRI, category).

Proposed Natural Treatments

Although there is no good evidence for natural treatments for sexual dysfunction, several substances have shown promising results in preliminary trials. These substances include dehydroepiandrosterone, yohimbine, and arginine.

Dehydroepiandrosterone. Some evidence suggests that the hormone dehydroepiandrosterone (DHEA) may be helpful for improving sexual function in older women. DHEA, however, may not be helpful for younger women.

DHEA is produced by the adrenal glands. Levels of DHEA decline naturally with age and fall precipitately in cases of adrenal failure. Because both elderly people and those with adrenal insufficiency report a drop in libido, several studies have examined whether supplemental DHEA can increase libido in these groups.

A twelve-month, double-blind, placebo-controlled trial evaluated the effects of DHEA (50 milligrams [mg] daily) in 280 persons between the ages of sixty and seventy-nine. The results showed that women older than age seventy years experienced an improvement in libido and sexual satisfaction. No benefits were seen in younger women. Two other trials did not find benefit, but they enrolled much fewer people and ran for a shorter time.

Two small, double-blind, placebo-controlled studies tested whether a one-time dose of DHEA at 300 mg could increase ease of sexual arousal in pre- or postmenopausal women, respectively. The results again indicate that DHEA is effective for older women but not for younger women.

One four-month, double-blind, placebo-controlled study of twenty-four women with adrenal failure found that 50 mg per day of DHEA (with standard treatment for adrenal failure) improved libido and sexual satisfaction. DHEA is not usually prescribed to persons with adrenal failure, but this study suggests that it should be.

Combination products. A double-blind, placebo-controlled trial evaluated a combination therapy containing the amino acid arginine; the herbs ginseng, ginkgo, and damiana; and multivitamins-multiminerals. Researchers enrolled seventy-seven women between the age of twenty-two and seventy-one years and followed them for four weeks. All participants complained of poor sexual function. The results showed superior sexual satisfaction scores in the treatment group compared with the placebo group. Some of the specific benefits seen included enhanced libido, increased frequency of intercourse and orgasm, greater vaginal lubrication, and augmented clitoral sensation. A larger follow-up study performed by the same research group also reported benefits. However, confirmation by an independent research group will be necessary before these results can be taken as reliable.

Yohimbine is a drug derived from the bark of the yohimbe tree. Studies have used only the standardized drug, not the actual herb. One small, double-blind, crossover study of yohimbine combined with arginine found an increase in measured physical arousal among twenty-three women with sexual arousal disorder, compared with placebo. However, the women themselves did not report any noticeable effects. Only the combination of yohimbine and arginine produced results; neither substance was effective when taken on its own.

An open trial of yohimbine alone to treat sexual dysfunction induced by the antidepressant fluoxetine (Prozac) found improvement in eight of nine people, two of whom were women. However, in the absence of a placebo group, these results cannot be taken as reliable; in addition, concerns exist about the safety of combining yohimbe with antidepressants.

Yohimbine and the herb yohimbe are relatively dangerous substances in general. One should use them only with physician supervision. The other constituents used in these combination therapies may also present some risks.

Other treatments. One double-blind, placebo-controlled study found evidence that the use of vitamin C led to an increase in intercourse frequency in healthy women, presumably because it increased libido. A small double-blind trial reported that a proprietary topical treatment containing gamma-linolenic acid and a variety of additional supplements and herbs improved sexual function in women with sexual arousal disorder.

A preliminary study has been used to claim that the herb ephedra is helpful for women with sexual dysfunction. However, this trial was small, enrolled women without sexual disorders, and examined only sexual responsiveness to visual stimuli. In another study, ephedrine improved sexual dysfunction caused by SSRIs, but so did placebo, and there was no significant difference between the benefits seen with the two treatments. There are serious health risks associated with ephedra. For this reason, ephedra is not recommended for use by women with sexual dysfunction.

Numerous case reports and uncontrolled studies raised hopes that the herb Ginkgo biloba might be an effective treatment for sexual dysfunction, particularly as a result of antidepressant medication. However, the results of a number of double-blind studies indicate that ginkgo is no more effective than placebo, whether or not subjects are taking antidepressants. Other treatments that are often proposed for treating female sexual dysfunction, but that lack any meaningful supporting evidence, include horny goat weed, maca, molybdenum, diindolylmethane, and Rhodiola rosea.

Bibliography

Brody, S. “High-Dose Ascorbic Acid Increases Intercourse Frequency and Improves Mood.” Biological Psychiatry 52 (2002): 371.

Ferguson, D. M., et al. “Randomized, Placebo-Controlled, Double Blind, Crossover Design Trial of the Efficacy and Safety of Zestra in Women with and Without Female Sexual Arousal Disorder.” Journal of Sex and Marital Therapy 29, suppl. 1 (2003): 33-44.

Hackbert, L., and J. R. Heiman. “Acute Dehydroepiandrosterone (DHEA) Effects on Sexual Arousal in Postmenopausal Women.” Journal of Women’s Health and Gender-Based Medicine 11 (2002): 155-162.

Ito, T. Y., et al. “The Enhancement of Female Sexual Function with ArginMax, a Nutritional Supplement, Among Women Differing in Menopausal Status.” Journal of Sex and Marital Therapy 32 (2006): 369-378.

Kang, B. H., et al. “A Placebo-Controlled, Double-Blind Trial of Ginkgo biloba for Antidepressant-Induced Sexual Dysfunction.” Human Psychopharmacology 17 (2002): 279-284.

Meston, C. M. “A Randomized, Placebo-Controlled, Crossover Study of Ephedrine for SSRI-Induced Female Sexual Dysfunction.” Journal of Sex and Marital Therapy 30 (2004): 57-68.

_______, and J. R. Heiman. “Acute Dehydroepiandrosterone Effects on Sexual Arousal in Premenopausal Women.” Journal of Sex and Marital Therapy 28 (2002): 53-60.

_______, and M. Worcel. “The Effects of Yohimbine plus L-Arginine Glutamate on Sexual Arousal in Postmenopausal Women with Sexual Arousal Disorder.” Archives of Sexual Behavior 31 (2002): 323-332.

_______, A. H. Rellini, and M. J. Telch. “Short- and Long-Term Effects of Ginkgo biloba Extract on Sexual Dysfunction in Women.” Archives of Sexual Behavior 37 (2008): 530-547.

Wheatley, D. “Triple-Blind, Placebo-Controlled Trial of Ginkgo biloba in Sexual Dysfunction Due to Antidepressant Drugs.” Human Psychopharmacology 19 (2004): 545-548.

