18.2: Trailblazer
Multimodal Trailblazer: Torika Bolatagici
"I can never deny the deeply personal
place that the work comes from."
Figure \(18.7\) Torika Bolatagici ( https://openstax.org/r/4S3YIw-PFAs ) works to bring attention to indigenous artists. Speculation exists as to the origin of this wall- like stone structure; some believe it was constructed by early peoples of Australia. (credit: “Man-made stone wall” by Rupert Gerritsen/Wikimedia Commons, CC0).
By the end of this section, you will be able to:
- Identify various rhetorical and culture contexts while reading for inquiry, learning, critical thinking, and communication.
- Demonstrate that genre conventions vary and are shaped by purpose, culture, and expectation.
Digital Representations of Embodiment and Cultural Identity
Torika Bolatagici is a creator, educator, and art historian who works with various modalities, including photography ( https://openstax.org/r/photography ), video, fine art, and mixed media ( https://openstax.org/r/ mixed_media). Bolatagici was born in Tasmania and, as a young person, spent time living in Hobart, Tasmania; Sydney, Australia; and her father’s village of Suvavou, Fiji. Her work has been featured across the globe, including in exhibits in the United States, Taiwan, and Mexico as well as throughout New Zealand and Australia. She has a PhD from the School of Art and Design, University of New South Wales, where she wrote her dissertation on “Somatic Sotia: Commodity, Agency and the Fijian Military Body.”
In 2013 and 2014, Bolatagici coordinated the Contemporary Pacific Arts Festival ( https://openstax.org/r/ contemporary_specific), curating an experience that focused on Pacific arts practices in Australia. She invited speakers to present on themes spanning activism and the arts, cultural appropriation, and contemporary artistic practices. Bolatagici now works as an educator, lecturing on art and performance at Deakin University in Australia, and has led youth arts workshops in the local Pacific community.
Reflecting on the beginnings of her career, she describes going through her undergraduate coursework and feeling the responsibility of bringing “brown-ness” to the classroom. After finding that higher education largely dismissed the lived experiences of marginalized communities and spending time at the Stuart Hall Library at the Institute of International Visual Arts, Bolatagici was inspired to create the pop-up Community Reading Room in Melbourne, Australia, in 2013.
Through the pop-up room, she hoped to engage the community in international visual arts and culture. She began her initiative by sharing her own personal collection, including texts and anthologies of BIPOC (Black, Indigenous, and people of color) art. The Community Reading Room provides an emphasis on contemporary art and theory from Africa, the Americas, and Oceania.
Bolatagici has incorporated a variety of media ( https://openstax.org/r/variety ) into her academic and professional portfolios, describing how her work helps her not only represent diverse cultures ( https://openstax.org/r/represent ) but also explore her own identity. From photo essays ( https://openstax.org/r/ photo_essays) to academic papers, her compositions are anchored by the common thread of representing marginalized people and experiences, particularly those related to communities of color. Her creative output has focused on representation of mixed-race identity, Pacific arts practices, and militarism. Through mixed media, she investigates relationships between visual culture and historiography (study of historical writings); human ecology (study of relationships between humans and their natural, social, and created environments); and the intersection of gender, knowledge, and globalization.
Bolatagici describes her work as interdisciplinary, creating components across a wide range of media. Instead of limiting herself, she allows her work to flow naturally, staying focused in the moment. With these unique components, she looks at the relationship between visual culture and human ecology. This interdisciplinary approached emerged for Bolatagici even before she knew it as multimodalism. Because her interests in college varied so greatly, she pursued a media arts degree so that she could explore visual arts as they related to cultural studies. This pursuit grew into a career that now includes new modes and media sources, such as photography, video, and mixed media.
Choosing a multimodal approach because it better communicates the complex subjects she conveys, Bolatagici draws on her own experiences in order to represent the experiences of marginalized people at the forefront of her compositions. For Bolatagici, creating in any form is bigger than the page, and she aims to bring her reality to life through visual, textual, and multimedia creations that communicate in four dimensions.
Read Bolatagici’s weekly journal ( https://openstax.org/r/freshmilk ) during her residency in Barbados.
Discussion Questions
- How does using a multimodal approach allow Bolatagici to communicate her lived experience?
- Why does representation matter in multimodal composition? How has Bolatagici addressed this in her methods?
- What role can multimodal compositions play in exploring experiences beyond your own?
- How can multimodal works at times better communicate aspects of culture and history than literary text alone?
- In what sense is bringing communities together an important aspect of Bolatagici’s work?


4.1: Prelude to Stoichiometry
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Solid-fuel rockets are a central feature in the world’s space exploration programs, including the new Space Launch System being developed by the National Aeronautics and Space Administration (NASA) to replace the retired Space Shuttle fleet (Figure \(\PageIndex{1}\)). The engines of these rockets rely on carefully prepared solid mixtures of chemicals combined in precisely measured amounts. Igniting the mixture initiates a vigorous chemical reaction that rapidly generates large amounts of gaseous products. These gases are ejected from the rocket engine through its nozzle, providing the thrust needed to propel heavy payloads into space. Both the nature of this chemical reaction and the relationships between the amounts of the substances being consumed and produced by the reaction are critically important considerations that determine the success of the technology. This chapter will describe how to symbolize chemical reactions using chemical equations, how to classify some common chemical reactions by identifying patterns of reactivity, and how to determine the quantitative relations between the amounts of substances involved in chemical reactions—that is, the reaction stoichiometry .


10.11: Assignment- Two Independent Samples
The purpose of this activity is to give you guided practice in obtaining and interpreting a 95% confidence interval for μ 1 − μ 2 following a two-sample T-test that rejected H 0 . Recall our second example:
Instructions
Click on the link corresponding to your statistical package to see instructions for completing the activity, and then answer the questions below.
R | StatCrunch | Minitab | Excel | TI Calculator
Question:
Obtain the 95% confidence interval for μ 1 – μ 2 and interpret it in context.
Contributors and Attributions
- Concepts in Statistics. Provided by : Open Learning Initiative. Located at : http://oli.cmu.edu . License : CC BY: Attribution


11.1.1D: Social Definition of Race
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Most social scientists and biologists believe race is a social construct affecting sociopolitical, legal, and economic contexts.
Learning Objectives
- Identify two ways, other than “race,” that social researchers conceptualize and analyze human variation
Key Points
- A social construct refers to something that does not have a basis in the natural world but is an artificial distinction created by humans.
- Some researchers now conceptualize and analyze human variation in terms of populations, dismissing racial classifications altogether.
- Many social scientists have replaced the word ” race ” with the word ” ethnicity ” to refer to groups that self-identify based on shared religion, nationality, or culture.
- Ethnicity refers to groups that self-identify based on shared beliefs, culture, ancestry, and history.
Key Terms
- population : A count of the number of residents within a political or geographical boundary, such as a town, a nation, or the world or of the number of individuals belonging to a particular group.
- ethnicity : The identity of a group of people having common racial, national, religious, or cultural origins.
- social construct : Social constructs are generally understood to be the by-products of countless human choices rather than laws resulting from divine will or nature.
Debates continue in and among academic disciplines as to how race should be understood. Most social scientists and biologists believe race is a social construct, meaning it does not have a basis in the natural world but is simply an artificial distinction created by humans.
As a result of this understanding, some researchers have turned from conceptualizing and analyzing human variation by race to doing so in terms of populations, dismissing racial classifications altogether. In the face of the increasing rejection of race as a valid classification scheme, many social scientists have replaced the word race with the word “ethnicity” to refer to self-identifying groups based on shared religion, nationality, or culture.
History
Following the World War II, alongside empirical and conceptual problems with “race,” evolutionary and social scientists were acutely aware of how beliefs about race had been used to justify discrimination, apartheid, slavery, and genocide. This questioning gained momentum in the 1960s during the United States ‘ civil rights movement and the emergence of numerous anti-colonial movements worldwide. Many academics and researchers across disciplines, therefore, came to the conclusion that race itself is a social construct.
As anthropologists and other evolutionary scientists have shifted away from the language of race to the term “population” to talk about genetic differences, historians, cultural anthropologists and other social scientists have accordingly re-conceptualized the term “race” as exclusively a cultural category or social construct. Many social scientists have also replaced the word race with the word “ethnicity” to refer to self-identifying groups based on beliefs concerning shared culture, ancestry and history.
Race as a Social Construct
The social construction of race has developed within various legal, economic, and sociopolitical contexts, and may be the effect, rather than the cause of major race-related issues. While race is understood to be a social construct by many, most scholars agree that race has real, material effects in housing discrimination, in the legal process, in policing practices, in education, and many other domains of society.
Sociologists Omi and Winant’s theories of racial formation describe how “race is a concept which signifies and symbolizes social conflicts and interests by referring to different types of human bodies. ” The meanings and implications of race are produced and invested in by social institutions, as well as through cultural representations.


4.8: Checklist for Applying and Removing Sterile Gloves
Use the checklist below to review the steps for completion of “Applying and Removing Sterile Gloves.”
Steps
Disclaimer: Always review and follow agency policy regarding this specific skill.
- Gather the supplies: hand sanitizer and sterile gloves.
- Perform hand hygiene.
