Management Styles and Organizational Performance Exploratory Essay. Introduction Management styles are methods of leadership for organizing, directing, influencing, leading and facilitating organizational performance. They dictate how managers are to make decisions, whether to involve subordinates or whether to disregard them. In addition, each style has its unique features that dictate how employees and managers are to relate and communicates. On the other hand, Management theories are the set of rules or guidelines that seek to help and direct managers in developing effective ways of managing an organization (Miles 2012). Such theories act by assisting employees in ensuring that they develop an effective relationship with the goals of the business and implement some effective ways of achieving these goals. Management theories include Fayol’s theory of management, Taylor’s scientific theory, Max Weber’s theory and Maslow’s hierarchical theory of human needs. Each has its unique features. Fayol’s theory emphasises on division of labour/work as a way of reducing the span of human efforts (Cole 2011). Taylor’s theory (Taylorism) involves breaking down of the key components of manufacturing tasks and timing each movement in order to determine the best way of performing each of the tasks (Jide 2011). Weber’s theory emphasizes on bureaucratic leadership models. Bureaucracy in this theory implies to the organizational form applied in an individual institution it applies to a number of dominant facets of the organization, including hierarchy of authority (Gomez-Mejia, BalkinManagement Styles and Organizational Performance Exploratory Essay
Is it possible to distinguish testicular torsion and other causes of acute scrotum in patients who underwent scrotal exploration? A multi-center, clinical trial ABSTRACT Objectives: We assessed the importance of the clinical presentation of boys who underwent surgical exploration for acute scrotum. Materials and Methods: We retrospectively analyzed the records of 97 boys (≤25 years old) who underwent surgical exploration for acute scrotum between May 2007 and July 2013. Diagnosis of acute scrotum was confirmed by physical examination, colour Doppler ultrasound (CDUS) and laboratory findings. Results: In total, 97 scrotal explorations were carried out for acute scrotal pain. 74.2% (n=72) had testicular torsion (TT), 25.8% (n=25) had other pathologies included torsion of testicular appendage (n=13), epididymo-orchitis (n=8), testicular trauma (n=2), and Henoch-Schönlein purpura (n=2). In the TT group, 32 cases (44.4%) presented to hospital within the less than 6 hours after pain onset, and more than half (64%) others group cases presented >24 hours after pain onset. Fever and pyuria appeared more frequently in the others group than in the TT group, and the results reached statistical significance. Patients with TT had more testicular tenderness compared to the others group (p<0.001). Our testicular salvage rate was 59.7% and missed testicular torsion rate was 40.3%. Conclusions: CDUS was largely predicted the diagnosis of TT (sensitivity, 98.6%). Clinical findings such as testicular tenderness, fever and pyuria may be helpful in making the differentiation in TT and others (nonsurgical) group. Key words: surgical acute scrotum; non-surgical acute scrotum; testicular torsion; torsion of testicular appendages; epididymo-orchitis; scrotal exploration. INTRODUCTION When acute scrotal pain is experienced by a child or teenage boy in his adolescence, one should always treat this condition as an emergent condition, whether or not it is accompanied by swelling. Torsion of the spermatic cord, epididymo-orchitis, torsion of testicular appendages, trauma, tumor, hernia, idiopathic scrotal edema vasculitis and cellulitis are signs looked for when diagnosing acute scrotum. Although the majority of these conditions are non-emergent, when torsion of the spermatic cord occurs, it is vital that it be immediately diagnosed and treated. If it is not, the testicle could suffer permanent ischemic damage (1). The most common causes of acute scrotum in young people are testicular torsion (TT), epididymo-orchitis (EO), torsion of testicular appendage (TTA), and epididymo-orchitis (EO) (2-4). Because of the possible risk of permanent damage to the testicle, it is vitally important to determine whether the acute