Saturday, January 25, 2020

Mechanism Of Action Of Warfarin Biology Essay

Mechanism Of Action Of Warfarin Biology Essay Warfarin is an anticoagulant medication that is used to prevent thrombosis (clots) and embolism in many disorders. Warfarin activity has to be monitored by frequent blood testing for the International Normalized Ratio (INR). Warfarin is a synthetic derivative of coumarin, a chemical found naturally in many plants it decreases blood coagulation by interfering with vitamin K metabolism. Mechanism of Action of Warfarin Warfarin is vitamin K antagonist that produce its anticoagulant effect by interfering with the cyclic interconversion of vitamin K and its 2,3 epoxide (vitamin K epoxide). Vitamin K is a cofactor for the posttranslational carboxylation of glutamate residues to ÃŽÂ ³-carboxyglutamates on the N-terminal regions of vitamin K-dependent proteins (Whitlon, et al., 1978; Fasco, et al., 1982) .123456 These coagulation factors (factors II, VII, IX, and X) require ÃŽÂ ³-carboxylation for their biological activity. Coumarins produce their anticoagulant effect by inhibiting the vitamin K conversion cycle, thereby causing hepatic production of partially carboxylated and decarboxylated proteins with reduced procoagulant activity.78 In addition to their anticoagulant effect, the vitamin K antagonists inhibit carboxylation of the regulatory anticoagulant proteins C and S and therefore have the potential to exert a procoagulant effect. In the presence of calcium ions, carboxylation causes a conformational change in coagulation proteins91011 that promotes binding to cofactors on phospholipid surfaces. The carboxylation reaction requires the reduced form of vitamin K (vitamin KH2), molecular oxygen, and carbon dioxide, and is linked to the oxidation of vitamin KH2 to vitamin K epoxide. Vitamin K epoxide is then recycled to vitamin KH2 through two reductase steps. The first, which is sensitive to vitamin K antagonists,123 reduces vitamin K epoxide to vitamin K1 (the natural food form of vitamin K1), while the second, which is relatively insensitive to vitamin K antagonists, reduces vitamin K1 to vitamin KH2. Treatment with vitamin K antagonists leads to the depletion of vitamin KH2, thereby limiting the ÃŽÂ ³-carboxylation of the vitamin K-dependent coagulant proteins. The effect of coumarins can be counteracted by vitamin K1 (either ingested in food or administered therapeutically) because the second reductase ste p is relatively insensitive to vitamin K antagonists (Fig 1). Patients treated with a large dose of vitamin K1 can also become warfarin resistant for up to a week because vitamin K1 accumulates in the liver and is available to the coumarin-insensitive reductase. Pharmacokinetics and Pharmacodynamics of Warfarin Warfarin is a racemic mixture of two optically active isomers, the R and S forms in roughly equal proportion. It has high bioavailability,1920 is rapidly absorbed from the GI tract, and reaches maximal blood concentrations in healthy volunteers in 90 min after oral administration.1921 Racemic warfarin has a half-life of 36 to 42 h, circulates bound to plasma proteins (mainly albumin), and accumulates in the liver where the two isomers are metabolically transformed by different pathways.22 The dose-response relationship of warfarin is influenced by genetic and environmental factors, including a recently identified common mutation in the gene coding for one of the common cytochrome P450 enzymes (2C9), the hepatic enzyme responsible for oxidative metabolism of the warfarin S-isomer.2324 This mutation likely contributes to the variability in dose response to warfarin among healthy subjects.25 In addition to known and unknown genetic factors, various disease states, drugs, and dietary fac tors can interfere with the response to warfarin. The anticoagulant response to warfarin is influenced by pharmacokinetic factors, including drug interactions that affect the absorption or metabolic clearance of warfarin, and pharmacodynamic factors that alter the hemostatic response to given concentrations of the drug. Variability in anticoagulant response also occurs as a result of inaccuracies in laboratory testing, patient noncompliance, and miscommunication between patient and physician. Other drugs may influence the pharmacokinetics of warfarin by reducing GI absorption or by disrupting its metabolic clearance. For example, the anticoagulant effect of warfarin is reduced by cholestyramine, which impairs its absorption, and is potentiated by drugs that inhibit warfarin clearance through stereoselective or nonselective pathways.252627 Stereoselective interactions affect oxidative metabolism of either the S-isoner or R-isomer of warfarin.2627 Inhibition of S-warfarin metabolism is more important clinically because this isomer is five times more potent as a vitamin K antagonist than the R-isomer.2627 Clearance of S-isomer warfarin is inhibited by phenylbutazone,2829 sulfinpyrazone,30 metronidazole,31 and trimethoprim- sulfamethoxazole,32 each of which potentiates the effect of warfarin on the prothrombin time (PT). In contrast, drugs such as cimetidine and omeprazole that inhibit clearance of the R-isomer have only moderate potentiating effects on the PT in patients treated with warfarin.272833 Amiodarone inhibits the metabolic clearance of both the S-isomer and R-isomer and potentiates the anticoagulant effect of warfarin.34 The anticoagulant effect is inhibited by barbiturates,32 rifampicin,34 and carbamazepine,32 which increase its metabolic clearance by inducing hepatic mixed oxidase activity. Although long-term alcohol use has a potential to increase the clearance of warfarin through a similar mechanism, consumption of even relatively large amounts of wine was shown in one study29 to have little influen ce on PT in subjects treated with warfarin. For a more thorough discussion of the effect of enzyme induction on warfarin therapy, the reader is referred to a critical review (Table 2 ).35 The pharmacodynamics of warfarin are subject to genetic and environmental variability. Hereditary resistance to warfarin occurs in rats36 as well as in human beings.3738 Patients with genetic warfarin resistance require doses fivefold to 20-fold higher than average to achieve an anticoagulant effect. This disorder is attributed to altered affinity of the receptor for warfarin since the plasma warfarin levels required to achieve an anticoagulant effect are increased. Two mis-sense mutations in the factor IX propeptide have been described394041 that cause bleeding without excessive prolongation of PT. When affected individuals are treated with coumarin drugs, factor IX activity decreases to about 1 to 3%, while levels of other vitamin K-dependent coagulation factors decrease to 30 to 40% of normal. These mutations are uncommon and have been estimated to occur in Subjects receiving long-term warfarin therapy are sensitive to fluctuating levels of dietary vitamin K,4243 which is provided predominantly by phylloquinone in plant material.43 The phylloquinone content of a wide range of foodstuffs has been listed by Sadowski and associates.44 Phylloquinone acts