Overactive bladder Essay Example for Free

Overactive bladder Essay Overactive bladder is a condition, especially observed in older adults and is associated with a sudden and uncontrollable need to pass urine (urinary urgency), urge incontinence (leakage of urine before the woman has a chance to reach the toilet) and increased frequency of micturition (Rovner, Walls, 2007). An overactive bladder is a condition that results from sudden, involuntary contraction of the muscles in the wall of the urinary bladder. Another type of urinary continence is known as stress incontinence which is associated with involuntary loss of urine when the woman gets involved in activities, like coughing, sneezing, laughing etc, which cause only a slight increase in intra-abdominal pressure. Vaginal childbirth is often cited as a big risk factor for development of problems related to urinary incontinence by causing weakening of the pelvic tissues and structures around the urethra which can prevent it from holding back urine even when a mild physical activity causes slightest increase in intra-abdominal pressure. Vaginal childbirth can also causes weakness of various tissues and ligaments supporting the uterus, resulting in prolapse of uterus out of vaginal opening. All these problems associated with the weakness of pelvic floor structures may cause significant social, psychological, occupational, domestic, physical, and sexual problems for the woman. Thus overactive bladder can be considered as an important problem which can significantly influence the health related quality of life of affected women. In this essay, a comparison would be done between what the public reads about the problem of overactive bladder in the written media, and the way medical community supports or refutes the information that has been presented by the media. This would be done by presenting the summary and main points of the two articles, one after the other, followed by the comparison of two articles. The article by Sheehan (2008) titled, â€Å"Your most embarrassing ‘female’ problem solved† describes the symptoms of the various pelvic-floor disorders including bladder incontinence, (both stress incontinence and urge incontinence) and uterine prolapse. The article describes the problem in simple language, which even a layperson can understand. It helps in alleviating fears out of the mind of lay person by explaining that these disorders occur commonly, affecting almost one in every three women under the age of 54 years. One of the main reasons for development of stress incontinence is the weakening of the tissues and structures around the urethra, which can prevent it from holding back urine whenever there is even the slightest increase in intra-abdominal pressure related to minor degree physical activities like coughing, laughing etc as well as with more-energetic activities like sexual intercourse or exercise. Pelvic-organ prolapse, can be defined as protrusion of the pelvic organs through the vaginal opening. Though the main risk factor associated with weakening of pelvic floor tissues is vaginal delivery particularly that associated with a large baby, prolonged labor and the use of forceps or vacuum extraction, other risk factors which can contribute to the risk of development of pelvic tissue weakness include obesity, hysterectomy, estrogen deficiency (e. g. menopause), constipation etc. Uterine prolapse can result in significant distress to the women by causing pelvic and back discomfort, increased frequency of urinary tract infections, and problems related to emptying the bladder or bowel. Besides explaining the symptoms and pathophysiology related to the development of various pelvic floor disorders, this article also highlights various treatment options for these disorders. Kegel exercises or the exercise which aim at strengthening the muscles of pelvic floor by regularly squeezing-and-holding the pelvic floor muscles can especially prove to be helpful both for problems related to incontinence and uterine prolapse. For overactive bladder, kegel exercises can prove to be really helpful if combined with behavior modification strategies. Behavior modification aims at re-training the bladder by helping the patient schedule her bathroom trips, helping her resist the urge to urinate between trips, thereby gradually increasing the intervals between trips. Prescription medicines like Detrol (tolterodine) and Ditropan (oxybutynin) can help by reducing the activity of hyperactive tissues. For overactive bladder use of botox injection, though yet not approved by the FDA, is also being commonly used. It is thought to provide relief from overactive bladder by paralyzing the overactive bladder muscles. Stress incontinence symptoms can also be relieved through the use of a small diaphragm like device known as pessary, which is placed inside the vagina in order to support the uterus and other pelvic structures. Surgical procedures involving the use of a synthethic mesh or sling to support the utrethra also help in providing relief. Though the vaginal delivery is more likely to be associated with development of incontinence and prolapse, having a caesarean section may not necessarily prevent their development. Besides, caesarean sections are associated with their own share of complications including bleeding, scarring, prolonged recovery, risk of development of infections etc. Summary of Professional Article (Journal of the American Academy of Nurse Practitioners) This review article by Bradway et al (2008) titled, â€Å"Lower urinary tract symptoms in women—A common but neglected problem† is a review article which focuses primarily towards providing the nurse practitioners (NPs) an understanding of female lower urinary tract symptoms (LUTS). This article also highlights the present evidence regarding the prevalence, epidemiology, risk factors, symptoms, impact of these symptoms on the patient’s quality of life, diagnosis and treatment, and treatment barriers for LUTS in women. Though these symptoms are commonly present, they are often overlooked, and may not be adequately addressed in many women. This article emphasizes the fact that LUTS forms a global women’s health problem, which requires a