NIEUW: Blog reclamevrij maken?
Op zoek naar een bepaalde info ? Geef dan hieronder een trefwoord in...
Zoeken in blog

Foto
Welkom ! Welkom ! Welkom ! Welkom ! Welkom ! Welkom ! Welkom ! Welkom ! Welkom ! Welkom ! Welkom ! Welkom !
Foto
Gastenboek
  • online dispensary California
  • online dispensary California
  • California online dispensary
  • edibles
  • mota edibles

    Druk oponderstaande knop om een berichtje achter te laten in mijn gastenboek

    Foto
    Raadpleeg steeds je arts !
    Foto
    Laatste commentaren
  • olxntouckynfwe (kmuPeque)
        op Fibromyalgie in het kort
  • fhvihjjibraBtjemawnkmgi (nyhDrath)
        op Fibromyalgie - Chronische slaapstoornissen
  • olxntouckyoohz (kmuPeque)
        op Fibromyalgie - Chronische slaapstoornissen
  • when does viagra go generic (RichCEASE)
        op Vluchten in het werk
  • fhvihjjibraBtjemawnmkkv (nyhDrath)
        op Vluchten in het werk
  • dhffAbanoBrtinopsidi (gfhLayem)
        op Vluchten in het werk
  • dhffGeogsBrtHoincdfw (gfherymn)
        op Fibromyalgie & hormonen... - Deel II
  • jsdgfbFlignBtjemawnp (kqqGunse)
        op Fibromyalgie - Chronische slaapstoornissen
  • how to buy cheap viagra b.uycial.i.s.on.l.in.e (TyroneNek)
        op Fibromyalgie & hormonen... - Deel II
  • jsdgfbglalaBtjadentq (kqqplefs)
        op Fibromyalgie & hormonen... - Deel II
  • Foto
    Blog als favoriet !
    Foto
    Willekeurig SeniorenNet Blogs
    natuurfreek2
    blog.seniorennet.be/natuurf
    Willekeurig SeniorenNet Blogs
    gilbertruud
    blog.seniorennet.be/gilbert
    Willekeurig SeniorenNet Blogs
    noyo
    blog.seniorennet.be/noyo
    Willekeurig SeniorenNet Blogs
    dianedesign
    blog.seniorennet.be/dianede
    Willekeurig SeniorenNet Blogs
    kraaie57
    blog.seniorennet.be/kraaie5
    Foto
    Mijn favorieten
  • Kennis=macht=gezondheid - Pillie Willie
  • Vlaamse Liga voor Fibromyalgie Patiënten
  • Lotgenoten Fibromyalgie Nederland
  • APS-Therapie
  • Alles over fibromyalgie
  • Fibromyalgie-Online
  • Leven met CVS / Leven met Fibromyalgie
  • Gezondheidspein.nl
  • TopSiteGuide.BelgischeTop100
  • Fibromyalgie PR-site
    Foto
    Fibromyalgie
    Strijd om erkenning
    19-10-2008
    Klik hier om een link te hebben waarmee u dit artikel later terug kunt lezen.Rumors of Gulf War Syndrome
    Klik op de afbeelding om de link te volgen  




























              Reviving the Broken Marionette
    - Treatments for CFS/ME and Fibromyalgia -

    Maija Haavisto – CFS-verkko, May 12, 2008 – ISBN : 978-1-4092-0335-3
    Cfr. : http://www.brokenmarionettebook.com/?main

     

    Rumors of Gulf War Syndrome

    Bruce Bower, October 17th, 2008

    Informal communication among British veterans of the first Iraq war may have shaped the vets' characterization of Gulf War Syndrome.

    After the bullets stopped flying, the rumors took off among British veterans of the 1991 Gulf War.
    Early accounts of physical and emotional reactions to wartime experiences spread from one person to another through networks of veterans.
    Within a few years, these former soldiers had decided among themselves that many of them suffered from the controversial illness known as Gulf War Syndrome, a new study concludes.

    Simon Wessely of King’s College London and his colleagues analyzed extensive written accounts provided in 1996, five years after the Gulf War, by 1,100 British Gulf War vets participating in a larger survey of veterans’ health.
    Vets described their wartime experiences and related what had happened in the conflict to their later health and illness.

    The research team doesn’t regard rumor as necessarily untrue or misleading.
    Rumor proved to be critical among the British Gulf War vets because it counteracted a lack of communication from military and government authorities regarding possible wartime health risks, Wessely says.

    Scared and confused vets turned to their own social grapevine for answers, Wessely’s group reports in an upcoming Social Science & Medicine.
    Out of their shared stories and explanations grew a collective conviction that Gulf War Syndrome existed as a unitary illness with elusive causes.

    The nature of Gulf War Syndrome in the years after the conflict was keenly shaped by these early rumors, which entangled specific ideas about the illness with feelings of betrayal, distrust and ambiguity,” Wessely says.

    Symptoms attributed to Gulf War Syndrome include joint and muscle pain, bouts of depression or violent behavior and cancers of various types.
    Some researchers regard the condition as a psychological disorder related to the stress of combat.
    Others, as well as many vets, contend that it’s a physical disorder caused by exposure to toxic substances shortly before or during the war.

    By 2001, an estimated 15 percent to 20 percent of those who served in the Gulf War believed that they suffered from Gulf War Syndrome.

    Current medical consensus holds that Gulf War veterans indeed display unusually high rates of various health problems, but that these conditions don’t constitute a discrete illness or syndrome, Wessely says.

    Research on this issue remains contentious.
    In a commentary slated to be published with the new study, Thomas Shriver of Oklahoma State University in Stillwater and Sherry Cable of the University of Tennessee in Knoxville say that Wessely’s team appears to regard veterans’ symptoms as purely psychological and perhaps partly invented out of rumor.
    The authors come perilously close to blaming the victims,” the two sociologists contend.

    U.S. Gulf War vets used rumors early after their return to define collective grievances and develop a plan to press authorities for medical treatment and compensation, Shriver and Cable say.

    But, Wessely responds, “Far from blaming vets, we are shifting the spotlight to the role of governments in allowing an information vacuum to develop regarding potential health risks, which allowed rumors to spread and gain currency after the war.

    Military authorities in the United States and England have learned a hard lesson from that experience, he says.

    Consider that the anthrax vaccine was administered to U.S. and British soldiers entering the Gulf War, but that the vaccine was given under a code name.
    Rumors about the vaccine spread quickly, including one that soldiers were being injected with an experimental AIDS vaccine.
    Before the 2003 invasion of Iraq, U.S and British soldiers were told upfront that they were receiving the anthrax vaccine.

    The new study confirms that rumors about health risks, especially from vaccinations and pills, spread rapidly among troops just before, during and after the war.

    About 90 percent of the survey participants listed one or more personal problems, including anger, depression, forgetfulness, lumps, rashes, seizures, post-traumatic stress disorder, brain lesions, incontinence and self-enforced isolation.

    More than one-third of vets worried about unknown pollutants that had somehow entered their bodies.
    Concern focused on exposure to depleted uranium used during the war by U.S. and British forces, tablets and vaccinations provided to protect against Iraqi biological and chemical warfare and smoke from oil fires set by Iraqi forces as they retreated from Kuwait.

    About two-thirds of vets said that they did not, at the time of the survey, suffer from any full-blown illness but still felt susceptible to developing Gulf War Syndrome.

    Most participants also cited a lack of confidence in their leaders, from commanders of military units to government officials. Frustration over military secrecy and over not knowing whom to trust was common.

    After the war, rumors reaffirmed the social bond among returning vets and helped them to shape a bewildering array of physical and psychological symptoms into the common burden of Gulf War Syndrome, the scientists propose.


    Cfr. : http://www.sciencenews.org/view/generic/id/37761/title/Rumors_of_Gulf_War_Syndrome

    19-10-2008 om 00:00 geschreven door Jules

    0 1 2 3 4 5 - Gemiddelde waardering: 0/5 - (0 Stemmen)
    >> Reageer (0)
    15-10-2008
    Klik hier om een link te hebben waarmee u dit artikel later terug kunt lezen.Anxiety and physical illness - Part I
    Klik op de afbeelding om de link te volgen  































       Anxiety in health behaviors and physical illness
       Jasper A. J. Smits, Michael J. Zvolensky
       Springer Verlag, 11/07/2007 - ISBN : 9780387747521
       Cfr. :
    http://www.keenzo.com/showproduct.asp?ID=2059008



    Anxiety and physical illness

    Part I

     

    The link between anxiety and physical illness

    Research on the physiology of anxiety-related illness is still young, but evidence continues to grow of the mutual influence between emotions and physical functioning.
    An estimated 57 million adults suffer from anxiety disorders.
    They share an unwarranted fear or distress that interferes with daily life.
    Now, anxiety has been implicated in several chronic physical illnesses, including heart disease, chronic respiratory disorders and gastrointestinal conditions.
    When people with these disorders have untreated anxiety, the physical disease is more difficult to treat, symptoms often become worse and in some cases they die sooner.

    Cfr. : http://www.health.harvard.edu/healthbeat/HEALTHbeat_080508.htm




    Disability associated with comorbid anxiety disorders in women with chronic physical illness in Ontario, Canada

    Tahany M. Gadalla PhD, Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada : tahany.gadalla@utoronto.ca - Women Health. 2008;48(1):1-20, 07/15/2008 - PMID: 18843837 – ISSN : 0363-0242 - © Haworth Press, Inc. 2006


    Anxiety disorders are more prevalent in individuals with chronic physical illness compared to individuals with no such illness and about twice as prevalent in women as in men.

    This study used data collected in the 2005 Canadian Community Health Survey (21,198 women and 20,478 men) to examine factors associated with comorbid anxiety disorders and to assess the relation of these disorders on short-term disability and suicidal ideation.

    Comorbid anxiety disorders were more prevalent among women who were young, single, poor and Canadian-born and among women with chronic fatigue syndrome, fibromyalgia, bowel disorder or stomach or intestinal ulcers or bronchitis had the highest rates of anxiety disorders.

    The presence of comorbid anxiety disorders was significantly associated with short-term disability, requiring help with instrumental daily activities and suicidal ideation.

    Our findings underscore the importance of early detection and treatment of anxiety disorders in the physically ill, especially those who also suffer from mood disorders.


    Cfr. : http://www.haworthpress.com/store/ArticleAbstract.asp?ID=112214




    Physical illness as an outcome of chronic anxiety disorders

    Bowen RC, Senthilselvan A, Barale A, Department of Psychiatry, University of Saskatchewan, Saskatoon : bowen@duke.usask.ca - Can J Psychiatry. 2000 Jun;45(5):459-64 - PMID: 10900526


    Background
    The literature indicates increased rates of some medical conditions in patients with anxiety disorders.
    We used the Saskatchewan Health databases to examine the development of nonpsychiatric medical diseases in patients with anxiety disorders.
    This study has a large population base, and the Saskatchewan health plan does not limit the provision of services to this population.

    Method
    We observed the annual incidence of specified medical conditions in patients with anxiety disorders and in control subjects over a 10-year period.
    Subjects in both groups had not been treated for the specified medical conditions before the start of the observation period.

    Results
    The anxiety cohort had a significantly higher relative risk of developing medical diseases compared with the control group.
    The highest relative risk, indicated by the hazard ratio, was for cerebrovascular disease (hazard ratio 2, 95% CI 1.09-3.65).
    Hazard ratios were significant for cerebrovascular disease and atherosclerosis as well as for ischemic heart, gastrointestinal, hypertensive and respiratory diseases.

    Conclusions
    This study provides additional evidence for an association between anxiety disorder and the later development of medical morbidity.


    Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/10900526




    Anxiety disorders
    Comorbidity

    Brainexplorer.org


    Anxiety disorder
    A disorder where sufferers usually experience constant or repeated and exaggerated worry and tension for no appropriate reason.
    This can be accompanied by physical symptoms such as fatigue, trembling, muscle tension, headache and nausea.
    Anxiety disorders include generalised anxiety disorder, panic disorder, phobias, obsessive-compulsive disorder and post-traumatic stress disorder.

    Comorbidity
    In medicine, comorbidity (literally "additional morbidity") is either :
    - the presence of one or more disorders (or diseases) in addition to a primary disease or disorder or
    - the effect of such additional disorders or diseases.


    1. - Depression

    Depression
    A mood disorder characterised by persistent feelings of sadness for several weeks or more.
    Depression is associated with feelings of worthlessness, helplessness and guilt and can lead to appetite and sleep disorders.
    Depression can occur in people who suffer from other brain disorders such as Parkinson's disease and Alzheimer's disease and usually occurs in people who have an anxiety disorder.
    People who have bipolar disorder experience cycles of depression and mania.

    Anxiety is a common symptom of depression and depression is often associated with anxiety.
    In fact, approximately 42% of people with depression reported symptoms of worry, psychic anxiety and somatic anxiety of at least moderate severity in a 1983 survey (Fawcett and Kravitz, 1983).

    Anxiety syndromes and their relationship to depressive illness
    Fawcett J, Kravitz HM - J Clin Psychiatry. 1983 Aug;44(8 Pt 2):8-11 - PMID: 6874657
    The DSM-III categories of anxiety disorder are reviewed and a study of anxiety symptoms in subjects with RDC-defined major depression is described.
    Anxiety appears to be common in major depression : 29% of the sample studied had a history of panic attacks and moderate psychic anxiety was reported in 62%.
    Analysis by depressive subtypes showed no differences for the bipolar/unipolar distinction.
    However, significant differences in anxiety symptoms were seen in the primary vs. secondary and, more strikingly, endogenous vs. nonendogenous categories.
    The presence/severity of anxiety symptoms thus appears to be an important factor in the clinical management of major depression and may eventually serve as a guide to choosing among the increasing number of available antidepressant medications.
    Cfr. :
    http://www.ncbi.nlm.nih.gov/pubmed/6874657

    Atypical depression – characterised by depression with significant anxiety, hyperphagia, hypersomnia, reverse diurnal variation and extreme reaction sensitivity – is particularly associated with anxiety in depression.

