Carpaal tunnel syndroom (CTS) is een van de meest voorkomende zenuwen problemen van de arm. Pijn, tintelingen, gevoelloosheid en spieruitval kunnen hierbij optreden. Dit ontstaat doordat een belangrijke zenuwen ingeklemd raakt ter hoogte van de pols. Dit geeft met name klachten in je hand maar soms ook pijn tot aan je schouder.
Bij 1 op de 4 mensen gaan de klachten na een periode vanzelf over. Bij de rest kan dit een zeer hardnekkige probleem zijn.
In deze presentatie geven wij je inzicht in de laatste stand van zaken: wat is CTS, hoe ontstaat het, hoe voorkom je het en hoe kom je ervan af.
When Culture Saved the Day: Organization Culture and Crisis Managementlmaguire2150
Descriptive case study presents a healthcare organization's approach to building an intentional culture which greatly contributed to its ability to survive a crisis
Este documento presenta un árbol genealógico de la familia Padilla Beleño. Muestra a Rafael Padilla como el patriarca con su esposa Mildre Beleño, y sus hijos Angie, Tatiana y Steven Padilla Beleño.
Three IBM Champions each give a short presentation, then spend the remainder of the time answering XPages questions.
The brief presentations are from XPages experts:
-Mark Roden on "Speeding Up Designer"
-Jesse Gallagher on "Recycle: When, where, why, how and the OpenNTF Domino API"
-Ulrich Krause on "Using Dojo with Multi-Lingual Apps"
Marketing To Leisure Travelers (1st Part)David Cadabos
This document discusses marketing strategies for attracting different types of leisure travelers. It outlines key differences between business and leisure travelers, noting that leisure travelers are more seasonal, flexible with bookings, and seek packages and discounts.
The document separates leisure travelers into individual and group segments. Individual leisure travelers like families, seniors, and baby boomers are discussed in detail. Their travel preferences, budgets, and effective marketing channels are described. The document provides recommendations for hotels to meet the specific needs of each group and attract more leisure travelers.
When Culture Saved the Day: Organization Culture and Crisis Managementlmaguire2150
Descriptive case study presents a healthcare organization's approach to building an intentional culture which greatly contributed to its ability to survive a crisis
Este documento presenta un árbol genealógico de la familia Padilla Beleño. Muestra a Rafael Padilla como el patriarca con su esposa Mildre Beleño, y sus hijos Angie, Tatiana y Steven Padilla Beleño.
Three IBM Champions each give a short presentation, then spend the remainder of the time answering XPages questions.
The brief presentations are from XPages experts:
-Mark Roden on "Speeding Up Designer"
-Jesse Gallagher on "Recycle: When, where, why, how and the OpenNTF Domino API"
-Ulrich Krause on "Using Dojo with Multi-Lingual Apps"
Marketing To Leisure Travelers (1st Part)David Cadabos
This document discusses marketing strategies for attracting different types of leisure travelers. It outlines key differences between business and leisure travelers, noting that leisure travelers are more seasonal, flexible with bookings, and seek packages and discounts.
The document separates leisure travelers into individual and group segments. Individual leisure travelers like families, seniors, and baby boomers are discussed in detail. Their travel preferences, budgets, and effective marketing channels are described. The document provides recommendations for hotels to meet the specific needs of each group and attract more leisure travelers.
An increasing number of educational institutions in the UAE offer or plan to start using web-based mode of course delivery. According to Haughey and Anderson (1998), all types of education are affected as technology is used to enhance and deliver courses online. There are several colleges and universities in the UAE that are considering incorporating online education to support the traditional face-to-face classes in addition to offering courses as distance learning.
This presentation outlines the purpose and benefits of online instruction while describing the target audience, required technology, resources, staffing, and necessary curriculum development and quality assurance program to support the delivery of education online.
Mobilisez vos Applications IBM Notes avec Teamstudio Unplugged ! (French Lang...Teamstudio
Rejoignez IBM et Teamstudio pour un webinar (en Français) le mercredi 24 juin et découvrez comment Unplugged permet une mobilisation simple et rapide de vos applications IBM Notes. Et pas seulement! Avec Teamstudio Unplugged vos utilisateurs nomades auront un accès read/write à leurs applications depuis leurs tablettes et leurs smartphones, même offline!
