How did Tom Robinson injure his left arm in To Kill a Mockingbird?

When Tom Robinson stands up, Scout observes "he looked oddly off balance, but it was not from the way he was standing" (Chapter 18). Jem whispers that Tom Robinson is crippled. His left arm hangs limply beside his body. It also appears shorter than the other arm. His hand is misshapen, and it is clear he could not throw a punch with it. Atticus points out that the witness testimonies accuse Tom of punching Mayella with his left fist. Given his crippled state, this is impossible.

Reverend Sykes tells Scout and Jem how Tom's arm and hand were injured. Many years before, when he was a boy, Tom worked for Mr. Dolphus Raymond. While working, young Tom's hand got caught in the cotton gin. It was severely injured, and he never regained full use of it.

What evidence is there that nature itself is in chaos because of Macbeth seeking to kill the king?

A good place to see how the natural world in Scotland descends into chaos in response to Duncan's murder is in Act II scene 4.  It is dark at midday, and Ross asks a wise old man if he thinks it is dark because of "the day's shame"--Duncan's murder--or "night's predominance". The old man agrees that the daytime darkness is unnatural, just like the murder of the king.  He notes that an owl has recently killed a falcon. Ross adds that Duncan's horses broke out of their stalls, went wild, and menaced people.  The old man adds that he heard that the horses were cannibalizing one another. Ross confirms this rumor, saying that he had witnessed it himself or he never would have believed it.  

What is the psychopathology of nicotine dependence?

Introduction

Nicotine produces a temporary mood-altering “lift,” or “buzz,” that encourages continued use and helps produce an addictive craving. The body receives nicotine (and other addictive substances) through receptors in the brain. Dependence increases slightly each time the drug is used, leading to more intense addiction. Thus, although going without the drug is easier for younger people, the addiction becomes more trenchant with age. Going without nicotine causes withdrawal symptoms, including irritability and anxiety, that vary in intensity and duration among individuals.

History and Health Risks

The smoking of tobacco once was deemed healthy. Nicotine was named for the tobacco plant Nicotiana tabacum, which itself was named after Jean Nicot de Villemain, a French ambassador who imported it to Portugal in 1560 as a medicine.

Until the 1950s, university lecture halls were built with ashtrays, and indoor smoking was commonplace. The newsroom of the New York Times, for example, contained so many chain smokers (people who smoke one cigarette after another) in the 1930s that by the end of the workday janitors used push brooms to sweep away a carpet of butts an inch or two deep.

In 1963, however, the US Surgeon General issued a report linking smoking with a large number of health problems, including heart disease, stroke, and cancer. Since then, even the inhalation of tobacco effluvia from other people’s lungs, so-called passive (or secondhand) smoking, especially by children, has been associated with health risks. The nicotine itself usually does not cause health risks. Other substances in tobacco, including tar and various chemicals, do most of the damage. As of 2012, about 18 percent of adults in the United States smoked tobacco, according to the Centers for Disease Control and Prevention. The percentage using tobacco was higher in other countries, such as China and Russia.

Physical and Psychological Cues

Nicotine reaches the brain within seven to ten seconds after inhalation. One of the major symptoms of nicotine dependence (addiction) is an inability to go without smoking, even after serious attempts to stop. Other symptoms of addiction, according to the Mayo Clinic, include anxiety, irritability, restlessness, difficulty concentrating, depressed mood, frustration or anger, increased hunger, insomnia, and constipation or diarrhea.

Continued use of tobacco even in the face of serious health problems is another obvious sign of serious addiction. Some people have been known to continue smoking even after lung-cancer surgery. Some people defend their “freedom” to smoke, as if engaging in addictive behavior could be defended as an exercise of free choice. Studies have found that a propensity to smoke may be related to genetic makeup. In other words, smoking behavior can be inherited, to a degree. Some people do not experience pleasure from the use of nicotine and are unlikely to continue its use after experimenting.

