Who or what is the antagonist in the story "The Devil and Tom Walker"?

Usually if the incarnation of the devil is a character in a story, it can be assumed that he is the antagonist. An antagonist is a character in opposition to the main character or protagonist. Even though Tom Walker's character merits no sympathy, he is the protagonist in Irving's tale, and the devil, here named the "black woodsman" or "old scratch," is set up in conflict with Tom. When they first meet in the swamp, the...

Usually if the incarnation of the devil is a character in a story, it can be assumed that he is the antagonist. An antagonist is a character in opposition to the main character or protagonist. Even though Tom Walker's character merits no sympathy, he is the protagonist in Irving's tale, and the devil, here named the "black woodsman" or "old scratch," is set up in conflict with Tom. When they first meet in the swamp, the devil talks about his hatred of the whites who have settled the area around his swamp. He has even labeled some of the trees with the names of rich men in the area. Eventually Tom strikes a deal with "old scratch" and becomes a very wealthy man. The reader may assume that one of those trees came to be marked with Tom's name as well. In the end of the story, despite attempting to fend off the devil with religion, Tom is eventually taken away by a "black man" on a "black horse" to the swamp, which is then set ablaze.

How much heat is added if .685 g of water increases in temperature by 287 degrees C?

The temperature of the water will increase in proportion to the amount of heat added. The quantity of heat that is needed can be calculated by the following formula:

heat added (or lost) = mass of water x specific heat of water x change in temperature

where specific heat is the amount of heat required to raise the temperature of a unit mass of a substance by 1 degree Celsius. In case of water, the...

The temperature of the water will increase in proportion to the amount of heat added. The quantity of heat that is needed can be calculated by the following formula:

heat added (or lost) = mass of water x specific heat of water x change in temperature

where specific heat is the amount of heat required to raise the temperature of a unit mass of a substance by 1 degree Celsius. In case of water, the specific heat is 4.186 J/K/g. 

However, for a temperature change of 287 degrees, one must note that water converts to steam at 100 degrees C and the specific heat of steam is 1.996 J/K/g and the latent heat of vaporization is 2256 J/g. 

Assuming some initial temperature (since it is not given), say 20 degrees C. Thus, the water sample undergoes three phases:

Boiling from 20 degrees C to 100 degrees C (80 degree Temperature change):

Heat needed = 0.685 g x 4.186 J/K/g x (100 -20) = 229.4 J

Phase change to steam at 100 degrees C:

Heat needed = mass x latent heat = 0.685 g x 2257 J/g = 1546.1 J

Heating steam from 100 degrees C to 307 degrees (temperature change by 207 degrees C):

Heat needed = 0.685 x 1.996 x (307 - 100)

= 283 J

Thus, the total heat needed to heat 0.685 gm of water, from 20 degrees C (assumed initial temperature) to 307 degrees C (an increase of 287 degrees C) is:

229.4 + 1546.1 + 283 J = 2058.5 J

Hope this helps.

How does Scout end up in the yard in front of the Radley house?

Scout, Jem, and Dill are playing in the street in front their house with an old tire.  They take turns getting inside the tire and rolling down the street.  When it’s Scout’s turn, Jem gives the tire a big push and the tire rolls into the Radley yard and ends up resting against the porch.  Scout is too dizzy to get up and run, so Jem courageously runs into the yard to rescue her from...

Scout, Jem, and Dill are playing in the street in front their house with an old tire.  They take turns getting inside the tire and rolling down the street.  When it’s Scout’s turn, Jem gives the tire a big push and the tire rolls into the Radley yard and ends up resting against the porch.  Scout is too dizzy to get up and run, so Jem courageously runs into the yard to rescue her from the Radley’s overgrown, weed-filled yard.   They run back home, and Scout remembers that she heard a laugh come from the Radley house when she was stuck in the tire.  This episode sets the scene for how the children feel about the reclusive Boo Radley, but it also gives us, the readers, a clue that perhaps Boo isn’t the spooky character the children think he is.  Boo laughing at the children’s adventures in the tire shows that he is perhaps harmless and enjoys watching the children play.  It is our first look at Boo Radley and foreshadows the continued interest he has in the welfare of Scout and Jem.

What are antibacterial agents? |

In its broadest sense, an antibacterial is an agent that destroys bacteria or interferes with its growth and reproduction. While antibiotics and antibacterials both fight bacteria, the two terms describe separate purposes. Antibiotics are used in medicine to fight disease. Antibacterials primarily are used to disinfect surfaces and eliminate potentially harmful bacteria. Antibacterial agents are found in consumer products such as soap, detergent, skin care products, and household cleansers. While no evidence exists indicating that the routine use of antibacterial agents provides a health benefit, the agents have demonstrated proven efficacy for killing bacteria. As a result, antibacterials can be helpful when sanitation is critical to prevent the spread of disease, such as in hospitals, day care centers, and other environments with higher concentrations of infectious bacteria.

Overview

Antibacterials are divided into two groups based on how fast they work and how much residue they produce. The first group is referred to as non-residue-producing and includes fast-acting antibacterial agents that leave no active residue behind. Examples include alcohols, chlorines, and peroxides, which have been used for decades in both health care settings and household cleaning products. The second group, residue-producing antibacterials, is made up of newer types of compounds, such as triclosan and benzalkonium chloride, which have slower but longer effectiveness as a result of long-acting residue that lingers on the surface being disinfected. Once used exclusively in health care settings, agents in the second group have become widely used in household soaps and cleaning products since 2000. One advance has been the bonding application of triclosan into the surface of many high-use consumer products, such as kitchen utensils, toys, and even bedding, to provide built-in antibacterial protection.

Non-residue-producing antibacterials have been used effectively for many years to help control the proliferation of disease organisms in health care settings. When used appropriately, residue-producing antibacterial agents also have demonstrated results for controlling bacterial and fungal infections in clinical settings such as hospitals, nursing homes, and newborn nurseries. However, there is no evidence to suggest that antibacterial agents used in consumer products, such as toothpaste, deodorant, and shampoo, provide a health benefit.

Some experts say that antibacterial agents actually may be detrimental to health if they are used in place of normal hygiene habits. Excessive use of antibacterials also can destroy beneficial bacteria and open the door for disease-causing bacteria to take hold and cause disease. In addition, long-term use of residue-producing antibacterial agents, even at low concentrations, may increase the risk of bacterial resistance and lower the effectiveness of the active agent.

Depending on their intended use, antibacterial agents may be subject to regulation by the US Food and Drug Administration (FDA). Antibacterial soaps and antibacterial substances that are intended for use on the human body or are involved in food processing in any way are subject to FDA regulation. Antibacterial agents with other uses must be registered with the US Environmental Protection Agency either as a non–public health antimicrobial agent or as a public health antimicrobial agent, a category that includes sanitizers, disinfectants, and sterilizers.