scrotal pain is caused by testicular torsion or something else. In the past, medical professionals have used sonography and clinical findings to help determine the cause (5,6). This study examines the results of scrotal exploration, the symptoms and signs of acute scrotum and ways to distinguish whether testicular torsion or other factors are the cause of acute scrotum in young patients. MATERIALS AND METHODS 97 patients underwent exploration of scrotum for acute scrotal pain between May 2007 and July 2013. A retrospective review off all boys up to the age of 25 years. Data were obtained retrospectively maintained hospital databases of all patients who underwent scrotal exploration in four tertiary referral centres (Suleyman Demirel University Faculty of Medicine, Isparta, Haydarpasa Training and Research Hospital, Istanbul, Tepecik Training and Research Hospital, Izmir, and Fatih Sultan Mehmet Training and Research Hospital, Istanbul). Patient selection The case notes of all the operated patients with acute scrotum were selected for evaluation. All participants were examined physically by a resident or the consultant of Urologist. Physical findings included scrotal erythema, swelling, tender scrotum was recorded. Patients’ ages, clinical findings, the affected side, pain duration, previous history, fever (>38°C), nausea-vomiting, final diagnosis, and type of surgery were evaluated. In all cases, a white blood cell (WBC) and urinalysis (pyuria) were requested. Patients with a recent surgery of the external genitalia, an incarcerated hernia, tumor and extravaginal neonatal spermatic cord torsion were excluded from the study. Colour Doppler ultrasonography (CDUS) was performed in all patients. Because of an assumed unreliability of CDUS the decision for surgical exploration was mainly based on the clinical findings because of the implications of missing testicular torsion. Torsion of the testis was managed by either orchidopexy or orchidectomy. The contralateral testis was also fixed. Torsion of the appendix testis was treated by excision. In cases of epididymo-orchitis the ipsilateral testis only was fixed. Orchiectomy was performed in two patients with testicular rupture and hematoma after trauma. Two HSP patients who had not got torsion, underwent bilateral testicular fixation. This study was approved by the Local Ethics Committee of the Suleyman Demirel University, Faculty of Medicine. Statistical analysis Statistical analysis was performed with the Statistical Package for the Social Sciences (SPSS) for Windows, version 19.0. A significance value of p<0.05 was accepted as statistically significant. Data are expressed as a mean ± standard deviation for continuous variables, and as a number and percentage for categorical variables. Categorical data between groups were compared using χ2 test or Fisher’s exact test while continuous distributed data were compared using either Mann–Whitney U test or analysis of variance. RESULTS A total of 97 patients were included in this study and divided into two groups. Seventy-two patients had TT (74.2%), 25 patients had other acute scrotal pathologies (25.8%). Other pathologies included torsion of testicular appendage (n=13), epididymo-orchitis (n=8), testicular trauma (n=2), and Henoch-Schönlein purpura (n=2). Table 1 presents final diagnoses after exploration. The characteristics of the two groups are presented in Table 2. The mean age of patients with TT (17.9±4.5 years) and other group (16.6±7.3 years) were similar. In TT patients, the left testicle was more often affected than the right one (58.3% vs 41.7%). The left testicle was more affected in both of the two groups. In terms of pain onset time, the TT group than in the other group referenced in the early hours was observed. (p=0.003). In the TT group, 32 cases (44.4%) presented to hospital within the less than 6 hours after pain onset, and more than half (64%) other group cases presented >24 hours after pain onset. Clinical features and physical examination findings are presented in Table 3. Fever and pyuria appeared more frequently in the others group than in the TT group, and the results reached statistical significance (p<0.05). Patients with TT had more testicular tenderness compared to the other group (p<0.001). The prevalence rate of nausea/vomiting, scrotal erythema and swelling among the two groups were not