Beginning smoking at a young age increases the chances of serious and intense addiction later in life. Nicotine binds to nicotinic acetylcholine receptors in the brain, increasing levels of neurotransmitters that play a role in the brain’s regulation of mood and behavior. Nicotine provides many people’s brains with a shot of dopamine, a neurotransmitter, producing a brief sense of euphoria and relaxation that rewards continued use, reinforcing the physiological addiction of the drug. Use of nicotine also increases the flow of the stimulating hormone adrenaline (epinephrine). Nicotine also increases heart rate by about twenty beats per minute and elevates blood pressure, as it constricts arteries.

The combustion of tobacco provokes release of more than sixty cancer-causing chemicals. According to the American Lung Association, smoking plays a role in 90 percent of lung-cancer cases among men (80 percent among women), as well as in cases of emphysema and chronic bronchitis. It also aggravates asthma. Smoking plays a major role in cancers of the mouth, esophagus, larynx, and throat (pharynx). It plays a role in other pathologies in the kidneys, bladder, stomach, pancreas, cervix, stomach, and other parts of the body. It can increase the risk of impotence and infertility.

Tobacco dependence is a physical process that also brings into play psychological cues. A smoker’s desire to increase his or her nicotine level may be linked to well-established daily rituals, such as morning coffee, drinking alcohol at a bar, or free time between tasks at work. Certain friends may provoke an urge to smoke. Smoking also can be associated with specific locations, such as a particular automobile. Stress can raise anxiety levels and lead to smoking. The smell of burning tobacco can increase the desire to use it. People who experience depression, schizophrenia, and other mental illnesses are, statistically speaking, more likely to smoke tobacco. Abusers of alcohol and illegal drugs also smoke in higher proportion than do other people. However, tobacco use has been studied as a treatment for schizophrenia, as well as for attention-deficit hyperactivity disorder (ADHD) and Parkinson’s disease.

Products designed to help smokers quit using tobacco have become a multibillion-dollar industry worldwide. In some countries, smoking tobacco remains legal for adults, but the places where people can smoke have become limited. In the Netherlands, for example, the smoking of tobacco has become illegal in some cafés where the use of marijuana is allowed. California was the first US state to ban smoking in all enclosed work areas, doing so in 1995.

Bibliography

Benowitz, Neal L., ed. Nicotine Safety and Toxicity. New York: Oxford UP, 1998. Print.

Bock, Gregory, and Jamie Goode, eds. Understanding Nicotine and Tobacco Addiction. Hoboken: Wiley, 2006. Print.

David, Sean P., Jennifer B. McClure, and Gary E. Swan. "Nicotine Dependence." Handbook of Psychology. Vol. 9. 2nd ed. 149–81. Hoboken: Wiley, 2013. PsycINFO. Web. 22 May 2014.

Di Giovanni, Giuseppe. Nicotine Addiction: Prevention, Health Effects, and Treatment Options. Hauppauge: Nova Science, 2012. eBook Collection (EBSCOhost). Web. 22 May 2014.

Johnson, Bankole A. Addiction Medicine: Science and Practice. New York: Springer, 2011. eBook Collection (EBSCOhost). Web. 22 May 2014.

Koskinen, Charles J. Handbook of Smoking and Health. New York: Nova Science, 2011. eBook Academic Collection (EBSCOhost). Web. 22 May 2014.

Kozlowski, Lynn T., Jack E. Henningfield, and Janet Brigham. Cigarettes, Nicotine, and Health: A Biobehavioral Approach. Thousand Oaks: Sage, 2001. Print.

Wagner, Eric F., ed. Nicotine Addiction among Adolescents. New York: Haworth, 2000. Print.

What is the mythological reference in Fahrenheit 451?

The mythical creature is the phoenix, which is the firemen’s logo.

