scholarly journals Physicians’ attitude towards Cancer and Cancer Patients in Jose R Reyes Memorial Medical Center

2021 ◽  
Vol 5 (4) ◽  
pp. 307-314
Author(s):  
Deepak Sundar Shrestha ◽  
Sajani Manandhar ◽  
Rajendra Rijal ◽  
Corazon A Ngelangel
Keyword(s):  
Cancer Patients ◽  
Positive Attitude ◽  
Medical Center ◽  
Age Groups ◽  
Negative Attitude ◽  
Medical Specialty ◽  
Cross Sectional Study ◽  
Attitude Scale ◽  
Cross Sectional ◽  
Strongly Agree

Introduction: This study evaluates the attitude of physicians regarding cancer the disease and patients with cancer, which may influence their management allowing for recommendations of appropriate interventions.Methods: This is a cross-sectional study, which interviewed 251 physicians of Jose R Reyes Memorial Medical Center regarding their attitudes on cancer and cancer patients. The study also explored and identified factors associated with such attitudes. The validated modified Cancer Attitude Scale of Haley et al (1968, 1977) was used. Ordinal (proportional odds) regression via Stata was used to examine the association between independent and dependent variables. A score of 1 to 5 was given from strongly agree to strongly disagree for all 21 negatively affirmed questions and a score of 1 to 5 was given from strongly disagree to strongly agree for the 11 positively affirmed questions. The cut off levels to say positive or negative attitude was set as a median score of above 3 for each question representing positive attitude and score of below 3 representing negative attitude.Results: In general the overall attitude of physicians working in Jose R Reyes Memorial Medical Center towards cancer and cancer patients is positive. However the physicians are skeptical of the patient’s inner resource to cope with cancer. Expertise, years of practice (of more than 25 years), having experience with cancer patients, being active in religion, Filipino nationality and protecting oneself from carcinogens showed to be associated with positive attitude. Conclusion: The factors that affect physicians’ attitude towards cancer and cancer patients should be further explored with a larger and more representative population of physicians for a wider view of attitudes across age groups, clinical experience, religion, medical specialty among others; so that appropriate interventions may be devised to determine ways that can positively impact their perception. Hence, improving patient management. 

scholarly journals Self-reported awareness and attitude of cancer patients towards clinical nurse coordinators

2017 ◽  
Vol 7 (7) ◽  
pp. 95 ◽  
Author(s):  
Ahmad Deeb ◽  
Mohammad O. AlKaiyat ◽  
Emad Abu Hlal ◽  
Areej Attari ◽  
Rania Mahaireh ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Positive Attitude ◽  
Clinical Care ◽  
Negative Attitude ◽  
Patient Characteristics ◽  
Cross Sectional Study ◽  
Cancer Center ◽  
Cross Sectional ◽  
Clinical Nurse ◽  
Roles And Responsibilities

Background and objective: Lack of knowledge or poor perception towards the roles and responsibilities of clinical nurse coordinators among cancer patients might lead to a decrease in seeking their services. The objective of the study was to assess the knowledge, perception and attitude towards clinical nurse coordinators among cancer patients at a specialized cancer center in Jordan.Methods: This is a cross sectional study that was conducted by distributing a self-reported and anonymous survey to 240 cancer patients visiting the center. The survey questioned some patient characteristics such as sex, age, educational level, marital status, disease type and duration, type of therapy. The patients’ knowledge (12-statement), the perception (9-statement) regarding the actual roles/responsibilities of coordinators and the attitude (5-statement) towards seeking their services were measured. Responses on Likert scales were converted to percentage mean scores.Results: The overall percentage mean scores ± standard deviation of knowledge was 59 ± 17, perception towards clinical nurse coordinators (79 ± 14) and attitude towards seeking their services (69 ± 16). Linear regression showed that participants on chemotherapy had significantly better perception (higher scores) compared to participants on concurrent therapies (β = -3.91, p = .049). Participants with higher knowledge scores had better perception indicating a better comprehension about the clinical nurse coordinators’ roles, compared to those with lower knowledge percentage mean scores (β = 0.13, p = .019). Female patients had higher percentage mean score of attitude compared to male particpants (β = -3.77, p = .034). Better perception of Clinical nurse coordinators (CNCs) among cancer patients was significantly more associated with  a more positive attitude towards seeking CNC services (β = 0.72, p < .001).Conclusions: Patients’ knowledge about the roles and responsibilities of nurse coordinators is associated with a better patients’ perception towards coordinators, which in return is associated with a more positive attitude towards seeking their services. Special consideration should be paid for patients on concurrent therapies who were more likely to have poorer perception towards clinical care coordinators compared to patients on chemotherapy. In addition, coordinators are expected to observe a more negative attitude towards seeking their services among male cancer patients.

