Benign Prostate Hyperplasia

The prostate gland is an exocrine gland found only in the male. Exocrine glands secrete chemicals to the outside of the body. It is a glandular organ and is found just below the bladder and at the top of the penis. It is normally about the size of a walnut and it surrounds the urethra which is the tube that brings urine from the bladder to the outside of the body. It is made of fibrous tissue and some muscle tissue. Anatomy The gland is divided into zones or lobes. The peripheral zone is the outside part of the prostate and this is where most prostate cancers are found.The central zone makes up about 25% of the gland and the transition zone makes up about 5% of the gland. The transition zone, however, is where are the hypertrophy happens. This part of the prostate is closest to the urethra so as it grows it puts pressure on and squeezes the urethra causing problems with urination. However, in benign prostate hyperplasia, the prostate grows and begins to cause the person problems. It is usually an age related disease which is nonmalignant. Large lesions grow on that central section of the prostate.It is believed that 60% of men over the age of 60 have BPH (Porth & Matfin, 2007). The exact cause is unknown but there are some risk factors which include age, history, race, dietary fat, and hormonal factors. The older one gets, the more likely to have it and African American men get it most often. When young the gland grows with the hormones testosterone and dihydrotestosterone and it is believed that in some men the hormones do not slow down and stop when they should so the gland continues to grow past what would be normal. Signs and SymptomsBPH causes compression on the urethra so it causes partial or complete obstruction of urine flow. As the obstruction increases (prostate gets larger), acute or emergent retention of the urine may occur with distention of the bladder. The urine that is left in the bladder when a man tries to urinate and is not able to empty his bladder causes a frequency to occur, consistently trying to empty the bladder. This usually becomes worse at night. When there is a lot of bladder distention accidents may happen every time pressure is put on the abdomen or when coughing causing pressure inside the abdomen.When urine is not completely emptied from the bladder the chances of a urinary infection occurs and this sometimes happens frequently. All of this develops in stages over time so there is often changes in the kidney and ureters because of the long time back up of urine causing hydronephosis which eventually begins to kill kidney gomeruli. If not treated early this can lead to renal failure. Diagnosis When making a diagnosis of BPH seven questions are at first ask. These questions are regarding incomplete emptying, frequency, intermittency, urgency, weak stream, straining, and nocturia.A final question relates to the quality of life the patient is having related to this problem. A history, physical exam and rectal exam is done. Also to be done are urinalysis, PSA, and serum creatinine as well as other blood tests. The urinalysis is done to detect bacteria or infection, the serum creatinine is used to estimate whether there is renal function problems and the PSA is used to screen for cancer. Our Patient JJ has BPH and he has symptoms of frequent or urgent need to urinate, he also has developed cysts in his urine and a urinary tract infection.All of these symptoms make sense because they are symptoms of the enlarged prostate putting pressure on the urethra. The urinary tract infection has occurred because of the retention of urine in the bladder. His treatment plan is medications and TURP or TIP. Treatment Treatment in the early stages is aimed at symptom relief, then there is a time of watchful waiting which is suggested by most physicians. There are presently medications that work pretty well for some time. These are Finasteride which reduces prostate size by blocking the effect of androgens on the prostate.This drug also cause atrophy of the prostate cells which can cause a 20% reduction in volume. The onset of the drug takes some time, sometimes 3-6 months but it usually works for some time. The side effects may be erectile dysfunction and decreased libido. There can also be the surgical removal of the enlarged prostate gland. This surgery can be done through the urethra, through a suprapubic incision, or through an incision in the peritoneum. The most commonly used way is called a TURP which is transurethral prostatectomy or through the urethra.The prostate is a very vascular organ and though this procedure is fairly simple to do, there is a great deal of bleeding on average and irrigations are often necessary post-operatively. There are presently many experimental treatments that it is hoped will provide less side effects. These include laser surgery, transurethral vaporization, transurethral microwave therapy, and transurethral needle ablation. There is also a new technique using balloon dilation but these effects at this time seem to be transitory. Stents can also be placed in those men that have major heart of lung issues and cannot tolerate surgical procedures.Treatment Plan So, JJ had symptoms of BPH which was treated by medication but his symptoms persisted and he had a TURP. This procedure after recovery relieved his symptoms and he is progressing quite well with most of his symptomology gone at this time. Conclusion BPH which is thought of as a cancerous condition of the prostate is a benign condition of the prostate. The symptoms which it causes are usually the method of treatment in the beginning and this may last for some time, but there may be a later need for a more aggressive method of treatment which at this time is the TURP.There are side effects of this surgery, some of them immediate because of the vascular condition of the prostate. This surgery, at this time usually solves the problem long term. There are many more less inv asive procedures being studied at this time. Our patient JJ is doing quite well after a TURP and will most likely not need a further procedure. It does not relieve him however, of the possibility of prostate cancer because that part of the prostate is still there so he will need to continue to have checkups. References Porth,C and Matfin, G. (2007). Pathophysiology. 8th ed. Lippincott: Boston Add textbook