stronger a nursing focus in order to fully understand its impact on the quality of woman’s life. The nursing staff also needs to understand the likely barriers which might prevent them from giving adequate care to these individuals and to develop strategies for acceptable and effective evidence-based management. The article divides LUTS into seven categories, with the three main ones being related to storage, voiding, and postmicturition symptoms. Storage symptoms, which are related to bladder filling, include increased urinary frequency, urgency, nocturia, and urinary incontinence (UI). UI has been further subdivided into urge urinary incontinence (UUI), stress urinary incontinence (SUI), and mixed urinary incontinence (MUI). This article has described overactive bladder (OAB) as a syndrome complex associated with LUTS mainly in relation to the storage symptoms, including urinary urgency, with or without UUI, along with increased frequency and nocturia. Voiding symptoms include slow stream, hesitancy, straining, and terminal dribbling etc. This article presents good evidence emphasizing how LUTS (and specifically OAB) can cause considerable emotional distress, have a negative impact on health related quality of life (HRQL), and can interfere with daily activities. Women with overactive bladder often restrict their physical and social activities, due to the fear of embarrassment in public, leading to social isolation and depression. LUTS can also profoundly affect the woman’s sexual behavior and her sexual quality of life. Treatment strategies for LUTS and OAB include a combination of patient education; pelvic floor muscle training exercises (Kegel’s exercises); behavior modification (management of fluid intake, controlling the frequency of micturition etc); and pharmacotherapy with antimuscarinic agents (e. . , oxybutynin, tolterodine, trospium, darifenacin, solifenacin, etc). Refractory cases may require surgery. The article highlights the importance of developing an awareness regarding the high prevalence of LUTS for the nursing professionals in clinical practice. Nurses also need to be aware that a large percentage of patients may not seek treatment, due to occurrence of embarrassing symptoms which may prevent them from discussing the problem with their health care provider. The nursing staff needs to develop an empathetic attitude towards these individuals and discuss the various available therapeutic options with them. Comparison of the two articles The two articles are basically same in the sense they both describe the same problem i. e. symptoms related to lower urinary tract dysfunction resulting from the weakness of the muscles of the pelvic floor. The main problems described in both the articles include urge incontinence, stress incontinence and uterine prolapse. However the two articles differ from each other based on the target audience they are meant to cater to. The article by Bradway et al (2008) is meant for the medical health professionals, especially the nursing staff. On the other hand, the article by Sheehan (2008) is meant for layperson, or a person who has no medical knowledge. This is the kind of article which may appear in woman’s magazine. It aims at making the layperson understand the problems commonly encountered in women, resulting from weakness of pelvic floor muscles. Though this article also describes more or less same things as the article by Bradway et al (2008), the terminology used by Bradway et al is more difficult and is meant for a person who already has knowledge regarding this topic. The article by Sheehan (2008) highlights simple changes in lifestyle which the woman can make on her in order to prevent the occurrence of this problem. For e. g. according to Sheehan (2008), â€Å"Dietary changes are also helpful: Eat more fiber to normalize the stool and avoid caffeine, carbonated beverages, dairy, spicy foods, and acidic fruit (like oranges and pineapples), which can irritate the bladder. On the other hand the article by Bradford et al (2008) highlights the interventions required on part of the nursing staff to prevent the occurrence of the disorders related to weakness of pelvic floor. According to Bradford et al (2008), â€Å"In terms of clinical practice, and given the large percentage of patients who do not seek treatment, increased attention is warranted as to the obstacles that prevent patients and healthcare providers from discussing the problem†. Though the information provided by Bradford is well supported by good evidence, the article by Sheehan (2008) gives generalized information not supported with high quality research studies. Even though the names of few renowned gynecologists and physicians have been included, the exact sources from where these references were taken have not been mentioned. If a person wants to go into further details of the subject he/she can readily do it with the help of article by Bradford et al (2008) but not with the help of article by Sheehan (2008)

Descriptive Essay - The Meadow -- Descriptive Essay, Descriptive Writin

The Meadow      Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   On a crisp autumn afternoon, I sat idly under an enormous oak tree watching as a whirlwind whisked across the rolling hills of   the meadow.   As it passed by me, the whirlwind scooped up a dormant pile of leaves lying next to the oak tree.   The leaves appeared to come alive twisting, turning, and dancing about the meadow.   They were sporting their new fall colors of red, orange, brown, and yellow.  Ã‚   The brittle autumn leaves seemed to be having a party.   As the party moved out of sight, I began to think about the last time I visited the meadow.   The memories of my last visit are vivid with relaxed and peaceful thoughts   motivated by the images, scents, and sounds of the meadow.      Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The beauty of the meadow in the summer is unequaled.   My memories contained many images of this special place.   Snow covered mountains extend high above the heavens; thus, setting the backdrop to the meadow.   Wildflowers speckled the base of the mountain becoming more abundant   near the babbling brook.   The brook ran through the midd...