scholarly journals Positive Correlation Between General Public Knowledge and Attitudes Regarding COVID-19 Outbreak 1 Month After First Cases Reported in Indonesia

2020 ◽  
Vol 46 (1) ◽  
pp. 182-189 ◽  
Author(s):  
Dina Keumala Sari ◽  
Rina Amelia ◽  
Ridha Dharmajaya ◽  
Liza Meutia Sari ◽  
Nadya Keumala Fitri
Keyword(s):  
General Population ◽  
General Public ◽  
Positive Attitude ◽  
Descriptive Analysis ◽  
Negative Attitude ◽  
Cross Sectional Study ◽  
Good Knowledge ◽  
Prevention Measures ◽  
Cross Sectional ◽  
Knowledge And Attitudes

AbstractThe increasing number cases of coronavirus disease (COVID-19) infections in the general population in Indonesia raises questions concerning the public’s knowledge and attitudes regarding this pandemic. To determine the correlation between the general public’s knowledge and attitudes regarding the COVID-19 outbreak 1 month after the first cases were reported in Indonesia. This cross-sectional study was conducted between early March and the end of April 2020 in the general population of Indonesia, beginning with the North Sumatra region, where the spread of COVID-19 in Indonesia began. Questionnaires were randomly distributed online in the red zone in Indonesia. Data were collected by collecting people’s responses to the questionnaire, which were distributed via WhatsApp (WA) application and were competed independently by the participants. A descriptive analysis was conducted to describe the demographic characteristics, knowledge, and attitudes of the general population. A total of 201 people had good knowledge (98%) and a positive attitude (96%) regarding the COVID-19 pandemic. The respondents had a negative attitude in relation to two aspects of the COVID-19 outbreak: having to always maintain a distance of 1.5 m when in crowds, and not being able to regularly exercise or eat nutritious food (78.6% and 79.1%, respectively). Most people in Indonesia have good knowledge and a positive attitude regarding the COVID-19 pandemic. However, negative attitudes were still found in this study, and as a result, transmission prevention measures cannot reach their maximum effectiveness by simply publicizing the increase in day-to-day cases to the general public.

scholarly journals GAMBARAN SIKAP TERHADAP KEBISINGAN PADA SISWA SMK NEGERI 2 MANADO

e-CliniC ◽  
2014 ◽  
Vol 2 (2) ◽  
Author(s):  
Haidy Febrian Raintung ◽  
Steward K. Mengko ◽  
Julied Dehoop
Keyword(s):  
Hearing Loss ◽  
Positive Attitude ◽  
Noise Exposure ◽  
Hearing Threshold ◽  
Negative Attitude ◽  
Primary Source ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Music Player ◽  
Senior Secondary

