Opposition to State-Mandated Premarital HIV Screening Essays -- AIDS

Resistance to State-Mandated Premarital HIV Screening When screening for HIV got conceivable in mid-1985, discusses started concerning the job of such screening in controlling the spread of AIDS. One such discussion concerned state-ordered pre-marriage HIV screening. This arrangement was proposed to the CDC meeting in February of 1987, yet never got a lot of across the board support, since it fulfilled neither the defenders of general wellbeing nor the advocates of common freedoms (Reamer 37). This paper will show that the state is unjustified in instituting such arrangement and ideally likewise shed some light on why such approach got so little help. In a liberal society, for example, the United States that qualities both common freedoms and general wellbeing, it is regularly indistinct which arrangements best location the danger presented by the AIDS pestilence. Obviously from one perspective, the United States is resolved to regard the security and individual self-rule of its residents. Despite the fact that not explicitly written in the constitution, the privilege to security is certain morally justified to deny illicit pursuit and seizure of home and express in the ongoing laws that ensure the protection of web and Mastercard clients. Then again, the United States is additionally dedicated to advance the general government assistance, which means it has an ethical commitment to advance general wellbeing. Generally, in the battle between common freedoms and general wellbeing, the United States has offered point of reference to common freedoms however respected takeoffs when it was demonstrated that doing so was reasonable by t he subsequent advantages to general wellbeing. Helps, in any case, challenges the harmony between common freedoms and general wellbeing like no different past pandemic, because of the solid danger it postures to general wellbeing and ... ...avior, they could most likely have been recognized through projects focused on bunches with a higher predominance of seropositives. Henceforth, the last two states of our moral structure are additionally not met. Utilizing a moral system obtained from Childress, obviously a state focused on maintaining the common freedoms of its residents just as advancing general wellbeing is unjustified in ordering pre-marriage HIV screening. Such screening encroaches on common freedoms and doesn't advance general wellbeing in an effective manner. The state is committed to look for different arrangements by which to advance general wellbeing, for example, deliberate testing and instructive programming for wedded couples, which don't abuse common freedoms and which all the more proficiently focus on the individuals who are seropositive. Works Cited Reamer, Frederic G. Helps and Ethics. Columbia University Press: New York, 1991.

Motivation theories used to explain turnover intention

Inspiration speculations used to clarify turnover goal This section talked about the utilized of inspiration hypothesis to clarify the turnover goal or conduct among the evaluators in Sabah. In addition, turnover goal the reliant variable, work fulfillment and hierarchical duty the free factors are being characterized and conceptualized in accordance with this examination. The important writing or past research done on this region of study is additionally being evaluated. Ultimately, the discoveries on the connections between the factors are being talked about. 2.1 Theory 2.1.1 Theory of Reasoned Action Turnover process models draw intensely from levelheaded dynamic models, for example, Fishbein and Ajzens (1980) hypothesis of contemplated activity, which focuses on the significance of social expectations in foreseeing and getting turnover. Nonetheless, there is examine on the way on which perspectives and goals get converted into conduct that can advise turnover hypothesis and research. Models remember look into for view of conduct control, conduct consistency, and the job of passionate excitement. With the end goal of this investigation, Perceived Behavioral Control is used㠢â‚ ¬Ã¢ ¦Ã£ ¢Ã¢â€š ¬Ã¢ ¦Ã£ ¢Ã¢â€š ¬Ã¢ ¦Ã£ ¢Ã¢â€š ¬Ã¢ ¦Ã£ ¢Ã¢â€š ¬Ã¢ ¦Ã£ ¢Ã¢â€š ¬Ã¢ ¦Ã£ ¢Ã¢â€š ¬Ã¢ ¦Ã£ ¢Ã¢â€š ¬Ã¢ ¦Ã£ ¢Ã¢â€š ¬Ã¢ ¦Ã£ ¢Ã¢â€š ¬Ã¢ ¦Ã£ ¢Ã¢â€š ¬Ã¢ ¦. 