through the warfarin-insensitive reductase reaction.45 Important fluctuations in vitamin K intake occur in both apparently healthy and sick subjects.46 Increased intake of dietary vitamin K sufficient to reduce the anticoagulant response to warfarin42 occurs in patients on weight-reduction diets consuming green vegetables or receiving vitamin K-containing supplements, and in patients treated with IV supplements containing vitamin K. Reduced dietary vitamin K1 intake potentiates the effect of warfarin in sick patients treated with antibiotics and IV fluids without vitamin K supplementation and in states of fat malabsorption. Hepatic dysfunction potentiates the response to warfarin through im paired synthesis of coagulation factors. Hypermetabolic states produced by fever or hyperthyroidism increase warfarin responsiveness, probably by increasing the catabolism of vitamin K-dependent coagulation factors.4748 Drugs may influence the pharmacodynamics of warfarin by inhibiting synthesis or increasing clearance of vitamin K-dependent coagulation factors or by interfering with other pathways of hemostasis (Table 3 ). The anticoagulant effect of warfarin is augmented by the second-generation and third-generation cephalosporins, which inhibit the cyclic interconversion of vitamin K,4950 by thyroxine, which increases the metabolism of coagulation factors,48 and by clofibrate, through an unknown mechanism.51 Doses5253 of salicylates > 1.5 g/d also augment the anticoagulant effect of warfarin,54 possibly because these drugs have warfarin-like activity. Acetaminophen has also been reported to augment the anticoagulant effect of warfarin,52 although this contention has been challeng ed (see below). Although heparin potentiates the anticoagulant effect of warfarin, in therapeutic doses, it produces only slight prolongation of the PT. Drugs such as aspirin,55 nonsteroidal anti-inflammatory drugs,56 high doses of penicillins,5758 and moxolactam50 increase the risk of warfarin-associated bleeding by inhibiting platelet function. Of these, aspirin is the most important because of its widespread use and prolonged effect.59 Aspirin and nonsteroidal anti-inflammatory drugs can also produce gastric erosions that increase the risk of upper-GI bleeding.58 The risk of clinically important bleeding is heightened when high doses of aspirin are taken in combination with high-intensity warfarin therapy (INR, 3.0 to 4.5).5560 In two studies, one study61 in patients with prosthetic heart valves and the other study62 in asymptomatic individuals at high risk of coronary artery disease, low doses of aspirin (100 mg/d and 75 mg/d, respectively) were also associated with increased rates of minor bleeding when combined with moderate-intensity and low-intensity warfarin anticoagulation. The mechanisms by which erythromycin63 and some anabolic steroids64 potentiate the anticoagulant effect of warfarin are unknown. Sulfonamides and several broad-spectrum antibiotic compounds may augment the anticoagulant effect of warfarin by eliminating bacterial flora and aggravating vitamin K deficiency in patients whose diet is deficient of vitamin K.65 Wells and associates66 performed a critical analysis of articles reporting possible interaction between drugs or foods and warfarin. Studies were assigned to one category if the interaction was considered highly probable, to a second category if interaction was probable, to a third level if judged possible, and to a fourth level if doubtful. Of 751 citations retrieved, pertinent results from 172 original articles are summarized in Table 3. Strong evidence of interaction was found for 39 of the 81 different drugs and foods appraised; 17 potentiate warfarin effect, 10 inhibit, and 12 produce no effect. Many other drugs have been reported to either interact with oral anticoagulants or alter the PT response to warfarin,6768 but convincing evidence of a causal association is lacking. In a case-control study,52 low to moderate doses of acetaminophen (nine or more tablets per week) were reported to be associated with excessively prolonged INR values. The presence of a causal association bet ween acetaminophen use and potentiation of a warfarin effect is uncertain. The article52 was supported by an editorial,53 but has been challenged by personal experiences (case series) cited in two letters6970 and by the results of a prospective study71 in normal volunteers. However, until more information is presented, it would be prudent to monitor the INR more frequently when acetaminophen is used in this quantity by patients during warfarin therapy. Indeed, it would be reasonable to monitor the PT more frequently when any drug therapy is added or withdrawn from the regimen of a patient treated with an oral anticoagulant. DRUG INTERACTIONS: Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any drug, vitamin, or herbal product without checking with your doctor or pharmacist first.Warfarin interacts with many prescription, nonprescription, vitamin, and herbal products. This includes medications that are applied to the skin or inside the vagina or rectum. The following interactions listed do not contain all possible drug interactions. The interactions with warfarin usually result in an increase or decrease in the blood-thinning (anticoagulant) effect. Your doctor or other health care professional should closely monitor you to prevent serious bleeding or clotting problems. While taking warfarin, it is very important to tell your doctor or pharmacist of any changes in medications, vitamins, or herbal products that you are taking.This drug should not be used with the following medications because v ery serious interactions may occur: imatinib, mifepristone.If you are currently using any of these medications listed above, tell your doctor or pharmacist before starting warfarin.Aspirin and aspirin-like drugs (salicylates) and nonsteroidal anti-inflammatory drugs (NSAIDs such as ibuprofen, naproxen, celecoxib) may have effects similar to warfarin. These drugs may increase the risk of bleeding problems if taken during treatment with warfarin. Carefully check all prescription/nonprescription product labels (including drugs applied to the skin such as pain-relieving creams) since the products may contain NSAIDs or salicylates. Talk to your doctor about using a different medication (such as acetaminophen) to treat pain/fever. Low-dose aspirin and related drugs (such as clopidogrel, ticlopidine) should be continued if prescribed by your doctor for specific medical reasons such as heart attack or stroke prevention. Consult your doctor or pharmacist for more details.Many herbal medicati ons have blood-thinning or blood-clotting effects, and some may directly affect warfarin. Tell your doctor before taking any herbal products, especially bromelains, coenzyme Q10, cranberry, danshen, dong quai, fenugreek, garlic, ginkgo biloba, ginseng, goldenseal, and St. Johns wort, among others.This medication may interfere with a certain laboratory test to measure theophylline levels, possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug.This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist

Friday, January 17, 2020

Characteristic of an Effective Teacher Essay

1. A ‘Calling’ for the profession This is supposed to be the most important. And this is what is causing me the most headache at the moment. To accept the fact that someone might be doing this job as a job for the perks and the advantages without a real commitment is a real hindrance in achieving my aim of helping teachers become better professionals. How do you train teachers to develop a calling for the profession? Is this something I can possibly aim at? 2. Professional knowledge I tend to feel that a lot of what is considered professional knowledge is in easy-to-assess tests, like TKT or CELTA. Does he know the different kinds of assessments, and the present perfect? Yes, great, then he’s good. Professional knowledge is a matter of pride among teachers. Local teachers make a lot of effort to speak better English and expect ‘native teachers’ to explain random weird ideas they learnt 30-40 years before. I personally attribute little importance to this aspect. Long gone are the days when a clever teacher taught a stupid child about the big-big world. 3. Personal qualities Yeah, yeah. Here we go again: the teacher as the frustrated (failed) actor, the clown, the village idiot†¦ Well actually no, I think there are much more important personal qualities we tend to ignore these days and we shouldn’t: honesty, emotions, intelligence, reliability, enthusiasm, curiosity. These are all characteristics we use to define effective learners, but the more these qualities are shared by their teachers, the more likely it is that they get what they want. It’s always going to be more entertaining to watch Friends, or whatever it is teenagers watch these days, than to attend an English class. So, why compete? Establishing an efficient and mutually beneficial working environment is much more helpful I believe†¦. 4. With-it-ness (McEwan, E K 2002. How to survive and strive in the first three weeks of school) This is an exciting addition to the list. The essential skill of being able to envisage possible classroom and curriculum events. Planning with an awareness of the objectives and the conditions. This is definitely an acquired skill that you can get better with every new year, school and group. This is why every employer should be wary of teachers who do a year or so and then move on regularly. They will not have this understanding of their actions within the bigger picture. It’s arguable of course how important this is, but if we see education – especially public schools – as a continuum with precise expectations, it is important to have teachers who understand them. This is especially true if we want to liberate teachers from prescribed teaching materials and expect them to develop customised tasks for their students. 5. Instructional Effectiveness To be an effective teacher you have to teach well. Hard to argue. The interesting thing about this is that this demands again a very high level of flexibility and a wide range of expertise from the teacher, since something that may be a piece of cake with one group of students can prove to be an absolute nightmare with another. Even if I planned the same lesson for two different groups, they could and they should never be the same. So, this is again a hunch, not more. This seems to work with this group so let’s go with it, but heaven forbid I would try it with the other group. 6. Good communicator Well, this is pretty obvious, and necessary not only with students, but with teachers, managers and parents. Communication is not always direct, which is difficult. Other teachers and management hear about you from students and parents. It’s all a vicious circle, and to communicate your message well in all directions is a bit of a juggling act. 7. Street smart Know about who you teach. This is sometimes perceived as the great advantage of having local teachers or teachers who come from the same-similar context. While I admit that this has its advantages, I think it has just as many disadvantages. There is a false sense of mutuality between the local teachers and students against the foreign teacher in the school. All those dismissive nods from the colleagues and students are the same, really. Sometimes blowing up a little bit of a bomb with a completely innocent face can be very helpful. I’ll never forget the conversation I had with my students about respecting women and giving them rights and me doing the cooking and the washing up. I loved it. In many situations you are expected to be the foreigner. Embracing your foreignness is one way of being successful. You are not expected to be one of them. Why try? Clearly, you don’t want to be rude or hurt anyone but there are several stages between the extremes. Don’t do any thing that would offend you if it was the other way round but don’t expect them to eat the goulash as you serve it, what’s more, they can even be allowed not to like goulash. 8. Willing to go the extra mile This is closely linked to the first one. If you follow a calling, you will go the extra mile. Otherwise you won’t. There is no way of making someone do more than what they are paid to. 9. Lifelong learner The excitement of Amazon delivering yet another book about ELT, Russell Tarr recommending another mindboggingly good link. A conference near you, a conference on the web, all the tweets from last night. If you are still excited about any of these things, we’re talking about you. If you watch a movie and 2 minutes into the film you start thinking about how you could use this in class, this is about you. Most teachers start forgetting what they learn when they start their education, and will have forgotten why they are standing in front of a class by the time they have finished. They are the life-long forgetters. Heaven save students from them. This is not about the ‘best method’ the ‘best book’ ’the greatest author’, ‘the best publisher’, it’s about you and where you are in the wonderful process of your professional development 10 Life outside the classroom Your life outside the classroom is the bread and butter you bring to your students and re-contextalise to feed their learning appetite.

