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Urinary Incontinence: Impact on Long Term Care
Urinary Incontinence: Impact on Long Term Care Muhammad S. Choudhury, MD, FACS Professor and Chairman Department of Urology New York Medical College Director of Urology Westchester Medical Center 1 Urinary Incontinence: Overview • Definition • Scope • Anatomy and Physiology of Micturition • Types • Diagnosis • Management • Impact on Long Term Care 2 Urinary Incontinence: Definition • Involuntary leakage of urine which is personally and socially unacceptable to an individual. • It is a multifactorial syndrome caused by a combination of: • Genito urinary pathology. • Age related changes. • Comorbid conditions that impair normal micturition. • Loss of functional ability to toilet oneself. 3 Urinary Incontinence: Scope • Prevalence of Urinary incontinence increase with age. • Affects more women than men (2:1) up to age 80. • After age 80, both women and men are equally affected. • Urinary Incontinence affect 15% to 30% of the general population > 65 years. • > 50% of 1.5 million Long Term Care residents may be incontinent. • The cost to care for this group is >5 billion per year. • The total cost of care for Urinary Incontinence in the U.S. is estimated to be over $36 billion. Ehtman et al., 2012. 4 Urinary Incontinence: Impact on Quality of Life • Loss of self esteem. • Avoidance of social activity and interaction. • Decreased ability to maintain independent life style. • Increased dependence on care givers. • One of the most common reason for long term care placement. Grindley et al. Age Aging. 1998; 22: 82-89/Harris T. Aging in the eighties. NCHS # 121 1985. Noelker L. Gerontologist 1987; 27: 194-200. 5 Health related consequences of Urinary Incontinence • Increased propensity for fall/fracture. -
CMS Manual System Human Services (DHHS) Pub
Department of Health & CMS Manual System Human Services (DHHS) Pub. 100-07 State Operations Centers for Medicare & Provider Certification Medicaid Services (CMS) Transmittal 8 Date: JUNE 28, 2005 NOTE: Transmittal 7, of the State Operations Manual, Pub. 100-07 dated June 27, 2005, has been rescinded and replaced with Transmittal 8, dated June 28, 2005. The word “wound” was misspelled in the Interpretive Guidance section. All other material in this instruction remains the same. SUBJECT: Revision of Appendix PP – Section 483.25(d) – Urinary Incontinence, Tags F315 and F316 I. SUMMARY OF CHANGES: Current Guidance to Surveyors is entirely replaced by the attached revision. The two tags are being combined as one, which will become F315. Tag F316 will be deleted. The regulatory text for both tags will be combined, followed by this revised guidance. NEW/REVISED MATERIAL - EFFECTIVE DATE*: June 28, 2005 IMPLEMENTATION DATE: June 28, 2005 Disclaimer for manual changes only: The revision date and transmittal number apply to the red italicized material only. Any other material was previously published and remains unchanged. However, if this revision contains a table of contents, you will receive the new/revised information only, and not the entire table of contents. II. CHANGES IN MANUAL INSTRUCTIONS: (N/A if manual not updated.) (R = REVISED, N = NEW, D = DELETED) – (Only One Per Row.) R/N/D CHAPTER/SECTION/SUBSECTION/TITLE R Appendix PP/Tag F315/Guidance to Surveyors – Urinary Incontinence D Appendix PP/Tag F316/Urinary Incontinence III. FUNDING: Medicare contractors shall implement these instructions within their current operating budgets. IV. ATTACHMENTS: Business Requirements x Manual Instruction Confidential Requirements One-Time Notification Recurring Update Notification *Unless otherwise specified, the effective date is the date of service. -
The 007Th Minute Ebook Edition