Which type of heat transfer is not blocked even by an insulated thermos? a. radiation b. thermal c. convection d. conduction

A cup of hot coffee, left on a table top, will go cold in few minutes. However, the same coffee can stay very hot, even for hours, inside an insulated thermos or a vacuum flask. Effectively, the insulated thermos prevents the heat loss to the surroundings. 

There are 3 main mechanisms of heat transfer: conduction, convection and radiation. Conduction takes place through physical contact (and that is why a cup of hot coffee is hot to touch) and convection takes place through the movement of fluids (liquids or gases). Radiation, on the other hand, requires no physical contact.

An insulated thermos or vacuum flask is, in simple terms, a bottle inside another bottle, with vacuum separating the two. Since there is vacuum between the inner chamber and the outer casing of the thermos, no physical contact (or extremely little contact) takes place between the two and hence conduction and convection are almost non-existent. The radiation is also minimized to a great extent by the silver coating of the inside chamber in many of the thermoses available in the market today. However, there is still some heat transfer due to it.

Thus, among the given options, radiation (choice A) is the best choice. 

Hope this helps.

Why is variation important in evolution?

Without variation, there would be no evolution by natural selection in any species. Genetic variation refers to differences in genes that result in slightly different traits in individuals. This variation can come from sexual reproduction, crossing over during meiosis, or random mutations. Traits that result from genetic variation can be anything from shapes and sizes of beaks, coloring, body size, age of sexual maturation, etc. The entire concept of evolution by natural selection relies on the fact that some of these variations make it more likely for an individual to survive to reproduce, thus passing on those genes. Over time, these traits will become more common in a population. 

Here's an example that includes an issue we are dealing with today. When bacteria reproduce, random mutations occur every now and then in their DNA. This is also true for all living things. Sometimes a mutation occurs that provides an individual bacterium with some resistance to antibiotics. If this bacteria is then exposed to antibiotics, it may survive when the others don't and then reproduce, passing on its trait for resistance. Because of the extreme selection pressure on the bacteria by the antibiotics, this resistance may become very common in the population in a short period of time. The population has evolved and has a new trait. The key here is that without the initial genetic variation provided by the random mutation, this evolution would not have happened. 

As the story begins, where are the children and what are they doing?

Ray Bradbury's story is set on the planet Venus on a very special day--the one day in every seven years that the rain stops and the sun comes out. The children featured in the story are nine-year-old schoolchildren--children of the "rocket men and women" who have come to build a civilization on Venus. Although most of the settlement the people have built on Venus consists of underground tunnels, the complex the school is in has windows. One can imagine a hallway that slants upwards as it mounts to an observation room with "great thick windows." In this viewing area the children press together to look out on the outer environment that has produced rain for as long as they can remember. This area is described as the children's schoolroom. Whether other areas of the complex have windows or whether there are other schoolrooms like this one, the story does not say. 

On this day the children are all crowded around the window watching the weather. The weather is rainy as it always is, yet the children are pushing and shoving among each other to get close to the window. This is because they are anticipating a change in the weather that will occur this day--a change none of them can remember seeing. The last time the sun came out on Venus, these children were only two years old. Only Margot remembers seeing the sun before, and only Margot does not crowd in to look out the window. That's because Margot came to Venus five years ago and still remembers the sunny Earth, which sets her apart from the other students and makes her a target of their teasing and bullying. 

Why does Dexter tell Judy that he's "probably making more money than any man [his] age in the Northwest?"

That's a good question to ask! Although we know that Dexter is ambitious and even greedy, he also doesn't usually go around making a show of his success or telling people about it, unless it's for a good reason.

This conversation of his with Judy takes place in Section III of the story, when they're having their first official date. They are talking on the porch after dinner, and Judy complains about being disappointed by another guy. This other fellow had charmed Judy, and she cared about him, but then he revealed to her that he was very poor. Naturally, considering Judy's somewhat snobby upbringing in a wealthy family, she had to break up with this guy; it disappointed her. "He didn't start right," she complains to Dexter, meaning that this fellow hadn't given her all the details of his situation from the beginning.

Wanting to "start right" with Judy by telling her honestly what his financial situation is, Dexter confesses how he's actually made himself extremely wealthy even though he's still young. Dexter also probably senses that this information about his wealth will make him more appealing to Judy, and it does. As soon as he tells her this, she kisses him passionately.

In Shakespeare's Romeo and Juliet, which character refers to Juliet as a flower?

Lord Capulet refers to Juliet as a flower in two separate scenes, but most specifically in Act IV, Scene 5 when the girl is found supposedly dead in her chamber. She is really faking her death after taking a potion mixed by Friar Lawrence so that she won't have to go through with the marriage to Count Paris and will eventually be reunited with Romeo. The Nurse first discovers the unconscious Juliet and alerts the family that she is dead. The Friar's potion not only slowed her pulse but also rendered her "stiff and stark and cold." When Lord Capulet sees his daughter, he uses a simile to compare her to a flower that has been struck down by the cold. He says,

Ha, let me see her! Out, alas, she’s cold.
Her blood is settled, and her joints are stiff.
Life and these lips have long been separated.
Death lies on her like an untimely frost
Upon the sweetest flower of all the field.

Lord Capulet personifies death here and a little later when he says,

Flower as she was, deflowerèd by him.

Much earlier in the play, Lord Capulet refers to "fresh fennel buds" (fennel buds turn into small yellow flowers) to describe the young girls, including Juliet, who will be at his party during his talk with Paris in Act I, Scene 2. Capulet is telling Paris to look at all the girls to make sure Juliet is really the one he wants.

What is the hook at the beginning of Freak the Mighty?

A hook is the attention-getter and can start out with a short anecdote, a quote, or even a shocking or mysterious statement to pique the reader's interest. Rodman Philbrick starts his book Freak the Mighty with this mysterious statement:

"I never had a brain until Freak came along and let me borrow his for a while, and that's the truth, the whole truth. The unvanquished truth, is how Freak would say it" (1).

The first mysterious question might be, how is it that the narrator never had a brain until someone named Freak comes along? What does that mean? And, how does this person get the name Freak in the first place? Next, the reader might wonder if the narrator doesn't have a brain (or is not smart) how is s/he writing this story and what type of person would use a word like unvanquished?

All of these questions should hook the reader into reading forward in an effort to discover the answers. In addition to the questions that are piqued in the opening paragraph, there is also some foreshadowing for things that the reader will learn along the way. For example, the word "unvanquished" foreshadows similar words that Freak teaches Max. These types of words help the friends to bond as Freak helps Max with reading and writing; and without Freak, Max would not have been able to write their story.

In The Cay, by Theodore Taylor, should Phillip's father have insisted that his family remain on Curacao?

Opinions will vary on this issue. Here's mine: No. Phillip's father was right not to insist that they remain on the island. He was right to allow Phillip and his mother to make the perilous journey by boat to the safety of Virginia.

