Walk Essay Example For Students

Walk Essay Dear Friends, this is a little lengthy but very true of our feelings for you, dear friends. Louise Redden, a poorly dressed lady with a look of defeat on her face, walked into a grocery store. She approached the owner of the store in a most humble manner and asked if he would let her charge a few groceries. She softly explained that her husband was very ill and unable to work, they had seven children, and they needed food. John Longhouse, the grocer scoffed at her and requested that she leave his store. Visualizing the family needs, she said: Please, sir! I will bring you the money just as soon as I can. We will write a custom essay on Walk specifically for you for only $16.38 $13.9/page Order now John told her he could not give her credit, as she did not have a charge account at his store. Standing beside the counter was a customer who overheard the conversation between the two. The customer walked forward and told the grocer that he would stand good for whatever she needed for her family. The grocer said in a very reluctant voice, Do you have a grocery list? Louise replied, Yes sir O. K. he said, put your grocery list on the scales and whatever your grocery list weighs, I will give you that amount in groceries. Louise, hesitated a moment with a bowed head, then she reached into her purse and took out a piece of paper and scribbled something on it. She then laid the piece of paper on the scale carefully with her head still bowed. The eyes of the grocer and the customer showed amazement when the scales went down and stayed down. The grocer, staring at the scales, turned slowly to the customer and said begrudgingly, I can not believe it. The customer smiled and the grocer started putting the groceries on the other side of the scales. The scale did not balance so he continued to put more and more groceries on them until the scales would hold no more. The grocer stood there in utter disgust. Finally, he grabbed the piece of paper from the scales and looked at it with greater amazement. It was not a grocery list, it was a prayer which said: Dear Lord, you know my Needs and I am leaving this in your hands. The grocer gave her the groceries that he had gathered and stood in stunned silence. Louise thanked him and left the store. The customer handed a fifty-dollar bill to the grocer and said, It was worth every penny of it. Only God Knows how much a prayer weighs. POWER OF PRAYER: When you receive this, say a prayer. Thats all you have to do. Just stop right now, and say a prayer for the one who sent this to you. Prayer is one of the best free gifts we receive. There is no cost but a lot of rewards. Remember the five simple rules to be happy:) No one can go back and make a brand new start. Anyone can start from now and make a brand new ending. God didnt promise days without pain, laughter without sorrow, sun without rain, but He did promise strength for the day, comfort for the tears, and light for the way. Disappointments are like road bumps, they slow you down a bit but you enjoy the smooth road afterwards. Dont stay on the bumps too long. Move on! When you feel down because you didnt get what you want, just sit tight and be happy, because God has thought of something better to give you. When something happens to you, good or bad, consider what it means. Theres a purpose to lifes events, to teach you how to laugh more or not to cry too hard You cant make someone love you, all you can do is be someone who can be loved, the rest is up to the person to realize your worth. .ude2281ca9527d2711f8833a3a53824b4 , .ude2281ca9527d2711f8833a3a53824b4 .postImageUrl , .ude2281ca9527d2711f8833a3a53824b4 .centered-text-area { min-height: 80px; position: relative; } .ude2281ca9527d2711f8833a3a53824b4 , .ude2281ca9527d2711f8833a3a53824b4:hover , .ude2281ca9527d2711f8833a3a53824b4:visited , .ude2281ca9527d2711f8833a3a53824b4:active { border:0!important; } .ude2281ca9527d2711f8833a3a53824b4 .clearfix:after { content: ""; display: table; clear: both; } .ude2281ca9527d2711f8833a3a53824b4 { display: block; transition: background-color 250ms; webkit-transition: background-color 250ms; width: 100%; opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #95A5A6; } .ude2281ca9527d2711f8833a3a53824b4:active , .ude2281ca9527d2711f8833a3a53824b4:hover { opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #2C3E50; } .ude2281ca9527d2711f8833a3a53824b4 .centered-text-area { width: 100%; position: relative ; } .ude2281ca9527d2711f8833a3a53824b4 .ctaText { border-bottom: 0 solid #fff; color: #2980B9; font-size: 16px; font-weight: bold; margin: 0; padding: 0; text-decoration: underline; } .ude2281ca9527d2711f8833a3a53824b4 .postTitle { color: #FFFFFF; font-size: 16px; font-weight: 600; margin: 0; padding: 0; width: 100%; } .ude2281ca9527d2711f8833a3a53824b4 .ctaButton { background-color: #7F8C8D!important; color: #2980B9; border: none; border-radius: 3px; box-shadow: none; font-size: 14px; font-weight: bold; line-height: 26px; moz-border-radius: 3px; text-align: center; text-decoration: none; text-shadow: none; width: 80px; min-height: 80px; background: url(https://artscolumbia.org/wp-content/plugins/intelly-related-posts/assets/images/simple-arrow.png)no-repeat; position: absolute; right: 0; top: 0; } .ude2281ca9527d2711f8833a3a53824b4:hover .ctaButton { background-color: #34495E!important; } .ude2281ca9527d2711f8833a3a53824b4 .centered-text { display: table; height: 80px; padding-left : 18px; top: 0; } .ude2281ca9527d2711f8833a3a53824b4 .ude2281ca9527d2711f8833a3a53824b4-content { display: table-cell; margin: 0; padding: 0; padding-right: 108px; position: relative; vertical-align: middle; width: 100%; } .ude2281ca9527d2711f8833a3a53824b4:after { content: ""; display: block; clear: both; } READ: Trainers Report Essay Its better to lose your pride to the one you love, than to lose the one you love because of pride. We spend too much time looking for the right person to love or finding fault with those we already love, when instead we should be perfecting the love we give. Never abandon an old friend. You will never find one who can take his place. Friendship is like wine, it gets better as it grows older. Bibliography:the bible. unknown