A phoenix is a creature that supposedly burned and was reborn, or rose from the ashes.  Firemen have the logo on a disc on their chest and a salamander on their arms.  A salamander supposedly can live in ashes, according to myth.  The bird makes sense as the mascot and logo of the firemen because they burn the books and the items in the houses, but not the houses themselves.  The houses are fireproof, so they are like phoenixes rising from the flame. 

The phoenix comes into the conversation after the city is burned. 

"It's flat," he said, a long time later. "City looks like a heap of baking-powder. It's gone." And a long time after that. "I wonder how many knew it was coming? I wonder how many were surprised?"  (Part III) 

People were not really paying attention to the war.  It was not real.  Beatty says, “Let him forget there is such a thing as war” (Part I).   All that mattered was their entertainment.  They lived every day on a high, focusing on pleasure and making no deep connections.  They were alive, but not really living.  

Granger brings up the phoenix, a bird he says lived “back before Christ.” 

But every time he burnt himself up he sprang out of the ashes, he got himself born all over again. And it looks like we're doing the same thing, over and over, but we've got one damn thing the Phoenix never had. We know the damn silly thing we just did. (Part III) 

Granger says that mankind is foolish, because we keep making the same mistakes in our society. He says that “even when we had the books on hand, a long time ago, we didn't use what we got out of them.”  Montag’s society burns itself up, and it will re-emerge.  Will the new society be better than the former one?

Which character is Juliet's mother's foil?

A foil is a character that highlights the qualities of another character, often through direct contrast; by generating a secondary character with differing personality traits, an author can use a foil to display the difference between two people. The foil of Juliet's mother, Lady Capulet, is the Nurse. 

Whereas Lady Capulet behaves with a great deal of emotional distance toward her daughter, the Nurse is affectionate and invested in Juliet's wellbeing. When it is suggested to Juliet that she get married at the tender age of thirteen, Lady Capulet replies to the girl's protestations that she must, "think of marriage now; younger than you, / Here in Verona, ladies of esteem, / Are made already mothers..." Lady Capulet seems to have little interest in her daughter's happiness; rather, she emphasizes the importance of obedience as a woman and wife. The Nurse, on the other hand, is directly involved with Juliet's disobedience. She serves as a messenger between Romeo and Juliet and helps arrange their secret marriage and its subsequent consummation. Eventually the Nurse does try to convince Juliet to marry Paris, but only after facing the wrath of Lord Capulet; this suggestion seems more like an attempt to protect Juliet from her terrifying father than a betrayal of Juliet's already existing marriage.

Ultimately, the Nurse plays a nurturing, supportive, motherly presence in Juliet's life, which highlights just how absent, cold, and dismissive Lady Capulet can be. 

How are the blood libels of the 1840s linked to Antisemitism and how were they part of European culture?

Throughout European history, Jewish communities have almost always been a minority. They have repeatedly been scapegoated as the committers of otherwise-unsolved crimes or demonized for their relative isolation and traditions which may have been at odds with greater cultural practice. Though the first blood libels date to the Middle Ages, a series of accusations sprang up during the 1840s across Europe. It began with an incident in Damascus, when a Christian priest disappeared. As had been common for several centuries, the Jewish community was blamed, even with no evidence that might have supported the accusations of torture and murder. What's more, there was a rumor that the purpose of the murder was to drain the man of his blood to be drank at Passover.

From there, crimes in both the Muslim and Christian parts of Europe were often blamed on the Jewish minorities. Even in areas where no crimes were committed, rumors circulated that Jewish people would kidnap children to drain them of their blood. False "confessions" were forced by the torture of Jewish people, and their statements were used as evidence of ritual murder. Across Europe, especially in the West, Jewish people were made into the enemy of Catholicism and Islam. Antisemitism flourished as the Jewish community was blamed for all of society's troubles. A number of Antisemitic texts were published at this time about the dangers of the Jewish people (all falsehoods) and how one ought to deal with them. Such circulation of ideas, in numerous languages, helped to spread the ideology of Antisemitism and directly influenced later Antisemitic action.