significantly different. Patients in the others group had a higher WBC count than the TT groups, but was not statistically significant. Scrotal exploration was performed in all patients (100%). Viable testes were found in 43 of 72 patients with TT during operation. Detorsion and fixation of testes were performed. The other 29 patients received orchiectomy for nonviable testis and orchiopexy for unaffected testis to prevent further TT. The salvage rate of TT was 59.7% (Table 4). Only one case was performed manual detorsion before scrotal exploration and fixation. All patients underwent CDUS (Table 5). Importantly, 71 of 72 TT (98.6%) were correctly identified as torsions. DISCUSSION For young people, the most common causes of acute scrotum are TT, EO and TTA (2,3,4,7). Of these three, TT is the cause for 25%-35% of acute pediatric scrotal disease and is found in .025% of males under 25 years of age (8). In our study, values of TT, TTA and EO were found to be 74.2%, 13.4% and 8.2%, respectively. This result is compatible not only with clinical studies (6,7,8,9,10) in which only scrotal exploration was evaluated, but also with clinical studies (11,12,13,14,15) in which surgical and medical treatments were evaluated in terms of three clinical entities. The most common reason for acute scrotum is TT in five of the studies (6,7,9,12,15), TTA in three of them (8,11,13) and EO in 2 of them (10,14). Interestingly, there are studies which find a strangulated inguinal hernia responsible within these most common 3 clinical conditions (16). In our study, TT is discovered to be the cause for most of the cases of acute scrotum. Also, the condition that is most often reported in Turkey is TT. Ideally, though sometimes clinically impossible, there should be a distinction between TT and other causes not requiring surgery (17). Studies have been made to distinguish TT from other acute scrotal pathologies and reduce the ratio of negative exploration. In these studies, clinical findings such as a pain duration <24 h, nausea/vomiting, a high position of the testis, and an abnormal cremasteric reflex are found to be predictive of TT (18,19). In our study, a comparison is made between the “TT group” and an “others group” consisting of patients not requiring surgery other than two trauma cases who underwent orchiectomy due to testicular rupture. According to our findings, there were no statistically significant differences in the way that the two different groups of patients reacted as far as scrotal erythema/swelling, nausea/vomiting and other clinical presentations. Whereas testicular tenderness was found to be high in the TT group, pyuria and fever were high in the other group both significantly and statistically. This difference observed in pyuria and fever in the other group may be related to urinary system infections which are more common in EO (20). Over the past 20 years, medical professionals have frequently used the Colour Doppler ultrasound (CDUS) to determine the presence and extent of TT. This machine is helpful in determining when surgical exploration of the scrotum is unnecessary, cutting down the number of unnecessary explorations (21). Nevertheless, the information provided by the CDUS is affected by how the user uses the machine and should be compared with the medical history of the patient and the results of a physical exam (22). In the diagnosis of TT, CDUS is reported to have 69.2-100% sensitivity and 87-100% specificity ratios (23,24). Only in one patient, a false negative result was achieved in the diagnosis of TT, and CDUS sensitivity was found to be 98.6%. It is known that CDUS causes complexity in making diagnosis of ATT and EO cases and causes over diagnosis in EO (20). Although it is reported that CDUS doesn’t deviate in HSP, which is the nonsurgical cause of acute scrotum, asymmetrically reduced blood flow and absence of blood flow in CDUS could not be clinically differentiated from TT due to scrotal hyperemia and edema (25). Bilateral testicular fixation was applied in cases not presenting tortion in scrotal exploration. Although scrotal trauma is usually taken care of with minimal intervention, when the testis is ruptured traumatically this is a signal that immediate surgical exploration is necessary (21). We performed orchiectomy in two trauma cases in which hematoma developed and was followed by traumatic