Mechanism of Vitamin D Action The WritePass Journal

Mechanism of Vitamin D Action Introduction Mechanism of Vitamin D Action ) also retaliates that once peak bone mass is reached, adults lacking vitamin D in their system will annually loose approximately 0.5% of their skeletal mass if they lack sufficient vitamin D and calcium in their systems (p.18). In addition, vitamin D deficiency can also lead to osteomalacia (DeLuca Schnoes, 1976); a mineralization defect of the collagen matrix. This condition is often accompanied by throbbing bone pain and aching (DeLuca Schnoes, 1976). Holick (2010) points out another research at the University of Pittsburgh that also established a correlation between vitamin D deficiency and increased susceptibility to bone fractures. The study measured the vitamin D levels of 400 participants with hip fractures and compared the results with the vitamin D levels of 400 other healthy women. The outcome demonstrated that individuals with the lowest levels of Vitamin D were 71 percent susceptible to bone fractures compared to those with the highest levels of vitamin D. Consequently, the role played by vitamin D in sustaining bone health can never be overemphasized. Not only does it aid in mineral absorption and bone development in intrauterine growth and childhood, but is also responsible for strong bones in adults as well. References DeLuca, H, F., and Schnoes K.K., (1976). Metabolism and Mechanism of Action of Vitamin D. Annual Review of Biochemistry. Vol. 45: 631- 637 Holick, M.F., (2010). Vitamin D: Physiology, Molecular Biology, and Clinical Applications. New York: Springer Science Business Media Watson, R.S., (2013). Handbook of Vitamin D in Human Health: Prevention, Treatment and Toxicity, Chicago: Wageningen Academic Pub.

Adv. Accounting Theory & Practice Essay Example | Topics and Well Written Essays - 1000 words

Adv. Accounting Theory & Practice - Essay Example It is obvious that corporate social responsibility is a part which is very important for running the businesses successfully. But following the predefined the environmental policies compels businesses to behave in a certain a way, for example using high quality raw material, and atmosphere friendly plants. It brings cost to the business which is certainly not favorable for businesses. So, businesses have started deceiving the regulatory institutions and other stakeholders. They have found their ways in fulfilling the requirements of the regulatory bodies. There are loop holes in the system which companies use for manipulating the data and information shared with the stakeholders (Hooghiemstr, 2010). Businesses always communicate with their stakeholders in written form. So there is a lot of documentary material involves. They are shared with stakeholders periodically. Companies which are always under pressure by their stakeholders seem to be using different tactics for the satisfactio n of their stakeholders (Clatworthy and Jones, 2001). For that they give out the company information in a manner that will always highlight the areas with positive performance figures regarding company. They never talk about their weaknesses. This is called impression management. Two types of information are presented in the above mentioned documents of company. One is related to the qualitative data and the other is about calculated accounting figures. The qualitative narratives are highly manipulated. They never give out the exact matter. The quantitative narratives used in financial reporting are obtained from accounting books and financial statements of the company (Jones & Shoemaker, 1994). The usage of rhetorical devices in following accounting standards helps companies to manipulate the opinions of the readers of those reports. Rhetorical devices are related to accounting standards which allows businesses to present their accounting information in a customized format of their choice. The accounting narratives used in accounting reports mostly are out of the consideration of the auditors. The reason is that they do not come under the scope of auditing. This gives room to the companies to manipulate the information they share with their stakeholders. Generally, the external auditors of the company are restricted to check limited amount of information in financial records of the firms. The accounting narratives which are outside the scope of auditing have been given the name of discretionary accounting narratives by Brennan & Merkl-Davies, 2011. Impression management is complicated. Because while following the impression management strategy companies have to look into the interests of all stakeholder, then they decide which of them are at conflict with business, and which of them are conflicting with each other. Then they look at the multiple choices available to them for communicating their financial information. Then they analyze all the choice and choos e the best, which aids in attaining the utmost interests of

