Tim OBrien essays

Tim OBrien essays The terms fear and courage played a major role in the life experience of Tim O'Brien. Like most other young males who just graduated college, in 1968 after graduating from Macalester College in St. Paul, Minnesota, he sought different opportunities in hopes of becoming independent and gaining a career. Before these hopes of opportunity are realized, however, he receives notice that he has been drafted to the Vietnam War. He acknowledges the tragedies that may occur in war, and fears for his life. Generally courage is a way of overcoming fear. However, in O'Brien's supreme perspective, he reveals his extreme fear of courage. He finds himself in a "moral emergency" where he must analyze his perception of courage in order to make such a critical decision (901). After his analysis, he felt that as much as he feared loosing his life in war, he couldnt reveal that reason for not wanting to go to war to avoid any type of humiliation. He doubted his life if he pursued on with the process of war and therefore made excuses for himself to stay out. Because O'Brien didn't accept the challenge to follow his heart, he took the easy way out and went to war. His lack of courage forced him to live under the circumstance of not believing in him and theyre of continuing by facing the results of his fear of war. O'Brien compared his thoughts of fear and courage and believed that he had the potential to be full of courage, but does not realize the effort he must contribute. He doesnt realize that becoming independent is process he must go through in order to make a difference and solve his problems. He doesnt want to attend war because he fears it, what in the world can he do? Many can answer what they could do but OBrien was in doubt of what he could do for himself in order to be out of such of a dilemma. He writes "Courage, I seemed to think, comes to us in finite quantities, like an inheritance, and by being fru...