Bibliography

Aminov, Rustam I. “A Brief History of the Antibiotic Era: Lessons Learned and Challenges for the Future.” Frontiers in Microbiology. December 2010. Print.

Amyes, Sebastian G. B. Bacteria: A Very Short Introduction. Oxford: Oxford UP, 2013. Print.

Anderson, Rosaleen, Paul Groundwater, Adam Todd, and Alan Worsley. Antibacterial Agents: Chemistry, Mode of Action, Mechanisms of Resistance and Clinical Applications. Chichester: Wiley & Sons, 2012. Print.

Mascaretti, Oreste A. Bacteria Versus Antibacterial Agents: An Integrated Approach. Washington: ASM, 2003. Print.

Miller, Alita A., and Paul F. Miller. Emerging Trends in Antibacterial Discovery: Answering the Call to Arms. Norfolk: Caister Academic, 2011. Print.

Skold, Ola. Antibiotics and Antibiotic Resistance. Hoboken: Wiley & Sons, 2012. Print.

“The Golden Age of Antibacterials.” Antimicrobial Resistance Learning Site. Michigan State University. Web. 14 May 2014.

Wilson, Michael, Rod McNab, and Brian Henderson. Bacterial Disease Mechanisms: An Introduction to Cellular Microbiology. Cambridge: Cambridge UP, 2002. Print.

What is the relationship between ethics and participant rights in experimentation?

Introduction

A primary task of government is to protect people from exploitation. Since scientists are sometimes in a position to take advantage of others and have occasionally done so, there is a role for government to regulate research to prevent exploitation of research participants. On the other hand, excessive regulation can stifle innovation; if scientists are not allowed to try new (and perhaps risky) experimental techniques, science will not progress, and neither will human understanding. This puts government in a difficult position: since research topics, scientific methodology, and public attitudes are continuously changing, it would be impossible to write a single law or set of laws defining which research topics and methods are acceptable and which are not. As soon as such a law were written, it would be out of date or incomplete.

Institutional Review Boards

The United States Congress has decided to deal with this issue of research ethics by letting local communities determine what research with human participants is and is not appropriate according to contemporary local standards. Today, each institution conducting research must have a committee called an institutional review board (IRB) consisting of a minimum of five members, all of whom belong to the local community. To ensure that the committee is kept up to date on current human research methodologies, the IRB membership must include at least one scientist. At least one member must represent the general public and have no official or unofficial relationship with the institution where the research is taking place. A single person may fill multiple roles, and IRBs are also required to ensure that the board consists of both men and women and includes representatives with a variety of professions.

Each IRB is required to review written proposals for all local research on human participants before that research can begin. At most large institutions, the IRB has enough staffing to break into subcommittees to review proposals from different areas. It is the job of the IRB to ensure that unethical research is screened out before it starts. Government agencies that fund research projects will not consider a proposal until it has been approved by the local IRB, and if research is conducted at an institution without IRB approval, the government can withhold all funds to that institution, even funds unrelated to the research.

Informed Consent

To evaluate all aspects of a proposed research project, the IRB must have sufficient information about the recruitment of participants, the methods of the study, the procedures that will be followed, and the qualifications of the researchers. The IRB also requires that proposals include a copy of the informed consent contract that each potential participant will receive. This contract allows potential participants to see, in writing, a list of all possible physical or psychological risks that might occur as a result of participation in the project. People cannot be coerced or threatened into signing the form, and the form must also tell participants that even if they agree to begin the research study, they may quit at any time for any reason. Informed consent contracts must be written in nontechnical prose that can be understood by any potential participant; it is generally recommended that contracts use vocabulary consistent with an eighth-grade education.

Except for the file holding the signed contracts between the researcher and the participants, names of participants generally do not appear anywhere in the database or in the final written documents describing the study results. Data are coded without using names, and in the informed consent contract, participants are assured of the complete anonymity of their responses or test results unless there are special circumstances that require otherwise. If researchers intend to use information in any way that may threaten participants’ privacy, this issue needs to be presented clearly in the informed consent contract before the study begins.

Deception

Occasionally in psychology researchers use a form of deception
by telling the participants that the study is about one thing when it really is about something else. Although it usually is considered unethical to lie to participants, deception is sometimes necessary, because participants may behave differently when they know what aspect of their behavior is being watched. (This is called a demand characteristic of the experimental setting.) More people will probably act helpful, for example, when they know that a study is about helpfulness. A researcher studying helpfulness thus might tell participants that they are going to be involved in a study of, say, reading. Participants are then asked to wait in a room until they are each called into the test room. When the first name is called, a person may get up and trip on his or her way out of the room. In actuality, the person who was called was really the experimenter’s assistant (although none of the participants knows that), and the real point of the research is to see how many of the participants get up to help the person who fell down. In situations such as this, where demand characteristics would be likely, IRBs will allow deception to be used as long as the deception is not severe and the researchers debrief participants at the end by explaining what was really occurring. After deception is used, experimenters must be careful to make sure that participants do not leave the study feeling angry at having been “tricked”; ideally, they should leave feeling satisfaction for having contributed to science.

Even when participants have not been deceived, researchers are required to give an oral or written debriefing at the end of the study. Researchers are also obliged to ensure that participants can get help if they do experience any negative effects from their participation in the research. Ultimately, if a participant feels that he or she was somehow harmed or abused by the researcher or the research project, a civil suit can be filed in an attempt to claim compensation. Since participants are explicitly told that they can drop out of a study at any time for any reason, however, such long-term negative feelings should be extremely rare.

Special Issues in Clinical Trials

Clinical psychology is perhaps the most difficult area in which to make ethical research decisions. One potential problem in clinical research that is usually not relevant for other research settings is that of getting truly informed consent from the participants. The participants of clinical research are selected specifically because they meet the criteria for some mental disorder. By making sure that participants meet the relevant criteria, researchers ensure that their study results will be relevant to the population who suffers from the disorder; on the other hand, depending on the disorder being studied, it may be that the participants are not capable of giving informed consent. A person who suffers from disordered thinking (as with schizophrenics) or dementia (as with Alzheimer’s disease patients) or is otherwise mentally handicapped cannot be truly “informed.” In the cases of individuals who have been declared incompetent by the courts, a designated guardian can give informed consent for participation in a research study. There are also cases, however, of participants being legally competent yet not capable of truly understanding the consequences of what they read. Authority figures, including doctors and psychologists, can have a dramatic power over people; that power is likely to be even stronger for someone who is not in full control of his or her life, who has specifically sought help from others, and who is trusting that others have his or her best interests in mind.

