Wim Peersman | Ghent University (original) (raw)

Papers by Wim Peersman

PloS one, 2015

Uganda is one of the 57 countries with a critical shortage of health workers. The aim of this stu... more Uganda is one of the 57 countries with a critical shortage of health workers. The aim of this study was to determine how the human resources and health service crisis was covered in Ugandan newspapers and, in particular, how the newspapers attributed accountability for problems in the health services. We collected all articles related to health workers and health services for the calendar year 2012 in the two largest national newspapers in Uganda (collection on daily basis) and in one local newspaper (collection on weekly basis). These articles were analysed qualitatively regarding the main themes covered and attribution of accountability. The two more urban national newspapers published 229 articles on human resources and health services in Uganda (on average over two articles per week), whereas the local more rural newspaper published only a single article on this issue in the 12 month period. The majority of articles described problems in the health service without discussing acc...

Global health action, 2015

Migrant health workers fill care gaps in their destination countries, but they also actively enga... more Migrant health workers fill care gaps in their destination countries, but they also actively engage in improving living conditions for people of their countries of origin through expatriate professional networks. This paper aims to explore the professional links that migrant health workers from sub-Saharan African countries living in five African and European destinations (Botswana, South Africa, Belgium, Austria, and the United Kingdom) have to their countries of origin. Qualitative interviews were conducted with migrant doctors, nurses, and midwives from sub-Saharan Africa (N=66). A qualitative content analysis of the material was performed using the software ATLAS.ti. Almost all migrant health workers have professional ties with their countries of origin supporting health, education, and social structures. They work with non-governmental organizations, universities, or hospitals and travel back and forth between their destination country and country of origin. For a few responden...

Background: Many studies have investigated the migration intentions of sub-Saharan African medica... more Background: Many studies have investigated the migration intentions of sub-Saharan African medical students and health professionals within the context of a legacy of active international recruitment by receiving countries. However, many health workers migrate outside of this recruitment paradigm. This paper aims to explore the reasons for migration of health workers from sub-Saharan Africa to Belgium and Austria; European countries without a history of active recruitment in sub-Saharan Africa. Methods: Data were collected using semistructured interviews. Twenty-seven health workers were interviewed about their migration experiences. Included participants were born in sub-Saharan Africa, had trained as health workers in sub-Saharan Africa, and were currently living in Belgium or Austria, though not necessarily currently working as a health professional. Results: Both Austria and Belgium were shown not to be target countries for the health workers, who instead moved there by circumstance, rather than choice. Three principal reasons for migration were reported: 1) educational purposes; 2) political instability or insecurity in their country of origin; and 3) family reunification. In addition, two respondents mentioned medical reasons and, although less explicit, economic factors were also involved in several of the respondents' decision to migrate. Conclusion: These results highlight the importance of the broader economic, social, and political context within which migration decisions are made. Training opportunities proved to be an important factor for migration. A further development and upgrade of primary care might help to counter the common desire to specialize and improve domestic training opportunities.

BMC Family Practice

Integrated team-based primary care is an international imperative. This is required more so in Af... more Integrated team-based primary care is an international imperative. This is required more so in Africa, where fragmented verticalised care dominates. South Africa is trying to address this with health reforms, including Primary Health Care Re-engineering. Family physicians are already contributing to primary care despite family medicine being only fully registered as a full specialty in South Africa in 2008. However the views of leaders on family medicine and the role of family physicians is not clear, especially with recent health reforms. The aim of this study was to understand the views of key government and academic leaders in South Africa on family medicine, roles of family physicians and human resource issues.

BMC public health, 2014

Social capital has been related to various aspects of health. While literature suggests that men ... more Social capital has been related to various aspects of health. While literature suggests that men and women differently access and mobilize social capital, gender has received little attention within social capital research. This study examines whether the association between individual social capital and psychological distress is different for men and women. We made use of data from a representative sample of 1025 adults within 50 neighbourhoods of Ghent (Belgium), collected in the context of the cross-sectional Social capital and Well-being In Neighbourhoods in Ghent (SWING) Survey 2011. Six components of social capital were discerned: generalized trust, social support, social influence, social engagement and attachment, the volume of social capital and the mean occupational prestige in one's network. Multilevel linear regression models were fitted to explore interactions between gender and these components of social capital. In accordance with previous research, men report low...