rupture. The success rate of preserving the testicle in the case of TT closely depends on early admission. Cimador et al (25) reports that testicular infarction initiates after the 2nd hour of ischemia and that complete infarctus occurs in 6 hours and the irreversible loss of the testicle would develop in 24 hours. Also, it is reported that a non-viabile testicle is a very specific symptom in admissions after 10 hours and that this characteristic would require orchiectomy in all cases. The ratio of preserving testicles varies between 37 to 88% in literature (9,10,13,14,15). In our study, it was observed that the TT group was admitted significantly earlier (55.5% < 12 h) than the others group (p=0.003). In accordance with that, the rate of preserving the testicle was found to be 59.7% (43/72). This result suggests that more TT cases are admitted with the sudden onset of pain when compared to nonsurgical acute scrotum cases. In our study, non TT acute scrotal pathologies are used for the comparison group. The lower patient number in this group and 2 trauma cases not leading to a 100% homogeneous study can be counted as study restrictions. Conclusion In order to avoid the loss of the testicle and unnecessary surgical interventions, it is important to distinguish TT from other acute scrotal pathologies. Thus, CDUS, which presents more specific findings for TT, and clinical findings such as testicular tenderness, fever and pyuria may be helpful in making the differentiation. Again, it should be remembered that TT cases are mostly admitted earlier with the sudden onset of pain. Conflict of interest: None declared. REFERENCES 1. Gatti JM, Patrick Murphy J. Current management of the acute scrotum. Semin Pediatr Surg. 2007;16:58-63. 2. Lewis AG, Bukowski TP, Jarvis PD, Wacksman J, Sheldon CA. Evaluation of acute scrotum in the emergency department. J Pediatr Surg. 1995;30:277-81. 3. Burgher SW. Acute scrotal pain. Emerg Med Clin North Am. 1998;4:781-809. 4. Kadish HA, Bolte RG. A retrospective review of pediatric patients with epididymitis, testicular torsion, and torsion of testicular appendage. Pediatrics. 1998;102:73-6. 5. Beni-Israel T, Goldman M, Bar Chaim S, Kozer E. Clinical predictors for testicular torsion as seen in the pediatric ED. Am J Emerg Med. 2010;28:786-9. 6. Nason GJ, Tareen F, McLoughlin D, McDowell D, Cianci F, Mortell A. Scrotal exploration for acute scrotal pain: A 10-year experience in two tertiary referral paediatric units. Scand J Urol. 2013;47:418-22. 7. Jefferson RH, Perez LM, Joseph DB. Critical analysis of the clinical presentation of acute scrotum: a 9-year experience at a single institution. J Urol. 1997;158:1198-200. 8. Waldert M, Klatte T, Schmidbauer J, Remzi M, Lackner J, Marberger M. Color Doppler sonography reliably identifies testicular torsion in boys. Urology. 2010;75:1170-4. 9. Hegarty PK, Walsh E, Corcoran MO. Exploration of the acute scrotum: a retrospective analysis of 100 consecutive cases. Ir J Med Sci. 2001;170:181-2. 10. Cavusoglu YH, Karaman A, Karaman I, Erdogan D, Aslan MK, Varlikli O, et al. Acute scrotum – etiology and management. Indian J Pediatr. 2005;72:201-3. 11. McAndrew HF, Pemberton R, Kikiros CS, Gollow I. The incidence and investigation of acute scrotal problems in children. Pediatr Surg Int. 2002;18:435-7. 12. Molokwu CN, Somani BK, Goodman CM. Outcomes of scrotal exploration for acute scrotal pain suspicious of testicular torsion: a consecutive case series of 173 patients. BJU Int. 2011;107:990-3. 13. Mushtaq I, Fung M, Glasson MJ. Retrospective review of paediatric patients with acute scrotum. ANZ J Surg. 2003;73:55-8. 14. Lyronis ID, Ploumis N, Vlahakis I, Charissis G. Acute scrotum-etiology, clinical presentation and seasonal variation. Indian J Pediatr. 2009;76:407-10. 15. Moslemi MK, Kamalimotlagh S. Evaluation of acute scrotum in our consecutive operated cases: a one-center study. Int J Gen Med. 2014;15:75-8. 16. Erikci VS, HoÅŸgör M, Aksoy N, Okur O, YÄ±ldÄ±z M, Dursun A, et al. Treatment of acute scrotum in children: 5 years’ experience. Ulus Travma Acil Cerrahi Derg. 2013;19:333-6. 17. Kalfa N, Veyrac C, Baud C, Couture A, Averous M, Galifer RB. Ultrasonography of the spermatic cord in children with testicular torsion: impact on the surgical strategy. J Urol. 2004;172:1692-5. 18. Boettcher M, Bergholz R, Krebs TF, Wenke K, Aronson DC. Clinical predictors of testicular torsion in children. Urology. 