Urinary Incontinence and Social Isolation

Urinary Incontinence and Social Isolation Beverly Phelps Abstract Urinary incontinence is loss of bladder control, that one in every 25 million Americans deal with on a daily basis, and it can mean anything from a slight leak to complete inability to maintain control. (Chris Lliades, 2009) Discuss the social concerns associated with incontinence. What nursing interventions would be appropriate to assist a patient who is experiencing social isolation as a result of incontinence? Include community resources, as appropriate. Many women, at one stage of life or another, experience that annoying leakage of urine when their bladder is too full, and/or when laughing, running, jumping, or sneezing. For some it occurs after childbirth when all of those muscles down in the pelvic region are stretched out and recovering. For others, it occurs later in life with the change of hormones and loss of estrogen. There are three most common types of incontinence. Stress incontinence occurs when you put stress or pressure on your bladder with coughing, sneezing, or running. Urge incontinence happens when you have the immediate urge to urinate and can’t seem to hold it. Mixed is a combination of both. Urine is specifically kept in the bladder until you are ready to use the bathroom, however if the detrusor muscle and urethra aren’t behaving like they should, you leak. Improved My Health Changed My Life Saved My Life Research â€Å"suggests that 30 to 40 percent of women 60 years and older deal with incontin ence.† Risk factors include: pregnancy, multiple births, menopause, obesity, diabetes, certain autoimmune conditions, prolapse, abdominal surgery, diuretics, anxiety, and nerve damage to the mid-low back, bladder infections, overactive bladder, inability to urinate regularly when needed, and stimulants such as coffee/soda/chocolate. Evaluation by your health care provider, or a specialist called an Urogynecologic, often involves a full intake surrounding the situations in which you are incontinent, your history, medications, and pregnancy history. A vaginal physical exam is important to assess for proper anatomy and then testing may be needed such as a hormone testing, urinalysis (to look for infection), a bladder stress test, an ultrasound of your kidneys/bladder/ureters, or cystoscopy (a scope inside your bladder). Treatment depends on what they find. It may be something like pelvic floor physical therapy where you learn how to do a proper Kegel exercise and recruit all of y our muscles, not just the strong ones. It may require bladder retraining, hormone evaluation, weight loss coaching, or surgery in some cases (Jones, 2011) Psycho-Social Issues of Adult Incontinence Incontinence is not a disease but symptom of an underlying problems. Urinary incontinence is viewed as a hidden condition that is secreted by many and often feared due to loss of independence and quality of life. Often underreported Incontinence is associated with a social stigma. The stigma tends to be negative rather than positive. Many individuals are embarrassed to talk about the problem In North America incontinence is the major reason for nursing home placement. -Approximately 45-70% of residents in nursing home have incontinence. Urinary incontinence affects 15-30% in the community setting and affects up to 50% in long-term care. Only 25% of the population will discuss this problem with a provider. 60% of this individuals will avoid physical activity One study cited 2-64% had sexual dysfunction, and 28% will not seek treatment (Sue Reif, 2012) Easing the Emotional Effects of Urinary Incontinence Loss of bladder control can leave an individual constantly worried about embarrassing accidents. Managing urinary incontinence symptoms can help boost your confidence. (3) Urinary incontinence can have a major impact on your personal, social, and professional lives, especially when a loss of bladder control results in an embarrassing accident. â€Å"There can be significant social issues with urinary incontinence,† says Roger Dmochowski, MD, professor of urology at Vanderbilt University in Nashville, Tenn. â€Å"There’s fear of embarrassment and hygiene issues, and there can be withdrawal from normal social behavior. Some people can’t work because of this disruption. â€Å"Urinary incontinence emotional effects Doctors point out that the emotional effects of urinary incontinence can be as significant and far-reaching as those of any chronic condition. â€Å"Urinary incontinence has been shown to have a severe impact on quality of life, similar to other chronic diseases, such as Alzheimers disease, stroke, and emphysema,† says Leslie Rickey, MD, an urologist at the University of Maryland Medical Center in Baltimore. However, there are ways to manage urinary incontinence and boost confidence so that you can enjoy social activities again without worrying about embarrassing accidents. Urinary Incontinence: The Emotional Effects Worrying about loss of bladder control and embarrassing accidents