Another concern about clinical research is the susceptibility of participants to potential psychological damage. The typical response of research participants is positive: they feel they are getting special attention and respond with healthy increases in self-esteem and well-being. A few, however, may end up feeling worse; for example, if they feel no immediate gain from the treatment, they may label themselves as “incurable” and give up, leading to a self-fulfilling prophecy.

A third concern in clinical research regards the use of control or placebo treatments. Good research designs always include both a treatment group and a control group. When there is no control group, changes in the treatment group may be attributed to the treatment when in fact they may have been caused by the passage of time or by the fact that participants were getting special attention while in the study. Although control groups are necessary to ensure that research results are interpreted correctly, the dilemma that arises in clinical research is that it may be unethical to assign people to a control group if they need some kind of intervention. One way of dealing with this dilemma is to give all participants some form of treatment and to compare the different treatment outcomes to one another rather than to a no-treatment group. This works well when there is already a known treatment with positive effects. Not only are there no participants who are denied treatment; the new treatment can be tested to see if it is better than the old one, not only if it is better than nothing. Sometimes, if there is no standard treatment for comparison, participants assigned to the control group are put on a “waiting list” for the treatment; their progress without treatment is then compared with that of participants who are getting treatment right away. To some extent, this mimics what happens in nonresearch settings, as people sometimes must wait for therapy, drug abuse counseling, and so on. On the other hand, in nonresearch settings, those who get assigned to waiting lists are likely to be those in less critical need, whereas in research, assignment to treatment and nontreatment groups must be random. Assigning the most critical cases to the treatment group would bias the study’s outcome, yet assigning participants randomly may be perceived as putting research needs ahead of clients’ needs.

The Milgram Studies

Concern about potential abuse of research participants arose in the 1960s, in response to publicity following a series of studies by Stanley Milgram
at Yale University.
Milgram was interested in finding out how physicians who had devoted their lives to helping people were so easily able to hurt and even kill others (in the name of science) in experiments in Nazi concentration camps.

In Milgram’s now-famous experiment, each participant was paired with one of Milgram’s colleagues but was told that this partner was another volunteer. Then each participant, both real and pretend, drew a slip of paper assigning him or her to the role of either “teacher” or “learner.” Actually, both slips always said “teacher,” but the assistants pretended that theirs said “learner”; this way, the real participants were always assigned the role of teachers. Milgram then showed participants an apparatus that supposedly delivered shocks; teachers, on one side of a partition, were instructed to deliver a shock to the learner on the other side whenever a mistake was made on a word-pairing task. The apparatus actually did not deliver shocks, but the learners pretended that it did; as the experiment continued and the teachers were instructed to give larger and larger shocks, the learners gave more and more extreme responses. At a certain point, the learners started pounding on the partition, demanding to be released; eventually, they feigned a heart attack.

When Milgram designed this study, he asked psychiatrists and psychologists what percentage of people they thought would continue as teachers in this experiment; the typical response was about 0.1 percent. What Milgram found, however, was that two-thirds of the participants continued to deliver shocks to the learner even after the learner had apparently collapsed. The participants were clearly upset; they repeatedly expressed concern that someone should check on the learner. Milgram would simply reply that although the shocks were painful, they would not cause permanent damage, and the teacher should continue. In spite of their concern and distress, most participants obeyed.

Milgram’s results revealed much about the power of authority; participants obeyed the authority figure (Milgram) even against their own moral judgment. These results help explain the abominable behavior of Nazi physicians, as well as other acts of violence committed by normal people who were simply doing what they were told. Ironically, although Milgram’s study was so valuable, he was accused of abusing his own participants by “forcing” them to continue the experiment even when they were clearly upset. Critics also claimed that Milgram’s study might have permanently damaged his participants’ self-esteem. Although interviews with the participants showed that this was not true—they generally reported learning much about themselves and about human nature—media discussions and reenactments of the study led the public to believe that many of Milgram’s participants had been permanently harmed. Thus began the discussion of experimental ethics that ultimately led to the system of regulation in force today.

Bibliography

American Psychological Association. “Ethical Principles of Psychologists and Code of Conduct.” http://www.apa.org/ethics/code2002.html.

Boyce, Nell. “Knowing Their Own Minds.” New Scientist 20 June 1998: 20–21. Print.

Creswell, John W. Research Design: Qualitative, Quantitative, and Mixed Methods Approaches. Thousand Oaks: Sage, 2014. Print.

Garner, Mark, Claire Wagner, and Barbara Kawulich, eds. Teaching Research Methods in the Social Sciences. Burlington: Ashgate, 2012. Digital file.

Penslar, Robin L. Research Ethics: Cases and Materials. Bloomington: Indiana UP, 1995. Print.

Perry, Gina. Behind the Shock Machine: The Untold Story of the Notorious Milgram Psychology Experiments. New York: New, 2013. Print.

Rothman, K. J., and K. B. Michels. “The Continuing Unethical Use of Placebo Controls.” New England Journal of Medicine 331.6 (1994): 394–98. Print.

Sales, Bruce D., and Susan Folkman, eds. Ethics in Research with Human Participants. Washington: American Psychological Association, 2005. Print.

Sieber, Joan E. Planning Ethically Responsible Research: A Guide for Students and Internal Review Boards. Newbury Park: Sage, 1995. Print.

Slife, Brent, ed. Taking Sides: Clashing Views on Controversial Psychological Issues. 13th ed. Guilford: Dushkin, 2004. Print.

In Lord of the Flies, has Simon alone grasped what is wrong on the island?

Ralph and Piggy also notice how the boys are falling out of civilized ways and into barbarism. Piggy continually returns to the conch. He remembers how it had been used to organize the boys and establish reason and order. He clearly sees the danger of losing that order. Shortly before his death, Piggy says

"Which is better—to have rules and agree, or to hunt and kill?"

Roger continues to drop rocks upon them and this...

Ralph and Piggy also notice how the boys are falling out of civilized ways and into barbarism. Piggy continually returns to the conch. He remembers how it had been used to organize the boys and establish reason and order. He clearly sees the danger of losing that order. Shortly before his death, Piggy says

"Which is better—to have rules and agree, or to hunt and kill?"

Roger continues to drop rocks upon them and this symbolizes his answer: that he (Roger) prefers violence to rules. 

Ralph also sees the danger. He echoes Piggy's sentiments.

"Which is better, law and rescue, or hunting and breaking things up?"

In the subsequent paragraph, we have a last image of Piggy, supporting Ralph, still clutching the object that established reason and order: 

By him stood Piggy still holding out the talisman, the fragile, shining beauty of the shell. 

Piggy and the shell are destroyed together. Democracy, reason and order are also destroyed. 

Simon is the most intuitive boy on the island. So, one could argue that he is the first boy to become aware of the potentially dangerous slide into savagery. At the end of Chapter 8, Simon speaks to the Beast. The hallucination (from Simon's own mind) acknowledges that Simon had always known this potential dark side of the boys: 

You knew, didn’t you? I’m part of you? Close, close, close! I’m the reason why it’s no go? Why things are what they are? 