Abstract: Hearing loss is the inability of a person’s sense of hearing in listening range of sound that can still be heard by people with normal hearing. With the growing popularity of entertainment venues (discos, karaoke, music concerts, internet cafes, etc.) as well as the use of portable music player, leisure noise have become the primary source that causing increased incidence of adolescent noise induced hearing loss (NIHL). Attitudes towards noise needs to be assessed at a young age, this is because the attittude is the basis of behavior, and behavior (towards leisure noise) can affect the amount of noise exposure of each person. Chronicity of NIHL symptoms often make adolescent tends to ignore the serious long-term problem that can arise and not take steps to resolve it. Objective: The purpose of this study is to obtain data from students of Manado 2nd Vocational Senior Secondary School concerning attitudes towards noise. Method: This research used descriptive observational with cross-sectional study. The subjects are students of Stone Concrete’s majors in Manado 2nd Vocational  Senior Secondary Schoolthat have passed initial hearing screening. Result: Of the 20 respondents who willingly take part in this research, obtained 5 respondents (25%) had negative attitude, 10 respondents (50%) had neutral attitude, and 5 respondents (25%) had positive attitude. From audiometric examination, obtained 4 respondents had a mild decreased in hearing threshold. Of the 4 respondents, 2 (50%) of them had a neutral attitude and 2 other respondents (50%) had positive attitude. Conclusion: Respondents with positive attitude towards noise are vulnurable to hearing threshold changes caused by daily noise exposure.Keywords: adolescent, hearing, noise, attitudes towards noise     Abstrak: Gangguan pendengaran merupakan ketidakmampuan indra pendengaran seseorang dalam mendengarkan rentang suara yang masih dapat didengar oleh orang dengan pendengaran normal. Semakin berkembangnya popularitas dari tempat-tempat hiburan (diskotik, karaoke, konser musik, warung internet, dan lain sebagainya) serta penggunaan pemutar musik portabel telah menjadi sumber peningkatan angka kejadian gangguan pendengaran akibat bising (GPAB) pada usia muda. Sikap terhadap kebisingan perlu dinilai pada usia muda, hal ini dikarenakan sikap merupakan dasar dalam berperilaku, dan perilaku (terhadap kebisingan sosial) dapat mempengaruhi derajat paparan bising masing-masing orang. Kronisitas dari gejala (GPAB) membuat kaum muda kurang menanggapi serius masalah-masalah jangka panjang yang dapat ditimbulkan, serta mengambil langkah untuk mengatasinya. Tujuan: Tujuan penelitian ini adalah untuk memperoleh data sikap terhadap kebisingan pada siswa sekolah menengah kejuruan (SMK) Negeri 2 Manado. Metode Penelitian:Penelitian ini merupakan penelitian deskriptif observasional dengan menggunakan metode cross-sectional. Subjek penelitian adalah siswa jurusan Teknik Konstruksi Batu Beton (TKBB) SMK Negeri 2 Manado yang sudah melewati screening pendengaran awal. Hasil: Dari 20 responden yang bersedia menjadi responden penelitian, didapatkan 5 responden (25%) mempunyai sikap negatif, 10 responden (50%) mempunyai sikap netral, dan 5 responden (25%) mempunyai sikap positif. Dari pemeriksaan audiometrik, didapatkan 4 responden mengalami penurunan ambang dengar derajat ringan. Dari 4 responden tersebut, 2 (50%) diantaranya mempunyai sikap netral dan 2 responden (50%) mempunyai sikap positif. Simpulan: Responden yang bersikap positif terhadap bising (pro-bising) rentan terhadap terjadinya perubahan ambang dengar yang akibatkan oleh paparan kebisingan sehari-hari.Kata kunci: usia muda, pendengaran, bising, sikap terhadap kebisingan

scholarly journals Attitude Towards Menstruation Among Female In-School Adolescents: A Comparative Cross-Sectional Study in Southwest Nigeria

2020 ◽  
Author(s):  
Olufemi Oludare Aluko ◽  
Jireh Ngozi Udechukwu ◽  
Oluwaseun Anthonia Loto ◽  
Ayoola Oluwaniyi Orisawayi ◽  
Grace Ojodomo Ojogba ◽  
...  
Keyword(s):  
Public Schools ◽  
Private Schools ◽  
Negative Attitude ◽  
Sampling Technique ◽  
Cross Sectional Study ◽  
Attitude Scale ◽  
Sectional Study ◽  
Cross Sectional ◽  
Public And Private ◽  
Menstrual Symptoms

Abstract Background: Menarche and menstruation are natural procedures in a girl’s transition to womanhood. Lack of awareness thereof, before menarche and stigmatizing menstrual hygiene management (MHM) perception and experiences predominate in low resource economies and influences attitude. The study aims to determine and compare the attitude of adolescents attending public and private schools on menstruation and MHM in the study area.Methods: The cross-sectional study recruited 357 respondents, comprising of 177 and 180 female adolescents from public and private schools through a three-stage sampling technique. The study administered a validated, semi-structured questionnaire that was facilitated self-administered. Descriptive and inferential statistics presented results, while binary logistic regression identified predictors of attitude at Pά0.05.Results: Except for religion, other socio-demographic characteristics (age, class, ethnicity, whom adolescents’ lives with, highest education and wealth) were significantly different between public and private schools. However, respondents in public schools were older (15.4±1.75 years) when compared with those attending private schools (14.3±1.18 years). On attitude, negative feelings and openness scales were significantly different between respondents attending public and private schools, while those of positive feelings, menstrual symptoms, acceptance of menarche and living with menstruation were respectively similar at Pα0.05. Overall attitude scale indicated a higher negative rating (87.4) when compared with a positive score (12.6%). With a positive attitude as a reference, ethnicity was the only negative attitude predictor (Pα0.05).Conclusions: Adolescents attending public and private schools have negative attitudes toward menstruation and MHM. Therefore, awareness and puberty education through ethnic constructs, on menstruation and MHM before menarche is indispensable to improve their attitude.