2012;79:670-4. 19. Boettcher M, Krebs T, Bergholz R, Wenke K, Aronson D, Reinshagen K. Clinical and sonographic features predict testicular torsion in children: a prospective study. BJU Int. 2013 ;112:1201-6. 20. Yin S, Trainor JL. Diagnosis and management of testicular torsion, torsion of the appendix testis, and epididymitis. Clin Ped Emerg Med. 2009;10:38-44. 21. Gronski M, Hollman AS. The acute paediatric scrotum: the role of colour doppler ultrasound. Eur J Radiol. 1998;26:183-93. 22. Pepe P, Panella P, Pennisi M, Aragona F. Does color Doppler sonography improve the clinical assessment of patients with acute scrotum? Eur J Radiol. 2006;60:120-4. 23. Zini L, Mouton D, Leroy X, Valtille P, Villers A, Lemaitre L, et al. Should scrotal ultrasound be discouraged in cases of suspected spermatic cord torsion? Prog Urol. 2003;13:440-4. 24. Lam WW, Yap TL, Jacobsen AS, Teo HJ. Color Doppler ultrasonography replacing surgical exploration for acute scrotum: myth or reality? Pediatr Radiol. 2005;35:597-600. 25. Cimador M, DiPace MR, Castagnetti M, DeGrazia E. Predictors of testicular viability in testicular torsion. J Pediatr Urol. 2007;3:387-90. Diagnosis Patients (n=97) Testicular torsion 72 (74.2%) Other causes of acute scrotum 25 (25.8%) – Torsion of testicular appendage 13 – Epididymoorchitis 8 – Testicular trauma 2 – Henoch-Schönlein purpura 2 Table 1. Final diagnoses after scrotal exploration. Table 2. Characteristics both of two patient groups. TT (n = 72) Others (n = 25) p Age (yr) 17.9±4.5 16.6±7.3 0.707 Location 0.02 Right 30 (41.7%) 11 (44%) Left 42 (58.3%) 14 ( 56%) Duration of pain (hr) 0.003 ≤6 32 (44.4%) 2 (8%) 6-12 8 (11.1%) 2 (8%) 12-24 12 (16.7%) 5 (20%) >24 20 (27.8%) 16 (64%) TT, testicular torsion; Others, other acute scrotal pathologies Table 3. Clinical findings and laboratory data both of two patient groups. TT (n = 72) Others (n = 25) p Clinical findings Fever 1 (1.4%) 8 (32.0%) <0.001 Scrotal erythema/swelling 19 (26.4%) 19 (76 %) 0.52 Testicular tenderness 63 (87.5%) 12 (48.0%) <0.001 Nausea/vomiting 11 (15.3%) 3 (12.0%) 0.487 Laboratory data WBC counts (/μL) 10.590±3.173 11.396±3.387 0.455 Pyuria 8 (11.1%) 7 (28%) 0.044 TT, testicular torsion; Others, other acute scrotal pathologies Table 4. Treatment types and salvage rate of patients with testicular torsion. Treatment options TT(n) Detorsion and fixation 43 Orchiectomy 29 Total 72 Salvage rate 59.7% TT, testicular torsion Table 5. Results of color Doppler ultrasonography both of two patient groups. TT (n = 72) Others (n = 25) p CDUS Absent/decreased flow 71 (98.6%) 9 (36%) <0.001 Increased/normal flow 1 (1.4%) 16 (64%) TT, testicular torsion; Others, other acute scrotal pathologies; CDUS, color Doppler ultrasonography
issc361 assignment. Need help with my Programming question – I’m studying for my class.
Visit the United States Government Accountability Office website for Key Issues, Ensuring the Security of Federal Information Systems and Cyber critical infrastructure and Protecting the Privacy of Personally Identifiable Information – High Risk Issue. http://www.gao.gov/key_issues/ensuring_security_federal_information_systems/issue_summary#t=0
Under the Key Report tabs, select report and provide a summary.
EET Strengths and Weakness of ENGT Engineering Tech Oriental Development Discussion.
ooking back on what we have covered in this class, identify three areas that you would consider to be your strengths and discuss the following:Why do you feel that you excel in these areas more than others? What have you learned from the course about these topics, strategies, and/or techniques that you did not know before? What campus organizations or activities could you get involved with that would highlight your strengths?How will applying these strengths impact your academic journey and help you to reach your goals? Also, identify three areas that you would like to work on and discuss the following:What have you learned from the course about these topics, strategies, and/or techniques that you did not know before? What is your plan of action to improve upon them? What campus support resources could you reach out to for help in these areas? How can improving upon them impact your future success and help you to reach your goals?Write a well-organized reflection, 2 pages in length (typed, double-spaced).