British Journal of Sports Medicine, 2009

To determine prospectively gait-related risk factors for lower leg overuse injury (LLOI). A prosp... more To determine prospectively gait-related risk factors for lower leg overuse injury (LLOI). A prospective cohort study. Male and female recruits from a start-to-run (STR) programme during a 10-week training period. 131 healthy subjects (20 men and 111 women), without a history of any lower leg complaint, participated in the study. Before the start of the 10-week STR programme, plantar force measurements during running were performed. During STR, lower leg injuries were diagnosed and registered by a sports physician. Plantar force measurements during running were performed using a footscan pressure plate. During the STR, 27 subjects (five men and 22 women) developed a LLOI. Logistic regression analysis revealed that subjects who developed a LLOI had a significantly more laterally directed force distribution at first metatarsal contact and forefoot flat, a more laterally directed force displacement in the forefoot contact phase, foot flat phase and at heel-off. These subjects also had a delayed change of the centre of force (COF) at forefoot flat, a higher force and loading underneath the lateral border of the foot, and a significantly higher directed force displacement of the COF at forefoot flat. These findings suggest that a less pronated heel strike and a more laterally directed roll-off can be considered as risk factors for LLOI. Clinically, the results of this study can be considered important in identifying individuals at risk of LLOI.

American Journal of Physiology - Endocrinology And Metabolism, 2015

A particular allele of the carnosinase gene (CNDP1) is associated with reduced plasma carnosinase... more A particular allele of the carnosinase gene (CNDP1) is associated with reduced plasma carnosinase activity and reduced risk for nephropathy in diabetic patients. On the one hand, animal and human data suggest that hyperglycemia increases plasma carnosinase activity. On the other hand, we recently reported lower carnosinase activity levels in elite athletes involved in high-intensity exercise, compared to untrained controls. Therefore, this study investigates whether exercise training and the consequent reduction in hyperglycemia can suppress carnosinase activity and content in adults with type 2 diabetes. Plasma samples were taken from 243 males and females with type 2 diabetes (mean age = 54.3 yr, SD = 7.1) without major microvascular complications before and after a 6-month exercise training program (4 groups: sedentary control (n=61), aerobic exercise (n=59), resistance exercise (n=63) and combined exercise training (n=60)). Plasma carnosinase content and activity, hemoglobin A1c, lipid profile and blood pressure were measured. A 6-month exercise training intervention, irrespective of training modality, did not decrease plasma carnosinase content or activity in type 2 diabetic patients. Plasma carnosinase content and activity showed a high inter-individual but very low intra-individual variability over the 6-month period. Age and sex, but not HbA1c, were significantly related to the activity or content of this enzyme. It can be concluded that the beneficial effects of exercise training on the incidence of diabetic complications is probably not related to a lowering effect on plasma carnosinase content or activity.

Welzijnsgids, 2010

a. Veerle Vyncke en Sara Willems maken deel uit van de Vakgroep huisartsgeneeskunde en eerstelijn... more a. Veerle Vyncke en Sara Willems maken deel uit van de Vakgroep huisartsgeneeskunde en eerstelijnsgezondheidszorg, Universiteit Gent b. Tine Buffel is verbonden aan de Vakgroep educatiewetenschappen, Vrije Universiteit Brussel en aan het Fonds voor Wetenschappelijk Onderzoek c.Dominique Verté is werkzaam bij de Vakgroep educatiewetenschappen, Vrije Universiteit Brussel d. Wim Peersman is verbonden aan de Vakgroep revalidatiewetenschappen en kinesitherapie, Arteveldehogeschool Gent

PloS one, 2015

Child Care Health and Development

Background The Alberta Infant Motor Scales (AIMS) is a reliable and valid assessment tool to eva... more Background The Alberta Infant Motor Scales (AIMS) is a reliable and valid assessment tool to evaluate the motor performance from birth to independent walking. This study aimed to determine whether the Canadian reference values on the AIMS from 1990-1992 are still useful tor Flemish infants, assessed in 2007-2010. Additionally, the association between motor performance and sleep and play positioning will be determined. Methods A total of 270 Flemish infants between 0 and 18 months, recruited by formal day care services, were assessed with the AIMS by four trained physiotherapists. Information about sleep and play positioning was collected by mean of a questionnaire. Results Flemish infants perform significantly lower on the AIMS compared with the reference values (P < 0.001). Especially, infants from the age groups of 4, 5, 6, 7, 8, 9, 10, 11, 12, 13 and of 15 months showed significantly lower scores. From the information collected by parental questionnaires, the lower motor sc...

