The occurrence of cancer around the world is receiving increased attention by the medical establishment and the community. Numerous charities, universities, and non-profit organizations expend vast amounts of money and research to eliminate this disease in all of its forms. Unfortunately, not all types of cancer receive the same amount of attention in the media spotlight.  Whether it is due to embarrassment, ignorance, or fear, conversations about cancers involving the sexual reproduction systems are not as freely discussed in the United States or any other societies. 

While penile cancer is rare in the United States, it accounts for approximately 10% of cancers in African and South American men (Huether, McCance, Brashers, and Rote, 2017). A lack of social understanding, as well as the fear and ignorance that accompany diseases associated with sexual subjects, make delays a compounding problem. A specific diagnosis of penile cancer generally comes after a patient has noted a tumor or lesion. Further diagnosis, if it is not delayed, is done through an examination of the size, location, and fixation of the lesion. A biopsy is then performed along with imaging to determine if any metastasis has occurred in the surrounding lymph nodes. Treatment of this condition is usually completed with surgery although multimodal chemotherapy options are also being studied.  

Vaginal or cervical cancer is often discovered by females who experience vaginal bleeding or discomfort. These symptoms, again if not delayed, likely are followed by a physical including a bimanual pelvic examination and a Pap test. Additional testing for suspected cancerous growth includes an HPV test, colposcopy, and biopsy test to look for abnormal cellular growth or signs of cancer. Lastly, imaging, including MRI scans, computerized tomography, and positron emission tomography may be employed to identify and plan for the treatment of abnormal cellular growths. Treatment for cancer in the female reproductive organs is similar to that of men as surgery and chemotherapy, including radiation is often employed. 

Another similarity among men and women developing penile or cervical/vulvar cancer is the acquisition of the Human Papilloma Virus (HPV). Douglawi and Masterson (2019) note that nearly 40% of cases in France have been linked to this virus, which is most often acquired through unprotected sexual contact. Abramowitz et al. (2018) indicate an incidence of 7.5 per 100,000 women in the United States. Recent campaigns to vaccinate young adults, teens, and those in early adulthood has shown positive results in preventing transmission of this disease Joura, et al. (2019) agree that proper vaccination combined with screening can reduce recurrent or subsequent HPV disease transmission. 

A difference in the ability to recognize the presence of cancer includes visibility to the patient. Male sexual organs present an additional chance to catch the presence of a lesion by existing outside the body. Men that use good hygiene and self-examination practices are more likely to note a sore or lump on the penis than a female who must contend with pelvic pain or vaginal bleeding as a warning sign. 

Many of the same behavioral factors that cause cancer in other areas of the body are believed to be linked to the development of cancer within the reproductive organs. Factors such as smoking, poor personal hygiene, and HPV infection from unprotected sexual contact are associated with higher instances of penile or cervical/vulvar cancer (Emilio, Luigi, Riccardo, and Carlo, 2019). Additional factors such as diet and physical activity levels, remain a modifiable risk that can be adjusted with the appropriate education and effort. 

 Continued education of low-risk areas, as well as increased education of high-risk areas in Africa and South America, is the best way to reduce these debilitating illnesses. Information about the risk factors and best practices for maintaining a healthy lifestyle allow uneducated populations to realize access to treatment. The most effective avenue of treatment will include vaccines for males and females, to prevent acquiring HPV and information that stresses a healthier lifestyle, including physical activity and a low-fat diet.

References

Abramowitz, L., Lacau Saint Guily, J., Moyal-Barracco, M., Bergeron, C., Borne, H., Dahlab, A., Bresse, X., Uhart, M., Cancalon, C., Catella, L., and Bénard, S. (2018). Epidemiological and economic burden of potentially HPV-related cancers in France. Plos One, 13(9), e0202564. doi:10.1371/journal.pone.0202564

Emilio, S., Luigi, V., Riccardo, B., & Carlo, G. (2019). Lifestyle in urology: Cancer. Urologia, 86(3), 105–114. doi:10.1177/0391560319846012

Douglawi, A., & Masterson, T. A. (2019). Penile cancer epidemiology and risk factors: a contemporary review. Current Opinion In Urology, 29(2), 145–149. doi:10.1097/MOU.0000000000000581

Joura, E., Kyrgiou, M., Bosch, F., Kesic, V., Niemenen, P., Redman, C. W., & Gultekin, M. (2019). Human papillomavirus vaccination: The ESGO–EFC position paper of the European society of Gynaecologic Oncology and the European Federation for colposcopy. European Journal of Cancer, 116, 21–26. doi:10.1016/j.ejca.2019.04.032

"Looking for a Similar Assignment? Get Expert Help at an Amazing Discount!"

 The article I found is called Problem Based Learning in Clinical Nursing Education. The theory used in this article is Problem Based Learning Strategies, or PBL. PBL is the use of predefined clinical situations or case studies to enhance or stimulate students to acquire specific skills, knowledge, or abilities (Rowles, 2012). The article describes how clinical nursing education is very challenging in Pakistan due to the lack of knowledge, resources, and expertise in building connection between the classroom and clinical practice (Farid, 2012). The study implemented Problem based learning because it has been proven to be an effective approach in developing student skills, such s problem solving and self-directed learning. The nursing program in Pakistan that implemented PBL saw a great increase in the students’ knowledge and clinical skills.