Originally, Phillip's father wanted them to stay on the island because he believed the trip would pose more dangers than actually just staying put. The invading German forces were getting closer and closer to their island, it's true, even blowing up a refinery in nearby Aruba. And their otherwise peaceful town was all abuzz with preparations for an attack: checking on their blackout curtains, making sure they had food and water stored up, and so on. Schools were canceled, and soldiers manned the island's fort. People were on edge, to say the least.

Phillip's father had no way of knowing that his hunch would be correct: that the trip would be more dangerous than the risk of staying at home. He only knew that both options were dangerous--and doing either posed a risk, so there was no safe option available. It would be unfair to blame Phillip's father for the torpedo that attacked the ship, or for Phillip's physical and mental hardships during the time he was marooned on the island with Timothy. Phillip's father couldn't have predicted these events and was forced to protect his family by making a decision based on limited information.

And to my mind, he made the right choice. Say you're given the option to stay where you are and wait for the enemy to find you, or instead make a run for it and hope the enemy doesn't catch you while you're on your way. What would you do? I would run, just like Phillip and his mother did. At least you're a moving target then, not a sitting duck--and at least you're taking some sort of action to try to keep yourself safe.

What are zoonotic diseases?

Definition

Domestic and wild animals, and their ecosystems, contribute to human health and well-being. Animals provide protein-rich nutrients, transportation, fuel, recreation, and companionship. With the many benefits people derive from animals (including arthropods) comes health risks at this human, animal, and ecosystem interface. This interface can be described as a continuum of direct or indirect human exposure to animals, their products, and their ecosystems.

Zoonotic diseases, also known as zoonoses, are diseases caused by infectious agents (viruses, bacteria, and parasites such as worms and protozoa) transmitted or shared by animals and humans. These diseases are caused by a diverse group of pathogenic microorganisms that ordinarily live among animals. Some zoonotic diseases are transmitted directly from animals to humans, some result from contamination of the environment by animals, and others require a vector, such as a tick or mosquito.

Viral Infections

Arthropod-borne viruses include any of a large group of ribonucleic acid (RNA) viruses that are transmitted primarily by arthropods. There are more than four hundred species of arboviruses. Zoonotic diseases caused by viruses include the following:

Encephalitis. Encephalitis is inflammation of the
brain caused by infection. All arboviral encephalitides are zoonotic. They are
maintained in complex life cycles involving a nonhuman primary vertebrate host and
a primary arthropod vector. Many arboviruses that cause encephalitis have a
variety of vertebrate hosts, and some are transmitted by more than one vector.

Four main flavivirus agents of encephalitis exist in the United States:
eastern equine
encephalitis, western equine encephalitis, St. Louis
encephalitis, and La Crosse encephalitis, all of which are transmitted by
mosquitoes. Most human infections are asymptomatic or may result in nonspecific
flulike symptoms. In some infected persons, infection may progress to full-blown
encephalitis, with permanent neurologic damage or even death. Because the
arboviral encephalitides are viral diseases, antibiotics
are not effective for treatment; no effective antiviral drugs have been developed.
There are no commercially available human vaccines for these diseases, so
treatment is supportive.

West Nile virus. West Nile virus (WNV) is a flavivirus
commonly found in Africa, West Asia, the Middle East, and the United States. The
virus can infect humans, birds, mosquitoes, horses, and other mammals. WNV was
first diagnosed in the United States in 1999.

Most human infections are asymptomatic or may result in a nonspecific flulike syndrome. Approximately 80 percent of people who are infected with WNV will not show any symptoms. Up to 20 percent of infected people develop swollen lymph glands or a skin rash on the chest, stomach, and back. About 1 in 150 infected persons will develop severe illness, with symptoms that can include high fever, headache, neck stiffness, stupor, disorientation, coma, tremors, convulsions, and muscle weakness.

There is no specific treatment for WNV infection. In milder cases, symptoms resolve on their own. In more severe cases, infected persons should seek supportive treatment in a hospital.

Hantavirus pulmonary syndrome. Hantavirus pulmonary syndrome
(HPS) is contracted from rodents and has been identified throughout the United
States. Rodent infestation in and around the home remains the primary risk factor
for hantavirus exposure. In the United States, deer mice, cotton
rats, rice rats, and white-footed mice carry hantaviruses that cause HPS.

Although rare, HPS is potentially deadly. Humans can contract the disease when they come into contact with infected rodents or their urine and droppings or when they breathe in the hantavirus from the air. HPS cannot be transmitted from one person to another.

Early symptoms include fatigue, fever, muscle aches, headaches, dizziness, chills, and abdominal problems. Four to ten days later, additional symptoms appear. These symptoms include coughing and shortness of breath, as the lungs fill with fluid. There is no specific treatment or vaccine for hantavirus infection. Supportive care is the basis for therapy.

Lymphocytic choriomeningitis. Lymphocytic choriomeningitis (LCM) is a rodent-borne viral disease that appears as aseptic
meningitis (inflammation of the membrane that surrounds the brain and spinal
cord), encephalitis, or meningoencephalitis (inflammation of the brain and
meninges). LCM is caused by the lymphocytic choriomeningitis virus (LCMV). The
common house mouse, Mus musculus, is the primary host. The virus
is found in the saliva, urine, and feces of infected mice, and people become
infected when exposed to these substances. Other types of rodents, such as
hamsters, can become infected with LCMV in pet stores.

Initial LCM symptoms include fever, malaise, lack of appetite, muscle aches,
headache, nausea, and vomiting. In the second phase of the infection, persons have
symptoms of meningitis (fever, headache, and stiff neck) or
characteristics of encephalitis (drowsiness, confusion, and sensory disturbances),
or have symptoms such as motor abnormalities (for example, paralysis). LCM is
usually not fatal. Aseptic meningitis, encephalitis, or meningoencephalitis
require hospitalization. Anti-inflammatory drugs, such as corticosteroids, may be helpful in treating the disease.

Monkeypox. Monkeypox is a rare viral disease that
usually occurs in central and western Africa. It is caused by the monkeypox virus,
which was first found in 1958 in laboratory monkeys. In June, 2003, several people
in the United States contracted monkeypox after having contact with pet prairie
dogs that were sick with monkeypox. The disease was traced to a shipment of
Gambian rats that were imported to the United States and later kept near prairie
dogs at an Illinois animal vendor.

People can get monkeypox if they are bitten by an infected animal or if they
touch the animal’s blood or body fluids. The disease also can spread from person
to person. After infection, symptoms include fever, headache, muscle aches,
backache, and swollen lymph nodes. A few days later, symptoms include a skin rash
that develops into raised bumps filled with fluid; these bumps will eventually
fall off the skin. The illness usually lasts two to four weeks. There is no
specific treatment for monkeypox.