2.1.1.1 Perceived Behavioral Control Numerous noticeable models of the turnover procedure certainly or unequivocally use components of Fishbein and Ajzens (1980) Theory of Reasoned Action. This hypothesis and its advancement into the Theory of Planned Behavior (Ajzen, 1991) propose that goals to play out a conduct are the more quick forerunners to genuine conduct. Expectations are an element of perspectives toward playing out the conduct, which are thusly an element of convictions concerning the outcomes and attractive quality of such results of playing out the conduct, and emotional standards concerning the conduct, which are a component of convictions concerning what significant referents consider the conduct and ones inspiration to consent to those referents. A decent arrangement of experimental research has upheld this model, particularly the basic job of goals (Kim and Hunter, 1998). People that having the conduct goal a bit much execute the aim in all actuality, which present the significance of the job of social control. Ajzen (1991) characterized control convictions as the nearness or nonattendance of variables that may encourage or block the presentation of a conduct. Seen conduct control is a people view of their capacity to play out a conduct dependent on control convictions. Conduct control is required to strengthen social expectations through expanded determination and thought of potential hindrances (Hom and Griffeth, 1995). Indeed, Ajzen (1991) contends that conduct is a component of good expectations and view of social control. Seen conduct control should direct the impact of goals on social control is certain. In this way, in a turnover setting, turnover goals may possibly prompt turnover when people see that they have command over the choice to stop. There are various reasons that people may see less power over this choice. Family or budgetary imperatives could limit versatility. After some time, people become progressively put resources into an association, making it increasingly hard to leave (Becker, 1960). View of the accessibility and nature of options may influence apparent control. There is some proof view of options cooperate with work fulfillment in prompting withdrawal (Jacofsky et al, 1986). Steel et al as of late proposed that hindrances to portability are basic parts of work showcase perceptions. Be that as it may, turnover explores don't normally straightforwardly gauge apparent social power over turnover choices and have not surveyed control as a potential mediator of the connection between turnover goals and turnover. Conduct control should direct the goals turnover relati onship with the end goal that the relationship is more grounded when control is higher, and more fragile when control is most minimal. 2.1.2 Role Theory With the end goal of study, job hypothesis is utilized to clarify the job pressure experienced by the evaluators. Job hypothesis expect that people lives are spent showcasing a combination of jobs both inside and outside the hierarchical setting (Fisher, 2001). As refered to by Fisher (2001), Katz and Kahn clarified that every one of these jobs is thought to be more an element of social setting as opposed to of the people own character qualities. Hence, Fisher (2001) recommended that each position inside an association can be thought of as a particular job into which an individual is mingled. Under the job scene model, the procedure of socialization happens when a job senders legitimately or by implication imparting to the job occupant (central individual) their desires for the officeholders obligations. Job equivocalness exits when objectives of ones occupation or strategies for performing it are muddled (Johns et al, 2007). Researchers Johns et al (2007) further clarified that there are three components that can prompt vagueness, which are (1) the hierarchical variables, for instance the center administration may neglect to give the 10,000 foot view as they are not in the upper administration level; (2) the job sender, for instance job senders have indistinct desires for a central individual, or the message isn't adequately convey between a job sender and a central individual; (3) the central individual, as another staff need time to completely process the work desire imparted to him. Then again, job strife happens when consistence with one sent job would consistence with another troublesome (Cited by Fisher (2001) from Kahn et al, 1964). Kahn et al (1964) distinguish five significant sorts of job struggle as beneath:- 1) Intra-sender strife clashing solutions/bans from a similar sender 2) Inter-sender strife clashing solutions/bans from various sender 3) Inter-job struggle strife between jobs in circumstances where an individual holds more than one job 4) Person-job struggle where a people job prerequisites are incongruent with hus/her own convictions, qualities and standards 5) Role-over-burden sensible desires may have been gotten from job senders, yet he/she might not have sufficient opportunity to address them all (Refered to from Fisher (2001) survey on Kahn et al (1964) examine work) Researchers Van Sell at al (1981), Jackson and Schuler (1985) saw that both job vagueness and job strife are connected to negative results, for example, lower work fulfillment, increment on saw work pressure, lower work execution and more prominent turnover expectation. 