Anyway, ik zou het over iets met muziek doen als ik nog geen onderwerp had. Een band of een stijl ofzo. Lekker uitgebreid, kun je alle kanten mee op.

quote:

---

Op woensdag 12 maart 2003 14:42 schreef Mini_rulez het volgende:
6? Wij hoefden er maar 4...

Anyway, ik zou het over iets met muziek doen als ik nog geen onderwerp had. Een band of een stijl ofzo. Lekker uitgebreid, kun je alle kanten mee op.

---

quote:

---

Op woensdag 12 maart 2003 14:43 schreef jdmorpheus het volgende:

[..]

weet ik das et probleem, as je er alle kanten mee op kan vind ik geen bronnen meer... :|

---

quote:

---

Op woensdag 12 maart 2003 14:42 schreef Luigi het volgende:
Briljante topic-titel!

---

Euhmm, sjaaah, pak iets wat in de picture staat heder ten dage, pak een altijd interressant onder werp als auto's, gevolgen van kerntroep, blader een stapel Kijken, NAtional Geographics, etc. door. En als je ECHT nix weet pak je de vivaas, yessen en cosmoos van je zus en doet het over "chatrelaties"

anders kies als opnderwerp die leraar zelf gaat hem/haar interviewen in engels are you married, have you ever cheated

quote:

---

Op woensdag 12 maart 2003 14:44 schreef blieblie het volgende:

[..]

.

Euhmm, sjaaah, pak iets wat in de picture staat heder ten dage, pak een altijd interressant onder werp als auto's, gevolgen van kerntroep, blader een stapel Kijken, NAtional Geographics, etc. door. En als je ECHT nix weet pak je de vivaas, yessen en cosmoos van je zus en doet het over "chatrelaties"

---

quote:

---

Op woensdag 12 maart 2003 14:52 schreef rkloeg het volgende:
internet en zijn ontwikkeling
verzin een origineel iets!
Bloemetjes en bijtjes ik weet nog met mijn mondeling engels 3 jaar geleden ik had een wrede leraar daar kon ik wel over doorgaan

anders kies als opnderwerp die leraar zelf gaat hem/haar interviewen in engels are you married, have you ever cheated

---

quote:

---

Op woensdag 12 maart 2003 14:42 schreef Luigi het volgende:
Briljante topic-titel!

---

quote:

---

Op woensdag 12 maart 2003 14:55 schreef blieblie het volgende:

[..]

bloemetjes en bijtjes roelt wel .
vragen aan het einde offie meer uitleg nodig heeft...

---

quote:

---

Op woensdag 12 maart 2003 14:55 schreef blieblie het volgende:

[..]

bloemetjes en bijtjes roelt wel .
vragen aan het einde offie meer uitleg nodig heeft...

---

quote:

---

Op woensdag 12 maart 2003 14:57 schreef jdmorpheus het volgende:

[..]

tis een zei, en ik schat d'r op 400 jaar oud, met TEveel make up... dus doen we maar niet

---

quote:

---

Op woensdag 12 maart 2003 14:58 schreef blieblie het volgende:

[..]

over tenalady dan

---

quote:

---

Op woensdag 12 maart 2003 14:58 schreef jdmorpheus het volgende:

[..]

jij bezorgt mij 16 A4 volgeschreven over tenalady??

---

quote:

---

Intercontinence information facts:

Prevalence
Bladder weakness, or urinary incontinence is very common. It has been estimated that about 4 million people in the UK are likely to suffer regularly from the condition and for nearly 1 million of these it is a daily occurrence.

Many of the people who suffer from urinary incontinence may never seek help or advice. This is often due to embarrassment about discussing an intimate subject, a lack of understanding, or fear of knowing about the cause or the treatment required.

For those that do seek help or advice, the condition can, in most cases, be cured or at least considerably improved. We would urge you as a health care professional to encourage as many people as possible to discuss their situation with you.

Types of incontinence
As some of the following classifications show incontinence can be experienced in many different ways, depending on its physical cause. Nevertheless, incontinence should always be regarded as a symptom of a disease or disability and not as a disease in itself.