What are melanomas?

Related conditions:
Basal cell cancer, squamous cell cancer

Definition:

Melanomas are malignant tumors of the skin that occur in the melanocytes, the cells that produce melanin (skin pigment).

Risk factors: Melanomas occur most commonly in fair-skinned people, particularly natural blonds and redheads, especially those with a history of sun exposure or multiple serious sunburns. A history of serious sunburns in childhood is a particular risk. Risk for the disease is strongly related to having a family history; which is characteristic of about 1 in 10 of patients with melanoma. Additional risk factors include large or multiple moles and past personal history of melanoma or of less serious skin cancers, known as basal cell or squamous cell cancers. People with diseases that suppress the immune system are at added risk for melanoma. Occupational exposure to coal tar, pitch, creosote, arsenic compounds, or radium increase a person’s risk for the disease. Celtic descent, male gender, and older age are also risk factors.

Etiology and the disease process: Repeat exposure to harmful ultraviolet rays from the sun or artificial sources such as sunlamps or tanning booths appears to be the most significant factor contributing to the development of melanoma. This is borne out by the fact that the incidence of melanoma increases in the lower latitudes of the world where the sun is strongest. Additionally, in parts of the world where the ozone layer is thin, the incidence is higher. In Queensland, Australia, for example, where there is a hole in the ozone, between 1979 to 1987, the rate of melanoma doubled to 55.8 per 100,000 men and rose to 42.9 per 100,000 women.

Melanomas can occur on parts of the body not usually exposed to the sun, including the soles of the feet and the genitals. Melanoma starts with an abnormal skin growth, which is generally quite small. When discovered at this early stage, melanomas can be easily removed and the cancer cured. If the growth is not removed, it thickens and invades surrounding tissue and nearby lymph nodes. The cancer can then spread through the lymph nodes to sites distant from the original growth, including vital organs, soft tissues, and other lymph nodes.

Incidence: In the 1970s, the incidence rate of melanoma rose dramatically to about 6 percent a year. Incidence continues to rise but at a slower rate; from 1981 to 2001 the rate of growth was about 3 percent a year. In 2011, the number of new cases of melanoma was 21.3 per 100,000 men and women.

Melanoma affects adults of all ages as well as teenagers. According to the American Cancer Society, an estimated 76,100 new melanomas would be diagnosed in 2014, with about 9,710 deaths from melanoma. Rates for whites are ten times higher than for African Americans. However, one type of melanoma, which develops on the palms of the hands, soles of the feet, and nail beds, occurs more frequently in African Americans and Asians.

Symptoms: Melanoma generally first appears as a new mole or a change in the shape, size, or color of an existing mole. The American Cancer Society describes the warning signals in terms of a mnemonic: ABCD. “A” for asymmetry, meaning that the mole is not uniformly round; “B” for border, in that the edges of the mole are irregular; “C” for color, referring to the varied colors (generally in tones of tan, brown, and black) throughout the mole; and “D” for diameter, meaning that the mole is larger than 6 millimeters (mm).

Screening and diagnosis: People with serious risk factors or symptoms should have regular full body exams by a dermatologist to identify any skin abnormalities, and baseline photographs should be taken so that any changes can be tracked. Suspect moles or skin abnormalities should be removed and analyzed for cancer cells.

The stages of melanoma are defined as follows:

• Localized, Stage 0: These melanomas involve only the top layer of skin, the epidermis.





• Localized, Stages I and II: These melanomas involve the underlying layer of skin, the dermis, and are rated according to the depth they penetrate the skin (known as the Breslow depth) and their degree of ulceration (how much the epidermis is eroded and exposes the dermis below). Ulceration is determined by a pathologist, using a microscope.





• Regional, Stage III: These melanomas include those in which the cancer has spread to nearby lymph nodes.