Rabies. Rabies is a viral disease of mammals
transmitted through the bite of a rabid animal. Transmission is through the
virus-containing saliva of an infected host. The majority of rabies cases occur in
wild animals such as raccoons, skunks, bats, and foxes.

The rabies virus infects the central nervous system of humans, ultimately involving the brain and leading to death. Early symptoms include fever, headache, and general weakness. As the disease progresses, more specific symptoms appear, including insomnia, anxiety, confusion, partial paralysis, hallucinations, hypersalivation (increased saliva), difficulty swallowing, and hydrophobia (fear of water). Once clinical signs of rabies appear, the disease is nearly always fatal, and treatment is mainly supportive.

Several tests are required for the diagnosis of rabies. Thorough wound cleansing has been shown to markedly reduce the likelihood of contracting rabies. A tetanus shot should be given if the infected person has not received one within the previous ten years. A doctor will determine if antibiotics should be used. Persons not previously vaccinated should receive a postexposure vaccination against rabies that includes administration of both passive antibody and vaccine.

Bacterial Infections

Zoonotic diseases caused by bacterial infections include the
following:

Anthrax. Anthrax is an acute infectious disease
caused by the bacterium Bacillus anthracis. It most commonly
occurs in wild and domestic mammals such as cattle, sheep, and goats, but it also
can occur in humans who are exposed to infected animals or to tissue from infected
animals. B. anthracis spores can survive in the soil for many
years. Humans can become infected by handling products from infected animals or by
inhaling anthrax spores in contaminated animal products. Anthrax can also be
contracted by eating undercooked meat from infected animals.

Anthrax infections can be of three types: cutaneous (skin), inhalation, and gastrointestinal. Most cutaneous infections occur when the bacterium enters a cut or abrasion on the skin. About 20 percent of untreated cases of cutaneous anthrax result in death, but death is rare with antimicrobial therapy. The first symptoms of inhalation infection resemble a common cold, but after several days, the symptoms may progress to severe breathing problems. Inhalation anthrax is usually fatal. The gastrointestinal form of anthrax follows the eating of contaminated meat and is followed by an acute inflammation of the intestinal tract. Intestinal anthrax results in death in 25 to 60 percent of cases of infection. Antibiotics are used to treat all three types of anthrax. Early identification and treatment are critical.

Lyme disease. Lyme disease is caused by the bacterium
Borrelia burgdorferi and is transmitted to humans by the bite
of infected blacklegged ticks. The Lyme disease bacterium lives in deer, mice,
squirrels, and other small animals, and ticks become infected by feeding on these
animals. In the northeastern and north-central United States, Lyme disease is
transmitted by the deer tick Ixodes scapularis. In the Pacific
Northwest, the disease is spread by the Western blacklegged tick (I.
pacificus).

In approximately 70 to 80 percent of infected persons, the first sign of infection is usually a circular rash that appears three to thirty days after the tick bite. This “bull’s eye” rash gradually expands in several days, reaching up to twelve inches in diameter. Other early symptoms include fever, chills, headache, fatigue, swollen lymph nodes, and joint and muscle aches. If Lyme disease is left untreated, it can spread to other parts of the body. Symptoms of late-stage Lyme disease include painful, swollen joints; severe headaches and neck stiffness from meningitis; and nervous system problems, such as impaired concentration and memory loss.

Several laboratory tests for Lyme disease are available to measure
antibodies to the infection. These tests may return
false-negative results in persons with early disease, but they are reliable for
diagnosing later stages of disease. Most cases of Lyme disease can be treated and
cured with antibiotics.

Plague. Plague is an infectious disease of
animals and humans caused by the bacterium Yersinia pestis. It is
transmitted from animal to animal and from animal to human by the bites of
infected fleas. Humans usually contract plague from being bitten by a rodent flea
that is carrying the plague bacterium or by handling an infected animal. Plague is
also transmitted by inhaling infected droplets expelled by the coughing of an
infected person or animal, especially domestic cats, which may become infected by
eating infected wild rodents. Fleas become infected by feeding on rodents, such as
chipmunks, prairie dogs, ground squirrels, mice, and other mammals that are
infected with the bacterium. Fleas transmit the plague bacterium to humans and
other mammals during the feeding process.

The characteristic sign of plague is a very painful, swollen lymph node called
a bubo. This sign, accompanied with fever, extreme exhaustion, headache, and a
history of possible exposure to rodent fleas, should lead to suspicion of plague.
The disease progresses rapidly; the bacteria can then invade the bloodstream and
produce severe illness called plague septicemia and lung infection. Once a
human is infected, a progressive and potentially fatal illness generally results
unless specific antibiotic therapy is given. The plague vaccine is no longer
commercially available in the United States.

Rocky Mountain spotted fever. Rocky Mountain spotted
fever (RMSF) is the most severe tickborne illness in the
United States. It is caused by infection with the bacterial organism
Rickettsia rickettsii, which is transmitted by the bite of an
infected tick. The American dog tick (Dermacentor variabilis) and
Rocky Mountain wood tick (D. andersoni) are the primary arthropod
vectors in the United States.

The early symptoms of RMSF are often nonspecific. Initial symptoms may include
severe headache, lack of appetite, muscle pain, nausea, and fever. Later signs and
symptoms include diarrhea, joint pain, abdominal pain, and rash. RMSF can be a
severe illness, and the majority of infected persons are hospitalized. Diagnosis
is based on a combination of clinical signs and symptoms and laboratory tests. It
is best treated using a tetracycline antibiotic, usually
doxycycline.

Salmonellosis. Salmonellosis is an infection with the
bacterium Salmonella, which lives in the intestinal tracts of
humans, animals, and birds. Salmonella is usually transmitted to
humans through foods contaminated with animal feces. Contaminated foods are
usually of animal origin and include beef, poultry, milk, and eggs, but any food,
including vegetables, may become contaminated. Salmonella is
killed by thorough cooking. Salmonella may also be found in the
feces of some pets. Reptiles, such as turtles, lizards, and snakes, and chicks and
young birds, are particularly likely to carry Salmonella in their
feces. People should always wash their hands immediately after handling one of
these animals, even if it appears healthy. Most persons infected with
Salmonella develop diarrhea, fever, and abdominal cramps
twelve to seventy-two hours after infection. The illness usually lasts four to
seven days, and most persons recover without treatment.