- Open the sterile gloves on a dry, flat, clean work surface.
- Remove the outer package by separating and peeling apart the sides of the package.
- Grasp the inner package and lay it on a clean, dry, flat surface at waist level.
- Open the top flap away from your body; open the bottom flap toward your body.
- Open the side flaps without contaminating the inside of the wrapper or allowing it to close.
- With your nondominant hand, use your thumb and index finger to only grasp the inside surface of the cuff of the glove for your dominant hand.
- Lift out the glove, being careful to not touch any surfaces and holding the glove no more than 12-18″ above the table without contaminating the sterile glove; carefully pull the glove over your hand.
- Use your nondominant, nonsterile hand to grasp the flap of the package, and hold the package steady. With the sterile glove on your dominant hand, hold 4 fingers together of the gloved hand to reach in the outer surface of the cuff of the sterile glove, reaching under the folded cuff and with the thumb outstretched to not touch the second sterile glove. Lift the glove off the package without breaking sterility.
- While holding the fingers of the nondominant hand outstretched and close together, tuck your thumb into the palm, and use the sterile dominant hand to pull the second sterile glove over the fingers of the nondominant hand.
- After the second sterile glove is on, interlock the fingers of your sterile gloved hands, being careful to keep your hands above your waist.
- Do not touch the inside of the package or the sterile part of the gloves with your bare hands during the process.
- Maintain sterility throughout the procedure of donning sterile gloves.
Removing Sterile Gloves
- Grasp the outside of one cuff with the other gloved hand. Avoid touching your skin.
- Pull the glove off, turning it inside out and gather it in the palm of the gloved hand.
- Tuck the index finger of your bare hand inside the remaining glove cuff and peel the glove off inside out and over the previously removed glove.
- Dispose of contaminated wastes appropriately.
- Perform hand hygiene.


6.6: Instilling Eye, Ear, and Nose Medications
Instilling Eye Medications
The eye is the most sensitive organ to which medication may be applied (Perry et al., 2014). The cornea is especially sensitive, making the conjunctival sac the appropriate site for instilling eye (ophthalmic) medications.
Checklist 48 outlines the steps for instilling eye medications.
Checklist 48: Instilling Eye (Ophthalmic) MedicationsDisclaimer: Always review and follow your hospital policy regarding this specific skill. |
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Safety considerations:
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Steps |
Additional Information |
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| 1. Check MAR against doctor’s orders. |
Check that MAR and doctor’s orders are consistent. Night staff usually complete and verify this check as well. |
||
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2. Perform the SEVEN RIGHTS x 3 (must be done with each individual medication):
Medication calculation: D/H x S = A ( D or d esired dosage/ H or h ave available x S or s tock = A or a mount prepared) |
The right patient: check that you have the correct patient using two patient identifiers (e.g., name and date of birth). The right medication (drug): check that you have the correct medication and that it is appropriate for the patient in the current context. The right dose: check that the dose makes sense for the age, size, and condition of the patient. Different dosages may be indicated for different conditions. The right route: check that the route is appropriate for the patient’s current condition. The right time: adhere to the prescribed dose and schedule. The right reason: check that the patient is receiving the medication for the appropriate reason. The right documentation: always verify any unclear or inaccurate documentation prior to administering medications. NEVER document that you have given a medication until you have actually administered it. |
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3. The label on the medication must be checked for name, dose, and route, and compared with the MAR at three different times:
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These checks are done before administering the medication to your patient. If taking drug to bedside (e.g., eye drops), do third check at bedside. |
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| 4. Before instilling eye medication, offer a tissue to the patient. | Drops may spill from the eye with administration. | ||
| 5. Wear clean non-sterile gloves. | Using gloves protects the nurse from potential contact with patient body fluids and medications. | ||
| 6. Cleanse the eyelashes and eyelids of any drainage or crusting with a warm washcloth or gauze. Use each area of cleaning surface only once and move from inner to outer eye area. | Cleansing removes debris from eye area. | ||
| 7. Tilt patient’s head back slightly if patient is sitting up, or place patient’s head over a pillow (under the neck) if they are lying down. |
Tilting the head back makes it easier to reach the conjunctival sac for instilling drops.
Do not tilt head back if patient has a cervical spine injury. |
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| 8. Invert the eye-drop container and have patient look up and focus on something on the ceiling. | Keeping the eye focused will help keep it still. | ||
| 9. Gently pull patient’s lower lid down, using thumb or two fingers to expose conjunctival sac. | Place eye drop in conjunctival sac, not directly on eyeball (cornea). | ||
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10. Eye drops: Hold eye-drop container above eye, taking care not to touch the eye, eyelids, or eyelashes. Instill one drop or more, if prescribed, into conjunctival sac.
Eye ointment: Apply about 1.5 cm of ointment along conjunctival sac, moving from inner to outer canthus. Twist tube to break off ribbon of ointment. |
Touching the tip of the container to anything can contaminate the medication. | ||
| 11. Release lower lid after instillation and ask patient to close eyes gently. Ask patient to move the eyeball while eyes are closed. | This step allows the medication to be distributed across the eye. | ||
| 12. Eye drops only: apply gentle pressure over inner canthus for 30 to 60 seconds to prevent medication from entering the lacrimal duct. | This minimizes the systemic effects of the medication. | ||
| 13. Instruct patient not to rub eye. | This is to prevent irritation and injury to the eye. | ||
| 14. Remove gloves and assist patient to a comfortable and safe position. | This ensures patient safety and comfort. | ||
| 15. Perform hand hygiene. | Hand hygiene prevents the spread of microorganisms. | ||
| 16. Document as per agency policy. Include date, time, dose, route; which eye the medication was instilled into; and patient’s response to procedure. | Timely and accurate documentation helps to ensure patient safety. | ||
| Data source: BCIT, 2015; Lilley et al., 2011; Perry et al., 2014 |
Instilling Ear Medications
Internal ear structures are particularly sensitive to temperature extremes. Therefore, ear (otic) medications should always be administered at room temperature. Always use sterile ear drops in case the ear drum is ruptured.
Checklist 49 outlines the steps for instilling ear medications.
Checklist 49: Instilling Ear (Otic) MedicationsDisclaimer: Always review and follow your hospital policy regarding this specific skill. |
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Safety considerations:
|
|||
Steps |
Additional Information |
||
| 1. Check MAR against doctor’s orders. |
Check that MAR and doctor’s orders are consistent. Night staff usually complete and verify this check as well. |
||
2. Perform the SEVEN RIGHTS x 3 (must be done with each individual medication):
Medication calculation: D/H x S = A ( D or d esired dosage/ H or h ave available x S or s tock = A or a mount prepared) |
The right patient: check that you have the correct patient using two patient identifiers (e.g., name and date of birth). The right medication (drug): check that you have the correct medication and that it is appropriate for the patient in the current context. The right dose: check that the dose makes sense for the age, size, and condition of the patient. Different dosages may be indicated for different conditions. The right route: check that the route is appropriate for the patient’s current condition. The right time: adhere to the prescribed dose and schedule. The right reason: check that the patient is receiving the medication for the appropriate reason. The right documentation: always verify any unclear or inaccurate documentation prior to administering medications. NEVER document that you have given a medication until you have actually administered it. |
||
3. The label on the medication must be checked for name, dose, and route, and compared with the MAR at three different times:
|
These checks are done before administering the medication to your patient. If taking drug to bedside (e.g., eye drops), do third check at bedside. |
||
| 4. Before instilling ear drops, don clean non-sterile gloves. | Using gloves protects the nurse from potential contact with patient body fluids and medications. | ||
| 5. Cleanse external ear of any drainage using a warm wet washcloth. | Drainage or debris may prevent some medication from entering ear canal. | ||
| 6. Position patient with affected ear uppermost, on unaffected side if lying down, or tilt head to side if sitting up. |
Proper positioning helps to stop medication from escaping.
Do not tilt head if patient has a cervical spine injury. |
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7. Draw up medication into ear dropper, ensuring correct dosage.
Do not return excess medication to stock bottle. |
Risk for contamination is increased if medication is returned to bottle. | ||
| 8. Gently pull ear pinna back and up for an adult. | Pulling the pinna straightens ear canal. | ||
| 9. Hold dropper tip just above ear canal. Do not touch dropper tip to ear. | Touching the ear with the dropper tip will contaminate the dropper and the medication. | ||
| 10. Allow drops to fall on the side of the ear canal. | Dropping the drops directly into the canal and onto the tympanic membrane will cause the patient discomfort. | ||
| 11. Release ear pinna and have patient remain in the position for at least 5 minutes. | This position prevents medication from escaping from ear. | ||
| 12. Apply gentle pressure to tragus several times. | Pressure helps move medication toward tympanic membrane. | ||
| 13. If ordered, a cotton ball may be placed loosely in the ear canal. | Cotton ball helps prevent medication from escaping from ear. | ||
| 14. Remove gloves and assist patient to a comfortable and safe position. | This ensures patient safety and comfort. | ||
| 15. Perform hand hygiene. | Hand hygiene prevents the spread of microorganisms. | ||
| 16. Document as per agency policy. Include date, time, dose, route; which ear the medication was instilled into; and patient’s response to procedure. | Timely and accurate documentation helps to ensure patient safety. | ||
| Data source: BCIT, 2015; Lilley et al., 2011; Perry et al., 2014 |
Instilling Nasal Medications
Nasal medications are instilled for the treatment of allergies, nasal congestion, and sinus infections. The nose is not a sterile cavity, but medical asepsis must be observed because of its connection to the sinuses.
