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National action plan to combat multidrug-resistant tuberculosis.

At no time in recent history has tuberculosis (TB) been as great a concern as it is today. TB cases are on the increase, and the most serious aspect of the problem is the recent occurrence of outbreaks of multidrug-resistant (MDR) TB, which pose an urgent public health problem and require rapid intervention. A Task Force composed of representatives of many federal agencies has developed a National Action Plan for addressing this problem. The Task Force identified a number of objectives to be met if MDR-TB is to be successfully combatted. These objectives fall under the categories of a) surveillance and epidemiology--determining the magnitude and nature of the problem; b) laboratory diagnosis--improving the rapidity, sensitivity, and reliability of diagnostic methods for MDR-TB; c) patient management--effectively managing patients who have MDR-TB and preventing patients with drug-susceptible TB from developing drug-resistant disease; d) screening and preventive therapy--identifying persons who are infected with or at risk of developing MDR-TB and preventing them from developing clinically active TB; e) infection control--minimizing the risk of transmission of MDR-TB to patients, workers, and others in institutional settings; f) outbreak control; g) program evaluation--ensuring that TB programs are effective in managing patients and preventing MDR-TB; h) information dissemination/training and education; and i) research to provide new, more effective tools with which to combat MDR-TB. The Action Plan lays out a series of activities to be undertaken at the national level. For each category, the Plan presents statements of problems to be overcome, followed by a summary of the objective to be achieved and steps to be carried out. For each implementation step, responsibility is assigned to the appropriate organization and start-up dates are listed.

Antitubercular Agents↗

A Disordered Eating Response Team's Effect on Nutrition Practices in College Athletes.

The disordered eating response team developed a protocol for assessment and intervention for athletes who are identified as at risk for disordered eating. Team members included the team physician, athletic trainers, a dietitian with knowledge of sports nutrition, and a psychologist. Team members also developed education programs for coaches and athletic trainers, athletes, and dining services personnel regarding eating to support health and athletic performance. During the first year of the program, 12 athletes were referred to the disordered eating program. Evaluations from the education programs indicated that they were well received by all participants. Information considered to be most useful by the athletes included: high-carbohydrate vs high-fat foods (98%), timing of food intake (88%), and fluid needs (68%). Topics about which the athletes requested more information included: increasing lean body mass (70%) and foods to eat while traveling (55%). In response to the program(s), the athletes reported increasing intake of carbohydrate foods (100%), decreasing intake of caffeine-containing beverages (68%), and increasing dietary intake of iron and calcium (78% females). Our programs have improved athletes' knowledge of nutrition to support health and performance and have provided intervention for athletes at risk for disordered eating.

Journal Article↗

Hearing conservation: implementing and evaluating a program.

1. More than eight million workers in the United States are affected by some noise-induced hearing loss. Noise pollution is a significant health hazard in the workplace today. 2. Occupational health nurses are in a key position to make tremendous contributions to the effectiveness of a hearing conservation program. 3. Cooperative efforts between management and labor are needed to prevent noise-induced hearing loss. 4. A hearing conservation program is an effective instrument for preventing noise-induced occupational hearing loss, complying with governmental regulation, and controlling a company's compensation cost.

Audiometry↗