Parasitic Infections

Zoonotic diseases caused by parasitic infections include the following:

Cryptosporidiosis. Cryptosporidiosis is a disease caused
by parasites of the genus Cryptosporidium. Both the disease and
the parasite are known as crypto. Many species of crypto infect humans and a wide
range of animals. The parasite is protected by an outer shell that allows it to
survive outside the body for long periods of time. Crypto is one of the most
frequent causes of waterborne disease among humans in the United States and
throughout the world. Crypto lives in the intestines of infected humans or
animals. An infected person or animal passes the parasites in the stool. Crypto is
found in soil, food, water, or surfaces that have been contaminated with the feces
from infected humans or animals. Some people with crypto have no symptoms, but the
most common symptom is watery diarrhea. Other symptoms include stomach cramps,
dehydration, diarrhea, nausea, fever, or weight loss. Diagnosis is made by
examination of stool samples. Most people who have healthy immune systems will
recover without treatment.

Cysticercosis. Cysticercosis is an infection caused by
the pork tapeworm Taenia solium. Infection occurs when the
tapeworm larvae enter the body and form cysticerci (cysts). When cysticerci are
found in the brain, the condition is called neurocysticercosis. The tapeworm that
causes cysticercosis is most often found in rural, developing countries where pigs
are allowed to roam freely and eat human feces.

When pigs swallow pork tapeworm eggs, the eggs are passed through the bowel
movement. The eggs are subsequently spread by people who ingest contaminated food
or water. Once inside the stomach, the tapeworm egg hatches, penetrates the
intestine, travels through the bloodstream, and may develop into larvae in the
muscles, brain, or eyes. Although rare, larvae may float in the eye and cause
swelling or detachment of the retina. Symptoms of neurocysticercosis can include
seizures, headaches, confusion, lack of attention, or difficulty with balance.
Death can occur suddenly with heavy infections.

Diagnosis is usually made by magnetic resonance imaging or computed
tomography brain scans. Infections are generally treated with antiparasitic drugs
in combination with anti-inflammatory drugs.

Trichinellosis. Trichinellosis, also called trichinosis,
is caused by eating the raw or undercooked meat of animals infected with the
larvae of a species of worm called Trichinella. Infection occurs
commonly in domestic pigs. When an animal eats meat that contains
Trichinella cysts (larvae), their stomach acid dissolves the
hard covering of the cyst and releases the worms. The worms migrate into the small
intestine and mature in one to two days. After mating, adult females lay eggs that
develop into immature worms and travel through the arteries to muscles. Inside the
muscles, the worms curl into a ball and become enclosed in a capsule. Infection in
humans occurs when these capsules are consumed in undercooked meat.

The first symptoms of trichinellosis include nausea, diarrhea, vomiting, fatigue, fever, and abdominal discomfort. These first symptoms are later followed by headaches, fevers, chills, cough, eye swelling, aching joints, muscle pains, itchy skin, or diarrhea. In severe cases, death can occur. For mild to moderate infections, most symptoms subside within a few months, although fatigue, weakness, and diarrhea may last for months afterward. Several effective prescription drugs are available to treat trichinellosis.

Impact

Zoonotic diseases have the potential to spread efficiently across international
boundaries, thereby affecting not only human health and well-being but also
international travel and trade. More than 60 percent of the newly identified
infectious agents that have affected people since the mid-twentieth century have
been caused by pathogens originating from animals or animal products. Of
these zoonotic infections, 70 percent originated from wildlife.

Bibliography

Hugh-Jones, Martin E., William T. Hubbert, and Harry V. Hagstad. Zoonoses: Recognition, Control, and Prevention. Ames: Iowa State University Press, 2000. Preceding synopses of parasitic, fungal, and viral agents are sections on the principles and history of zoonoses recognition, newer disease agents, and advances in control and prevention.

Krauss, Hartmut, et al. Zoonoses: Infectious Diseases Transmissible from Animals to Humans. 3d ed. Washington, D.C.: ASM Press, 2003. Discusses the myriad infections introduced by human-animal contact.

Mandell, Gerald L., John E. Bennett, and Raphael Dolin, eds. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases. 7th ed. New York: Churchill Livingstone/Elsevier, 2010. This thorough two-volume textbook provides comprehensive coverage of infectious diseases, including zoonotic diseases.

Romich, Janet A. Understanding Zoonotic Diseases. Clifton Park, N.Y.: Thomson Delmar, 2008. A good introduction to zoonotic diseases in humans.

Schlossberg, D., ed. Clinical Infectious Disease. New York: Cambridge University Press, 2008. A detailed presentation of infectious diseases, their causes, epidemiology, symptoms, and treatments.

What are measles?

Causes and Symptoms

Measles is a highly contagious viral disease characterized by a maculopapular (pimply) rash that develops on the skin and spreads rapidly over much of the cutaneous surface of the body. Measles virus is classified with the paramyxoviruses, a class of viruses in which ribonucleic acid (RNA) serves as the genetic material. Closely related viruses in the same group include rinderpest and distemper virus, agents associated with disease in ruminants such as cows and in dogs or cats, respectively. It is likely that measles originated when one of these other animal viruses became adapted to humans several thousand years ago.

In modern times but before the advent of measles vaccination, measles was a common disease of childhood, usually appearing between the ages of five and ten. The illness is among the most contagious of infections, and the virus was generally spread among children in schools. Widespread immunization of children, begun in the 1960s, tended to push the age of exposure into the teenage years. Most outbreaks since the 1980s have occurred among college students. Since recovery from the disease confers lifelong immunity, infection among older adults is infrequent. In developing nations, places where vaccination may be haphazard, measles is still a disease of early childhood; malnutrition and related problems of poverty have resulted in a significant level of mortality among infected children.

Exposure generally follows an oral-oral means of transmission, as the person inhales contaminated droplets from an infected individual. The incubation period for active measles ranges from seven to fourteen days. During this early stage, the infected individual becomes increasingly contagious. The lack of any obvious symptoms during these early stages lends itself to the spread of the disease.

Contact by the virus with the surface cells of the respiratory passages, or sometimes the conjunctiva (the outer surface of the eye), allows the infectious agent to enter the body. The virus spreads through the local lymph nodes into the blood, producing a primary viremia. During this period, the virus replicates both in the lymph nodes and in the respiratory sites through which the virus entered the body. The virus returns to the bloodstream, resulting in a secondary viremia and widespread passage of the virus throughout the body by the fifth to seventh day after the initial exposure. Viral levels in the blood reach their peak toward the end of the incubation period, some fourteen days after infection. Once symptoms begin, the virus is widely disseminated throughout the body, including sites in small blood vessels, lymph nodes, and even the central nervous system.

The initial incubation period is followed by a prodromal stage, in which active symptoms appear. This stage is characterized by a fever that may reach as high as 103 degrees Fahrenheit, coughing, sensitivity of the eyes to light (photophobia), and malaise. Koplik’s spots appear on the buccal mucosa in the mouth one to two days prior to development of the characteristic measles rash.