What is autism, and how does it affect an autistic child's siblings?

Autism spectrum disorder (ASD) has been diagnosed at an increasingly high rate since the 1980s. For example, in 2010 the US Centers for Disease Control and Prevention (CDC) estimated that 1 in every 150 children was diagnosed with ASD; in 2012 that number jumped to 1 in 88. Although some of this increase can be attributed to doctors' and parents' greater awareness of the condition, the CDC believes this increase is also because of the disorder's growing prevalence, which means many more families now have to deal with the effects of ASD.

ASD is a disorder that affects the entire family. It most strongly affects the person diagnosed with ASD, as he or she has to lead a different kind of life than peers. The parents or guardians of those with ASD must cope with the extra care involved in raising a disabled child. Similarly, the siblings of children with ASD sometimes struggle. They may feel sadness, guilt, and even anger because their sibling has this disorder and requires so much care. They may receive less attention from their parents than the sibling with autism.

Despite these challenges, however, most siblings eventually have caring, fruitful relationships with their brother or sister with ASD. They can also seek comfort and help from professional groups and organizations created to assist those in such situations.

ASD and the ASD Diagnosis

Autism spectrum disorder (ASD) is a disorder that is generally characterized by challenges with social interaction, communication, and repetitive movements, behaviors, or ideas. Although most children suffering from ASD have such problems, people with ASD can have different symptoms that range in severity. ASD first affects children during their early developmental period, around age two. Scientists are not sure what causes ASD but know it is linked to genetics and the environment. People should understand that ASD is not contagious like a cold or other illness. They should also realize that it is no one's fault that someone they love has ASD.

The sooner a child is diagnosed with ASD, the better. Early treatment and intervention can help children suffering from ASD. Doctors generally make a diagnosis based on checklists, observations, and input from parents and caretakers. There is not yet a medical test, such as a blood test, to diagnose ASD.

Effects of ASD on Siblings

ASD affects the entire family. Although many studies have been conducted showing the effects of ASD on those who suffer from it and their parents, few studies have focused on how ASD affects siblings. Much of the research that has been conducted on the effects of the disease on siblings has been anecdotal, meaning it is based on individual reports and stories. However, if these findings are to be believed, the siblings of those with ASD are greatly affected by their brother's or sister's disorder.

Siblings of those affected by ASD may have complicated feelings toward their brother or sister. Often, their lives and routines are altered by their siblings' wants and needs. For example, many children with ASD need to follow very particular routines—because of these routines, their siblings may not be able to go on vacations or participate in activities because the family must always adhere to the same schedule. Parents' stress in caring for an autistic child may also affect their other children, whether by changing their normal parent-child interaction or by causing a child to worry at seeing their parents overworked.

Experiences like this can upset siblings of people with ASD and affect their relationships with parents and others. Furthermore, some siblings feel guilty because they are able to lead more normal lives than their ASD-affected brother or sister. In some cases they may attempt to compensate for their affected sibling's inability to perform tasks or chores, potentially increasing their own stress. They may also feel jealous of the attention that their sibling with the disorder receives from their parents (sibling rivalry), or embarrassed around their friends because their family is different. Occasionally a sibling may become a target to a person with ASD displaying aggressive behavior. Younger children who do not understand their sibling's condition may be frustrated that they are unable to interact normally with their brother or sister. Older children may become concerned about the possibility of having to take over as their ASD-affected sibling's caretaker.

Although the siblings of people with ASD do often experience some negative emotions, research suggests that most of these individuals have overall positive, close sibling relationships with their brother or sister despite the challenges. According to a 2012 Easter Seals Siblings Study, 80 percent of people who have a developmentally disabled sibling feel their relationship with that sibling enhances their life. Many people feel protective of their disabled sibling and help care for him or her at home and in social settings.

People with an ASD-affected sibling can have their lives affected in other ways, too. Some people change their daily schedules to help care for their sibling. Others become the primary caretaker of their sibling. This can be like having a full-time job. Giving a sibling this level of care affects people emotionally, mentally, physically, and socially.

Because autism is thought to include a genetic component, siblings of those with ASD are also potentially at a higher risk for this disorder themselves, but scientists still debate the subject. A 2013 study from researchers at Aarhus University in Denmark found that children with a older sibling affected by ASD are seven times likelier to be diagnosed as well, while the CDC provides the broad estimate that an identical twin of someone with autism has a 36 to 95 percent chance of being diagnosed. Parents with an autistic child have also been shown to have an increased risk of having another child with ASD. Several inherited genes have been linked to autism, although no exact cause is known. However, a 2015 study from the Hospital for Sick Children in Canada cast doubt on the inheritability of ASD, finding that almost 70 percent of siblings who both have been diagnosed with ASD in fact have different gene mutations linked to autism and have varying symptoms. This suggests that each case of ASD may be the result of wholly independent factors

Resources and Strategies for Siblings of People with ASD

Supportive parents are the best resource for unaffected siblings as well as those with ASD, so parents should do their best to be informed about caregiving responsibilities and stress management, and help their children develop a life independent of their siblings. Young children must be educated about what autism is, and research suggests that this information should be provided to children of all ages at appropriate levels. For example, younger siblings can simply be made aware of their ASD-affected brother or sister's limitations, such as the inability to speak, while preteens should be given more detailed explanations about the disorder. Repetition is important to ensure that children have an appropriate understanding of the issue rather than simply a familiarity with associated terms.

With ASD-affected individuals and siblings of young ages, parents can take specific steps towards ensuring their children form positive relationships. Researchers suggest that siblings can be easily trained to follow guidelines in order to effectively play with a brother or sister with ASD. By using strategies such as providing easy instructions, giving praise, and maintaining attention, children can often overcome the barriers between a sibling with ASD caused by tantrums or lack of social skills. At the same time, parents must be aware that children need time away from their sibling with autism as well. Children should be allowed time on their own or with peers and individual parental attention.

Older children and adults with ASD-affected siblings can seek out resources and use strategies to help them deal with the problems they encounter. They can look to others who have ASD-affected siblings for support. Talking to people who have had the same experiences can be extremely helpful and can help them justify their feelings. Conversing with others can also give new insight into how to deal with particular issues. National or local support groups exist with the aim of helping siblings of those with disabilities, including The Sibling Support Project of the Arc of the United States, Autism New Jersey, and many others. Siblings of those with ASD may also look for books and websites produced for families with children with ASD. They can also become involved in ASD social media campaigns or community events. Parents must also communicate with their adult children to plan for the long-term care of an ASD-affected family member, including who will become their guardian after the parents' death.