    Hyperphagia
    bnormally increased appetite for and consumption of food, thought to be associated with a lesion or injury in the hypothalamus.

    Hypersomnia
    The hypersomnias are a type of dyssomnia and are characterised by excessive deep sleep or a prolonged period of sleep.
    There are two main types of hypersomnia : sleep apnoea and narcolepsy.
    People with hypersomnias experience daytime sleepiness, irritability, headaches and impaired memory and concentration.

    The efficacy of the selective serotonin reuptake inhibitors (SSRIs) in the treatment of both mood and anxiety disorders clearly demonstrates an overlap between the two.

    Serotonin
    A neurotransmitter thought to be implicated in many brain disorders.
    The role of serotonin in depression and anxiety disorders is well established.
    Neurons containing serotonin are largely restricted to the midbrain although their axons branch out over much of the central nervous system.

    Selective serotonin reuptake inhibitors (SSRIs)
    Selective serotonin reuptake inhibitors (SSRIs) are a class of antidepressants used in the treatment of depression, anxiety disorders and some personality disorders.
    They are also typically effective and used in treating premature ejaculation problems as well as some cases of insomnia.
    SSRIs increase the extracellular level of the neurotransmitter serotonin by inhibiting its reuptake into the presynaptic cell, increasing the level of serotonin available to bind to the postsynaptic receptor.
    They have varying degrees of selectivity for the other monoamine transporters, having little binding affinity for the noradrenaline and dopamine transporters.
    The first class of psychotropic drugs to be rationally designed, SSRIs are the most widely prescribed antidepressants in many countries.

    Furthermore, a recent epidemiological study by the World Health Organization on the association between anxiety and depression (Sartorius et al, 1996) confirmed the association between the two disorders.

    Depression comorbid with anxiety - Results from the WHO study on psychological disorders in primary health care
    Sartorius N, Ustün TB, Lecrubier Y, Wittchen HU, Department of Psychiatry, University of Geneva, Switzerland - Br J Psychiatry Suppl. 1996 Jun;(30):38-43 - PMID: 8864147
    The World Health Organization collaborative study on "Psychological Problems in General Health Care" investigated the form, frequency, course and outcome of common psychological problems in primary care settings at 15 international sites.
    The research employed a two-stage case-finding procedure. GHQ-12 was administered to 25916 adults who consulted health-care services.
    The second-stage assessment (n = 5438) consisted of the Composite international Diagnostic Interview (CIDI), the Social Disability Schedule and questionnaires.
    Possible cases or borderline cases of mental disorder and a sample of known cases, were followed up at three months and one year.
    Using standard diagnostic algorithms (ICD-10), prevalence rates were calculated for current disorder (one-month) and lifetime experience disorder.
    Well-defined psychological problems are frequent in all the general health-care settings examined (median 24.0%).
    Among the most common were depression anxiety, alcohol misuse, somatoform disorders and neurasthenia.
    Nine per cent of patients suffered from a "subthreshold condition" that did not meet diagnostic criteria but had clinically significant symptoms and functional impairment.
    The most common co-occurrence was depression and anxiety.
    Comorbidity increases the likelihood of recognition of mental disorders in general health care and the likelihood of receiving treatment.
    Cfr. :
    http://www.ncbi.nlm.nih.gov/pubmed/8864147

    Anxiety symptoms were more pronounced in the elderly and in patients with concomitant medical disease.
    Another authority (Liebowitz, 1993) confirms the co-occurrence of the two disorders and recommends that anxiety symptoms should be taken into account when assessing the most appropriate antidepressant agent for treating someone with depression, to optimise treatment outcome and recovery rate.

    Depression with anxiety and atypical depression
    Liebowitz MR, Department of Clinical Psychiatry, Columbia University College of Physicians and Surgeons, New York, N.Y. - J Clin Psychiatry. 1993 Feb;54 Suppl:10-4; discussion 15 - PMID: 8444829
    Some forms of anxiety and affective disorder, such as panic disorder and major depression, appear distinct, but frequently symptoms of depression and anxiety occur together.
    The comorbidity of anxiety and depression not only has implications for the differential diagnosis of the disorder but affects the severity and course of illness and its responsiveness to treatment.
    The results of studies of atypical depression suggest that this form of depressive illness responds better to monoamine oxidase inhibiting medications than to tricyclic antidepressant agents and this preferential responsiveness may in fact define the boundaries of atypical depression.
    The serotonin selective reuptake inhibitor paroxetine seems to have a beneficial effect on symptoms of anxiety and agitation in depressed patients.
    Further clinical research is needed, however, to determine the best way to manage depression with anxiety and atypical depression.
    Cfr. :
    http://www.ncbi.nlm.nih.gov/pubmed/8444829

    People with depression who have high anxiety levels take significantly longer to recover, have a higher rate of multiple drug treatments, a higher incidence of suicide and more frequent episodes of depression than people with depression who have no symptoms of anxiety (Joffe, 1993; Angst, 1997).

    Anxious and nonanxious depression
    RT Joffe, RM Bagby and A Levitt, Clarke Institute of Psychiatry, University of Toronto, Ont., Canada - Am J Psychiatry 1993; 150:1257-1258 - © 1993 by American Psychiatric Association
    The authors used the anxiety summary score described by Clayton and associates to assess anxious and nonanxious subtypes of depression in a group of 134 outpatients with major depression.
    Patients with anxious depression were only slightly less likely to respond to their first tricyclic antidepressant than patients with nonanxious depression.
    When functional severity or symptom severity was controlled for, this differential treatment response did not hold.
    Cfr. :
    http://www.ajp.psychiatryonline.org/cgi/content/abstract/150/8/1257

    Toward validation of atypical depression in the community - Results of the Zurich cohort study
    Jules Angst - Journal of Affective Disorders, Volume 72, Issue 2, Pages 125 – 138
    Aims - This paper (1) examines the validity of the atypical subtype of depression in a community-based longitudinal cohort study, (2) presents estimates of the prevalence and sex differences of DSM-IV atypical depression and a newly more broadly defined atypical syndrome in the community and (3) compares the clinical correlates and treatment patterns of those with atypical depression with other depressives.
    Methods - The Zurich cohort study is comprised of 591 subjects selected from a population-based cohort of young adults representative of the canton of Zurich in Switzerland, who were screened in 1978 with the Symptom Checklist 90-R [L.R. Derogatis (1977)] and followed prospectively with five interviews between 1979 and 1993. Atypical depression was defined on a spectrum ranging from atypical major to minor to atypical depressive symptoms alone.
    Results - The rate of DSM-IV atypical major depressive episodes in this community is 4.8% and for major atypical depression syndrome is 7.3%.
    Whereas there was no marked sex difference for nonatypical features, there was a significant female preponderance for DSM-IV and broadly defined atypical depressive subtypes.
    Systematic investigation of the diagnostic criteria for atypical depression revealed that a nonhierarchical definition of atypical depression with respect to mood reactivity yielded as valid a syndromic definition as the current hierarchy based on mood reactivity as an essential feature.
    Very high comorbidity (odd ratios>2.0) was found with seasonality, bipolar II, social phobia, binge eating, neurasthenia and sociopathy.
    Limitations - Atypical depression was not defined à priori, its criteria were derived from two sections of the Zurich interview.
    Conclusions - Atypical depression has high population prevalence and substantial significance in terms of clinical severity, impairment and service use.
    The intriguing finding that the sex difference in depression may be attributed to atypical features of depression will need further investigation.
    Overall, our data indicate that the atypical subtype of depression is a valid entity based on evidence from such traditional indicators of validity as inclusion criteria and indicators of course.
    However, there are some problems with discriminatory validity from other disorders.
    Although comorbidity with these disorders may in part reflect an operational artifact of symptom overlap, further work needs to be done in distinguishing atypical depression from bipolar II.
    Cfr. :
    http://linkinghub.elsevier.com/retrieve/pii/S0165032702001696

    The precise relationship between depression and anxiety disorders is still to be fully established.
    Anxiety is not a requirement for the diagnosis of major depression (DSM-IV, 1994; ICD-10, 1992) and mood and anxiety disorders are recognised as distinctly separate diseases.

    Diagnostic and Statistical Manual of Mental Disorders DSM-IV
    American Psychiatric Association, Washington, DC, 1994
    Cfr. :
    http://nl.wikipedia.org/wiki/DSM-IV
    Cfr. also the text revision of this manual :
    Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR
    American Psychiatric Association, Washington, DC (4th ed.), Janauary 2000
    Since the DSM-IV was published in 1994, we've seen many advances in our knowledge of psychiatric illness.
    This Text Revision incorporates information culled from a comprehensive literature review of research about mental disorders published since DSM-IV was completed in 1994.
    Updated information is included about the associated features, culture, age and gender features, prevalence, course and familial pattern of mental disorders.
    The DSM-IV-TR brings this essential diagnostic tool up-to-date, to promote effective diagnosis, treatment and quality of care.
    Now you can get all the essential diagnostic information you rely on from the DSM-IV along with important updates not found in the 1994 edition.
    Stay current with important updates to the DSM-IV-TR :
    -benefit from new research into Schizophrenia, Asperger's Disorder and other conditions
    - utilize additional information about the epidemiology and other facets of DSM conditions
    - update ICD-9-CM codes implemented since 1994 (including 'Conduct Disorder', 'Dementia' & 'Somatoform Disorders')
    Cfr. :
    http://www.bol.com/nl/p/boeken-engels/diagnostic-and-statistical-manual-of-mental-disorders-dsm-iv-tr/1001004001341827/index.html

    International Statistical Classification of Diseases (and Related Health Problems) – ICD-10
    The International Statistical Classification of Diseases and Related Health Problems (ICD-10) was endorsed by the Forty-third World Health Assembly in May 1990 and came into use in WHO Member States as from 1994.
    The classification is the latest in a series which has its origins in the 1850s.
    The first edition, known as the 'International List of Causes of Death', was adopted by the International Statistical Institute in 1893.
    WHO took over the responsibility for the ICD at its creation in 1948 when the Sixth Revision, which included causes of morbidity for the first time, was published.
    The World Health Assembly adopted in 1967 the WHO Nomenclature Regulations that stipulate use of ICD in its most current revision for mortality and morbidity statistics by all Member States.
    The ICD is the international standard diagnostic classification for all general epidemiological, many health management purposes and clinical use.
    These include the analysis of the general health situation of population groups and monitoring of the incidence and prevalence of diseases and other health problems in relation to other variables such as the characteristics and circumstances of the individuals affected, reimbursement, resource allocation, quality and guidelines.
    It is used to classify diseases and other health problems recorded on many types of health and vital records including death certificates and health records.
    In addition to enabling the storage and retrieval of diagnostic information for clinical, epidemiological and quality purposes, these records also provide the basis for the compilation of national mortality and morbidity statistics by WHO Member States.
    Cfr. :
    http://www.who.int/classifications/icd/en/
    Cfr. also :
    -
    History of the development of the ICD
    cfr. :
    http://www.who.int/classifications/icd/en/HistoryOfICD.pdf
    -
    International Statistical Classification of Diseases and Related Health Problems, 10th Revision - Version for 2007
    Cfr. : http://www.who.int/classifications/apps/icd/icd10online/
    -
    Implementation of ICD
    Cfr. : http://www.who.int/classifications/icd/implementation/en/index.html

    However, the question of a continuum has never been completely abandoned and a group of ‘in-between’ patients, with symptoms of both anxiety and depression, has been described (Angst, 1997).

    Depression–anxiety relationships with chronic physical conditions - Results from the World Mental Health surveys (cfr. above)


    2. - Bipolar Disorders

    Bipolar disorder
    Bipolar disorder is a type of mood disorder.
    It is also known as bipolar depression or manic depression.
    The illness is characterised by cycles of mania and depression which cause a person with bipolar disorder to experience severe mood swings.
    There are three types of bipolar disorder : type I, type II and cyclothymia.

    The Stanley Foundation Bipolar Network reports a high percentage of concomitant psychiatric conditions with bipolar disorder.
    Panic disorder, social phobia, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD) and impulse control disorders (eg pathologic gambling, kleptomania) often present concurrently with bipolar disorder (NIMH, 2000; Suppes et al, 2000).

    Panic disorder
    People who suffer from panic disorder experience repeated episodes of intense fear that strike often and without warning.
    These are panic attacks.
    Physical symptoms include palpitations, sweating, trembling, chest pain, nausea, dizziness and hot flushes.

    Social phobia
    People with social phobia have an overwhelming and disabling fear of scrutiny, embarrassment or humiliation in social situations, which causes them to avoid many potentially pleasurable and important activities.

    Stress
    A series of physiological or behavioural responses to an environmental or perceived threat.
    These responses can include numbing of emotion, depression, anger, irritability and loss of concentration.
    The term 'stress' is also used to refer to the stimuli that elicit these reactions.

    Obsessive-compulsive disorder (OCD)
    A type of anxiety disorder causing the sufferer to experience repeated, unwanted thoughts or compulsive behaviours that seem impossible to stop or control.