Shareholder Wealth Assignment Example | Topics and Well Written Essays - 1500 words

Shareholder Wealth - Assignment Example Such claims are limited by the proportion of ownership derived from the amount of the investment. Shareholders who invest have one common goal: maximise the value of invested wealth. Every investment decision is made with the expectation that its value would increase over time. Shareholders do not necessarily manage the business, so they hire managers as their agents to increase the value of their (shareholders') wealth such that there would be enough profits for everybody. A portion of these profits is given back to owners through dividends whilst the balance may be re-invested to create more wealth. The agency theory describes the dynamics of the relationship and potential conflicts of interest between shareholder-owners and manager-agents. How shareholder wealth is measured indicates how managers can maximise it. For any business with more than one shareholder, the ultimate measure of shareholder wealth is the share price, the value of one share of ownership in the business. Share valuation follows a systematic process based on the value of the corporation's assets, which equal its liabilities plus stockholders' equity, all information available from the balance sheet. At start-up, the value of a share is derived from dividing equity by the number of shares offered. Once the business generates profits, cash can be distributed as dividends to shareholders or re-invested in the business. Profits increase assets and the value of the shareholders' equity, thereby increasing each share's value. Or, assets can increase with debt, but it does not automatically follow that stockholders' equity would stay the same, decrease, or increase. The effects of debt depend on what managers do with it, and whether or not borrowing allows the corporation to generate more cash. At some future time, when a shareholder decides to sell the shares, both buyer and seller only need to analyse the balance sheet to agree on the price. However, a single share of stock is not only a claim on the assets the corporation owns today, or the value of the shareholders' equity now. It is also a claim on future profits and the future selling price of the share. Neither is the investment totally risk-free, since the share's value could drop because of mismanagement and bankruptcy. Risk is part of valuation because of the risk-return relationship. Therefore, a share's value today is calculated by getting the present value of: 1) Cash dividends until the shares are sold; 2) Proceeds from selling the shares; or if the corporation ceases operations, 3) The firm's break-up value after selling assets to pay off liabilities. Financial analysts simplify share valuation by focusing on the present value of cash dividends, making the convenient assumptions that shares would not be sold and the business would not be closed. Since cash dividends are equivalent to the free cash flow (FCF), the value of a share now is the present value of the FCF stream discounted at the rate of return investors expect to receive on comparable investments. FCF is not profits, which can be re-invested or given out as dividends. Rather, FCF is the cash not retained nor

Immigration Essay Example | Topics and Well Written Essays - 250 words - 1

Immigration - Essay Example Meanwhile, New York Times writer Alan Dershowitz commented that he actually favors a national ID card, for it will not only give citizens better protection and security especially from terrorism, but will also benefit illegal immigrants given that they will soon be given legal status by the government and be issued such IDs (Dershowitz n. p.). In this case, I personally think that the SB 1070 is unconstitutional and that it violates human rights, given that this law actually encourages racial profiling by the state police, given that they can actually search and arrest immigrants which they suspect not having the proper documents at hand. In addition, I also think that the proposed national ID card is actually harmful to immigrants, given that it will seriously impair every person’s right to privacy. Works Cited Dershowitz, Allan. â€Å"Why Fear National ID Cards?† www.nytimes.com. New York Times, 2001. Web. 26 April 2011.