Checklist 50 outlines the steps for instilling nasal medications.
Checklist 50: Instilling Nasal MedicationsDisclaimer: Always review and follow your hospital policy regarding this specific skill. |
|||
Safety considerations:
|
|||
Steps |
Additional Information |
||
| 1. Check MAR against doctor’s orders. |
Check that MAR and doctor’s orders are consistent. Night staff usually complete and verify this check as well. |
||
2. Perform the SEVEN RIGHTS x 3 (must be done with each individual medication):
Medication calculation: D/H x S = A ( D or d esired dosage/ H or h ave available x S or s tock = A or a mount prepared) |
The right patient: check that you have the correct patient using two patient identifiers (e.g., name and date of birth).
The right medication (drug): check that you have the correct medication and that it is appropriate for the patient in the current context. The right dose: check that the dose makes sense for the age, size, and condition of the patient. Different dosages may be indicated for different conditions. The right route: check that the route is appropriate for the patient’s current condition. The right time: adhere to the prescribed dose and schedule. The right reason: check that the patient is receiving the medication for the appropriate reason. The right documentation: always verify any unclear or inaccurate documentation prior to administering medications. NEVER document that you have given a medication until you have actually administered it. |
||
3. The label on the medication must be checked for name, dose, and route, and compared with the MAR at three different times:
|
These checks are done before administering the medication to your patient. If taking drug to bedside (e.g., eye drops), do third check at bedside. |
||
| 4. Before instilling nasal medication, don clean non-sterile gloves. | Using gloves protects the nurse from potential contact with patient body fluids and medications. | ||
| 5. Provide patient with tissues and ask that they blow their nose. | This clears the nose prior to medication instillation. | ||
| 6. Position patient sitting back or lying down with head tilted back over a pillow (underneath neck). |
This position allows medication to flow back into nasal cavity.
Do not tilt head back if patient has a cervical spine injury. |
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| 7. Nose drops: draw fluid into medication dropper with enough for both nares. Do not return excess fluid into stock bottle. | Returning fluid to stock bottle increases risk for contamination of medication. | ||
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8. Ask patient to breathe through the mouth.
Nose drops: hold dropper about 1 cm above naris and drop medication into one naris and then the other. Nasal spray: have patient hold one nostril closed and breathe gently through the other as the spray is being administered. Do not touch the naris with the dropper/spray bottle. |
Breathing through the mouth will help prevent aspiration of the medication. Touching the naris with the dropper/spray tip will contaminate the dropper/spray bottle and the medication. |
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| 9. Position patient with head back for 2 to 3 minutes. | This position prevents escape of the medication. | ||
| 10. Remove gloves and assist patient to a comfortable and safe position. | This ensures patient safety and comfort. | ||
| 11. Perform hand hygiene. | Hand hygiene prevents the spread of microorganisms. | ||
| 12. Document as per agency policy. Include date, time, dose, route; which naris the medication was instilled into (or whether it was both nares); and patient’s response to procedure. | Timely and accurate documentation helps to ensure patient safety. | ||
| Data source: BCIT, 2015; Lilley et al., 2011; Perry et al., 2014 |
Critical Thinking Exercises
- Your patient is due to receive a dose of medication instilled into both ears. You find the ear medication stored in the refrigerator. How should you proceed?
- Your patient is due to receive medication instilled into her right eye, but you notice that her left eye has crusting and discharge. Discuss how you would proceed in this situation.
- Your patient is to receive nasal drops for a sinus infection. Describe how you would position this patient to receive the nasal drops.


2.3: The Axial Skeleton
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The axial skeleton functions to support and protect the organs of the dorsal and ventral cavities and serves as a surface for the attachment of muscles and parts of the appendicular skeleton.
Learning Objectives
- List the components of the axial skeleton
Key Points
- The axial skeleton is the part of the skeleton that consists of the bones of the head and trunk of a vertebrate animal, including humans.
- The primary divisions of the skeleton system are the head, thorax, and vertebral column.
- The human cranium supports the structures of the face and forms the brain cavity.
- The rib cage functions as protection for the vital organs of the chest such as the heart and lungs.
- The cervical vertebrae make up the junction between the vertebral column and the cranium, and the bone makes up the junction between the vertebral column and the pelvic bones.
Key Terms
- flat bones : Thin bones (although often curved) that serve as points of attachment for muscles and protect internal organs (examples, cranium, sternum).
- cranial vault : The space in the skull occupied by the brain.
- sutures : Fibrous joints that are only found in the cranium.
The axial skeleton is the part of the skeleton that consists of the bones of the head and trunk of a vertebrate animal, including humans.
Axial skeleton : Image depicting the human skeleton with the axial skeleton.
The word axial is from the word axis, and refers to how the bones of the axial skeleton are located along the central axis of the body.
The axial skeleton functions to support and protect the organs of the dorsal and ventral cavities. It also serves as a surface for the attachment of muscles and parts of the appendicular skeleton.
The human’s axial skeleton is composed of 80 bones and is the central core of the body. The primary divisions of the skeleton system are:
- Head, including the bones of the skull (cranium), face, auditory ossicles, and hyoid bone.
- Thorax, including the rib cage and sternum.
- Vertebral column.
Bones of the Head
Skull (Cranium)
The human cranium consists of the flat bones of the cranium and includes the facial bones. The cranium protects the brain that is contained in the cranial vault. The cranium is formed from eight bones connected by sutures.
Fourteen facial bones form the lower front part of the cranium. Important facial bones include the lower jaw or mandible, the upper jaw or maxilla, the zygomatic or cheek bone, and the nasal bone.
The immature cranium has separate plates to allow the flexibility needed for a newborn to pass through the birth canal and pelvis.
These plates fuse as the skull matures (except the mandible). The human cranium supports the structures of the face and forms the brain cavity.
Ossicle
The ossicles (also called auditory ossicles) consist of three bones (malleus, incus, and stapes) that are the smallest in the body. These are located in the middle ear and serve to transmit sounds from the air to the fluid-filled labyrinth.
Hyoid Bone
The hyoid bone is a horseshoe-shaped bone situated in the anterior midline of the neck between the chin and the thyroid cartilage. It provides attachment to the muscles of the floor of the mouth, the tongue above, larynx below, and the epiglottis and pharynx behind.
Rib Cage
The rib cage is composed of 25 bones that include the 12 pairs of ribs plus the sternum. It functions as protection for the vital organs of the chest, such as the heart and lungs. The rounded ends are attached at joints to the thoracic vertebrae posteriorly and the flattened ends come together at the sternum anteriorly.
The first seven pairs of ribs attach to the sternum with costal cartilage and are known as true ribs. Thelength of each rib pair increases from number one to seven. After rib seven, the size begins to decrease. The 8th through 10th ribs have noncostal cartilage that connects them to the ribs above.
The last two ribs are called floating ribs because they do not attach to the sternum or to other ribs.
Vertebral Column
There are normally thirty-three vertebrae in the human vertebral column. The upper twenty-four articulate and are unfused, the lower nine are fused. The fused vertebrae are the five in the sacrum and four in the coccyx.
The articulating vertebrae are named according regions:
- Cervical vertebrae (seven vertebrae).
- Thoracic (twelve vertebrae).
- Lumbar (five vertebrae).
The first and second cervical vertebrae are the atlas and axis, respectively, on which the head rests. The cervical vertebrae make up the junction between the vertebral column and the cranium, and the bone makes up the junction between the vertebral column and the pelvic bones.


29.18A: Ectopic Pregnancy
An ectopic pregnancy is implantation and development of the embryo outside the uterus, typically in the fallopian tubes.
- Identify the factors involved in ectopic pregnancies
Key Points
- An ectopic pregnancy, or eccysis, is a complication of pregnancy in which the embryo implants outside the uterine cavity. With rare exceptions, ectopic pregnancies are not viable. Furthermore, they are dangerous for the mother, since internal haemorrhage is a life threatening complication.
- Most ectopic pregnancies occur in the Fallopian tube (called tubal pregnancies), but implantation can also occur in the cervix, ovaries, and abdomen. An ectopic pregnancy is a potential medical emergency, and, if not treated properly, can lead to death.
- If left untreated, about half of ectopic pregnancies will resolve without treatment and are called tubal abortions.
- A heterotopic pregnancy occurs when there are two fertilized eggs, one outside the uterus and the other inside.
- The mortality rate from ectopic pregnancies in Western countries is very low (less than one percent), but in underdeveloped countries, especially in Africa, the maternal death rate is extremely high and are a major cause of death among women of childbearing age.
Key Terms
- heterotopic pregnancy : A heterotopic pregnancy is a rare complication of pregnancy in which both extra-uterine (ectopic pregnancy) and intrauterine gestation occur simultaneously.
- ectopic pregnancy : A pregnancy in which the fertilized ovum is implanted in any tissue other than the uterine wall.