Battle of Wauhatchie in the Civil War

Battle of Wauhatchie in the Civil War fBattle of Wauhatchie - Conflict Dates: The Battle of Wauhatchie was fought October 28-29, 1863, during the American Civil War (1861-1865).   Armies Commanders: Union Major General Joseph HookerBrigadier General John W. Geary3 divisions Confederate Lieutenant General James Longstreet1 division Battle of Wauhatchie - Background: Following the defeat at the Battle of Chickamauga, the Army of the Cumberland retreated north to Chattanooga.  There Major General William S. Rosecrans and his command were besieged by General Braxton Braggs Army of Tennessee.  With the situation deteriorating, the Union XI and XII Corps were detached from the Army of the Potomac in Virginia and sent west under the leadership of Major General Joseph Hooker.  In addition, Major General Ulysses S. Grant received orders to come east from Vicksburg with part of his army and assume command over all Union troops around Chattanooga.  Overseeing the newly-created Military Division of the Mississippi, Grant relieved Rosecrans and replaced him with Major General George H. Thomas.   Battle of Wauhatchie - Cracker Line: Assessing the situation, Grant implemented a plan devised by Brigadier General William F. Baldy Smith for reopening a supply line to Chattanooga.  Dubbed the Cracker Line, this called for Union supply boats to land cargo at Kelleys Ferry on the Tennessee River.  It would then move east to Wauhatchie Station and up Lookout Valley to Browns Ferry.  From there goods would re-cross the river and move over Moccasin Point to Chattanooga.  To secure this route, Smith would establish a bridgehead at Browns Ferry while Hooker moved overland from Bridgeport to the west (Map).   Though Bragg was unaware of the Union plan, he directed Lieutenant General James Longstreet, whose men held the Confederate left, to occupy Lookout Valley.  This directive was ignored by Longstreet whose men remained on Lookout Mountain to the east.  Before dawn on October 27, Smith successfully secured Browns Ferry with two brigades led by Brigadier Generals William B. Hazen and John B. Turchin.  Alerted to their arrival, Colonel William B. Oates of the 15th Alabama attempted a counterattack but was unable to dislodge the Union troops.  Advancing with three divisions from his command, Hooker reached Lookout Valley on October 28.  Their arrival surprised Bragg and Longstreet who were having a conference on Lookout Mountain.  Ã‚   Battle of Wauhatchie - The Confederate Plan: Reaching Wauhatchie Station on the Nashville Chattanooga Railroad, Hooker detached Brigadier General John W. Gearys division and proceeded north to encamp at Browns Ferry.  Due to a shortage of rolling stock, Gearys division had been reduced by a brigade and was only supported by the four guns of Knaps Battery (Battery E, Pennsylvania Light Artillery).  Recognizing the threat posed by Union forces in the valley, Bragg directed Longstreet to attack.  After assessing the Hookers deployments, Longstreet determined to move against Gearys isolated force at Wauhatchie.  To accomplish this, he ordered Brigadier General Micah Jenkins division to strike after dark.  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Moving out, Jenkins sent the brigades of Brigadier Generals Evander Law and Jerome Robertson to occupy high ground south of Browns Ferry.  This force was tasked with preventing Hooker from marching south to aid Geary.  To the south, Brigadier General Henry Bennings brigade of Georgians was directed to hold a bridge over Lookout Creek and act as a reserve force.  For the assault against the Union position at Wauhatchie, Jenkins assigned Colonel John Brattons brigade of South Carolinians.  At Wauhatchie, Geary, concerned about being isolated, posted Knaps Battery on a small knoll and ordered his men to sleep with their weapons at hand.  The 29th Pennsylvania from Colonel George Cobhams brigade provided pickets for the entire division. Battle of Wauhatchie - First Contact: Around 10:30 PM, the lead elements of Brattons brigade engaged the Union pickets.  Approaching Wauhatchie, Bratton ordered the Palmetto Sharpshooters to move east of the railroad embankment in an attempt to flank Gearys line.  The 2nd, 1st, and 5th South Carolinas extended the Confederate line west of the tracks.  These movements took time in the darkness and it was not until 12:30 AM that Bratton commenced his assault.  Slowing the enemy, the pickets from the 29th Pennsylvania bought Geary time to form his lines.  While the 149th and 78th New Yorks from Brigadier General George S. Greenes brigade took a position along the railroad embankment facing east, Cobhams remaining two regiments, the 111th and 109th Pennsylvanias, extended the line west from the tracks (Map).  Ã‚   Battle of Wauhatchie - Fighting in the Dark: Attacking, the 2nd South Carolina quickly sustained heavy losses from both the Union infantry and Knaps Battery.  Hampered by the darkness, both sides were often reduced firing at the muzzle flashes of the enemy.  Finding some success on the right, Bratton attempted to slip the 5th South Carolina around Gearys flank.  This movement was blocked by the arrival of Colonel David Irelands 137th New York.  While pushing this regiment forward, Greene fell wounded when a bullet shattered his jaw.  As a result, Ireland assumed command of the brigade.  Seeking to press his attack against the Union center, Bratton slid the battered 2nd South Carolina to the left and threw forward the 6th South Carolina.   In addition, Colonel Martin Garys Hampton Legion was ordered to the far Confederate right.  This caused the 137th New York to refuse its left to prevent being flanked.  Support for the New Yorkers soon arrived as the 29th Pennsylvania, having re-formed from picket duty, took a position on their left.  As the infantry adjusted to each Confederate thrust, Knaps Battery took heavy casualties.  As the battle progressed both battery commander Captain Charles Atwell and Lieutenant Edward Geary, the generals eldest son, fell dead.  Hearing the fighting to the south, Hooker mobilized the XI Corps divisions of Brigadier Generals Adolph von Steinwehr and Carl Schurz.  Moving out, Colonel Orland Smiths brigade from von Steinwehrs division soon came under fire from Law.   Veering east, Smith began a series of assaults on Law and Robertson.  Drawing in Union troops, this engagement saw the Confederates hold their position on the heights.  Having repulsed Smith several times, Law received erroneous intelligence and ordered both brigades to withdraw.  As they departed, Smiths men attacked again and overran their position.  At Wauhatchie, Gearys men were running low on ammunition as Bratton prepared another assault.  Before this moved forward, Bratton received word that Law had withdrawn and that Union reinforcements were approaching.  Unable to maintain his position in these circumstances, he repositioned the 6th South Carolina and Palmetto Sharpshooters to cover his withdraw and began retreating from the field. Battle of Wauhatchie - Aftermath:  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   In the fighting at the Battle of Wauhatchie, Union forces sustained 78 killed, 327 wounded, and 15 missing while Confederate losses numbered 34 killed, 305 wounded, and 69 missing.  One of the few Civil War battles fought entirely at night, the engagement saw the Confederates fail to close the Cracker Line to Chattanooga.  Over the coming days, supplies began to flow to the Army of the Cumberland.  Following the battle, a rumor circulated that Union mules had been stampeded during the battle leading the enemy to believe that they were being attacked by cavalry and ultimately their causing their retreat.  Though a stampede may have occurred, it was not the cause of the Confederate withdrawal.  Over the next month, Union strength grew and in late November Grant commenced the Battle of Chattanooga which drove Bragg from the area. Selected Sources Civil War Trust: Battle of WauhatchieCWSAC Battle Summaries: Battle WauhatchieHistory of War: Battle of Wauhatchie

Pricing Strategy Research Paper Example | Topics and Well Written Essays - 1250 words