Grapefruit Interactions with Drugs

Grapefruit Interactions with Drugs What is Grapefruit? Grapefruit, a relative newcomer to citrus clan, has a fascinating history. It is a large orange berry with a thick rind. It is the belief of the most botanists that grapefruit is a naturally occurring accidental hybrid between pomelo and orange. It is believed that, although its appearance is very much different from an ordinary grape, the name ‘grapefruit’ was used because they grow in clusters, and these clusters may seem as large yellow grapes. The original belief was that, the grape fruit is a kind of a pomelo. (1) But in 1837, James Macfayden, separated grapefruit from pomelo, in his Flora of Jamaica, giving it a botanical name, Citrus paradisi. After its hybrid nature was genetically identified, the botanical name was altered to Citrus X paradisi. (1) Nutritional value Grapefruit, like most of the other citrus fruits, is a great source of vitamin C, which helps the immune system. It is advantageous for the fight against, from simple cold to, asthma, rheumatoid fever, osteoarthritis, cancer, heart disease and stroke. (2) Lycopene, which gives grapefruit its red and pink colors, is a carotenoid phytonutrient, with high anti-tumor ability. Also lycopene has the highest capacity among the common dietary carotenoids to fight free radicals. (2) According to the availability of the content of phenolic compounds in the grapefruit juice, it is ranked among the highest in food products of antioxidant activity. (2) Limonoids, another phytonutrient in grapefruit, promotes the formation of glutathione-S-transferase, thus minimizing the tumor formation. Pectins, a form of soluble fiber in grapefruit is useful against the progression of atherosclerosis. (2) Also, the grapefruit juice increases urinary pH value and citric acid excretion, and significantly reduces the formation of calcium oxalate stones, thus minimizing kidney stone formation. (2) Naringenin, a flavonoid concentrated in grapefruit, helps to repair damaged DNA, especially in human prostate cancer cells. 8-oxoguanine-DNA glycosylase and DNA polymerase beta, enzymes are induced by Naringenin, which are useful in DNA base excision repair pathway. (2) Although the nutritional value of grapefruit is highly commended and proved, around a decade ago, scientists found that the availability of oral drugs can be severely reduced by grapefruit food products, especially grapefruit juice. The cytochrome P-450 3A4 system, in the intestine, which is facilitates the first pass metabolism in many drugs, can be inhibited by grapefruit. Also in the brush border of intestinal wall, there are P-glycoprotein pumps. They transport many of the substances used by cytochrome P-450 3A4. This system is also inhibited by grapefruit. Inhibition of both these systems can be dangerous. Because of these, knowledge and awareness of these interactions is massively important. These interactions can lead to severe effects and these interactions can occur very commonly as most of the times, both the drugs and grapefruit food products are used together at breakfast. (3) Mechanism of interaction Cytochrome 3A4 is a member of cytochrome P-450 enzyme system. In the endoplasmic reticulum of cells all over the body, it can be found. It is a heme-containing large multigene family. As oxidative bio-transformation of different exogenous and endogenous substances occurs in liver and intestinal wall, cytochrome P-450 is abundant in those places. In the apical brush border of enterocytes, P-glycoprotein can be found. It is a membrane transporter and a member of adenosine triphosphate binding cassette (ABC). Once lipophilic drug is taken into the enterocytes, it is pumped back into the lumen by P-glycoprotein or metabolized by cytochrome P-450 3A4. These actions limit the oral delivery of many drugs. With the intake of grapefruit juice, cytochrome P-450 system is inhibited, thus pre-systemic metabolism of drug is decreased and bioavailability of the drug increase. (4) Grapefruit juice causes massive reduction in translation of these enzymes from its m-RNA. However the transcription of m-RNA from DNA is not affected. Grapefruit also promotes the deterioration of these enzymes. These actions together, massively decline the cytochrome P-450 activity in a quick and irreversible manner. A decline of 47% of total levels of cytochrome P-450 3A4 levels can be seen within the four hours of grapefruit juice ingestion. With this decrease, increased bioavailability of the drug can be maintained for about a day. Even after that, for some time, 30% of its effect is still there. (5-7) Some studies indicate that effect on grapefruit juice on cytochrome p-450 3A4 system and P-glycoprotein system are controversial. Means grapefruit juice can activate the P-glycoprotein pumps in vitro in a way (9). This could result in massive efflux of drugs back into the lumen. This is believed to be the cause for diminished bioavailability of some particular substrates, or sometimes this can neutralize the effect of reduced cytochrome P-450 3A4 activity due to ingestion of grapefruit juice. However Digoxin, a prototypical P-glycoprotein substrate, is found as one of the substrates in P-glycoprotein pump, which is not affected by grapefruit juice (8, 10). By both inhibition of function and, down-regulation, grapefruit juice inhibits the function of P-glycoprotein pumps. Example: increased bioavailability of cyclosporine with the grapefruit juice. This is believed to be a result of P-glycoprotein