An ectopic pregnancy, or eccysis, is a complication of pregnancy in which the embryo implants outside the uterine cavity. With rare exceptions, ectopic pregnancies are not viable. Furthermore, they are dangerous for the mother, since internal haemorrhage is a life threatening complication that may result. Most ectopic pregnancies occur in the Fallopian tube (so-called tubal pregnancies), but implantation can also occur in the cervix, ovaries, and abdomen. An ectopic pregnancy is a potential medical emergency, and, if not treated properly, can lead to death.
In a normal pregnancy, the fertilized egg enters the uterus and settles into the uterine lining where it has plenty of room to divide and grow. About 1% of pregnancies are in an ectopic location with implantation not occurring inside of the womb; of these pregnancies, 98% occur in the Fallopian tubes.
Detection
Detection of ectopic pregnancy in early gestation has been achieved mainly due to enhanced diagnostic capability. Despite all these notable successes in diagnostics and detection techniques ectopic pregnancy remains a source of serious maternal morbidity and mortality worldwide, especially in countries with poor prenatal care.
Treatment
Ectopic pregnancy : schematic view of ectopic pregnancy
In a typical ectopic pregnancy, the embryo adheres to the lining of the fallopian tube and burrows into the tubal lining. Most commonly, this invades vessels and will cause bleeding. This intratubal bleeding hematosalpinx expels the implantation out of the tubal end as a tubal abortion. Tubal abortion is a common type of miscarriage. There is no inflammation of the tube in ectopic pregnancy. The pain is caused by prostaglandins released at the implantation site, and by free blood in the peritoneal cavity, which is a local irritant. Sometimes the bleeding might be heavy enough to threaten the health or life of the woman. Usually, this degree of bleeding is due to delay in diagnosis, but sometimes, especially if the implantation is in the proximal tube (just before it enters the uterus), it may invade into the nearby Sampson artery, causing heavy bleeding earlier than usual.
If left untreated, about half of ectopic pregnancies will resolve without treatment. These are the tubal abortions. The advent of methotrexate treatment for ectopic pregnancy has reduced the need for surgery; however, surgical intervention is still required in cases where the Fallopian tube has ruptured or is in danger of doing so. This intervention may be laparoscopic or through a larger incision, known as a laparotomy.
While a fetus of ectopic pregnancy is typically not viable, very rarely, a live baby has been delivered from an abdominal pregnancy. In such a situation the placenta sits on the intraabdominal organs or the peritoneum and has found sufficient blood supply. This is generally bowel or mesentery, but other sites, such as the renal (kidney), liver or hepatic (liver) artery or even aorta have been described.
In rare cases of ectopic pregnancy, there may be two fertilized eggs, one outside the uterus and the other inside. This is called a heterotopic pregnancy. Often the intrauterine pregnancy is discovered later than the ectopic, mainly because of the painful emergency nature of ectopic pregnancies. Since ectopic pregnancies are normally discovered and removed very early in the pregnancy, an ultrasound may not find the additional pregnancy inside the uterus. When hCG levels continue to rise after the removal of the ectopic pregnancy, there is the chance that a pregnancy inside the uterus is still viable. This is normally discovered through an ultrasound.
Risk Factors
There are a number of risk factors for ectopic pregnancies. However, in as many as one third to one half of ectopic pregnancies, no risk factors can be identified. Risk factors include: pelvic inflammatory disease, infertility, use of an intrauterine device (IUD), previous exposure to DES, tubal surgery, intrauterine surgery (e.g., D&C), smoking, previous ectopic pregnancy, and tubal ligation.
Prognosis
The prognosis in Western countries is very good; maternal death is rare. For instance, in the UK, between 2003 and 2005 there were 32,100 ectopic pregnancies resulting in 10 maternal deaths (meaning that 1 in 3,210 women with an ectopic pregnancy died). In the developing world, however, especially in Africa, the death rate is very high, and ectopic pregnancies are a major cause of death among women of childbearing age.
Fertility following ectopic pregnancy depends upon several factors, the most important of which is a prior history of infertility. The treatment choice, whether surgical or nonsurgical, also plays a role. For example, the rate of intrauterine pregnancy may be higher following methotrexate compared to surgical treatment. Rate of fertility may be better following salpingostomy than salpingectomy.


27.7C: Adjustments of the Infant at Birth
Post birth, an infant’s physiology must adapt to breathing independently, changes in blood flow and energy access, and a cold environment.
- Analyze the perinatal adjustments of the infant
Key Points
- Following birth, the newborn’s lungs inflate and respiration begins to occur through the pulmonary system. The subsequent changes to oxygenated blood flow that occur follow the adult pattern of circulation.
- The energy metabolism of the infant is also quickly converted from a continuous placental supply to intermittent feeding. Glycogen stores created during the second and third trimesters of pregnancy are relied upon for energy during the first few days following birth.
- Physiological changes occur via thermoregulation to maintain core temperature including: vasoconstriction (a decrease of blood flow to skin), maintaining the fetal position (a decrease of the surface area of exposure), jittery large muscle activity (to generate muscular heat), and non-shivering thermogenesis.
Key Terms
- respiratory distress syndrome : Infant respiratory distress syndrome (IRDS), also called neonatal respiratory distress syndrome or respiratory distress syndrome (previously called hyaline membrane disease), is a syndrome in premature infants caused by the developmental insufficiency of surfactant production and structural immaturity in the lungs. It can also result from a genetic problem with the production of surfactant-associated proteins.
- surfactant : A lipoprotein in the tissues of the lung that reduces surface tension and permits more efficient gas transport.
- non-shivering thermogenesis : The process of heat production in organisms. Non-shivering thermogenesis usually occurs in brown adipose tissue (brown fat) that is present in human infants and hibernating mammals.
The first challenge of a newborn is to perfuse its body by breathing independently instead of utilizing placental oxygen. At birth, the baby’s lungs are filled with fetal lung fluid (which is not amniotic fluid) and are not inflated.
As the newborn is expelled from the birth canal, its central nervous system reacts to the sudden change in temperature and environment. This triggers it to take the first breath within about 10 seconds of delivery.
With the first breaths, there is a fall in pulmonary vascular resistance and an increase in the surface area available for gas exchange. Over the next 30 seconds, the pulmonary blood flow increases and is oxygenated as it flows through the alveoli of the lungs. Oxygenated blood now reaches the left atrium and ventricle and, through the descending aorta, reaches the umbilical arteries.
Respiration and Circulation
Oxygenated blood now stimulates constriction of the umbilical arteries resulting in a reduction in placental blood flow. As the pulmonary circulation increases, there is an equivalent reduction in the placental blood flow that normally ceases completely after about three minutes. These two changes result in a rapid redirection of blood flow into the pulmonary vascular bed, from approximately 4% to 100% of cardiac output.
The increase in pulmonary venous return results in left atrial pressure being slightly higher than right atrial pressure, which closes the foramen ovale. This change in the pattern of flow results in a drop in blood flow across the ductus arteriosus.
The higher blood oxygen content of blood within the aorta stimulates the constriction and ultimately the closure of this fetal circulatory shunt. All of these cardiovascular system changes result in the adaptation from fetal circulation patterns to an adult circulation pattern.
During this transition, some types of congenital heart diseases that were not symptomatic in utero during fetal circulation will present with cyanosis or respiratory signs.
Following birth, the expression and re-uptake of surfactant, which begins production at 20 weeks gestation, is accelerated. Expression of surfactant into the alveoli is necessary to prevent alveolar closure.
At this point, rhythmic breathing movements also commence. If there are any problems with breathing, management can include stimulation, bag and mask ventilation, intubation, and ventilation. Cardiorespiratory monitoring is essential to track potential problems.
Pharmacological therapy, such as caffeine, can also be given to treat apnea in premature newborns. A positive airway pressure should be maintained and neonatal sepsis must be ruled out. Potential neonatal respiratory problems include apnea, transient tachypnea of the newborn (TTNB), respiratory distress syndrome (RDS), meconium aspiration syndrome (MAS), airway obstruction, and pneumonia.
Energy Requirements
The energy metabolism of the fetus must be converted from a continuous placental supply of glucose to intermittent feeding. While the fetus is dependent on maternal glucose as the main source of energy, it can use lactate, free fatty acids, and ketone bodies under some conditions. Plasma glucose is maintained by glycogenolysis.
Glycogen synthesis in the liver and muscle begins in the late second trimester of pregnancy, and storage is completed in the third trimester. Glycogen stores are maximal at term, but even then, the fetus only has enough glycogen available to meet its energy needs for 8–10 hours, which can be depleted even more quickly if the demand is high.
Newborns will then rely on gluconeogenesis for energy. Fat stores are the largest storage source of energy. At 27 weeks gestation, only 1% of a fetus’ body weight is fat. At 40 weeks, that number increases to 16%.
Inadequate glucose substrate can lead to hypoglycemia, fetal growth restriction, preterm delivery, or other problems. Similarly, an excess substrate can also lead to problems, such as infant of a diabetic mother (IDM), hypothermia, or neonatal sepsis.