    Goals for research on bipolar disorder - The view from the National Institute of Mental Health (NIMH)
    Hyman SE, National Institute of Mental Health, Bethesda, MD 20892-9669, USA - Biol Psychiatry. 2000 Sep 15;48(6):436-41 - PMID: 11018216
    We have much yet to accomplish in research on bipolar disorder.
    We must find vulnerability genes.
    We must identify the circuits that regulate mood, emotion, energy and other relevant functions that are affected in bipolar disorder and we must determine what goes wrong in those circuits during mania, depression and other aspects of this illness.
    We will need to translate findings in basic neuroscience, genetics and basic behavioral science into diverse clinical applications : novel treatments, diagnostic tools, epidemiologic approaches that could lead to preventive interventions and surrogate markers for clinical trials.
    We must develop improved psychosocial interventions and test both pharmacologic and psychosocial treatments in trials that, simultaneously, improve the quality of care available and convince insurers and employers that these treatments are of substantial benefit and cost effective.
    The agenda is ambitious, but entirely feasible, given the scientific tools and technologies that are currently available or on the horizon.
    The National Institute of Mental Health is newly recommitted to harnessing these tools and technologies for the benefit of people with bipolar disorder.
    Cfr. :
    http://www.ncbi.nlm.nih.gov/pubmed/11018216

    The longitudinal course of bipolar disorder
    Suppes T, Dennehy EB, Gibbons EW, Department of Psychiatry, University of Texas, Southwestern Medical Center, Dallas 75390-9070, USA - J Clin Psychiatry. 2000;61 Suppl 9:23-30 - PMID: 10826657
    Course of illness is central to our focus on bipolar disorder due to the lifelong nature of this illness in the majority of patients.
    In this overview, we highlight areas of consensus and debate on factors that impact course of illness.
    Findings on age at onset, psychiatric comorbidity, frequency of episodes, cycle pattern, rapid cycling, mixed symptoms, and precipitants of episodes including use of substances and antidepressants and lithium discontinuation are discussed.
    The diversity and range of presentation and even course of illness become quickly apparent in this review.
    Highlighting these factors rather than seeking a unifying theory should be a productive way to refine our ability to identify additive factors contributing to course of illness for patients with bipolar disorder.
    Cfr. :
    http://www.ncbi.nlm.nih.gov/pubmed/10826657?ordinalpos=18&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed
    _DefaultReportPanel.Pubmed_RVDocSum

    The National Institute of Mental Health (NTMH) recently reported an especially high incidence of PTSD and OCD in people with bipolar disorder, with 43% of people with bipolar disorder exhibiting symptoms of PTSD.


    3. - Suicide

    Severe anxiety may be a risk factor for suicide (Fawcett and Kravitz, 1983; Fawcett, 1997).

    Anxiety syndromes and their relationship to depressive illness
    Fawcett J, Kravitz HM - J Clin Psychiatry. 1983 Aug;44(8 Pt 2):8-11 - PMID: 6874657
    The DSM-III categories of anxiety disorder are reviewed and a study of anxiety symptoms in subjects with RDC-defined major depression is described.
    Anxiety appears to be common in major depression : 29% of the sample studied had a history of panic attacks and moderate psychic anxiety was reported in 62%.
    Analysis by depressive subtypes showed no differences for the bipolar/unipolar distinction.
    However, significant differences in anxiety symptoms were seen in the primary vs. secondary and, more strikingly, endogenous vs. nonendogenous categories.
    The presence/severity of anxiety symptoms thus appears to be an important factor in the clinical management of major depression and may eventually serve as a guide to choosing among the increasing number of available antidepressant medications.
    Cfr. :
    http://www.ncbi.nlm.nih.gov/pubmed/6874657?dopt=Abstract

    The detection and consequences of anxiety in clinical depression
    Fawcett J, Department of Psychiatry, Rush-Presbyterian-St. Luke's Medical Centre, Chicago, IL 60612-3824, USA J Clin Psychiatry. 1997;58 Suppl 8:35-40 - PMID: 9236734
    Anxiety symptoms and comorbid anxiety are common in depressive syndromes and there is evidence they are associated with increased severity of depression and a poorer outcome.
    Anxiety and agitation symptoms also appear to be an acute risk factor for suicide in patients who have major affective disorder, an observation that has been supported by a number of biological correlates.
    Rapid and aggressive treatment of these anxiety/agitation symptoms with suitable antidepressants or benzodiazepines should be considered in order to avoid the immediate risk of suicide and to permit successful treatment of the affective disorder.
    Cfr. :
    http://www.ncbi.nlm.nih.gov/pubmed/9236734

    Studies have reported that a significant number of people who committed suicide were diagnosed as having an anxiety disorder (Allebeck, 1988) and a significantly increased suicide rate is seen in people with panic disorder (Coryell, 1988).

    Predictors of completed suicide in a cohort of 50,465 young men - Role of personality and deviant behaviour
    Allebeck P, Allgulander C, Fisher LD, Karolinska Institute, Huddinge University Hospital, Sweden - BMJ. 1988 Jul 16;297(6642):176-8 - PMID: 3408955
    Suicide seems to be increasing in young people in various countries and causes the greatest loss of years of life under the age of 65 in the Swedish population.
    Data from a national survey of 50,465 conscripts in Sweden were used in a prospective follow up study to assess personality and behavioural predictors of suicide in young men.
    Altogether 247 completed suicides occurred in the cohort during 13 years' follow up.
    Baseline data on social conditions, psychological assessments and psychiatric diagnoses of the conscripts were entered into a Cox regression model with suicide as the outcome variable.
    Several early indicators of antisocial personality (poor emotional control, contact with a child welfare authority or the police and lack of friends) were strongly predictive of suicide.
    None of the few conscripts who had a diagnosis of schizophrenia or affective psychosis committed suicide.
    A diagnosis of neurosis was associated with a twofold increase in the suicide rate and personality disorder with a threefold increase.
    Although the risk of suicide is difficult to assess in an unselected population owing to the low base rate of suicide, the predictors identified in the study may help to identify those at high risk in units where people with deviant behaviour and personality disorders cluster.
    Cfr. :
    http://www.ncbi.nlm.nih.gov/pubmed/3408955

    Panic disorder and mortality
    Coryell W, Department of Psychiatry, University of Iowa, Iowa City - Psychiatr Clin North Am. 1988 Jun;11(2):433-40 - PMID: 3047710
    Evidence so far indicates two sources for excess mortality in panic disorder--suicide and cardiovascular morbidity.
    The risk for eventual suicide may rival that for primary depression, but the predictors and the necessary antecedents probably differ.
    The lapse between diagnosis and suicide may be larger for panic disorder, and complications such as secondary depression and substance abuse may be necessary.
    There are few well-established predictors for primary depression despite many relevant studies.
    The risk for suicide in panic disorder is barely recognized and established predictors are accordingly remote.
    One study has demonstrated excess cardiovascular mortality among males with panic disorder and another from the same center has provided weak support.
    Only one additional study has provided the necessary detail as to sex and cause and those findings were quite supportive, although the subjects may have been mixed diagnostically.
    There are numerous feasible explanations for excess cardiovascular mortality in panic disorder and even some reason to believe that successful treatment might lessen it.
    To so advise patients would be not only premature at this point but unnecessary and countertherapeutic--unnecessary because these patients are motivated by discomfort to seek treatment and countertherapeutic because cardiovascular morbidity is what many of these patients pathologically fear.
    Rather, the findings suggest focus for future study.
    The initial findings of excess cardiovascular morbidity in males badly need replication, as do the more recent findings of Kahn et al. Likewise, animal models may reveal some of the pathophysiologic mechanisms at work.
    It is hoped that these efforts will converge in the not-too-distant future.

    Cfr. : http://www.ncbi.nlm.nih.gov/pubmed/3047710?dopt=Abstract

    A study in Finland investigating the role of anxiety as a comorbid diagnosis found that over a period of 1 year, 17% of people who committed suicide were diagnosed retrospectively as having depression with a comorbid anxiety disorder and 6% had bipolar disorder with a comorbid anxiety disorder (Isometsä, 1994).

    Suicide in major depression in different treatment settings
    Isometsa ET, Aro HM, Henriksson MM, Heikkinen ME, Lonnqvist JK, National public health inst., dep. mental health, 0300 Helsinki, Finlande - J Clin Psychiatry 1994;55:523-527 – ISSN 0160-6689 - © 2008 INIST-CNRS
    Background - Whether suicide victims having suffered from major depression differ in their characteristics and treatment of depression received in various settings prior to death has been unknown.
    Method - From a random sample representing all completed suicides in Finland within a 12-month period, cases with a best estimate diagnosis of current unipolar DSM-III-R major depression (N=71) were comprehensively analyzed using the method of psychological autopsy.
    Suicide victims with major depression were classified according to treatment setting and the victims in different settings-psychiatric care (N=32), medical care (N=27) and no contact with health care (N=12)-were compared.
    Results - The sex distribution of suicides who had major depression was equal within psychiatric care; but in medical care or without contact with health care, 77% (30 of 39) were men (p=.018).
    Significantly more victims in psychiatric than in medical care had communicated to attending personnel their intent to commit suicide (59% [19 of 32] vs. 19% [5 of 27], p=.004).
    Antidepressants were received by 60% of victims in psychiatric care but only 16% in medical care (p=.002).
    Conclusion - Suicide victims with major depression differ in sex distribution and communication of suicide intent among treatment settings, which may complicate the ability to generalize research findings, particularly from psychiatric to medical care.
    Promoting suicide prevention in major depressive disorders would seem to require improving not only the quality of treatment within psychiatric care, but also basic skills in recognizing and treating depression in medical care, especially for male patients.
    Cfr. :
    http://cat.inist.fr/?aModele=afficheN&cpsidt=3391578

    In a prospective study by Fawcett et al. (1990), also investigating the comorbidity of anxiety and suicide, the role of the anxiety symptoms in suicide was clarified.
    Fawcett et al concluded that suicidal ideation, a history of past suicide attempts and the severity of hopelessness did not correlate significantly with suicide, whereas the severity of psychic anxiety and the presence of panic attacks did show a significant correlation with suicide.

    Time-related predictors of suicide in major affective disorder
    J Fawcett, WA Scheftner, L Fogg, DC Clark, MA Young, D Hedeker and R Gibbons, Department of Psychiatry, Rush-Presbyterian-St. Luke's Medical Center, Chicago, IL 60612 - Am J Psychiatry 1990; 147:1189-1194 - © 1990 American Psychiatric Association
    The authors studied 954 psychiatric patients with major affective disorders and found that nine clinical features were associated with suicide.
    Six of these--panic attacks, severe psychic anxiety, diminished concentration, global insomnia, moderate alcohol abuse and severe loss of interest or pleasure (anhedonia)--were associated with suicide within 1 year and three others--severe hopelessness, suicidal ideation and history of previous suicide attempts--were associated with suicide occurring after 1 year.
    These findings draw attention to the importance of :
    1) standardized prospective data for studies of suicide
    2) assessment of short-term suicide risk factors and
    3) anxiety symptoms as modifiable suicide risk factors within a clinically relevant period.
    Cfr. :
    http://ajp.psychiatryonline.org/cgi/content/abstract/147/9/1189

    Further studies by this team confirmed the important role of severe psychic anxiety 1 week before suicide (Fawcett, 1997).

    The detection and consequences of anxiety in clinical depression (cfr. above)

    It is known that serotonin dysfunction has a role in both suicide and anxiety.
    Furthermore, a number of biological markers, such as markers of the hypothalamo–pituitary–adrenal axis and serotonin function, appear to be associated with both anxiety and suicide risk in depression.
    Dysfunction in the hypothalamo–pituitary–adrenal axis and the serotonin system may be associated with states of overwhelming anxiety-agitation and decisive treatment to correct the dysfunction seems to resolve this crisis and allow successful resolution of the episode.

    However, little attention is given to the role of anxiety in suicide in clinical practice and the potential for suicide is often not considered when planning treatment regimens for people with anxiety disorders.


    Cfr. : http://www.brainexplorer.org/anxiety/Anxiety_Comorbidity.shtml




    Anxiety and Physical Illness
    Understanding and treating anxiety can often improve the outcome of chronic disease

    Harvard Medical School - © 2008 Patient Education Center, L.L.C. & 2008 Harvard Health Publications


    With headlines warning us of international terrorism, global warming and economic slowdown, we're all likely to be a little more anxious these days.
    As an everyday emotion, anxiety — the "fight or flight" response — can be a good thing, prompting us to take extra precautions.
    But when anxiety persists in the absence of a need to fight or flee, it can not only interfere with our daily lives but also undermine our physical health.
    Evidence suggests that people with anxiety disorders are at greater risk for developing a number of chronic medical conditions.
    They may also have more severe symptoms and a greater risk of death when they become ill.


    The Anatomy of Anxiety

    Anxiety is a reaction to stress that has both psychological and physical features.
    The feeling is thought to arise in the amygdala, a brain region that governs many intense emotional responses.
    As neurotransmitters carry the impulse to the sympathetic nervous system, heart and breathing rates increase, muscles tense and blood flow is diverted from the abdominal organs to the brain.
    In the short term, anxiety prepares us to confront a crisis by putting the body on alert.
    But its physical effects can be counterproductive, causing light-headedness, nausea, diarrhea and frequent urination.
    And when it persists, anxiety can take a toll on our mental and physical health.


    Anxiety as Illness

    Research on the physiology of anxiety-related illness is still young, but there's growing evidence of mutual influence between emotions and physical functioning.
    Yet anxiety often goes unidentified as a source of other disorders, such as substance abuse or physical addiction, that can result from attempts to quell feelings of anxiety.
    And it's often overlooked in the myriad symptoms of chronic conditions like irritable bowel syndrome (IBS) or migraine headache.

    Nearly two-thirds of the estimated 57 million adults with anxiety disorders are women.
    What people with these disorders have in common is unwarranted fear or distress that interferes with daily life (cfr. below).
    Anxiety also plays a role in somatoform disorders, which are characterized by physical symptoms such as pain, nausea, weakness or dizziness that have no apparent physical cause.
    Somatoform disorders include hypochondriasis, body dysmorphic disorder, pain disorder and conversion disorder.