“What a load of crap. Next time, mate, keep your drug tripping private.” JACQUES A person on Facebook. STEWART “What utter drivel” Another person on Facebook. “I may be in the minority here, but I find these editorial pieces to be completely unreadable garbage.” Guess where that one came from. “No, you’re not. Honestly, I think of this the same Bond thinks of his obituary by M.” Chap above’s made a chum. This might be what Facebook is for. That’s rather lovely. Isn’t the internet super? “I don’t get it either and I don’t have the guts to say it because I fear their rhetoric or they’d might just ignore me. After reading one of these I feel like I’ve walked in on a Specter round table meeting of which I do not belong. I suppose I’m less a Bond fan because I haven’t read all the novels. I just figured these were for the fans who’ve read all the novels including the continuation ones, fan’s of literary Bond instead of the films. They leave me wondering if I can even read or if I even have a grasp of the language itself.” No comment. This ebook is not for sale but only available as a free download at Commanderbond.net. If you downloaded this ebook and want to give something in return, please make a donation to UNICEF, or any other cause of your personal choice. BOOK Trespassers will be masticated. Fnarr. BOOK a commanderbond.net ebook COMMANDERBOND.NET BROUGHT TO YOU BY COMMANDERBOND.NET a commanderbond.net book Jacques I. -
Why Menstrual Hygiene Products Should Be Provided for Free in Restrooms
University of Miami Law Review Volume 73 Number 1 Fall 2018 Article 10 10-30-2018 The Bring Your Own Tampon Policy: Why Menstrual Hygiene Products Should Be Provided for Free in Restrooms Elizabeth Montano Follow this and additional works at: https://repository.law.miami.edu/umlr Part of the Human Rights Law Commons Recommended Citation Elizabeth Montano, The Bring Your Own Tampon Policy: Why Menstrual Hygiene Products Should Be Provided for Free in Restrooms, 73 U. Miami L. Rev. 370 (2018) Available at: https://repository.law.miami.edu/umlr/vol73/iss1/10 This Note is brought to you for free and open access by the Journals at University of Miami School of Law Institutional Repository. It has been accepted for inclusion in University of Miami Law Review by an authorized editor of University of Miami School of Law Institutional Repository. For more information, please contact [email protected]. The Bring Your Own Tampon Policy: Why Menstrual Hygiene Products Should Be Provided for Free in Restrooms ELIZABETH MONTANO* Like toilet paper, menstrual hygiene products,1 such as tampons and pads, are necessities for managing natural and unavoidable bodily functions. However, menstrual hygiene products widely receive separate treatment in restrooms across the globe. While it would be absurd today to carry a roll of toilet paper at all times, it is considered necessary and common sense for all menstruators to carry menstrual hy- giene products at all times, for approximately forty years, in case of an emergency. This is the “Bring Your Own * Editor-in-Chief, University of Miami Law Review, Volume 73; J.D. -
Technology Review of Urine-Diverting Dry Toilets (Uddts) Overview of Design, Operation, Management and Costs
Technology Review of Urine-diverting dry toilets (UDDTs) Overview of design, operation, management and costs As a federally owned enterprise, we support the German Government in achieving its objectives in the field of international cooperation for sustainable development. Published by: Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH Registered offices Bonn and Eschborn, Germany T +49 228 44 60-0 (Bonn) T +49 61 96 79-0 (Eschborn) Friedrich-Ebert-Allee 40 53113 Bonn, Germany T +49 228 44 60-0 F +49 228 44 60-17 66 Dag-Hammarskjöld-Weg 1-5 65760 Eschborn, Germany T +49 61 96 79-0 F +49 61 96 79-11 15 E [email protected] I www.giz.de Name of sector project: SV Nachhaltige Sanitärversorgung / Sustainable Sanitation Program Authors: Christian Rieck (GIZ), Dr. Elisabeth von Münch (Ostella), Dr. Heike Hoffmann (AKUT Peru) Editor: Christian Rieck (GIZ) Acknowledgements: We thank all reviewers who have provided substantial inputs namely Chris Buckley, Paul Calvert, Chris Canaday, Linus Dagerskog, Madeleine Fogde, Robert Gensch, Florian Klingel, Elke Müllegger, Charles Niwagaba, Lukas Ulrich, Claudia Wendland and Martina Winker, Trevor Surridge and Anthony Guadagni. We also received useful feedback from David Crosweller, Antoine Delepière, Abdoulaye Fall, Teddy Gounden, Richard Holden, Kamara Innocent, Peter Morgan, Andrea Pain, James Raude, Elmer Sayre, Dorothee Spuhler, Kim Andersson and Moses Wakala. The SuSanA discussion forum was also a source of inspiration: http://forum.susana.org/forum/categories/34-urine-diversion-systems- -