scholarly journals Parental Awareness and Attitude about Childhood Immunization in Riyadh, Saudi Arabia: A Cross-Sectional Study

2021 ◽  
Vol 18 (16) ◽  
pp. 8455
Author(s):  
Shuaa Z. Alshammari ◽  
Isamme AlFayyad ◽  
Youssef Altannir ◽  
Mohamad Al-Tannir
Keyword(s):  
Saudi Arabia ◽  
Parental Education ◽  
Positive Attitude ◽  
Age Groups ◽  
Cross Sectional Study ◽  
Good Knowledge ◽  
Sectional Study ◽  
Childhood Immunization ◽  
Cross Sectional ◽  
Validated Questionnaire

Parental beliefs about vaccination are one of the main factors in reaching high vaccination rates. This cross-sectional study aims to assess the awareness and attitudes regarding routine childhood immunization among Saudi parents in Riyadh, Saudi Arabia. This survey, with a pretested 18-item questionnaire, was conducted on parents having at least one child from Riyadh, Saudi Arabia, between 1 May 2019 and 1 November 2019. The validated questionnaire consisted of three sections; participants’ demographics, awareness, and attitude regarding the immunization of their children. In total, 1200 parents participated in the study, 883 (73.3%) of the parents scored a good knowledge of childhood immunization, and 93% knew that routine vaccination protects children from infectious diseases and their complications. Around 10% stated that immunization can cause autism. Only parents in age groups 30–39 and 40–49 were 1.76 (p < 0.05) times and 1.92 (p < 0.05) times, respectively, more likely to exhibit good knowledge. About 522 (43.6) of the parents attained a positive attitude toward immunization. Adherence to the immunization schedule was confirmed important by 93%, while 91% presumed that immunization keeps their children healthy. Additionally, immunization was perceived as important by 94% of parents and only 8% agreed that immunization is prohibited by religion. Females were 1.45 (p < 0.05) times more likely to exhibit positive attitudes than males. Parents have good knowledge and a positive attitude towards child immunization. However, parental education should be focused on the fact that religion supports immunization, and more awareness should be focused on the lack of correlation between autism and vaccination.

Writing a Feedback

2021 ◽  
Vol 15 (12) ◽  
pp. 3545-3546
Author(s):  
Farrukh Sarfraz ◽  
Nadeem Razaq ◽  
Fahad Sarfraz ◽  
Sadia Ikram ◽  
Saima Rubab Khan ◽  
...  
Keyword(s):  
Academic Writing ◽  
Positive Attitude ◽  
Peer Feedback ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Medical College ◽  
Validated Questionnaire ◽  
State Of Mind ◽  
Strongly Agree

Introduction: Writing or composing has been seen an issue to several of undergraduates students, composing has been the most difficult micro skill of all times. Feedback plays an essential part in composing process. Considering the issues in composing classes, the point of this study was to see at a planning procedure through which language learners can make self-confidence, be impelled, advance the quality of publication, secure communications through composing and taking after feedbacks. Objective: To investigate the purpose of students’ attitude towards peer-feedback and facilitator feedback. Materials and Methods: Study design: Quantitative cross sectional Settings: Azra Naheed Medical College Duration: Six months i.e. 1st January 2021 to 30th June 2021 Methodology: This is quantitative cross sectional study conducted in the medical undergraduate’s students at Azra Naheed medical college Lahore. Total participants were 200 selected after taking the informed consent. Students have an idea of giving and receiving feedback. A validated questionnaire was circulated to elicit students thought about the effectiveness regarding feedback in academics. The data was entered an analyzed using SPSS version 23. Results: Results revealed maximum students showed positive attitude. As collectively 3% students are strongly disagree, 14% are disagree, 17.5% are neutral, 38% are agree and 17.5% are strongly agree. Conclusion: The main issue in this study was to explore participants state of mind towards peer and teacher-feedback. This study showed that medical students showed positive attitude towards giving and receiving peer feedback. Most of the participants may consider that facilitators composed observations have fruitful technique to move forward the quality of their writing. Likely since they acknowledged that facilitators had more data. Consequently, this study help the participants to think fundamentally rather than living in anxiety and it has been only due to the facilitator’s feedback. Keywords: feedback, writing, peer feedback, academic writing