    Anxiety has now been implicated in several chronic physical illnesses, including heart disease, chronic respiratory disorders and gastrointestinal conditions.
    When people with these disorders have untreated anxiety, the disease itself is more difficult to treat, their physical symptoms often become worse and in some cases they die sooner.


    Anxiety disorders and their symptoms

    • Generalized anxiety disorder
      Exaggerated worry about health, safety, money and other aspects of daily life that lasts six months or more.
      Often accompanied by muscle pain, fatigue, headaches, nausea, breathlessness and insomnia.

    • Phobias
      Irrational fear of specific things or situations, such as spiders (arachnophobia), being in crowds (agoraphobia) or being in enclosed spaces (claustrophobia).

    • Social anxiety disorder (social phobia)
      Overwhelming self-consciousness in ordinary social encounters, heightened by a sense of being watched and judged by others and a fear of embarrassment.

    • Post-traumatic stress disorder (PTSD)
      Reliving an intense physical or emotional threat or injury (for example, childhood abuse, combat or an earthquake) in vivid dreams, flashbacks or tormented memories.
      Other symptoms include difficulty sleeping or concentrating, angry outbursts, emotional withdrawal and a heightened startle response.

    • Obsessive/compulsive disorder (OCD)
      Obsessive thoughts, such as an irrational fear of contamination, accompanied by compulsive acts, such as repetitive hand washing, that are undertaken to alleviate the anxiety generated by the thoughts.

    • Panic disorder
      Recurrent episodes of unprovoked feelings of terror or impending doom, accompanied by rapid heartbeat, sweating, dizziness or weakness.


    Anxiety and Gastrointestinal Disorders

    About 10% to 20% of Americans suffer from the two most common functional digestive disorders — IBS and functional dyspepsia (upset stomach).
    In these disorders, the nerves regulating digestion appear to be hypersensitive to stimulation.
    Because these conditions don't produce lesions like ulcers or tumors, they aren't considered life-threatening.
    But their symptoms — abdominal pain, bloating and diarrhea or constipation in IBS and pain, nausea and vomiting in functional dyspepsia — can be chronic and difficult to tolerate.

    There are no firm data on the prevalence of anxiety disorders in people with functional digestive disorders, but a 2007 New Zealand study of subjects with gastroenteritis (inflammation of the digestive tract) found an association between high anxiety levels and the development of IBS following a bowel infection.


    Chronic Respiratory Disorders

    In asthma, inflamed airways constrict spasmodically, reducing the flow of air through the lungs.
    In chronic obstructive pulmonary disease (COPD), inflammation of the airways is exacerbated by a loss of elasticity in the lungs : not only is it more difficult for air to reach the lungs, but the lungs neither fill nor expel air completely.

    Although results vary, most studies have found a high rate of anxiety symptoms and panic attacks in patients who have chronic respiratory disease, with women at greater risk than men.
    In several studies involving COPD patients, anxiety has been associated with more frequent hospitalization and with more severe distress at every level of lung function.
    So even if anxiety doesn't affect the progress of the disease, it takes a substantial toll on quality of life.


    Anxiety and Heart Disease

    Anxiety disorders have also been linked to the development of heart disease and to coronary events in people who already have heart disease.
    In the Nurses' Health Study, women with the highest levels of phobic anxiety were 59% more likely to have a heart attack and 31% more likely to die from one, than women with the lowest anxiety levels.
    Data from 3,300 postmenopausal women in the Women's Health Initiative showed that a history of full-blown panic attacks tripled the risk of a coronary event or stroke.

    Two studies — one involving Harvard Medical School and the Lown Cardiovascular Research Institute; the other, several Canadian medical colleges — concluded that among both men and women with established heart disease, those suffering from an anxiety disorder were twice as likely to have a heart attack as those with no history of anxiety disorders.


    Physical Benefits of Treating Anxiety

    Therapies that have been successful in treating anxiety disorders are now being used to ease the symptoms of chronic gastrointestinal and respiratory diseases.
    These therapies may have an important role in preventing and treating heart disease.
    These are the best-studied approaches :

    • Cognitive-behavioral therapy
      The cognitive component helps people identify and avoid thoughts that generate anxiety and the behavioral part helps them learn how to react differently to anxiety-provoking situations.
      The specifics of the treatment depend on the type of anxiety.
      For example, patients with generalized anxiety disorder or panic disorder may be asked to examine their lives for habits and patterns that foster a sense of dread.
      They may also be taught relaxation techniques to diminish anxiety.
      Patients with OCD characterized by excessive washing may be asked to dirty their hands and wait with a therapist for increasingly longer intervals before cleaning up.

    • Psychodynamic psychotherapy
      Anxiety is often triggered by a deep-seated emotional conflict or a traumatic experience that can sometimes be explored and resolved through psychotherapy.
      In the first randomized controlled clinical trial comparing relaxation therapy to psychodynamic psychotherapy (focused talk therapy), clinician-researchers at Columbia University in New York found that panic-disorder patients treated with psychodynamic therapy had significantly fewer symptoms and functioned better socially than those who underwent relaxation therapy (American Journal of Psychiatry, February 2007).
      Nearly three-quarters of the psychotherapy group responded to treatment compared with only 39% of the relaxation-therapy group.


    Drug Therapy

    Medications alone are less effective than psychotherapy over the long term; they may also have unpleasant side effects and interact with other medications.
    Still, they can be helpful when used in combination with psychotherapy.
    The most commonly used types of drugs include these :

    • Anti-anxiety drugs
      Benzodiazepines — clonazepam (Klonopin) and alprazolam (Xanax) — were developed to relieve anxiety.
      They act rapidly and have few side effects except occasional drowsiness.
      But they're not recommended for long-term use, because patients develop tolerance and require increasing doses.
      A newer drug, buspirone (BuSpar), needs two weeks to take effect but can be taken for longer periods than benzodiazepines.

    • Antidepressants
      Antidepressants, especially selective serotonin reuptake inhibitors (SSRIs) such as sertraline (Zoloft), have been replacing benzodiazepines in the long-term treatment of panic disorder and generalized anxiety.
      Antidepressants have the advantage of relieving depression as well as anxiety and they are believed to create less risk of dependence and abuse.
      However, patients sometimes prefer benzodiazepines to antidepressants because they act more quickly (antidepressants take two weeks to work) and don't cause weight gain or sexual problems.

    • Beta blockers
      These drugs can relieve acute anxiety by slowing the heart rate and reducing blood pressure; they are often used, for example, to treat stage fright.


    Seeking Help

    About 30% of people with anxiety disorders go through life untreated.
    If you think you might fall into this category — or if you have IBS, asthma, COPD or heart disease and haven't been evaluated for anxiety — you may want to consult your primary care clinician.
    You may also want to talk to your clinician if you have pain, dizziness, insomnia or other symptoms that persist after physical causes have been ruled out.
    Keep in mind that all symptoms are real — and treatable — whether they originate in the body or the brain.
    If you're just feeling a little more anxious than you once did, you might want to consider trying some relaxation techniques (for some examples, visit :
    www.health.harvard.edu/womenextra -).


    Cfr. : http://www.patienteducationcenter.org/aspx/HealthELibrary/HealthETopic.aspx?cid=W0708d




    Read more : Part II


    15-10-2008 om 22:24 geschreven door Jules

    0 1 2 3 4 5 - Gemiddelde waardering: 0/5 - (0 Stemmen)
    >> Reageer (0)
    Klik hier om een link te hebben waarmee u dit artikel later terug kunt lezen.Anxiety and physical illness - Part II
    Klik op de afbeelding om de link te volgen






    Anxiety and physical illness

    Part II



    Chronic physical illness, psychiatric disorder and disability in the workplace

    Dewa C. S. (1) & Lin E. (1), (1) Centre for Addiction and Mental Health, Clarke Site, Health Systems Research Unit, University of Toronto, Department of Psychiatry, 250 College Street, Toronto, Ont., M5T 1R8, Canada - Social science & medicine, 2000, vol. 51, no1, pp. 41-50 (27 ref.) - © Elsevier, Oxford, Royaume-Uni - ISSN 0277-9536


    While agreement is growing that mental illness burdens the North American economy, how it impacts productivity particularly compared to physical illness is unclear.
    Hypothesizing that lost work days are only the tip of the iceberg, we also examined the association of mental and chronic physical illness with partial work days and days requiring extra effort to function.
    Data from 4225 employed individuals, aged 18-54, were analyzed.
    These were a subset of respondents to the Ontario Health Survey's Mental Health Supplement, a 1990/91 epidemiologic survey of households across Ontario, Canada.
    Psychiatric disorder was assessed using the University of Michigan' modification of WHO's Composite International Diagnostic Interview (UM-CIDI).
    Similar to US reports, professional/managerial groups had lower rates of affective and anxiety disorders and fewer disability days compared to the rest of the workforce.
    However, no single occupational group was consistently at greater risk for either physical or psychiatric problems.
    Even after accounting for sociodemographic characteristics and work conditions, mental and physical status had clear, but different, impacts on productivity.
    Physical conditions alone had a fairly constant effect across all types of disability days and were the largest contributor to total work day loss.
    They also significantly impacted partial and extra effort days but were far less important than conditions involving a mental disorder.
    Respondents with mental health problems, either alone or in combination with physical illnesses, appeared more likely to go to work hut to require greater effort to function.
    WHO projects that mental illness will become the second most important cause of global disease burden in the next century.
    Our findings suggest that among working individuals, it affects productivity more subtly than does physical illness.
    However, with an estimated eight percent of Ontario's workforce experiencing more than two months annually of decreased productivity, it still incurs significant social and economic costs.


    Cfr. : http://cat.inist.fr/?aModele=afficheN&cpsidt=1326911




    Anxiety in Health Behaviors and Physical Illness

    Jasper A. J. Smits, Michael J. Zvolensky – Springer Verlag, 11/07/2007 – ISBN : 9780387747521


    Table of Contents

    Preface

    Contributors

    Part I. - Health Behaviors and Anxiety Disorders

    1. Tobacco Use and Panic Psychopathology - Current Status and Future Directions
      Michael J. Zvolensky, Theresa Leyro, Amit Bernstein, Matthew T. Feldner, Andrew R. Yartz, Kimberly Babson and Marcel O. Bonn-Miller

    2. Alcohol Use and Anxiety Disorders
      Brigitte C. Sabourin and Sherry H. Stewart

    3. Illicit Drug Use Across the Anxiety Disorders - Prevalence, Underlying Mechanisms and Treatment
      Matthew T. Tull, David E. Baruch, Michelle S. Duplinsky and C.W. Lejuez

    4. The Promise of Exercise Interventions for the Anxiety Disorders
      Jasper A. J. Smits, Angela C. Berry, Mark B. Powers, Tracy L. Greer and Michael W. Otto

    5. Anxiety and Insomnia - Theoretical Relationship and Future Research
      Thomas W. Uhde and Bernadette M. Cortese

    Part II. - Physical Conditions and Anxiety Disorders

    1. Anxiety Disorders and Physical Illness Comorbidity - An Overview
      Tanya Sala, Brian J. Cox and Mender Sareen

    2. The Relation Between Puberty and Adolescent Anxiety - Theory and Evidence
      Ellen W. Leen-Feldner, Laura E. Reardon, Chris Hayward and Rose C. Smith

    3. Anxiety, Anxiety Disorders and the Menstrual Cycle
      Sandra T. Sigmon and Janell G. Schartel

    4. Pain and Anxiety Disorders
      Gordon J.G. Asmundson, Murray P. Abrams and Kelsey C. Collimore

    5. Asthma in Anxiety and Its Disorders - Overview and Synthesis
      Lisa S. Elwood and Bunmi O. Olatunji

    6. Cardiovascular Disease and Anxiety
      Kamila S. White

    7. HIV and Anxiety
      Conall O'Cleirigh, Trevor A. Hart and Carolyn A. James

    8. Physical Illness and Treatment of Anxiety Disorders - A Review
      Norman B. Schmidt, Meghan E. Keough, Lora Rose Hunter and Ann P. Funk

    Index


    Cfr. : http://www.keenzo.com/showproduct.asp?ID=2059008



    Cfr. also :

    1. Anxiety in Health Behaviors and Physical Illness
      Michael J. Zvolensky, University of Vermont & Jasper A. J. Smits, Southern Methodist University - Series : Series in Anxiety and Related Disorders, 2008, XII – ISBN : 978-0-387-74752-1 - © Springer
      While the links between physical illness and depression have been well-documented and analyzed, little has been made of the data relating physical illness to anxiety—until now.
      Anxiety in Health Behavior and Physical Illness explores complex relationships between medical and anxiety pathology on the theoretical, research and practical fronts.
      Over forty experts examine reciprocal roles of anxiety and medical illness as causal or exacerbating factors in each other’s onset and development, describe forms of anxiety typical to major disease entities, discuss common health behaviors as they impact anxiety, recast anxiety disorders as chronic illness and identify patients for whom new forms of treatment may be warranted.
      Among the topics covered :
      - Anxiety in the context of specific illness : heart disease, asthma, HIV/AIDS.
      - Self-medication across the anxiety disorders : alcohol, tobacco, illegal drugs.
      - Possible links between anxiety and insomnia.
      - The relationship between puberty and adolescent anxiety.
      - Anxiety, anxiety disorders and the menstrual cycle.
      - Anxiety disorders and chronic pain.
      - Current and emerging treatments for anxiety disorders, from CBT to exercise-based interventions.
      Anxiety in Health Behavior and Physical Illness is a comprehensive resource to be read not only by clinical psychologists, psychiatrists and, other health professionals, but also by researchers and graduate students on the cutting edge of the field.
      Cfr. :
      http://www.springer.com/psychology/psychology+general/book/978-0-387-74752-1