The maculopapular rash first appears on the head and behind the ears and gradually spreads over the rest of the body during the course of twenty-four to forty-eight hours. Clear signs of respiratory infection appear, including a cough, pharyngitis, and occasional involvement of the bronchioles or even pneumonia. While malaise and anorexia (appetite loss) are common during the fever period, diarrhea and vomiting generally do not occur. Over time, the rash becomes increasingly dense, exhibiting a blotchy character. Desquamation is common in many affected areas of the skin. Gradually, over a period of three to five days, the rash begins to fade, usually following the sequence by which it first appeared. The rash fades first on the forehead, then on the extremities.

Complications, while they do occur, are unusual in otherwise healthy individuals. Most result from secondary bacterial infections. Occasionally, these complications may manifest themselves as infections of the ear. Pulmonary infections are common among cases of measles and account for most of the rare deaths that follow development of the disease. Photophobia is also common, accounting for the former belief that measles patients had to be kept in a dark room; as long as the patient is comfortable, this step is unnecessary.

The obvious manifestations of measles infection make the isolation of the virus unnecessary for diagnosis. Ironically, the near disappearance of measles in the United States has made most physicians there unfamiliar with the disease; it is not unusual for an attending physician to mistake the rash for another illness. For this reason, laboratory diagnosis is often useful. Laboratory confirmation is generally based on a serological assay for measles antibodies in the blood of infected persons.

A rare sequela to measles infection is the development of subacute sclerosing panencephalitis, a disease characterized by progressive neurological deterioration. The specific mechanism by which measles infection may develop into this disease remains unclear, but it may be the result of a rare combination of events in the victim. Since spread of the virus into the central nervous system is common during measles infection whereas the development of subacute sclerosing panencephalitis is rare (approximately one case per one hundred thousand measles infections), it is likely that some form of immune impairment is at the root of this disease. Diagnosis of subacute sclerosing panencephalitis is difficult and is based on developing dementia accompanied by unusual levels of measles antibodies in cerebrospinal fluid.

Treatment and Therapy

No specific treatment for measles is available; therapy consists of symptomatic intervention. Bed rest is recommended, and the patient should not come into contact with persons not previously exposed to the virus through either natural infection or immunization.

Itching of the rash is common and may be treated with cool water or the standard regimen of cornstarch or baking soda applications. The most common complications result from secondary bacterial infections, which generally take the form of otitis media (middle-ear infection), pharyngitis, or pneumonia. Appropriate use of antibiotics is usually sufficient to prevent or treat such complications.

Immunization with the measles virus may be either passive or active. Children less than one year of age and patients who are immunocompromised or chronically ill may be protected if human immunoglobulin is administered within a week after exposure. While effective immunity is short term, it is capable of protecting these individuals during this period. Since no active disease or infection develops, however, immunity to future infection remains minimal in these cases.

During the early 1960s, an effective
vaccine was developed to immunize children against measles. The vaccine consists of an attenuated form of the virus. Although early forms of the vaccine were inconsistent in producing a lifelong immunity, they were effective in decreasing the prevalence of the disease. Later generations of the attenuated vaccine proved more effective in developing long-term immunity among the recipients.

Since maternal antibodies are present in newborns, it is recommended that measles immunization begin between twelve and fifteen months of age. Often, this program is part of a combination MMR vaccine, for measles, mumps, and rubella (German measles). A second booster is given following elementary school. The American Academy of Pediatrics does not consider a third vaccination to be necessary if the approved routine has been followed. It is recommended that children who were first immunized prior to their first birthday should receive boosters at fifteen months of age and again at age twelve. Indications are that immunity from vaccination is long term, if not lifelong. Recovery from natural infection results in a lifelong immunity to measles.

Inconsistency of the first generation of vaccine resulted in ineffective immunity among some individuals vaccinated during the 1960s. A number of small outbreaks during the 1980s were the result. Most cases of measles, however, have occurred in individuals who failed to be immunized.

Perspective and Prospects

The origin and early history of measles is uncertain, as the first authentic description of measles as a specific entity was that by the Arab physician al-Razi (Rhazes) in a 910 CE treatise on smallpox and measles. Rhazes quoted earlier work by the Hebrew physician El Yehudi, so it is likely that familiarity with these respective illnesses had existed for some time.

Measles is entirely a human disease, with no known animal reservoir. Consequently, the paucity of human populations of sufficient size to maintain transmission means that the spread of such an epidemic disease would have been unlikely before 2500 BCE. It is probable that the disease entered the human species through adaptation of the similar animal viruses of rinderpest or distemper. The absence of any description of a disease like measles in the writings of Hippocrates (c. fourth century BCE) likewise renders it unlikely that the disease was widespread before that date.

Epidemic disease with a rash characteristic of measles is known to have spread through the Roman Empire during the early centuries of the common era. The difficulty in differentiating measles from smallpox by the physicians of the time contributes to the difficulty in understanding the history of the illness. It is certain that by the time of Rhazes, measles had become common in the population.

The terminology of measles lent further confusion during the Middle Ages. Measles was often referred to as morbilli, a Latin term meaning “little disease,” to distinguish it from il morbo, or plague. The word measles first appeared in the fourteenth century treatise Rosa Anglica, by John of Gaddesden. The term may have been applied initially to the sores on the legs of lepers (mesles), and it was only later that illnesses characterized by similar rashes (measles, smallpox, and rubella) were clearly differentiated by European physicians. The significance of a rash with a white center in the mouth was probably recognized by John Quier in Jamaica and Richard Hazeltine in New England during the latter portion of the eighteenth century, but it was in 1896 that the American pediatrician Henry Koplik firmly reported its role in early stages of the disease.

Measles followed the path of European explorers to the Americas during the sixteenth century. Repeated outbreaks of measles devastated American Indian populations, which had minimal immunity to the newly introduced disease. The most thorough epidemiological investigation of measles newly introduced into a population was that by Peter Panum in his study Observations Made During the Epidemic of Measles on the Faroe Islands in the Year 1846 (1940). In the population of 7,864 persons, 6,100 became ill, with 102 deaths. Mortality rates as high as 25 percent were not unusual in previously unexposed populations. In Hawaii in 1848, about 40,000 deaths occurred among the population of 150,000 persons following the introduction of measles. Even higher mortality rates probably occurred among the populations of Peru and Mexico in 1530–31, following their exposure to infected Spanish explorers.

The earliest attempt at immunization was probably that of Francis Home of Edinburgh in 1758. Home soaked cotton in the blood of measles patients and placed it on the small cuts on the skin of children. The viral nature of measles was first demonstrated by John Anderson and Joseph Goldberger of the United States Public Health Service, who in 1911 induced the disease in monkeys using filtered extracts from human tissue. In 1954, the virus itself was isolated by John Enders, who grew the agent in human and monkey tissue in a laboratory.