Evaluate and Use Information and Communications Technology Essay

The purpose of this essay is to research a technological toy, I focused on Bee Bots, which I use in my setting, evaluate and critically analyse the effectiveness of that toy in promoting children’s learning. Later I will demonstrate my personal use of ICT and a record of use of Information and Communications Technology (ICT) over a period of one month as a professional role in promoting children’s development in my setting. Finally, I will reflect on my tracking sheet and identify the opportunity to develop ICT in communication with parents. According to Siraj-Blatchford, Whitebread (2003) in supporting children in their development of an early understanding of ICT we are concerned to support them in learning about a wide range of products that are used to manipulate, store, retrieve, transmit or receive information not only computers. Most of the ICT applications that we are familiar with today are put to use in electronic products such as telephones, audio and video, CD player, recorders, computers, television. I am going to focus on a programmable toy – Bee Bot. I chose that particular piece of ICT toy as we use it quite often in our setting. Bee Bot is a bright and a colourful and multi-sensory programmable floor robot, suitable for use in Early Years. According to Morgan, Siraj-Blatchford (2009) the use of programmable toys in early years educational settings is based upon the constructionist teaching approach, which is underpinned by the idea that learning can happen most effectively when people are actively engaged with doing and making things in the real world and was first developed by Papert, in 1993. Bee Bot â€Å"enable young children to learn through play about control and directional language and provides a perfect ‘hands on’ introduction to robotics† (Sprainger, 2007). Sturdy construction and colourful, easy-to-operate design is a perfect tool for teaching alphabet, number recognition, fine motor skills by using the directional buttons, and social skills such as turn taking. Direction keys are used to enter up to forty commands which send Bee Bot forward, back, left and right. Pressing the green ‘Go’ button starts the toy on its way. â€Å" Bee Bot blinks and beeps at the conclusion of each command to allow children to follow Bee Bot through the program they have entered and then confirms its competition with lights and sound† (Terapine Software, no date). It works on rough or smooth surfaces and is small enough to be used on a table (Inclusive Technology, no date). Bee Bot moves in 6†steps and 90 degree turns and compact size as well as durable material make Bee Bot child and classroom friendly. Bee Bot is equally adaptable to home and school environment, it can be use both indoor and outdoor and operates on three AA batteries (Interactive Learning in the Early Phase, No date). In 2005, Bee Bot was awarded a Gold Award at the Practical Pre-School Award in London and in 2006 Bee Bot was a winner of an Education Resources Award in the Primary ICT category awarded by The British Educational Suppliers Association (BESA), (TTS: Educational Supplies for Schools, Nurseries & Childminders , No date). After an initial introduction to the toy Bee Bot help children to engage in playful exploratory activity which allows for numerous opportunities such as self-initiated activity, which provide opportunities for quality adult-child and child-child interactions (Siraj-Blatchford, Whitebread, 2003). According to Light and Butterworth, activities requiring ‘joint attention’ and which involve ‘children learning to share’ provide a better cognitive challenge for young children than activities were they work alone† (Developmentally Appropriate Technology in Early Childhood, No date). Learning with the Bee Bot is a highly social experience and support communication and social skill development, children learn about negotiating, taking turns, sharing and peer work. The Bee Bot has the capacity to support children to develop a broad range of essential skills across curriculum and the only limit is the practitioner and children imagination. It is available with across curriculum mats to enhance children learning in all area of their development, therefore in my work place we adapt the mats that we already have in our setting and I still feel that we did not use its full potential. So far we used Bee Bot with Alphabet mat, and alphabet flash cards to extend children letter sound recognition and oral language development for children with English as an Additional Language (EAL) to support their listening and recalling skills. Number and shape mat is used to expand children mathematical skills such as counting, number recognition, positional language, shape recognition. Road mat is used to develop children orientation as they need to manipulate, orientate, track and rotate the Bee Bot as well as road safety skills. Using a Bee Bot also introduce the children to a range of science skills as they interpret design challenges, generate possible solutions, make plans, test and evaluate and modifying the program were necessary (Sprainger, 2007). I founded as well as a number of eachers around the world (see teachers reviews in Appendix C) that Bee Bot are good value for money (manufacture instruction enclose in Appendix B) and the only disadvantage I can find is that after each activity program needs to be