Siblings of children with ASD can also talk to mental health professionals or therapists. These professionals are usually more objective than family members and friends. They give people a safe place to discuss their emotions, thoughts, and experiences. Some mental health professionals even specialize in caring for families with disabled children. They can help family members develop personalized plans to deal with stress or other negative emotions.

It is important for people with ASD-affected siblings to make time for themselves. By making time to care for themselves, these individuals will likely be happier and more supportive of their brother or sister and parents.

Bibliography

“Autism and Developmental Disabilities Monitoring (ADDM) Network.” Centers for Disease Control and Prevention. CDC, 26 Feb. 2015. Web. 10 Mar. 2015.

Baio, Jon. “Prevalence of Autism Spectrum Disorder Among Children Aged 8 Years—Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2010.” Centers for Disease Control and Prevention. CDC, 28 Mar. 2014. Web. 10 Mar. 2015.

Cain, Barbara. “Autism’s Invisible Victims: The Siblings.” Time. Time, 30 Nov. 2012. Web. 10 Mar. 2015.

Harris, Sandra. "Siblings." Autism Society. Autism Society, n.d. Web. 10 Mar. 2015.

“A Message for Teen Brothers and Sisters.” Sibling Support Project. Sibling Support Project, n.d. Web. 10 Mar. 2015.

Scherer, Stephen W., et al. "Whole-Genome Sequencing of Quartet Families with Autism Spectrum Disorder." Nature Medicine 21 (2015): 185–91. Print.

“Siblings.” Autism Science Foundation. Autism Science Foundation, 2015. Web. 10 Mar. 2015.

Why do you think Charles Chestnutt focuses so much on skin color as the backdrop for "The Wife of His Youth"?

"The Wife of His Youth" is the best-known story in Charles Chestnutt's collection regarding the "color line." Of course, legal segregation had drawn a line, separating the lives of black and white people. However, there was also "a line" that was intended to separate light-skinned blacks from dark-skinned ones. It is this distinction on which Chestnutt focuses in the story.

Mr. Ryder, the protagonist, is organizing a ball. He is also known to be "the dean of the Blue Vein Society," an organization of well-to-do light-skinned blacks in some Northern cities. The Blue Vein Society was a real organization. Only black people whose skin was light enough so that their veins were transparent through the skin were allowed into the club. There were other similar social tests to determine one's fitness, such as the "paper bag test." For this one, a standard paper bag was placed over someone's head. If their skin was the same color or lighter than the bag, then they would be granted entry into the society.

During Chestnutt's time, the late-19th and early-20th century, having light skin was associated with being more refined, more educated, and having better manners. In the story, Mr. Ryder is said to have "irreproachable" manners and "poetry was his passion." These aspects of his character, in addition to his ability to throw a ball, indicate that he has had certain opportunities that have been denied to other black people. Moreover, light skin was prized for its proximity to whiteness. Mr. Ryder is said to have "refined" features and "his hair was almost straight." "Refined" features usually indicated European features: an aquiline nose and thin lips. Having these features often allowed people who would have been considered black to "pass" for white.

Later in the story, a darker-skinned black woman comes knocking at Mr. Ryder's door, inquiring as to the whereabouts of her husband, Sam, who turns out to be Mr. Ryder. She is inarticulate and uneducated. We learn that they were married during slavery. She had been sold away, soon after his escape North.

Chestnutt's story ends happily, in that Mr. Ryder and his guests agree to "acknowledge" this woman. Acknowledgement here works in two senses: he acknowledges that this is his wife; she is also acknowledged as a member of their society -- one of their people -- in spite of rules that would disqualify her on the basis of skin color. With this final comment, Chestnutt is saying that the standards of societies such as the Blue Veins are wrong, and that black people are one people who should acknowledge and accept one another, disavowing colorism, or discrimination amongst people of the same race or ethnicity on the basis of skin color.

In this short story, as in numerous others by Chestnutt, skin color is not a "backdrop," but is instead a major theme. His stories examine the ways in which black people had been affected by racism, internalizing white people's beliefs about the inferiority of blackness.

What are dizziness and fainting?

Causes and Symptoms

In humans, several mechanisms have evolved by which adequate blood flow to organs
is maintained. Without a constant blood supply, the body’s tissues would die from
a lack of essential nutrients and oxygen. In particular, the brain and heart are
very sensitive to changes in their blood supply as they, more than any other
organs, must receive oxygen and nutrients at all times. If they do not, their
cells will die and cannot be replaced.

While the heart supplies most of the force needed to propel the blood throughout
the body, tissues rely on changes in the size of arteries to redirect blood flow
to where it is needed most. For example, after a large meal the blood vessels that
lead to the gastrointestinal tract enlarge (vasodilate) so that more blood can be
present to collect the nutrients from the meal. At the same time, the blood
vessels that supply muscles decrease in diameter (vasoconstrict) and effectively
shunt the blood toward the stomach and intestines. During exercise, the blood
vessels that supply the muscles dilate and the ones leading to the intestinal
tract vasoconstrict. This mechanism allows the cardiovascular system to supply the
most blood to the most active tissues.

The brain is somewhat special in that the body tries to maintain a nearly constant
blood flow to it. Located in the walls of the carotid arteries, which carry blood
to the brain, are specialized sensory cells that have the ability to detect
changes in blood
pressure. These cells are known as baroreceptors. If the
blood pressure going to the brain is too low, the baroreceptors send an impulse to
the brain, which in turn speeds up the heart rate and causes a generalized
vasoconstriction. This reflex response raises the body’s blood pressure,
reestablishing adequate blood flow to the brain. If the baroreceptors detect too
high a blood pressure, they send a signal to the brain, which in turn slows the
heart rate and causes the arteries of the body to dilate. These reflexes prevent
large fluctuations in blood flow to the brain and other tissues.

Most people have experienced a dizzy feeling or maybe even a fainting response
when they have stood up too quickly from a prone position. The ability of the
baroreceptors to maintain relatively constant arterial pressure is extremely
important when a person stands after having been lying down. Immediately upon
standing, the pressure in the carotid arteries falls, and a reduction of this
pressure can cause dizziness or even fainting. Fortunately, the falling pressure
at the baroreceptors elicits an immediate reflex, resulting in a more rapid heart
rate and vasoconstriction, minimizing the decrease in blood flow to the brain.

Blood pressure is not the only factor that is essential in maintaining tissue
viability. The accumulation of waste products and a lack of essential nutrients
and gases can also have a profound effect on how much blood flows through a
particular tissue and how quickly. In a region of the carotid arteries near the
baroreceptors are chemoreceptors. Chemoreceptors detect the concentration of the
essential gas oxygen and the concentration of the gaseous waste product
carbon
dioxide. When carbon dioxide concentrations increase and
oxygen concentrations decrease, the chemoreceptors stimulate regions in the brain
to increase the heart rate and blood pressure in an attempt to supply the tissues
with more oxygen and flush away the excess carbon dioxide. If the chemoreceptors
detect high levels of oxygen and low levels of carbon dioxide, an impulse is
transmitted to the brain, which in turn slows the heart rate and decreases the
blood pressure.