2.2 Conceptualization of Dependent Variable Turnover alludes to abdication from an association (Lee and Liu, 2006; Johns et al, 2007). Turnover can be delegated inward and outer, intentional or automatic (Wiley, 1993). By inward turnover, it implies that a representative is moved to another division inside a similar organization or gathering of organizations. Then again, outside turnover alludes to the acquiescence of a representative forever and from this time forward speaks to the cost outpouring to an association. Wiley (1993) further clarified that automatic turnover happens when a representative is fired for just caused, for instance: infection, passing, retirement because of mature age; and deliberate turnover is a circumstance whereby the worker join another association on his/her agreement, or take an interest in the willful partition plot. Worker is the human capital of an association (Quote). Representatives have become the significant unmistakable resource in an association in this new k-information world, particularly inside the administration business. Fruitful and set up organizations, for example, Virgin Airline and Honda have put generous sum on their workers in term of preparing and improvement cost, intending to shape their representatives to keep up the serious edge. From now on, a worker takeoff is viewed as a bad dream to an association particularly with the profoundly talented representatives, for example, the IT expert and review directors. Not just the association can't recoup the preparation cost (Quote), they additionally lose their upper hand when the exceptionally experienced and gifted workers join another contender firm. High turnover additionally experienced in the untalented position, for example, in the assembling plant and lodging line because of the low substitution cost for incompetent worker s. The simplicity of trading representatives for the lower rank staff no uncertainty won't cause considerable misfortune to an association, yet will influence the administration or item quality as the new representatives are new to the associations culture and work strategies. Because of the noteworthiness of these costs, representatives turnover has been broadly concentrated since the 1900s with the different distributions of subjective and quantitative analysts of surpassing 1500 (Munchinsy and Morrow, 1980). Given the noteworthiness of the examination, the determinants of turnover expectation is broadly concentrated in different ventures, for example, the hotelier (Atang, 2010), producing (Udo et al, 1007), instructors (Currivan, 2000) data framework (IT) (Rahman, 2008; Muliawan et al, 2009) and among open bookkeepers or inspectors (Lander et al, 1993; Perryer et al, 2010; Reed et al, 1994; Viator, 2001; Law, 2005; Lui et al, 2001; Hsieh et al, 2009; Hasin and Omar, 2007). The purposes behind willful turnover are various and the rundown of determinants is as yet growing. The most widely recognized reasons given by leavers are because of employment disappointment, lacking of profession development openings, poor connection among director and subordinate, to give some examples. Khatri et al (2001) concentrated high turnover in Asian nations with test size of 422 taken from food and drink industry, delivery and marine industry and retailing indust

How Do You Ask Someone to Be Your Cosigner

How Do You Ask Someone to Be Your Cosigner How Do You Ask Someone to Be Your Cosigner? How Do You Ask Someone to Be Your Cosigner?If you dont have a great credit score or a large income, you might have to ask for help in order to get a loan or an apartment. Whats the best way to go about it?Asking for help is never easy. You’d probably rather come across as someone who can take care of themselves all on their own. But asking for help shouldn’t be seen as a sign of weakness. In fact, knowing when to ask for help is one of the most important skills you can have.But asking someone for help is even harder when it’s not just your pride on the line. It’s difficult to know exactly how to ask someone else to put something, whether it’s their money or even just their reputation, on the line for you.If you need a personal loan but you cant get approved for one, that means asking someone to be your cosigner. How might you approach that?Why do I even need a cosigner?You can sign on your own. You have a perfectly good signature. Why do you need a cosigner?Odds are it’s because you want a loan or a lease and you can’t get it on your own. Maybe your credit is bad or maybe your income isn’t high enough. Or it could be both!And needing a cosigner isn’t anything to be ashamed of. In some cities, you could need an annual income of more than forty times your monthly rent to sign a lease on an apartment by yourself. There’s no reason to feel embarrassed about having a less than extravagant income.In addition to how much money you earn, a lousy credit scoreâ€"or even a so-so scoreâ€"could mean needing a cosigner with better credit to help you get a loan or a lease for an apartment.Even if the person