cleared in order to reprogrammed again. Although, it is clear that ICT should be used ‘to develop skills across all six areas of learning’ it is the ‘Knowledge and Understanding of the World ’ strand alone in the guidance that makes direct reference to ICT usage. â€Å"It is clear that young children are computer†¦ literate at an early age† (Keating, 2007, pg. 126). According to DATEC (No date) any application introduced to children in order to develop understanding and experience of ICT should not just be enjoyable, although this is important but more importantly should be educationally effective. Children need a variety of applications which encourage a range of development, including creativity, self-expression and language. From analysing my tracking sheet which recorded the use of ICT in my setting (details in Appendix A) I must admit that I was quite impressed with the amount of ICT equipment we use with children each day without even realising. From the tracking sheet I understood how important modelling and collaborative play is in Early Years. Programmable toys and many screen based applications offer the possibility of collaboration but adult intervention is frequently needed to gain the most from the ICT ‘equipment’. According to the UK Effective Provision of Preschool Education (EPPE) (Sylva et al, 2004), and Researching Effective Pedagogy in Early Childhood (REPEY) (Siraj-Blatchford et al, 2002) studies have found that the most effective foundation stage settings combined the provision of free play opportunities with more focused group work involving adult instruction. This approach appears to be most desirable model to promote ICT and I must proudly admitted that we are focusing on small group activities to meet all children’s needs, especially with EAL children. The relationship between cognitive strategies and language development is currently regarded as central to understanding children’s difficulties developing language as a first or additional language. Skinner emphasizes the roles of imitation, repetition, reward and reinforcement in formal language teaching situation (Lewis, Norwich, 2005). Adult-child interactions that involved some elements of ‘sustained shared thinking’ were especially valuable in terms of children’s early learning† (Siraj-Blatchford, and Siraj-Blatchford, No date). Activities I have provided for the children in my setting are differentiated according to their interest, age and learning style and were â€Å"targeted at learner’s educational needs and stage of understanding† (Hurst, 1997, pg. 82), as according to Miller, Devereoux (2004, pg155) â€Å"children need to be able to experiment, repeat activities in variety of ways and have some control over a pace of what they are doing†¦ ollaborate with adult and each other and share their discoveries and triumphs†. Furthermore, the work of Bruner and Vygotsky suggests that â€Å"we actually come to understand what it is we think through talk† (Moyles, 1995). â€Å"Bruner showed that children need to be reminded of previous experience†¦ by pictures, books†¦ he called this ‘iconic thinking’, he also felt that role of adult was important†¦ as†¦ adult provides support as children develop their competence and confidence† (Tassoni, H uccker, 2005, pg. 31). I believe that according to North, McKeown, (2005, pg. 72) â€Å"ICT meets all learners styles as it â€Å"lets pupils learn by looking, listening and doing†. â€Å"Although the evidence on gender differences in attitudes towards computer-related activities, levels of participation with computers,†¦ it appears that girls perform just as well as boys when they engage with computer-based learning† ( Bancroft, Carr, 1998, pg. 104) and it has been proved in my setting that girls get involved as equally often and well in ICT related equipment as boys. From my tracking I also realised that we are meeting entire requirement as Every Child Matter (2008) suggested relating to observation, assessment, planning, key person by using ICT equipments such as cameras, video recorder, Interactive White Board (IWB) and Fronter – School Blackboard (explained deeply in Appendix D), which is available through London Managed Learning Environment (MLE) (Ealing Grid for Learning, No date) and all the staff have been given training on it. Children from key stage one and two are able to access Fronter from home and share their school life with their parents. In the sector I work in – Early Years Foundation Stage parents are given individual logins and passwords to be able to track what is happening in our nursery each term, check any events that are taking place in school but in my opinion working with parents in relation of ICT is an area that needs improving. I discovered three main issues that must be improved in my opinion to develop a better communication and build better relationship with our parents. First of all, I must mention that even though as a school staff we have opportunities for professional development and ICT â€Å"supporting learning† (Teaching and Learning, No date). Training are usually organised by our school ICT co-ordinator. Insets quite frequently and I recognise myself as being a computer literate person thus we must consider that not all of our parents â€Å"can present barrier† (Plowman, Stephen, 2003, pg. 160) and perhaps school could extend ‘children Fronter club’ for ‘parents Fronter club’ to help parents overcome that barrier as â€Å"home