Thursday, January 9, 2020

Can This Marriage Be Saved - 804 Words

Can This Marriage Be Saved - Answers You Need to Hear By Catherine R King | Submitted On February 22, 2014 Recommend Article Article Comments Print Article Share this article on Facebook Share this article on Twitter Share this article on Google+ Share this article on Linkedin Share this article on StumbleUpon Share this article on Delicious Share this article on Digg Share this article on Reddit Share this article on Pinterest Expert Author Catherine R King Divorce happens, this we know. About half of all marriages will end because of irreconcilable differences, and that is a well known statistic that we dread. Sometimes it may feel hopeless, as you try to ignore your suspicions but only face one disappointment after another. Maybe it seems as if your partner is unwilling to work with you. It feels like you re battling the inevitable. Can this marriage be saved is certainly the resounding thought in your mind. How It Used to Work Back in the Old Days You want things the way they used to be, that is quite understandable. Like most of us, you probably heard your parents or grandparents say, Till death do us part. Back in the day, people tried harder to stay together. Today social norms have changed; there are more divorces in the modern age than there ever were in previous decades. It s not a question of can this marriage be saved; anything could be forced to work. It s should it be saved? Relationships that involve physical violence or emotionalShow MoreRelatedThe Moral View Of Homosexuality1708 Words   |  7 Pagesin existence. This argument has been viewed by philological experts and people all over the world for centuries and it continues to be a major argument today. The moral view of homosexuality has many arguments, but the arguments that are going to be mentioned are the normative ethics argument, the argument on why the moral law is true when it comes to homosexuality, and why homosexuality should be viewed immoral in today’s world. The normative ethics argument against gay marriage states how oneRead MoreShould Gay Marriage Be A Hot Button Issue?944 Words   |  4 PagesGay marriage has been and is continuing to be a hot-button issue in America for some time now in which both sides have strong and passionate support. To say the least hysteria and outrage has ensued leading to discrimination against a whole community of people. Questions like â€Å"Is homosexuality genetically caused or is it by choice?† have been one of the main debating points. 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Mrs Bennett is very determined to get her daughters married to someone with a lot of money. An entail is to limit the inheritance of property or estate to a specified succession of heirs. A good marriage is very important for everyone. This is because the personRead MoreEvolution Of Male Dominance Throughout A Doll s House1416 Words   |  6 Pages the audience is guided through a dictatorship masked by the word â€Å"marriage†. The setting of the play is in Norway, where the Helmer family lives together in a patriarchal society around the late 1870’s. Nora and Torvald Helmer appear to be a delightful couple. However, as the novel progresses, it is easily seen that there are major problems in their marriage. Torvald’s male dominance slowly diminishes in his superficial marriage to Nora and he soon gains knowledge over a touchy implication.Torvald’sRead MorePortrayal Of Women : A Closer Look At Sleeping Beauty1527 Words   |  7 Pageswitches and ogress usually perish in the end whereas, beautiful, patient and good maidens are saved by charming princes who marry them and live happily ever after. This paper will analyze the French author, Charles Perrault’s fairytale version of â€Å"Sleeping beauty in the woods† to determine the feminine roles as portrayed by the heroines. 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A further hint comes when Helmer remarks: I pretend were secretly in love--engaged in secret--and that no one dreams that theres anythi ng between us. Why does he want that? Is this not a reference to the conflict of interest regarding her father? Lastly, after reading Krogstads letter, almost immediately Noras father comes to mind; he exclaims, So this is what I get for condoning his fault! I did it for your sake, and this is howRead More Henrik Ibsens A Dolls House Essay1067 Words   |  5 Pages Marriage is a forever commitment between two individuals to love one another but marriages dont always have the fairytale happy ending. In Henrik Ibsens play A Doll House, Nora and Torvald Helmer learn some things about their marriage that they had not realized before. Nora Helmer discovers Torvald, herself, her marriage, as well as her own identity as a woman. Nora Helmer, the wife of Torvald Helmer, throughout the whole play has been keeping a secret from her husband. A few years

