Greep op psychische klachten.

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Motivational interviewing bij type 2 diabeten.

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Problem-solving treatment during general practice residency: feasibility, and effectiveness for patients with emotional symptoms in primary care.

Contains fulltext : 82618.pdf (publisher's version ) (Open Access)Radboud Universiteit Nijmegen, 12 oktober 2010Promotor : Weel, C. van Co-promotores : Weel-Baumgarten, E.M. van, Lucassen, P.L.B.J., Beek, M.M.L.176 p

[High time for a total ban on smoking in the hotel, restaurant and catering industry: the arguments are mounting],Hoogste tijd voor een rookvrije horeca: de argumenten stapelen zich op.

Item does not contain fulltextActive and passive smoking are well-known causes of disease, including respiratory and cardiovascular disease and cancer. In 2004 the Dutch government introduced new legislation to regulate smoking in the workplace. However, smoking is still allowed in hotels, bars and restaurants, despite the fact that two-thirds of the Dutch population support a total ban on smoking in public places. Several other European countries and American states have banned smoking in public places. Studies performed in these regions show that the new smoking regulations have had no negative economic effects. Moreover, various studies have shown that smoking bans have a positive impact on public health, even in the short-term, including a significant decrease in respiratory and cardiovascular disease. There is therefore no reason to continue to exclude hotels, bars and restaurants from the smoking ban in all public places in The Netherlands

Blood pressure measurement in hemiparetic patients: which arm?

Contains fulltext : 70289.pdf (publisher's version ) (Closed access

Vrije toegang tot CT-scans bij chronische hoofdpijn

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A different way of looking at depression.

International audienceNo abstract was required (Chris Graf

Mental health problems and the presentation of minor illnesses: data from a 30-year follow-up in general practice.

Contains fulltext : 69217.pdf (publisher's version ) (Open Access)BACKGROUND: Somatic comorbidity in patients with depression and anxiety is very prevalent and mainly studied with respect to chronic conditions. Patients with mental health problems are high utilizers of medical care. This may be a result of their functional impairment and illness behaviour, but also of their interpretation of common symptoms and their attitude towards healthcare. Therefore, we expect that patients with mental health problems are more likely to present with minor illnesses to the general practitioner. OBJECTIVE: To assess the association of minor illnesses with depression and anxiety. METHODS: A historic cohort study in a general practice database of 13,500 patients, with more than 30 years' follow-up. Three prevalent categories of minor illnesses were assessed: skin, musculoskeletal, and respiratory disorders. We studied the number of patients with a diagnosis of a minor illness in patients with depression and anxiety disorder compared with their matched controls. RESULTS: We found 799 patients with depression and 153 patients with anxiety disorder. More patients with depression present skin, musculoskeletal, and respiratory disorders in the year before and the years following the initial diagnosis of depression. Depression appeared to be statistically significantly associated with presenting all three types of minor illnesses. More patients with anxiety disorder present skin and respiratory disorders in the year before diagnosis, and more musculoskeletal disorders in the years following the diagnosis of anxiety disorder. Anxiety disorder appeared to be statistically significantly associated with presenting skin and musculoskeletal morbidity. CONCLUSION: Compared to controls, more patients with depression and anxiety disorder present minor illnesses. This could be due to their high attendance rate, altered illness behaviour, or to factors--e.g., stress--underlying both the development of depression or anxiety and the susceptibility to diseases

[Summarisation of the NHG practice guideline 'Anxiety']

Item does not contain fulltextAnxiety and anxiety disorders are addressed in the practice guideline of the Dutch College of General Practitioners (NHG). It is important to distinguish anxiety and anxiety disorders because of differences in prognosis and treatment. Several visits may be needed before the diagnosis is established. Treatment is based on a stepped-care model. For anxiety, psychoeducation and follow-up visits are often sufficient. For anxiety disorders with relatively low levels of distress or social dysfunctioning, self-help with supervision in addition to psychoeducation is helpful. If this is not effective or if there is severe distress or social dysfunctioning, cognitive behavioural therapy is the first choice treatment. An antidepressant could be started after or in addition to cognitive behavioural therapy. If an antidepressant is prescribed, SSRIs are preferred above tricyclic antidepressants because of the lesser risk of severe adverse effects

GPs' experiences with enhanced collaboration between psychiatry and general practice for children with ADHD

BACKGROUND: Most general practitioners (GPs) do not feel comfortable with diagnosing and treating children with attention deficit hyperactivity disorder (ADHD). This is problematic since ADHD is a prevalent disorder and an active role of GPs is desired. In the Netherlands a collaborative ADHD programme was established, comprising of shortened diagnostic assessment in specialized mental healthcare followed by psycho-education in mental healthcare and pharmacological treatment by pre-trained GPs. OBJECTIVES: To explore the experiences of GPs regarding the diagnosis and treatment of children with uncomplicated ADHD within this programme. METHODS: Semi-structured interviews with 15 GPs were conducted. The GPs participated in an evaluation of the collaborative ADHD programme. Data was analysed using the principles of constant comparative analysis. RESULTS: Most participating GPs expressed reluctance to diagnose ADHD themselves. The reluctance was due to a lack of time, knowledge and experience. The GPs welcomed the collaborative programme because it met their need for both quick and adequate diagnosis by a specialist. Furthermore, an online ADHD course, offered by the programme, gave them the confidence to start and monitor ADHD medication. Finally, they appreciated the possibility of consulting a specialist when necessary. CONCLUSION: GPs preferred that ADHD was diagnosed by a specialist. In the context of the ADHD collaborative programme, they felt competent and comfortable to start and monitor medication in children with uncomplicated ADHD. Key Messages Within a collaborative ADHD programme for children, participating GPs were positive about a quick and specialist diagnostic process within secondary care. After an online course, GPs felt confident to start and monitor ADHD medication in children with uncomplicated ADHD. GPs were content about the collaboration between primary and secondary care