    2. Association of Chronic Work Stress, Psychiatric Disorders and Chronic Physical Conditions With Disability Among Workers
      Carolyn S. Dewa, Ph.D., M.P.H., Elizabeth Lin, Ph.D., Mieke Kooehoorn, Ph.D. and Elliot Goldner, M.D., M.H.Sc. - Psychiatr Serv 58:652-658, May 2007 - © 2007 American Psychiatric Association
      Objective - There appear to be links between psychiatric disorders and work-related stress as well as between psychiatric disorders and physical conditions.
      This study explores the relationships between chronic work stress, psychiatric disorders and chronic physical conditions and disability among workers.
      By doing so, this study sought to understand how these factors are associated with worker disability when they are experienced alone versus in combination with one another.
      Methods - The study population was drawn from the Canadian Community Health Survey 1.2, a national population-based survey that gathered cross-sectional data on health status from 22,118 working respondents.
      The relationship between chronic work stress, chronic physical conditions and psychiatric disorders and disability in the past 14 days was examined for working respondents by using logistic regressions controlling for sociodemographic characteristics, region and occupation.
      Results - Thirty-one percent of respondents experienced chronic work stress either alone or in combination with a chronic physical condition, a psychiatric disorder or both.
      Forty-six percent reported at least one chronic physical condition either alone or in combination.
      Finally, 11% had a psychiatric disorder.
      Compared with the group with none of the factors, those with an increasing number of combined conditions had increasing odds of disability after the analysis controlled for sociodemographic characteristics, occupation and region.
      Conclusions - The presence of chronic work stress seems to amplify effects of psychiatric disorders and chronic physical conditions on disability.
      In addition, psychiatric disorders co-occurring with physical illness seem to be associated with significantly higher odds of disability.
      Cfr. :
      http://psychservices.psychiatryonline.org/cgi/content/full/58/5/652

    3. Co-occurrence of mental and physical illness in US Latinos
      Ortega Alexander N. (1), Feldman Jonathan M. (2), Canino Glorisa (3), Steinman Kenneth (4), Algeria Margarita (5) -- (1) University of California Los Angeles School of Public Health Dept. of Health Services Box 951772, Los Angeles (CA) 90095-1772, Etats-Unis _- (2) Yeshiva University Ferkauf Graduate School of Psychology, Bronx (NY), Etats-Unis -- (3) University of Puerto Rico Medical Sciences Campus Behavioral Sciences Research Institute, San Juan, Portoa Ricao -- (4) Ohio State University Division of Health Behavior & Health Promotion School of Public Health, Columbus (OH), Etats-Unis - (5) Cambridge Health Alliance and Harvard Medical School Center for Multicultural Mental Health Research Dept. of Psychiatry, Sommerville (MA), Etats-Unis - Social psychiatry and psychiatric epidemiology; 2006, vol. 41, no12, pp. 927-934 – ISSN 0933-7954 - ©2008 Springer, Heidelberg, Allemagne
      Background - This study describes the prevalence of comorbid physical and mental health problems in a national sample of US Latinos.
      We examined the co-occurrence of anxiety and depression with prevalent physical chronic illnesses in a representative sample of Latinos with national origins from Mexico, Cuba, Puerto Rico and other Latin American countries.
      Method - We used data on 2,554 Latinos (75.5% response rate) ages 18 years and older from the National Latino and Asian American Study (NLAAS).
      The NLAAS was based on a stratified area probability sample design, and the sample came from the 50 states and Washington, DC.
      Survey questionnaires were delivered both in person and over the telephone in English and Spanish.
      Psychiatric disorders were assessed using the World Mental Health Survey Initiative version of the World Health Organization Composite International Diagnostic Interview (WMH-CIDI).
      Physical chronic illness was assessed by self-reported history.
      Results - Puerto Ricans had the highest prevalence of meeting criteria for any comorbid psychiatric disorder (more than one disorder).
      Puerto Ricans had the highest prevalence (22%) of subject-reported asthma history, while Cubans had the highest prevalence (33%) of cardiovascular disease.
      After accounting for age, sex, household income, number of years in the US, immigrant status and anxiety or depression, anxiety was associated with diabetes and cardiovascular disease, in the entire sample.
      Depression and co-occurring anxiety and depression were positively associated with having a history of asthma but not with other physical diseases, in the entire sample.
      Interestingly, Puerto Ricans with a depressive disorder had a lower odds of having a history of cardiovascular disease than Puerto Ricans without a depressive disorder.
      The relationship between chronic physical and mental illness was not confounded by immigration status or number of years in the US.
      Discussion - Despite previous findings that link acculturation with both chronic physical and mental illness, this study does not find that number of years in the US nor nativity explain the prevalence of psychiatric-medical comorbidities.
      This study demonstrates the importance of considering psychiatric and medical comorbidity among specific ethnic groups, as different patterns emerge than when using aggregate ethnic measures.
      Research is needed on both the pathways and the mechanisms of comorbidity for the specific Latino groups.
      Cfr. :
      http://cat.inist.fr/?aModele=afficheN&cpsidt=18446689

    4. The relationship between anxiety disorders and physical disorders in the U.S. - National Comorbidity Survey
      Sareen J, Cox BJ, Clara I, Asmundson GJ.. Depress Anxiety 2005; 21(4): 193-202 - Wiley-Liss, New York, NY, Etats-Unis, (Revue), 1996 - Depression and anxiety, 2005, vol. 21, no4, pp. 193-202 – ISSN 1091-4269
      Although depression has clearly been shown to be associated with physical disorders, few studies have examined whether anxiety disorders are independently associated with medical conditions after adjusting for comorbid mental disorders.
      We examined the relationship between anxiety disorders and a wide range of physical disorders in a nationally representative sample.
      Data came from the National Comorbidity Survey (N=5,877, range=age 15-54 years, response rate=82.4%).
      The Composite International Diagnostic Interview [Kessler et al., 1998] was used to make DSM-III-R [American Psychiatric Association, 1987] mental disorder diagnoses.
      Physical disorders were assessed based on a list of several conditions shown to respondents.
      All analyses utilized multiple logistic regression to examine the relationship between past-year anxiety disorder diagnosis and past-year chronic physical disorder.
      Anxiety disorders were positively associated with physical disorders even after adjusting for mood disorders, substance-use disorders and sociodemographics.
      Among respondents with one or more physical disorders, a comorbid anxiety disorder diagnosis was associated with an increased likelihood of disability even after adjusting for severity of pain, comorbid mood and substance use disorders.
      Among specific anxiety disorders, posttraumatic stress disorder, panic attacks and agoraphobia were more likely to be associated with specific physical disorders than generalized anxiety disorder, social phobia or simple phobia.
      There is a strong and unique association between anxiety disorders and physical disorders.
      Clinically, the presence of an anxiety disorder among patients with physical disorders may confer a greater level of disability.
      Cfr. :
      http://cat.inist.fr/?aModele=afficheN&cpsidt=17029420



    15-10-2008 om 22:15 geschreven door Jules

    0 1 2 3 4 5 - Gemiddelde waardering: 0/5 - (1 Stemmen)
    >> Reageer (0)
    Klik hier om een link te hebben waarmee u dit artikel later terug kunt lezen.Meer geld voor chronische zieken...
    Klik op de afbeelding om de link te volgen  











    Ruim 400 miljoen
    voor koopkracht chronisch zieken

    de Volkskrant, 06-10-2008
     Bron : ANP


    Den Haag - Het kabinet steekt ruim 400 miljoen euro in de reparatie van de koopkracht voor chronisch zieken, gehandicapten en minima.
    Volgens ingewijden wordt er onder meer geld uitgetrokken voor een hogere zorgtoeslag voor alleenstaanden met een minimuminkomen.

    Dat is de uitkomst van overleg tussen de fractievoorzitters van de coalitiepartijen CDA, PvdA en ChristenUnie en minister Piet Hein Donner (Sociale Zaken) en staatssecretaris Jet Bussemaker (Volksgezondheid) over de buitengewone zorgkosten.
    Aanleiding is de aangekondigde bezuiniging op de fiscale compensatieregeling voor buitengewone zorgkosten, waardoor vooral chronisch zieken en gehandicapten erop achteruit dreigen te gaan.

    Om de gevolgen voor hun portemonnee te verzachten gaan tegemoetkomingen waarop chronisch zieken straks recht hebben omhoog.
    Ook komt er een hogere toeslag voor arbeidsongeschikten.
    Chronisch zieken en gehandicapten mochten hun zorgkosten meer dan verdubbelen voor ze die gingen aftrekken.
    Het kabinet wilde hiervan af, maar laat dit toch deels in stand.
    Naast de hogere zorgtoeslag, steekt het kabinet ook nog geld in een ruimere ouderenkorting.

    Coalitiepartij PvdA is tevreden met de uitkomsten.
    Er zijn nog laatste berekeningen nodig, maar PvdA-fractievoorzitter Mariëtte Hamer zei maandag na overleg tussen de coalitiepartijen en het kabinet dat ‘het de goede kant uit gaat’.
    GroenLinks wil dinsdag in het wekelijkse vragenuur opheldering over het coalitieberaad.

    De aanpassingen waar het kabinet nu mee komt betreffen de nieuwe wet voor tegemoetkomingen voor chronisch zieken en gehandicapten.
    De bestaande fiscale compensatieregeling voor hoge zorgkosten wordt sterk afgeslankt.
    Deze wordt voor een groot deel vervangen door toeslagen voor chronisch zieken en gehandicapten, verlaging van eigen bijdragen voor AWBZ-zorg en een algemene compensatie voor ouderen en arbeidsongeschikten.


    Cfr. : http://www.volkskrant.nl/binnenland/article1074877.ece/Ruim_400_miljoen_voor_koopkracht_
    chronisch_zieken




    Chronisch zieken opnieuw gekort

    Douwe Douwes - de Volkskrant, 12-09-2008


    Den Haag - Voor de derde keer snijdt het kabinet in de tegemoetkoming voor kosten van chronisch zieken en gehandicapten.
    Een meevaller van 200 miljoen euro – gevolg van ingrepen in de fiscale tegemoetkoming voor designbrillen en verbanddozen – gaat niet terug naar chronisch zieken, maar wordt gebruikt om andere gaten op de begroting te dichten.

    Bij de kabinetsformatie werd al 400 miljoen euro per jaar aan bezuinigingen ingeboekt op de ‘tegemoetkoming buitengewone uitgaven’, een fiscale aftrekpost bedoeld voor bijkomende ziektekosten als taxivervoer of aanpassing van de woning.
    In de praktijk bleek die regeling steeds meer oneigenlijk te worden gebruikt.
    Miljoenen Nederlanders trokken ziektekostenpremie, Armanibrillen en steunzolen af van de belasting.

    Het kabinet besloot daarom tot een nieuwe regeling.
    Gehandicapten mochten er daarin niet op achteruitgaan.
    Tegelijkertijd moest een bezuiniging worden ingeboekt van 250 miljoen euro – die had het kabinet nodig voor gratis schoolboeken.

    Het voorstel dat het kabinet voor de zomer naar de Kamer stuurde, bleek echter ook de gehandicapten te raken voor wie de aftrekpost wel was bedoeld.
    Het Nibud rekende voor dat de koopkracht van sommige chronisch zieken met 9 procent zou dalen.
    En dus gaf de Kamer het kabinet opdracht de regeling zo aan te passen dat de ergste gevolgen werden teruggedraaid.
    Het lijkt er nu op dat dat niet is gelukt.
    Op Prinsjesdag worden de plannen bekendgemaakt.

    Directeur Ad Poppelaars van de Chronisch zieken en Gehandicapten Raad zegt ‘geschokt’ te zijn : ‘De zieken en gehandicapten draaien op voor het koopkrachtbehoud van de rest van Nederland.’
    Hij gaat het Nibud nogmaals vragen in kaart te brengen wat de gevolgen zijn van de ingreep voor de koopkracht van mensen met een chronische aandoening.


    Cfr. : http://www.volkskrant.nl/binnenland/article1066380.ece/Chronisch_zieken_opnieuw_gekort




    Veel deels afgekeurden werken in de zorg

    Gijs Herderscheê - de Volkskrant, 15-10-2008


    Den Haag - Het grootste aantal werknemers dat gedeeltelijk wordt afgekeurd, werkt in de zorg.
    Omdat in de zorg veel mensen werken, wijkt het risico om arbeidsongeschikt te worden in de zorg niet af van het landelijk gemiddelde.
    Dit blijkt uit cijfers van het UWV :

    Hoe staat het met de WGA-instroom van mijn bedrijf ?
    - Instroomcijfers WGA 2007 -

    UWV, Voor Integratie en Tijdelijk Inkomen, oktober 2008
    Cfr. :
    http://www.uwv.nl/Images/Toelichting_WGA_instroom_grote_werkgevers_2007_AG110
    02567_tcm26-177815.pdf

    Landelijk is het risico om arbeidsongeschikt te worden voor werknemers in vaste dienst 0,13 procent.
    Dat betekent dat van elke tienduizend werknemers er dertien deels worden afgekeurd.

    In 2007 ging het om 9755 werknemers die deels werden afgekeurd.
    Daarnaast werden zevenduizend mensen afgekeurd die een tijdelijk contract hadden of werkloos waren.
    Vijfduizend werknemers zijn volledig afgekeurd, omdat zij geen uitzicht op herstel hebben.
    Het UWV geeft in de cijfers niet aan in welke sectoren zij werkten.


    Zorg

    In de zorg werden in 2007 1657 werknemers deels afgekeurd, bijna eenvijfde van het totaal, 9755.
    Omdat er ruim 1,2 miljoen mensen in de zorg werken, is het risico op arbeidsongeschiktheid daar gelijk aan het landelijk gemiddelde.

    Het risico op arbeidsongeschiktheid is het hoogst bij de reïntegratiebedrijven.
    Daar werden vorig jaar 352 mensen deels afgekeurd, ofwel 0,35 procent van de ruim honderdduizend werknemers.