Anticipating potential problems is the key to managing most neonatal problems of energy metabolism. For example, early feeding in the delivery room or as soon as possible may prevent hypoglycemia. If the blood glucose is still low, then an intravenous (IV) bolus of glucose may be delivered, with continuous infusion if necessary. Rarely, steroids or glucagon may have to be employed.
Environmental Temperature
Infant in incubator : Infants, especially preterm infants, have trouble regulating their body temperature. Placement in an incubator allows them to adjust without draining their energy stores.
Newborns come from a warm environment to the cold and fluctuating temperatures of this world.
Physiologic mechanisms for preserving core temperature include vasoconstriction (a decrease of blood flow to the skin), maintaining the fetal position (a decrease of the surface area exposed to the environment), jittery large muscle activity (to generate muscular heat), and non-shivering thermogenesis.
Non-shivering thermogenesis occurs in brown fat. Brown fat is specialized adipose tissue with a high concentration of mitochondria designed to rapidly oxidize fatty acids in order to generate metabolic heat. The newborn’s capacity to maintain these mechanisms is limited, especially in premature infants.
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8.3: Parts of the Brain Involved with Memory
Learning Objectives
- Explain the brain functions involved in memory
- Recognize the roles of the hippocampus, amygdala, and cerebellum
Are memories stored in just one part of the brain, or are they stored in many different parts of the brain? Karl Lashley began exploring this problem, about \(100\) years ago, by making lesions in the brains of animals such as rats and monkeys. He was searching for evidence of the engram : the group of neurons that serve as the “physical representation of memory” (Josselyn, 2010). First, Lashley (1950) trained rats to find their way through a maze. Then, he used the tools available at the time—in this case a soldering iron—to create lesions in the rats’ brains, specifically in the cerebral cortex. He did this because he was trying to erase the engram, or the original memory trace that the rats had of the maze.
Lashley did not find evidence of the engram, and the rats were still able to find their way through the maze, regardless of the size or location of the lesion. Based on his creation of lesions and the animals’ reaction, he formulated the equipotentiality hypothesis : if part of one area of the brain involved in memory is damaged, another part of the same area can take over that memory function (Lashley, 1950). Although Lashley’s early work did not confirm the existence of the engram, modern psychologists are making progress locating it. Eric Kandel, for example, spent decades working on the synapse, the basic structure of the brain, and its role in controlling the flow of information through neural circuits needed to store memories (Mayford, Siegelbaum, & Kandel, 2012).
Many scientists believe that the entire brain is involved with memory. However, since Lashley’s research, other scientists have been able to look more closely at the brain and memory. They have argued that memory is located in specific parts of the brain, and specific neurons can be recognized for their involvement in forming memories. The main parts of the brain involved with memory are the amygdala, the hippocampus, the cerebellum, and the prefrontal cortex.
The Amygdala
First, let’s look at the role of the amygdala in memory formation. The main job of the amygdala is to regulate emotions, such as fear and aggression ( Figure ). The amygdala plays a part in how memories are stored because storage is influenced by stress hormones. For example, one researcher experimented with rats and the fear response (Josselyn, 2010). Using Pavlovian conditioning, a neutral tone was paired with a foot shock to the rats. This produced a fear memory in the rats. After being conditioned, each time they heard the tone, they would freeze (a defense response in rats), indicating a memory for the impending shock. Then the researchers induced cell death in neurons in the lateral amygdala, which is the specific area of the brain responsible for fear memories. They found the fear memory faded (became extinct). Because of its role in processing emotional information, the amygdala is also involved in memory consolidation: the process of transferring new learning into long-term memory. The amygdala seems to facilitate encoding memories at a deeper level when the event is emotionally arousing.
The Hippocampus
Another group of researchers also experimented with rats to learn how the hippocampus functions in memory processing ( Figure ). They created lesions in the hippocampi of the rats, and found that the rats demonstrated memory impairment on various tasks, such as object recognition and maze running. They concluded that the hippocampus is involved in memory, specifically normal recognition memory as well as spatial memory (when the memory tasks are like recall tests) (Clark, Zola, & Squire, 2000). Another job of the hippocampus is to project information to cortical regions that give memories meaning and connect them with other connected memories. It also plays a part in memory consolidation: the process of transferring new learning into long-term memory.
Injury to this area leaves us unable to process new declarative memories. One famous patient, known for years only as H. M., had both his left and right temporal lobes (hippocampi) removed in an attempt to help control the seizures he had been suffering from for years (Corkin, Amaral, González, Johnson, & Hyman, 1997). As a result, his declarative memory was significantly affected, and he could not form new semantic knowledge. He lost the ability to form new memories, yet he could still remember information and events that had occurred prior to the surgery.
The Cerebellum and Prefrontal Cortex
Although the hippocampus seems to be more of a processing area for explicit memories, you could still lose it and be able to create implicit memories (procedural memory, motor learning, and classical conditioning), thanks to your cerebellum . For example, one classical conditioning experiment is to accustom subjects to blink when they are given a puff of air. When researchers damaged the cerebellums of rabbits, they discovered that the rabbits were not able to learn the conditioned eye-blink response (Steinmetz, 1999; Green & Woodruff-Pak, 2000).
Other researchers have used brain scans, including positron emission tomography (PET) scans, to learn how people process and retain information. From these studies, it seems the prefrontal cortex is involved. In one study, participants had to complete two different tasks: either looking for the letter a in words (considered a perceptual task) or categorizing a noun as either living or non-living (considered a semantic task) (Kapur et al., 1994). Participants were then asked which words they had previously seen. Recall was much better for the semantic task than for the perceptual task. According to PET scans, there was much more activation in the left inferior prefrontal cortex in the semantic task. In another study, encoding was associated with left frontal activity, while retrieval of information was associated with the right frontal region (Craik et al., 1999).
Neurotransmitters
There also appear to be specific neurotransmitters involved with the process of memory, such as epinephrine, dopamine, serotonin, glutamate, and acetylcholine (Myhrer, 2003). There continues to be discussion and debate among researchers as to which neurotransmitter plays which specific role (Blockland, 1996). Although we don’t yet know which role each neurotransmitter plays in memory, we do know that communication among neurons via neurotransmitters is critical for developing new memories. Repeated activity by neurons leads to increased neurotransmitters in the synapses and more efficient and more synaptic connections. This is how memory consolidation occurs.
It is also believed that strong emotions trigger the formation of strong memories, and weaker emotional experiences form weaker memories; this is called arousal theory (Christianson, 1992). For example, strong emotional experiences can trigger the release of neurotransmitters, as well as hormones, which strengthen memory; therefore, our memory for an emotional event is usually better than our memory for a non-emotional event. When humans and animals are stressed, the brain secretes more of the neurotransmitter glutamate, which helps them remember the stressful event (McGaugh, 2003). This is clearly evidenced by what is known as the flashbulb memory phenomenon.
A flashbulb memory is an exceptionally clear recollection of an important event. Where were you when you first heard about the \(9/11\) terrorist attacks? Most likely you can remember where you were and what you were doing. In fact, a Pew Research Center (2011) survey found that for those Americans who were age \(8\) or older at the time of the event, \(97\%\) can recall the moment they learned of this event, even a decade after it happened.
DIG DEEPER: Inaccurate and False Memories
Even flashbulb memories can have decreased accuracy with the passage of time, even with very important events. For example, on at least three occasions, when asked how he heard about the terrorist attacks of \(9/11\), President George W. Bush responded inaccurately. In January 2002, less than \(4\) months after the attacks, the then sitting President Bush was asked how he heard about the attacks. He responded:
" I was sitting there, and my Chief of Staff—well, first of all, when we walked into the classroom, I had seen this plane fly into the first building. There was a TV set on. And you know, I thought it was pilot error and I was amazed that anybody could make such a terrible mistake ." (Greenberg, 2004, p. 2)
Contrary to what President Bush recalled, no one saw the first plane hit, except people on the ground near the twin towers. The first plane was not videotaped because it was a normal Tuesday morning in New York City, until the first plane hit.
Some people attributed Bush’s wrong recall of the event to conspiracy theories. However, there is a much more benign explanation: human memory, even flashbulb memories, can be frail. In fact, memory can be so frail that we can convince a person an event happened to them, even when it did not. In studies, research participants will recall hearing a word, even though they never heard the word. For example, participants were given a list of \(15\) sleep-related words, but the word “sleep” was not on the list. Participants recalled hearing the word “sleep” even though they did not actually hear it (Roediger & McDermott, 2000). The researchers who discovered this named the theory after themselves and a fellow researcher, calling it the Deese-Roediger-McDermott paradigm.
Summary
Beginning with Karl Lashley, researchers and psychologists have been searching for the engram, which is the physical trace of memory. Lashley did not find the engram, but he did suggest that memories are distributed throughout the entire brain rather than stored in one specific area. Now we know that three brain areas do play significant roles in the processing and storage of different types of memories: cerebellum, hippocampus, and amygdala. The cerebellum’s job is to process procedural memories; the hippocampus is where new memories are encoded; the amygdala helps determine what memories to store, and it plays a part in determining where the memories are stored based on whether we have a strong or weak emotional response to the event. Strong emotional experiences can trigger the release of neurotransmitters, as well as hormones, which strengthen memory, so that memory for an emotional event is usually stronger than memory for a non-emotional event. This is shown by what is known as the flashbulb memory phenomenon: our ability to remember significant life events. However, our memory for life events (autobiographical memory) is not always accurate.