Seminars in Arthritis and Rheumatism, 2014

Aim: This study provides insight into the profile and importance of autonomic symptoms in the hyp... more Aim: This study provides insight into the profile and importance of autonomic symptoms in the hypermobility type (HT) of Ehlers-Danlos syndrome (EDS). The impact of these symptoms is put into perspective by comparing with fibromyalgia (FM) and two other EDS types. Methods: Overall, 80 patients with EDS-HT participated, as well as 11 with classical EDS (cEDS), seven with vascular EDS (vEDS), 38 with FM, and 43 healthy controls. All participants filled out the autonomic symptom profile (ASP). Furthermore, they were inquired about quality of life (QOL, SF-36) and factors contributing to the EDS disease burden, e.g., hypermobility (5-point questionnaire, GHQ), fatigue (checklist individual strength, CIS), pain (pain detect questionnaire, PDQ), affective distress (hospital anxiety and depression scale, HADS), and physical activity (Baecke). Results: The total autonomic symptom burden was higher in EDS-HT (57.9 7 21.57) than in controls (11.3 7 19.22), cEDS (32.3 7 19.47), and vEDS (29.1 7 19.18), but comparable to FM (53.8 7 19.85). Especially orthostatic and gastrointestinal complaints were prevalent. The importance of autonomic symptoms in EDS-HT was emphasized by the correlation with lowered QOL (r ¼ À0.402), fatigue (r ¼ 0.304), and pain severity (r ¼ 0.370). Although affective distress and decreased physical activity are often suggested as possible causes for dysautonomia, the ASP did not correlate with the HADS and Baecke score. By contrast, the correlation of the GHQ (r ¼ 0.298) and PDQ (r ¼ 0.413) with the ASP supports the hypothesis that joint hypermobility and neuropathy may play a role in the development of autonomic symptoms. Conclusion: Autonomic symptoms, especially orthostatic and gastrointestinal complaints, are frequent extraarticular manifestations of EDS-HT and contribute to the disease burden. (I. De Wandele). Seminars in Arthritis and Rheumatism ] (2014) ]]]-]]]

The Annals of Family Medicine, 2006

Antibiotics are still overprescribed for self-limiting upper respiratory tract infections such as... more Antibiotics are still overprescribed for self-limiting upper respiratory tract infections such as acute sore throat, and physicians mention patient&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s desire for antibiotics as a driving force. We studied patients&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; concerns when visiting their family physician for acute sore throat, more specifically the importance they attach to antibiotic treatment and pain relief. Family physicians in 6 peer groups in Belgium participated in an observational postvisit questionnaire survey. Patients aged 12 years and older making an office visit for acute sore throat were invited to indicate the importance of different reasons for the visit. Sixty-eight family physicians provided data from 298 patients. The 3 most frequently endorsed reasons for visiting the physician were examination to establish the cause of the symptoms, pain relief, and information on the course of the disease. Hopes for an antibiotic ranked 11th of 13 items. Patients who considered antibiotics very/rather important valued pain relief significantly more than patients who considered them little/not important (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;.001). Patients who hoped for antibiotics felt more unwell (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;.001), had more faith in antibiotics to speed recovery (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;.001), and were less convinced that sore throat was a self-limiting disease (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;.012). A multivariate model, adjusted for age, sex, and educational status, showed that the desire for pain relief is a strong predictor of the hope to receive a prescription for antibiotics. Our study suggests that patients with acute sore throat and who hope for antibiotics may in fact want treatment for pain. Trials are needed to test whether exploring patients&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; expectations about pain management and offering adequate analgesia can assist physicians in managing sore throats without prescribing antibiotics.

