FAMILY MEDICINE

 

 

Publication Record

 

Adib, S., and G. Hamadeh. 1999. Attitudes of the Lebanese public regarding disclosure of serious illness. Journal of Medical Ethics 25 (5):399–403.

Akel, M., and G. Hamadeh. 1999. Quality of diabetes care in a university health center in Lebanon. International Journal for Quality in Health Care 11 (6):517–521.

Ammar, W., R. Hamadeh, Z. Abu-Shakra, and G. Hamadeh. 2000. The government health center role redefined: Cervical cancer screening in the Shouf area. Lebanese Medical Journal 48 (3):161–163.

Azar, S., S. C. Major, and B. Safief-Garabedian. 1999. Altered plasma levels of nerve growth factor (NGF) and transforming growth factor B (TGF B) in type-1 diabetes mellitus. Brain Behavior and Immunity 13 (4):361–366.

Azar, S., I. Salti, M. Zantout, and S. Major. 2000. Alterations in plasma transforming growth factor beta in normoalbuminuric type 1 and type 2 diabetic patients Journal of Clinical Endocrinology & Metabolism 85 (12):4680–4682.

Dakik H.A., and S. Alam. 2001. Myocardial Stunning Induced and Detected by Adenosine Stress Perfusion Imaging. J Nucl Cardiol 8:711–712.

 

Dakik H.A., S. Alam, and N. Timani. 2000. Resolution of perfusion defects with anti-ischemic medical therapy. J Nucl Cardiol 7:395-396.

 

Dakik,  H.A., S. Arnaout, M. Khoury, and M. Obeid. 2000. Cox-maze procedure for treatment of atrial flutter associated with an atrial septal defect. Clinical Cardiology 23:548–549.

 

Dakik H.A., and A. Nasrallah. 2001. Repeated doses of tissue plasminogen activator for failed thrombolysis. Heart Disease 3:362–364.

 

Dakik H.A., and M. S. Verani. 2000. Utilization of invasive and nuclear stress testing in patients with acute ischemic coronary syndromes in a large, urban, university-affiliated hospital. J Nucl Cardiol 7:328–732.

 

Gerbaka, B., R. Akatcherian, G. Hage, I. Melki, I. Nuwayhid, and B. Saab. 1999. Prevention of accidents on public roads in children in Lebanon. Archives of Pediatrics & Medicine.

Hamadeh, G. 2000. Automation of practice management in Lebanese University Health clinic. Topics in Health Information Management 20 (3):75–79.

 

Hamadeh, G., L. Dickerson, B. Saab, and S. Major. 2001. Common prescriptions in ambulatory care in Lebanon. The Annals of Pharmacotherapy 35 (5):636–640.

Hamadeh, G., B. Saab, S. Adib, and S. Mroueh. 2000. Recommendations for the school health physical examination in Lebanon. Lebanese Medical Journal 47 (6):333–338.

 

Jamal, N., B. Choucair, H. Khalil, and G. Hamadeh. 1999. Survey of a Bekaa community health needs. Lebanese Medical Journal 47 (1):13–17.

Lee J.R., Z. X. He, H. A. Dakik, and M. S. Verani. 2001. Myocardial perfusion and angiographic correlations in patients with ST-segment elevation during dobutamine stress perfusion imaging. J Nucl Cardiol 8:365–70.

 

Saab, B., J. Usta, and G. Hamadeh. 2000. Head restraint and seat belt use by car drivers in Lebanon. International Journal of Risk & Safety in Medicine.

Sawaya J.I., and H. A. Dakik. 2000. Angiographic visualization of an atrial myxoma. N Engl J Med 342:294–295.

 

 

 

Abstracts, Conferences, and Proceedings

 

Major, S. October 1999. Application of evidence based medicine in the undergraduate medical curriculum in family medicine. Annual Northeast Regional Meeting of the Society of Teachers of Family Medicine, Syracuse, New York, USA.

———. June 2000. Clinicians experiences counseling young adults seeking information and assistance in their sexual development. Sexuality in the Middle East, Oxford, UK.

Major, S., N. Pashayan, K. Kazanjian, A. F. Masri, R. Chidiak-Tannoury, I. Uthman, S. Atweh, and T. Arayssi. Practice patterns of Antiphospholipid syndrome Diagnosis at a Tertiary Teaching Hospital in Lebanon. Annals of Rheumatic Diseases 59 (1):183–184.

 

Major, S., and B. Saab. July 2000. Promoting excellence in doctor-patient communication: Experiences from predoctoral training in family practice. WONCA 2000, Vienna, Austria.