Chapter 4 Fixtures, Faucets and Fixture Fittings
Color profile: Generic CMYK printer profile Composite Default screen CHAPTER 4 FIXTURES, FAUCETS AND FIXTURE FITTINGS SECTION 401 402.2 Materials for specialty fixtures. Materials for specialty GENERAL fixtures not otherwise covered in this code shall be of stainless 401.1 Scope. This chapter shall govern the materials, design steel, soapstone, chemical stoneware or plastic, or shall be and installation of plumbing fixtures, faucets and fixture fit- lined with lead, copper-base alloy, nickel-copper alloy, corro- tings in accordance with the type of occupancy, and shall pro- sion-resistant steel or other material especially suited to the vide for the minimum number of fixtures for various types of application for which the fixture is intended. occupancies. 402.3 Sheet copper. Sheet copper for general applications 401.2 Prohibited fixtures and connections. Water closets shall conform to ASTM B 152 and shall not weigh less than 12 having a concealed trap seal or an unventilated space or having ounces per square foot (3.7 kg/m2). walls that are not thoroughly washed at each discharge in 402.4 Sheet lead. Sheet lead for pans shall not weigh less than accordance with ASME A112.19.2M shall be prohibited. Any 4 pounds per square foot (19.5 kg/m2) coated with an asphalt water closet that permits siphonage of the contents of the bowl paint or other approved coating. back into the tank shall be prohibited. Trough urinals shall be prohibited. 401.3 Water conservation. The maximum water flow rates SECTION 403 and flush volume for plumbing fixtures and fixture fittings MINIMUM PLUMBING FACILITIES shall comply with Section 604.4. -
Instructions for Clean Catch Urine Collection for Diagnostic Testing
INSTRUCTIONS FOR CLEAN CATCH URINE COLLECTION FOR DIAGNOSTIC TESTING. IMPORTANT CAUTION: PLEASE READ AND FOLLOW ALL DIRECTIONS CAREFULLY. IT IS IMPORTANT THAT THE SPECIMEN BE AS CLEAN AS POSSIBLE FOR ACCURATE RESULTS. Male 1. Thoroughly wash and dry hands. 2. Unscrew cap of the urine specimen cup. To avoid contamination, do not touch inside of cup or cap. Place cap on the counter with the inside facing up. 3. Cleanse external areas as follows: Wipe head of penis in a single motion with first towelette. If not circumcised hold foreskin back before cleansing. 4. Hold the sterile cup in one hand. First urinate a small amount into toilet, then catch the rest of the urine directly into the sterile container without stopping the urine stream. (Urinating a small amount into the toilet first flushes out any contaminating organism). 5. Collect specimen until cup is at least half full. 6. Finish voiding in toilet or bedpan. 7. Replace cap on cup and tighten securely. Female 1. Thoroughly wash and dry hands. 2. Unscrew cap of the urine specimen cup. To avoid contamination, do not touch inside of cup or cap. Place cap on the counter with the inside facing up. 3. Cleanse external areas as follows: With one hand spread the labia and keep spread until the specimen is collected. Wipe inner labia folds front to back in a single motion with the first towelette. Repeat with the second towelette. 4. Keep the labia separated and hold the sterile container with the other hand. Urinate a small amount into toilet, then catch the rest of the urine directly into the sterile container without stopping the urine stream. -
Bedpan Management Teleclass Slides, May.12.11