Glossary
- arousal theory
- strong emotions trigger the formation of strong memories and weaker emotional experiences form weaker memories
- engram
- physical trace of memory
- equipotentiality hypothesis
- some parts of the brain can take over for damaged parts in forming and storing memories
- flashbulb memory
- exceptionally clear recollection of an important event
Contributors and Attributions
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Rose M. Spielman with many significant contributors. The OpenStax name, OpenStax logo, OpenStax book covers, OpenStax CNX name, and OpenStax CNX logo are not subject to the creative commons license and may not be reproduced without the prior and express written consent of Rice University. For questions regarding this license, please contact<EMAIL_ADDRESS>.Textbook content produced by OpenStax College is licensed under a Creative Commons Attribution License 4.0 license. Download for free at<EMAIL_ADDRESS>.


11.4: Quiz 3-Bloodborne Pathogens in Commercial and Light Industrial Facilities
1. Which of the following are the two most prevalent blood borne diseases in the United States?
________ Hepatitis B.
________ HIV.
________ Tuberculosis.
________ Mononucleosis.
2. Approximately how many new cases of Hepatitis B occur in the United States each year?
________ 70,000.
________ 300,000.
________ 3 million.
3. True or False... Vaccines do exist that can prevent infection from Hepatitis C and HIV?
4. What is the most important personal hygiene practice for preventing infection from blood borne diseases?
________ Cleaning fingernails daily.
________ Hand washing.
________ Gargling with disinfectant.
5. What color must be used as the "background" on biohazard warning labels?
________ Yellow.
________ Red/orange.
________ Black.
6. True or False... All types of gloves can be reused after an exposure incident if they are decontaminated?
7. True or False... Personal protective equipment can help guard against infection by blood borne pathogens?


8.3: The Evolution of the Media
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Learning Objectives
By the end of this section, you will be able to:
- Discuss the history of major media formats
- Compare important changes in media types over time
- Explain how citizens learn political information from the media
The evolution of the media has been fraught with concerns and problems. Accusations of mind control, bias, and poor quality have been thrown at the media on a regular basis. Yet the growth of communications technology allows people today to find more information more easily than any previous generation. Mass media can be print, radio, television, or Internet news. They can be local, national, or international. They can be broad or limited in their focus. The choices are tremendous.
Print Media
Early news was presented to local populations through the print press. While several colonies had printers and occasional newspapers, high literacy rates combined with the desire for self-government made Boston a perfect location for the creation of a newspaper, and the first continuous press was started there in 1704. 22 Newspapers spread information about local events and activities. The Stamp Tax of 1765 raised costs for publishers, however, leading several newspapers to fold under the increased cost of paper. The repeal of the Stamp Tax in 1766 quieted concerns for a short while, but editors and writers soon began questioning the right of the British to rule over the colonies. Newspapers took part in the effort to inform citizens of British misdeeds and incite attempts to revolt. Readership across the colonies increased to nearly forty thousand homes (among a total population of two million), and daily papers sprang up in large cities. 23
Although newspapers united for a common cause during the Revolutionary War, the divisions that occurred during the Constitutional Convention and the United States’ early history created a change. The publication of the Federalist Papers , as well as the Anti-Federalist Papers, in the 1780s, moved the nation into the party press era, in which partisanship and political party loyalty dominated the choice of editorial content. One reason was cost. Subscriptions and advertisements did not fully cover printing costs, and political parties stepped in to support presses that aided the parties and their policies. Papers began printing party propaganda and messages, even publicly attacking political leaders like George Washington. Despite the antagonism of the press, Washington and several other founders felt that freedom of the press was important for creating an informed electorate. Indeed, freedom of the press is enshrined in the Bill of Rights in the first amendment.
Between 1830 and 1860, machines and manufacturing made the production of newspapers faster and less expensive. Benjamin Day’s paper, the New York Sun , used technology like the linotype machine to mass-produce papers (Figure 8.6). Roads and waterways were expanded, decreasing the costs of distributing printed materials to subscribers. New newspapers popped up. The popular penny press papers and magazines contained more gossip than news, but they were affordable at a penny per issue. Over time, papers expanded their coverage to include racing, weather, and educational materials. By 1841, some news reporters considered themselves responsible for upholding high journalistic standards, and under the editor (and politician) Horace Greeley, the New-York Tribune became a nationally respected newspaper. By the end of the Civil War, more journalists and newspapers were aiming to meet professional standards of accuracy and impartiality. 24
Yet readers still wanted to be entertained. Joseph Pulitzer and the New York World gave them what they wanted. The tabloid-style paper included editorial pages, cartoons, and pictures, while the front-page news was sensational and scandalous. This style of coverage became known as yellow journalism. Ads sold quickly thanks to the paper’s popularity, and the Sunday edition became a regular feature of the newspaper. As the New York World’s circulation increased, other papers copied Pulitzer’s style in an effort to sell papers. Competition between newspapers led to increasingly sensationalized covers and crude issues.
In 1896, Adolph Ochs purchased the New York Times with the goal of creating a dignified newspaper that would provide readers with important news about the economy, politics, and the world rather than gossip and comics. The New York Times brought back the informational model, which exhibits impartiality and accuracy and promotes transparency in government and politics. With the arrival of the Progressive Era, the media began muckraking: the writing and publishing of news coverage that exposed corrupt business and government practices. Investigative work like Upton Sinclair’s serialized novel The Jungle led to changes in the way industrial workers were treated and local political machines were run. The Pure Food and Drug Act and other laws were passed to protect consumers and employees from unsafe food processing practices. Local and state government officials who participated in bribery and corruption became the centerpieces of exposés.
Some muckraking journalism still appears today, and the quicker movement of information through the system would seem to suggest an environment for yet more investigative work and the punch of exposés than in the past. However, at the same time there are fewer journalists being hired than there used to be. The scarcity of journalists and the lack of time to dig for details in a 24-hour, profit-oriented news model make investigative stories rare. 25 There are two potential concerns about the decline of investigative journalism in the digital age. First, one potential shortcoming is that the quality of news content will become uneven in depth and quality, which could lead to a less informed citizenry. Second, if investigative journalism in its systematic form declines, then the cases of wrongdoing that are the objects of such investigations would have a greater chance of going on undetected.
In the twenty-first century, newspapers have struggled to stay financially stable. Print media earned $46 billion from ads in 2012, but only $20.5 billion from ads in 2020. 26 Given the countless alternate forms of news, many of which are free, newspaper subscriptions have fallen. Advertising and especially classified ad revenue dipped. Many newspapers now maintain both a print and an Internet presence in order to compete for readers. The rise of free news blogs, such as the Huffington Post , have made it difficult for newspapers to force readers to purchase online subscriptions to access material they place behind a digital paywall. Some local newspapers, in an effort to stay visible and profitable, have turned to social media, like Facebook and Twitter. Stories can be posted and retweeted, allowing readers to comment and forward material. 27 Yet, overall, newspapers have adapted, becoming leaner—though less thorough and investigative—versions of their earlier selves. However, despite this adaptation, one-fifth of small-town newspapers have folded. The fear is that Americans will know less about their community as a result. 28 This drop-off in available news has also occurred at the state level, as state legislative press corps have shrunk considerably. Many surviving small-town papers have been acquired by larger conglomerates. National newspapers have done comparatively better, although consolidation has occurred there to some degree, too. 29
Radio
Not just something to be enjoyed by those in the city, the proliferation of the radio brought communications to rural America as well. News and entertainment programs were also targeted to rural communities. WLS in Chicago provided the National Farm and Home Hour and the WLS Barn Dance . WSM in Nashville began to broadcast the live music show called the Grand Ole Opry , which is still broadcast every week and is the longest live broadcast radio show in U.S. history. 31
As radio listenership grew, politicians realized that the medium offered a way to reach the public in a personal manner. Warren Harding was the first president to regularly give speeches over the radio. President Herbert Hoover used radio as well, mainly to announce government programs on aid and unemployment relief. 32 Yet it was Franklin D. Roosevelt who became famous for harnessing the political power of radio. On entering office in March 1933, President Roosevelt needed to quiet public fears about the economy and prevent people from removing their money from the banks. He delivered his first radio speech eight days after assuming the presidency:
“My friends: I want to talk for a few minutes with the people of the United States about banking—to talk with the comparatively few who understand the mechanics of banking, but more particularly with the overwhelming majority of you who use banks for the making of deposits and the drawing of checks. I want to tell you what has been done in the last few days, and why it was done, and what the next steps are going to be.” 33
Roosevelt spoke directly to the people and addressed them as equals. One listener described the chats as soothing, with the president acting like a father, sitting in the room with the family, cutting through the political nonsense and describing what help he needed from each family member. 34 Roosevelt would sit down and explain his ideas and actions directly to the people on a regular basis, confident that he could convince voters of their value. 35 His speeches became known as “fireside chats” and formed an important way for him to promote his New Deal agenda (Figure 8.8). Roosevelt’s combination of persuasive rhetoric and the media allowed him to expand both the government and the presidency beyond their traditional roles. 36
The number of professional and amateur radio stations grew quickly. Initially, the government exerted little legislative control over the industry. Stations chose their own broadcasting locations, signal strengths, and frequencies, which sometimes overlapped with one another or with the military, leading to tuning problems for listeners. The Radio Act (1927) created the Federal Radio Commission (FRC), which made the first effort to set standards, frequencies, and license stations. The Commission was under heavy pressure from Congress, however, and had little authority. The Communications Act of 1934 ended the FRC and created the Federal Communications Commission (FCC), which continued to work with radio stations to assign frequencies and set national standards, as well as oversee other forms of broadcasting and telephones. The FCC regulates interstate communications to this day. For example, it prohibits the use of certain profane words during certain hours on public airwaves.