you’re asking is a good friend or family member, it can be awkward. You’re asking them to have a pretty significant amount of trust in you because if you don’t make your payments on time, it’ll negatively affect the cosigner’s creditâ€"and they could be on the hook for payments you don’t or are unable to make!Choose your cosigner wisely.But where should you turn for a cosigner? Obviously, you’ll want someone who has the necessary income or credit score to actually help you get what you’re looking for. And it will need to be someone you trust who also trusts you.But there are other things to consider when choosing who to ask, as we learned when we spoke to Casey Stubbs, founder of Finance and Markets (@FinanceMarkets1):“When I first left the military to start going to college for my undergraduate degree, I too had to find a cosigner myself as I did not qualify to even rent an apartment on my own. What worked for me was simply to make sure that I had collateral that could cover my cosigner should something have happened to me, and finding someone who no longer needs to rely on credit as they already have paid off their house and their cars. If your parents have already paid their house off and have no intention of moving, chances are they could care less about their credit score dropping a few points during the app lication process, and they can be a great resource as well for you to start building credit on your own.”So if you know anyone who you’re close with who doesn’t have to worry about their credit, it should be easier to get them on board. But regardless of who you ask, it’s important to ask in the right way.Show them that you are trustworthy.As we said at the start, asking for help isn’t always easy. So it helps to make sure you’re asking in a way that is likely to be well-received.“If you cannot find someone who is indifferent to their credit score because they are still relying on credit heavily in their everyday lives,” advised Stubbs, “your best solution is to show them that you have the means to cover the debt, and that it is simply that you do not have enough to cover the bank’s standard, but that you do indeed have something to cover their loses should something happen to you down the line.”It can also help if you present your case to the cosigner with the same preparation and consideration you’d give a bank.“If you’re going to ask someone to be a cosigner on a loan or a lease, there are a couple of things you should do up front,” explained Michael Gerstman, CEO of Gerstman Financial Group. “First, you should insist on putting it in writing that you are committed to repaying the note under the terms of the note. That means no late payments.There should be a personal penalty for a default. For example, if I default on this loan, I’ll be cleaning your house once a week for the next three years. When both parties have ‘skin in the game’ the chances for a default are more limited.“I’d also make sure that if someone is agreeing to cosign a loan or lease they recognize I’d rather cut off my arm than default on a payment.”But as long as you work out a payment plan and stick to it, you should be able to get the loan or lease you need without cutting off any limbs. Show that you have a plan and ask for help, and you’ ll probably find that people will do what they can for you.Finding a cosigner for a standard  loan is far preferable to getting a predatory no credit check loan or cash advance. And even if you cant find a cosigner, remember that payday loans and  title loans are not your only option in a financial emergency. There are safer, more affordable bad credit loans out there. To learn more about navigating life when you have bad credit, check out these related posts and articles from OppLoans:How Bad Credit Can Affect Your UtilitiesIf You Have Bad Credit, a Letter of Explanation Could HelpHow to Finance a Phone with Bad CreditWhat are your stories of asking someone to be a cosigner? We want to hear from you! You can find us  on  Facebook  and  Twitter.ContributorsMichael Gerstman, ChFC, CLU, has been in the financial field for over 25 years. Michael is committed to helping clients make informed financial decisions and strives to use his knowledge, experience,  and commitment to help people enjoy a comfortable lifestyle today while building towards a financially secure future tomorrow.Casey Stubbs is a United States Army Veteran and lifelong entrepreneur dedicated to helping investors from all walks of life achieve financial freedom and abundance in their lives. After launching his first website, Winner’s Edge Trading, Casey has gone on to launch several other successful brands such as Trading Strategy Guides, Learn To Trade For Profit, and  Finance and Markets (@FinanceMarkets1); all dedicated towards helping investors at every level learn how to profitably manage their investments, as well as their personal finances, for themselves.