causes many people with urinary incontinence to stop participating in everyday activities. â€Å"Many individuals, especially older people with urge incontinence, stop exercising or going out with friends and stay at home,† says Dr. Rickey. â€Å"Younger women may stop jogging, and women may stop gardening because squatting can be a problem. People stop traveling and swimming, and even start avoiding intercourse. â€Å"For many people with incontinence, engaging in certain activities involves a couple of obstacles. First, it’s a lo gistical challenge to manage the symptoms of urinary incontinence when you’re on the go, away from bathrooms, or doing an activity that puts pressure on your bladder. â€Å"Say it’s an older person who relies on a bus or a van and has no other way to get places,† says Rickey. For these people, not being able to get off the bus and to a bathroom can be a problem. Then there are the emotional concerns. The loss of bladder control can cause stress, anxiety, and embarrassment. (Sue Reif, 2012) Ways to Boost Confidence You can boost confidence about your condition by finding effective ways to manage the symptoms. â€Å"Techniques like timed voiding, not drinking too much fluid at once, doing pelvic floor muscle contractions — these can all help,† says Rickey. â€Å"You can also carry around a change of clothes and wear light pads. â€Å"Getting symptoms under control can help you carry on with your life with confidence. â€Å"Some individuals may have dramatic improvements and can re-embark on many activities,† says Dr. Dmochowski. These tips can help you manage the fears and anxieties of urinary incontinence: Don’t accept incontinence as inevitable. Many people think that urinary incontinence is a normal part of aging or childbearing, so they dont bother getting treatment for it. However, even though urinary incontinence is common, it is not normal, says Rickey. Don’t view your urinary incontinence as unchangeable. â€Å"There’s almost an acceptance of the condition, a fatal resignation,† says Dmochowski. â€Å"Instead of acceptance, consider aggressive management flip the negativity and create a positive-looking approach.† Changing your way of thinking will do even more than boost confidence, says Dmochowski. It will also help you better manage your urinary incontinence symptoms. Talk openly about your urinary incontinence with your doctor. Some people may simply feel too embarrassed about their loss of bladder control to discuss it with their doctor. It might be because they incorrectly believe that it can’t be treated. â€Å"People think that nothing can be done, or it can only be treated with intensive surgery,† says Rickey. â€Å"I reassure people that there are treatments.† It’s important to talk about your symptoms, especially with your health care provider. Don’t give up. Managing the loss of bladder control and learning how to handle embarrassing accidents is an ongoing proc ess. Urinary incontinence is a chronic condition not something that is cured after a few days of medication but there are many options available to you. â€Å"If one thing doesn’t work, keep trying different approaches,† advises Dmochowski. â€Å"We are continually finding new treatments, new types of drugs. 1.†Seek support. Talk about your urinary incontinence with your family and friends both to get support and to know you are not alone. Since an estimated 30 percent of women report an incidence of urine leakage at some point, it’s likely that someone you know has also experienced the problem, says Rickey. â€Å"It may not be what you talk about at the dinner table with the kids, but you must feel comfortable talking about it. 2.†Get the facts. â€Å"Go online and look up how common it is,† says Rickey. 3. â€Å"Do a little research.† Sites such as the American Urogynecologic Society’s Mypelvichealth.org are reliable sources of information. â€Å"You can gain confidence and get motivation to seek out help,† says Rickey. 4. â€Å"Don’t be embarrassed. â€Å"View your urinary incontinence as what it is, a chronic medical condition.† â€Å"It’s not something to be embarrassed about, any more than someone who has high blood pressure would be embarrassed,† Rickey says. No longer a taboo topic, urinary incontinence can and should be discussed openly, at least with your doctor, so that you can find the medical treatments that will help you better manage the condition and its emotional effects. (Lee, 2010) Bibliography Chris Lliades, M. (2009, August 31). Urinary Incontinence Resources. Retrieved from everyday health: http://www.everydayhealth.com/urinary-incontinence/incontinence-resources.aspx Jones, D. C. (2011, June 03). Experiencing Incontinence? Retrieved from Empow Her: http://www.empowher.com/urinary-incontinence/content/experiencing-incontinence Lee, K. (2010, August 03). Easing the Emotional Effects of Urinary Incontinence. Retrieved from http://www.everydayhealth.com/health-report/urinary-incontinence/emotional-effects-of-urinary-incontinence.aspx Sue Reif, M. C. (2012). Psycho-Social Issues of Adult Incontinence. Retrieved from Center for Connected Care: http://my.clevelandclinic.org/ccf/media/files/Digestive_Disease/woc-spring-symposium-2013/psycho-social-issues-related-to-incontinence.pdf