Pricing Strategy - Research Paper Example For instance, market strategy development, which entails market analysis, segmentation, positioning and targeting. Two, making market mix choices entails brand definition, distribution of the brands and brand promotion tactics. Three, demand carve estimation, which entails understanding how quantity required differs from the price. Four, pricing strategy can be determined by calculating the cost, which entails including the variable and fixed costs related with the goods, (Takano, Ishii & Muraki, 2041). The goods cost of a unit is set at a reduced coat that a company might charge and this indicates the margin profit at increased costs. Five, setting objectives of pricing such as maximization of profit, maximization of revenue or stabilization of prices is another way. These pricing strategy steps are interconnected and serve as starting point in pricing strategy creation. Product pricing should consider the legal and competitive condition that the business operates. In competitive pe rspective, the firm should consider its pricing impacts on the competitor’s decisions of pricing; for instance, setting low prices may threaten the price competition, which may not be in favor of any party, while setting high prices encourage increased competitor numbers who have interests in profit sharing. From a legal perspective, a company has no freedom to price its brands at its chose level, for instance, there are price limitations that restrict high product pricing too, (Taylor, & Prestoungrange, 2009). Similarly, low pricing may be seen as predatory or dumping pricing in international trade cases. Proving different prices of diverse clients may infringe laws against discrimination pricing and collusion with rivals to set prices at a consensual degree is illegal in various nations. What drives pricing strategy? Pricing choices affects the product demand in the market, the competitors pricing strategy, the company profitability and the purchasing decision of the custom er like brand product. Determining products pricing may be difficult but yet very crucial for business. Whereas there is no standard way of pricing strategy determination there are various factors that drive ones decision to pricing strategy, MCB University Press, 2003). For instance, the cost, all the hidden costs of the products such as invoice, insurance and taxes drives the pricing strategy because the cost of production must be lower than the selling cost. Second, profit – for instance, the pricing strategy is driven by the amount of money the firm intents to make from above the production cost. The cost factor is another drive, for instance, to make a profit, a company must charge high prices on the products to offset their production cost and marketing costs of the products. The average unit cost must consider both fixed costs such as rent and variable costs such as raw materials cost that changes with production volume. Thirdly, market demand is another driver because demand is the indicator of how clients will purchase a good or a service at certain cost. While the reduced costs attract more customers, the price effect over a prolonged period depends on elasticity. The buyers’ sensitivity on a certain products increases its price. If a company’s products are in higher demand, the company charges higher prices

Compare and Contrast Paper Essay Example | Topics and Well Written Essays - 1000 words - 1

Compare and Contrast Paper - Essay Example Thus, as the name implies, current asserts can be consumed during the current period or they can be converted into cash within a short period of time. A good example of a current asset is a bar of soap in the shop or a bottle of cooking oil. These can be used within the current period or they can be converted into cash when they are bought by a buyer. 2. Any assets whose use is restricted for purposes other than the current operations must be excluded from current assets (Glautior & Underdown, 2001). Assets are classified as noncurrent assets if they are not expected to be converted into cash or consumed during one year of their operating cycle. The operating life cycle of the noncurrent assets is usually very long and it can exceed a period of ten years. In some instances, the noncurrent assets are intangible and they include investments and special purpose funds. These funds cannot be withdrawn or used within a short period but can only be used after proper plans have been put into place. Long term investments are regarded as noncurrent assets as this money will be meant for long term plans and may not be immediately withdrawn even in case of emergence. Noncurrent assets also include property, plant and equipment used in the firm. This equipment cannot be readily disposed given that it is in everyday use to manufacture goods and products that can be sold to generate cash. This equipment can only be disposed if it has past its expected life span but not for quick cash like current assets. 3. The main difference between current assets and noncurrent assets is that current assets can be in form of cash or other assets which can be easily converted into cash. On the other hand, noncurrent assets include investment and special purpose funds and these cannot be readily used like the current assets. Most current assets are tangible and they can be converted into cash easily. On the other hand, noncurrent assets are big assets which include equipment or machinery as well as other property which cannot be converted into cash over a very short period. In some instances, noncurrent assets are intangible which makes them different from the current assets. Another major notable difference between current assets and noncurrent assets is that their operating cycles are different. The operating cycle of a current asset is relatively shorter and it does not exceed a period of one year while that of a current asset is very long. The operating cycle of a noncurrent asset is more than 10 years long which makes it different from the current asset. For instance, operating cycle of a wine distillery which is a noncurrent asset may extend 10 years while that of a grocery shop may be no more than just a several days. 4. Order of liquidity can be loosely defined as the order upon which the items in the balance shit are listed depending on their liquidity (Chasteen, Flaherty & O’connor, 1998). As the name implies, order is concerned with chronological orga nisation of items in their descending order while liquidity is concerned with establishing the readiness upon which cash can be disposed. Something that is liquid is readily used such as cash which can be taken straight away from the pocket to purchase something. In this order, the current assets will come after cash or other payments as these can be

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

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.

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. 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