Wednesday, January 1, 2020

Essay about Critical Thinking - 769 Words

Critical Thinking Application Critical thinking is the art of thinking in a manner that is critical. This means that prior to making a decision one must be informed about possible repercussions and/or outcomes, this is particularly true in the case of both employers and an employees. A decision maker must be willing to â€Å"choose how to respond to opportunities and problems on the basis of a simplified and approximate account of the situation† (George Jones, 2005, pg 475), while a stakeholder (in this case an employee) must be willing and able to complete any task that is put before him or her. The stakeholder must also make an informed decision based on their personal code of ethics. Based on that belief it becomes evident†¦show more content†¦We use reCon in a three tiered, interconnected manner: maintaing an in-depth contact index, for keeping track of what is going on in properties in our market, and as an invoice and voucher system. Each of these is referenced and used by all members of the organization, to an extent. CBRE has determined that due to possible turnover in employees all contact information is the property of CBRE. This has been met with a lot of trepidation as brokers rely on their contacts for their paychecks. Importance Benefit At CBRE we have found that many of the brokers who continually call into the office to request phone numbers from the administrative staff have not been maintaining their contacts within the reCon system, instead maintaining them in personal rolodex within their offices. This means that busy admin staff must rummage through brokers personal spaces in order to give the information to brokers. It is understandable why the contacts index is infrequently updated, as brokers work on a commission basis and need to maintain the integrity of their proprietary relationships with Owners and Tenants. Due to reCon’s need to have contact information for each lease, sale or consultation in the system in order for us to be paid on a deal, Brokers are findingShow MoreRelatedCritical Thinking And Critical Thinking753 Words   |  4 Pagesaway from the normal. We begin the critical thought process of thinking outside the box. Critical thinking is the process of evaluating your decisions, providing positive or negative feedback, and researching conclusions. At the point when used correctly, it reduces the issue of complacency in how we carry on with everyday activities. Critical thinking in a personal business decision Before I started my business as being a mobile deejay, I had to make critical decisions on the type of events, sortRead MoreCritical Thinking1715 Words   |  7 Pagesï » ¿KENYATTA UNIVERSITY SCHOOL: HOSPITALITY AND TOURISM DEPARTMENT: TOURISM UNIT CODE: UCU 103 UNIT TITLE: INTRODUCTION TO CREATIVE AND CRITICAL THINKING GROUP MEMBERS NAMES: REG.NO. CONTACTS SIGN GEOFFREY A.G T12S/8705/2013 0728812037 †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. PETER WAMBUI T12S/19590/2013 0726581625 †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. ROSE WACHIRA T12S/21534/2013 0717236599 †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦... NASSIUMA PURITY T12S/21394/2013 0702057789 †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦... RADHI OLANG’O T12S/19632/2013 0704290026 †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ CHEMUTAI DAISY T12S/19632/2013 0702645207Read MoreCritical Thinking2910 Words   |  12 Pagescreate the correct and fast solution to solve our problems. One of the ways is to think critically. Thinking is a good process but thinking alone will not help us to develop our minds. That is when critical thinking may take place. Critical thinking is the ability to think clearly and rationally. It includes the ability to engage in reflective and independent thinking. Using critical thinking one makes a decision or solves the problem of judging what to believe or what to do. 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Some problems that can be resolved effortlessly and efficiently but other obstacles may require a more critical and creative thinking to overcome. When it comes down to thinking to solve problemsRead MoreCritical Thinking975 Words   |  4 Pageseliminated to strengthen the authors argument?†¨.†¨You can also support your assignment using the critical thinking concepts from previous chapters with points on evidence, confirmation bias, the authors communication and research skills, manipulation of language, use of reason, emotion, open-mindedness vs. narrowmindedness, the three-tier model of thinking, resistance and barriers to critical thinking, etc.†¨Ã¢â‚¬ ¨Ã¢â‚¬ ¨Ã¢â‚¬ ¨Assignment Expectations: Your assignment should be a minimum of 500 words (this does notRead MoreCritical Thinking . Critical Thinking Is A Major Component862 Words   |  4 Pages Critical Thinking Critical thinking is a major component of the nursing process. 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My professors have played a role in my learning, with some of them helping me learn more than others, but even the best professors will be very little help to me if I’m deficient in the critical intellectual skills essential for learning. Over the semester I have seen significant improvement in my time management skills and reasoning and writing skills