    Grote bedrijven

    Het UWV publiceert ook een lijst met het risico op arbeidsongeschiktheid bij bedrijven met meer dan 250 werknemers.
    Bij de reïntegratiebedrijven springt daar de gemeente Enschede eruit.
    Daar is het risico op arbeidsongeschiktheid 2,6 procent.
    Dat is het twintigvoudige van het landelijk gemiddelde.

    Bij de grootwinkelbedrijven springt de Brilmij Groep eruit met een risico van 1,8 procent.
    Bij de overheid piekt de gemeente Lelystad met een risico voor ambtenaren op arbeidsongeschiktheid van 1,2 procent.

    Ook drie FNV-bonden staan in de lijst.
    Bij de Abvakabo FNV is het risico om arbeidsongeschikt te worden 0,2 procent, bij FNV Bouw 0,3 procent en bij FNV Bondgenoten 0,1 procent.


    Versobering

    Het risico op arbeidsongeschiktheid is sterk gedaald door de versobering van de arbeidsongeschiktheidswetten.
    Bij de oude arbeidsongeschiktheidswet WAO schommelde het risico afgekeurd te worden door de jaren heen rond 1,3 procent.
    Dat is door de strenge keuringseisen tot eentiende gedaald.


    Cfr. : http://www.volkskrant.nl/binnenland/article1078340.ece/Veel_deels_afgekeurden_werken_in_de_
    zorg




    ‘Groot verlof’ voor wie in de zorg werkt

    de Volkskrant, 08-10-2008 – Bron : ANP


    Den Haag - Wie in de zorg werkt maar daarmee stopt wegens kleine kinderen, moet ‘groot zorgverlof’ kunnen krijgen.
    Zoals vroeger, toen de dienstplicht nog bestond, militairen op herhaling geroepen konden worden, zouden verpleegsters op die manier een relatie met hun oude werkgever kunnen houden.
    Tussentijds zouden de (vooral vrouwelijke) werknemers bijscholing kunnen krijgen om snel weer aan de slag te kunnen als ze dat willen.

    PvdA-staatssecretaris Ahmed Aboutaleb (Sociale Zaken) zei woensdag dat hij dit idee voor groot verlof bekijkt met collega en partijgenoot Jet Bussemaker (Volksgezondheid).
    De bewindslieden hopen op deze manier zowel de personeelstekorten in de zorg aan te pakken als een blijvend verlies van veel goed opgeleide vrouwen voor de arbeidsmarkt tegen te gaan.


    Stoppen met werken begrijpelijk

    Aboutaleb heeft er begrip voor dat vrouwen helemaal stoppen met werken, zolang hun kinderen nog niet naar de basisschool gaan.
    Hij vindt dat ze na die circa vier jaar een soort terugkeerrecht moeten kunnen krijgen bij hun oude werkgever als zij hun bekwaamheden bijhouden tijdens het groot verlof.
    Nu stuiten herintreedsters vaak op problemen om weer aan de slag te komen, omdat hun kennis verouderd is.

    Groot verlof zou volgens Aboutaleb misschien ook een idee zijn voor het onderwijs.
    Hij wijst erop dat deze sector eveneens kampt met personeelstekorten en veel vrouwelijke werknemers kent.


    Cfr. : http://www.volkskrant.nl/economie/article1075660.ece/Groot_verlof_voor_wie_in_de_zorg_werkt




    Balkenendenorm ver te zoeken in zorg

    Merijn Rengers & Xander van Uffelen – de Volkskrant, 28-08-2008


    Amsterdam - Twintig van de honderd grootste zorginstellingen van Nederland betalen hun directeur meer dan 220 duizend euro, het maximum jaarinkomen dat de branche zelf voor ogen heeft.
    Zestig van de honderd zorgdirecteuren ontvingen in 2007 een salaris dat hoger lag dan dan de Balkenendenorm van 176 duizend euro.
    Dat blijkt uit een inventarisatie van de Volkskrant.

    De grootverdieners zijn vooral werkzaam bij ziekenhuizen.
    Maar ook in de gehandicaptenzorg, de geestelijke gezondheidszorg en bij verzorgingstehuizen betalen instellingen hun directeuren boven de Balkenendenorm.
    Elf van de honderd instellingen heeft geen gegevens beschikbaar over salarissen.


    Radboud

    Het Radboud Ziekenhuis uit Nijmegen betaalt zijn bestuursvoorzitter het hoogste bedrag.
    Emile Lohman, voorheen werkzaam bij het OLVG in Amsterdam, kreeg in 2007 een brutojaarsalaris van 290 duizend euro.
    De zorgsector lanceerde deze week een salarisnorm, waarbij zorginstellingen onder strikte voorwaarden maximaal 220 duizend euro bruto zouden mogen uitbetalen.

    Voor instellingen waar geen marktwerking is, mag het salaris niet hoger zijn dan de Balkenendenorm van 176 duizend euro.
    De vereniging van toezichthouders in de zorg, één van de initiatiefnemers van de nieuwe beloningsregels, wil niet zeggen of de salarissen van zorgdirecteuren op korte termijn om laag zullen gaan.
    De vereniging wil niet reageren zolang de code nog ‘in ontwikkeling’ is.


    Verplegers

    Verplegersvakbond NU91 vindt zelfs de Balkenendenorm voor zorginstellingen veel te hoog.
    Wat is er mis met de hoogste salarisschaal in de zorg van rond de 80 duizend euro ?’, zegt voorzitter Monique Kempff van NU91.
    Zij vindt het ‘geen argument’ dat voor dat salaris geen goede bestuurder is te vinden : ‘Voor de werkvloer zijn ook geen mensen te vinden. Krijgen die dan ook meer betaald ?

    Het gat tussen top en werkvloer is volgens Kempff veel te groot.
    De klachtenlijn van Nu91 staat roodgloeiend door telefoontjes van verontwaardigde thuiszorgmedewerkers.
    Het personeel staat op straat, terwijl de mensen die verantwoordelijk zijn voor de puinhopen met tonnen naar huis gaan. Voor die bedragen kun je veel problemen in de organisatie oplossen.


    Lijst met zorginstellingen

    Bekijk de complete lijst met zorginstellingen op : http://www.volkskrant.com/bijlagen/Zorginstellingen.pdf -.


    Cfr. : http://www.volkskrant.nl/economie/article1061299.ece/Balkenendenorm_ver_te_zoeken_in_zorg




    Ziekenhuis - Temperen topsalaris is lastig

    Merijn Rengers & Xander van Uffelen – de Volkskrant, 28-08-2008


    Amsterdam - Het lijstje met naderende salarisverlagingen van bestuurders in de semi-publieke sector wordt gestaag langer.
    Na toezichthouder AFM, de Publieke Omroep en luchthaven Schiphol gaat nu ook een reeks van ziekenhuizen snijden in hun salarissen.

    Tenminste, dat is het geval als de sector zijn eigen voornemens serieus neemt.
    Twintig van de honderd grootste zorginstellingen betalen hun directeur op dit moment meer dan het voorgestelde maximum bruto jaarsalaris van 220 duizend euro, blijkt uit een inventarisatie door De Volkskrant.

    Als de nieuwe maximumnorm ingang vindt – daarover wordt volgende week in de Tweede Kamer gedebatteerd – zullen de zorginstellingen een groot aantal salarissen moeten inperken.
    Een deel van het parlement vindt dat de Balkenendenorm van 176 duizend euro voor álle zorginstellingen zou moeten gelden.
    Op dit moment krijgen zestig van de honderd directeuren meer betaald dan de premier.

    Neem Philadelphia Zorg. Frits Brink, de voorzitter van de Raad van Bestuur van deze landelijk opererende stichting voor gehandicaptenzorg verdiende in 2007 een bruto salaris van 243 duizend euro – 23 duizend euro meer dan het voorgestelde maximum en bijna 70 duizend euro boven ‘Balkenende.’

    Gaat Brink, die inmiddels ook zitting heeft genomen in de Raad van Bestuur van de overkoepelende zorggigant Espria salaris inleveren ?
    Het gemeenschappelijke voorstel van de branche-organisaties NVZD en NVTZ wordt voorgelegd aan de leden. Die zullen het bestuderen en dan pas kunnen we reageren,’ is alles wat een woordvoerder daarover kwijt wil.

    De leiding van Ipse De Bruggen, een andere, recent gefuseerde zorginstelling voor gehandicapten in Zuid-Holland is veel stelliger.
    In 2007 ontving interim-bestuursvoorzitter Adriaan van Belzen van het toen nog zelfstandige
    De Bruggen 287 duizend euro.
    Dat was een honorarium voor een tijdelijke klus,’ zegt een woordvoerster : ‘We zijn inmiddels gefuseerd. De huidige voorzitter is gewoon in dienst en houdt zich aan de normen. Daar hecht hij zeer aan.

    Veel zorginstellingen vinden dat een weinig aanlokkelijk perspectief.
    Het openbreken van bestaande arbeidscontracten is vrijwel onmogelijk, redeneren zij.
    En de salarissen die momenteel betaald worden, waren ooit noodzakelijk om geschikte kandidaten te vinden.

    Dat is ook het verhaal van het Haga Ziekenhuis in Den Haag. Directeur Chiel Huffmeijer, die in 2007 bruto 235 duizend euro verdiende, kwam daar in dienst toen het gefuseerde ziekenhuis in de problemen zat.
    De zorgelijke situatie vroeg destijds om een zwaar gekwalificeerde bestuurder, voor wie een behoorlijk afbreukrisico gold. Een hogere honorering was dan ook alleszins te billijken. Het salaris is door de tijd geïndexeerd en het zou niet rechtvaardig dit nu terug te draaien,’ zegt een woordvoerder.

    Op de werkvloer heerst vaak een heel ander sentiment.
    Niet zozeer onder de doktoren en medisch specialisten, die in sommige gevallen meer verdienen dan de bestuursvoorzitter het ziekenhuis waar zij werken.
    Maar wel onder verplegers en het personeel in bijvoorbeeld de gehandicaptenzorg en de psychiatrie.
    Die spiegelen zich aan de situatie in de thuiszorg.
    Daar zijn de gevolg van de marktwerking in de gezondheidszorg vanuit het personeel bezien hoekig : de salarissen van de thuiszorgdirecteuren zijn fors gestegen, terwijl de arbeidsvoorwaarden van het thuiszorgpersoneel onder druk staan.


    Cfr. : http://www.volkskrant.nl/economie/article1061298.ece/Ziekenhuis_temperen_topsalaris_is_lastig


    15-10-2008 om 16:40 geschreven door Jules

    0 1 2 3 4 5 - Gemiddelde waardering: 0/5 - (0 Stemmen)
    >> Reageer (0)


    Blog als favoriet !

