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Biomedical subjects

G Hamadeh

Publications and source records attributed to G Hamadeh.

14 recordsLinked to original sources
PubMed2001

The current status of Balint groups in US family practice residencies: A 10-year follow-up study, 1990-2000.

BACKGROUND AND OBJECTIVES: In 1990, the first and, to date, only objective study of Balint groups in US family practice residencies was conducted to measure their prevalence, composition, leadership, and function. The study reported here collected similar information about Balint groups. METHODS: Surveys were sent to all 464 US family practice residency program directors, with a 1-month follow-up to nonrespondents. The survey included questions about the existence, leadership, meeting frequency, and objectives of Balint training. RESULTS: A total of 298 (64%) residencies responded. Almost half (48%) of US responding residences reported conducting Balint groups, and 40% of those residencies have more than one group. The frequency of Balint group meetings has shifted in the past 10 years. In 1990, 55% of groups met weekly; in 2000, only 15% of groups met weekly. Sixty-five percent of residencies require Balint participation. One third of Balint groups are conducted without a coleader and the number of physicians leading groups is 22%, a decrease of 10% from 10 years ago. Forty-four percent of groups are led by psychologists, an increase of 19% from 10 years ago. Respondents indicated uncertainly about whether their groups were true Balint groups or simply resident support groups. CONCLUSIONS: About half of US family practice residencies operate groups described as Balint groups. They meet less frequently then 10 years ago and are less likely to have a physician involved in group leadership. Some of the groups may actually be support groups rather than Balint groups.

Clinical Competence↗
PubMed2000

Automation of practice management in a Lebanese University Health Clinic.

Interest in technology and the recognition that clinical practice analysis data is crucial for planning have stimulated the development of information management solutions at all levels in developing countries. The spectrum of such endeavors remains restrained due to the limitations in human resources skills. This paper describes an inexpensive operation for automating practice analysis in a Lebanese University Health Clinic. The system was developed in piecemeal fashion to accommodate the needs of the staff and their computer expertise. It demonstrates the impact of such automation on patient care, including missing medical records, appointment scheduling, referral rates, and repeat prescriptions.

Database Management Systems↗
PubMed1999

Quality of diabetes care in a university health center in Lebanon.

OBJECTIVE: To assess the quality of care provided to diabetic patients by family physicians in a university health clinic, using measures of glycemic and cardiovascular risk control as well as documentation of and adherence to World Health Organization (WHO) guidelines for diabetes primary care. DESIGN: Chart review of the previous year's medical notes for all identified diabetics in the practice over 2.5 years. RESULTS: Two-hundred and four diabetic patients were identified, with an estimated prevalence of 4.1%. The majority was type II diabetics, on oral hypoglycemic agents. Glycosylated hemoglobin was documented in 39.7% of patients, fasting plasma glucose in 99%, cholesterol in 93.1%, triglycerides in 91.2% and blood pressure in 85.8%; optimal control of these indicators was noted in 28.4%, 17.8%, 34%, 29.6% and 55.4% respectively. Fifty percent of the diabetics were referred for retinal checks. Physicians documented the presence of nephropathy in 46.8% and neuropathy in 59.6%; however, they documented patient instruction on foot care, diet, exercise and diabetes self-care poorly. CONCLUSION: There is a need for interventions to improve management and documentation in diabetes care in order to achieve early detection and prevention of complications. Developing a protocol for the clinic based on standard guidelines, and the use of flow sheets may be helpful in improving these intermediate indicators of quality of care.

Adult↗
PubMed1995

Postpartum fever.

Postpartum fever is a common obstetric complication. It often results from endometritis but can also be caused by urinary tract infection, would infection or phlebitis. The rate of endometritis is higher among patients who have a cesarean delivery, compared with those who have a vaginal delivery. Postpartum febrile episodes in which temperatures are less than 38.4 degrees C (101.1 degrees F) often resolve without intervention, especially when they occur in the first 24 hours after delivery. Treatment options for patients whose febrile episodes do not resolve spontaneously or are higher than 38.7 degrees C (101.6 degrees F) during the first 24 hours or higher than 38.0 degrees C (100.4 degrees F) on any two of the first 10 days postpartum include administration of antibiotics with specific activity against anaerobic bacteria. Additional diagnostic modalities, such as computed tomography, ultrasonography, heparin administration and surgical exploration, should be employed when the patient fails to respond to antibiotic therapy.