Tuesday, December 24, 2019

Capital Punishment Just or Unjust Essay - 1927 Words

Capital Punishment: Just or Unjust? Can you imagine knowing the exact day, time, and place you were going to die, not to mention how your death was to come about? Day after day of mental pain just knowing that days, hours, minutes and even seconds from now you are going to be killed. The night before, tossing and turning, playing through your head just the way you imagine your death is going to be, asking yourself heaven or hell, suffering or short? If only you can take that one moment of sin back or maybe there was never a moment of sin at all. After what seems like a hundred of years, the day finally arrives. You slowly walk into the chamber, your heart is racing, your hands are clammy, and you are shaking not because it is†¦show more content†¦The gas chamber, first used in Nevada in 1921, was located in an airtight room with a chair into which the accused was strapped. Death was then caused by an exposure to cyanide gas. As noted in the article Debate Over Capital Punishment-A Pro Stance, the suffering cau sed is easy to see; the prisoner is writing, vomiting, shaking and gasping for breath for many seconds (â€Å"Debate Over†). Lethal Injection, another form of execution, was introduced in 1977 and is now used in twenty-three states. This is the most widespread method and believed to be the most humane. The convicted is strapped to a table and injected with sodium thiopentone, loosing consciousness in ten to fifteen seconds. This is then followed by pancuronium bromide, which blocks respiration, and finally potassium chloride to stop the heart (â€Å"Debate Over†). In the 1930’s there were more executions than any other decade. The average executions were one-hundred and sixty-seven per year, which is an incredibly high number of deaths(â€Å"Amnesty Facts†). During the 1960’s people began challenging the legality of the death penalty. Many people said that it was â€Å"cruel and inhumane† and it violated the Eighteenth Amendment(â€Å"Amnesty Facts† ). In 1972 the Supreme Court ruled that the death penalty was cruel and inhumane which is unconstitutional according to the Eighteenth Amendment. The United States reversed this decision when a â€Å"cleaner† way to bring about death wasShow MoreRelatedCapital Punishment: Just or Unjust?953 Words   |  4 Pagesmarksmen, seated 10 feet away behind a canvas curtain, fired at a black target pinned on his chest, and Gilmore died, the first man in the United States to be put to death following the ten-year moratorium on capital punishment ended by the Sup reme Court in 1967. (Mill 57) Capital punishment does not only lower the murder rate, but it s value as retribution alone is a good reason for handing out death sentences. Support for the death penalty in the U.S. has risen to an average of 80 percent. Read MoreRacial Discrimination And Capital Punishment1682 Words   |  7 Pagesand capital punishment has been a heated topic discussed ever since the 1972 case Furman v. Georgia. In the article, â€Å"Does Racial Discrimination Make Capital Punishment Wrong?† by Stephen Nathanson, his position in this argument is affirmative as he argues that racial discrimination makes capital punishment wrong since death penalty is administered in an arbitrary manner. Arbitrariness is the quality of being determined by chance or impulse, and not by reason or principle. He claims capital punishmentRead MoreAnnuling Capital Punishment Essay602 Words   |  3 PagesHomicide is unjust. Since youth we have been taught this unquestionable truth. Ask yourself, then, what i s the death penalty? In its easiest structure, the death penalty is characterized as one individual taking the life of another human. Incidentally, that is the meaning of homicide. There are 36 states with capital punishment, and they should change. These states need to get rid of it because it conveys a perilous danger of disciplining the innocent, is unjust and primitive, and is an insufficientRead MoreThe Deterrence Theory Vs. Deterrence853 Words   |  4 Pagesrewards and punishments that would result from such actions. Which has led many theorists to believe that the proper to punish, a defiant act is by severe, certain, and swift punishment was the key to deterrence. The deterrence theory relies on three individual components: severity, certainty, and celerity. It is thought severe penalties, will desist from criminal acts, which thus prevent crime. However, if the sentence believed to be too harsh would be considered unjust. While, punishments not severeRead MoreThe Death Pe nalty Is A Morally Appropriate Punishment846 Words   |  4 PagesHowever, times have changed and most of society relegates this â€Å"ultimate penalty† to the most heinous of crimes such as capital murder. There is much debate about the ethical nature of the death penalty with contrasting arguments on both the far left and far right. Nonetheless, I believe the Death penalty is a morally appropriate punishment only when the legal system is just and imposes strict scrutiny in giving/applying the penalty. It can be argued that society gains no utility by providing heinousRead MorePersuasive Essay : Capital Punishment1200 Words   |  5 Pages2015 Capital Punishment Capital punishment, which is also known as the death penalty, is the punishment of a crime by execution. This extreme retribution is reserved for those who have committed heinous, or capital crimes against society, therefore considered an ongoing threat. Capital punishment was abolished from the Canadian Criminal Code in 1976. It was substituted with a compulsory life sentence without possibility of parole for 25 years for all first-degree murders. However capital punishmentRead MoreThe Death Penalty Is A Capital Punishment1271 Words   |  6 Pages What is the death penalty? The death penalty is a capital punishment that is punishable by death or execution. This is usually given to people that have committed serious offences or capital crimes. There are 31 states in the United States that are for the death penalty. Crimes that are punishable by the death penalty, vary from state to state. Examples of such crimes are; first degree murder or premeditated murder, murder with special circumstances, such as: intended, multiple, and murder whichRead MoreCapital Punishment And The Death Penalty1106 Words   |  5 Pages Jesse Jackson once said, â€Å"Capital punishment turns the state into a murderer.† Capital punishment has been around for several hundred years, the first documented execution in America taking place in 1608, but more recently this form of punishment has been raising questions on its morality. While the form of execution has changed over the years, from firing squad to lethal injection, all forms succeed in their purpose: to kill. Support for capital punishment is still very strong in America, the reasonsRead More Capital Punishment Essay1685 Words   |  7 PagesCapital Punishment Works Cited Not Included Capital Punishment was basically thought of for the good of society. The objective of Capital Punishment is to stop people from committing violent and offensive acts. Capital Punishment or the death penalty has failed however, to prevent or discourage crime. Moreover, it is cruel and gruesome. At present there are five methods of execution. The most commonly used form of execution is by lethal injection. In this method the convict is first injectedRead MoreA Look on the Impact of Capital Punishment in Canada1240 Words   |  5 PagesCapital punishment was the most severe punishment within the Canadian Justice system before it was abolished in the 1970’s. It is still used in many other countries around the world such as the United States, China and India, as it is believed to lower the crime rate within their country. Capital punishment was basically a form of torturing the suspect, but to their death as a consequence of their heinous crime. Many believe that capital punishment should be reinstated into Canada, while others are