    Gastenboek

    Druk op onderstaande knop om een berichtje achter te laten in mijn gastenboek


    Foto

    Raadpleeg steeds je arts !
    Inhoud blog
  • Tijd om afscheid te nemen...
  • Fibromyalgie in het kort
  • Leden ME/CVS Vereniging unaniem tegen CBO-voorstel
  • Blood donation, XMRV & chronic fatigue syndrome
  • Illness duration and coping style in chronic fatigue syndrome
  • Review confirms PTSD in Gulf vets - Panel finds many reports of multisymptom illnesses
  • M.E. (cvs) - Richtlijnen voor psychiaters - Deel I
  • M.E. (cvs) - Richtlijnen voor psychiaters - Deel II
  • M.E. (cvs) - Richtlijnen voor psychiaters - Deel III
  • M.E. (cvs) - Richtlijnen voor psychiaters - Deel IV
  • M.E. (cvs) - Richtlijnen voor psychiaters - Deel V
  • M.E. (cvs) - Richtlijnen voor psychiaters - Deel VI
  • M.E. (cvs) - Richtlijnen voor psychiaters - Deel VII
  • M.E. (cvs) - Richtlijnen voor psychiaters - Deel VIII
  • M.E. (cvs) - Richtlijnen voor psychiaters - Deel IX
  • M.E. (cvs) - Richtlijnen voor psychiaters - Deel X
  • M.E. (cvs) - Richtlijnen voor psychiaters - Deel XI
  • When do symptoms become a disease ?
  • Burnout
  • Gepest ? - Zet de juiste stappen
  • Voldoet jouw werkplek aan de ARBO-normen ?
  • Chiropractie - Vrijspraak voor Simon Singh in smaadzaak
  • ME/CVS ? - Werk mee aan onderzoek naar tegemoetkoming chronisch zieken !
  • Magical Medicine - How to make a disease disappear
  • A new hypothesis of chronic fatigue syndrome - Co-conditioning theory
  • A light in the darkness - Good news ahead for XMRV ?
  • Zomertijd - Help je biologische klok
  • Beter van de bedrijfsarts
  • De invloed van economisering op het werk van artsen
  • Chronisch Vermoeidheidssyndroom (IOCOB)
  • Gezond brein, gezonde darmen
  • A retrospective review of the sleep characteristics in patients with chronic fatigue syndrome and fibromyalgia
  • Opdracht voor het volgende kabinet : afschaffing van het UWV
  • Test maakt validering pijn bij ME/CVS patienten mogelijk
  • Surprise discovery that HIV retrovirus hides in bone marrow offers new hope for eradication
  • A doctor's roadmap for dealing with the problems of ME/CFS
  • De Terug Plezant Club
  • Het retrovirus XMRV - Waar of niet waar ?
  • Being homebound with chronic fatigue syndrome - A multidimensional comparison with outpatients
  • Oplaaiende symptomen ME patient verraden ontstekingsreactie
  • UWV : 'ME/CVS is ziekte in zin van arbeidsongeschiktheid'
  • Een succesverhaal met Vistide in de strijd tegen ME/CVS - Een verhaal over herstel
  • Depressie
  • Hoe stressvol is je leven ?
  • Making the diagnosis of CFS/ME in primary care - A qualitative study
  • A new system of evaluating fibromyalgia and chronic fatigue
  • Nijmeegs onderzoek haalt CVS-doorbraak onderuit
  • Psychotherapie bij depressie overschat
  • Secrets of novel retrovirus unfolding
  • XMRV : 'missing link' bij ME/CVS ?
  • Reeves, hoofd van CDC CVS onderzoeksprogramma, gaat weg
  • Constant agony of an ME sufferer
  • Canon van de geneeskunde in Nederland
  • Dr. Frank dieet
  • Defeatism is undermining evidence that chronic fatigue syndrome can be treated
  • Cellular and molecular mechanisms of interaction between the neuroendocrine and immune systems under chronic fatigue syndrome in experiment
  • Zo zorg je voor weerstand - Houd je lichaam in optimale conditie
  • Fibromyalgie Vlaanderen Nederland - Dr. Bauer
  • Bussemaker komt terug op erkenning CVS
  • Postexertional malaise in women with chronic fatigue syndrome - Laboratioriumonderzoek bevestigt inspanningsintolerantie bij ME/CVS
  • Ze vertelden stervende dochter dat ze een leugenaar was - Interview met ME moeder Criona Wilson
  • Bijwerkingen antidepressiva erger dan gedacht
  • Bereken je BMI
  • Host range and cellular tropism of the human exogenous gammaretrovirus XMRV
  • The Brain Boosting B-12 - Hydroxocobalamin
  • Vertaling Canadese criteria ME/CVS
  • Slapeloosheid & osteopathie
  • Het Advies- en meldpunt ziekteverzuim en arbeidsongeschiktheid
  • Association between serum ferritin [stored iron] level and fibromyalgia syndrome
  • Dr. Mikovits XMRV Seminar (videos)
  • Zorgen voor een ander (2010) - Antwoorden op veelgestelde vragen
  • Herwin je veerkracht - Omgaan met chronische vermoeidheid en pijn
  • Je eten bepaalt je slaap
  • Dierenleed
  • ME/CVS erkend als chronische ziekte
  • Understanding fibromyalgia pain
  • Hyperalgesia in chronic fatigue syndrome
  • Wegwijzer psychische problemen
  • Positieve psychologie
  • Fietsen in de sneeuw...
  • Tips tegen de koude
  • Failure to detect the novel retrovirus XMRV in chronic fatigue syndrome
  • Nieuwe behandeling VermoeidheidCentrum zeer effectief
  • Een Zalig Kerstfeest en een gezond en voorspoedig 2010 !
  • Taming stressful thoughts
  • Burn-out - Werken tot je erbij neervalt - Deel I
  • Burn-out - Werken tot je erbij neervalt - Deel II
  • Canadese kriteria voor kinderen ook geschikt om onderscheid te maken tussen "milde" en "ernstige" gevallen
  • Stop met piekeren
  • Gedumpt, wat nu ? - Deel I
  • Gedumpt, wat nu ? - Deel II
  • Making a Difference in ME/CFS (Chronic Fatigue Syndrome) and FM
  • Psychotherapie - Van theorie tot praktijk
  • Fibromyalgie, waardevolle dagbesteding en werk - Deel I
  • Fibromyalgie, waardevolle dagbesteding en werk - Deel II
  • Fibromyalgie
  • Europees instrument spoort fibromyalgie op
  • Gezinsgeluk heeft positieve invloed op werk
  • Cognitieve gedragstherapie bij depressie
  • Nooit meer hetzelfde...
  • Rugklachten en RSI beroepsziekten nummer 1
  • SOS ! Hulp voor ouders
  • Dr. Nancy Klimas opens new Chronic Fatigue Center
  • The dramatic story of microbiologist Elaine DeFreitas' discovery
  • Fibromyalgie - Genezing is mogelijk - Gratis boek !
  • Verdedig je tegen wintervirussen
  • 7 geheimen die vrouwen verzwijgen
  • Eén op de twee Belgen krijgt ooit last van reuma
  • Wie langdurig ziek wordt heeft nood aan informatie
  • Snel weer aan het werk - Bedrijfsartsen op bres voor arbeidsongeschikten - Deel I
  • Snel weer aan het werk - Bedrijfsartsen op bres voor arbeidsongeschikten - Deel II
  • Snel weer aan het werk - Bedrijfsartsen op bres voor arbeidsongeschikten - Deel III
  • Snel weer aan het werk - Bedrijfsartsen op bres voor arbeidsongeschikten - Deel IV
  • Snel weer aan het werk - Bedrijfsartsen op bres voor arbeidsongeschikten - Deel V
  • Snel weer aan het werk - Bedrijfsartsen op bres voor arbeidsongeschikten - Deel VI
  • Snel weer aan het werk - Bedrijfsartsen op bres voor arbeidsongeschikten - Deel VII
  • Snel weer aan het werk - Bedrijfsartsen op bres voor arbeidsongeschikten - Deel VIII
  • Snel weer aan het werk - Bedrijfsartsen op bres voor arbeidsongeschikten - Deel IX
  • Snel weer aan het werk - Bedrijfsartsen op bres voor arbeidsongeschikten - Deel X
  • Snel weer aan het werk - Bedrijfsartsen op bres voor arbeidsongeschikten - Deel XI
  • Snel weer aan het werk - Bedrijfsartsen op bres voor arbeidsongeschikten - Deel XII
  • Snel weer aan het werk - Bedrijfsartsen op bres voor arbeidsongeschikten - Deel XIII
  • Snel weer aan het werk - Bedrijfsartsen op bres voor arbeidsongeschikten - Deel XIV
  • Snel weer aan het werk - Bedrijfsartsen op bres voor arbeidsongeschikten - Deel XV
  • Snel weer aan het werk - Bedrijfsartsen op bres voor arbeidsongeschikten - Deel XVI
  • Snel weer aan het werk - Bedrijfsartsen op bres voor arbeidsongeschikten - Deel XVII
  • Snel weer aan het werk - Bedrijfsartsen op bres voor arbeidsongeschikten - Deel XVIII
  • Snel weer aan het werk - Bedrijfsartsen op bres voor arbeidsongeschikten - Deel XIX
  • Snel weer aan het werk - Bedrijfsartsen op bres voor arbeidsongeschikten - Deel XX
  • Snel weer aan het werk - Bedrijfsartsen op bres voor arbeidsongeschikten - Deel XXI
  • Snel weer aan het werk - Bedrijfsartsen op bres voor arbeidsongeschikten - Deel XXII
  • Snel weer aan het werk - Bedrijfsartsen op bres voor arbeidsongeschikten - Deel XXIII
  • Snel weer aan het werk - Bedrijfsartsen op bres voor arbeidsongeschikten - Deel XXIV
  • Snel weer aan het werk - Bedrijfsartsen op bres voor arbeidsongeschikten - Deel XXV
  • Snel weer aan het werk - Bedrijfsartsen op bres voor arbeidsongeschikten - Deel XXVI
  • Snel weer aan het werk - Bedrijfsartsen op bres voor arbeidsongeschikten - Deel XXVII
  • Snel weer aan het werk - Bedrijfsartsen op bres voor arbeidsongeschikten - Deel XXVIII
  • Snel weer aan het werk - Bedrijfsartsen op bres voor arbeidsongeschikten - Deel XXIX
  • Doe een wens... - Make a wish...
  • 7 geheimen die mannen verzwijgen
  • Snel weer aan het werk - Bedrijfsartsen op bres voor arbeidsongeschikten - Deel XXX
  • Fibromyalgie - Genezing is mogelijk - GRATIS !
  • Af en toe een geheim is juist gezond
  • FM/CVS en verzekeringen - Info voor thesis
  • Mogelijke doorbraak MS-behandeling
  • Wees een winterdepressie voor
  • Vitamine B12-tekort - Een mogelijke oorzaak van Chronische vermoeidheid ? - Deel I
  • Vitamine B12-tekort - Een mogelijke oorzaak van Chronische vermoeidheid ? - Deel II
  • The Guaifenesin Story
  • A virus linked to chronic fatigue syndrome - Dr. Nancy Klimas interviews
  • Don't wait for a cure to appear
  • Gezonde chocoladeletters van Sinterklaas
  • Oorzaken van puisten
  • Sporten beter dan pauzeren bij RSI
  • Alles voor het goeie doel !!
  • Gewoon gelukkig zijn...
  • Chronic Fatigue Syndrome - La bête noire of the Belgian Health Care System
  • Persoonlijkheidstests
  • Vaccinatie risicogroepen H1N1
  • Geopereerd Prof. Johann Bauer - Een update (Greta)
  • Weersfactoren oorzaak van hoofdpijn
  • Infection as one possible cause of fibromyalgia - Part I
  • Infection as one possible cause of fibromyalgia - Part II
  • Infection as one possible cause of fibromyalgia - Part III
  • Infection as one possible cause of fibromyalgia - Part IV
  • Infection as one possible cause of fibromyalgia - Part V
  • Infection as one possible cause of fibromyalgia - Part VI
  • Infection as one possible cause of fibromyalgia - Part VII
  • Infection as one possible cause of fibromyalgia - Part VIII
  • Infection as one possible cause of fibromyalgia - Part IX
  • Challenges to conventional thinking about mind and body
  • What is CFS and what is ME ?
  • CVS-Referentiecentra - Opheffing en sluiting
  • Heb ik voldoende ontspanning ?
  • 7 tips tegen een overactieve blaas
  • Wallen en kringen onder de ogen
  • Recovered CFS/ME Patient Goes to Washington, D.C.
  • Chronische vermoeidheid zit niet tussen de oren
  • Dr. Bauer heeft mijn leven gered
  • Has your marriage been damaged by fibromyalgia or chronic fatigue syndrome ?
  • Vijf grootste bedreigingen gezondheid
  • Onbegrepen lage rugpijn beter te behandelen
  • Je beste antistresstip
  • Sufferers of chronic fatigue see life as a balancing act
  • Te hard gewerkt...
  • Prof. Dr. Johann Brauer op mijn blog
  • Geopereerd Prof. Johann Bauer
  • Is de griepprik gevaarlijk ?
  • Griep en verkoudheid - Deel I
  • Griep en verkoudheid - Deel II
  • Support the 500 Professionals of the IACFS/ME
  • Slanker met je hartritme
  • Enzym veroorzaakt gevolgen slaaptekort
  • Now we can get down to business
  • XMRV and chronic fatigue syndrome
  • Verslaving is een behandelbare hersenziekte
  • Kopstukken filosofie - Oktober 2009
  • Gek op je werk
  • Fikse schadevergoeding om antidepressivum
  • ME/CFS patients have retrovirus (XMRV) on YouTube