12angry Men - 1118 Words

12 Angry Men paper Influence Like power, influence deals with the capacity to impact the behaviors of others. Influence, however, arises directly from one’s behavior toward others. There are 8 methods you can use: Foreman –giving options, being likeable, listening to others 1. Coalition building: seeking alignment with others Asking everyone what they thought when he gave everyone the story about the woman. Comparing kids juror #2 and #8 seeking sympathy to show how kids can be ungrateful #8 Involved everyone in discussion and made changes as suggested (speed it up anyone can walk faster than that) One juror looking at the other juror – did or didn’t the old man see the boy moving out the house?†¦show more content†¦judicial system and the task facing the jury: Knows the man better than anyone here†¦.. Multiple jurors Going over and over each detail of the case 8 is more effective because he remains calm, precise, used precise calculations , logical thinking, visual demonstrations shouty guy less effective and was able to be pushed to threatening which dis-proved him. Very good at disproving all objections or setting up reasonable doubt, Very good at going through all the points and creating reasonable doubt. Respecting everyone whether he agreed with tem or not – now the onus is on him to prove that boy is guilty. _______________________________________ 9. The accused, or defendant, is presumed to be innocent unless proven guilty. The jury must decide beyond a reasonable doubt that the defendant is guilty. 10. The verdict must be unanimous. Anything other than a unanimous conclusion on the part of the jury—either guilty or not guilty—will result in a hung jury. If and when the jury announces that it cannot reach a unanimous decision, the judge will declare the trial to be ended. At that time, the state prosecutor can decide to retry the case with a completely new jury. 11. At the time this film was made—the mid-1950s—juries tended to be dominated by white males. Women were issued automatic exceptions and people of color were excluded because of racial/Show MoreRelatedEssay about Influencing an Entire Crowd in 12 Angry Men1021 Words   |  5 PagesTwelve Angry Men is a movie that was made in 1957. The movie is a classic showing how one person can change the minds of an entire crowd. In this gro up of a dozen jurors you have very different personalities and also you have some men that want to be leaders and some that do not. Also the movie demonstrates that actions and behaviors of the twelve jurors. This is an example of small group communications. The juror that was the Architect in the suit was probably the strongest leader in the

Advertisements Influence Consumers - 1048 Words

Bao Ying You Professor: Thomas J. Sayles English 001A, 1194 Draft 1st 09/28/10 Advertisements Influence Consumers Nowadays, there are a lot of advertisements of various brands in television, magazines, newspaper, the Internet or on the streets. We are living in a world which advertisements appear in many kinds of methods twenty four hours a day. Advertisements often use different images to promote their products for obtaining more economic benefits; the advertisement also brings many bad influences to audiences as well. Because advertisements have a lot of wrong ideas, audiences’ ways of thinking and behaviors may potentially be impacted. The private businesses in profit organization composes attractive images in†¦show more content†¦Children may create unrealistic idea for themselves when they influenced by advertising. They may lose to do themselves and change the life style. Take an example of A Brand by Any Other Name, the advertising engender a young person’s loyalty by pretending to disarm itself. Soft drink advertising asks â€Å"Get it?† can make au diences misunderstand that you have to do it if you are cool. Although every people know that soft drink is unhealthy for body, they may drink this kind unhealthy soft drink to be the cool image because audiences have a wrong idea about this soft drink advertising. In similarity, this situation often in MacDonald’s advertising, KFC advertising or other fast food advertising. Audiences can create another idea artificially of popular that affects their life style. Moreover, advertisements often make consumers create unrealistic idea about popularity. Many teenagers consider that follow most people’s fashion is popular and choose the latest brand items will be â€Å"in†. In the article â€Å"A Brand by Any Other Name† of Douglas Rushkoff, a thirteen years old young boy considered a Nike brand shoes at first, however; he was afraid that wear this brand might label him as too anti-Green. Next, he looked at another shoe that was not popular and understood by a small group people in school. Finally, he can only consider the â€Å"retro†Show MoreRelatedThe Influence of TV Advertisements on the Buying Behavior of Adult Consumers in the State of Haryana3060 Words   |  13 PagesIntroduction Advertisements are cost-effective ways to disseminate messages with a view to build a brand preference or to educate people (Kotler Keller, 2006). The majority of the marketers use mass media for their marketing communications. The choice