Stress incontinence
Stress incontinence occurs when bladder pressure exceeds maximum urethral pressure in the absence of detrusor muscle activity. It can be caused by one or more of the following three interacting factors. The first is loss of support of the urethra and bladder neck producing hyper-mobility of these structures and leading to stress incontinence because the bladder neck becomes displaced during physical stress. A second factor is intrinsic weakness of the sphincter which may lead to stress incontinence due to sphincter failure even though the outlet is well supported.
The third factor is neurological damage to the pelvic floor, bladder neck and urethra. This damage may be directly related to the previous two factors (Wall, L.; Norton, P.; Delance, Y.: 'Understanding Incontinence', in: Practical Uro-gynaecology, 1994).

Urge incontinence
Urge incontinence (overactive bladder, detrusor instability) occurs when the bladder objectively contracts, spontaneously or on provocation during the filling phase, while the patient is attempting to inhibit micturition.
In the majority of cases of urge incontinence no underlying cause is found and therefore the term 'idiopathic detrusor instability' is often used. Poorly learned bladder control as an infant may be the cause of detrusor instability in men or women with lifelong symptoms, or maladaptive patterns of voiding may occur later in life (Cardozo, L.; Staskin, D.; Kirby, M.: 'Development of urinary incontinence. Urinary Incontinence in Primary Care'; in: Isis Medical Media, 2000, 23).

Benign Prostatic Hyperplasia (BPH)
Benign Prostatic Hyperplasia (BPH) is a common condition affecting up to one third of men over the age of 50, and the incidence rate rises with each decade (Garraway, W.M.; Collins, G. N.; Lee, R. J.: 'High prevalence of benign prostatic hypertrophy in the community', in: Lancet: 338, 469-471).
Enlargement of the prostate is linked with the androgen dihydro-testosterone which is produced as a result of the conversion of testosterone by the enzyme 5-alpha-reductase. The most troublesome symptoms include a decreasing flow rate, increased delay in starting to urinate, frequency, urgency and nocturia (Holmes, A.; Webb, V.: 'Prostate disease: Expanding the nurse's role', in: Community Nurse Magazine - Men's Health, 1998, 23-24).

Acontractile Bladder
An acontractile bladder is defined as one that cannot be shown to contract during urodynamic studies.
Some common causes of detrusor acontractibility are (Dasgupta, P.; Shah, J.: 'The acontractile bladder', in: Urology News, 2000, 4,3; 7-12) spinal injury, herniated disc, spina bifida, radiation, myelodysplasia, polio, herpes zoster and sacral agenesis; lesions affecting the afferent feedback pathways; peripheral nerve injury; prolonged bladder outlet obstruction and over-distention injury

Faecal incontinence
Faecal incontinence is the involuntary or inappropriate passage of faeces. Some of the causes for faecal incontinence are the following (Norton,C.: 'Faecal incontinence in adults: prevalence and causes'; in: British Journal of Nursing, 1996; 5,22, 1366-1374):

Sphincter or pelvic floor damage e.g.: Obstetric trauma, direct injury

Diarrhoea/intestinal hurry e.g.: inflammatory bowel disease, irritable bowel syndrome

Iatrogenic/post-surgical e.g.: Post haemorrhoidectomy, sphincterotomy for fissure or anal stretch

Ano rectal pathology e.g.: Rectal prolapse, anal fissure or rectovaginal fistula

Neurological e.g.: Spinal cord injury, multiple sclerosis, spina bifida, Parkinsons disease

Impaction with overflow 'spurious diarrhoea' e.g.: institutionalised or immobile elderly

Environmental e.g.: Poor toilet facilities, inadequate care

Idiopathic

Definitions

'Urinary incontinence is the involuntary loss of urine which is objectively demonstrable and a social or hygienic problem.' (Anderson, J.; Abrams, P.; Blaivis, J.G.; Stanton, S.L.: 'The standardisation of terminology of lower urinary tract function'. In: Scandinavian Journal of Urology and Nephrology, Supplement, 1988; 114:5-19).

'An acontractile bladder is defined as one that cannot be shown to contract during urodynamic studies.' (Abrams, P.; Blaivis, J.G.; Anderson, J.T.: ' The standardisation of terminology of the lower urinary tract function'. In: Scandinavian Journal of Urology and Nephrology, Supplement, 1988; 114:5-19).