Indo - German CC - Life skills - impactMadhuri Lele
The VETnet Newsletter provides an update on their one-year Industry Mechanic training course at Don Bosco. The trainees have completed basic training in metal work, including theoretical subjects like math and practical workshops in areas like drilling and fitting. An unusual subject called "Social Studies" encouraged trainees to think about goals, strengths, weaknesses, entrepreneurship, and their role as employees. Feedback on this class was very positive. The newsletter then introduces the teacher for social skills, Madhuri Lele, who discusses the importance of self-esteem and self-efficacy for human development. Finally, the newsletter reports that trainees took interim exams this week, with an 11% overall improvement in theoretical exam results compared to the beginning
Transformations: Smart Application Migration to XPagesTeamstudio
Migrating legacy applications with XPages without using any third party tools can be hard. Your code that was built and maintained over the years should be reused and ported to a current XPages environment. Oliver Busse will show you how to benefit from the possibilities of using Java in XPages to reproduce the functionality you already have and extend it to the next level, including:
-User profiles: create, use, and maintain
-Application profiles: reinvented
-Getting user and environment information: made easy and smart
-Transformation of the full-text search to a "facetted search" all over your application(s)
Multiple exposure is a technique that combines two images into one by overlaying them. It allows effects like ghostly or mirrored images. While some cameras provide a multiple exposure function, photo editing software like Photoshop provides more control by allowing images from different times to be combined. Light writing involves long exposure photography where lights are used to create effects and objects by moving them during the exposure. A tripod is important to avoid camera shake, and different light sources can be used along with settings like a high aperture number and low ISO to reduce noise for long exposures.
It's Not Infernal: Dante's Nine Circles of XPages HeavenTeamstudio
Come join us for this fun but informative webinar on XPages development with Paul Withers and Mike McGarel as they present their session from Connect 2014! Your very own Dante and Virgil will take you through a divine comedy of nine circles that show that XPages is more paradise than perdition. We'll show how XPages and related concepts like OSGi plugins make XPages a modern and vibrant development technology for web, mobile and rich client. On the way we'll guide you past some pitfalls to avoid becoming one of the lost souls. When we re-emerge, you'll see the sky's the limit with star-studded opportunities.
An increasing number of educational institutions in the UAE offer or plan to start using web-based mode of course delivery. According to Haughey and Anderson (1998), all types of education are affected as technology is used to enhance and deliver courses online. There are several colleges and universities in the UAE that are considering incorporating online education to support the traditional face-to-face classes in addition to offering courses as distance learning.
This presentation outlines the purpose and benefits of online instruction while describing the target audience, required technology, resources, staffing, and necessary curriculum development and quality assurance program to support the delivery of education online.
Mobilisez vos Applications IBM Notes avec Teamstudio Unplugged ! (French Lang...Teamstudio
Rejoignez IBM et Teamstudio pour un webinar (en Français) le mercredi 24 juin et découvrez comment Unplugged permet une mobilisation simple et rapide de vos applications IBM Notes. Et pas seulement! Avec Teamstudio Unplugged vos utilisateurs nomades auront un accès read/write à leurs applications depuis leurs tablettes et leurs smartphones, même offline!
Indo - German CC - Life skills - impactMadhuri Lele
The VETnet Newsletter provides an update on their one-year Industry Mechanic training course at Don Bosco. The trainees have completed basic training in metal work, including theoretical subjects like math and practical workshops in areas like drilling and fitting. An unusual subject called "Social Studies" encouraged trainees to think about goals, strengths, weaknesses, entrepreneurship, and their role as employees. Feedback on this class was very positive. The newsletter then introduces the teacher for social skills, Madhuri Lele, who discusses the importance of self-esteem and self-efficacy for human development. Finally, the newsletter reports that trainees took interim exams this week, with an 11% overall improvement in theoretical exam results compared to the beginning
Transformations: Smart Application Migration to XPagesTeamstudio
Migrating legacy applications with XPages without using any third party tools can be hard. Your code that was built and maintained over the years should be reused and ported to a current XPages environment. Oliver Busse will show you how to benefit from the possibilities of using Java in XPages to reproduce the functionality you already have and extend it to the next level, including:
-User profiles: create, use, and maintain
-Application profiles: reinvented
-Getting user and environment information: made easy and smart
-Transformation of the full-text search to a "facetted search" all over your application(s)
Multiple exposure is a technique that combines two images into one by overlaying them. It allows effects like ghostly or mirrored images. While some cameras provide a multiple exposure function, photo editing software like Photoshop provides more control by allowing images from different times to be combined. Light writing involves long exposure photography where lights are used to create effects and objects by moving them during the exposure. A tripod is important to avoid camera shake, and different light sources can be used along with settings like a high aperture number and low ISO to reduce noise for long exposures.