school link and parents involvement is therefore a component of effective school† (Curriculum Guidance, 2001). Secondly, the language barrier could be one of the reasons why parents are not so keen on using our School Blackboard. To overcome this barrier after having an Inset with my manager we decided that the school news letter both in electronic form and hard copy could be translated in the most common spoken languages in our school, such as Tamil, Somali, Arabic and Farsi. As a Foundation Stage Practitioners we all agree that when â€Å"parents, teachers and children collaborate towards the same goals it leads to the improved academic performance of children† (Curriculum Guidance, 2001). Lastly, in my opinion the main issue could be, as the school is situated in low-income industrial area, that not all household might have an access to the computer. According to Morgan, Siraj-Blatchford (2009) research evidence has shown that the efforts of parents and preschools can make a considerable difference to children’s future educational achievements regardless of their socio-economic background and current national policy initiatives aim is to close the gap in educational achievement for children from disadvantaged background. â€Å"One of the ways in which this commitment has manifested itself has been in the Government’s three hundred million pounds Home Access project which provides computers and internet access to families to enhance learning at home† (Morgan, Siraj-Blatchford , 2009, pg. 13). Our school received the funding three years ago and designed the ‘parent computer room’ which was very popular at the begging but now seems to be forgotten. I think it is a good time to bring up that issue during the Inset to make use of that room again. When talking about ICT I must mention about a â€Å"number of queries and concerns regarding health and safety issues and other risks, which may be associated with technology routinely used by young children (Morgan, Siraj-Blatchford, 2009, pg. 39) , such as using electricity . Our children are thought not to â€Å"investigate or play with any equipment that uses mains electricity† (Creary, 2002, pg. 4) and all sockets are protected with socket protector to eliminate any hazards. According to Health and Safety at Work Act (1974) Portable Appliance Testing (PAT Testing and Portable Appliance, No date) is required once a year and our school has passed one two weeks ago. It is important that while children learn about ICT they also learn how to manage their own space and select the right tools when sitting at the computer. According to Morgan, Siraj-Blatchford (2009) it is therefore advisable that the regular use of any computer application by three years old child should not be longer than ten to twenty minutes. Young children, parents and practitioners are using ICT in novel and creative ways† (Morgan, Siraj-Blatchford, 2009, pg. 40) and it is important to use all available ICT equipment safely. Our school leaders with ICT co-ordinator â€Å"consider the issue of e-safety† (E-safety, No date) and drew Acceptable Use Policy (AUP) (See Appendix E). According to Every Child Matter (2008), suitable premises, environment and equipment our outdoor and indoor spaces, furniture, equipment and toys are safe as they are checked on regular basis and school is monitored by CCTV camera and locked.

Hum 105 WORLD MYTHOLOGY Essay - 779 Words

Hum 105~World Mythology Assignment One How is the word myth used popularly? For example, what does the statement, â€Å"It’s a myth† mean? In contrast, how is the word myth used in the academic context? After considering the definition in your textbooks and course materials, write a definition in your own words. The word myth is used most popularly in tales and stories. These tales and stories have been passed down from generation to generation and are based on some truth, but mostly an idea or common theme. The statement â€Å"It’s a myth† means that a tale or story may be based on some truth, but that it is also based on fiction. For example, if one of your friends told you that they saw a UFO it would be hard to believe them†¦show more content†¦What is the relationship between belief, knowledge, mythology, and religion? Where do mythology and religion intersect? Where do they diverge? Think about the function of myth and religion in helping human beings cope with change, suffering, loss, and death. The very first thing I am able to think of with this is the Bible. It encompasses everything that has been asked. As far as humans being able to cope, it is said in the Bible that â€Å"I can do all things through God who strengthens me.† Even with this example, one can assume that there is literally nothing that cannot be done, as long as God is on your side. The Bible also encompasses suffering, loss and death just through the crucifixion of Jesus Christ. Having said that, its what happens after that that can be tied directly to mythology. He is resurrected from the dead ascends into Heaven, thus creating that idea that one is capable of immortality, even if you have died. Where this diverges is that unlike Greek mythology, most people who identify themselves as Christians will not recognize the Bible as one of the greatest stories of mythology, ever. How would you defend mythology’s relevance in contemporary culture? Think about familial and cultural traditions. Also, consider how mythology is used in the