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Biomedical subjects

S Barnoon

Publications and source records attributed to S Barnoon.

8 recordsLinked to original sources
PubMed1990

Social class differences in coping with a physicians' strike in Israel.

The 1983 physicians' strike in Israel lasted 118 days. Striking physicians established alternative medical care centers (ACC) providing primary and specialized medical care on a fee for service basis. This contrasted with the usual pre-paid health insurance system, and provides an interesting natural experiment in health care services. Hospital emergency rooms remained open during the strike. Thus, primary medical care was available in these two settings. This paper compares people of different educational levels as they experienced and adapted to this strike with regard to their expressed need for physicians, their health behavior and outcomes in terms of patterns of utilization of the two services, financial expenses, satisfaction with the ACC's and perceived damage to health caused by the strike. The data were extracted from 719 self-administered questionnaires which were distributed in 14 primary care clinics and among university employees. The results show that the groups with lower levels of education, as compared to groups with higher education levels, reported more need for physicians' care and more damage to health. They were, however, less critical of the parties involved in the strike. When urgent need was reported, all respondents behaved similarly; however, people of lower social classes reported less satisfaction and perceived more damage. In non-urgent need conditions, although lower class respondents had higher utilization rates and higher expenses, they achieved no better results than the higher classes. It is suggested that due to a relative lack of psychological, social and financial resources, people of lower socio-economic classes cope less effectively with sudden changes in the provision of health services.

Adaptation, Psychological↗
PubMed1987

Perceived health damages during a physicians' strike in Israel.

This study analyzed the relationship between perceived need for health services and perceived damages to the health of the public due to curtailment of medical services during a physicians' strike. A model describing this relationship was hypothesized and tested in one city in Israel during the course of the strike. Results indicated that significant damage was perceived by the public as a result of the strike, a perception that persisted despite utilization of alternative care centers set up by the strikers. Furthermore, it was shown that financially weaker segments of the population were more likely to perceive damages to their health during a strike than were the more affluent segments of society.

Adolescent↗
PubMed1985

Comparative study of costs and quality of life of chronic ambulatory peritoneal dialysis and hemodialysis patients in Israel.

The more widespread use of chronic ambulatory peritoneal dialysis (CAPD) as an alternative to hemodialysis (HD) has focused attention on costs and quality of life aspects of different dialysis modalities. Costs for hospital HD exceed $23,000 annually, while CAPD annual costs are near $10,500 and home HD about $9,000. There are additional initial costs incurred during the first year of treatment, which range from under $2,000 for hospital-based HD and CAPD to over $11,000 for home HD. Quality of life aspects were compared for CAPD and hospital HD patients. Forty-six CAPD patients and 208 hospital HD patients were interviewed regarding ability to work, performance of physical activity, quality of sleep and sexual activity. The two patient groups were similar demographically (age, sex, origin and level of education). There were no statistically significant differences between the two patient groups for each of the quality of life variables, although CAPD patients showed slightly better results.

Adolescent↗
PubMed1982

A required course in decision-making for preclinical medical students.

Objectives, methods of instruction, and evaluation of a preclinical course in decision-making are described in this article. One set of objectives that related to learning to read and write clinical algorithms was taught by having students read a clinical algorithm about a problem, solve a patient management problem about the problem, and write an algorithm. A second set of objectives that related to learning clinical decision analysis was taught by solving problems and discussing them. Three methods used to evaluate three classes showed the following results: large increases in taped interview problem (TIP) scores after learning algorithms, high mean scores on a final examination that tested all course objectives, and high voluntary class attendance. It is concluded that preclinical medical students can be taught cognitive decision-making skills, that the TIP is a promising tool for measuring such skills, and that careful monitoring of a course in clinical decision-making may provide valuable information regarding learning and teaching technical clinical management.

Curriculum↗
PubMed1979

Reliability of the middle ear examination.

Interobserver reliability of physical signs elicited and diagnoses made on middle ear examination were studied. Effect on reliability of variation in observer knowledge, patient age and instrument were defined. Two board-certified, color-seeing pediatric specialists who worked in the same clinic examined consecutively 350 ears with the same otoscope for each case. Over a period of four months, four different otoscopes were used to examine at least 50 ears with each. The following groups of findings were graded independently by the pediatrician according to pre-set criteria: color, landmarks and light reflex. Diagnosis was also recorded. At no time did the observers discuss their findings or diagnoses. Degree of interobserver agreement was expressed by the reliability coefficient (values given below) and the K coefficient. Overall agreement on findings ranged from 0.50 for landmarks to 0.85 for air-fluid level. Overall agreement for diagnoses was 0.72. Specific agreement on physical findings ranged from 0.0 for presence of air-fluid level to 0.85 for absence of air-fluid level. Specific agreement on diagnoses ranged from 0.08 on serous otitis to 0.56 on otitis media and 0.61 on normal. After the age of one year, agreement did not increase with age. Agreement did not change significantly with different instruments or as the study progressed. We concluded that equivalence of observer knowledge strongly increases agreement, while patient age less than one year decreases agreement, and type of instrument does not affect agreement. Clinicians should be trained to recognized middle ear signs and diagnoses according to specified criteria to maximize interobserver agreement.

Age Factors↗