inhibition, other than cytochrome P-450 3A4, since the increase of bioavailability, produced by reduced enterocyte cytochrome P-450 3A4 concentrations, are tend to differ than the obtained results (8). MRP2 (multi-drug resistant protein 2) an associated P-glycoprotein efflux protein, has also shown its inhibition of action, with the ingestion of grapefruit juice (11). In spite of all the acquired knowledge, researchers still further investigate the grapefruit and drug interactions. In vivo effect of grapefruit juice on P-glycoprotein is an area believed to be needed to investigate further more. OATPs or organic anion-transporting polypeptides also said to be potently inhibited by grapefruit juice. In the small intestine, they are involved in the process of apical to basal transport of drugs (8, 10, and 12). The knowledge and conclusions obtained with the studies carried out in vitro cytochrome P-450 3A4 inhibition by grapefruit, the likelihood of these interactions happening in a natural way (the ingestion of grapefruit food products) can be predicted. It is also believed that the reported ethnic differences and the activity of the cytochrome P-450 3A4 could be because of the dietary differences, such as consumption of grapefruit. All in all, because of the potential of grapefruit and grapefruit related food items to interact with drugs, intake of grapefruit should be carefully monitored, in order to maintain necessary drug concentrations within the body of a patient, within the therapeutic windows. Phytochemistry Another aspect that the researchers are still thoroughly studying on is knowledge about active constituents in grapefruit juice in the molecular level, which can interfere and act on P-glycoprotein pumps and cytochrome P-450 systems. Although these studies are not extensively studied or completely proven, they indicate various molecules that take part in the drug interaction process. Flavonoid glycosides such as naringin, naringinin, hesperidin, neohespiridin, narirutin, quercetin, and didymin are some of substances responsible. Also, sesquiterpen and furanocoumarins (such as 6,7-dihydroxybergamottin) are also responsible (3, 14-16). Naringin is the most abundant flavonoid contained in the grapefruit juice. Also the flavonoids in the grapefruit exist as glycosides. After ingestion, the actions of intestinal flora convert these to sugars and aglycones. These compounds can inhibit the cytochrome P-450 enzymes. Theoretically, it is believed that electron rich polyphenolic nature of these compounds is responsible for that. Most studies show the in vitro effect of these compounds on cytochrome P-450 enzyme system. But in vivo, researchers have not yet completely proven or identified their effects on cytochrome enzyme system (17). Naringinin, which is a metabolite of naringin, has a higher activity in vitro, although naringin has no visible effect. This leads to a complication and some suspicion among researchers that flavonoids may not be the main active substance in grapefruit, which is responsible for the whole drug interaction dilemma. Even though with all these debates, due to very high concentration of these compounds in grapefruit juice and the fact naringin is present only in grapefruit among the fruits in citrus clan, quest for flavonoids still continues. Recent researchers are mostly focusing on furanocoumarins. Main furanocoumarins are bergomottin and its derivative 6,7-dihydroxybergomottin(DHB)(18). Debates still going on about the extent of effect these compounds on interaction mechanism certain studies have shown that DHB and, to an average amount bergamottin are vital contributors of grapefruit-drug interaction process (18, 19). In one particular study, furanocoumarins, DHB and four others, mixed and tested. The inhibitory potency on cytochrome enzyme systems declinedeven when any one of these compounds taken out from the mixture, not just DHB. That created a complication. There are even studies supporting that perhaps DHB and bergomattin may not be the primary compounds in the inhibition process (20). With all these facts this idea also still in the process of intense research and suspicion. Drug-Grapefruit interactions Amiodarone and anti-hypertensive drugs 1,4-dihydropyridine calcium antagonists are used mostly for patients with angina pectoris and also for patients with essential hypertension. They are lipid soluble drugs, metabolized by cytochrome P-450 3A4 in vivo, and grapefruit juice can affect its bioavailability. Intensive study and research began with the effects of grapefruit juice with felodipine, another calcium channel blocker and an anti-hypertensive drug. It was found that when grapefruit juice is ingested, oral bioavailability of these drugs can increase by 112% (21). Furthermore it demonstrates that intra-venous pharmacokinetics of felodipine remains without a significant change with the grapefruit juice ingestion (21). Also the interaction frequency gradually increases with the increased grapefruit juice ingestion. Because of these reasons, it is recommended that interval of 2-3 days between administration of felodipine and ingestion of grapefruit juice. The elderly specially should be warned about this situation. Amioderone is used for cardiac arrhythmias. It is converted into N-desethylamioderone by cytochrome P-450 3A4. With the ingestion and interaction with grapefruit juice, N-desethyl amioderone production inhibits almost completely, with an overall decline in side effects produced by amiodarone (8). Furthermore benzothiazepine