Monday, December 16, 2019

Coca Cola External Environmental Factors Free Essays

During the strategic marketing management process, there are many external forces that any company must be aware of in order to be profitable. These very important factors to be considered come in the form of technology trends, economic and government trends, consumer trends and innovations. It is very important to become aware of all of the potential opportunities and threats that may arise from these trends. We will write a custom essay sample on Coca Cola External Environmental Factors or any similar topic only for you Order Now I believe that for Coca-Cola, there are external forces in all of these areas that they must be aware of and incorporate into their planning if they are to continue to be successful.When it comes to technology, in recent years there are many emerging trends that I feel that Coca-Cola could use to their advantage. The popularity of services such as Twitter and Facebook may give Coca-Cola the opportunity to spread the word about their products to territories that haven’t yet been reached by their competitors. Since the majority of people use these services all over the world, we feel that it is a great place for them to advertise.While it is still very important to have advertisements on television, more and more people are using the internet, and we feel that by collaborating with internet companies, they would be able to increase their profits. In addition to the increased use of the internet, another technology trend that Coca-Cola should be aware of is the production of bio -degradable bottles. Today’s plastic bottles are very bad for the environment and people are aware of this. Until recently, there was only technology to produce plastic that was made from petroleum.Now though, in the year 2010, there is technology to produce plastic that is made from plants. This plastic, also known as PLA or polylactide, emits fewer greenhouse gases, uses less energy than other plastic bottles and is also recyclable and compostable. We believe that since the environment is such a high priority in everyone’s minds, they should take advantage of this technological development. Economic and Government trends are an extremely important part of the external environment. Since consumers are directly affected by the status of n economy, a company should always be aware of the economic conditions in the countries in which they operate. Currently, all over the world, we are dealing with a recession. The unemployment rate is very high, and as a result, consumers have decreased buying power. When consumers have less income, the first thing that they stop buying are luxury goods. In my opinion, Coke is a luxury item and not a necessity. I feel that if Coca-Cola wants to continue to be successful in the current economic conditions, they must begin to produce goods that people must buy. An example of such a product would be dairy products, like milk.While a consumer who has a strict budget may skip purchasing Coke, they will not skip on purchasing milk. While technological and economic factors are extremely important to Coca-Cola, we feel that currently, the most important factor that needs to be addressed are changing consumer trends. Today, consumers are becoming more and more health conscious. When people purchase a food or drink, we think that they would ideally prefer something that has some health benefits to it. Coke has always been criticized for being bad for your health due to the food coloring, carbonation and high-fructose corn syrup.While we don’t believe that it is likely that Coca-Cola will lose much business to other cola competitors such as Pepsi, I do feel that they will lose business to companies that are producing healthy alternatives to cola, such as fruit drinks. I feel that Coca-Cola should be innovative and possibly consider changing some of the ingredients in Coke, such as using natural sugar instead of corn syrup and natural sources of food coloring rather than chemicals. Another very important cons umer trend that should be noticed by Coca-Cola is the increasing population of Hispanics in the United States. Hispanics make up a very large part of the population, and Coke isn’t marketed specifically to this ethnic group. We feel that if Coca-Cola marketed more directly to Hispanics, they would increase their profit. Lastly, a very important consumer trend is being â€Å"green†. As previously mentioned, consumers in the United States, as well as the majority of other countries in the world, are very concerned with the effects of pollution and the general well being of the planet. Coca-Cola’s biggest competition is Pepsi. In the past year, Pepsi has introduced the â€Å"Pepsi Refresh Project. †This program awards funding to people in America who have come up with great ideas on how they can improve their community. Some of the ideas that have been funded by Pepsi so far are making school buses more eco-friendly, growing fresh produce at schools to fight childhood obesity and making buildings in cities more energy efficient. In 2010, the Pepsi Refresh Project will give away more than $20 million to people with similar ideas. Each month, Pepsi will accept up to 1,000 new ideas every month and will award up to $1. 3 million in grants to the ideas who have received the most votes by other consumers.We feel that this is a very effective way of bettering the world that we live in and that Coca-Cola should do something very similar. Pepsi has so far only implemented this program in the United States, so this gives Coca-Cola the opportunity to use this idea on a global scale, and extend the benefits to other countries. We feel that being â€Å"green† is a very important consumer trend, and if Coca-Cola used a similar program across the world, they would begin to develop an image where they have the environment’s best interest at heart, and will gain the support of people all over the world as well as increasing their profits. How to cite Coca Cola External Environmental Factors, Papers

