Biomedical subjects

Yacov Fogelman

Publications and source records attributed to Yacov Fogelman.

5 recordsLinked to original sources

PubMed2003

Somatization in response to undiagnosed obsessive compulsive disorder in a family.

BACKGROUND: Somatization is a common problem in primary care and often presents puzzling problems for the family physician. A family or contextual approach is often useful in investigating and treating refractory symptoms. CASE PRESENTATION: A 63 year-old patient presented to his family physician with recurrent episodes of syncope, weakness and various other somatic symptoms. Lengthy clinical investigations found no organic pathological findings but a brief family assessment by the family physician revealed that the patient's wife was the "hidden" patient. Successful treatment of the patient's wife led to full recovery for both. CONCLUSIONS: Exploration and treatment of the family context may often hold the key to the solution of difficult problems in somatizing patients.

Antidepressive Agents, Tricyclic↗

PubMed2003

Patient and family physician preferences for care and communication in the eventuality of anthrax terrorism.

BACKGROUND: The threat of bioterrorism consequent to the September 11, 2001 attack in the USA generated suggestions for improved medical response mainly through hospital preparedness. OBJECTIVES: The aim of the present study was to investigate the impact of this period of tension on patients' first choice for care and for receiving relevant information, and on primary care doctors' feelings of responsibility in the eventuality of an anthrax attack. METHODS: During October 11-31, 2001, 500 patients from 30 clinics throughout Israel were asked to complete a questionnaire on their awareness of the anthrax threat, measures taken to prepare for it, and preferred sources of care and information. Their 30 physicians, and an additional 20, completed a questionnaire on knowledge about anthrax and anthrax-related patient behaviours and clinic visits. RESULTS: The outstanding finding was the low rate (30%) of patients who chose the hospital emergency department as their first choice for care or information if they were worried about an anthrax attack or the media communicated that an attack was in progress. The other two-thirds preferred their family doctor or the health authorities. Most of the physicians (89%) felt it was their responsibility to treat anthrax-infected patients and that they should therefore be supplied with appropriate guidelines. CONCLUSION: This study suggests that in Israel, a country with a high degree of awareness of civil defence aspects, both patients and primary care doctors believe that family physicians should have a major role in the case of bioterrorist attacks. This must be seriously considered during formulation of relevant health services programmes.

Anthrax↗

PubMed2003

Prevalence of and change in the prescription of methylphenidate in Israel over a 2-year period.

INTRODUCTION: The use of methylphenidate for the treatment of attention deficit-hyperactivity disorder (ADHD) has increased dramatically in the past decade in some countries in Europe and North America. In response to a public debate in Israel, several Knesset members introduced a legislative initiative that aims to limit the prescription of methylphenidate by physicians. The objective of this study was to examine the rate methylphenidate prescriptions dispensed for the treatment of ADHD in children in northern and central Israel in 1999 and 2001. PATIENTS AND STUDY DESIGN: The population included all children aged 0-18 years living in central or northern Israel and insured by the largest national health management organisation who were prescribed methylphenidate at least once in 1999 or 2001. This was a population-based prevalence study comparing the two timepoints using data from the health management organisation and descriptive statistics. RESULTS: The overall 1-year prevalence of methylphenidate prescriptions dispensed to children was 1.01% in 1999 and 1.22% in 2001 (relative risk [RR] 1.21, 95% CI 1.15-1.26), an increase of 21%. Seventy-seven percent of those prescribed methylphenidate were boys. The prescription rate ranged from 0.2% (RR 1.24, 95% CI 0.76-2.05) in Arabic cities to 5.99% (RR 1.19, 95% CI 1.09-1.30) in kibbutzim; this wide variation by type of residence apparently involved cultural, racial and economic factors. CONCLUSION: Israel shows no unusual or unexpected patterns in methylphenidate prescriptions dispensed to children and a lesser increase over time than other developed countries. This suggests that limiting physician freedom to prescribe methylphenidate to children may not be justified.

Adolescent↗

PubMed2003

Josef.

Explore the source record for details and available documents.

Depression↗

PubMed2002

Increasing the satisfaction of general practitioners with continuing medical education programs: a method for quality improvement through increasing teacher-learner interaction.

BACKGROUND: Continuing medical education (CME) for general practitioners relies on specialist-based teaching methods in many settings. Formal lectures by specialists may not meet the learning needs of practitioners and may cause dissatisfaction with traditional CME. Increasing learner involvement in teaching programs may improve learner satisfaction. METHODS: A quality improvement program for CME for 18 general practitioners in the Tel Aviv region was designed as a result of dissatisfaction with traditional CME activities. A two-step strategy for change was developed. The CME participants first selected the study topics relevant to them from a needs assessment and prepared background material on the topics. In the second step, specialist teachers were invited to answer questions arising from the preparation of selected topics. Satisfaction with the traditional lecture program and the new participatory program were assessed by a questionnaire. The quality criteria included the relevance, importance and applicability of the CME topic chosen to the participant's practice, the clarity of the presentation and the effective use of teaching aids by the lecturer and the potential of the lecturer to serve as a consultant to the participant. RESULTS: The participatory model of CME significantly increased satisfaction with relevance, applicability and interest in CME topics compared to the traditional lecture format. CONCLUSIONS: Increased learner participation in the selection and preparation of CME topics, and increased interaction between CME teachers and learners results in increased satisfaction with teaching programs. Future study of the effect of this model on physician performance is required.

Consumer Behavior↗