Daimler-Chrysler: Post Merger News Analysis

1. The merger was expected to result in synergy from which attributes of each organization? With the merger, both profitable automobile companies, will have the opportunity to benefit from the potential of each other. They had both identified opportunities to increase sales, to create new markets for both while being able to expand their markets in new countries, to reduce purchasing costs and to realize enconomies of scale. The synergy would drive to product integration and ensure sharing of innovation, knowledge, technologies and ideas.At the time of the merger, Daimler Benz had close to 1% of the American Market, which Chrysler could aid them with this problem. Chrysler also wanted to enter into the European market, which Daimler Benz could help sell Chrysler products at their distribution centers in Europe. Mutually, the two companies expected to exploit on retail sales, purchasing, distribution, product design and research and development. And last but not least, Chryslerâ€℠¢s Dream Team was an attribute that could be beneficial to the merger. It could work as an innovative addition to Daimler Benz to help them find ways to expand a limited Daimler Benz market. . What were the issues/problems encountered after the merger. One of the main problems with the merger was the cultural clash between management and work styles. Even thou they had fairly equal number of members of the board of management, the integration efforts lacked between the Americans and the Germans. They clearly had differences in management styles, processes, cultures and work styles, which resulted in an abyss between the two. Other issue encountered was the mocking and thought from Daimler Benz that Chrysler was low quality and poor in technology.This rejection reflected in a tangible manifestation of the growing separation when Daimler refused to offer Chrysler vehicles at their distribution centers for fear of ruining their image. This had been an essential key in planning for Chry sler to enter into the Europe market. Although they were clear that strict guidelines segregated the Daimler and Chrysler brands, synergies were expected from joint administrative functions, market research, vehicle and spare parts logistics, and wholesale operations. With this rejection, this wasn’t happening. They needed to work upon effective communication and overcome their cultural differences. . What went well with the merger? Although this companies underestimated the level of cultural difficulties they had to face in order to be successful, and in 2001 the merger resulted in the biggest lost in German business history, the beginning of the merger was well received by the public. Over the first years, the share price from DaimlerChrysler rose significantly, indicating that the public speculated that this merger could be good for all parties and the new company would be considered to have the potential to revolutionize the automobile industry.Also, management at the top level agreed and was on board to making the merger be successful. Management starting sharing plants and parts as to saving huge amounts of money. Furthermore, management agreed on cutting expenses such as fixed manufacturing cost and material costs. By the nine-month period, net income and revenues had increased 12 per cent. Operating profit had improved by 15 per cent. Clearly, the results are attained were higher than expected, therefore, this were some beneficial aspects of the merger. . Discuss the historical background that has most influenced Germany. It is said that countries, much like individuals, are influenced by their experiences. Therefore, one could say that the most influential historical events that have affected Germany and transformed the country to what it is today are: 1) its role in the first and second World Wars, 2) related periods of extreme inflation, and 3) the â€Å"economic miracle† phenomenon of the post-WWII reconstruction of what was then West Germany.Every single one of these circumstances has had huge impact in German’s character in general: in the way Germans reason and behave. One example is how due to the hardships associated with wars, the fear and uncertainty, and the economic challenges of inflation, that Germans tend to be really risk averse, skeptical about organization and order, prefers security and structure and are way perfectionists. They are really focused when they want to achieve something and take pride on a job well done and highly performed. All this istory from 1914’s until present day have taken part in shaping Germans to what they are today and their beliefs. 