Normally, most of the blood flow to the brain is controlled by the baroreceptor and chemoreceptor reflexes. However, the brain has a backup system. If blood flow decreases enough to cause a deficiency of nutrients and oxygen and an accumulation of waste products, special nerve cells respond directly to the lack of adequate energy sources and become strongly excited. When this occurs, the heart is stimulated and blood pressure rises.

Dizziness is a sensation of light-headedness often accompanied by a sensation of
spinning (vertigo). Occasionally, a person experiencing dizziness will
feel nauseated and may even vomit. Most attacks of dizziness are harmless,
resulting from a brief reduction in blood flow to the brain. There are several
causes of dizziness, and each alters blood flow to the brain for a slightly
different reason.

A person rising rapidly from a sitting or lying position may become dizzy. This is
known as postural hypotension, which is caused by a relatively slow reflexive
response to the reduced blood pressure in the arteries providing blood to the
brain. Rising requires increased blood pressure to supply the brain with adequate
amounts of blood. Postural hypotension is more common in the elderly and in
individuals prescribed antihypertensive medicines (drugs used
to lower high blood pressure).

If the patient experiences vertigo with dizziness, the condition is usually caused
by a disorder of the inner ear equilibrium system. Two
disorders of the inner ear that can cause dizziness are labyrinthitis
and Ménière’s
disease. Labyrinthitis, inflammation of the fluid-filled
canals of the inner ear, is usually caused by a virus. Since these canals are
involved in maintaining equilibrium, when they become infected and inflamed, one
experiences the symptom of dizziness. Ménière’s disease is a degenerative disorder
of the ear in which the patient experiences not only dizziness but also
progressive hearing loss.

Some brain-stem disorders also cause dizziness. The brain stem houses the
vestibulocochlear nerve, which transmits messages from the ear to several other
parts of the nervous system. Any disorder that alters the functions of this nerve
will result in dizziness and vertigo. Meningitis (inflammation of the
coverings of the brain and spinal cord), brain tumors,
and blood-flow deficiency disorders such as atherosclerosis may affect the function of the
vestibulocochlear nerve.

Syncope (fainting) is often preceded by dizziness. Syncope
is the temporary loss of consciousness as a result of an inadequate blood flow to
the brain. In addition to losing consciousness, the patient may be pale and
sweaty. The most common cause of syncope is a vasovagal attack, in which an
overstimulation of the vagus nerve slows the heart. Often
vasovagal syncope results from severe pain, stress, or fear. For example, people
may faint when hearing bad news or at the sight of blood. More commonly,
individuals who have received a painful injury will faint. Rarely, vasovagal
syncope may be caused by prolonged coughing, straining to defecate or urinate,
pregnancy, or forcing expiration. Standing still for long
periods of time or standing up rapidly after lying or sitting can cause fainting.
With the exception of vasovagal syncope, all the causes of syncope are
attributable to inadequate blood returning to the heart. If blood pools in the
lower extremities, there is a reduced amount available for the heart to pump to
the brain. In vasovagal syncope and some disorders of heart rhythm such as
Adams-Stokes syndrome, it is the heart itself that does not force enough blood
toward the brain.

Treatment and Therapy

Short periods of dizziness usually subside after a few minutes. Deep breathing and
rest will usually help relieve the symptom. Prolonged episodes of dizziness and
vertigo should be brought to the attention of a physician.

Recovery from fainting likewise will occur when adequate blood flow to the brain is reestablished. This happens within minutes because falling to the ground places the head at the same level as the heart and helps return the blood from the legs. If a person does not regain consciousness within a few minutes, a physician or emergency medical team should be notified.

The most common cause of syncope is decreased cerebral blood flow resulting from
the limitation of cardiac output. When the heart rate falls below its normal
seventy-five beats per minute to approximately thirty-five beats per minute, the
patient usually becomes dizzy and faints. Although slow heart rates can occur in
any age group, they are most often found in elderly people who have other heart
conditions. Drug-induced syncope can also occur. Drugs for congestive heart
failure (digoxin) or antihypertensive medications that slow the heart rate
(propranolol, metoprolol) may reduce blood flow to the brain sufficiently to cause
dizziness and fainting.

Exertional syncope occurs when individuals perform some physical activity to which
they are not accustomed. These physical efforts demand more work from the
cardiovascular system, and in patients with some obstruction of the arteries which
leave the heart, the cardiovascular system is overstressed. This defect, combined
with the vasodilation in the blood vessels that provide blood to the working
muscles, reduces the amount of blood available for use by the brain. If the person
also hyperventilates during exercise, he or she will effectively
reduce the amount of carbon dioxide in the blood and rid the cardiovascular system
of this normal stimulus for increasing heart rate and blood flow to the brain.
Some persons also hold their breath during periods of high exertion. For example,
people attempting to lift something very heavy often take a deep breath just prior
to exerting and then hold their breath when they lift the object. This practice,
known as the Valsalva maneuver, increases the pressure within the chest cavity,
which in turn reduces the amount of blood returning to the heart. A decrease in
blood returning to the heart (venous return) causes a decrease in the availability
of blood to be pumped out of the heart and reduces cardiac output. The reduction
in cardiac output decreases the amount of blood flowing to the brain and initiates
a fainting response. It is interesting to note that humans also use the Valsalva
maneuver when defecating or urinating, particularly when they strain. These acts
can also lead to exertional syncope.

For a physician to diagnose and treat dizziness and fainting accurately, he or she
must take an accurate medical history, paying particular attention to
cardiovascular and neurological problems. In addition to experiencing episodes of
dizziness and fainting, patients often have a weak pulse, low blood pressure
(hypotension), sweating, and shallow breathing. Heart rate and blood pressure are
monitored while the patient assumes different positions. The clinician also
listens to the heart and carotid arteries to determine whether there are any
problems with these tissues, such as a heart valve problem or atherosclerosis of
the carotid arteries. An electrocardiogram (ECG or EKG) can
detect abnormal heart rates and rhythms that may reduce cardiac output. Laboratory
tests are used to determine whether the patient has low blood sugar
(hypoglycemia), too little blood volume (hypovolemia), too
few red blood cells (anemia), or abnormal blood gases
suggesting a lung disorder. Finally, if the physician suspects a neurological
problem such as a seizure disorder, he or she may run an electroencephalogram (EEG) to record brain activity.

