Vending machines and the self-care concept.

PIP: For the past 3 years (1980-83), students at the University of Rochester in Rochester, New York, have had 24-hour access to a vending machine which dispenses over the counter medicines and contraceptives. The machine is located in a small health facility near the undergraduate residence halls. The health facility is staffed by a registered nurse who provides treatment for minor illnesses, health education information, and referrals to the university's medical center. The facility stresses self-care, and a bulletin board located near the vending machine provides numerous health education brochures. The vending machine program represents a continuation of the emphasis on self-care. Instead of fostering dependency on the nursing staff the vending machine helps the students become self-reliant in reference to assessing their own health needs. Items dispensed by the machine include condoms, condoms and foam, aspirin, Sudafed, Robitussin, Acetaminiphen, Chlortrimeton, Cepacol, bandages, and thermometers. The items are sold to the students at cost. Condoms are the most popular item, and in 1982-83, 404 condom packages, priced at US$.50, were sold. Students who know what kind of medicine or health aid they want no longer are required to obtain these items by visiting the nursing staff. The image of the nurses at the facility is no longer that of a dispenser of over the counter drugs but that of someone who provides counseling, health education, and referrals. A survey conducted in 1983 revealed that the majority of the student body knew about the vending machine. This awareness reached 100% among senior class males. The purpose of the vending machine project is to make nonprescription medicines readily available to students, to make contraceptives available on a 24-hour basis, and to emphasize that the primary role of the facility's nursing staff is to provide education, counseling, and referral services.^ieng

Absence of the booster phenomenon in serial tuberculin skin testing.

The Center for Disease has recently recommended that tuberculin skin testing of new hospital employees be done in two steps because of the so-called "booster phenomenon." To assess the feasibility of the two-step method in our hospital, we performed a pilot study using this method on all our new hospital employees during a 6-month period. From July 1, 1980, to December 31, 1980, all newly hired employees of the Strong Memorial Hospital were given a two-step tuberculin skin test as part of their preemployment health evaluation. During this time, 571 new employees were tested, 416 (73%) of whom completed both steps. The mean age of the 416 employees was 26 yr. Fourteen of 448 employees (3.1%) had positive reactions on the first test. None of the 416 employees had positive reactions on the second test. Additional visits for skin test administration, costs of informational materials, administrative expenses, and supplies added approximately $2,600 to the costs of our tuberculin skin testing program during the study period. The absence of the booster phenomenon in our employee population may be due to (1) the relatively young age of our hospital employee population who may be less likely to have remote infection with Mycobacterium tuberculosis and/or (2) the relatively uncommon occurrence of nontuberculous mycobacterial infection in our area of the country. Depending on the age of employees of an institution and its geographic location, the two-step method may not detect any additional reactors. We recommend that hospitals contemplating adoption of this method first perform a similar pilot study in order to assess the frequency of the booster phenomenon in their employee populations.