2. What are some of the cultural dimensions that have shaped German management? Some of Hoftede’s and GLOBE cultural characteristics and dimensions are discussed in the reading to help explain the significant elements in the German culture that have shaped their management. The most significant elements in the German cult ure are: their high levels of uncertainty avoidance, assertiveness and individualism, and low levels of humane orientation and power distance.According to Hofstrede, Germany’s power distance scores a 35. It is highly decentralized, which is supported by a strong middle class. They believe in a flatter organizational structure. A very good example is their welfare system. A direct and participative communication and meeting style is common, control is disliked and leadership is challenged to show expertise and best accepted when it’s based on it. Another dimension is individualism. Germany scores a 67 on the Hofstede scale making it one of the most individualistic countries in the world.In Individualist societies people are supposed to look after themselves and their direct family only. They are not team-oriented but rather task-oriented. They are better at following rules than managing personal relationships and being perceived as kind or nice. Germans are also honest to a fault about an individual’s mistake, but will give that individual a fair chance to learn from those mistakes as well. Another important dimension is that which indicates if a society is driven by competition, achievement and success: masculinity/femininity.According to Hofstede, Germany scores a 67 on the masculine/feminine scale, therefore is considered to be a more masculine society. Germans tend to value competition and high standard of quality. Are considered to be perfectionists and a highly trained workforce. Managers are decisive and assertive. Due to the hardships and uncertainties of war and economic struggles, Germans score a 65 in terms of uncertainty avoidance and risk aversion. This means German leaders prefer deductive approaches to planning and thinking. Germs like to be told what to do therefore; a systematic verview has to be given in order to proceed. This deductive way of thinking coupled with the low power distance, results in Germans to prefer compe nsating for their high uncertainty by strongly relying on expertise. And last but not least, Germans have a low Long Term Orientation, scoring a 31 on the Hofstede scale. Germans prefer quick results as well as a social pressure to keep up with the competition. In terms of management, Germans are impatient for achieving quick results and attain better and faster products than the competition. Germans do take pride in a job well done.All these cultural dimensions take part in defining and shaping German management and leadership. 3. Discuss in detail the leadership framework in Germany. The German culture focuses a great deal on the importance of knowing business unlike Americans that focus more on self-knowledge, cultural awareness and business acumen. German leaders are more specific and concentrated in a certain area (â€Å"Fuhrung durch Fachwissen†). They are usually prepared to focus and in a specific subject matter since their power base of leaders is in their expertise rather than experience.It is known that German leadership strives on competency and expertise. As a result, German managers tend to be less able to develop effective visions for their organizations. Their fundamental mode of operation is that â€Å"Deliver Quality and your business will succeed. † They are well known for their organization and management but lack skills as innovators. In this way, Germans struggle to expand their businesses in creative and innovative ways. Also, German leader does believe in communication, which is to be very direct and straightforward.Germans desire a very structured framework in that each person should have clearly stated goals and objectives that will work for the overall success of the organization. For this reason, German leaders act as role models rather than bosses. They are very hand-on and translate their goals into actions hence, participate in the work processes (â€Å"Stellvertreter†). They are not team-oriented and are hig h in uncertainty avoidance therefore makes German leaders to lack flexibility and difficult to them to cope with today’s fast-moving global business environment.The current economic challenges Germany faces forces German leaders to focus on three critical areas upon improvement: 1) revise and asses in a broad non-technical manner, 2) focus on vision and attempt to take greater risks and set more visionary strategies, and 3) develop more well-rounded leaders with the strategic and interpersonal skills side. 4. Knowing more of the culture in Germany and the US, discuss the steps you would have recommended to the management to prevent the cultural issues for the Daimler Chrysler merger.The cultural clashes amongst USA and German cultures were the hardest thing to put together and make it work, which caused the merger to fail. As a result of the differences, the perceptions of both companies and their communication and understanding were never fair and transparent, causing tensio n and problems