Treatment for any of these underlying disorders may cure the dizziness and
fainting episodes. In patients with postural hypotension, merely being aware of
the condition will allow them to change their behavior to lessen the chances of
becoming dizzy and fainting. These patients should not make any sudden changes in
posture that could precipitate an attack. Often, this means simply slowing down
their movements and learning to assume a horizontal position if they feel dizzy.
Patients also can learn to contract their leg muscles and not hold their breath
when rising. This increases the amount of blood available for the heart to pump
toward the brain. If these techniques do not provide an adequate solution for
postural hypotension, then a physician can prescribe drugs to increase blood
pressure.

Heart rhythm disturbances (arrhythmias) that cause an abnormally
fast or slow heart rate can be corrected with drug therapy such as quinidine or
disopyramide (if the rate is too rapid) or a pacemaker (if the rate is too slow).
It is interesting to note that even too fast a heart rate can cause dizziness and
fainting. In patients with this type of arrhythmia, the heart beats at such a
rapid rate that it cannot efficiently fill with blood before the next contraction.
Therefore, less blood is pumped with each beat.

Other treatments for dizziness and fainting may include correcting the levels of
certain blood elements. Patients with hypoglycemia often feel dizzy. The brain and
spinal cord require glucose as their energy source. In fact, the brain and spinal
cord have a very limited ability to utilize other substrates such as fat or
protein for energy. Because of this, patients often feel light-headed when there
are inadequate levels of glucose in the blood. Patients can correct this condition
by eating more frequent meals, and if necessary, physicians can administer drugs
such as epinephrine or glucagon. These agents liberate glucose from storage sites
in the liver.

Individuals with a low blood volume are often dehydrated and upon becoming
rehydrated no longer have dizziness or fainting episodes. If dehydration
is not corrected and becomes worse, the patient can go into shock, a state of
inadequate blood flow to tissues that will result in death if left untreated. In
addition to being dizzy or fainting, the patient is often cold to the touch and
has a rapid heart rate, low blood pressure, bluish skin, and rapid breathing.
These patients are treated by emergency medical personnel, who keep the individual
warm, elevate the legs, and infuse fluid into a vein. Drugs may be used to help
bring blood pressure back to normal. The cause of the shock should be identified
and corrected.

Perspective and Prospects

As humans evolved, they assumed an upright posture. This is advantageous because
it allows for the use of the front limbs for other things besides locomotion.
Unlike most four-legged animals, however, humans have their brains above their
hearts and must continually force blood upwards to reach this vital tissue. This
adaptation to the upright posture is a continuing physiological problem because
the cardiovascular system must counteract the forces of gravity to provide the
brain with blood. If this does not occur, the individual becomes dizzy and
faints.

Another significant problem that humans face is adaptation to brain blood flow
during exercise. The amount of blood flowing to a tissue is usually proportional
to the metabolic demand of the tissue. At rest, various organs throughout the body
receive a certain amount of the cardiac output. For example, blood flow to
abdominal organs such as the spleen and the kidneys requires about 43 percent of
the total blood volume. The total flow to the brain is estimated to be 13 percent,
and the skin and skeletal muscles require 21 percent and 9 percent, respectively.
Other areas such as the gastrointestinal tract and heart receive the remaining 14
percent. During exercise, the skeletal muscles may receive up to 80 percent of the
cardiac output while the rest of the organs are perfused at a much reduced
rate.

Most data indicates that the brain receives only 3 percent of the total cardiac
output during heavy exercise. Even though there is a large change in the
redistribution of cardiac output, physiologists do not know the absolute amount of
blood reaching the brain or the mechanism for the change in the perfusion
rate.

With strenuous aerobic exercise such as jogging, there is an increase in cardiac
output. During strenuous anaerobic exercise such as weight lifting, however, there
may be a decrease in cardiac output, attributable to the Valsalva maneuver.
Therefore, it has been difficult to predict accurately, using available
techniques, the volume of blood reaching this critical tissue.

Bibliography

Babikian, Viken K.,
and Lawrence R. Wechsler, eds. Transcranial Doppler
Ultrasonography. 2nd ed. Boston: Butterworth-Heinemann, 1999.
Print.

Brandt, Thomas.
Vertigo: Its Multisensory Syndromes. 2nd ed. New York:
Springer, 2003. Print.

Furman, Joseph M., and
Stephen P. Cass. Vestibular Disorders: A Case-Study
Approach. 3rd ed. New York: Oxford UP, 2010. Print.

Geelen, G., and J. E.
Greenleaf. “Orthostasis: Exercise and Exercise Training.” Exercise
and Sport Sciences Reviews 21 (1993): 201–30. Print.

Guyton, Arthur C.
Human Physiology and Mechanisms of Disease. 6th ed.
Philadelphia: Saunders, 1997. Print.

Leikin, Jerrold B.,
and Martin S. Lipsky, eds. American Medical Association Complete
Medical Encyclopedia. New York: Random House Reference, 2003.
Print.

What is atherosclerosis? |

Risk Factors

There are two types of factors that increase an individual’s chance of atherosclerosis: risk factors the individual cannot control and risk factors the individual can control.

The National Heart, Lung, and Blood Institute states that some of the risk factors that cannot be controlled as having a father or brother who developed complications of atherosclerosis before age fifty-five, or having a mother or sister who developed complications of atherosclerosis before age sixty-five; men forty-five years of age or older and women fifty-five or older are also at risk. Men have a greater risk of heart attack than women.

Risk factors that can be controlled include having high levels of low-density lipoprotein (LDL), or “bad” cholesterol, and low levels of high-density lipoprotein (HDL), or “good” cholesterol; having high blood pressure; cigarette smoking; diabetes type I and type II; being overweight or obese; and a lack of physical activity.

Metabolic syndrome is a combination of three out of the following five findings: low HDL cholesterol (also called “good” cholesterol), high triglycerides, elevated blood sugar, elevated blood pressure, and an increased waist circumference (greater than forty inches in men and thirty-five inches in women).

Etiology and Genetics

Multiple environmental and genetic factors play a contributing part in atherosclerosis. Some individuals are genetically predisposed to developing the condition, yet a detailed genetic analysis and prediction of inheritance patterns are not possible, since so many different genes seem to be implicated. A 2012 literature review by I. M. Stylianou, R. C. Bauer, M. P. Reilly, and D. J. Rader, published in Circulation Research, indicated that thirty-four candidate gene loci and hundreds of single-nucleotide polymorphisms may be involved in atherosclerosis in humans.

One gene with a clear association with atherosclerosis is APOE, found on the long arm of chromosome 19 at position 19q13.2. APOE encodes the protein apolipoprotein E, which functions to carry excess cholesterol from the blood to receptors on the surface of cells in the liver. Some mutations in the gene lead to altered protein products that lack the ability to bind to the receptors, resulting in a marked increase in an individual’s blood cholesterol.