Group Motivation Essay

This chapter has talked about how to get people motivated and what it takes to meet the member’s needs. â€Å"Group motivation provides the inspiration, incentives, and reasons that move group members to work together to achieve a common goal† (Engleberg & Wynn, 2010, p. 138). Engleberg and Wynn (2010) stated, â€Å"Without motivation, we may know what we need to do and even how to do it, but we lack the will and energy to do it† (p. 138). Some members may not have high achievement needs; instead, they focus on meeting the needs of others. Many people work in groups for several reasons. Maslow’s Hierarchy of Needs (Engleberg & Wynn, 2010) there are two categories of needs: satisfiers and motivators. The satisfiers are people whom like to give people material things; however, the motivators are a good essential to the group more so than the satisfiers. These categories are broken down into eight personality types. Some of these can be both positive and negative influences in group motivation. The extrovert personality encourages interaction and provides frequent feedback† (Engleberg & Wynn, 2010, p. 142). Engleberg and Wynn (2010), â€Å"intuitive personality encourages creativity, visioning and brainstorming within the group that will help the members to be better prepared and present a better product†. According to Engleberg and Wynn (2010), the feeler strategies include discussing impact of decisions and how they affect others, as well as, encouraging cooperation and harmony, also the judger provides agendas and set realistic deadlines while setting standards and expectations of the group. The thinker strategies for motivation are to encourage the decision making. The thinker’s personality could be both positive and negative. All these personalities combined will make a group strong, keep the members grounded and focused, aid in group decision making and help settle conflict with discussion rather the arguments. Also, these personalities contribute to positive team cohesion forming a tight bond, sense of responsibility and group unity. The negative personality types are introvert, sensor and sometimes the thinker. The introvert personality believes the group does not use their time wisely. The sensor believes that groups can be easily distracted and lose focus on the task at hand. The perceiver personality type is similar to the sensor personality but is also different. Perceivers believe that people in groups procrastinate and rush the task at hand last minute resulting in failure. These personalities are more negative than positive and could cause conflict, disagreements, and division between group members causing the group cohesion to deter. Cohesion affects groups in both positive and negative ways. Some groups may share common views and agree on a specific topic, but most group members share different views and have to come up with a way to agree to disagree. As a result, groups could become divided into counterparts or smaller groups due to disagreements and conflict. This is where maintenance roles come into play are needed to settle the situation. The harmonizer of the group will help the resolve conflict while the observer tries to express everyone’s point of view so that everyone understands. The compromiser would get everyone to agree to disagree to settle conflicts while the gatekeeper would try to get the silent person to speak out which may settle everything. Group maintenance roles are important and help keep team cohesion positive. The different roles will assist groups in settling conflict, motivating one another lend a helping hand when needed and keep the lines of communication open amongst group members. In conclusion, group motivation is a good asset for working in groups. The first reason would be because it helps the team member work better together. It is easier to get the assignments done. As a group people need to have a sense of the following thing so that they can feel that they belong in a group, a sense of meaningfulness of choice and be competence of the thing they are doing for the group and making progress knowing that as a group you are getting something accomplished. In addition, you should get feedback from your other group member good or bad as a member of this group. The group should always encourage its member to do better and perform at the very top of their ability to be number one because the rewards are great at the end for the group.

House of the Scorpion and WALL-E

By: Jacob Bernhardt The book House of the Scorpion is very similar to the movie Wall-E. They both use propaganda to control the characters. In the book and the movie the people are under surveillance constantly so the people don't have freewill to do what they want. This is making the characters not act themselves. The book and the movie are both samples of dystopian literature. Wall-E is based in the future and The House of the Scorpion is not as modern. Wall-E was on earth when it was just covered in dust. In both the movie and the story people aren't allowed to be themselves. They are expected to be the same as everyone else. The robots and eejits are treated as the lowest characters. A couple examples of this are that eejits cannot go to school like the regular kids. The eejits aren't looked at as normal people and often are hated for this. The humans in Wall-E are not allowed to go where they wanted to go they had to stay in there hovering chair. They are all required to follow paths that are lit up all around the ship. The robots are used to take care of the humans and they must follow the same rules. If these rules are broken they are often punished and robots are taken to be rewired or fixed. The robots and eejits are always being watched and never have any privacy one bit. The eejits and robots are being ruled over. Matt is not allowed to do basic things like normal humans because he is an eejit. People hate him because of this and that causes him to not be allowed to do everyday things like other humans. Robots and humans in Wall-E are treated not much different. Humans are only allowed to follow paths for their chairs and not go off. If a robot acts up and doesn't do what they're supposed to they are taken to a room that had robots fixing the broken or bad ones to be repaired. The humans are under constant surveillance along with the robots. Robots and eejits are not allowed to be like the humans in both the story and movie. The people in both the story and the movie were expected to act a certain way and were punished if they were to express themselves differently. In the book Tam Lin was always the person he was expected to be until he decided to tell Matt why people were mean to him and why they treated him in a different way. This caused El Patron to get mad and Tam Lin was severely punished for his actions. This relates to the movie, The robots were never allowed to do anything differently like go off the glowing trails. This shows the dystopian characteristic of not being able to express yourself and to be different in anyway. Everyone must act the same and not express themselves or act out in any way. Both the book and movie heavily refer to dystopian characteristics. The book The House of The Scorpion and the movie WALL-E have a lot of references and relations to many dystopian characteristics. One of the main characteristics that show above the rest of them is the fact that they cannot be themselves. They are expected to be like everyone else. They would be in lots of trouble if they acted differently or broke the laws of where they are. Even in the book and movie dystopian characteristics were present. Both the movie and book were set in two completely different time periods.

