Teaching internal medicine in the community.

Background: Teaching Internal Medicine is mainly hospital-based. Chronic diseases are treated mostly in community-based ambulatory care. This study describes our experience during the first year of teaching Internal Medicine in the community, with a focus on chronic disease management.

Patients' perceptions of radical prostatectomy for localized prostate cancer: a qualitative study.

Background: Radical prostatectomy is one option for treating localized prostate cancer, but it can cause functional impairment of the urogenital system.

Objectives: To describe the outcomes of radical prostatectomy as perceived by the patients, and their ways of coping with them.

Methods: We conducted a qualitative study of 22 men with localized prostatic cancer 1 year after surgery.

Acute cough: the use of antibiotics and health care services in an urban health centre in Israel.

Background: Acute cough, often caused by a viral respiratory infection, is a common symptom in primary care. Although clinical guidelines recommend symptomatic treatment for acute cough, antibiotics are frequently prescribed.

Objective: To determine antibiotic prescribing for acute cough at the initial consultation and to follow subsequent medical consultations and use of medications.

Rehabilitation of elderly patients in the community following surgery for hip fracture - utilization of personal and health care services.

Purpose: To assess the change in utilization of personal and health care services following surgery for hip fracture in elderly patients rehabilitated in the community.

Methods: A descriptive study of patients hospitalized in the orthopedic surgery ward for traumatic hip fracture. The first interview took place after surgery and included functional and medical data, and details on utilization of personal and health care services in the month prior to surgery.

Factors associated with hypertensive patients' compliance with recommended lifestyle behaviors.

Background: A crucial element in controlling blood pressure is non-pharmaceutical treatment. However, only a few studies specifically address the question of hypertensive patients' compliance with physicians' recommendations for a healthy lifestyle.

Objectives: To explore factors associated with hypertensive patients' compliance with lifestyle recommendations regarding physical activity, smoking cessation and proper diet.

[How family physicians estimate their knowledge and skills in musculoskeletal problems?].

Unlabelled: Musculoskeletal conditions are common reasons for consultation in primary care and constitute 14-28% of primary care visits and visits to emergency services. General practitioners [GP] diagnose and treat the majority of patients with musculoskeletal problems. Surveys conducted confirmed the discrepancy between the number of GP musculoskeLetal consultations and the amount of time spent on orthopedic and musculoskeletal teaching in undergraduate and postgraduate education in different countries.

The effect of low back pain on work absenteeism among soldiers on active service.

Study Design: A prospective longitudinal study.

Objective: To identify factors that influence absenteeism among soldiers with acute low back pain (ALBP).

Summary Of Background Data: Recommendations for the treatment of low back pain include continuing physical activity.

Differences in cardiovascular disease risk factor management in primary care by sex of physician and patient.

Purpose: The purpose of this study was to evaluate differences in the management of cardiovascular disease (CVD) risk factors based upon the sex of the patient and physician and their interaction in primary care practice.

Methods: We evaluated CVD risk factor management in 4,195 patients cared for by 39 male and 16 female primary care physicians in 30 practices in southeastern New England.

Results: Many of the sex-based differences in CVD risk factor management on crude analysis are lost once adjusted for confounding factors found at the level of the patient, physician, and practice.

Teamwork in treating diabetes and hypertension in Israeli managed care organizations.

Purpose: This article aims to analyze existing and preferred labor divisions between physicians and nurses treating patients with hypertension and diabetes in managed care organizations.

Design/methodology/approach: A mail survey was conducted in 2002/2003 among a representative sample of 743 physicians employed by Israel's largest managed care health plans (78 percent response rate). A telephone survey among a representative sample of 1,369 hypertensive or diabetic patients (77 percent response rate) was also used.

[Screening for domestic violence in primary care setting].

Objective: To assess the dimensions of the problem of domestic violence among patients in primary care practice. The study also aimed to examine the various kinds of violence and what family physicians know about the subject as it pertains to their patients.

Methods: A detailed questionnaire was distributed, randomly and without any pre-selection process, to patients over the age of 18 as they sat in the waiting room of their family doctor's clinic.

Thirty years of family medicine publications in Israel (1975-2004): what, where, and how much?

Background: Departments of family medicine in Israel were established in the 1970s. Until now, little or no effort has been made to characterize the productivity of Israeli board-certified family medicine physicians in publishing peer-reviewed scientific articles.

Methods: Publications were identified by 2 methods.

Determinants of quality of life in primary care patients with diabetes: implications for social workers.

Using a cross-sectional design of 400 primary care patients with diabetes, the authors evaluated demographics, health status, subjective health and mental health, health behaviors, health beliefs, knowledge of diabetes treatment, satisfaction with medical care, and quality of medical care as potential predictors of QoL and QoL in the hypothetical absence of diabetes. Those who reported difficulties meeting basic needs, diabetes-related complications, worse subjective health, and dissatisfaction with medical care were more likely to report worse QoL. Those who reported difficulties meeting basic needs, higher cholesterol level, and worse subjective health also were more likely to report better QoL in the hypothetical absence of diabetes.