'Stress incontinence occurs when bladder pressure exceeds maximum urethral pressure in the absence of detrusor muscle activity.' (O'Dowd, T.: 'Management of urinary incontinence in women'. In: British Journal of General Practice, 1993; 43: 426-429).

'Overactive bladder (detrusor instability) is when the bladder objectively contracts, spontaneously or on provocation during the filling phase while the patient is attempting to inhibit micturition.' (International Incontinence Society: 'The standardisation of terminology of the lower urinary tract function'. In: British Journal of Obstretics and Gynaecology, Supplement, 1990; 1-16).

'Constipation can be defined as a decrease in the frequency of defaecation differentiated by hard formed stools which are difficult to pass.' (Mcmillan S., Williams, F.: 'Validity and reliability of the Constipation Assessment Scale'. In: Cancer Nursing, 1989; 12,3, 182-183).
'Faecal incontinence is the involuntary or inappropriate passage of faeces.' (Royal College of Physicians: 'Incontinence: Causes, Management and Provision of Services'. 1995).

---

quote:

---

incontinence information treatment:

As many treatment programmes are related to a change of lifestyle and/or exercises, treatment is often not that expensive. Patients with bladder instability and genuine stress incontinence can often be treated at a cost of less than £50.00 in nursing time. Where products of containment are necessary, it is important that funds are made available for their provision, enabling the person to achieve an improved quality of life.

Listed below are some examples of the different treatment options for various forms of incontinence:

Pelvic floor exercises

Vaginal cones

Biofeedback

Electro-stimulation

Oestrogen treatment

Behaviour modification

Drug therapy

Medication

Abdominal massage

Pelvic floor exercises
Pelvic floor exercises are often poorly taught and ineffectively carried out. It is therefore important that the person instructing the women is appropriately trained.
Digital palpation of the lavator ani is essential to ensure that patients are able to perform the correct muscle contraction prior to teaching the exercises. Length and strength of each pelvic floor contraction will vary with each individual. As pelvic floor training will only be effective if the muscles are 'overloaded', patients should have their own specific exercise programme prescribed (Laycock, J.: 'Physiotherapy management of incontinence', in: Urology news; 1997, 1,4).
With pelvic floor exercises in the elderly, it is important to understand that continence may take longer to achieve and sometimes the use of a perineometer (instrument used to measure muscle strength through a vaginal probe) may offer encouragement as a monitor of progress. Exercises should be carried out on a regular basis throughout the day, and prompts such as to exercise with every drink or a coloured marker placed strategically around the house should act as a reminder (Billington, A.: 'Managing incontinence in older women', in: Elderly Care Magazine; 1999, 11:9).

Weighted vaginal cones
A set of graded cone shaped weights (20g - 90g) that are used in conjunction with pelvic floor exercises to improve muscle tone. One weight is inserted into the vagina for up to 30 minutes, twice a day. Pelvic floor contraction is essential to keep the weights in place. Contracting the abdominal or gluteal muscles will not help retention.
The strength of the pelvic floor may be increased by gradually increasing the weight of the cone. The positioning of the cone is important: it should be just above the pelvic floor. Cones are not suitable for women with large rectoceles as the cone becomes wedged above the prolapse and is thus ineffective (Cardozo, L.; Staskin, K.; Kirby, M.: 'Urinary Incontinence in Primary Care', in: Isis Medical Media, 2000).

Biofeedback
This is a relatively new technique that uses a computer to monitor the results of patient effort through a vaginal or rectal sensor. Elderly patients can be treated very successfully because the technique helps to identify the pelvic floor muscles. But some may find the treatment too intimate and therefore unacceptable.
A study from the Netherlands found that statistically, biofeedback improved incontinence when given in conjunction with pelvic floor exercises (Bergmans, L.C.M.; Frederiks, C.M.A.; De Bie, R. A. et al.: 'Efficacy of biofeedback, when included with pelvic floor muscle exercise treatment, for genuine stress incontinence, in: Neurology and Urodynamics, 1996, 15:1, 37-52).

