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Then, sharpen the crease by pinching the nails of your thumb and index finger against the fold and zipping them from end-to-end along the cut line. If you need help making a straight fold along your cut line, slide a ruler against the line and fold the paper against and over the top of it. You can also sharpen the crease by pressing the folded-over paper against a table with one hand and firmly zipping your thumbnail along the fold with your other thumb. Use both thumbs and index fingers to pinch the paper on either side of the crease, right at the edge of the paper. Push one pair of fingers away from you while you pull the others toward you in order to begin a tear along the cut line. This initial rip doesn't need to be more than about 0.5in (1.3cm) long.

summary: Fold the paper over right along the line where you want to cut it. Create a small rip at one end of the crease with your fingertips.

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The best approach to teaching German depends a lot on whom you are teaching. Teaching adults, for instance, is different from teaching children. Ask yourself some of the following questions about your students and their circumstances: "How old are my students?" "Do they have any prior experience with learning German or other foreign languages?" "Do they have any family members or friends they can speak German with at home?" "Will I be teaching a large group of students, or working closely with individuals or small groups?" "What do my students hope to gain from this experience? Do they want to use German in casual conversation, or are they hoping to pass a graduate-level reading exam?" Traditionally, foreign languages have been taught with an emphasis on the rules of grammar and vocabulary, with lots of repetition and rote memorization. However, immersive or task-based approaches are becoming increasingly popular. Both approaches are useful, and which approach works best will depend a lot on the individual needs and learning styles of your students. Traditional methods that focus on grammar, syntax, and vocabulary may be best for students who want to focus on building their German reading proficiency. Some teachers and students may find it helpful to combine both methods. Immersive or task-based methods allow students to learn more naturally by jumping straight into using the language without worrying about rules or memorization. This approach may be most effective for students learning to speak and understand spoken German. Immersive or task-based teaching focuses on engaging the students through topic-focused conversation, activities, and play. For example, instead of giving your students a vocabulary list to memorize, you might start a unit on the human body in German by teaching them to sing "Kopf, Shulter, Knie und Fu" ("Head, Shoulders, Knees and Toes"). Before you start teaching German, look for materials that support the approach you're interested in. In addition to print textbooks, there are plenty of lesson plans, teaching tips, immersive learning communities, cultural resources, and other tools available online for German teachers. The University of South Dakota's library has put together a useful list of online resources for teaching German here: http://libguides.usd.edu/c.php?g=752831&p=5393272 For more tips and teaching tools, visit the website of the Goethe Institute: https://www.goethe.de/en/spr/unt.html

summary: Identify your audience. Try traditional teaching methods for a structured approach. Use immersive or task-based methods for a more natural approach. Gather resources and teaching materials.

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Most of the time esophageal diverticulitis presents no symptoms. That said, even if you have had no symptoms in the past, the pockets in your esophagus may grow larger, and new symptoms may appear over time. If your symptoms change, notify your doctor. Typical side effects and symptoms include: Regurgitation of food Trouble swallowing (dysphagia) Chest pain Pneumonia Excessive clearing of throat Bad breath (halitosis) Coughing Weight loss In most cases, esophageal diverticulitis requires no special treatment. You should still have regular check-ups at least once or twice a year with your doctor to make sure that none of the pockets have grown larger. A gastroenterologist may be most helpful when diagnosing and treating esophageal diverticulum. You can ask your general physician for a recommendation. If your condition is severe, you may have to contact a thoracic surgeon. If you have an unusual bulge on your throat, tell your doctor about it. This may be a sign of Zenker's diverticulum. There are a number of tests that your doctor may perform to diagnose esophageal diverticulum. If you have already been diagnosed, your doctor may want to do more tests to discover the underlying condition causing your diverticula and related disorders. These tests include: Endoscopy: In this procedure, you will be given a topical anesthetic. The doctor will lower a tube down your throat to examine what types of pockets are developing in your esophagus. Barium Swallow: You will be asked to swallow a chalk-like liquid. Using a special x-ray, the doctor will track the liquid as it travels down your esophagus to see if there are any obstructions. Esophageal manometry: A tube will be lowered down your throat to measure contractions of your esophagus. This will determine if food can pass safely down to your stomach. 24-Hour Esophageal pH Test: A tube will be lowered into your esophagus through your nose. The outer part of the tube will remain attached to your face. After a day, the tube is removed. This can also be used to diagnose a related condition called gastroesophageal reflux disease (GERD), which is the cause of esophageal diverticulum in many people. Antacids can help manage some of the symptoms of esophageal diverticulum, especially if your diverticula are caused by GERD. Talk to your doctor about which antacids may be most appropriate for your condition. Make sure you inform your doctor about any other medications you are taking or allergies you have. Some commonly recommended antacids include: Maalox Mylanta Rolaids Tums If you are no longer able to swallow without pain, if food is entering your lungs (aspiration), or if a diverticulum ruptures, you may have to undergo surgery. Discuss these options with your doctor. There are many different types of surgery used to treat these problems, based on their severity and your medical condition. Some common procedures include: Diverticulectomy: Removal of the diverticulum. This is usually performed in conjunction with another treatment or surgery. Myotomy: Incisions in muscle fiber to relax pressure in the lower esophageal sphincter. Laparoscopic and Cricopharyngeal are the most common types. Endoscopy with CO 2 laser: Removal of the diverticulum with a laser.
summary: Keep track of symptoms. Make regular appointments with your doctor. Undergo tests. Ask about antacids. Consider surgery if treatment worsens.