scholarly journals Use of Maximum Surgical Order Schedule (MSBOS) among pediatric patients to optimize blood utilization

2019 ◽  
Vol 15 (1) ◽  
Author(s):  
Johann Paulo S. Guzman ◽  
Leandro L. Resurreccion ◽  
Maria Beatriz P. Gepte
Keyword(s):  
Surgical Procedures ◽  
Pediatric Patients ◽  
Medical Center ◽  
Adult Population ◽  
Age Groups ◽  
Subsequent Development ◽  
Cross Sectional Study ◽  
Utilization Rate ◽  
Cross Sectional ◽  
Blood Utilization

Abstract Background Evaluating blood ordering and subsequent development of a blood ordering schedule can decrease over-ordering of blood among pediatric surgical patients. The objective is to assess our practice of blood utilization using various blood utilization indices and calculate the Maximal Surgical Blood Order Schedule (MSBOS). This is a cross-sectional study for 3 years that included patients (≤ 18 years old) who underwent major surgical procedures in the Philippine Children’s Medical Center. Data included type of surgery, age and sex, number of units crossmatched, number of units transfused, and timing of transfusion. Indices were calculated. Results This study revealed that the utilization rate was only 39.1% of blood among a total of 5314 cases done. The indices were analyzed according to different procedures among different age groups. Procedures for head and neck, colorectal, ostomy, solid tumors, genitourinary abnormalities, upper gastrointestinal, and appendectomy had CT (crossmatched to transfusion) ratio exceeding 2.0, indicating inappropriate blood ordering. Major abdominal, major thoracic, and hepatobiliary surgery all have CT ratio < 2.0. MSBOS was calculated, and a requisition of 1 unit of blood among patients undergoing these procedures is suggested. Conclusions The MSBOS is largely utilized to the adult population but its creation can also be utilized among pediatric patients. Our data shows that in majority of elective pediatric surgical procedures, routine crossmatch is not necessary which is proven by our high underutilization of requested blood products.

scholarly journals Pelvic inflammatory disease and causative pathogens in older women in a medical center in eastern Taiwan: A retrospective cross-sectional study

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257627
Author(s):  
Pei-Chen Chen ◽  
Pei-Chen Li ◽  
Dah-Ching Ding
Keyword(s):  
Pelvic Inflammatory Disease ◽  
Older Women ◽  
Inflammatory Disease ◽  
Medical Center ◽  
Age Groups ◽  
Cross Sectional Study ◽  
Chi Square ◽  
Cross Sectional ◽  
Sexually Transmitted ◽  
Younger Women

Objectives Most research into the management of pelvic inflammatory disease (PID) is in younger women and focuses on sexually transmitted pathogens such as N. gonorrhoeae or C. trachomatis. Non-sexually transmitted bacterial pathogens and PID in older women are rarely examined. The objective of this study is to explore cervical culture pathogens in women of different age groups in a medical center in eastern Taiwan. Methods We enrolled patients whose medical records were diagnosed with PID (ICD-9-CM 614.0 [N70.01–03], 614.1[N70.11–13], 614.9 [N73.5, N73.9]) at our hospital from October 2014 to March 2020. Patients were divided into three groups according to age: the age <25 years, age 25–44 years, and the ≥ 45 years group. Chi-square test, ANOVA and logistic regression were used for statistical analysis. In subgroup analysis, endocervical pathogens were further stratified into vaginal, respiratory, enteric, skin, oral, and other. Results A total of 96 patients were included in the study. There were 31 patients in the age ≥ 45 years group, 52 patients in the age 25–44 years group, and 13 patients in the age <25 years group. Vagina and enteric pathogens were the most common pathogens among all groups. The isolated respiratory and other pathogens were more in the age ≥ 45 years group than in the other two groups. Prevotella bivia was more common in the age <25 years and 25–44 years groups. Conclusions This may be due to different pathogeneses of PID in the age ≥ 45 years patients. Our study can be used as a reference for antibiotic choice of non-sexually transmitted PID and to prevent long-term sequelae of PID.