Prior to WWII, radio frequencies were broadcast using amplitude modulation (AM). After WWII, frequency modulation (FM) broadcasting, with its wider signal bandwidth, provided clear sound with less static and became popular with stations wanting to broadcast speeches or music with high-quality sound. While radio’s importance for distributing news waned with the increase in television usage, it remained popular for listening to music, educational talk shows, and sports broadcasting. Talk stations began to gain ground in the 1980s on both AM and FM frequencies, restoring radio’s importance in politics. By the 1990s, talk shows had gone national, showcasing broadcasters like Rush Limbaugh and Don Imus.
In 1990, Sirius Satellite Radio began a campaign for FCC approval of satellite radio. The idea was to broadcast digital programming from satellites in orbit, eliminating the need for local towers. By 2001, two satellite stations had been approved for broadcasting. Satellite radio has greatly increased programming with many specialized offerings, such as channels dedicated to particular artists. It is generally subscription-based and offers a larger area of coverage, even to remote areas such as deserts and oceans. Satellite programming is also exempt from many of the FCC regulations that govern regular radio stations. Howard Stern, for example, was fined more than $2 million while on public airwaves, mainly for his sexually explicit discussions. 38 Stern moved to Sirius Satellite in 2006 and has since been free of oversight and fines.
In a related vein, which speaks to the blurring of radio with the internet, is the explosion in podcasting. These audio shows, which are usually original but can be recorded versions of existing radio programs, explore a variety of topics and are enjoyed by millions of people around the world. They are especially popular for those who commute to and from work, but can be enjoyed anywhere, anytime. Total U.S. podcast listeners are a whopping 106.7 million, with 77.9 million listening to a podcast at least once per week. According to Business Insider: "A proliferation of shows, involvement from celebrity talent, investment from large companies like Spotify, and the spread of technologies that boost awareness, like smart speakers, have all helped podcast growth." 39 Podcasts with celebrity hosts include those offered by Anna Faris, Ricky Gervais and Stephen Merchant, and John Oliver. 40
Television
Television combined the best attributes of radio and pictures and changed media forever. The first official broadcast in the United States was President Franklin Roosevelt’s speech at the opening of the 1939 World’s Fair in New York. The public did not immediately begin buying televisions, but coverage of World War II changed their minds. CBS reported on war events and included pictures and maps that enhanced the news for viewers. By the 1950s, the price of television sets had dropped, more televisions stations were being created, and advertisers were buying up spots.
As on the radio, quiz shows and games dominated the television airwaves. But when Edward R. Murrow made the move to television in 1951 with his news show See It Now , television journalism gained its foothold (Figure 8.9). As television programming expanded, more channels were added. Networks such as ABC, CBS, and NBC began nightly newscasts, and local stations and affiliates followed suit.
Even more than radio, television allows politicians to reach out and connect with citizens and voters in deeper ways. Before television, few voters were able to see a president or candidate speak or answer questions in an interview. Now everyone can decode body language and tone to decide whether candidates or politicians are sincere. Presidents can directly convey their anger, sorrow, or optimism during addresses.
The first television advertisements, run by presidential candidates Dwight D. Eisenhower and Adlai Stevenson in the early 1950s, were mainly radio jingles with animation or short question-and-answer sessions. In 1960, John F. Kennedy’s campaign used a Hollywood-style approach to promote his image as young and vibrant. The Kennedy campaign ran interesting and engaging ads, featuring Kennedy, his wife Jacqueline, and everyday citizens who supported him.
Television was also useful to combat scandals and accusations of impropriety. Republican vice presidential candidate Richard Nixon used a televised speech in 1952 to address accusations that he had taken money from a political campaign fund illegally. Nixon laid out his finances, investments, and debts and ended by saying that the only election gift the family had received was a cocker spaniel the children named Checkers. 41 The “Checkers speech” was remembered more for humanizing Nixon than for proving he had not taken money from the campaign account. Yet it was enough to quiet accusations. Democratic vice presidential nominee Geraldine Ferraro similarly used television to answer accusations in 1984, holding a televised press conference to answer questions for over two hours about her husband’s business dealings and tax returns. 42
In addition to television ads, the 1960 election also featured the first televised presidential debate. By that time most households had a television. Kennedy’s careful grooming and practiced body language allowed viewers to focus on his presidential demeanor. His opponent, Richard Nixon, was still recovering from a severe case of the flu. While Nixon’s substantive answers and debate skills made a favorable impression on radio listeners, viewers’ reaction to his sweaty appearance and obvious discomfort demonstrated that live television had the potential to make or break a candidate. 43 In 1964, Lyndon B. Johnson was ahead in the polls, and he let Barry Goldwater’s campaign know he did not want to debate. 44 Nixon, who ran for president again in 1968 and 1972, declined to debate. Then in 1976, President Gerald Ford, who was behind in the polls, invited Jimmy Carter to debate, and televised debates became a regular part of future presidential campaigns. 45
Link to Learning
Visit American Rhetoric for free access to speeches, video, and audio of famous presidential and political speeches.
Between the 1960s and the 1990s, presidents often used television to reach citizens and gain support for policies. When they made speeches, the networks and their local affiliates carried them. With few independent local stations available, a viewer had little alternative but to watch. During this “Golden Age of Presidential Television,” presidents had a strong command of the media. 46
Some of the best examples of this power occurred when presidents used television to inspire and comfort the population during a national emergency. These speeches aided in the “rally ’round the flag” phenomenon, which occurs when a population feels threatened and unites around the president. 47 During these periods, presidents may receive heightened approval ratings, in part due to the media’s decision about what to cover8 45 In 1995, President Bill Clinton comforted and encouraged the families of the employees and children killed at the bombing of the Oklahoma City Federal Building. Clinton reminded the nation that children learn through action, and so we must speak up against violence and face evil acts with good acts. 49
Following the terrorist attacks in New York and Washington on September 11, 2001, President George W. Bush’s bullhorn speech from the rubble of Ground Zero in New York similarly became a rally. Bush spoke to the workers and first responders and encouraged them, but his short speech became a viral clip demonstrating the resilience of New Yorkers and the anger of a nation. 50 He told New Yorkers, the country, and the world that Americans could hear the frustration and anguish of New York, and that the terrorists would soon hear the United States (Figure 8.10).
New Media Trends
The invention of cable in the 1980s and the expansion of the Internet in the 2000s opened up more options for media consumers than ever before. Viewers can watch nearly anything at the click of a button, bypass commercials, and record programs of interest. The resulting saturation, or inundation of information, may lead viewers to abandon the news entirely or become more suspicious and fatigued about politics. 52 This effect, in turn, also changes the president’s ability to reach out to citizens. For example, viewership of the president’s annual State of the Union address has decreased over the years, from sixty-seven million viewers in 1993 to thirty-two million in 2015. 53 Citizens who want to watch reality television and movies can easily avoid the news, leaving presidents with no sure way to communicate with the public. 54 Other voices, such as those of talk show hosts and political pundits, now fill the gap.
Electoral candidates have also lost some media ground. In horse-race coverage , modern journalists analyze campaigns and blunders or the overall race, rather than interviewing the candidates or discussing their issue positions. Some argue that this shallow coverage is a result of candidates’ trying to control the journalists by limiting interviews and quotes. In an effort to regain control of the story, journalists begin analyzing campaigns without input from the candidates. 55 The use of social media by candidates provides a countervailing trend. President Trump’s hundreds of election tweets in 2016 are the stuff of legend. He continued to tweet with gusto as president and during the 2020 election, at times surprising even those who worked for him with the subject areas being tweeted about. The presidential tweet replaced the presidential press conference. Ultimately, in the wake of the January 6th insurrection at the U.S. Capitol, Twitter closed down Trump's account after he repeatedly raised topics and points that were of questionable veracity. Facebook and Instagram also followed suit with their own bans. 56
Milestone
The First Social Media Candidate
When president-elect Barack Obama admitted an addiction to his Blackberry, the signs were clear: A new generation was assuming the presidency. 57 Obama’s use of technology was a part of life, not a campaign pretense. Perhaps for this reason, he was the first candidate to fully embrace social media.
While John McCain, the 2008 Republican presidential candidate, focused on traditional media to run his campaign, Obama did not. One of Obama’s campaign advisors was Chris Hughes, a cofounder of Facebook. The campaign allowed Hughes to create a powerful online presence for Obama, with sites on YouTube, Facebook, MySpace, and more. Podcasts and videos were available for anyone looking for information about the candidate. These efforts made it possible for information to be forwarded easily between friends and colleagues. It also allowed Obama to connect with a younger generation that was often left out of politics.