Heath, R. L., S. C. Major, O. Mahmasani, and B. A. Khoury. Individual Psychological constructs in the management of headache pain.44the annual scientific Meeting of the American Headache society, June 21 – 23, 2002, Seattle, Washington, USA. Published in Headache (details to follow).

 

Saab, B., S. Major, J. Usta, and U. Musharrafieh. July 2000. Promoting excellence in communication skills: Experience from a predoctoral program in family medicine. World Organization of Family Doctors. WONCA, Vienna, Austria.

Saab, B., J. Usta, and G. Hamadeh. February 2000. The head rest: The unrecognized safety item. Fifth World Conference on Injury Prevention and Control, New Delhi, India.

Saab, B., J. Usta, G. Hamadeh, and N. Kanaan. August 2000. A postgraduate continuous educational program in remote areas in Lebanon. Fourth World Rural Health Conference, Calgery, Canada.

 

Saab, B., J. Usta, S. Major, and U. Musharrafieh. May 2001. Communication skills: From movie theatres to medical circles. 16th World Congress of Family Doctors, Durban, South Africa.

Saab, B., J. Usta, U. Musharaffieh, and S. Major. May 2001. Communication skills: A video companion to physicians and medical students. XXXVIth Middle East Medical Assembly, Beirut, Lebanon.

———. May 2001. Teaching communication skills: A companion for teachers and learners. MEMA, Beirut, Lebanon.

 

 

Research Projects

 

Design of a health information system for district health management

Design of software to be used by Ministry of Public Health cada physicians for management of their districts. The project reviewed work patterns of the cada physician and trained groups on data collection and report generation using software the developed software. Hamadeh, G.


Supported by World Health Organization
Completed or in progress at the Ministry of Public Health

 

Developing clinical practice guidelines for use in primary health care centers in Lebanon

Adapting international clinical guidelines in primary care by using consensus techniques. A team of Family Physicians collaborated in reviewing and summarizing guidelines then building consensus on their use with Lebanese Order of Physicians specialty committees and with general practitioners practicing in the Ministry of Public Health primary care centers. G. Hamadeh.


Supported by the Ministry of Public Health
Completed or in progress at the Ministry of Public Health and AUB

 

Prescription patterns in primary care in Lebanon

Prescription study with costing and prescribed drug dosages (PDD) derived from prospective data collection over one year, and correlation with medical diagnoses in a defined service population at the Univeristy Health Services, AUB. Hamadeh, G., B. Saab, S. Major, M. Akel, M. Khogali, and S. Adib.

Supported by World Health Organization
Completed or in progress at AUB

 

The Peer Education Program at the American University of Beirut

 

The Peer Education Program at AUB is a result of a larger initiative begun by the Faculty of Health Sciences along with the Department of Family Medicine (the SIBER program) to promote the health of students on campus and to continue the process of making AUB a health promoting university. The overall goal of the program is to empower students to take a pro-active role in matters related to their health. It takes a holistic view of health to include physical, mental, and social well being (WHO, 1948).  The overall objectives of the Peer Education Program at AUB are:

1.       To raise the health consciousness of students at large on campus

2.       To provide students at large with knowledge, skills, and resources that can be used to sustain their good health

The mediators to achieve these objectives are trained peer educators/counselors.  The objective of the program as it specifically relates to these persons is to provide them with the knowledge, skills, and methods to positively influence their peers

 

The Peer Education Program is hypothesized to be beneficial to the trained peers through an increase in (a) self esteem; (b) feelings of social usefulness, and (c) internal locus of control, (d) knowledge related to health issues; and an improvement in (i) confidence in communication, (ii) listening skills, (iii) skills for coping with stress, (iv) decision making skills, (v) conflict resolution skills, (vi) social support, and (vii) attitudes and behaviors related to health.

 

Furthermore, the Peer Education Program is hypothesized to be beneficial to the student body at large by improving their knowledge, attitudes, and behaviors related to their health broadly defined. Drs. Stella Major and Rima Afifi Soweid are currently evaluating the hypothesis of effect of the Peer Education Program on the trained peers.  P.I - Major, S. and R. Assad Swoeid.

 

Funding: Middle East Awards

Work ongoing at AUB

 

 

Designing Interventions to promote cessation of smoking on college campus using the Transtheoretical Model

 

SIBER project stands for (surveillance and intervention for behavioral risks.) It aims to assess health risk behaviors of college students, propose, implement and evaluate interventions.