An Examination Of The Financial Challenges Faced By Students At The Ivy League School

An Examination Of The Financial Challenges Faced By Students At The Ivy League School Over thirty thousand people applied to Brown university this year, and only about twenty-six hundred made it in. Thats about an eight percent acceptance rate for all the poor saps who applied to that ivy league school. But they why do they need that schools name on their diploma so badly? These people are just out of school and shooting for the stars with their big dreams, but maybe a local university or even a technical college is more the speed some of these people need. Ivy League schools are ranked better, but are not better than other schools because: they are not financially accommodating, they are very stressful, and under the rug embarrassing. Financially, Ivy League schools may not be the best for someone who doesn’t come from money. Two thirds of the people accepted into ivy league schools this year of 2015 applied for financial aid. that does not mean they all acquired it, or even a reasonable amount that they may need, but they took the extra effort because they dont believe they can take on the financial burden. all of the applications for scholarships and grants that they applied for cannot cover their costs of living. Next year, tuition will rise an average of 3.76 percent at the Ivies—pushing the cost of attendance as high as $63,000 (Akane Otani). Students need about as much money for living than they do for basic tutions at a tech school. Spending money they dont have on: food, clothes, personal items (hair products, toiletries, cell phones, etc.). Thats not including if anything were to get stolen, such as textbooks or computers or anything from their dorm rooms. Theres too much to pay for financia lly with these schools for most of these kids to be attending it. seventeen percent of students who attend ivy league schools are the first of their families to attend school (Ivy Coach). that number triples for those who attend a technical college, so imagine the new burden that they have on their shoulders. not only are they the first to go to school, they are going to a big, brand name one. Stress on an ivy league college student can get so great that it leads to life changing decisions. â€Å"The stresses that comes with academia including pressure to get good grades, financial worries, failed relationships and conflicts with roommates are enough to force some students to leave college or worse. In fact, depression is the number one reason students drop out of school or die by suicide.† ( Pakistan Observer) .It can cause a person to feel a lack of self worth when trying to keep up with other students because they dont believe that they are doing as good as the others, or that they dont get the information as well as everyone else may be comprehending it. what they dont realize is that, most of the time, they all feel this way about each other. this type of emotional stress can lead to them ‘giving up and giving in’ to the pressures around them such as skipping class, slacking off, and dropping out. Embarrassing, not a work commonly used for Ivy League schools, but it’s still one to represent it. They underestimate themselves and develop a feeling of ‘checking your privilege’ (Rega Jha) which people who attend these schools shouldnt do because they are paying so much to attend these schools so they should have gloating rights. this feeling causes them to not want to stand out in the crowd and when everyone is busy trying to convince them how great it is and how well theyre doing, the person who didnt want any attention in the first place, now seems to everyone like thats all they wanted. Then these people who feel inferior to be in an ivy’s presence, expects these students to be geniuses on everything. They are bombarded with ridiculous questions that they never have or will cover in their classes because people expect so much and then are seen as dumb because they dont know the answer and are paying out the butt to have a better education, when in rea lity they could have gotten the same degree and education for a university in their state. It’s embarrassing to be just as smart as they guy at a university when theyre going to an ivy league school to get the exact same degree as the guy next to them. Yes, these schools are viewed as big names for a reason. they are prestige and only have the best of the best. Why is it then that these degrees mean so much more than one someone obtained from a university? because of the name. With so many years to build up the buildings and time to really make it better, how could anything compete? these schools are may even only be seen so greatly because they reject so many. With these schools not even having some of the programs people would need to become what they want most, why wouldnt they work to â€Å"Find the university program that loves you for you, the school that matches your values and specializes in the fields that you are passionate about† (Montesano, Mandell). as a student who goes to a technical college i can never give personal insight to someone who does actually go to an ivy league school. im a realist, so im not one to ever really fantasize or shoot for the stars when my rocket is made of cardboard. Though i admire the ones who shoot for those stars, i think they are crazy and dumb. i hope this paper has shown why my light shines on that idea of ivy league students through the financial struggles, the stress it comes with, and the silent embarrassment.