Implementing QA programs in managed care health plans: factors contributing to success.

Purpose: The purpose of this paper is to identify the factors that contribute to the success or failure of quality assurance programs implemented by Israeli managed care health plans.

Design/methodology/approach: An in-depth study of seven quality assurance programs was conducted, comparing successful with unsuccessful ones using the comparative "case study" method. Employing a semi-structured questionnaire, 42 program directors and professionals in the field were interviewed.

Primary care physicians' discussion of emotional distress and patient satisfaction.

Objectives: To assess: a) the prevalence and determinants of self-reported emotional distress in the Israeli population; b) the rate of self-reported discussion of emotional distress with family physicians; and c) the association between such discussions and patient satisfaction with care.

Design: Retrospective, cross-sectional survey that was conducted through structured telephone interviews in Hebrew, Arabic, and Russian. This study was part of a larger study assessing patients' perceptions of the quality of health services.

The association between inquiry about emotional distress and women's satisfaction with their family physician: findings from a national survey.

Background: Women appear to be more vulnerable than men to emotional distress (ED) However, ED often goes unrecognized by family physicians.

Purpose: To (1) assess the rate of inquiry about ED by family physicians and (2) explore the association between physician's inquiry about ED and women's satisfaction with care.

Methods: Telephone interviews were conducted in 2003 using a structured questionnaire in a representative sample of 991 Israeli women aged 22 years or older, with a response rate of 84%.

The effect of commitment to the organization on physicians' familiarity with guidelines for diabetes in managed care organizations.

Despite continuous efforts, healthcare organizations still find it difficult to influence physicians to follow clinical guidelines. Previous studies have not taken into account the organizational context of the physicians' practice. We conducted a survey of a representative sample of 743 primary care physicians employed in Israel's 2 largest managed care health plans.

Physicians' ability to influence the life-style behaviors of diabetic patients: implications for social work.

Diabetes is aggravated by a sedentary lifestyle, obesity and smoking. Based on a theoretical model relating attitudes and behavior, this study examined the association between physicians' self efficacy in counseling diabetic patients on life style behaviors and their counseling practices. Data were gathered from a representative sample of 743 primary care physicians in Israel's two largest health plans.

Correlates of quality of life in primary care patients with hypertension.

Background: Hypertension has been associated with lower levels of quality of life (QoL). However, the specific correlates of lower QoL in this patient population have remained largely unclear.

Methods: A cross-sectional design of 1,125 primary care patients with hypertension.

Antibiotic consumption successfully reduced by a community intervention program.

Background: The association between antibiotic use in the community and antimicrobial resistance is known. Attention has recently focused on the type of agents being prescribed.

Objectives: To implement, evaluate and compare the efficacy of two community intervention programs--continuous versus seasonal medical education--oriented to primary care physicians with emphasis on the appropriate use of antimicrobial drugs.

Factors affecting primary care physicians' perceptions of health system reform in Israel: professional autonomy versus organizational affiliation.

This paper examines primary care physicians' perceptions of a National Health Insurance Law that introduced managed competition into Israel's health care system, and the factors affecting their perceptions. Between April and July 1997, we conducted a mail survey of primary care physicians employed by Israel's four health plans (which are managed care organizations). Eight hundred questionnaires were returned, representing a response rate of 86%.

Health counseling for women in the absence of financial barriers: comparing reported counseling rates of women in the United States and Israel.

This study compares rates of health counseling for women in the United States and Israel and identifies factors affecting counseling rates, based on a weighted sample of 2,257 US and 848 Israeli women. In both countries, fewer than half of the women reported speaking with a physician about any of a set of preventive counseling topics (e.g.

The effect of postpartum depression on women's consultations with physicians.

Background: Postpartum depression is a well-known phenomenon that occurs in about 10% of births and affects the quality of life of the mother as well as the family. As in other cases of depression, under-diagnosis of PPD may keep patients from getting proper care and increase their physical and emotional distress.

Objectives: To identify patients with PPD and to describe their consultation patterns with primary care physicians for themselves and their babies.

Gender differences in time spent during direct observation of doctor-patient encounters.

Background: Despite increasing recognition of women's health needs, little is known about how primary care physicians spend time with women. Therefore, we examined differences in time use and preventive service delivery during outpatient visits by male and female patients.

Methods: As part of a multimethod study of 138 family physicians, 3384 outpatient visits by adults were directly observed, medical records were reviewed, and patient surveys were performed.

[Knowledge and attitudes among women in the Arab village regarding contraception and family planning and the reasons for having numerous children].

Background: Families with numerous children (5 or more) are a common phenomenon in the Arab sector in Israel. Whereas the fertility rate of Jewish women is 2.6, Muslim women have a rate of 4.