The Faecal Quandary – Bedpan Management in a Modern Age Gertie van Knippenberg-Gordebeke, Netherlands Sponsored by Meiko (www.meiko.de) The Faecal Quandary Disclaimer/Disclosure The findings and conclusions in this presentation are those of the author "Bedpan Management in a Modern Age" Consultant current & past for: Diversey the Netherlands, Hakerman Turkey, Medwaste Control the Netherlands Gertie van Knippenberg-Gordebeke, RN, CCIP Meiko Germany, SCA Hygiene Products Sweden, Sigex Brazil Consultant Infection Prevention [email protected] ΄T Like “It‘s what I “I DON to do DO Best” A Tribute to All Nurses in the Bedpans” Sponsored by: world Webber Teleclass& 10 year Anniversary www.meiko.de Hosted by Paul Webber [email protected] 2 www.webbertraining.com April 12, 2011 Florence Nightingale ‘Lady with the lamp’ (12-05-1820 – 03-08-1910) Do No Harm 12 May International Nursing Day Florence Nightingale & Hippocrates 2011 • Founder professional nursing Healthcare Associated Infections (HAI) • Advocate improvement of care & hygiene ± 10% in Hospitals (Netherlands 6,2%) • Improvement reduced mortality rate from 42% to 2% • Author books & manuscripts* > 25% on Intensive Care > 25% in Low income countries * Notes on Nursing: What is and what is not * Notes on Hospitals: Sanitary techniques to medical facilities Harm what could be prevented 3 4 Risk Factors HAI • Antimicrobial resistance • Human behaviour • Staff-shortage Breaking the chain with basic precautions Nr.1 • Difference in medical- and nursing care structure • Resource availability -
DSA Bulletin BU 17-01-01:Identification Of
BU 17-01-01 BULLETIN: IDENTIFICATION OF SINGLE–USER TOILET FACILITIES AS ALL–GENDER: FREQUENTLY ASKED QUESTIONS Division of the State Architect (DSA) documents referenced within this publication are available DSA Publications webpages. PURPOSE: This bulletin is a supplement to BU 17-01: Identification of Single-User Toilet Facilities as All- Gender and is provided to assist facility operators and design professionals who design facilities under the jurisdiction of DSA in interpreting the requirements of Health and Safety Code (HSC) 118600. DISCUSSION: HSC 118600 requires: a) All single-user toilet facilities in any business establishment, place of public accommodation, or state or local government agency shall be identified as all-gender toilet facilities by signage that complies with Title 24 of the California Code of Regulations, and designated for use by no more than one occupant at a time or for family or assisted use. b) During any inspection of a business or a place of public accommodation by an inspector, building official, or other local official responsible for code enforcement, the inspector or official may inspect for compliance with this section. c) For the purposes of this section, “single-user toilet facility” means a toilet facility with no more than one water closet and one urinal with a locking mechanism controlled by the user. d) This section shall become operative on March 1, 2017. FOLLOWING IS A LIST OF FREQUENTLY ASKED QUESTIONS: In applying this statute to existing facilities, how does HSC section 118600 reconcile with the provisions in the California Building Standards Code (CBSC)? According to Assembly analysis: Assembly Bill 1732 does not change existing laws with respect to the number of, specifications for, or other facility requirements for restrooms that a business or entity must comply with under the existing CBC or current local ordinances, but changes the restroom identification and availability of use. -
Urinary Retention in Women Workshop Chair: David Castro-Diaz, Spain 07 October 2015 08:30 - 11:30
W16: Urinary Retention in Women Workshop Chair: David Castro-Diaz, Spain 07 October 2015 08:30 - 11:30 Start End Topic Speakers 08:30 08:45 Urinary retention in women: concepts and pathophysiology David Castro-Diaz 08:45 08:50 Discussion All 08:50 09:05 Evaluation Tufan Tarcan 09:05 09:10 Discussion All 09:10 09:30 Conservative management Cristina Naranjo-Ortiz 09:30 09:35 Discussion All 09:35 09:55 Medical and surgical management Christopher Chapple 09:55 10:00 Discussion All 10:00 10:30 Break None 10:30 11:20 Typical clinical cases discussion All 11:20 11:30 Take home messages David Castro-Diaz Aims of course/workshop Urinary retention in women is rare and diverse. Diagnostic criteria are not agreed and epidemiology is not