EET Strengths and Weakness of ENGT Engineering Tech Oriental Development Discussion
Startford University Using RAPTOR Solve Computer Programming Question
Startford University Using RAPTOR Solve Computer Programming Question.
Raptor Flowchart Play Video Phase II Design step 2 (Lesson 4) FlowchartIn this phase of the project, you will implement the solution in Raptor. This will involve sequencing, selection, and iteration. Remember, Your game should allow the user to play five full rounds if they have money in their bank. Each round, the user needs to be prompted to enter a bet amount and a choice of color. The actual winning color logic is provided below. You will need to figure out where this goes in your code. After a winning color is determined, Your output should include the winning color, if the user won or lost, the user’s updated bank and the round number.How do I determine what the winning color was for each round? Raptor: Raptor comes with a function called random. random takes no arguments. The function returns a random number in the range [0.0,1.0). That is, it may sometimes return 0.0 but will never return 1.0. To generate a random integer from 1 to n, use floor((random*n) + 1). For example, you can simulate the roll of a die (random number from 1 to 6) with floor((random * 6) + 1).A flip of the coin would be represented by 0 or 1. 0 could be heads and 1 could be tails: if random<.5 flipResult=0Else flipResult=1In this scenario (red or black), we will use a flip of a coin to determine that outcome.
Startford University Using RAPTOR Solve Computer Programming Question
Chapter 5 Discussion Essay
online assignment help Every Chapter in the book is important. This week we will use the information in the book to make an informative post. Pick a topic or reference you found interesting in this week’s assigned chapter. Make sure you notate MLA or SLA style and the page you found the information on. Also, you may do some additional internet research on that same topic. You must follow the following minimum requirements: 1. Word count equal to or more than 300 words. 2 The topic and noted MLA/SLA page number reference of the materials. Failure to meet each of the above requirements will result in loss of points and a possibility of late point reduction also applies.
NSG 4055 South University Obesity Health Promotion Paper
NSG 4055 South University Obesity Health Promotion Paper.
NSG4055 Illness & Disease Management across Life Span CP01In a Microsoft Word document of 4-5 pages formatted in APA style, describe the information collected about a person with a chronic illness. Please note that the title and reference pages should not be included in the total page count of your paper.Using the information from the interview you conducted in Week 2:List the support needs of your participant beginning with the highest priority and then in descending order.Provide examples of appropriate interventions of the professional caregiver, for example, the nurse.Discuss how to implement objectives of Healthy People 2020 to increase wellness.Discuss nursing’s role as an advocate for participant acceptance of diagnosis and treatment.Discuss the impact of the environment on patient’s health.Include social determinants that impact care.Support your responses with examples and information from library resources, textbook and lectures.On a separate references page, cite all sources using APA format. Helpful APA guides and resources are available in the South University Online Library. Below are guides that are located in the library and can be accessed and downloaded via the South University Online Citation Resources: APA Style page. The American Psychological Association website also provides detailed guidance on formatting, citations, and references at APA Style.• APA Citation Helper• APA Citations Quick Sheet• APA-Style Formatting Guidelines for a Written Essay• Basic Essay TemplateSubmission DetailsName your document SU_NSG4055_W3_Project_LastName_FirstInitial.doc.
NSG 4055 South University Obesity Health Promotion Paper
Reading Response on: If a Stranger Approaches You: Stories by Laura Kasischke
Reading Response on: If a Stranger Approaches You: Stories by Laura Kasischke.
Reading Response on Kasischke Two short essays, at least 400 words each Prompt One: unreliable narrators Pick at least three stories from the collection, at least ONE must be one of the longer pieces. Discuss the way that Kasischke builds unreliable narrators in each of these stories and explain, using quotations and examples, how this aids the plot progression. Prompt two: close reading Look at at least one story from the collection, not used in your answer to the other prompt in this exam. Choose a passage of dialog or description where something important to the overall story is communicated. Explain how language choices, including dialog and vocabulary, build into the entire story. Explain why this matters.
Reading Response on: If a Stranger Approaches You: Stories by Laura Kasischke