It's Not Infernal: Dante's Nine Circles of XPages HeavenTeamstudio
Come join us for this fun but informative webinar on XPages development with Paul Withers and Mike McGarel as they present their session from Connect 2014! Your very own Dante and Virgil will take you through a divine comedy of nine circles that show that XPages is more paradise than perdition. We'll show how XPages and related concepts like OSGi plugins make XPages a modern and vibrant development technology for web, mobile and rich client. On the way we'll guide you past some pitfalls to avoid becoming one of the lost souls. When we re-emerge, you'll see the sky's the limit with star-studded opportunities.
Presentatie over carpaal tunnelsyndroom tijdens snijzaalcursus CWK en bovenste extremiteiten d.d. 12-03-2010, verzorgd door Axcen Scholing & Onderzoek.
2. Check het filmpje op de
volgende pagina
Een belangrijke zenuw van
je arm komt onder druk te
staan ter hoogte van je pols
3. Komt bij bijna 4% van alle mensen voor.
Is de meest voorkomende zenuw inklemming
(neuropathie)
* Symptomen komen niet voor in je pink en de helft van je ringvinger
4. Wat zijn de oorzaken?
AGE
Vrouwen
hebben meer
kans
Werk waarbij je
pols langdurig
belast wordt
Trauma zoals pols
fractuur
Komt het meeste
voor tussen 40-60
jaar
Zwaar werk met
vibrerend
gereedschap
Meestal is de
oorzaak
onduidelijk
REUMA
Zwangerschap
Gewrichtsontstekingen
5. Fasen van carpale tunnel syndroom
1
Je wordt geregeld wakker vanwege een gevoelloze hand.
Ook heb je tintelingen in je hand en pijn die tot je schouder
kan doorlopen. De symptomen worden minder als je je hand
schudt. ´S ochtends voelt je hand stijf.
2
Bovenstaande symptomen heb je nu ook overdag. Met
name als je lang in dezelfde positie blijft of herhaalde
bewegingen uitvoert. Ook kan de motoriek minder worden.
Dit is merkbaar omdat je geregeld dingen uit je handen laat
vallen.
3
De omvang van de spieren van je duim worden zichtbaar
minder. Ook de kracht neemt af. Je gevoelsklachten zoals
pijn en tintelingen kunnen afnemen.
6. Behandeling
De behandeling van carpale tunnel syndroom
valt uiteen in 2 categoriëen:
1
2
Conservatief:
bij milde/matige klachten
Operatie:
bij aanhoudende en
ernstige klachten
7. Conservatief
Spalken ‘s nachts en/of
overdag helpt als
klachten gedurende de
nacht of tijdens het werk
voorkomen. De spalk
voorkomt dat je pols
buigt. Je moet verbetering
merken binnen 4 weken.
Injecteren van
ontstekingsremmers helpt
op de korte termijn tegen
de pijn en zwelling. Dit
wordt veelal gedaan als
spalken geen effect heeft.
Deze medicijnen hebben
het nadeel dat ze
lichaamsweefsel zwakker
maken.
Tijdelijk stoppen met de
werkzaamheden die de
klachten veroorzaken.
Deze rust vermindert de
irritatie van de zenuw en
de zwelling en ontsteking
ter plaatse. Als de klachten
zijn verdwenen is het zaak
om de belasting
stapsgewijs op te bouwen.
8. Operatie
Operatieve behandeling
van Carpale Tunnel
Syndroom (CTS) komt zeer
veel voor. Bij wat ernstige
en/of langdurige klachten
werkt een operatie zeer
goed.
De peesachtige band aan de voorzijde van je
pols wordt doorgesneden om zo ruimte te
maken voor je zenuwen. 70-90% van de
patiënten hebben op de lange termijn goede
tot uitstekende resultaten na een operatie.
Na de operatie kun je je hand niet (volledig)
gebruiken.