well known. Forms of urinary retention in women include: complete retention, incomplete or insufficient emptying and elevated post-void residual. It may be acute or chronic, symptomatic or asymptomatic. Etiology is multifactorial including anatomic or functional bladder outlet obstruction and bladder dysfunction related to neurological diseases, diabetes mellitus, aging, pharmacotherapy, pain and infective/inflammatory disease and idiopathic or unknown aetiology. This workshop will analyse and discuss physiopathology, evaluation and management of urinary retention in women from an integral, practical and evidence based approach. Learning Objectives 1. Identify urinary retention in women, its etiology and risk factors. 2. Carry out proper diagnosis of urinary retention in women as well as its relationship with risk and influent factors. 3. Properly manage female acute and chronic acute and chronic urinary retention with the different approaches including conservative, medical and surgical therapies. -
What I Need to Know About Bladder Control for Women
What I need to know about BladderBladder ControlControl forfor WomenWomen U.S. Department NATIONAL INSTITUTES OF HEALTH of Health and National Kidney and Urologic Diseases Information Clearinghouse Human Services What I need to know about Bladder Control for Women NATIONAL INSTITUTES OF HEALTH National Diabetes Information Clearinghouse Contents Urine Leakage: A Common Health Problem for Women of All Ages ................................................................ 1 How does the bladder work?................................................. 2 What are the different types of bladder control problems? ................................................................................ 5 What causes bladder control problems? .............................. 7 How do I tell my health care team about my urine leakage?................................................................................... 9 How is loss of bladder control treated?.............................. 11 Hope Through Research...................................................... 17 For More Information.......................................................... 18 Acknowledgments................................................................. 19 *Inserts in back pocket A. What Your Doctor Needs to Know B. Your Daily Bladder Diary C. Kegel Exercise Tips D. Medicines for Bladder Control Urine Leakage: A Common Health Problem for Women of All Ages You may think bladder control problems are something that happen when you get older. The truth is that women of all ages have urine -
Cruising Game Space
CRUISING GAME SPACE Game Level Design, Gay Cruising and the Queer Gothic in The Rawlings By Tommy Ting A thesis exhibition presented to OCAD University in partial fulfillment of the requirements for the degree of Master of Fine Arts in Digital Futures Toronto Media Arts Centre 32 Lisgar Street., April 12, 13, 14 Toronto, Ontario, Canada April 2019 Tommy Ting 2019 This work is licensed under the Creative Commons Attribution-Non Commercial-ShareAlike 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc- sa/4.0/ or send a letter to Creative Commons, 444 Castro Street, Suite 900, Mountain View, California, 94041, USA. Copyright Notice Author’s Declaration This work is licensed under the Creative Commons Attribution-NonCommercial- ShareAlike 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-sa/4.0/ or send a letter to Creative Commons, 444 Castro Street, Suite 900, Mountain View, California, 94041, USA. You are free to: Share – copy and redistribute the material in any medium or format Adapt – remix, transform, and build upon the material The licensor cannot revoke these freedoms as long as you follow the license terms. Under the follower terms: Attribution – You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use. NonCommericial – You may not use the material for commercial purposes. ShareAlike – If you remix, transform, or build upon the material, you must distribute you contributions under the same license as the original.