of media is dependent upon the nature of the message and the intended target audience (Etzel et al, 2008). Television is generally acknowledged as the most powerful advertising medium. The wide reach translates to low cost per exposure (Kotler KellerRead MoreEffects of TV Commercials on Consumers1134 Words   |  5 Pagesservices; without this influential and dominant form of advertisements, the majority of the companies and their respective products and services would not maximize their ability to reach various consumer bases (commercial. laws). Effects of TV commercials on consumer: Many of the researches have been conducted to see the influence of advertisement or TV commercials on consumer.The findings of these study support the current study that consumers are very much affected through TV advertisement.TV commercialsRead MoreAdvertisements Are Manipulating Or Informing989 Words   |  4 PagesAdvertisements Are Manipulating or Informing Advertisement has taken a significant role in people’s daily lives. With the development of technological devices; it is impossible to escape from the advertisements. People now are surrounded by advertisements everywhere, on the TV screen, newspapers, magazines, and on the internet. Advertisements help people know information about the products and keep track of the new products. However, with all the advertising out there, advertising techniques haveRead MoreAdvertising Effects Of The Counter And Prescription Drug On Consumer Purchasing Habits1415 Words   |  6 Pages Advertising Effects of Over-the Counter and Prescription drug on Consumer Purchasing Habits By Celise Blackman Mass Communications Research Professor Roman Introduction This study looks at how prescription drugs (Rx) and over-the-counter drugs (OTC) are advertised and how that potentially effects buying habits of consumers. There have been studies on this in the past but researchers failed to consider important factors such as age, exposure to advertising, health conditionsRead MoreUnderstanding Consumer Behavior1285 Words   |  5 PagesConsumer Behavior 1 Abstract This paper analyzes an online advertisement of Amsoil engine oil in a view to appraise different dimensions of consumer behavior. The paper focuses on analyzing the target consumers for this advertisement, the effectiveness and strategies behind designing this type of advertisement, and the impact of different social, cultural, and demographical factors. Introduction Consumers are considered as the most important external stakeholders of an organization. They areRead MoreImpact Of Advertising On Female Identity Formation1592 Words   |  7 Pageshighly concerned with beauty. From magazine to television advertisements, women are bombarded with images of perfection—perfect figure, perfect hair, and perfect skin. Moreover, advertisements sell products that would help improve women’s appearance. The problem with these advertisements is the subjectivity of beauty as a whole. Every individual has his or her own preference and perspective on what it means to be beautiful, but for advertisements beauty is obtaining perfection. One of the most controversialRead MoreEssay on Why is Retouching Photographs Necessary?1063 Words   |  5 Pagesforms—photographs, online advertisements, magazines, and more. There are more forms of advertisements today than ever before. Technology is becoming more and more advanced. With more advanced tech nology come more consumers, ranging in all ages. Younger generations are becoming more acquainted with new gadgets today. They are likely to be exposed to retouched photographs from online advertisements. Many models in these photographs are often retouched in such a way that negatively influences consumers, teenagersRead MoreTitle of the project report Effectiveness of Advertisement in Telecom Industry on consumers with1400 Words   |  6 PagesTitle of the project report Effectiveness of Advertisement in Telecom Industry on consumers with reference to Airtel. Objectives of the study I. To study types of advertisements. II. To study effectiveness of advertisements i.e. on sales, profitability. III. To study the perception of consumers towards the product due to advertisement. IV. To find the ways to make it more effective. Reaserch Methodology Research Design The research design is Descriptive studies. Descriptive studiesRead MoreSubliminal Perception Essay1374 Words   |  6 Pagesflipping through a dozen or more magazines, something seemed different about the Harley Davidson advertisement that was in front of me. Although it was not clear to me at first, the word â€Å"Sex† became very noticeable to me. I believe that it is a long shot, that this may just be a coincidence. Beginning with the capital S, and going horizontal, lays the subconscious word. This print advertisement came from Maxim Magazine, and there is an abundance of previous information linking Maxim and HarleyRead MoreImpact of Persuasive Advertisements on Consumer Buying Behavior Towards Health Related Products.1296 Words   |  6 PagesResearch Title: |    |   Impact of persuasive advertisements on consumer buying behavior towards health related products. | Introduction: |   Ã‚   | This thesis is about the study of consumer buying behavior towards health related product and their perceptions after watching advertisements and then make their decisions whether to purchase the product or not. This will help to find out the most important factors which can affect the buying behavior of the consumer while purchasing and on the other hand it