Algorithms↗
PubMed1995

Implementation and evaluation of a computer-based preventive services system.

BACKGROUND AND OBJECTIVES: Insufficient attention has been paid to the role that modern information systems can play in improving the delivery of and education about preventive services in family medicine training and practice sites. From September 1990-September 1993, the Department of Family Medicine at the Medical University of South Carolina conducted a demonstration project designed to develop, implement, and evaluate a comprehensive, computer-based preventive services delivery and educational system, based on the recommendations in the US Preventive Services Task Force (USPSTF) Report. METHODS: A computer-based patient record (CPR) system was implemented. The system had sophisticated preventive services tracking and reminder, physician, and patient education features. Twenty-nine basic USPSTF recommendations were incorporated in the system. An extensive physician education series was also implemented. A multi-method evaluation system, including patient exit surveys, physician interviews, and practice audits was used to evaluate and design improvements to the CPR and education systems. RESULTS: Although the system initially had no effect on patient perceptions about the frequency of preventive services delivery, there was reasonable concordance between patient desires and physician behavior for the discussion of preventive services (Kappa = .5 to .6). Physician acceptance of the system was good--in 1992, 30% of physicians used the preventive services reminders in most of their patient visits, and in 1993, 88% of physicians reported more frequent use. Practice audits from February 1992-July 1993 showed increased adherence with all seven counseling services, 10 of 15 screening services, and one of five immunization services. CONCLUSIONS: A CPR-based preventive services system coupled with an adaptable physician education about and delivery of preventive services. an ideal solution to improving the education about and delivery of preventive services.

Adolescent↗
PubMed1993

Introducing the Objective Structured Clinical Examination to a family practice residency program.

BACKGROUND: The Objective Structured Clinical Examination (OSCE) is a multiple station examination where examinees are expected to demonstrate mastery of a competency within a specified time at each station. It is commonly used to evaluate medical students and is less often used in residency programs. This paper describes the process of introducing a 12-station OSCE to a university-based family practice residency program. METHODS: The examination evaluated cognitive, psychomotor, and behavioral competencies in 31 residents. The 10-minute stations included: two simulated patients; two skills demonstrations; six modified essay questions, four in response to a written scenario and two in response to a video trigger; and two rest stations. Feedback was given in a large group at the conclusion of the examination. RESULTS: Construct validity was demonstrated by increasing scores with training year; concurrent validity was demonstrated by significant correlations of the OSCE scores with the American Board of Family Practice in-training examination scores and the residents' monthly rotation evaluation scores. Reliability was demonstrated by significant correlation between the scores of the OSCE and its subsets. CONCLUSIONS: As a method of formative evaluation, the OSCE had an overall positive response from residents and faculty.

Clinical Competence↗
PubMedDate not supplied

Survey of a Bekaa community health needs.

Rural underserved areas can benefit from private and non governmental organizations in improving health delivery. Many such organizations operate in the underserved Bekaa area in Lebanon. This study aimed to assess the nature, scope, utilization and satisfaction with health services available to the population living in the vicinity of the American University of Beirut Agricultural Research and Education Center in Bekaa. A random sample from the residents of the area (475 individuals) and all physicians and representatives of health delivery institutions serving this population were interviewed. Individuals interviewed reported 3.7 health related visits/person/year, 65% vaccination rate and 34.1% labeled available services as poor. Interviewed physicians and health institution administrators identified the study area priority needs as nurses, emergency transport units and primary care centers. Systematic evaluation and priority setting of the health needs of this population are necessary and the establishment of health centers should be strongly considered.

Adolescent↗
PubMedDate not supplied

Documentation of after-hours telephone contacts by family medicine residents.

It is not known how many of the telephone calls received by family medicine residents get documented in a retrievable form. This descriptive study attempted to answer this question by comparing a university telephone operator's logbook to the files of after-hours encounter slips kept in a university based family medicine training program. Over a period of 10 weeks, 38% of the calls recorded by the operator were documented by residents in a retrievable fashion. Second-year residents documented calls significantly more than third-year residents, and all residents kept better documentation on calls that concerned young children. Documentation varied significantly among individual residents but was not affected by the day or time of calls. These results suggest that having a system for recording after-hours telephone calls is not sufficient to ensure adequate documentation. Monitoring after-hours call records may provide a solution.

Adult↗