Studies using deoxyribonucleic acid (DNA)
microarray analyses have implicated another gene, EGR1
(early growth response gene 1), as a contributor to some cases of atherosclerosis. Found on the long arm of chromosome 5 at 5q23–q31, this gene encodes a protein that is an important part of the body’s vascular repair system. When inappropriately active in coronary arteries, the effect is the slow closure of the arteries, leading to angina and possible starvation of heart muscle. This important discovery opened new avenues of research designed to develop drugs targeted to inhibit EGR1 gene expression.

Symptoms

There are no symptoms in early atherosclerosis. As the arteries become harder and narrower, symptoms may begin to appear. If a clot blocks a blood vessel or a large embolus breaks free, symptoms can occur suddenly.

Symptoms depend on which arteries are affected. For example, coronary (heart) arteries may cause symptoms of heart disease, such as chest pain; arteries in the brain may cause symptoms of a stroke, such as weakness or dizziness; and arteries in the lower extremities may cause pain in the legs or feet and trouble walking.

Screening and Diagnosis

Most patients are diagnosed after they develop symptoms. However, patients can be screened and treated for risk factors.

A patient who has symptoms will be asked questions by his or her doctor; these questions will help to determine which arteries might be affected. The doctor will also need to know a patient’s full medical history, and a physical exam will be conducted. Tests will depend on which arteries may be involved; these tests will be decided based on the patient’s symptoms, physical exam, and/or risk factors.

Many of these tests detect problems with the tissue that is not getting enough blood. Two common tests that directly evaluate the atherosclerotic arteries are angiography and ultrasonography. In angiography, a tube-like instrument is inserted into an artery. Dye is injected into the vessel to help determine the degree of blood flow. When done in the heart, this test is called cardiac catheterization. An ultrasound is a test that uses sound waves to examine the inside of the body. In this case, the test examines the size and shape of arteries.

Treatment and Therapy

An important part of treatment for atherosclerosis is reducing risk factors. Beyond that, treatment depends on the area of the body most affected.

Treatment may include medications, such as drugs to interfere with the formation of blood clots, like aspirin or clopidogrel (Plavix); drugs to control blood pressure, if elevated; drugs to lower cholesterol, if elevated; and drugs that improve the flow of blood through narrowed arteries, such as cilostazol (Pletal) or pentoxifylline (Trental).

Procedures involving a thin tube, called a catheter, can also be used. The catheter is inserted into an artery. Catheter-based procedures are most often done for arteries in the heart; they may be used to treat atherosclerosis elsewhere in the body. These procedures include balloon angioplasty, in which a balloon-tipped catheter is used to press plaque against the walls of the arteries, increasing the amount of space for the blood to flow.

Stents are usually done after angioplasty. In this procedure, a wire mesh tube is placed in a damaged artery; it will support the arterial walls and keep them open.

In an atherectomy, instruments are inserted via a catheter. They are used to cut away and remove plaque so that blood can flow more easily. This procedure is not often performed.

Surgical options include endarterectomy—removal of the lining of an artery obstructed with large plaques. This procedure is often done in the carotid arteries of the neck; these arteries bring blood to the brain.

Arterioplasty can repair an aneurysm; it is usually done with synthetic tissue. Bypass is the creation of an alternate route for blood flow using a separate vessel.

Prevention and Outcomes

There are a number of ways to prevent, as well as reverse, atherosclerosis. They include eating a healthful diet that should be low in saturated fat and cholesterol and rich in whole grains, fruits, and vegetables. Patients should exercise regularly, maintain a healthy weight, and lose weight if they are overweight. They should not smoke; if they smoke, they should quit. Patients should also control their diabetes, if present.

If a doctor recommends it, a patient should take medication to reduce his or her risk factors. This may include medicine for high blood pressure or high cholesterol. Patients should also talk to their doctors about screening tests for atherosclerotic disease of the heart (coronary artery disease) if they have risk factors.

Bibliography

American Association for Clinical Chemistry. "APOE Genotyping, Cardiovascular Disease." Lab Tests Online. Amer. Assn. for Clinical Chemistry, 18 Mar. 2014. Web. 22 July 2014.

Ballantyne, Christie M., James H. O’Keefe, and Antonio M. Gotto. Dyslipidemia and Atherosclerosis Essentials. 4th ed. Sudbury: Jones, 2009. Print.

Beers, Mark H., ed. The Merck Manual of Medical Information. 3rd home ed. Whitehouse Station: Merck Research Laboratories, 2009. Print.

Kohlstadt, Ingrid, ed. Food and Nutrients in Disease Management. 2nd ed. Boca Raton: CRC, 2012. Print.

National Heart, Lung, and Blood Institute. "Atherosclerosis." National Institutes of Health. US Dept. of Health and Human Services, 1 July 2011. Web. 22 July 2014.

Roberts, Robert, Ruth McPherson, and Alexandre F. R. Stewart. “Genetics of Atherosclerosis.” Cardiovascular Genetics and Genomics. Ed. Dan Roden. Hoboken: Wiley-Blackwell, 2009. Print.

Rosenbaum, Laurie. "Atherosclerosis." Health Library. EBSCO, 2 May 2014. Web. 14 July 2014.

Stephenson, Frank H. “Atherosclerosis.” DNA: How the Biotech Revolution Is Changing the Way We Fight Disease. Amherst: Prometheus, 2007. Print.

Stylianou, Ioannis M., Robert C. Bauer, Muredach P. Reilly, and Daniel J. Rader. "Genetic Basis of Atherosclerosis: Insights from Mice and Humans." Circulation Research 110 (2012): 337–55. PDF file.

In the short story "The Pedestrian" when the author says the television touched the faces of the people but never really touched them. What does he...

The tombs, ill-lit by television light, where the people sat like the dead, the gray or multicolored lights touching their faces, but never really touching them.

The touching part is fairly straightforward.  A television that is on in a dark room is the only luminous object in the room.  That means it produces light.  The light will travel away from the television at 300,000,000 m/s and hit any opaque object that is in the way....

The tombs, ill-lit by television light, where the people sat like the dead, the gray or multicolored lights touching their faces, but never really touching them.

The touching part is fairly straightforward.  A television that is on in a dark room is the only luminous object in the room.  That means it produces light.  The light will travel away from the television at 300,000,000 m/s and hit any opaque object that is in the way.  A person's face is an opaque object that is in the way, so the light will be touching the person.  

Light is not made of matter, so technically it can't touch anything.  Bradbury is a science guy, so he knows this, but that is not what he means.  What the quote is trying to convey is the fact that the things that the people are watching on television are ultimately empty and meaningless.  Most likely, the people are watching fictional stories about fictional people.  It's entertaining, but meaningless, because no matter what happens on the TV screen, it doesn't affect people and events in "real life."  Either that, or the people are in such a trance-like state that they are no longer "touched" or moved by anything that they see on television anymore.  They have become immune and desensitized.