 

Background: Smoking is a preventable risk to good health. The Transtheoretical model TM of change has been validated for smoking cessation interventions. Objectives: To describe smoking attitudes and behavior among Lebanese college entering students using the TM of Change, describe the significant components of the model for each stage, and propose stage specific concepts for smoking cessation and prevention programs on campus. Methods: Self-administered questionnaire completed by 43.5% of all entering students at the American University of Beirut in fall 1999. Results/Conclusions: 13.6% are current regular smokers, of whom 40%, 27.5%, 15%, 12.5% and 5% are in pre contemplation, contemplation, preparation, action and maintenance, respectively. We propose the following strategies to be included in stage-specific interventions on campus: For pre contemplators efforts towards reinforcing dramatic relief, self re evaluation and contingency management as well as promoting the belief that the smoker will be in better health if he/she quits smoking, and should entertain the thought of use of the money spent on buying cigarettes for other more enjoyable alternatives. For contemplators, special emphasis needs to be placed on making smokers feel confident that they can commit themselves to quitting. Across all stages efforts to improve perceived self-efficacy, and self-esteem are needed. Positive influences of peers and parents against smoking should be encouraged. Monitoring and evaluation of these interventions is needed. P.I- Major, S., R. Assad Swoeid, and M. Shediak-Rizkallah.

 

Funding: Middle East Awards

Work ongoing at AUB

 

 

 

Determining the Impact of Health Awareness Course on College Studentsf Health Related Attitude and Behavior: A Comparison Group Study

 

Background and Rational: Smoking, drug and alcohol abuse, violence, unsafe sex and poor dietary and exercise patterns are some risks adolescents face during the transition from childhood to adulthood. Intervening during adolescence provides an opportunity to prevent the onset of health damaging behaviors as well as change the existing ones. The Surveillance and Intervention for Behavioral Risk factors project assessed the health risk behaviors prevalent among Lebanese youth, specifically those at the AUB. Results suggest the need to develop effective interventions aimed at improving the student's health related knowledge, attitude and behaviors (K/A/B). One such intervention proposed was a health awareness course. A one-group pre test posttest evaluation of a health awareness course given in 2000-2001 revealed a positive impact on studentsf K/A/B.   However, absence of a comparison group and the small sample, limited the extent of confidence in the results.

 

Aims: We hypothesis that students taking the health awareness course will improve their knowledge, attitudes, and behaviors related to the health topics covered in that class as compared to similar students not enrolled in this particular class. Refine and test a survey instrument, which addresses K/A/B of a wider number of studentsf health risk behaviors. Determine the short and long-term influence of health awareness course on students who attended it vs. their matched controls. Determine whether this influence varies by demographic and social factors such as age, gender, socio-economic status, major, place of residence, social support, and extra-curricular activities. 

 

Methods: This is a pre test posttest comparison group design. All students in both sections of HBED 201,in February 2002 will be the intervention group. The comparison group will be from all other students who share same major as the intervention group and who match for age, sex, academic year, major and place of residence (off campus, on campus). The newly developed evaluation instrument will be administered to both groups, before the beginning of the course (O1), at the end of the semester (O2) during class time, and at six months and one year after the start of the course (O3 and O4) respectively by electronic mail. P.I- Major, S., R. Assad Swoeid, and F. El Kak.

 

Funding: Medical Practice Plan

 


 

 

Evaluating the role of Cognitive Constructs in The Treatment Of Headache using Mechanical Intervention

 

The aim of the study is to determine how cognitive factors changed when headache pain was controlled.  We administered self-efficacy, locus of control, somatization scales and the anxiety scales to 50 participants before and after a mechanical intervention— Migrend.  Overall, we found a statistically significant change in psychosocial factors such that post-intervention self-efficacy increased, anxiety decreased and somatization decreased.  However, the self-reported degree of pain relief did not correlate with any of the post-intervention psychosocial tests.  Our results suggested that Migrend might be as effective as pharmaceutical therapy. P.I- Heath, R., S. Major, O. Mahmasani, and B. Khoury.

 

Funding: Private funding by MIGREND

Work ongoing at AUB

 

 

Communication skills: A video companion for learners and teachers

The communication and relationship between doctors and patients has been given increased attention in recent years. Despite the remarkable advances in technology and diagnostic procedures, the medical interview remains the most valuable component in the clinical evaluation of a patient. In addition to its diagnostic usefulness, the medical interview is the foundation upon which the doctor-patient relationship is built. It is essential, then, that doctors and medical students be well-trained in interviewing skills. To accomplish this goal, several teaching methods have been used, including role-play, observing students as they conduct interviews and providing immediate feedback, and reviewing video-taped interviews.

The aim of this project is to come up with simulated video-tape interviews that can improve the interviewing behavior of medical students as well as their skills in communication with patients. The material obtained can thus be used as a teaching tool during training years in medical schools in Lebanon and other countries in the Arab world. Saab, B. J. Usta, S. Major, K. Ashkar, and U. Musharafieh. 

 

Supported by Lebanese National Research Council
Completed or in progress at AUB