between the two. By making assignments and decisions fair across the board, the cultural differences could have been assuaged through increased communication channels and meetings.A clearer task description matrix could have been beneficial in the understanding of who was in charge of what and should consult whom. Since the beginning, it was sort of a game of putting and taking out people from job positions along with resignations. Their differences in management styles, processes, and cultural work styles, amongst other differences should have been discussed since the beginning and reaching a consensus was needed. For example, the problem caused because Americans did not want to use weekends to fly on or out for weekly meetings.This is the type of problem that could have been evaded with better communication, planning and understanding of each other’s cultural preferences and work styles. Another aspect that affected the merger and should have been evaded was their goals and expectations of the merger. None were clear and discussed before the merger. A thorough plan and goals should have been discussed previous unifying. It was not clear how both would help each other achieve what desired. There was not a concrete plan. ————————————————-

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The Old Man and the Sea Analysis of Santiago - 841 Words

The Old Man and The Sea: Analysis of Santiago Ross Mueller Mr. Harocopos AP. English 11 29 September 1996 Ernest Hemingway had a specific type of character in each and every one of his works of literature. These characters were called the Hemingway Code Heroes. Hemingway Code Heroes followed a strict code of behaviors which allowed them to live their life to the fullest. These Heroes lived simple lives without all the luxuries that others had. They concentrate on the problem at hand and do not get swayed by outside events. Avoiding intense personal relationships allows the Hero to stay focused. In The Old Man And The Sea, Santiago is considered the Hemingway Code Hero for many reasons. Santiago lived an extremely simple life, the life†¦show more content†¦He fishes to be a fisherman. His goal was not to catch a huge fish. It was to fish and try to catch a fish of any size. He did not pride himself on catching the fish. He did not go running to tell the other fishermen of the town about it, he just went home and fell asleep. Landing the fish did not matter to the old man only to get it as far as the side of the boat. The Old Man And The Sea portrays Hemingway Code Heroes to their fullest potential. As Heroes they try their hardest to persevere under pressure and achieve the goal in front of them. They show the characteristics of a stoic, working hard in the hardest of situations. Hemingway Code Heroes are very rare in real life, but in fiction they survive, setting good examples forShow MoreRelatedThe Old Man And The Sea By Ernest Hemingway1744 Words   |  7 Pagesâ€Å"The Old Man and The Sea† by Ernest Heming way is a story about an old man named Santiago who has to overcome many obstacles in his time at sea and in life (Hemingway). Despite being a fisherman, Santiago has not caught fish in 84 days and is faced by numerous dilemmas and shortcomings as things seem to always go wrong for him (Hemingway). This paper provides an analysis of the novel by interpreting it as a secular humanist epic. This paper hypothesizes that the character of Santiago is guided byRead MoreThe Old Man and the Sea: an Annotated Bibliography1684 Words   |  7 PagesNick Choi Ms. Marshall English 11 Honors 18 January 2013 The Old Man and the Sea: An Annotated Bibiliography Ernest Hemingway’s novel, The Old Man and the Sea, can be construed as an allusion to the Bible and the struggles of Jesus based on Santiago’s experiences. Baskett, Sam S. Toward a Fifth Dimension in  The Old Man and the Sea.  The Centennial Review  19.4 (Fall 1975): 269-286. Rpt. in  Short Story Criticism. Ed. Anna Sheets- Nesbitt. Vol. 36. 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In works such as Old Man and the Sea and For whom the Bell Tolls, Ernest Hemmingway uses his style of writing to convey his purpose and ideas of literary elements, such as plot, mood, character, symbolism, and theme, which can be analyzed with New Critical Theory and Iceberg TheoryRead MoreAnalysis of Paulo Coehlos â€Å"the Alchemist† and Ernest Hemmingways â€Å"the Old Man and the Sea† Based on Danah Zohar and Ian Marshalls â€Å"Spiritual Capital: Wealth We Can Live by†1523 Words   |  7 PagesThis assignment analyses the novels â€Å"The Alchemist† by Paulo Coelho and â€Å"The Old Man and The Sea† by Ernest Hemmingway on the aspects defined in the book â€Å"Spiritual Capital: Wealth We Can Live By† by Danah Zohar and Ian Marshall. First we analyze â€Å"The Alchemist†. A major feature of the book by Zohar is the analysis if the motivations which stimulate a man’s actions and reactions. In the book Zohar advocates that there are majorly 16 types of motivations, eight negative and eight positive, each with