Saturday, December 7, 2019

The Human Genome Project (Hgp) and Bioinformatics free essay sample

Its goals were to identify  all the approximately 25,000-30,000 genes in the human genome, to determine  the sequences of the 3 billion chemical base pairs that make up the human genome, to store  the information that resulted from the project in databases, to improve  tools for data analysis, to transfer  related technologies to the private sector, and to address  the ethical, legal, and social issues (ELSI) that may arise from the project. As researchers learn more about the functions of genes and proteins through the results obtained from the project, it will have a major impact in the fields of medicine, biotechnology, and the life sciences. For instance, the genetic sequences recorded by the project will aid in the identification of genetic diseases. Once the causes of those diseases are discovered and understood, there is hope that defective genes may be repaired and the disease cured by establishing new drugs based on the DNA base sequences of those genes or the structure of proteins coded for by them. We will write a custom essay sample on The Human Genome Project (Hgp) and Bioinformatics or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page Already, the genes responsible for cystic fibrosis, breast cancer, colon cancer, and sickle cell anemia have been found, making genetic tests for carriers of the disease a reality. In addition to this, the sequencing of the entire human genome will give us new insights into the origins, evolution, and migration of humans. The need for bioinformatics capabilities has been precipitated by the explosion of publicly available genomic information resulting from the Human Genome Project. Bioinformatics is a field that deals with the  application of computer technology to gather, store, analyze, and integrate mainly molecular biological information. Using this information in a digital format, bioinformatics can solve problems of molecular biology, predict structures, and even simulate macromolecules. Its ultimate goal is to enable the discovery of new biological insights that could have profound impacts on fields as varied as human health, agriculture, environment, energy, and biotechnology. Bioinformatics is essential as its approaches are used to understand the function of genes, the regulation of cells, drug target selection, drug design, and disease. The most well-known application of bioinformatics is sequence analysis. In sequence analysis, DNA sequences of various organisms are stored in databases for easy retrieval and comparison. The Human Genome Project  is an example of a sequence analysis. Using massive computers and various methods of collecting sequences, the entire human genome was sequenced and stored within a structured database. DNA sequences used for bioinformatics can be collected in a number of ways. One method is to go through a genome and search out individual sequences to record and store. Another method is called the shotgun sequencing, which is to grab huge amounts of fragments of DNA and compare them all, finding whole sequences by overlapping the redundant segments. Shotgun sequencing is currently the most popular because of its ease and speed. By comparing known sequences of a genome to specific mutations, much information can be gleaned about undesirable mutations such as cancers. With the completed mapping of the human genome, bioinformatics has become very important in the research of cancers in the hope of an eventual cure. There are many other applications of bioinformatics, including predicting entire protein strands, learning how genes express themselves in various species, and building complex models of entire cells. As computing power increases and our databases of genetic and molecular information expand, the realm of bioinformatics is sure to grow and change drastically, allowing us to build models of incredible complexity and utility.