The first effective vaccine was developed by Enders in 1958 using an attenuated (live) form of the virus. The vaccine was tested and then licensed in 1963. Several variations of the vaccine that proved superior in producing long-term immunity were developed in the decades that followed. In 1974, the World Health Organization (WHO) introduced a widespread vaccination program within developing countries.

The absence of any natural reservoir for measles other than humans has made the eradication of the disease possible. Active immunization of children in the United States reduced the annual incidence of the disease from 482,000 reported cases in 1962 to fewer than 1,000 in the late 1990s. The Measles and Rubella Initiative, a collaboration between the WHO, UNICEF, American Red Cross, US Centers for Disease Control and Prevention (CDC), and UN Foundation, has vaccinated one billion children worldwide since 2000. While widespread vaccination and worldwide surveillance has made global eradication of the disease a realistic possibility, the WHO reports that more than twenty million people contract measles each year and that it remains one of the top killers of children around the world, causing 145,700 deaths in 2013. Most of these fatalities occurred in children younger than five.

Outbreaks in 2014 and 2015

Though the CDC reports that measles was declared eliminated (no longer endemic or constantly present) in the United States as of 2000 becuase of access to effective vaccination, a record number of cases were reported in 2014. Of the 644 cases that occurred throughout twenty-seven states that year, the CDC stated that the majority of people who suffered from the infection were unvaccinated; the incident was linked to travelers coming to the country from the Philippines, which had recently suffered an outbreak. At the beginning of the following year, yet more measles outbreaks were highly publicized. From January to the end of February, the CDC confirmed that 170 people from seventeen states had measles. Most of these cases were considered part of an ongoing outbreak that experts believed began when an infected traveler visited a California amusement park. Aside from this outbreak, three other unrelated outbreaks were reported in Illinois, Nevada, and Washington state. The CDC issued an official Health Advisory in January to inform health care providers about the incidents and the ongoing investigations. At the state level, by the beginning of March lawmakers in several states started pushing for stricter regulations regarding nonmedical exemptions for vaccination; the surgeon general stressed the importance of vaccinating children.

Bibliography

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Bernstein, David, and Gilbert Schiff. “Viral Exanthems and Localized Skin Infections.” In Infectious Diseases. Ed. Sherwood L. Gorbach, John G. Bartlett, and Neil R. Blacklow. Philadelphia: Saunders, 2004. Print.

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"Measles Cases and Outbreaks." Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 2 Mar. 2015. Web. 3 Mar. 2015.

Szabo, Liz. "Measles Outbreak Raises Question of Vaccine Exemptions." USA Today. USA Today, 23 Jan. 2015. Web. 3 Mar. 2015.

Wagner, Edward K., and Martinez J. Hewlett. Basic Virology. 3rd ed. Malden: Blackwell, 2008. Print.

Woolf, Alan D., et al., eds. The Children’s Hospital Guide to Your Child’s Health and Development. Cambridge: Perseus, 2002. Print.

What did Atticus think Mayella did wrong in chapter twenty of To Kill A Mockingbird?

Atticus, in his summing up, says that Mayella Ewell has "put a man's life at stake" (i.e., Tom Robinson's), "in an effort to get rid of her own guilt."

He then clarifies that Mayella was not guilty of a crime, but she was guilty of breaking a rigid social code:

"... a code so severe that whoever breaks it is hounded from our midst as unfit to live with. ... She was white, and she tempted a Negro.  She did something that in our society is unspeakable: she kissed a black man.  Not an old Uncle, but a strong young Negro man.  No code mattered to her before she broke it, but it came crashing down on her afterwards."

Notice that Atticus does not say this social code is right, merely that Mayella Ewell knew she was "guilty" of breaking it.  He goes on to say that, in order to escape the severe consequences that would come her way if she admitted what she'd done (social ostracism, and probably more savage beatings from her father), Mayella desperately tried to blame Tom Robinson by accusing him of rape.  

Atticus has great sympathy for Mayella.  He knows she leads a lonely life, and that Tom Robinson was the only person in her world who was kind to her.  He understands why she was tempted.  However, he cannot spare her feelings by keeping her secret.  He must bring her secret out in order to save Tom Robinson's life. 

What are the main themes in the play Loyalties by John Glasworthy?

It is an irony that one of the main themes of Loyalties is the concept of loyalty. Each character has a different person or concept to which he or she is loyal.  Captain Dancy misjudges the loyalty of his friends.  Mabel is fiercely loyal to her mate.  Winsor is loyal to tradition.  Canynge is loyal to his reputation in the Army.  Most importantly, De Levin and Jacob Twisden are the only people loyal to the truth.  Of course, De Levin is the victim.  Jacob Twisden is the lawyer.

COLFORD.  Guilty or not, you ought to have stuck to him—it's not playing the game, Mr Twisden.

TWISDEN. You must allow me to judge where my duty lay, in a very hard case.

Yet another theme is that of discrimination.  In fact, this is the most general of themes to notice about this play.  In short, it is Jewish people (and especially De Levin) who are discriminated against.  He is trying to gain membership to the Jockey Club.  The rich people do not want to allow him membership and, as a result, stage a robbery.  De Levin decides to find the real culprit behind this robbery and find the only person he can trust is Twisden.

When you first read the story "A Rose for Emily" by William Faulkner, when did you realize how it would end? What is your response to the end?

Obviously the answer to when an individual reader figures out that Emily has murdered Homer Barron years ago will vary greatly. Having taught this story for several years to high school students, I can attest to the fact that most students don't figure it out until the very end, and many students are still confused about what happened even when they have finished the story. The jumbled timeline is one way that Faulkner keeps his readers off balance, making it less likely that they will guess what Emily did in her thirties. Most people have a good idea that when Emily is buying rat poison, she wants to murder someone with it because she asks for the strongest poison the druggist has and refuses to say what she wants it for. But since the issue of the horrible smell around Emily's house is reported in section II of the story and Homer Barron's disappearance is described in section IV, many readers have a hard time reconstructing the timeline while they are reading the story to make the smell come shortly after Barron's disappearance. In addition, the fact that Emily ordered what seemed to be wedding gifts for Barron seems inconsistent with her wanting to poison him. Not only that, but Miss Emily's family servant who stays with her until her death seems a mute testimony that nothing too horrific can have gone on under her roof, to say nothing of her opening up her home for china-painting lessons. Therefore, most readers can be forgiven for being completely in the dark until the third paragraph from the end.