calcium channel antagonist diltiazem, nisoldipine, verapamil, ACE inhibitors like enalapril and aptopril also said to have effect with grapefruit juice interaction. Benzodiazepines and CNS drugs Midazolam is a drug of benzodiazepine class used for acute seizures for inducing sedation and in insomnia. Certain studies have proven that grapefruit juice has a great effect on first-pass metabolism, which reduces the metabolism efficiency badly and increase its bioavailability (22). Clinical importance is that especially for the patients with cirrhosis of the liver, intestine metabolism of cytochrome P-450 3A4 is vital. So the ingestion of grapefruit juice has to be avoided. Another use of midazolam is in pediatric dentistry. Oral midazolam is very commonly used for this. There have been incidents that because of the bitter taste acquired with the administration of oral midazolam, patients tend to take sweetened food items, sometimes grapefruit. If grapefruit was taken in after administration of oral midazolam, blood plasma midazolam levels can increase and patient may tend to have exaggerated seduction time. Triazolamand clozapine are some other drugs that can also affect. Antimicrobials Indinavir is commonly used to treat HIV in highly active antiretroviral therapy. It is a protease inhibitor. There are reports showing that ingestion of grapefruit juice can delay indinavir absorption with the increase of gastric pH, but it does not affect systemic bioavailability (23). It is believed, because primary metabolism may not take place in the intestine. Saquinavir is also another drug used for patients with HIV. It is also a protease inhibitor. It is shown that the ingestion of grapefruit juice can increase the bioavailability of saquinavir (24). Although it increased the bioavailability, the clearance of the drug won’t change. This could be an indication that inhibition of cytochrome P-450 3A4 is affected. Theoretically, because of the dose dependent nature of the saquinavir, it is possible that effectiveness can increase with the inhibition of cytochrome P-450 3A4. Artemether an anti-malarial drug, also shown its increasing oral bioavailability, when grapefruit juice is ingested. But its time dependent reduction of bioavailability does not affect by grapefruit (25). This could indicate the importance of cytochrome P-450 3A4 in the pre-systemic metabolism. Quinine, a natural drug used in broad range of aspects, seemed to be does not affected by grapefruit juice. It is because it is primarily metabolized in the liver. (Where inhibition of cytochrome P-450 3A4 with grapefruit mainly effect on the gut)(8) Its low clearance is also helpful for this. Furthermore in antibiotics, clarithromycin, show increased time for reach for its peak concentration, but pharmacokinetics seemed to be unaffected (26). While abendazole, an anti-parasitic, shows an increased bioavailability with the ingestion of grapefruit juice (27). Chemotherapeutics Cyclosporine is a widely used immunosuppressant drugs, used in organ transplants. Studies have shown that cyclosporine and its metabolites both show rapid increase in their concentrations in plasma, when grapefruit juice was administered (28). Anti-histamines and serotonin analogues Cisapride is a drug that increases the motility of the upper GI tract. It is a serotonin receptor agonist. Studies have shown that cisapride systemic bioavailability gradually increases with the administration of grapefruit juice (29), because of the inhibition of cytochrome P-450 3A4. Therefore it’s advisable, that the patients who are taking cisapride, especially with a risk of cardiac arrhythmias, should avoid drinking grapefruit juice. Terfenadine, anti-histamine, also show increased system bioavailability when grapefruit juice is taken in (30). This also play an important role, because in an electrocardiogram, increased systemic levels of terfenadine can prolong the QT interval. Statins and cholesterol-lowering drugs Simvastatin, a cholesterol lowering drug, also shown increased serum concentrations when grapefruit juice is taken (31). Also its active metabolite simvastatin acid levels and HMG-CoA reductase inhibitors also increase. Active metabolites of the grapefruit juice, Bergamottin and Naringenin are said to be responsible for this. It is also carried out from the inhibition of cytochrome P-450 3A4 and thus limiting the first pass metabolism in small intestine. Lovastatin, another cholesterol reducing drug said to have same effects as simvastatin, when the grapefruit juice is administered. Serum concentrations of lovastatin and its active metabolite lovastatin acid seem to be elevated. By the same mechanism, prevention of first pass metabolism in the small intestine by inhibiting cytochrome P-450 3A4. Conclusion Because of the vast difference of effects given by grapefruit-drug interactions, and its effects on pharmacokinetics, physicians should be vigilant about the whole procedure. And also warn their patients about the possible consequences which can happen in a drug-grapefruit interaction. Patient-to-patient variability, mostly the age of the patient, should be thoroughly remembered. And the elderly should be warned especially as they are more prone to the grapefruit-drug interactions (8). Also the knowledge about these interactions can be used for the advantage of the physician. Example: to lower the dosage. Still, because all these are mostly in a research level and safe procedures should always be followed as patients safety is the top priority.