            I think Problem based learning is a great was to learn. I remember using it in nursing school, and I felt that it helped me in clinical. It is one thing to learn how you’re supposed to do something, but PBL helps to bring the learning to real life situations which is key to learning critical thinking skills.

            Curriculum is a formal plan that provides goals and guidelines for the delivery of a specific educational program (McEwen & Wills, 2014). Most nursing programs are based on the Tyler Curriculum Development Model. This model identifies the objectives of the program, which learning experiences should be chosen to get to the objectives, and how to organize experiences and evaluate whether they have been met. State boards of nursing set requirements that must be met by nursing programs to maintain accreditation. As health care continues to change, however, nursing programs will also have to change to keep up.

References

Farid, F. N., & Ali, S. F. (2012). Problem Based Learning in Clinical Nursing

            Education. International JouEBSCOhost.htm rnal of Nursing Education, 4(2), 14–16. Retrieved from

https://search-ebscohost-com.prx

McEwen, M. & Wills, E. (2014). Theoretical Basis for Nursing (4th Ed.); Lippincott Williams and Wilkins.

Rowles, C. J. (2012). Strategies to Promote Critical Thinking and Active Learning. Teaching in 

            Nursing, a Guide to Faculty. (4th ed. Pg. 258-284). St. Louis, Elsevier.

"Looking for a Similar Assignment? Get Expert Help at an Amazing Discount!"

It is important for nurses to understand and identify what research, evidence-based practice and improvement processes or Quality improvements are so that they can be better equipped to serve patients. Research is the critical investigation that answers questions about a nursing phenomena. Evidence based practice is the collection, and integration of the said research. Improvement processes or quality improvement is the use of data to monitor the results of care as well as the use of improvement methods to design and test changes in practice. Therefore with the results of research comes evidence based practice, and quality improvement is how things change after the evidence based practice was integrated into the medical practice.

 Thus these three components impact the medical practice in different but important ways. Pamela K. Ginex states the different impacts on practice as being ” Research generates new knowledge for practice and adds to our professions’ knowledge base through the literature. Evidence- Based practice translates knowledge with a goal of improving practice. And Quality improvement, improves patient care processes and outcomes in specific healthcare settings. (Ginex)”

Refrences

Ginex, P. k. (2020, January 20). The Difference Between Quality Improvement, Evidence-Based Practice, and Research. Retrieved January 23, 2020, from https://voice.ons.org/news-and-views/oncology-research-quality-improvement-evidence-based-practice

"Looking for a Similar Assignment? Get Expert Help at an Amazing Discount!"

please write a response on the diagnostic test and support your response with reference.  

"Looking for a Similar Assignment? Get Expert Help at an Amazing Discount!"

According to Huether and McCance (2017), Addison’s disease is an auto-immune disorder marked by adrenal insufficiency and is more common in white women than all ethnicities of men. Relatively rare, this disease most often occurs between the ages of 30-60 (Huether &McCance, 2017). Addison’s disease is an inherited disorder, however, research on the pathway of genetic inheritability has been limited because the genotype of a patient does not always predict their phenotype and the rarity of disease inhibits large scale genetic analysis (Mitchell & Pearce, 2012).  According to Mitchell and Pearce (2012), it is a progressive disease with symptoms developing over months or years. Initial clinical manifestations of disease will appear in the increase of adrenocorticotropic hormone and renin well before adrenal failure develops (Mitchell & Pearce, 2012). 

     Pathological changes of the adrenal glands (including adrenal atrophy) are combined with fatigue, hypotension, weight loss and hyper skin pigmentation (Mitchell & Pearce, 2012). The steroidogenic enzymes in the adrenal cortex of the patient with Addison’s disease become targets for the immune system to attack (Mitchell & Pearce, 2012). The presence of circulating steroid 21-hydroxylase antibodies is a reliable predictor of Addison’s Disease, this is normally located on the smooth endoplasmic reticulum of intact cells (Mitchell & Pearce, 2012).  This can lead to other autoimmune responses in the body, metastatic malignancy, amyloidosis, hemorrhage, infections, adrenoleuko dystrophy, or sarcoidosis. Other clinical manifestations include low levels of cortisol in serum and urine tests, increased ACTH levels, BUN increases (due to dehydration), Eosinophil and lymphocyte elevations, hyperkalemia and mild alkalosis (Huether & McCance, 2017). Treatment involves glucocorticoid and mineralocorticoid replacement for life as well as increases in sodium intake if patient experiences excessive sweating and diarrhea.

References

Huether, S. E., & McCance, K. L. (2017). Understanding Pathophysiology(6th ed.). St. Louis, 

MO: Mosby.

Mitchell, A. L., & Pearce, S. H. S. (2012). Autoimmune Addison disease: pathophysiology and 

genetic complexity. Nature Reviews. Endocrinology, 8(5), 306–316. https://doi-org.ezp.waldenulibrary.org/10.1038/nrendo.2011.245

"Looking for a Similar Assignment? Get Expert Help at an Amazing Discount!"