Regarding the ending, especially the suggestion of necrophilia, most people are, to put it in student language, "grossed out" by it. Readers tend to be first disgusted, then surprised, and then confused. Only when they take time to look back over the story do they come to appreciate Faulkner's skill in weaving this unusual and creepy story. 

What are some examples of selflessness in the novel To Kill a Mockingbird?

There are several examples of selfless behavior throughout the novel To Kill a Mockingbird. The most notable example being Atticus' decision to selflessly defend Tom Robinson in front of a prejudiced community. Despite the impossible odds, Atticus takes the challenge head on and risks his reputation, and also puts his family in harms way, by choosing to defend an innocent black man. Another example takes place in Chapter 3, when Little Chuck Little stands up to Burris Ewell and selflessly defends Miss Caroline's character in front of the class. Despite his small stature, Chuck Little does not waver when Burris Ewell looks towards him and even threatens Burris by putting his hand into his pocket, indicating that he is carrying a blade. At the end of the novel, Boo Radley risks his life by defending Jem and Scout while Bob Ewell is attacking them. Bob Ewell was armed, and Boo Radley left the safety of his home to wrestle Bob away from the children to save their lives. His selfless act prevented Bob Ewell from possibly murdering Jem and Scout, and Atticus is eternally grateful.

What are brain tumors?

Causes and Symptoms

The earliest symptom of a brain tumor may be a persistent headache, although this symptom does not necessarily stem from a brain tumor. Nevertheless, when headaches occur regularly, it is essential that the cause be investigated as early as possible and a diagnosis made.

As brain tumors continue to grow and crowd the brain, other symptoms become evident. Even though such tumors are frequently benign, they can become disabling. As brain tissue and the nerve tracks inside the skull are compressed by the incursion that such tumors make on them, patients may suffer muscle weakness, dizziness, loss of vision, reduction of hearing, nausea, speech problems, emotional problems, disorientation, and sometimes seizures.

Brain tumors can, but rarely, enhance mental functioning. Nearly always, they cause impairment across a range of mental aptitudes. Memory loss is common, as are unexplained mood swings. A tumor that grows so that it restricts the flow of cerebrospinal fluid will cause an additional condition, hydrocephalus. Hydrocephalus, also known as “water on the brain,” is when the cerebrospinal fluid flows into brain tissue itself. This swelling quickly becomes painful and is lethal if not reduced.

The incidence of brain tumors is small, representing about 1.3 percent of cancers diagnosed in the United States in a given year. Two age groups are at greater risk than the general population. Adult males between fifty-five and sixty-five years of age seem to be vulnerable to primary brain tumors, and children between three and twelve years of age also have a higher incidence of this condition.

The causes of brain tumors have not been fully determined. It has been noted that genetic factors may play a role in the development of such tumors in young people, particularly those with a parent who has had colon
cancer or cancer of the salivary glands or nervous system. Children exposed to high energy radiation applied to the head in the treatment of leukemia
or who develop neck or facial cancers suffer an increased risk of developing brain tumors.

Among adults, those whose work exposes them to vinyl chloride have a high incidence of brain tumors, as do those whose work involves exposure to lead in such industries as mining, printing, and chemical industries. Those who suffer from epilepsy are at higher risk of developing gliomas, tumors arising from brain substance, some 60 percent of which are malignant. The risk seems less in people whose diets include little fat and refined sugar and plentiful fresh fruits and vegetables.

Many brain tumors develop from tissues within the skull, but others result from the metastasis, or spread of cancer cells from malignancies elsewhere in the body, often the lungs or breasts. Of the 170,000 Americans who develop lung cancer annually, about 55,000 will also develop brain tumors. Adults who have had organ transplants are also at increased risk.

Treatment and Therapy

Where a brain tumor—malignant or benign—exists, the preferred treatment is surgical removal by opening the skull. Such delicate surgery is performed by a neuro-oncological surgeon who understands the brain’s contours and their relationship to the nervous system and spinal cord.

Such diagnostic tools as computed tomography (CT) scanning and magnetic resonance imaging (MRI) can determine the extent of a brain tumor before a decision is made about how to treat the condition. Sometimes surgery is not indicated because the tumor is embedded in vital areas of the brain that would be irreparably damaged by removal.

In such cases, radiation may be used initially to shrink the tumor, sometimes to the point that eventually it can be removed surgically. In other cases, it may be possible to remove part of the tumor, thereby releasing the pressure that it exerts on the brain. Partial removal is usually followed by a course of radiation and/or chemotherapy, generally with the expectation that additional surgical removal will occur if the tumor decreases in size.

Corticosteroids have in some cases succeeded in controlling the swelling of tumors so that pressure on the brain is reduced and symptoms are mitigated.

Perspective and Prospects

In the United States, brain tumors do not occur frequently. The American Cancer Society estimates that in 2013 there will be about twenty-three thousand new cases of primary brain and other nervous system cancers, and about fourteen thousand deaths related to such cancers. The life of one child in every three thousand in the population ends before age ten because of a primary brain tumor. Some fifteen hundred children are diagnosed every year with brain tumors, most located in the cerebellum, the midbrain, or the optic nerve.

There has been an increase in primary brain tumors among the elderly since 1980, while the percentage of resulting deaths has decreased. In viewing such statistics, one must remember that with advances in medical technology, more people are achieving old age and are developing diseases when, fifty years ago, they would not have still been living.

Advances in cell research and in the development of drugs that control and, in some cases, eliminate specific cancer cells provide encouragement that medical progress is being made consistently. Neuro-oncological surgery has undergone great advances and will likely substantially reduce the threat of human error as sophisticated robotic surgical procedures are developed. Although cancer is still a scourge, recent medical research offers realistic hope of controlling it.

Bibliography:

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Jasmin, Luc. "Brain tumor—Primary—Adults." MedlinePlus, Nov. 2, 2012.

Register, Cheri. The Chronic Illness Experience: Embracing the Imperfect Life. City Center, Minn.: Hazelden, 1999.

Roloff, Tricia Ann. Navigating Through a Strange Land: A Book for Brain Tumor Patients and Their Families. 2d ed. Minneapolis, Minn.: Fairview, 2001.

Shiminski-Maher, Tania, Patsy Cullen, and Maria Sansalone. Childhood Brain and Spinal Cord Tumors: A Guide for Families, Friends, and Caregivers. Sebastopol, Calif.: O’Reilly, 2002.

Stark-Vance, Virginia, and M. L. Dubay. One Hundred Questions and Answers About Brain Tumors. 2d ed. Sudbury, Mass.: Jones, 2011.

Wood, Debra. "Brain Tumor and Brain Cancer—Adult." Health Library, Jan. 18, 2013.

Zeltzer, Paul M. Brain Tumors: Leaving the Garden of Eden. Encino, Calif.: Shilysca, 2004.