European Urology Supplements, 2007

The Journal of Urology, 2007

There is a need for objective and validated measurements of ejaculation latency time and penile s... more There is a need for objective and validated measurements of ejaculation latency time and penile sensitivity in men with normal sexual function. We determined 1) the normal range and repeatability of ELT in a laboratory vs at home masturbation and intercourse in normal men, 2) the threshold and repeatability of penile sensitivity on 6 penile surface areas measured by 2 vibrometers and 3) whether penile sensitivity correlates with ejaculation latency time. A total of 58 healthy volunteers between 20 and 40 years old provided ejaculation latency times during 3 procedures and were evaluated with a biothesiometer and SMV-5 vibrometer (Suzuki-Matsuoka, Teknologue, Tokyo, Japan) on 6 penile surface areas. Ejaculation latency time was highest during intercourse (median 8.25 minutes, range 1.32 to 18.31), lower in the laboratory (median 7.22, range 1.37 to 18.79) and lowest during masturbation (median 4.89, range 1.08 to 14.19). The 3 ELT scores were highly reproducible within subjects (ICC 0.88 to 0.93). There was high variability among subjects. Vibrotactile thresholds on 6 penile surface areas were also similar and highly repeatable for the 2 vibrometers (ICC 0.81 to 0.96). However, there was no correlation between penile sensitivity and ELT (R2 less than 8%). ELT in the laboratory is lower than during intercourse and higher than during masturbation. Vibrometers produce reliable and repeatable penile vibrotactile threshold results. However, penile sensitivity measurements do not correlate with ELT in men with normal sexual function.

The aim of this analysis was to assess the impact of chronic back pain and psychological distress... more The aim of this analysis was to assess the impact of chronic back pain and psychological distress on the utilization of primary and secondary levels of care in the ambulatory health care sector in Austria - a country without a gatekeeping system. Additionally, we aimed to determine if the joint effect of chronic back pain and psychological distress was higher than the impact of the sum of the two single conditions. The database used for this analysis was the Austrian
Health Interview Survey, with data from15,474 individuals. Statisticalmethods used were descriptive tests, regression models and the calculation of synergistic effects. Both chronic
back pain and psychological distress had a positive association with the utilization of the primary (OR for chronic back pain 1.53 and psychological distress 1.33) and secondary (OR for chronic back pain 1.32 and psychological distress 1.24) levels of the health care sector. In the fully adjusted model, the synergistic effect of chronic back pain and psychological distress was significant for the secondary level of care (S 1.99, PAF 0.20), but not for the primary level of care (S
1.16, PAF 0.07). Synergistic effects and associations for chronic back pain and psychological distress on the utilization of both the primary and secondary levels of the ambulatory health
care sector were observed, particularly for the secondary level of care. Our results demonstrate the utilization of health care services settings by individuals with these conditions, and offer opportunities to consider reorganization and structuring of the Austrian health care system.

The Lancet Global Health, 2013

British Journal of General Practice, 2014

Many low-income and middle-income countries globally are now pursuing ambitious plans for univers... more Many low-income and middle-income countries globally are now pursuing ambitious plans for universal primary care, but are failing to deliver adequate care quality because of intractable human resource problems.

PloS one, 2015

Global health action, 2015

BMC Family Practice

BMC public health, 2014

British Journal of Sports Medicine, 2009

American Journal of Physiology - Endocrinology And Metabolism, 2015

Welzijnsgids, 2010

PloS one, 2015

Child Care Health and Development

Seminars in Arthritis and Rheumatism, 2014

The Annals of Family Medicine, 2006

European Urology Supplements, 2007

The Journal of Urology, 2007

The Lancet Global Health, 2013

British Journal of General Practice, 2014

Background: Migrant health workers fill care gaps in their destination countries, but they also a... more Background: Migrant health workers fill care gaps in their destination countries, but they also actively engage in
improving living conditions for people of their countries of origin through expatriate professional networks.
This paper aims to explore the professional links that migrant health workers from sub-Saharan African
countries living in five African and European destinations (Botswana, South Africa, Belgium, Austria, and the
United Kingdom) have to their countries of origin.
Design: Qualitative interviews were conducted with migrant doctors, nurses, and midwives from sub-Saharan
Africa (N66). A qualitative content analysis of the material was performed using the software ATLAS.ti.
Results: Almost all migrant health workers have professional ties with their countries of origin supporting
health, education, and social structures. They work with non-governmental organizations, universities, or
hospitals and travel back and forth between their destination country and country of origin. For a few
respondents, professional engagement or even maintaining private contacts in their country of origin is difficult
due to the political situation at home.
Conclusions: The results show that African migrant health workers are actively engaged in improving living
conditions not only for their family members but also for the population in general in their countries of origin.
Our respondents are mediators and active networkers in a globalized and transnationally connectedworld. The
research suggests that the governments of these countries of origin could strategically use their migrant health
workforce for improving education and population health in sub-Saharan Africa. Destination countries should
be reminded of their need to comply with the WHO Global Code of Practice for the international recruitment
of health professionals.