Modern Drama Essay -- essays research papers

What is Realism? Realism is the movement toward representing reality as it actually is, in art. Realistic drama is an attempt to portray real life on stage, a movement away from the conventional melodramas and sentimental comedies of the 1700s. It is expressed in theatre through the use of symbolism, character development, stage setting and storyline and is exemplified in plays such as Henrik Ibsen's A Doll's House and Anton Chekhov's The Three Sisters. The arrival of realism was indeed good for theatre as it promoted greater audience involvement and raised awareness of contemporary social and moral issues. It also provided and continues to provide a medium through which playwrights can express their views about societal values, attitudes and morals. A Doll's House, for example, is the tragedy of a Norwegian housewife who is compelled to challenge law, society and her husband's value system. It can be clearly recognized as a realistic problem drama, for it is a case where the indivi dual is in opposition to a hostile society. Ibsen's sympathy with the feminine cause has been praised and criticized; as he requires the audience to judge the words and actions of the characters in order to reassess the values. For another example we can look within the text of Brian Friel’s play Translations. In this play we can see most, if not all of the characteristics of Realism. Let us dissect the show through the characters and touch on Friel’s usage of symbolism, character development, stage setting and storyline to see his connections with realism. Symbolism, â€Å"the term Symbolism means the systematic use of symbols or pictorial conventions to express an allegorical meaning. Symbolism is an important element of most religious arts and reading symbols plays a main role in psychoanalysis.† At the opening of the text, Manus one of the main players is teaching Sarah to speak. He is being very patient with her because he believes that it is very important to teach her to articulate, 'Come on, Sarah. This is our secret'. When we see how hard Sarah is finding it to speak English it makes us feel that she is the symbol for Ireland's backward positions on English, and English influence. Jimmy another character on the other hand, represents the educated civilized tradition of old Ireland. He is a scholar, however Sarah is the opposite. She is a contemporary Ireland, as she has no v... ... may or may not have occurred â€Å"kind of like the movie Titanic†, it is still feasible. The plot is based on the characters having multiple catharses. Love is realized and lost, importance of heritage is found and lost, and death occurs. Realism has had a profound effect on fiction from places as far-flung as Russia and the Americas. The novel, which had been born out of the romance as a more or less fantastic narrative, settled into a realistic mode which is still dominant today. Aside from genre fiction such as fantasy and horror, we expect the ordinary novel today to be based in our own world, with recognizably familiar types of characters endowed with no supernatural powers, doing the sorts of things that ordinary people do every day. It is easy to forget that this expectation is only a century and a half old, and that the great bulk of the world's fiction before departed in a wide variety of ways from this standard, which has been applied to film and television as well. Even comic strips now usually reflect daily life. Repeated revolts against this standard by various postmodernist and magical realist varieties of fiction have not dislodged the dominance of realism in fiction.

Personal Statement on Nursing Essay

Nurses would do everything in their effort to make a patient feel better both emotionally and physically. That is also my ultimate goal. The aspiration to study nursing motivates me to study hard and read references and news extensively. My interest in nursing dates back to my years in high school. When I was a senior, I took an applied learning course in health studies, and score high marks in different subject such as medical, basic anatomy and basic life support. Honorably, I was also invited to demonstrate the skills of basic life support in the graduation ceremony. However, I did not want to go into the medical field. Nursing seemed to be the only field I want to go into. The University of Hong Kong is with a high reputation especially in Nursing and my interest in attending has deepened after I talked to students studying there. I am particularly impressed with the exchange program in nursing, which I know among the best in Hong Kong. To show my enthusiasm in nursing, I have taken related courses, such as health care assistance, physiotherapy assistance and first aid. I am also grateful to be able to work with some excellent nurses that really cared about their patients in practical training. Such experiences prepare me to further my studies in this field. Skills in communication and cooperation are the must a nurse should equip with. Being Stage Manager, supervising the work of whole backstage team, and captain of basketball team not only help strengthen my inter-personal skills, but also communication skills as well as leadership skills. In Form 6, I was invited to be the house chairperson, managing all the house stuff and organizing activities. It is a position, which enables me to develop an intimate relationship with house members and collaborate with other houses to hold some major events. I am an outgoing and cheerful person. My hobbies are wide-ranged, ranging from basketball, football and badminton to listening music, watching television and reading books. I will be proud to be able to share aspects of my life that are not apparent from my academic record. If I am offered a chance to study the program, I will do my utmost to complete the curriculum well and motivate others to be a good nurse.

The Road Not Taken- Analysis essays

The Road Not Taken- Analysis essays I chose the poem because I happened to recall Robert Frosts name when viewing a database of poems on the internet, and I remembered that the poems we read earlier as a class by Frost were well written and appealed to me. This specific poems ties in with the theme of our English class, identity and that is why I chose it. I think the theme of this poem is choice, the act of making a decision that involves a lot of contemplating. Its not a simple decision such as what to wear or what to eat, but something deeper, a decision that can impact ones entire life. We make millions of decisions every day and most of them require no thought, but decisions such as identity, choosing to be yourself, or choosing to be someone else are very serious. Its not the obvious decision, that everyone is themselves, because we are so heavily influenced by the media and our peers. Basically the author, Robert Lee Frost is talking about himself making a life decision that I think involves his identity. We can take example from this and apply this in our own lives. Have we taken the road less traveled by? In every decision there are always at least two choices (in this poem the two roads would be symbols for choices) and theres always a choice that is more common than the other. When it comes to identity, its a sad fact that many people take the popular road and leave the grassy one (the unpopular but genuine one). In the first stanza the author is confused, he has a dilemma and he looks at the obvious choice in front of him. He doesnt really know what he wants And sorry I could not travel both and be one traveler, hes facing a hard decision long I stood. The second stanza takes a look at the second choice the author has, this road is more grassy and wanted wear. I think this means that this choice is the one people take ...