• Advanced, Stage IV: These melanomas include those where cancer has spread beyond the region of the skin growth to distant sites in the body, including internal organs and distant lymph nodes.

Treatment and therapy: Significant advances have been made in the early detection of melanoma. All suspect moles or skin growths should be removed and tested for cancerous cells. Removal of localized growths (Stages 0-II) can be done one of three ways: surgically, cutting out the suspect tissue; by electrodessication and curettage, using an electric current to destroy the tissue and then scraping the area with a special tool to remove any possible remaining cancer cells; or by cryosurgery, which freezes the tissue. About 83 percent of melanomas are diagnosed in these early stages while the cancer is still confined to the primary skin growth, according to the Duke Raleigh Hospital Cancer Center. Surgery successfully removes the cancer for the majority of patients with early-stage melanoma. In some cases, radiation therapy may be directed at the area following surgery to kill any cancer cells that may remain. Patients with Stages 0 to II melanoma have an excellent prognosis.

If the growth is extensive, the surgeon will remove lymph nodes to determine if the cancer has spread. After their removal, Stage III and IV melanomas may be treated with radiation or immunotherapy (agents that attempt to harness the human body’s own disease-fighting properties to kill cancer cells) or chemotherapy (toxic agents targeted to kill cancer cells). Two therapeutic agents approved by the US Food and Drug Administration (FDA) for the treatment of Stage III and IV melanoma are dacarbazine (DTIC, chemotherapy) and interleukin-2 (IL-2, immunotherapy). Some patients with Stage III and IV disease experience a full recovery with chemotherapy; however, positive responses to the drug therapy, when they occur, are most often partial and brief. Much research is being done to explore other possible treatments for melanoma, including combinations of different chemotherapies and new immunotherapies. Some of these agents are not specifically approved by the FDA to treat melanoma. Patients with melanoma may be eligible to become subjects in clinical trials in which these experimental agents or combinations of agents are tested.

Prognosis, prevention, and outcomes: The thickness of a patient’s tumor is the best single indicator of the prognosis. After having melanomas of less than 0.76 mm removed, about 96 to 99 percent of patients are cured. About 1 in 10 patients with melanoma is diagnosed after the cancer has already spread to nearby lymph nodes. For these patients in the regional stage (Stage III), the prognosis is not as good, but survival rates for patients with Stage III disease range widely, depending on how many lymph nodes are affected by the cancer. About 3 of 10 patients with melanoma are diagnosed in an advanced stage (Stage IV), after the cancer has already spread (metastasized) to distant sites. Those with metastases to the skin or soft tissue or to distant lymph nodes appear to fare better than those with lung or other vital organ metastases.

Recommended measures to prevent melanoma include avoiding excessive direct sunshine, especially during the hours when the sun is high in the sky (from about 10 a.m. to 2 p.m.); using sunscreen and protective clothing to prevent sunburn; and not using sunlamps; tanning booths, or other artificial sources of ultraviolet light. People should become familiar with the moles and spots on their bodies and report any changes that could indicate melanoma to their doctors.

Bolognia, Jean, Julie V. Schaffer, Karynne O. Duncan, and Christine J. Ko, eds. Dermatology Essentials. Oxford: Saunders/Elsevier, 2014. Print.

Gershenwald, Jeffrey E. Melanoma. Philadelphia: Saunders, 2011. Print.

Kaufman, Howard. The Melanoma Book: A Complete Guide to Prevention and Treatment. New York: Gotham, 2005. Print.

Poole, Catherine M., and I. V. DuPont Guerry. Melanoma: Prevention, Detection, and Treatment. 2d ed. New Haven: Yale UP, 2005. Print.

Schofield, Jill R., and William A. Robinson. What You Really Need to Know About Moles and Melanoma. Baltimore: Johns Hopkins UP, 2000. Print.

Sharfman, William. Melanoma. New York: Demos Medical, 2012. Print.