Tuberculosis is the leading cause of infectious disease in Nepal. An estimated 60% of the adult population aged between 15-45 years is infected with tuberculosis, and 45% of the total population is infected. Ten percent of people infected with TB progress to active disease. To combat tuberculosis, Directly Observed Therapy (DOT) was adopted in Nepal in 1996. DOT was administered at four national demonstration sites in 1996 and expanded over time so that 56% of the population to date have been covered by DOT. This study aimed to evaluate DOT in pulmonary TB patients in Nepal in terms of patient outcome and compliance. DOT was compared against a conventional treatment program or self-administered therapy (SAT), which served as the control group. The project was a retrospective nonconcurrant cohort study. Patients were sputum positive pulmonary TB patients aged over 15 years from Bhaktapur district in Nepal, who had undergone DOT or SAT between 1996 and 1998. Medical records of all the patients were sent to the National TB Center in Thimi, Nepal. A total of 261 patients (DOT, 161 patients and SAT, 100 patients) were included in the study. The two groups were similar in terms of age, ethnicity, and religion status. The cure rate was 86.3% for DOT, which was significantly higher than the 75.0% for the SAT group (p<0.05). The compliance rate was also higher for DOT at 90.2% versus 81.8% for the SAT group (p<0.05). The mean treatment length was 6.8 months for the SAT group and 7.4 months for the DOT group (p<0.05). Higher rates of treatment compliance and cure rate were achieved in the DOT group versus the SAT group. Thus, DOT is advocated as a means of ensuring greater TB program success.

The purpose of this study is to assess the efficacy of violence prevention programs on the attitudes toward guns and violence among students in grades three through seven. This study represents an attempt to prove that third through sixth grade students who receive anger control training and seventh grade students who receive conflict resolution training will show a significantly lower attraction towards guns and violence than students receiving no such training. By understanding interrelation between adolescents' attitudes towards guns and violence and their psychosocial functioning, the public can seek out ways of preventing violence. To measure the impact and to provide information about the program's strengths and weaknesses, the Attitudes toward Guns and Violence Questionnaire (AGVQ) was used. Analysis of Variance (ANOVA) was utilized to assess the differences in attitudes towards guns and violence between groups that participated in violence prevention programs and those who did not. Anger control training and conflict resolution training, as conducted in this manner and in this setting, did not lead to a significantly lower attraction towards guns and violence.

To measure attitudes toward justice in access to health care services in managed care plans in a convenience sample of medical professionals at Clark Memorial Hospital in Jeffersonville, Indiana. Methods. A sixteen item, self-administered instrument based on Morreim's four concepts of justice in health care access was administered to 147 health care professionals, representing physicians, allied health, and hospital administration. SPSS was used to analyze the results. Results. The attitudes of the respondents were negative toward managed care. They did not feel that managed care had been a positive development in the United States or that managed care had improved access to preventive care or improved primary care. On the survey instrument, respondents scored highest on the scale measuring fairness to individual patients. Conclusion. In a convenience sample of health care professionals at Clark Memorial Hospital in Jeffersonville, Indiana, equity in distributing access to health care among individual patient needs was found to more closely meet their expectations of justice in health care access. There were no differences found across occupational groups in their responses to the two scales. There were differences in attitudes toward managed care among occupational groups.

Due to the teenage pregnancy rates and the incidence of sexually transmitted diseases (STDs) that exist in today's society, it is very important for teenagers to be informed of the facts related to pregnancy and STDs and how to prevent them from occurring. With this knowledge, they are able to make informed decisions related to their sexual experiences. The prime opportunity for such sharing of information can be in schools. The purpose of this study is to determine if sex education in school influences the knowledge and behaviors of teenagers toward sexual behavior, pregnancy, and sexually transmitted diseases. This research used the framework of the Health Belief model developed by Nola Pender. A pretest/ posttest design was used. A questionnaire, developed by the investigator, was administered prior to an educational program and then again three months later. A convenience sample of 31 high school students in a family dynamics course was utilized after informed consent was obtained from the student and parents. The subjects ranged in age from 14 to 18 years and consisted of 25 females and 6 males. According to the pretest data obtained from the subjects, over half of the participants obtained most of the sexual information from their friends. Only 19.4% (6) of the students reported learning about sexual matters from school. The same percentage of 19.4% reported TV/Movies as their major source of information related to sexual matters. Twenty-three (74.2%) of the subjects claimed to have already had sexual intercourse. The average age at which the sexually active participants started having sex was 14 years old, with a range of 9 to 17 years of age. Participants reported having an average of 4 different sexual partners. Of those reporting whether or not they used condoms, 14 answered "yes" and 10 answered "no." The 14 item questionnaire was administered again three months after the intervention to determine any change in knowledge. Four of the items showed a statistically significant increase in the knowledge of the participants when analyzed by paired sample t-tests using an alpha level < 0.05. Although only four of the items demonstrated a significant increase in knowledge from pretest to posttest, these data, coupled with the subjects' reported behaviors, indicates a great need for factual sex education in this teenage population.

The purpose of this study was to address any changes in select organizational and director or CEO attributes between 1989 and 1994, as well as, to determine whether or not college student health services are systematically evaluating their programs and incorporating efficiency measures used in other health care settings. The population of study was student health services at four-year institutions of post-secondary education in the United States. This researcher resurveyed the sample used by Kevin E. Charles in 1989 in order to allow the evaluation of temporal trends. The sample was a stratified, random sample of 400 institutions. Data were collected via a mail survey. A questionnaire was mailed to student health service directors. The findings of this study revealed that significant changes have occurred in the organizational and leadership characteristics of Student Health Services. However, they do not appear to be restructuring or adapting quality/efficiency enhancements as rapidly as the health care industry.

Immunizations for vaccine preventable diseases are ordinarily completed by young adulthood, and the school system is typically the institution required to determine compliance with state immunization requirements prior to enrollment. In recent years, outbreaks of measles on college campuses across the United States have led to the implementation of immunization requirements. Kentucky fouryear postsecondary institutions are not required by state law to request proof of immunization. The purpose of this study was to assess prematriculation immunization policies of Kentucky four-year colleges and universities. Participants completed a survey which appraised the existence of a university prematriculation policy, the diseases covered by their policy, year of policy implementation, and university departments responsible for initiating the policy. In addition, participants were asked if immunizations are available on campus, which vaccinations are available, if an immunization policy had been considered and how recently, and feedback from students, parents and faculty/staff. The survey assessed the attitudes of the respondent regarding policy benefits/dislikes, need for state legislation, and institutional attitude toward governmental intervention of their policy making. Future research on this topic should address the following: the status of prematriculation immunization policies among Kentucky state postsecondary institutions from an epidemiological/public health perspective; explore in greater detail the reason(s) affecting the institutional decision to implement or abandon a prematriculation immunization requirement; investigate or survey the attitudes of students, parents, and faculty/staff toward vaccination programs; include attempts to interview in person a representative from institutions that did not respond to the mailed survey. Further investigation should be conducted; Kentucky four-year colleges and universities would benefit from additional research on vaccine preventable diseases among college students and information gathered from other states with regard to PMIR policies.

No description available.

No description available.

No description available.

No description available.