A Draft U.S. Plan on Iraq Inspection Authorizes Force essays

A Draft U.S. Plan on Iraq Inspection Authorizes Force essays The Bush Administration has drafted a plan for inspections that provides for unrestricted access to all sited in Iraq, including Saddam Husseins presidential compounds and palaces. Also authorities the use of military force if Baghdad interferes with what the United States is going to do A U.S. official says if we find anything in what they give us that is not true, that is the trigger. The plan which American and British officials are presenting is to declare that Iraq is already violating its obligations to the United Nations. Iraq also needs to put the ownership on Saddam Hussein to comply. Saddam has a seven-day deadline to accept and declare all his weapons of mass destruction, and 23 more days to open site and provide documents to support this declaration. It appears that France, China and Russia who also have say in this are not supportive of force towards Iraq. They feel that military action should not be used. There was a provision of resolution in 1998 called 1154, which s tated that Iraq had to be notified before inspecting presidential sites and they were to have diplomats in their company when inspected. This new plan would override resolution 1154. I think we have to do something to find out what kind of mass destruction Iraq is capable of but I do not believe we should have to use military force and go to war. Too many people would be hurt and a lot of lives could be killed. I know that some how we need to stop Saddam Hussein but Im not sure how. I do not understand how anyone could be so sick and destructive as a man like Saddam Hussein. I hope the United States can find a way to prevent mass destruction and war because are world will be crushed if something of that notion happens. There is enough disease and death and sadness in life already without people risking others lives for no good reason. ...

Career Assessments Essay Example | Topics and Well Written Essays - 1750 words

Career Assessments - Essay Example The Myers-Briggs Type Indicator (MBTI) and Big Five Factor assessments are the most commonly used tools in career counseling nowadays. MBTI is a psychometric questionnaire which is formulated to measure psychological preferences of people about how they perceive the world and make decisions accordingly. On the other hand, The Big Five model or Five Factor Model (BFM) is the analysis of personality through five dimensions of personality traits, i.e., Extraversion, Agreeableness, Conscientiousness, Neuroticism and openness to experience. A Swiss psychiatrist Carl G Jung researched extensively in order to explore the psychological preferences of humans in making decisions and performing task which depicts their specific traits, for example; study habits and way of relaxation. Jung experiments influenced his students, Isabel Briggs and Katherine Briggs who took Myer’s theory into application which emerged into Type Indicator (MBTI[R]).It is more of a self report questionnaire which is devised to make Myer’s theory more understandable and adaptable in order to make clear psychological identification of normal people and guide them in making good decisions according to their strengths and potential. It is applied in the stress management, organizational development, learning and communication style and team building as well (Bryan & Ashley, 2004). Big Five is quite easy and short personality assessment; it is good for the assessment of non-managerial staff but not appropriate for managerial or executive level roles as they involve complex capabilities and working attitudes which are more than just personality. Dr. Robert Hogan (As cited in Matthias, 2009) narrates that the four MBTI scales are sorted in 16 Types which are attributed to preferences, values and cognitive styles Information about the specific Type is used for career guidance and organizational activities. Personality psychologists consider MBTI crucial and opt for

Psychoanalysis and Family Therapy Essay Example | Topics and Well Written Essays - 2000 words

Psychoanalysis and Family Therapy - Essay Example While psychology may be one of the oldest learned sciences, it remains still one that is shrouded in darkness and mystery. In the past, psychiatry was chiefly being carried out with the help of theories, ideologies and concepts with no idea about their true depth. The evolution of this field led to a world of revolutions and proposals. Some claimed that there is the role of biological factors while others blamed on the environmental factors etc. The complications in the treatment of various mental disorders are still lagging behind due to many reasons. There is still much to be learned about the efficacy of various treatment strategies that have been introduced in the field of psychology. More structured information needs to be made in order to achieve better results (Fonagy, 2004, p. 357). Psychoanalysis has been identified as one of the most efficient method of assessing various personality types and disorders. An invention of Freud, this methodology has been able to provide an alternative to hypnosis, a once very popular method of psyche assessment. Through in depth assessment of the person through verbal and symbolic communications, the psychiatrist is able to identify issues that are affecting the person (Fonagy, 2004, p. 357). â€Å"the deficiencies in our description would probably vanish if we were already in a position to replace the psychological terms with physiological or chemical ones†¦..we may expect [physiology and chemistry] to give the most surprising information and we cannot guess what answers it will return in a few dozen years of questions we have put to it. They may be of a kind that will blow away the whole of our artificial structure of hypothesis.† (Freud, 1920, pp 60). Psychoanalysis has been identified as one of the most effective methods in psychiatric treatments, and has been widely accepted in many health care systems of the world (Hau and Leuzinger- Bohleber, nd, pp 4). Many names have been given to this