Electro-stimulation
Electro-stimulation helps the pelvic floor muscles to develop new fibres and increases the number of capillaries supplying them. For stress incontinence, if the patient has little or no squeeze (less than 10 cm H2O on a perineometer), a course of short-term maximal stimulation will be more beneficial. This treatment can be administered at home. However, some patients need the discipline of attending a clinic, usually twice a week (Rigby, D.: 'The electric effect', in: Nursing Times, 1996, 92:32).

Oestrogen treatment
Oestrogen may thin out the mucosa, weakening the ureathral resistance (Turner, S.L.: 'As women age: Perspectives on urinary incontinence', in: Rehabilitation Nursing, 1988, 13:3, 132-135).
Although some minor improvement may be seen, it is unlikely that HRT will help stress incontinence to any great extent as most HRT regimes include progestogens that neutralise the positive effect of the oestrogen. Vaginal administration on the other hand is most likely to cause a favourable response and may also prevent urinary tract infection (Nager, C.; Stanton, S.: 'Can HRT help incontinence?, in: Nurse Prescriber/Community Nurse, 1997, May).

Behaviour modification
Behaviour modification is often seen by the health care professional as the first and easiest option but for the men and women concerned, it can be the hardest. This therapy includes changing diet and fluid intake, bowel regularity management and bladder retraining to promote good bladder habits. Dietary changes should include decreasing or eliminating irritants. All fluids and food should be caffeine free as caffeine is both a bladder irritant and a diuretic (Newman, D.: 'Urinary incontinence management in the USA: The role of the nurse'; in: British Journal of Nursing, 1996, 5,2; 78-85).

Drug therapy
Treatment of urge incontinence uses anticholinergic or musculo trophic agents, such as oxybutinin. The side effects of oxybutinin are dose related with 3 mgs twice a day causing fewer problems than a single, 5 mg dose (O'Dowd, T.: 'Management of urinary incontinence in women'; in: British Journal of General Practice, 1993, 43, 426-429).

Medication
Pharmacological agents that were once ignored are becoming more popular as efficacy improves and side effects are reduced.

Hormonal treatment
BPH is an androgen - dependent process and hormone treatment is directed at reducing androgen production in the prostate. Finasteride is described by Rittmaster et.al. as a potent, selective, reversible inhibitor of type 2%-alpha reductase. Its function is to reduce prostate volume and therefore associated obstruction (Rittmaster, R.S.; et.a.: 'Evidence for atrophy and apoptosis in prostates of men given Finasteride' in: Journal of Clinical Endocrinology Metabolism, 1996, 81, 814-819).

Abdominal massage
Abdominal massage as a therapy to relieve constipation has been known to be effective for many hundreds of years. In some spinal units, self-massage around the abdomen with a tennis ball is recommended. The movement is up the ascending colon, across the transverse colon and down the descending colon. The aim of the massage is to release spasm in the abdomen to allow normal gut activity (Richards, A.: 'Hands on help', in: Nursing times, 94' 32).

---

quote:

---

incontinence information impact on life

Compared with control groups, it became statistically clear from a survey carried out in 1993 that the incontinent primarily suffer more from sleep disturbance, a lack of energy and mobility problems. Further impacts are a feeling of social isolation and in some cases, emotional disturbance. Further, diagnoses of urinary incontinence are, discounting mental disorders, second only to hip and knee joint disorders and well above, for example, diabetes, lung diseases
and cancer.

From an economics point of view, it has been found that, measured in terms of cost per day, care at home is the most economical alternative, representing about half the cost of care in a nursing home and only 25% of the cost of acute care.

---

er is ook nog een links sectie voor meer informatie

quote:

---

Op woensdag 12 maart 2003 15:12 schreef blieblie het volgende:
komtie he:
[..]
[veel]
bron http://www.tena.co.uk/professionals/default.htm

er is ook nog een links sectie voor meer informatie

---

quote:

---

Op woensdag 12 maart 2003 14:42 schreef Luigi het volgende:
Briljante topic-titel!

---

maar ontopic:
Politiek
vogelpest
andere pesten die geweest zijn

Mischien ideeen?