Tuberculosis (abbreviated to TB) is one of important global health hazards. Since 1993, World Health Organization (WHO) and International Union Against Tuberculosis and Lung Disease (IUATLD) have been conducting an all-out global wide campaign of integrated care for TB patients called Directly Observed Treatment Short-course (DOTS). DOTS was found to be most effective by WHO after trials in many countries with high prevalence of TB, and now it is highly recommended by WHO to all countries as a profound TB control strategy. World Bank has also made an assessment of DOTS and hails it a health investment of the highest cost benefit. DOTS is to take advantage of the watchful eyes of a trustworthy bystander to closely observe the process, ascertain that the patient would take each and every dose of prescribed TB medications, and thus make sure the patient would get cured. It is hoped to be able to spot and identify 75% of all smear positive TB patients and cure 85% among them.
For many years, both incidence and mortality rates of TB have stayed number ones among those of all notifiable communicable diseases in Taiwan. Taiwan health authority finally followed the WHO
recommendation and launched a DOTS trial program in certain mountainous rural areas in 1997, and phased into a gradual expansion in 2001 in accordance with the execution of then TB Control Year campaign. In April 2006 after the last batch of counties and cities of Taiwan joined in, a brand new
nationwide ?DOTS program? was born, in which special case carers were officially hired, and hopefully we would reach the DOTS goals set by WHO in the foreseeable future. The purpose of this study was to find out the DOTS program?s cost-effectiveness in two consecutive years, i.e. one year (2005/4/1-2006/3/31) immediately prior to the launch of the new DOTS program, and the one (2006/4/1-2007/3/31) that followed, through the expenditures for the implementation of the DOTS program, indices of therapeutic effectiveness in the two years, and at various stages of its implementation and a cost-benefit analysis of the treatments involved. The figures used in this study were mainly obtained from a Taiwan CDC database for registration of TB case notifications. The individual notified cases studied took place either in. There were 5679 notified TB cases studied. Meanwhile, we also got access to a Department of Health database of death causes and the relevant medical expenditure records from Central Regional Branch, Bureau of National Health Insurance (NHI) for necessary data using the ID number of the patient involved.
Our results indicate that during the specified two years, the age of new TB cases was still getting older, and more males turned out than females, but it seemed the program had but little influence on the
therapeutic outcomes. Fore instance, the accumulated treatment success rate one year after the initiation of the new program turned out to be 97%, somewhat improved from the rate (92.3%) in the previous year of the launch of the new program. In the aspect of mortality, the total mortality of the four counties/cities in the central region of Taiwan that died of TB one year after the implementation of the new program was 20.4%, which is clearly lower than that (22.4%) in the previous year. This indicates that the region?s total mortality did drop considerably due to the enforcing of the DOTS program. Aside from that, about the qualifying rate expressed by successfully changing from smear-positive to smear-negative within three months, there were 91.0% of all cases being successful one year after the activation of the new program, which was, as a whole, better than the 84.2% showing just one year before. Also, among all individual cases that have participated in the DOTS program, the successful changing rates were all better when covered by formal DOTS 95.0%,DOTS program .Overall speaking, to promote DOTS intervening measures turned out to be with a certain degree of positive cost effectiveness. Comparing the accomplishments of the four counties/cities of the central region of Taiwan, we found that Changsha County ranked number one and its success made it a model for the other three to learn from.
The purpose of this study is to understand the internet-using behavior of senior high school students in Taichung city, Taiwan. And this research is also to explore their present status of Internet addiction, the related impact factors, and the correlation between personal characteristics, the internet-using behavior, psychological traits and Internet addiction. Accordingly, it is expected to provide practical information for the counselors to make use of. This study is carried out in overall 14 senior high schools in Taichung city, by sampling 2 classes for the first grade in every schools. There are 1210 students required to answer questionnaires. Among these, 1110 samples are effective for the analyses. The data collection schemes include personal characteristics, the internet-using behavior of senior-high-school students, Chinese Internet Addiction Scale, Gordon Personal Inventory, and so on.
The primary findings are as follows:
Most senior high school students live at home, with their parents.
Most of their fathers are working in the service industry, the manufacturing industry, and the commerce.
Most of their mothers are housewives. Most of their parents graduates from senior high school, vocational school, and college. More than 50% of the students have their own personal computers. On average, they have used the Internet for 6.25 years;.they used the Internet for 7.68 hours a week. And they usually use the Internet at home. Web is the most frequently used modes. Chat rooms/Instant Message stands as second. The third is blog.
As to the Internet addicts, they use the Internet 17.8 hours a week. The time is longer than that of normal students. The Internet-addicted subjects spend much more time on Chat Rooms/Instant Message, News, on-line games, blog, and Discussion forum. Internet-addicted subjects had lower scores of responsibility and stability than those of general users. The Internet users? personal characteristics, including the gender of the students, the living status, the family structure,parents? education, parents?careers, and having their own personal computers show no variation. The tendency of the Internet addicts shows different variation for different internet-using behavior. As for the internet experience, the internet-using weekly hours,and the internet-using modes, such as web, Chat rooms/Instant Message, BBS, on-line games, blog, and Discussion forum, they show complete variation. Concerning Gordon Personal Inventory, the Internet addiction is significantly correlated with responsibility and emotional stability; but there is no significant correlation with ascendancy and sociability.
In addition, via the Multiple Regression Analysis, the students who have Internet-using experience and longer Internet-using weekly hours are more interested in the using internet modes such as Chat
rooms/Instant Message, and on-line games are irresponsible, have stronger tendency to become addicts.