Benign Prostatic Hyperplasia Free Essays

Introduction The process of urination is vital to the body for the removal of certain waste products. Normally, when the bladder gets full, urine is emptied from the body through the urethra in a process called urination. In urinary retention, a person’s bladder fills up and there is an urge to urinate but he is unable to completely empty his bladder. We will write a custom essay sample on Benign Prostatic Hyperplasia or any similar topic only for you Order Now With chronic urinary retention, a person may be able to urinate, but he has some trouble starting a stream or emptying your bladder completely. He may urinate frequently, may feel an urgent need to urinate but have little success when he gets to the toilet; or he may feel he still have to go after having finished urinating. With acute urinary retention, he can’t urinate at all even though he has a full bladder. Acute urinary retention is a medical emergency requiring prompt action. Acute urinary retention (AUR) is an extremely uncomfortable and potentially life-threatening condition characterized by a sudden inability to urinate associated with intense suprapubic discomfort. It is most often secondary to obstruction, but may also be related to trauma, medication, neurologic disease, infection, and occasionally psychological issues. Acute urinary retention (AUR) is one of the most significant, uncomfortable and inconvenient event in the natural history of benign prostatic hyperplasia (BPH). BPH is the virtual universal overgrowth of the prostate gland in men as they age. Various factors affecting BPH are age, genetic makeup, testosterone levels, and environment. As the prostate enlarges it compresses the urethra causing obstruction to urine flow. The urinary stream becomes smaller; there may be difficulty in initiating the stream, dribbling, and intermittent flow, frequency of urination, getting up at night to void (nocturia), inability to empty, or even inability to void at all (retention). Patient’s Profile Name: c Age: 69 Address: Civil Status: Married Chief Complaint: Difficulty in urinating ptc and bloody urine few days ptc Tentative Diagnosis: Acute urinary retention prob. Secondary to BPH History of Present Illness a. Present History Patient is 69 years old male retiree, a resident of PS Tagas, Tabaco City admitted at BRTTH with a chief complaint of dysuria. One week prior to consultation he had difficulty in urinating and presence of blood in the urine b. Medical History The patient claimed that he has hypertension and diabetes mellitus type II. Anatomy and Physiology Prostate gland The prostate is a walnut-sized gland that forms part of the male reproductive system. The gland is made of two lobes, or regions, enclosed by an outer layer of tissue. As the diagrams show, the prostate is located in front of the rectum and just below the bladder, where urine is stored. The prostate also surrounds the urethra, the canal through which urine passes out of the body. Scientists do not know all the prostate’s functions. One of its main roles, though, is to squeeze fluid into the urethra as sperm move through during sexual climax. This fluid, which helps make up semen, energizes the sperm and makes the vaginal canal less acidic. Urinary Bladder The urinary bladder is a muscular sac for storing urine. The triangular base of the bladder, the trigone, is defined by the two ureters that deliver the urine and the one urethra that drains the urine. When empty, the bladder collapses, and folds (called rugae) from in the bladder wall. As it fills, the folds become distended and the bladder  becomes spherical. The wall of the bladder consists of three layers similar to those of  the urethra: the mucosa, the muscularis (here called the detrusor muscle), and the adventitia. Circular smooth muscle fibers around the urethra form the internal urethral sphincter. As a man matures, the prostate goes through two main periods of growth. The first occurs early in puberty, when the prostate doubles in size. At around age 25, the gland begins to grow again. This second growth phase often results, years later, in BPH. Though the prostate continues to grow during most of a man’s life, the enlargement doesn’t usually cause problems until late in life. BPH rarely causes symptoms before age 40, but more than half of men in their sixties and as many as 90 percent in their  seventies and eighties have some symptoms of BPH. As the prostate enlarges, the layer of tissue surrounding it stops it from expanding, causing the gland to press against the urethra like a clamp on a garden hose. The bladder wall becomes thicker and irritable. The bladder begins to contract even when it contains small amounts of urine, causing more frequent urination. Eventually, the bladder weakens and loses the ability to empty itself. Urine remains in the bladder. The narrowing of the urethra and partial emptying