By Election Day, Obama’s skill with the web was clear: he had over two million Facebook supporters, while McCain had 600,000. Obama had 112,000 followers on Twitter, and McCain had only 4,600. 58
Are there any disadvantages to a presidential candidate’s use of social media and the Internet for campaign purposes? Why or why not?
The availability of the Internet and social media has moved some control of the message back into the presidents’ and candidates’ hands. Politicians can now connect to the people directly, bypassing journalists. When Barack Obama’s minister, the Reverend Jeremiah Wright, was accused of making inflammatory racial sermons in 2008, Obama used YouTube to respond to charges that he shared Wright’s beliefs. The video drew more than seven million views. 59 To reach out to supporters and voters, the White House maintains a YouTube channel and a Facebook site, as did the recent Republican Speaker of the House of Representatives, John Boehner.
Social media, like Facebook, also placed journalism in the hands of citizens: citizen journalism occurs when citizens use their personal recording devices and cell phones to capture events and post them on the Internet. In 2012, citizen journalists caught both presidential candidates by surprise. Mitt Romney was taped by a bartender’s personal camera saying that 47 percent of Americans would vote for President Obama because they were dependent on the government. 60 Obama was recorded by a Huffington Post volunteer saying that some Midwesterners “cling to guns or religion or antipathy to people who aren’t like them” due to their frustration with the economy. 61 More recently, as Donald Trump was trying to close out the fall 2016 campaign, his musings about having his way with women were revealed on the infamous Billy Bush Access Hollywood tape. These statements became nightmares for the campaigns. As journalism continues to scale back and hire fewer professional writers in an effort to control costs, citizen journalism may become the new normal. 62
Another shift in the new media is a change in viewers’ preferred programming. Younger viewers like there to be humor in their news. In terms of TV, the popularity of The Daily Show with Trevor Noah, the Late Show with Stephen Colbert, and Full Frontal with Samantha Bee demonstrate that news, even political news, can win young viewers if delivered well. 63 Such soft news presents news in an entertaining and approachable manner, painlessly introducing a variety of topics. While the depth or quality of reporting may be less than ideal, these shows can sound an alarm as needed to raise citizen awareness (Figure 8.11). 64 Some young viewers also get their fun news from social media networks, such as TikTok, Twitter, and Instagram.
Link to Learning
This website archived all of President Trump’s tweets up until his Twitter account was permanently suspended.
Viewers who watch or listen to programs like John Oliver’s Last Week Tonight are more likely to be aware and observant of political events and foreign policy crises than they would otherwise be. 65 They may view opposing party candidates more favorably because the low-partisan, friendly interview styles allow politicians to relax and be conversational rather than defensive. 66 Because viewers of political comedy shows watch the news frequently, they may, in fact, be more politically knowledgeable than citizens viewing national news. In two studies researchers interviewed respondents and asked knowledge questions about current events and situations. Viewers of The Daily Show scored more correct answers than viewers of news programming and news stations. 67 That being said, it is not clear whether the number of viewers is large enough to make a big impact on politics, nor do we know whether the learning is long term or short term. 68
Get Connected!
Becoming a Citizen Journalist
Local government and politics need visibility. College students need a voice. Why not become a citizen journalist? City and county governments hold meetings on a regular basis and students rarely attend. Yet issues relevant to students are often discussed at these meetings, like increases in street parking fines, zoning for off-campus housing, and tax incentives for new businesses that employ part-time student labor. Attend some meetings, ask questions, and write about the experience on your Facebook page. Create a blog to organize your reports or use Storify to curate a social media debate. If you prefer videography, create a YouTube channel to document your reports on current events, or Tweet your live video using Periscope or Meerkat.
Not interested in government? Other areas of governance that affect students are the university or college’s Board of Regents meetings. These cover topics like tuition increases, class cuts, and changes to student conduct policies. If your state requires state institutions to open their meetings to the public, consider attending. You might be the one to notify your peers of changes that affect them.
What local meetings could you cover? What issues are important to you and your peers?


8.1: Editing a Page
If you are new to LibreTexts and need to start on your text, the best thing is to use the Remixer to start. Go to Chapter 7 to learn how to set up your book.
The Mindtouch platform we are using for the LibreTexts uses a modified CKE editor that allows for module construction without having to build/edit the raw source (HTML) code directly. The LibreTexts editor is a WYSIWYG editor that automatically creates HTML from visual authoring. The editor displays when you create a new page or edit a page. We strongly recommend that you use the Remixer to create new pages as it will automatically renumber chapters and pages as needed after you add the page. The CKEditor is a ready-for-use open source WYSIWYG text editor from CKSource designed to bring common word processor features directly to web pages, simplifying their content creation.
You can only edit pages for which you have editing permission, generally speaking pages in your sandbox, your team's sandbox if you are a team member, and pages in books that you have created, either de novo or by remixing.
- Navigate to the page you want to edit.
- On the MindTouch toolbar, select Edit .
- Edit the content as necessary. See a complete list of editor tools .
- In the Edit summary field at the bottom of the page, leave change notes for other editors or yourself (optional). Edit summaries can be viewed in the page revision history.
- Click Save to save the changes you made.
Automatic saving & Word Counts
- Automatic saving - By default, the LibreTexts libraries autosaves pages every 25 seconds in case your browser crashes or computer restarts so that you can return to the page and pick up where you left off.
- Word count - A word and character count is displayed in the upper right corner of the editor UI.
The Editor
The Editor has been configured for most of the needs contributors require. The layout is below; please refrain from using the advanced features in red until you are familiar with the Mindtouch structure. The Toolbar is the section located at the top of the editor window. It contains menu buttons that give you access to various functions of CKEditor. All buttons are grouped according to their function and include both simple operations (like basic text styling or formatting) and more advanced features (like inserting media or forms via a dialog window).
You are responsible for the content that you provide, including but not limited to photos, profiles information, messages, search results edits, and other content that you upload, publish or display on or through LibreTexts, or transmit to or share with other users. You may not submit content to LibreTexts that you did not create or that you do not have permission to submit. You understand and agree that others may, but are not obligated to, edit, delete or remove (without notice) any content from LibreTexts, for any reason or no reason.
Drop-down Menus
Drop-down menus within the Editor Toolbar contain tools organized by Edit, View, Format, Style, Elements, and Help.
Edit Menu
The Edit menu contains the basic actions your authors can use within the editor.
- Undo
-
Paste:
Paste cut or copied content from your operating system clipboard.
- Modern browsers to not allow Paste as Plain Text or Paste from Word options.
- Find
- Replace
- Select all
View Menu
The View menu allows authors different ways to see the content they'll be editing.
- Source - View and edit the HTML source for the page
- Show blocks - See the content blocks in WYSIWYG mode in order to better identify the HTML structure and format of your content
Format Menu
The
Format
menu contains tools that allow authors to change the look of selected text.
- Alignment
- Indentation
- Font - Change the font for selected text. (DO NOT USE)
- Size
- Text color
- Background color
- Heading - In the pages, the headings start with H2, H1 is reserved for the title of the page
-
Strikethrough:
Strikes a line through selected text. For example:
these words. - Subscript: Add a small letter or symbol below a line. E.g. writing the chemical compound N 2
- Superscript: Add a small letter or symbol above a line of text. E.g. writing equations 2 3 = 8
- Code: Insert a code block or apply a code block to selected text.
- Regular text: Exclude selected text from being parsed by the editor.
- Remove format: Remove all formatting from the selected content.
Style Menu
The
Style
menu contains options for changing content behavior or appearance.
- None
- <pre> Format (DO NOT USE)
- Blockquote
-
Comment
- Only appears when the page is being edited.
- Great for showing a replaced image when one is updated or corrected.
-
Conditional Text
(ADVANCED USE ONLY)
- Anonymous only
- Community member only
- Pro Member only
- DekiScript
- JavaScript (JEM)
- CSS
Elements Menu
The
Elements
menu contains options to insert media or alter HTML elements.
- Insert/Remove bulleted list
- Insert/Remove numbered list
- Definition list
- Insert horizontal line
- Page break
- Insert special character
- Content reuse
- Insert Path (DO NOT USE)
- Video
- Templates
- Link
- Anchor
- Image
- Table


7: Polynomial and Polynomial Functions
In this chapter you will investigate polynomials and polynomial functions and learn how to perform mathematical operations on them.
-
- 7.1: Prelude to Polynomial and Polynomial Functions
- You can use bitcoins to pay for goods at some companies, or save them as an investment. Although the future of bitcoins is uncertain, investment brokers are beginning to investigate ways to make business predictions using this digital currency. Understanding how bitcoins are created and obtained requires an understanding of a type of function known as a polynomial function.
-
- 7.2: Add and Subtract Polynomials
- We have learned how to simplify expressions by combining like terms. Remember, like terms must have the same variables with the same exponent. Since monomials are terms, adding and subtracting monomials is the same as combining like terms. If the monomials are like terms, we just combine them by adding or subtracting the coefficients.