PubMed Health⌕ Search

Biomedical subjects

M Peltenburg

Publications and source records attributed to M Peltenburg.

8 recordsLinked to original sources
PubMed2004

[Preserving vision in the elderly: a survey to start a quality development program in general practice].

The study examined the rate of patients, who do not follow recommendations for routine screening, do not visit physicians for eye-symptoms and when suffering from diabetes or glaucoma do not adhere to follow-up. To what extent can primary care physicians impact on these deficits of ophthalmologic care? 4918 consecutive, > or = 40 old patients of 107 primary care physicians of 9 networks participated. Of these patients 15% had never, 43% not within the last 3 years, consulted an ophthalmologist. 16% were diabetics, 7% had glaucoma and 46% had observed subjective eye symptoms. A quarter of these patients turn to their primary care physician, when having eye problems. Primary care physicians do not frequently suggest routine ophthalmologic controls nor do they use diagnostic tools like the Amsler-grid or the Swinging-Flash-Light Test.

Adult↗
PubMed2003

Communication in general practice: differences between European countries.

BACKGROUND: Based on differences in national health care system characteristics such as the gatekeeping role of GPs (at the macrolevel) and on diverging GP and patient characteristics (at the microlevel), communication may differ between countries. Knowledge of the influence of these characteristics on doctor-patient communication will be important for setting European health care policies. OBJECTIVES: Our objectives were (i) to compare doctor-patient communication in general practice between European countries; and (ii) to investigate the influence of the gatekeeping system and GP and patient characteristics on doctor-patient communication in general practice. METHODS: Fifteen patients per GP (in total 2825 patients) of 190 GPs in six European countries were included. Participating countries were The Netherlands, Spain, the UK (gatekeeping countries), Belgium, Germany and Switzerland (non-gatekeeping countries). Data were collected by means of patient and GP questionnaires and observation of videotaped consultations, and analysed by one-way and multilevel, multivariate analysis. RESULTS: Differences in communication between countries were found in: affective and instrumental behaviour; biomedical and psychosocial talk; GPs' patient-directed gaze; and consultation length. The study showed that GPs' gatekeeping role (with registered patients) was less important for doctor-patient communication than was expected. Patient characteristics such as gender, age, having psychosocial problems, and familiarity between the doctor and the patient were the most important in explaining differences in communication. CONCLUSION: The gatekeeping role of GPs is hardly important in explaining doctor-patient communication. The relationship is more complex than expected. Patient and GP characteristics are more important. Cultural factors should be included in future studies.

Adult↗
PubMed2001

Use of the Internet by medical doctors in Switzerland.

QUESTIONS UNDER STUDY: To investigate the utilisation of the Internet by primary care physicians for medical purposes during their daily practice, and to clarify the reasons for use or non-use of this technology. METHODS: Cross-sectional postal survey in German-speaking Switzerland employing a purpose-designed pre-validated 69-item questionnaire. A random sample of 2009 primary care physicians participated in the investigation. MAIN OUTCOME MEASURES: Number of primary care physicians with access to the Internet; reasons for using the Internet during consultations; sources of information in solving medical problems arising from concurrent patient care. RESULTS: 55% of the physicians returned the completed questionnaire. 75% of respondents reported access to the Internet. Only 7% use the Internet during patient consultations. The main reasons for not using the Internet were time pressure and concerns about potential negative interaction with physician-patient communication. To solve patient-specific problems arising during daily practice, 59% of the practitioners consult text-books or colleagues. Only 14% of respondents report regularly finding useful information on the Internet. Internet users assess information quality by checking on authorship, institution, publishing company, or whether the information is sponsored by a third party with a potential conflict of interest. CONCLUSIONS: Access to the Internet is widespread amongst German-speaking Swiss primary care physicians. Only a small minority use the Internet for information retrieval during consultation hours. Electronic information systems need to be tailored to the needs of primary care physicians.

Communication↗
PubMed2001

[Description of Internet-based models for continuing medical education. First results and experiences with asthma patients].

The Pilot study "Quality Development through the Internet" by the Horten Center is an integral part of a concept on dissemination of medical knowledge. It offers participants the possibility to compare interactively their own and their peers' performance with their competence and with accepted guidelines within a web-based Audit-Cycle. The participants can discuss the evidence-based recommendations which are offered. In addition, changes in behavior and care can be documented objectively.

Asthma↗
PubMed2000

Doctor-patient communication in different European health care systems: relevance and performance from the patients' perspective.

Our aim is to investigate differences between European health care systems in the importance attached by patients to different aspects of doctor-patient communication and the GPs' performance of these aspects, both being from the patients' perspective. 3658 patients of 190 GPs in six European countries (Netherlands, Spain, United Kingdom, Belgium, Germany, Switzerland) completed pre- and post-visit questionnaires about relevance and performance of doctor-patient communication. Data were analyzed by variance analysis and by multilevel analysis. In the non-gatekeeping countries, patients considered both biomedical and psychosocial communication aspects to be more important than the patients in the gatekeeping countries. Similarly, in the patients' perception, the non-gatekeeping GPs dealt with these aspects more often. Patient characteristics (gender, age, education, psychosocial problems, bad health, depressive feelings, GPs' assessment of psychosocial background) showed many relationships. Of the GP characteristics, only the GPs' psychosocial diagnosis was associated with patient-reported psychosocial relevance and performance. Talking about biomedical issues was more important for the patients than talking about psychosocial issues, unless the patients presented psychosocial problems to the GP. Discrepancies between relevance and performance were apparent, especially with respect to biomedical aspects. The implications for health policy and for general practitioners are discussed.

Adolescent↗
PubMed1978

Stereological study of the zona fasciculata of the adrenal cortex in stress situations (hypothermia, catabolism).

The ultrastructure of the rat fasciculata cells in stress situations, such as catabolism and hypothermia was compared descriptively and quantitatively by stereological methods with that of the nonstimulated rat fasciculata cell. The volume and surface densities are expressed per cm3 of cytoplasm, mitochondria and smooth endoplasmic reticulum. Furthermore, absolute values are given. In both stress situations the volume density of the mitochondria compared to the controls is enlarged significantly (H: 37% CA: 50%). The significant increase of the average single mitochondrium of the fasciculata cell (H: 58% CA: 58%) shows a real growth of the mitochondria in these stress situations. Also the surface density of the mitochondrial inner membranes--the mitochondrial enzymes for steroid genesis are partly located in these membranes--shows a significant increase (H: 31%, CA: 84%). Whereas the volume density of the smooth endoplasmic reticulum remains unchanged, the surface density is significantly raised (H: 44%, CA: 60%). An attempt was made to draw up a relationship between stereological and known biochemical data of steroid genesis within the fasciculata cell. An activation in both stress situations could be observed. The stereological data reflect a subcellular reaction pattern, which is similar to exogenous ACTH administration, thus indicating an endogenous ACTH liberation due to these stress conditions.

Adrenal Cortex↗