of the bladder cause many of the problems associated with BPH. Pathophysiology Urinary retention can be caused by an obstruction in the urinary tract or by nerve problems that interfere with signals between the brain and the bladder. If the nerves aren’t working properly, the brain may not get the message that the bladder is full. Even if you know that your bladder is full, the bladder muscle that squeezes urine out may not get the signal that it is time to push, or the sphincter muscles may not get the signal that it is time to relax. A weak bladder muscle can also cause retention. As a man ages, his prostate gland may enlarge. Doctors call the condition benign prostatic hyperplasia (BPH), or benign prostatic hypertrophy. As the prostate enlarges, the layer of tissue surrounding it stops it from expanding, causing the gland to press against the urethra like a clamp on a garden hose. As a result, the bladder wall becomes thicker and irritable. The bladder begins to contract even when it contains small amounts of urine, causing more frequent urination. Eventually, the bladder weakens and loses the ability to empty itself, so urine remains in the bladder. The pathophysiology of bladder outlet obstruction in men with BPH has been attributed to both static and dynamic factors. The static obstruction is due to the bulk enlargement of the prostate encroaching upon the prostatic urethra and bladder outlet, whereas the dynamic obstruction is related to the tension of prostate smooth muscle. Diagnostic Evaluation and Lab Examination a. Ultrasound of whole abdomen * Normal * Gassy epigastria, gassy filled bowel loops * Empty bladder b. CBC WBC| 8. 1| RBC| 4. 16| Hemoglobin| 103| Hematocrit| 0. 31| Platelet| 273| c. Urinalysis Specific gravity| 1. 025| pH| 5. 0| Sugar| (-)| RBC| 13-15| Medical Treatment and Evaluation Treatment a. Admit to surgical ward. b. Labs: Ultrasound -CBC -Urinalysis c. I ; O q 4H d. Intravenous Rehydration e. Indwelling Catheter – To facilitate accurate measurement of urinary output for critically ill patients, Drug Study Ciprofloxacin Action: Interferes the conversion of intermediate DNA fragments into high-molecular-weight DNA in bacteria; DNA gyrase inhibitor. Indication: Adult urinary tract infections (including complicated); c hronic bacterial prostitis; acute sinusitis; lower respiratory skin, bone, joint infections; infectious diarrhea, exposure to inhalation anthrax; conjunctivitis, corneal ulcers (ophthalmic). Dose: PO 500mg q12h Adverse Effects: CNS: Headache, dizziness, fatigue, insomnia, depression, restlessness, seizures, confusion. GI: Nausea, constipation, increased ALT, AST, flatulence, insomnia, heartburn, vomiting, diarrhea, oral candidasis, dysphagia, pseudomembranous colitis, dry mouth INTEG: Rash, pruritis, uriticaria, photosensitivity, flushing, fever, chills, MISC: Anaphylaxis,Stevens-Johnson Syndrome MS: Tremor, arthalgia, tendon rupture Nursing Considerations: * Assess patient for previous sensitivity reaction Identify urine output; if decreasing, notify prescriber (may indicate nephrotoxicity); also check for increased BUN, creatinine. Nursing Care Management Ongoing Assessment * Monitor Intake and Output. * Assess Vital signs| Provides information about fluid balance, renal function as well as guidelines for fluid replacement. BP, Pulse, RR, and Temperature indicate response to fluid status. | Diet * Low Sodium diet| A diet high in sodium may raise blood pressure and caus e fluid retention, resulting in swelling of the legs and feet. | Sex Being sexually active may help keep the urethra open. But the patient should not get sexually aroused without ejaculating because the urethra may get blocked. Some treatments may also cause sexual problems. These problems usually do not last forever and most can be helped. Complications * Urinary Tract Infection * Bladder Damage * Chronic Kidney Disease| Urine is normally sterile, and the normal flow of urine usually prevents bacteria from growing in the urinary tract. When urine stays in the bladder, however, bacteria have a chance to grow and infect the urinary tract. If the bladder becomes stretched too far or for long periods, the muscle may be permanently damaged and lose its ability to contract. If urine backs up into the kidneys, permanent kidney damage can lead to reduced kidney function and chronic kidney disease. If you lose too much of your kidney function, you will need dialysis or a kidney transplant to stay alive. | References: Mosby, Elsevier. Mosby’s Guide for Nurses, 6th edition. Missouri, St. Louis: 2005 http://www. pennmedicine. org/encyclopedia/em_DisplayAnimation. spx? gcid=000136;ptid=17 http://www. nsbri. org/humanphysspace/focus4/ep-urine. html http://kidney. niddk. nih. gov/kudiseases/pubs/UrinaryRetention/ http://www. uptodate. com/contents/acute-urinary-retention http://www. ncbi. nlm. nih. gov/pmc/articles/PMC1477632/ http://www. scribd. com/doc/5989689/Case-Study-BPH http://wps. prenhall. com/wps/media/objects/3918/4012970/NursingTools/ch48_NCP_UrinElim_1316-1317. pdf http://www. drugs. com/cg/urinary-retention-in -men-aftercare-instructions. html How to cite Benign Prostatic Hyperplasia, Papers

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