scholarly journals A study to assess the knowledge and attitude of adolescents towards obesity in a private school in Thrissur district Kerala, India

2019 ◽  
Vol 6 (7) ◽  
pp. 3140
Author(s):  
Garggy Shaji ◽  
Navya Choolaparambil Joseph ◽  
Aswathy Mathu ◽  
Vidhu Joshy
Keyword(s):  
Private School ◽  
Positive Attitude ◽  
Positive Family History ◽  
Negative Attitude ◽  
Cross Sectional Study ◽  
Overweight And Obesity ◽  
Transitional Period ◽  
Cross Sectional ◽  
Knowledge And Attitude ◽  
Christian Families

Background: Overweight and obesity are 5th leading risks for global deaths. Adolescence is a transitional period, which requires special attention. Prevalence of overweight and obesity among children and adolescents has widely increased world-wide, making it one of the most common chronic disorders in this age group. To assess knowledge and attitude of adolescents towards obesity and to assess its associated factors.Methods: This was a descriptive cross sectional study conducted among students of classes 9, 10, 11 and 12 in Devamatha public school, Thrissur from May to November 2018. In total there were 179 students. A pretested self administered questionnaire was used to collect data.Results: 46.4% of adolescents had low knowledge on obesity, 46.9 have moderate knowledge, and only 6.7% of them had high knowledge on obesity. 24.6% of adolescents have negative attitude towards obese individuals, 68.2% had neutral attitude and only 7.3% had positive attitude towards obesity. As the age increases, there is increase in knowledge about obesity and positive attitude towards obese individuals. Both knowledge and attitude is better in children belonging to Christian families. Better knowledge and attitude is seen among students who are hostlers than day scholars. Children with better marks in annual exam had better knowledge and attitude towards obesity. Children who had positive family history for obesity have better knowledge and attitude towards obesity.Conclusions: There is a need for targeted activities to improve the knowledge and attitude of the students towards obesity.

scholarly journals Attitude towards compulsory rural health services among interns of RajaRajeswari Medical College and Hospital, Bengaluru

2019 ◽  
Vol 6 (5) ◽  
pp. 2139
Author(s):  
Ranganatha S. C. ◽  
Damayanthi M. N. ◽  
Sheetu Jailkhani
Keyword(s):  
Health Services ◽  
Rural Health ◽  
Rural Areas ◽  
Positive Attitude ◽  
Cross Sectional Study ◽  
Rural Health Services ◽  
Chi Square ◽  
Cross Sectional ◽  
Medical College ◽  
Strongly Agree

Background: In India, majority of Doctors are working in urban than rural areas. Health situation report suggests that medical students should be provided with a rural clinical placement to make them familiar with the rural workplace. Hence the present study was conducted with the aim of assessing the attitude of the interns of RajaRajeswari Medical College and Hospital (RRMCH), Bengaluru, towards compulsory Rural Health Services.Methods: A cross sectional study was conducted at RRMCH, Bengaluru for a period of two months. All the interns willing to participate and present on the day of study were included. Consent was taken and the information was collected by using a self administered semi-structured questionnaire. The participants were asked to respond on a five point Likert scales, ranging from strongly agree to strongly disagree. The data was analyzed using SPSS version 21.0 and Pearson’s chi-square test was applied.Results: Out of 100 interns, majority (56%) was females, 85% were Hindu by religion and 68% were from urban locality. Out of 100 interns, only 14% showed positive attitude towards compulsory rural health services. The reasons for positive attitude were that it provides a good exposure of general practice and an opportunity for independent working.Conclusions: In the present study, only 14% interns showed positive attitude towards rural health services. Perceived factors such as Isolation from family and Inadequate Hospital infrastructure emerged as barrier for the interns to opt for rural services.

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