Trade in Endangered Species Research Paper Example | Topics and Well Written Essays - 2250 words

Trade in Endangered Species - Research Paper Example This essay stresses that the ban should be further maintained. Other possible measures which can be taken to reverse this trend include bigger finesand more harsh punishment, stricter regulations and laws, implementation of certain educating programs to inform the consumers about the brutal and uncivilized acts of violencemade for trading purposes towards the endangered species. This paper makes a conclusion that the illegal trade in endangered species is one of the crucial environmental issues of the contemporary world. Despite the numerous bans on such trades, rare animals are still brutally slaughtered in many countries. The number of species which are threatened with a total extinction is increasing at an alarming rate. Although the effectiveness of the bans is highly debatable nowadays, and there are a lot of people who are eager to eliminate them, it is a fallacy to suppose that legalizing trade will prevent animals from extinction. Only joint efforts of the international environmental communities can change this situation for the better. The bans on trade in endangered species should be constantly maintained, as they provide significant contribution to the conservation of the wildlife. Moreover, other necessary measures should be imposed by the international environmental organizations and governments of the countries which provide home to the mention ed animals in order to ensure that the introduced bans on trade are carried out efficiently and endangered species are protected from the threat of being killed by poaches.

The Clash of the Titans. Soviet-American rivalry Essay

The Clash of the Titans. Soviet-American rivalry - Essay Example Post World War II at the Yalta conference, Stalin, Churchill, and Truman agree to divide Germany into zones of military occupation in which the Soviets possessed the East Germany while the Americans would take control of West Germany Grant 4. On March 1948, a secret meeting between the United States, Great Britain and France took place where the three nations agreed that democracy was the best solution for Berlin Grant 8. The Soviets shocked by this conspiracy withdrew from the Allied Council and blockaded the city of Berlin, which cut all the supplies to West Berlin Grant 8. The tension of this situation can be best described by Winston Churchill, the leader of the Great Britain describes this division in his famous speech where he states, â€Å"†¦An iron curtain has descended across the continent†¦Behind that line... all are subject†¦I do not believe that Soviet Russia desires war. What they desire is the fruits of war and the indefinite expansion of their power and doctrines.† Grant 6. The â€Å"Berlin blockade† was a blessing in disguise for the United States, who quickly reacted by conducting airlift operations. The â€Å"Berlin airlift† showed the supremacy of American flight dominance and gave hope to citizens of Berlin, who feared that the West would abandon them 26. Finally, the Soviets ended the blockade and the West had won the first epic â€Å"battle.† The blockade was essentially a slap in the face, who failed to contain democracy at its best . Yet, the conflict was not over and the race for nuclear arms intensified the battle for the â€Å"survival of the fittest.†

Deming's 14 points Assignment Example | Topics and Well Written Essays - 500 words

Deming's 14 points - Assignment Example Deming makes clear that ‘defect detection’ and ‘defect prevention’ are preludes to the continuous improvement process. An optimal defect detection system would not operate on the misplaced assumption that increasing the quantity of tests (mass inspection) would automatically â€Å"decrease the variability of the quality characteristics of products and services.† Likewise, a robust defect prevention system would not consider ‘zero defects’ as the ultimate hallmark of quality. Instead it would take into account the concept of ‘entropy’ in the life-cycle of a product and device methods for mitigating it. Continuous Improvement is basically looked at as the â€Å"ongoing reduction of process (unit-to-unit) variation, even within specification limits†. It is impinged on the fact that by reducing unit-to-unit variation around the nominal value the incurred production costs are also reduced. The SDSA Cycle stands for Standardize-Do-Study-Act, which is a technique for standardization of a process. The first key step toward standardization is identification of â€Å"best practice methods with key indicators of process performance†. Consensus among employees involved in the process is important. Hence a commonly agreed flowchart of the process is followed by all to ensure consistency. In the second stage (Do) trials and experiments are run on the standardized best practice methods. Following this, in the Study stage of the SDSA Cycle, the efficacy of the best practice methods are evaluated through an analysis of key parameters. Finally, in the Act stage of the cycle, managers attempt to ‘formalize’ the best practice methods that have stood the scrutiny of trials. But in order to materialize and enhance the best practice methods thus formalized the management will have to follow through the PDSA cycle. The PDSA cycle stands for Plan-Do-Study-Act. Its purpose is to aid the management in â€Å"improving and innovating