    Foto

    Archief per week
  • 12/04-18/04 2010
  • 05/04-11/04 2010
  • 29/03-04/04 2010
  • 22/03-28/03 2010
  • 15/03-21/03 2010
  • 08/03-14/03 2010
  • 01/03-07/03 2010
  • 22/02-28/02 2010
  • 15/02-21/02 2010
  • 08/02-14/02 2010
  • 01/02-07/02 2010
  • 25/01-31/01 2010
  • 18/01-24/01 2010
  • 04/01-10/01 2010
  • 28/12-03/01 2010
  • 21/12-27/12 2009
  • 14/12-20/12 2009
  • 07/12-13/12 2009
  • 30/11-06/12 2009
  • 23/11-29/11 2009
  • 16/11-22/11 2009
  • 09/11-15/11 2009
  • 02/11-08/11 2009
  • 19/10-25/10 2009
  • 12/10-18/10 2009
  • 05/10-11/10 2009
  • 28/09-04/10 2009
  • 21/09-27/09 2009
  • 14/09-20/09 2009
  • 07/09-13/09 2009
  • 31/08-06/09 2009
  • 10/08-16/08 2009
  • 27/07-02/08 2009
  • 20/07-26/07 2009
  • 06/07-12/07 2009
  • 22/06-28/06 2009
  • 15/06-21/06 2009
  • 08/06-14/06 2009
  • 01/06-07/06 2009
  • 25/05-31/05 2009
  • 18/05-24/05 2009
  • 11/05-17/05 2009
  • 04/05-10/05 2009
  • 27/04-03/05 2009
  • 20/04-26/04 2009
  • 13/04-19/04 2009
  • 30/03-05/04 2009
  • 23/03-29/03 2009
  • 16/03-22/03 2009
  • 09/03-15/03 2009
  • 02/03-08/03 2009
  • 23/02-01/03 2009
  • 16/02-22/02 2009
  • 09/02-15/02 2009
  • 02/02-08/02 2009
  • 26/01-01/02 2009
  • 19/01-25/01 2009
  • 12/01-18/01 2009
  • 05/01-11/01 2009
  • 22/12-28/12 2008
  • 15/12-21/12 2008
  • 08/12-14/12 2008
  • 01/12-07/12 2008
  • 24/11-30/11 2008
  • 17/11-23/11 2008
  • 10/11-16/11 2008
  • 03/11-09/11 2008
  • 27/10-02/11 2008
  • 20/10-26/10 2008
  • 13/10-19/10 2008
  • 06/10-12/10 2008
  • 29/09-05/10 2008
  • 22/09-28/09 2008
  • 15/09-21/09 2008
  • 08/09-14/09 2008
  • 01/09-07/09 2008
  • 25/08-31/08 2008
  • 18/08-24/08 2008
  • 11/08-17/08 2008
  • 04/08-10/08 2008
  • 28/07-03/08 2008
  • 21/07-27/07 2008
  • 14/07-20/07 2008
  • 30/06-06/07 2008
  • 23/06-29/06 2008
  • 16/06-22/06 2008
  • 09/06-15/06 2008
  • 02/06-08/06 2008
  • 26/05-01/06 2008
  • 19/05-25/05 2008
  • 12/05-18/05 2008
  • 05/05-11/05 2008
  • 28/04-04/05 2008
  • 21/04-27/04 2008
  • 14/04-20/04 2008
  • 07/04-13/04 2008
  • 31/03-06/04 2008
  • 24/03-30/03 2008
  • 17/03-23/03 2008
  • 10/03-16/03 2008
  • 03/03-09/03 2008
  • 25/02-02/03 2008
  • 18/02-24/02 2008
  • 11/02-17/02 2008
  • 04/02-10/02 2008
  • 28/01-03/02 2008
  • 21/01-27/01 2008
  • 14/01-20/01 2008
  • 07/01-13/01 2008
  • 31/12-06/01 2008
  • 24/12-30/12 2007
  • 17/12-23/12 2007
  • 10/12-16/12 2007
  • 03/12-09/12 2007
  • 26/11-02/12 2007
  • 19/11-25/11 2007
  • 12/11-18/11 2007
  • 05/11-11/11 2007
  • 29/10-04/11 2007
  • 22/10-28/10 2007
  • 15/10-21/10 2007
  • 08/10-14/10 2007
  • 01/10-07/10 2007
  • 24/09-30/09 2007
  • 17/09-23/09 2007
  • 10/09-16/09 2007
  • 03/09-09/09 2007
  • 27/08-02/09 2007
  • 20/08-26/08 2007
  • 13/08-19/08 2007
  • 06/08-12/08 2007
  • 30/07-05/08 2007
  • 23/07-29/07 2007
  • 16/07-22/07 2007
  • 09/07-15/07 2007
  • 18/06-24/06 2007
  • 11/06-17/06 2007
  • 04/06-10/06 2007
  • 28/05-03/06 2007
  • 21/05-27/05 2007
  • 14/05-20/05 2007
  • 07/05-13/05 2007
  • 30/04-06/05 2007
  • 23/04-29/04 2007
  • 16/04-22/04 2007
  • 09/04-15/04 2007
  • 02/04-08/04 2007
  • 26/03-01/04 2007
  • 19/03-25/03 2007
  • 12/03-18/03 2007
  • 05/03-11/03 2007
  • 26/02-04/03 2007
  • 19/02-25/02 2007
  • 12/02-18/02 2007
  • 05/02-11/02 2007
  • 29/01-04/02 2007
  • 22/01-28/01 2007
  • 15/01-21/01 2007
  • 08/01-14/01 2007
  • 18/12-24/12 2006
  • 11/12-17/12 2006
  • 04/12-10/12 2006
  • 27/11-03/12 2006
  • 20/11-26/11 2006
  • 13/11-19/11 2006
  • 06/11-12/11 2006
  • 30/10-05/11 2006
  • 23/10-29/10 2006
  • 16/10-22/10 2006
  • 09/10-15/10 2006
  • 02/10-08/10 2006
  • 25/09-01/10 2006
  • 18/09-24/09 2006
  • 11/09-17/09 2006
  • 04/09-10/09 2006
  • 28/08-03/09 2006
  • 07/08-13/08 2006
  • 31/07-06/08 2006
  • 24/07-30/07 2006
  • 03/07-09/07 2006
  • 26/06-02/07 2006
  • 19/06-25/06 2006
  • 12/06-18/06 2006
  • 29/05-04/06 2006
  • 22/05-28/05 2006
  • 15/05-21/05 2006
  • 08/05-14/05 2006
  • 01/05-07/05 2006
  • 24/04-30/04 2006
  • 17/04-23/04 2006
  • 10/04-16/04 2006
  • 27/03-02/04 2006
  • 20/03-26/03 2006
  • 13/03-19/03 2006
  • 06/03-12/03 2006
  • 27/02-05/03 2006
  • 20/02-26/02 2006
  • 13/02-19/02 2006
  • 06/02-12/02 2006
  • 30/01-05/02 2006
  • 23/01-29/01 2006
  • 16/01-22/01 2006
  • 09/01-15/01 2006
  • 26/12-01/01 2006
  • 19/12-25/12 2005
  • 12/12-18/12 2005
  • 05/12-11/12 2005
  • 28/11-04/12 2005
  • 21/11-27/11 2005
  • 14/11-20/11 2005
  • 07/11-13/11 2005
  • 24/10-30/10 2005
  • 17/10-23/10 2005
  • 10/10-16/10 2005
  • 03/10-09/10 2005
  • 26/09-02/10 2005
  • 19/09-25/09 2005
  • 12/09-18/09 2005
  • 05/09-11/09 2005
  • 29/08-04/09 2005
  • 22/08-28/08 2005
  • 15/08-21/08 2005
  • 08/08-14/08 2005
  • 01/08-07/08 2005
  • 25/07-31/07 2005
  • 04/07-10/07 2005
  • 27/06-03/07 2005
  • 20/06-26/06 2005
  • 13/06-19/06 2005
  • 06/06-12/06 2005
  • 30/05-05/06 2005
  • 23/05-29/05 2005
  • 16/05-22/05 2005
  • 09/05-15/05 2005
  • 02/05-08/05 2005
  • 25/04-01/05 2005
  • 18/04-24/04 2005
  • 11/04-17/04 2005
  • 29/11-05/12 1999
  • 29/12-04/01 1970

    Foto

  • 12/04-18/04 2010
  • 05/04-11/04 2010
  • 29/03-04/04 2010
  • 22/03-28/03 2010
  • 15/03-21/03 2010
  • 08/03-14/03 2010
  • 01/03-07/03 2010
  • 22/02-28/02 2010
  • 15/02-21/02 2010
  • 08/02-14/02 2010
  • 01/02-07/02 2010
  • 25/01-31/01 2010
  • 18/01-24/01 2010
  • 04/01-10/01 2010
  • 28/12-03/01 2010
  • 21/12-27/12 2009
  • 14/12-20/12 2009
  • 07/12-13/12 2009
  • 30/11-06/12 2009
  • 23/11-29/11 2009
  • 16/11-22/11 2009
  • 09/11-15/11 2009
  • 02/11-08/11 2009
  • 19/10-25/10 2009
  • 12/10-18/10 2009
  • 05/10-11/10 2009
  • 28/09-04/10 2009
  • 21/09-27/09 2009
  • 14/09-20/09 2009
  • 07/09-13/09 2009
  • 31/08-06/09 2009
  • 10/08-16/08 2009
  • 27/07-02/08 2009
  • 20/07-26/07 2009
  • 06/07-12/07 2009
  • 22/06-28/06 2009
  • 15/06-21/06 2009
  • 08/06-14/06 2009
  • 01/06-07/06 2009
  • 25/05-31/05 2009
  • 18/05-24/05 2009
  • 11/05-17/05 2009
  • 04/05-10/05 2009
  • 27/04-03/05 2009
  • 20/04-26/04 2009
  • 13/04-19/04 2009
  • 30/03-05/04 2009
  • 23/03-29/03 2009
  • 16/03-22/03 2009
  • 09/03-15/03 2009
  • 02/03-08/03 2009
  • 23/02-01/03 2009
  • 16/02-22/02 2009
  • 09/02-15/02 2009
  • 02/02-08/02 2009
  • 26/01-01/02 2009
  • 19/01-25/01 2009
  • 12/01-18/01 2009
  • 05/01-11/01 2009
  • 22/12-28/12 2008
  • 15/12-21/12 2008
  • 08/12-14/12 2008
  • 01/12-07/12 2008
  • 24/11-30/11 2008
  • 17/11-23/11 2008
  • 10/11-16/11 2008
  • 03/11-09/11 2008
  • 27/10-02/11 2008
  • 20/10-26/10 2008
  • 13/10-19/10 2008
  • 06/10-12/10 2008
  • 29/09-05/10 2008
  • 22/09-28/09 2008
  • 15/09-21/09 2008
  • 08/09-14/09 2008
  • 01/09-07/09 2008
  • 25/08-31/08 2008
  • 18/08-24/08 2008
  • 11/08-17/08 2008
  • 04/08-10/08 2008
  • 28/07-03/08 2008
  • 21/07-27/07 2008
  • 14/07-20/07 2008
  • 30/06-06/07 2008
  • 23/06-29/06 2008
  • 16/06-22/06 2008
  • 09/06-15/06 2008
  • 02/06-08/06 2008
  • 26/05-01/06 2008
  • 19/05-25/05 2008
  • 12/05-18/05 2008
  • 05/05-11/05 2008
  • 28/04-04/05 2008
  • 21/04-27/04 2008
  • 14/04-20/04 2008
  • 07/04-13/04 2008
  • 31/03-06/04 2008
  • 24/03-30/03 2008
  • 17/03-23/03 2008
  • 10/03-16/03 2008
  • 03/03-09/03 2008
  • 25/02-02/03 2008
  • 18/02-24/02 2008
  • 11/02-17/02 2008
  • 04/02-10/02 2008
  • 28/01-03/02 2008
  • 21/01-27/01 2008
  • 14/01-20/01 2008
  • 07/01-13/01 2008
  • 31/12-06/01 2008
  • 24/12-30/12 2007
  • 17/12-23/12 2007
  • 10/12-16/12 2007
  • 03/12-09/12 2007
  • 26/11-02/12 2007
  • 19/11-25/11 2007
  • 12/11-18/11 2007
  • 05/11-11/11 2007
  • 29/10-04/11 2007
  • 22/10-28/10 2007
  • 15/10-21/10 2007
  • 08/10-14/10 2007
  • 01/10-07/10 2007
  • 24/09-30/09 2007
  • 17/09-23/09 2007
  • 10/09-16/09 2007
  • 03/09-09/09 2007
  • 27/08-02/09 2007
  • 20/08-26/08 2007
  • 13/08-19/08 2007
  • 06/08-12/08 2007
  • 30/07-05/08 2007
  • 23/07-29/07 2007
  • 16/07-22/07 2007
  • 09/07-15/07 2007
  • 18/06-24/06 2007
  • 11/06-17/06 2007
  • 04/06-10/06 2007
  • 28/05-03/06 2007
  • 21/05-27/05 2007
  • 14/05-20/05 2007
  • 07/05-13/05 2007
  • 30/04-06/05 2007
  • 23/04-29/04 2007
  • 16/04-22/04 2007
  • 09/04-15/04 2007
  • 02/04-08/04 2007
  • 26/03-01/04 2007
  • 19/03-25/03 2007
  • 12/03-18/03 2007
  • 05/03-11/03 2007
  • 26/02-04/03 2007
  • 19/02-25/02 2007
  • 12/02-18/02 2007
  • 05/02-11/02 2007
  • 29/01-04/02 2007
  • 22/01-28/01 2007
  • 15/01-21/01 2007
  • 08/01-14/01 2007
  • 18/12-24/12 2006
  • 11/12-17/12 2006
  • 04/12-10/12 2006
  • 27/11-03/12 2006
  • 20/11-26/11 2006
  • 13/11-19/11 2006
  • 06/11-12/11 2006
  • 30/10-05/11 2006
  • 23/10-29/10 2006
  • 16/10-22/10 2006
  • 09/10-15/10 2006
  • 02/10-08/10 2006
  • 25/09-01/10 2006
  • 18/09-24/09 2006
  • 11/09-17/09 2006
  • 04/09-10/09 2006
  • 28/08-03/09 2006
  • 07/08-13/08 2006
  • 31/07-06/08 2006
  • 24/07-30/07 2006
  • 03/07-09/07 2006
  • 26/06-02/07 2006
  • 19/06-25/06 2006
  • 12/06-18/06 2006
  • 29/05-04/06 2006
  • 22/05-28/05 2006
  • 15/05-21/05 2006
  • 08/05-14/05 2006
  • 01/05-07/05 2006
  • 24/04-30/04 2006
  • 17/04-23/04 2006
  • 10/04-16/04 2006
  • 27/03-02/04 2006
  • 20/03-26/03 2006
  • 13/03-19/03 2006
  • 06/03-12/03 2006
  • 27/02-05/03 2006
  • 20/02-26/02 2006
  • 13/02-19/02 2006
  • 06/02-12/02 2006
  • 30/01-05/02 2006
  • 23/01-29/01 2006
  • 16/01-22/01 2006
  • 09/01-15/01 2006
  • 26/12-01/01 2006
  • 19/12-25/12 2005
  • 12/12-18/12 2005
  • 05/12-11/12 2005
  • 28/11-04/12 2005
  • 21/11-27/11 2005
  • 14/11-20/11 2005
  • 07/11-13/11 2005
  • 24/10-30/10 2005
  • 17/10-23/10 2005
  • 10/10-16/10 2005
  • 03/10-09/10 2005
  • 26/09-02/10 2005
  • 19/09-25/09 2005
  • 12/09-18/09 2005
  • 05/09-11/09 2005
  • 29/08-04/09 2005
  • 22/08-28/08 2005
  • 15/08-21/08 2005
  • 08/08-14/08 2005
  • 01/08-07/08 2005
  • 25/07-31/07 2005
  • 04/07-10/07 2005
  • 27/06-03/07 2005
  • 20/06-26/06 2005
  • 13/06-19/06 2005
  • 06/06-12/06 2005
  • 30/05-05/06 2005
  • 23/05-29/05 2005
  • 16/05-22/05 2005
  • 09/05-15/05 2005
  • 02/05-08/05 2005
  • 25/04-01/05 2005
  • 18/04-24/04 2005
  • 11/04-17/04 2005
  • 29/11-05/12 1999
  • 29/12-04/01 1970

    Foto

    Willekeurig SeniorenNet Blogs
    barcelona
    blog.seniorennet.be/barcelo
    Foto


    Blog tegen de regels? Meld het ons!
    Gratis blog op http://blog.seniorennet.be - SeniorenNet Blogs, eenvoudig, gratis en snel jouw eigen blog!